Safety and Feasibility of Simultaneous Ipsilateral Proximal Carotid Artery Stenting and Cerebral Aneurysm Coiling

Coexistence of cerebral aneurysm and carotid artery disease may be encountered in clinical practice. Theoretical increase in aneurysmal blood flow may increase risk of rupture if carotid artery disease is treated first. If aneurysm coiling is performed first, stroke risk may increase while repeatedly crossing the diseased artery. It is controversial which disease to treat first, and whether it is safe to treat both simultaneously via endovascular procedures. We document the safety and feasibility of such an approach. Review of collected neurointerventional database at our institution was performed for patients who underwent both carotid artery stenting (CAS) and aneurysm coil embolization (ACE) simultaneously. All patients underwent carotid stenting followed by aneurysm coiling in the same setting. Demographic, clinical data, and outcome measures including success rate and periprocedural complications were collected. Five hundred and ninety aneurysms coiling were screened for patients who underwent combined CAS and ACE. Ten patients were identified. Mean age was 67.7 years (range 51–89). The success rate for stenting and coiling was 100% with no immediate complications. The coiling procedure time was extended by an average of 45 min for performing both procedures jointly. No stroke, TIAs, or aneurysmal rebleeding was found on their most recent follow up. Our case series demonstrates that it is safe and feasible to perform CAS and ACE simultaneously as one procedure which may avoid unwanted risk of treating either disease at two separate time sessions

Brain Behavior in Learning and Memory Recall Process: A High-Resolution EEG Analysis

Learning is a cognitive process, which leads to create new memory. Today, multimedia contents are common-ly used in classroom for learning. This study investigated brain physiological behavior during learning and memory process using multimedia contents and Electroencephalogram (EEG) method. Fifteen healthy subjects voluntarily participated and performed three experimental tasks: i) Intelligence task, ii) learning task, and iii) recall task. EEG was recorded duration learning and memory recall task using 128 channels Hydro Cel Geodesic Net system (EGI Inc., USA) with recommended specifications. EEG source localization showed that deep brain medial temporal region was highly activated during learning task. EEG theta band in frontal and parietal regions and gamma band at left posterior temporal and frontal regions differentiated successful memory recall. This study provides additional understanding of successful memory recall that complements earlier brain mapping studies

Dissecting Aneurysms of Posterior Cerebral Artery: Clinical Presentation, Angiographic Findings, Treatment, and Outcome

Background: The dissecting posterior cerebral artery (PCA) aneurysms are very rare. These aneurysms pose significant treatment challenge and need careful evaluation to formulate an optimal treatment plan in case of ruptured or un-ruptured presentations. Methods: Retrospective review of a prospectively collected data. Results: Seven patients with dissecting aneurysms of the PCA were identified. Six out of seven presented with subarachnoid hemorrhage (SAH) and one with ischemic stroke. Three out of seven were treated with endovascular coil embolization without sacrifice of the parent artery and the rest had parent artery occlusion (PAO) with coil embolization. None of the patients developed new neurological deficits post-procedure. Aneurysm re-occurred in two patients that were treated without PAO. Conclusion: Endovascular treatment of the dissecting PCA aneurysm is safe and feasible. It can be performed with or without PAO. Recurrence is more common without PAO and close follow-up is warranted

Endovascular Embolization of Head and Neck Tumors

Endovascular tumor embolization as adjunctive therapy for head and neck cancers is evolving and has become an important part of the tools available for their treatment. Careful study of tumor vascular anatomy and adhering to general principles of intra-arterial therapy can prove this approach to be effective and safe. Various embolic materials are available and can be suited for a given tumor and its vascular supply. This article aims to summarize current methods and agents used in endovascular head and neck tumor embolization and discuss important angiographic and treatment characteristics of selected common head and neck tumors

Interhospital Transfer Before Thrombectomy Is Associated With Delayed Treatment and Worse Outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke).

