BACKGROUND AND PURPOSE: Stent-assisted coiling of intracranial aneurysms requires antiplatelet therapy, typically aspirin and clopidogrel to prevent thromboembolic complications. There is a substantial concern that tirofiban may increase the risk of hemorrhage when used as an antiplatelet premedication in ruptured intracranial aneurysms. Our aim was to evaluate the safety and efficacy of intravenous tirofiban administration, instead of oral dual antiplatelet agents, as an antiplatelet premedication for stent-assisted coiling in patients with acutely ruptured intracranial aneurysms.

Fibrous hamartoma of infancy in the middle ear is extremely rare. We report the case of a 26-month-old male patient who presented with a mass in the left middle ear. A temporal bone CT scan showed complete opacification of the left middle ear and mastoid air cells without ossicular erosion. On MRI, the mass revealed heterogeneous signal intensities indicative of fat and fibrous components. A definitive diagnosis was made postoperatively based on the histological results. Although rare, fibrous hamartoma of infancy should be considered as a differential diagnosis of a middle ear mass during childhood.

Iatrogenic injury of the vertebral artery during cervical spine surgery though uncommon is critical. With advances in interventional endovascular techniques, the therapeutic approach for vertebral artery injuries has changed. Nonetheless, an established strategy for their management is lacking. We report a case of pseudoaneurysm due to vertebral artery injury, during cervical spine surgery for a tumor, that was treated successfully with endovascular coiling in a plug-and-patch fashion after triple stenting failed.

Branchio-otic (BO)-syndrome is a relatively uncommon genetic disease, and is characterized by branchial fistulae, congenital preauricular fistulae, and anomalies of the pinnae, external, middle, and inner ears, accompanied by hearing loss. The phenotype varies, so that degree of hearing loss and the type of branchial fistulae vary depending on the patient. Branchial cleft anomaly is common feature of BO syndrome (63%), and most of them are 2nd branchial cleft anomaly. There have been no reports of BO syndrome with 3rd or 4th branchial cleft anomaly published in literature. We report a case of bilateral 3rd branchial cleft anomaly in a 22 year-old male patient with BO syndrome, who treated with chemical and electrocauterization therapy, with a review of literatures.