Background: This study was carried out to examine indications for angiographic evaluation in the case of spontaneous putaminal hemorrhage. Methods: Angiographic examinations were performed on 62 consecutive adults with spontaneous putaminal hemorrhage without remarkable subarachnoid hemorrhage. Most patients were evaluated using conventional catheter angiography except for hypertensive patients over the age of 60 who underwent a magnetic resonance angiogram or a computed tomography angiogram. Computed tomography and clinical factors such as age and hypertension were correlated with the angiographic findings. Results:Nine of the 62 patients (15%) exhibited angiographic abnormalities, including middle cerebral artery aneurysm (n = 1), arteriovenous malformations (n = 3), moyamoya disease (n = 2), and the moyamoya phenomenon associated with a proximal middle cerebral artery occlusion (n = 3). The angiographic yield was significantly higher (1) among patients at or below the median age of 55 compared with those above (9/33, 27%, versus 0/29, 0%; p < 0.01), and (2) among patients without hypertension compared with those with hypertension (5/9, 56%, versus 4/53, 8%; p < 0.01). Conclusions: Although our data could be biased due to the patient selection procedure, they suggest that angiographic evaluation is highly useful for spontaneous putaminal hemorrhage regardless of volume and shape of the hematomas, excepting hypertensive patients over 55 years of age.

This pilot study demonstrated that thrombolytic evacuation of a post-craniotomy EDH using a closed suction drain is feasible without complications and may be associated with better outcomes.

The present results suggest that the venous phase of a preoperative angiogram should be carefully evaluated before distal ACA aneurysm surgery. In particular, a DTISBV and DII over 50% and 30%, respectively, in patients with a normal SSV and over 40% and 25%, respectively, in patients with an aplastic SSV were found to be critical to the production of postoperative venous infarction.

The urokinase plasminogen activator (BamHI) and plasminogen activator inhibitor type 1 (HindIII) genotypes may serve as useful markers for heritability of bone loss associated with periodontal disease.

The authors report on two types of carotid-A(1) junctional aneurysms projecting backwards. In the two A(1)-type examples, the aneurysm originated at the posterior wall of the proximal A(1) joining the carotid termination and could be clipped using an ipsilateral pterional approach. However, in the carotid-type example, the aneurysm originated at the posterior wall of the carotid termination just below the A(1) origin, and required a contralateral pterional approach to expose the aneurysm. Although the carotid-A(1) junctional aneurysms are rare, their exact location and size can affect the side of the operative approach.