Histopathological Examination of a Symptomatic Carotid Web: A Case Report.

Carotid webs cause ischemic stroke in young people and are associated with a high rate of stroke recurrence. Histopathological examination is crucial for clarifying the pathogenesis and mechanisms underlying the occurrence of carotid webs, although the mechanisms generally remain unclear. Here, we report a case of a symptomatic carotid web in a woman in her 50s who had a medical history of two ischemic strokes. She was diagnosed with a right carotid web and underwent carotid endarterectomy 18 days after the second stroke. Histopathological examination clearly revealed several phases of intimal hyperplasia. Furthermore, a thrombus attached to the carotid web showed invasion by fibroblasts and capillaries, and organization had begun. We presume that after the appearance of the carotid web, the thrombus formed by stagnant flow and became organized, causing the carotid web to grow and change in shape.

Impact of cancer history on long-term outcome after elective neuro-endovascular treatment in patients aged 80 years or older: A retrospective multicenter observational study.

AIM: Assessing the indication for elective neuro-endovascular treatment (EVT) in older patients requires consideration of the impact of systemic comorbidities on their overall reduced life expectancy. The objective of this study was to determine the long-term outcomes of elective neuro-EVT in patients aged ≥80 years, and to investigate the impact of pre-existing cancer on their long-term outcomes. METHODS: Of the patients enrolled in multicenter observational registry, those aged ≥80 years undergoing elective neuro-EVT between 2011 and 2020 were enrolled. A history of cancer was defined as a pre-existing solid or hematologic malignancy at the time of EVT. The primary outcome was time to death from elective neuro-EVT. RESULTS: Of the 6183 neuro-EVT cases implemented at 10 stroke centers, a total of 289 patients (median age, 82 years [interquartile range 81-84 years]) were analyzed. A total of 58 (20.1%) patients had a history of cancer. A total of 78 patients (27.0%) died during follow up. The 5-year survival rate of enrolled patients was 64.6%. Compared with patients without a history of cancer, those with a history of cancer showed significantly worse survival (log-rank test, P = 0.001). Multivariate Cox proportional hazards analysis showed history of cancer was an independent predictor of time to death from elective neuro-EVT (HR 1.74, 95% CI 1.01-3.00, P = 0.047). Cancer was the leading cause of death, accounting for 25.6% of all deaths. CONCLUSIONS: The present study showed that history of cancer has a significant impact on time to death from elective neuro-EVT in patients aged ≥80 years. Geriatr Gerontol Int 2024; 24: 211-217.

Mild trigonocephaly associated with microcephaly: surgical outcomes for 15 cases.

BACKGROUND AND IMPORTANCE: Surgical treatment for mild trigonocephaly associated with microcephaly is often attempted if neuroradiological studies show evidence of increased intracranial pressure. However, it is difficult to decide how to approach surgically these patients. Herein, we report the surgical outcomes of the patients we have treated surgically in our center. CLINICAL PRESENTATION: We performed surgery on 15 patients (ten girls and five boys) who were all diagnosed as microcephalic during infancy. All patients presented clinical symptoms and evidence of short stature. Symptoms included mental retardation, language delay, hyperactivity, motor dysfunction, and self-mutilation (head banging). Head circumferences were > 2 standard deviations below the normal range for their sex and age at the time of surgery. All patients were diagnosed with mild trigonocephaly based on three-dimensional computed tomography (3D-CT). No abnormal findings could be observed in the brain of 14 patients, as assessed by magnetic resonance imaging (MRI). One patient showed brain atrophy. 3D-CT showed marked digital markings in all. Intracranial pressure (ICP) was measured under normocapnia. Increased ICP could be observed in 13 patients. Decompressive cranioplasty was performed in all patients. After surgery, evidence of enlargement of the head circumference could be observed in six patients. Some degree of intelligence problems remained. However, every patient made some improvement in at least one of the other symptoms. CONCLUSION: We suggest that decompressive cranioplasty may be indicated in patients with mild trigonocephaly associated with microcephaly, if pre-surgical evaluation shows high ICP and no abnormal brain findings can be identified on MRI.

Differences in personality traits between male-to-female and female-to-male gender identity disorder subjects.

The present study aimed to investigate differences in personality traits among male-to-female (MtF), female-to-male (FtM) gender identity disorder (GID) subjects and non-transsexual male (M) and female (F) controls. Subjects were 72 MtF and 187 FtM GID subjects without psychiatric comorbidities together with 184 male and 159 female non-transsexual controls. Personality traits were assessed using a short version of the Temperament and Character Inventory (TCI-125). Group comparisons were made by two-way ANOVA. Statistical significances were observed as follows: 1) lower novelty seeking in FtM than in M or MtF, 2) higher reward dependence in FtM than in M, 3) higher cooperativeness in FtM than in M or MtF, 4) the highest self-transcendence in MtF among all the groups. The highest self-transcendence in MtF subjects may reflect their vulnerable identity and constrained adaptation to society as the minority. Nevertheless, higher reward dependence and cooperativeness in FtM subjects can be related to more determined motivation for the treatments of GID and might promise better social functioning and adjustment than MtF subjects.