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Background: Traumatic subacute subdural hematomas can usually be evacuated via craniotomy under general anesthesia. We report a traumatic subacute subdural hematoma in an elderly patient that was evacuated by endoscopic burr hole surgery using a curettage and suction technique under local anesthesia. This minimally invasive neurosurgery may lower the morbidity rate in elderly or sick patients with serious cardiac and/or pulmonary lesions in whom the inherent risks of general anesthesia are high., Patient: An 88-year-old man was referred to our institution with left hemiparesis 6 days after sustaining a head injury. He was on antiplatelet drugs for severe coronary and peripheral artery disease and underwent hemodialysis three times a week., Results: Endoscopic burr hole surgery using a curettage and suction technique resulted in the complete evacuation of his subacute subdural hematoma and complete hemostasis, and he recovered completely., Conclusion: Endoscopic burr hole surgery using a curettage and suction technique is a minimally invasive treatment to address subacute subdural hematomas. This method may be particularly useful in older patients in whom general anesthesia poses additional risks., (Georg Thieme Verlag KG Stuttgart · New York.)

Background: Indocyanine green videography has been introduced into neurosurgical fields for minimally invasive neurosurgery. To establish a new intraoperative imaging modality, we performed transdural indocyanine green videography during the surgery of meningiomas., Method: A dose of 12.5 mg of indocyanine green was injected transvenously in two cases of meningiomas just before the dural opening. Transdural indocyanine green videography was monitored., Results: The cortical arteries and veins and the venous sinus were identified by the indocyanine green videography transdurally in both cases. The projection of meningiomas was identified as the shadow and signal negative regions, and was visualized as "the Eclipse.", Conclusion: Transdural observation of the cortical arteries and veins and the venous sinus was successfully performed followed by the visualization of the projection of meningiomas as the shadow. We propose this sign as "the Eclipse sign." This transdural imaging method was of value in terms of precise and minimal dural incision., (Georg Thieme Verlag KG Stuttgart · New York.)

Subarachnoid hemorrhages with intraventricular hemorrhage (IVH) have been treated with aneurysmal clipping and ventricular drainage. We present a combined treatment with coiling and endoscopy: coiling of the ruptured distal anterior cerebral artery aneurysm and neuroendoscopic removal of IVH.

Platelet-derived microparticles (PDMPs), a procoagulant factor, are reportedly elevated in type 2 diabetes mellitus and acute coronary syndrome. The metabolic syndrome (MS) is strongly associated with cardio- and cerebrovascular disease-related atherothrombotic events. To clarify the level, distribution and correlates of PDMPs with special reference to MS, we conducted a cross-sectional study of 467 healthy Japanese volunteers without signs, symptoms, or a history of cardio- or cerebrovascular disease. They were 211 men and 256 women (median age 39 and 35 years, respectively). Using an ELISA kit and monoclonal antibodies against CD42b and CD42a (glycoprotein Ib and IX) we assayed the PDMP levels. Total cholesterol, low-density and high-density lipoprotein cholesterol, remnant cholesterol, triglycerides, C-reactive protein, and traditional cardiovascular risk factors were also recorded. There was a significant difference in the level of PDMPs between men and women. The median value and the interquartile range of PDMPs was 8.3 IU/ml and 6.2-10.5 IU/ml and 6.8 IU/ml and 5.2-8.6 IU/ml, respectively, in men and women. PDMPs were significantly associated with MS criteria in men (p < 0.001) and women (p = 0.040). Logistic regression analysis revealed a significant odds ratio of 3.9 [95% confidence interval (CI): 1.4-10.5] in men and of 4.2 [95% CI: 1.6-10.7] in the entire study population. Our results suggest that PDMPs identified by glycoprotein CD42b and CD42a are positively associated with MS.