[A Surgical Case of Currarino Syndrome with Syringomyelia].

Currarino syndrome is characterized by a triad of anorectal malformations, sacral defects, and presacral masses. Although it is not extremely rare, this report presents a surgical case of Currarino syndrome with syringomyelia and discusses related literature. The patient is a girl, aged 2 years and 2 months, who presented with marked constipation, chronic cystitis, and lower limb weakness. After examining the patient through magnetic resonance imaging, we diagnosed her with rectal compression due to meningocele and syringomyelia. The base of the meningocele was detached, and the spinal cord was untethered. One week after surgery, her lower limb weakness and constipation improved. Following up on symptoms and performing imaging is essential to determine a treatment plan for Currarino syndrome. (Received 28 February, 2023; Accepted 22 March, 2023; Published 1 August, 2023).

Endovascular Coil Embolization with Low-Profile Visualized Intraluminal Support Junior Stent for Ruptured Dissecting Aneurysm of Proximal Superior Cerebellar Artery-Case Report and Literature Review.

BACKGROUND: Superior cerebellar artery (SCA) aneurysm arising from the SCA itself is rare, and treatment of this aneurysm is challenging because of the important anatomic structures, such as the perforating arteries to the brainstem and cranial nerves. We describe a successful coil embolization with a Low-profile Visualized Intraluminal Support Junior (LVIS Jr.) stent for the proximal SCA dissecting aneurysm. CASE DESCRIPTION: A 50-year-old woman presented with right oculomotor nerve palsy and subarachnoid hemorrhage. Cerebral angiography showed a dissecting wide neck aneurysm at the anterior pontomesencephalic segment of the right SCA (diameter 1 mm). The patient was treated with coiling assisted by an LVIS Jr. stent. Postoperative angiography demonstrated a complete embolized aneurysm and parent artery preservation. CONCLUSIONS: Endovascular treatment assisted with LVIS Jr. stent for proximal SCA dissecting aneurysm arising from small parent artery was safely and effectively feasible.

Applicability of Carotid Artery Stenting for Patients 80 Years or Older: A Single-Center Experience.

BACKGROUND: A meta-analysis found that for internal carotid artery stenosis procedures in elderly patients, the risk of perioperative stroke is significantly greater for carotid artery stenting (CAS) than for carotid endarterectomy. We retrospectively examined characteristics and perioperative results of CAS for patients 80 years and older at a single medical center. METHODS: A total of 97 patients with internal carotid artery stenosis underwent CAS using the dual-protection (simultaneous flow reversal and distal filter) and blood-aspiration method. We divided patients into 2 groups, octogenarian and non-octogenarian. We evaluated patient background, captured visible debris, in-stent protrusion, major adverse events (i.e., major stroke and death), and hyperintense spots on diffusion-weighted images after CAS. RESULTS: The success rate of the CAS procedure was 100% with no major adverse events within 30 days. We found vulnerable plaque in 50% (15/30 patients) and 26.9% (18/67 patients) of octogenarian and non-octogenarian groups, respectively (P = 0.047). Diffusion-weighted images revealed small hyperintense spots in 20% (6/30 patients) and 18.0% (12/67 patients) of the octogenarian and non-octogenarian groups, respectively (P = 0.785). Visible debris was observed in 43.3% (13/30 patients) and 22.4% (15/67 patients) of the octogenarian and non-octogenarian groups, respectively (P = 0.004). CONCLUSIONS: The plaque of carotid stenosis in octogenarians is often vulnerable, but using a dual protection and blood aspiration method, we safely performed CAS in octogenarian patients.

A Case of Cutaneous Meningioma in the Rudimentary Meningocele.

We report a rare case of neonatal cutaneous meningioma derived from a rudimentary meningocele. This neonate had a congenital skin-covered hump in the thoracolumbar region. Computed tomography showed bifid laminae of T12 and L1 underneath the mass lesion. Magnetic resonance images showed the mass to have no cerebrospinal fluid space and that it had a stalk connecting to the spinal canal. Split cord malformation was also observed under the bifid laminae. Because of the increasing size of the lump and cosmetic reasons, the parents opted for surgical treatment. We operated on the patient 9 months after birth. Operative findings showed that the cutaneous mass was connected to intraspinal contents by a vascular stalk and it was totally removed. The split spinal cord was untouched. The histopathological findings of the mass showed components of meningioma with a collagenous matrix. We concluded that this patient had a meningioma derived from rudimentary meningocele.