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Background: Various techniques have been used for wrap-clipping a ruptured, fusiform intracranial aneurysm; however, there is no available literature on use of the falx cerebri for wrap-clipping. We present a review of the literature, with an illustrative case, of a ruptured fusiform pericallosal artery aneurysm firmly attached to the lower edge of the falx cerebri and not amenable to endovascular intervention., Methods: Although the firm attachment between the inferior falx and the fusiform aneurysm was maintained, a section of the lower thinner part of the falx cerebri firmly attached to the aneurysm was dissected and wrapped around the fusiform aneurysm, and then stabilized with a fenestrated clip. We chose a segment slightly longer than the length of the fusiform aneurysm to avoid pre- and post-wrap-clipping stenosis., Results: Postprocedure, except for a small area of numbness on the left distal anterolateral left leg, the patient was neurologically intact and remained neurologically intact at a 12-month follow-up., Conclusions: An inferior thin segment of the falx cerebri can be used for wrap-clipping of ruptured fusiform anterior cerebral artery aneurysms. Furthermore, the inferior falx can be wrapped around the attached fusiform anterior cerebral artery aneurysm without compromising flow, offering a safe solution in these unusually complex cases., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Spinal cord injury is a highly prevalent condition associated with significant morbidity and mortality. The pathophysiology underlying it is extraordinarily complex and still not completely understood. We performed a comprehensive literature review of the pathophysiologic processes underlying spinal cord injury. The mechanisms underlying primary and secondary spinal cord injury are distinguished based on a number of factors and include the initial mechanical injury force, the vascular supply of the spinal cord which is associated with spinal cord perfusion, spinal cord autoregulation, and post-traumatic ischemia, and a complex inflammatory cascade involving local and infiltrating immunomodulating cells. This review illustrates the current literature regarding the pathophysiology behind spinal cord injury and outlines potential therapeutic options for reversing these mechanisms., (© 2014 Wiley Periodicals, Inc.)

Introduction: A paucity of literature exists regarding spinal cord ischemia and atherosclerosis. Therefore, the present study aimed to review this literature in hopes of better understanding this pathology., Methods: Various search engines and databases were accessed using the following terms "atherosclerosis and spinal cord ischemia", "atherosclerosis and vascular myelopathy", "spinal cord ischemia" and "arteriosclerosis of spinal arteries"., Results: Twenty publications were found to be relevant to the present review. However, very few studies were identified that dealt specifically with atherosclerosis and spinal cord ischemia. The more valid cross-sectional studies indicated that local atherosclerosis in the spinal arterial network is minimal in comparison with the rest of the body. The anterior spinal artery appears to be one of the few arteries affected by atherosclerotic plaque formation. A greater propensity to affect the lower cervical spinal cord and a correlation with advancing age appears to exist. Systemic atherosclerosis may or may not have an effect on ischemia of the spinal cord., Conclusions: Much of the current literature regarding atherosclerosis and spinal cord ischemia is vague and conflicting. Future studies aimed at, for example, imaging of the spinal cord in patients with ischemic-like symptoms are warranted.

The artery of Desproges-Gotteron is rarely mentioned in the literature and is unfamiliar to most neurosurgeons. The authors report a unique case of an arteriovenous malformation (AVM) of the conus in an adult woman, which received blood supply from an artery of Desproges-Gotteron. The patient presented with intermittent pain radiating down the right posterior thigh and foot and transient bladder incontinence. On examination, there was weakness of the right lower limb with hypalgesia of the plantar aspect of the right foot. Magnetic resonance imaging revealed a mass near the anterior aspect of the conus medullaris and angiography confirmed a spinal AVM at the L-1 level and a shunt located at the inferior L-3 level. The patient underwent transarterial embolization, and at 2-year follow-up, repeat angiography demonstrated no evidence of residual or recurrent spinal AVM, intermittent and tolerable pain without treatment interventions, and a normal neurological examination. The artery of Desproges-Gotteron appears to be a rare arterial variation. Moreover, the authors believe this to be the first case of a conal AVM supplied by such an artery. The anatomy and implications of such an arterial variant are discussed.