BACKGROUND AND PURPOSE Deficiency of the free fraction of protein S has been associated with arterial or venous stroke. The pathogenesis of vascular occlusion in patients with protein S deficiency is not known. We present two cases of cerebral infarction and deficiency of protein S in which the subjects had progressive intracranial occlusions. CASE DESCRIPTION A 16-year-old girl was admitted ...

We report a rare case of internal carotid artery agenesis with stenosed intercavernous anastomosis. A 59-year-old male patient presented with a new infarction in the left basal ganglia. Magnetic resonance angiography and cerebral angiography showed that the right internal carotid artery disappeared from the origin to the foramen lacerum segment, and there was an anastomotic artery with severe s...

medications. Neurological examination revealed decerebrate rigidity and bilateral Babinski signs. CT on one day after admission demonstrated broad low-density area in the bilateral cerebral hemispheres, including the area of bilateral anterior cerebral artery and middle cerebral artery, but sparing the brainstem and occipital lobe (figure 1). Bilateral internal carotid artery embolisation was i...

PURPOSE To characterize cerebral hemodynamics in patients immediately before microsurgical resection of moderate to large arteriovenous malformations during isoflurane anesthesia. METHODS In angiographically defined arteriovenous malformation feeding and nonfeeding arteries, transcranial Doppler studies were performed in 25 surgeries on 22 patients. The mean blood flow velocity and pulsatilit...

We report a 61 years old male presenting with a right cerebral infarction, along with a type I persistent left proatlantal artery (PA), which is a form of primitive carotid-basilar anastomosis. The patient had an absence of the ipsilateral vertebral artery (VA) and hypoplasia of the contralateral VA, while the basilar artery was supplied by the PA. Other vascular anomalies present were a fusifo...

BACKGROUND AND PURPOSE With the increased investigation of cerebral arteries using magnetic resonance angiography in the general population, the detection of unruptured intracranial aneurysms (UIAs) has increased. Understanding the distribution and factors associated with UIAs might be helpful for understanding the pathomechanism. METHODS Subjects who underwent magnetic resonance angiography ...

Highly advanced optical equipment enables endoscopic surgery to be performed in neurosurgery. We developed an angle-type rigid endoscope having an angled shaft, and has performed endoscope-assisted surgery in neck clipping of 50 cerebral aneurysms. Anatomical study concerning the perforating branch was made through a pterional approach using 3 cadavers. By using endoscope, we can observe the po...

During the cerebral dissection of a 67-year-old male cadaver, a unique combination of variations at the circle of Willis and anterior cerebral artery (ACA) distribution were encountered. The A1 segment of both ACA were fused without an anterior communicating artery (ACoA), forming an X shape and giving rise to a common pericallosal artery (CPA), an incomplete distal ACA, and an incomplete dista...

Morley and Barr classify cerebral aneurysms as giant when their largest diameter is equal to or greater than 25 mm. The arbitrary limit of 2.5 cm distinguishes an aneurysm group with clinical and pathological characteristics, natural history, and treatment, which differ from those of small and medium aneurysms.1–4 The most common location is in the internal carotid artery (ICA), followed by the...