BACKGROUND: Endovascular treatment with mechanical thrombectomy (MT) is beneficial for patients with acute stroke suffering a large-vessel occlusion, although treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared with direct presentation. METHODS: STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter, observational, single-arm study of real-world MT for acute stroke because of anterior-circulation large-vessel occlusion performed at 55 sites over 2 years, including 1000 patients with severe stroke and treated within 8 hours. Patients underwent MT with or without intravenous tissue plasminogen activator and were admitted to endovascular-capable centers via either interhospital transfer or direct presentation. The primary clinical outcome was functional independence (modified Rankin Score 0-2) at 90 days. We assessed (1) real-world time metrics of stroke care delivery, (2) outcome differences between direct and transfer patients undergoing MT, and (3) the potential impact of local hospital bypass. RESULTS: A total of 984 patients were analyzed. Median onset-to-revascularization time was 202.0 minutes for direct versus 311.5 minutes for transfer patients ( CONCLUSIONS: In this large, real-world study, interhospital transfer was associated with significant treatment delays and lower chance of good outcome. Strategies to facilitate more rapid identification of large-vessel occlusion and direct routing to endovascular-capable centers for patients with severe stroke may improve outcomes. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02239640

Brain activation during cognitive tasks:An overview of EEG and fMRI studies

Brain controls all body functions that enable us to perform daily life events dynamically. Memory is an important part of brain that controls and processes our present and past information and interconnects with future plans to assist corresponding dynamic activities of whole body. In cognitive psychology, human memory processes are functionally divided into three categories namely encoding, retention, and recalling. This paper provides an overview of memory processes and brain regions that are activated during these processes using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). We discussed issues related to cognitive tasks design that may be helpful in future memory research to conduct experiment with EEG and fMRI in a better way.</p

Brain behavior in learning and memory recall process:A high-resolution EEG analysis

Learning is a cognitive process, which leads to create new memory. Today, multimedia contents are commonly used in classroom for learning. This study investigated brain physiological behavior during learning and memory process using multimedia contents and Electroencephalogram (EEG) method. Fifteen healthy subjects voluntarily participated and performed three experimental tasks: i) Intelligence task, ii) learning task, and iii) recall task. EEG was recorded duration learning and memory recall task using 128 channels Hydro Cel Geodesic Net system (EGI Inc., USA) with recommended specifications. EEG source localization showed that deep brain medial temporal region was highly activated during learning task. EEG theta band in frontal and parietal regions and gamma band at left posterior temporal and frontal regions differentiated successful memory recall. This study provide additional understanding of successful memory recall that complements earlier brain mapping studie

Effects of stereoscopic 3D display technology on event-related potentials (ERPs)

The purpose of this study is to explore the effects of stereoscopic 3D (S3D) display technology on event-related brain potentials (ERPs). A sample of thirty-four healthy participants was subjected to an oddball paradigm after being exposed to stereoscopic 3D contents with passive polarized display or traditional 2D display. The participants were randomly assigned to two groups - 2D group and S3D group; in such a way that their intelligence ability and age were controlled between the groups. The behavioral and ERP results did not show any significant differences between S3D and 2D groups for either ERP components (amplitude and latency) or accuracy and response time of the target detection. These results suggest that passive polarized S3D display technology may not induce any effects (cognitive or visual fatigue) which may disturb the ERP components.</p

Dynamics of scalp potential and autonomic nerve activity during intelligence test

The main objective of this study was to examine the changes in autonomic nervous system (ANS) and scalp potential during intelligence test (IQ). Electroencephalogram (EEG) and Electrocardiogram (ECG) signals were recorded simultaneously from eight healthy participants during IQ and resting states (eyes–closed and eyes-open). Heart rate (HR) and heart rate variability (HRV) were derived from ECG signal. EEG mean power was computed for five frequency bands (delta, theta, alpha, beta, and gamma) and analyzed in 12 regions across the scalp. The EEG frequency bands showed significant (p&lt;0.025) changes between IQ test and rest states. Delta and theta at frontal (PF, AF, F) and temporal regions (FT, T, TP) and alpha activity at parietal (P), parieto-occipital (PO) and occipital (O) regions were significant. In beta and gamma bands, highly reduced mean power was found at P, PO, and O regions as compared to PF, AF, and F regions in IQ test. HR and low frequency in normalized unit (LFnu) were increased significantly (p&lt;0.05 and p&lt;0.025, respectively) in IQ test. Further, high frequency in normalized unit (HFnu) was decreased (p&lt;0.11). Results showed parallel changes in scalp potential and automatic nervous activity during IQ test compared to rest conditions