In this study, the serum glucose/potassium ratio of patients with aneurysmal SAH at admission was significantly correlated with H-K grade and GOS score at discharge. Therefore, this ratio was useful for predicting prognosis of aneurysmal SAH, especially in severe cases.

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Fig. 1 Computed tomography scans on admission (left)showing subarachnoid hemorrhage (SAH) in the premedullary cistern, after surgery (center) showing no abnormal findings, and 8 hours after surgery (right) showing SAH in the right premedullary cistern. AbstractThe development of vertebral artery (VA) dissecting aneurysm after trapping of the contralateral VA is rare, and rupture of angiographically occult VA dissecting aneurysms immediately after trapping is even less common. A 39-year-old man suffered subarachnoid hemorrhage caused by rupture of a left VA dissecting aneurysm. The VA was trapped and the left occipital artery anastomosed to the posterior inferior cerebellar artery. Postoperatively, he suddenly developed apnea and died of rupture of a right VA dissecting aneurysm. Histological examination of the bilateral VAs and the basilar artery disclosed a hematoma between the media and the adventitia. This case further confirms the need for careful preoperative imaging study of the dissection and all segments of the dissected vessel in patients requiring trapping of a VA dissecting aneurysm, as well as preservation of VA anterograde flow.

Meningiomas are often embolized before their surgical resection to reduce blood loss during surgery. Polyvinyl alcohol (PVA) particles have been the most frequently used material for embolization of meningiomas. We have used n-butyl cyanoacrylate (NBCA) as the first-choice material since 2001. Thirty-one meningiomas were embolized with NBCA. We report the result of embolization of meningiomas with NBCA in comparison with PVA particles.

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The effect of edaravone as an inhibitor of ischemic brain damage in addition to routine treatment was retrospectively examined in 70 patients with lacunar infarction who were admitted within 24 hours of symptom onset. Clinical status was assessed using the National Institutes of Health Stroke Scale (NIHSS). The modified Rankin Scale (MRS) was used to assess clinical outcomes at 3 months after onset, with a good outcome defined as MRS score Ã2. Risk factors were also evaluated, including evidence of hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease, and a history of smoking longer than 2 months. The probability of a good outcome and independence at 3 months was assessed by backward stepwise logistic regression analysis based on the maximum likelihood ratio. Administration of edaravone yielded an odds ratio with multivariate adjustment of 6.49 (95% confidence interval, 1.35 to 50.32; p º 0.05) for a good outcome at 3 months. Higher baseline NIHSS score and higher age also adversely affected the outcome at 3 months (p º 0.005). Administration of edaravone improves the outcome of patients with lacunar infarction.