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Erez Nossek, David J. Chalif, Shamik Chakraborty, Kim Lombardo, Karen S. Black, and Avi Setton

competitive flow diversion: case report . Neurosurgery 10 : Suppl 1 E161 – E166 , 2014 28 Wong JH , Mitha AP , Willson M , Hudon ME , Sevick RJ , Frayne R : Assessment of brain aneurysms by using high-resolution magnetic resonance angiography after endovascular coil delivery . J Neurosurg 107 : 283 – 289 , 2007 29 Yavuz K , Geyik S , Saatci I , Cekirge HS : Endovascular treatment of middle cerebral artery aneurysms with flow modification with the use of the Pipeline Embolization Device . AJNR Am J Neuroradiol 35 : 529 – 535

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Henry A. Shenkin, Felix Jenkins, and Kwang Kim

arteriovenous anomaly in the right posteroparietal area and an aneurysm on the enlarged right carotid artery. Left: Lateral view. Right: Anteroposterior view, which shows the largest dimension of the aneurysm. Operation At craniotomy on September 3, 1969, the anomaly was removed without incident. The area of brain removed averaged 4.5 cm in diameter. Postoperative Course Recovery was uneventful except for the demonstration of classical parietal lobe signs as the patient's state of consciousness and cooperation improved. On September 13, 1969, a

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Darwin J. Ferry Jr. and Ludwig G. Kempe

R ecently , Hammon 4 reported 2187 cases of penetrating wounds of the brain treated in a 20-month period in one U.S. Army hospital in Vietnam. Thirty of these patients had orbitofacial wounds (25 orbital, 5 facial). Two of the 30 patients developed false aneurysms and were subsequently operated on at Walter Reed General Hospital. These were the only known arterial complications in the 2187 patients. Three similar arterial injuries have been previously reported, each of which also resulted from orbitofacial penetration. The following case reports were prompted

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Marcelo Magaldi Ribeiro de Oliveira, Taise Mosso Ramos, Carlos Eduardo Ferrarez, Carla Jorge Machado, Pollyana Helena Vieira Costa, Daniel L. Alvarenga, Carolina K. Soares, Luiza M. Mainart, Pedro Aguilar-Salinas, Sebastião Gusmão, Eric Sauvageau, Ricardo A. Hanel, and Giuseppe Lanzino

N eurosurgical simulation has been explored, but few options are available to learn and practice brain aneurysm microsurgery. 1 , 3 To date, the human placenta model has been the only training tool with predictive validity for such surgery, 5 , 13 and the parameters used in evaluation were subjective, based on experts’ opinion. 5 The OSATS (Objective Structured Assessment of Technical Skills) 11 was the first scale reported for evaluation of surgical performance. Despite the inclusion of the word “objective” in its the name, the OSATS relies on the opinion of

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Jaechan Park, Wonsoo Son, Duck-Ho Goh, Dong-Hun Kang, Joomi Lee, and Im Hee Shin

of the aneurysm neck, were all recorded based on digital subtraction angiography (DSA) and CT angiography (CTA). To measure the height of the ACoA aneurysm neck, meaning the vertical distance from the level of the planum sphenoidale to the highest point of the aneurysm neck, sagittal brain images were reconstructed using preoperative (n = 62) and postoperative (n = 60) CTA as the source images. When using postoperative CTA, the height was measured based on the aneurysm dimension and the heights of the A 1 –A 2 junction and aneurysm clip, whereas it was measured

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John H. Wong, Alim P. Mitha, Morgan Willson, Mark E. Hudon, Robert J. Sevick, and Richard Frayne

S ince the early 1990s, treatment of brain aneurysms has increasingly involved the use of the endovascular detachable coils first described by Guglielmi. 21 The endovascular approach has become an established and reliable technique for the treatment of certain types of aneurysms, particularly in persons who are at high risk if open surgical intervention is performed, and for lesions in anatomical locations that are difficult to access via a direct approach such as the basilar apex. 35 , 47 The long-term outcome of aneurysms treated with endovascular

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Stephen P. Lownie, Alan H. Menkis, Rosemary A. Craen, Bernard Mezon, James MacDonald, and David A. Steinman

giant aneurysms, deep hypothermia is regarded as an effective form of cerebral protection during prolonged surgical ischemia. In particular, closed-chest deep hypothermia has permitted successful surgery in a bloodless field during prolonged periods of circulatory arrest. 7–9, 15 This method, however, entails a period of complete cardiac standstill, with risks that include myocardial infarction, sepsis, and pulmonary embolus. 7, 15 In this report we detail a technique of selective brain cooling that eliminated the disadvantages of systemic hypothermia and total

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Atsuya Akabane, Hidefumi Jokura, Kuniaki Ogasawara, Kou Takahashi, Kazuyuki Sugai, Akira Ogawa, and Takashi Yoshimoto

patient with an AVM in whom perifocal brain edema developed adjacent to the nidus due to rapid development of an intranidal aneurysm within a period of 3 months. Case Report History and Examination In April 2001, this 22-year-old man with no history of intracranial bleeding or seizure was incidentally found to have an abnormal vascular signal void in the left parietal lobe on MR imaging ( Fig. 1 ). On T 2 -weighted MR images no high-intensity area was revealed around the signal void. Angiographic studies demonstrated an AVM with a major 25-mm axis, which was

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Ching-Jen Chen, Nisha Dabhi, M. Harrison Snyder, Natasha Ironside, Isaac Josh Abecassis, Ryan T. Kellogg, Min S. Park, and Dale Ding

outcomes data regarding IFD devices for the treatment of brain aneurysms. Compared with prior meta-analyses that have focused on WEB embolization of ruptured aneurysms, this review provides a comprehensive analysis of both ruptured and unruptured aneurysms treated using a variety of IFD devices. 29 – 31 At a mean radiographic follow-up duration of 15.7 months, complete occlusion was achieved in 58.2% of IFD-treated aneurysms with residual neck and aneurysm rates of 27.4% and 9.7%, respectively. However, there was significant study heterogeneity in the pooled data (p < 0

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Marcelo Magaldi Ribeiro de Oliveira, Carlos Eduardo Ferrarez, Taise Mosso Ramos, Jose Augusto Malheiros, Arthur Nicolato, Carla Jorge Machado, Mauro Tostes Ferreira, Fellype Borges de Oliveira, Cecília Félix Penido Mendes de Sousa, Pollyana Helena Vieira Costa, Sebastiao Gusmao, Giuseppe Lanzino, and Rolando Del Maestro

the real usefulness of a simulator, studies of its predictive validity are necessary. 11 Studies comparing different types of brain aneurysm surgical simulation have reported both face and content validity. 17 To our knowledge, concurrent and predictive validity have never been studied. These parameters refer to task-completing differences between experienced professionals and novices, the degree that 1 simulator correlates with previously described ones, and the end-point efficacy of simulators when one uses it to practice real situations. 18 The objectives of