For an effective and durable occlusion of cerebral aneurysm, the aneurysmal sac should be packed by detachable coils as densely as technically possible. Navigating microcatheters, coil framing, and packing of the sac are the major technical steps of aneurismal embolization. There are several additional techniques and devices for dealing with wide-necked aneurysms. This paper reviews and describes various techniques for safe navigation of microcatheters including tip shaping, selection of the shapes for initial coil framing, selection of coil sizes techniques for packing, and techniques of balloon- or stent-assisted coiling for embolization of wide-necked lesions.
Aneurysm ; Embolization, Therapeutic ; Intracranial Aneurysm*

Traumatic carotid carvenous fistula (CCF) associated with cerebral aneurysm is a rare condition. Early detection of the traumatic cerebral aneurysm (TCA) before traumatic CCF occlusion is difficult, largely because of steal phenomenon of the fistula, masking by complex venous drains and a nearby parent artery, and a latent period of the TCA. In addition, traumatic CCF caused by a combined aneurysm rupture is an extremely rare condition. It is a dangerous condition in which treatment should be performed immediately or even on an emergency basis. A 31-year-old man developed traumatic CCF after traffic accident. Cerebral angiography revealed a direct CCF communicated with an intradural aneurysm on the origin of right posterior communicating artery (PcomA). Successful transarterial coil embolization was achieved after consecutive two trials.
Accidents, Traffic ; Adult ; Aneurysm* ; Arteries ; Cerebral Angiography ; Embolization, Therapeutic ; Emergencies ; Fistula* ; Humans ; Intracranial Aneurysm ; Masks ; Parents ; Rupture*

Congenital intracranial pial arteriovenous fistula complicated with high output heart failure is a rare disease of the cerebral vasculature. Like vein of Galen malformation, it can cause high output cardiac failure, but the treatment strategy is different. To lead a neonate with severe heart failure to normally grow with the brain and body, a rapid treatment is mandatory and has to target on removing the fistula. The authors report on a neonate with congenital pial arteriovenous fistula complicated with high output heart failure, which recovered with transarterial embolization and allowed the neonate to thrive.
Arteriovenous Fistula* ; Brain ; Cerebral Veins ; Estrogens, Conjugated (USP)* ; Fistula ; Heart Failure* ; Humans ; Infant, Newborn* ; Rare Diseases

Dural sinus malformation (DSM) with arteriovenous fistula (AVF) is very rare in pediatric group. We experienced one case of DSM and treated AVF by endovascular embolization. Herein we report this rare case occurred in infant.
Arteriovenous Fistula ; Humans ; Infant*

Endovascular treatment of wide-necked intracranial aneurysms remains challenging despite continuing instrumental and technical advances. A 67-year-old woman visited us for an asymptomatic unruptured aneurysm at the right distal vertebral artery and was planned to undergo endovascular coil embolization. During a second coil placement through a single microcatheter, the first coil frame was deformed and protruded into the parent artery. We decided to jack-up the protruded coil using an additional microcatheter because the tortuous vertebral artery path didn't allow a balloon or stent device to approach this aneurysm for parent artery protection. Using that microcatheter-assisted technique, the parent artery could be preserved and the aneurysm could, moreover, be excluded.
Aged ; Aneurysm* ; Arteries ; Embolization, Therapeutic* ; Female ; Humans ; Intracranial Aneurysm ; Parents ; Stents ; Vertebral Artery*

We report one case showing the ferromagnetic artifact in the cortical area of brain after coil embolization of cerebral aneurysms. There were minimal ferromagnetic artifacts around coil mass on the MR after endosaccular coil embolization for intracranial aneurysm. But we were not able to find the report about the ferromagnetic artifact in the cortical area after coil embolization by means of a pubMed search.
Aneurysm ; Artifacts* ; Brain ; Embolization, Therapeutic* ; Intracranial Aneurysm ; Magnets*

This erratum is being published to correct the printing error on page 517 of the article. Corrections for Fig. 1 and main text in page 519 are needed. The authors apologize for any inconvenience that this may have caused.

OBJECTIVE: The purpose of this study is to review the results of two surgical methods of simple decompression for treatment of cubital tunnel syndrome. METHODS: Surgical procedure of simple decompression of the ulnar nerve using the conventional method requires a relatively long incision of 6-8 cm. Later with accumulating experience, we performed simple decompression using a skin incision of 2 cm or less. Between November 2005 and July 2010, simple decompression using the conventional method was performed in 10 elbows (Group 1), and simple decompression using the small skin incision method was performed in 10 elbows (Group 2). The surgical outcome was evaluated and the two groups were compared using a modified Bishop scoring system. We also compared the operation time and hospital stay between the two groups. RESULTS: There were no significant differences in the outcomes between the two groups using the modified Bishop scoring system (p>0.05). Also, there were no significant differences in the postoperative electrodiagnostic study results between the two groups (p>0.05). However, the operation time and hospital stay were significantly shorter in Group 2 (p<0.01). CONCLUSION: Both the methods can be recommended for the treatment of cubital tunnel syndrome due to their advantages including simplicity and safety of the method. However, the small skin incision method is superior to the conventional method due to the shorter operation time and hospital stay.
Cubital Tunnel Syndrome ; Decompression ; Elbow ; Length of Stay ; Lipids ; Quaternary Ammonium Compounds ; Skin ; Ulnar Nerve

OBJECTIVE: Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients. METHODS: According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less). RESULTS: Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbowbelow the elbow) was 41.8+/-15.2 m/s and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment (57.8+/-6.9 m/s) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from 39.8+/-12.1 m/s to 47.8+/-12.1 m/s (p<0.05). After an average follow-up of 4.8+/-5.3 months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve. CONCLUSION: Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.
Cubital Tunnel Syndrome* ; Decompression* ; Follow-Up Studies ; Humans ; Recurrence ; Skin ; Ulnar Nerve* ; Upper Extremity

We analyzed aquaporin (AQP) expression in the rat spinal cord following an electrical shock (ES) to elucidate the roles of AQP in spinal cord injury (SCI) induced by an electrical burn. In control animals, AQP1 immunoreactivity was observed in the small diameter dorsal horn fibers of laminae I and II and in astrocytes and neurons in the spinal cord. Both AQP4 and AQP9 immunoreactivity were detected in astrocytes. One week after the ES, AQP1 immunoreactivity in dorsal horn fibers was downregulated to 83, 61, and 33% of control levels following a 1-, 4-, or 6-second ES, respectively. However, AQP1 immunoreactivity in ventral horn neurons increased to 1.3-, 1.5-, and 2.4-fold of control levels following a 1-, 4-, or 6-second ES, respectively. AQP4 immunoreactivity was upregulated after an ES in laminae I and II astrocytes in a stimulus-intensity independent manner. Unlike AQP1 and AQP4, AQP9 immunoreactivity was unaffected by the ES. These findings indicate that altered AQP immunoreactivity may be involved in SCI following an ES.
Animals ; Anterior Horn Cells ; Aquaporins ; Astrocytes ; Burns ; Horns ; Neurons ; Rats ; Shock ; Spinal Cord ; Spinal Cord Injuries