Background: Intracranial intra-arterial calcifications (ICAC) are a common finding on head CT examinations, but their significance is not known. The aim of this study is to determine if a relationship exists between ICAC on head CT and the presence of a high-grade atherosclerotic stenosis on cerebral angiography. Methods: This was a retrospective study of 108 consecutive patients admitted to the stroke service at Parkland Hospital in Dallas, Tex., USA. Each patient had undergone a head CT and catheter-based angiographic study to meet the inclusion criteria. Demographic information was recorded along with CT imaging data in regards to the amount of calcification. Angiographic images were reviewed independently, and a comparison was made to determine if calcification was predictive of finding a high-grade stenosis on angiography. Results: A total of 108 consecutive patients with a mean age of 56 ± 12 years were studied. Of the 540 vessels studied, 65 (12%) were found to have a stenosis of ≥50% on angiography, and 71 (13.1%) were found to have a calcium grade of 3 or 4 on head CT. ICAC appeared to be more common in the anterior circulation compared to the posterior circulation. Patients with grade 3 or 4 calcification of an intracranial vessel on head CT were more likely to have a stenosis of ≥50% on cerebral angiography. Conclusions: The presence of ICAC on head CT appears to correlate with the presence of an underlying intracranial stenosis on angiography. Further study is required to validate these preliminary findings.

BACKGROUND AND PURPOSE:Hypothermia has been shown to be beneficial in the setting of acute SCI. However, widespread use has been hindered by the need for systemic hypothermia as the vehicle for achieving spinal cord hypothermia. This study demonstrates that localized spinal cord hypothermia can be achieved via a percutaneous approach while maintaining systemic normothermia.

Breast reconstruction is a viable option for transplant patients after mastectomy and should not be refused based on their transplant status. Close coordination with the transplant team and careful preoperative planning is essential for optimal outcomes.

Object The purpose of this paper was to demonstrate the usefulness of various fiberoptic endoscopes for percutaneous intraspinal navigation of the spinal canal, posterior fossa, and ventricular system. Methods Fresh, unembalmed cadavers were used, in which lumbar punctures were made for access to the sub-arachnoid space (in the case of larger [3.8- and 5-mm-diameter] endoscopes, small laminotomies were performed). Static and video images of pertinent structures were acquired for comparison among devices. Endoscopes were compared for their maneuverability, durability, field of view, and image quality. Seven sizes and types of endoscopes were considered. Overall, the devices offering a tip-deflecting mechanism were superior in maneuverability. Endoscopes in which a charged couple display chip was used at the tip of the scope for image acquisition offered improved image quality and field of view. Larger scopes, although more durable, were more rigid and may be limited in application. Multiple images from multiple devices are presented. Conclusions Percutaneous intraspinal navigation offers a promising neurosurgical approach to the spinal canal, the posterior fossa, and the ventricular system. Concerns regarding safety, management of complications, and the lack of adjunctive tools for intervention through the endoscopes or for use under fluoroscopic guidance represent areas that warrant further investigation and development.

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