A case of extravasation from a cerebral aneurysm during 3-dimensional computed tomography angiography.

BACKGROUND: Reports of rebleeding from an aneurysm during 3D-CTA are rare because this imaging method is not widely available. In previous cases, rebleeding of the aneurysm presented with certain imaging features, which were cap-like, corkscrew-like, ribbon-like, and nebulous areas of enhancement. We had a patient whose aneurysm had reruptured during 3D-CTA. This is the sixth report. CASE DESCRIPTION: The patient came to our hospital with SAH. A 3D-CTA showed a pooling of contrast medium in the temporal parenchyma and an aneurysm with an irregular bleb at the bifurcation of the right MCA. The aneurysm with bleb seemed to have a daughter aneurysm and a granddaughter aneurysm, which attached on the daughter aneurysm. We diagnosed rerupture during 3D-CTA because of a clear difference between the initial CT scan and those used as source data for 3D-CTA. Intraoperatively, we confirmed that a part of the aneurysm invaginated into the temporal lobe and that the possible granddaughter aneurysm was a clot on the daughter aneurysm. The intraparenchymal hematoma was attached to this clot. CONCLUSIONS: We report a patient with rerupture of a cerebral aneurysm during 3D-CTA showing new pattern in the image. When extravasation of blood occurs into the brain parenchyma, 3D-CTA clearly demonstrates its extent because there is little attenuation by CSF. In such cases, extravasated blood can form both a small mass that mimics a granddaughter aneurysm and a pooling of contrast medium.

Prefrontal cerebral activity during a simple "rock, paper, scissors" task measured by the noninvasive near-infrared spectroscopy method.

We conducted a noninvasive near-infrared spectroscopy (NIRS) study using the game of rock, paper, scissors (RPS) as a simple neurocognitive task for the prefrontal cortex (PFC) in 15 healthy volunteers. We employed an opposite "to lose" RPS task coupled with a normal "to win" RPS task, since the former requires inhibition of behavior, one of the most important functions of the prefrontal cortex. During the NIRS examination, subjects had to present one of the three RPS hands in response to hands displayed randomly on a computer screen every 1.5 s, and were required to show hands that lose to the computer, or that beat the computer. We measured the relative concentrations of oxyhemoglobin (oxy-Hb) using the prefrontal probes of the NIRS system during the tasks. The increases in oxy-Hb during the "to win" RPS task were small, but were quite large and laterally dominant during the "to lose" RPS task. The difference between the two tasks might have been due to the participants' cognitive conflict with losing on the RPS. We conclude that losing is better than winning on the RPS as a sensitive indicator in the NIRS examination of PFC.