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The prevalence of unruptured intracranial aneurysms varies with age, sex, and genetic diseases, including atherosclerotic diseases. The objectives of this study are to determine the prevalence of intracranial aneurysms among acute ischemic stroke patients and the clinical outcomes of the patients.

The authors included patients with acute ischemic stroke within 7 days of onset. Demographic data, stroke subtypes, risk factors, and modified Rankin scale (mRS) scores at 6 months after stroke were collected. Magnetic resonance angiography was performed to diagnose intracranial aneurysms. The occurrence of aneurysmal subarachnoid hemorrhage (aSAH) was recorded during the follow-up at 6 months.

Thirteen (7%) of the 186 patients were found to have incidental intracranial aneurysms. Age and sex were not different between the patients with and without aneurysms (
> 0.999,
> 0.999). Ten patients (76.9%) had a saccular aneurysm. The most common site of the aneurysm was the cavernous part of the internal carotid artery (
= 6). Nine patients (69.2%) had very small (<4 mm) aneurysms. No aSAH was detected until 6 months after stroke. Favorable outcomes (mRS 0-2) at 6 months were not different between the patients with and without aneurysms (69.2% vs. 75.1%,
= 0.665).

A higher prevalence of intracranial aneurysms was observed among acute ischemic stroke patients than among the general population. However, the variability of the general population should be considered. The functional outcomes of acute ischemic stroke patients are not affected by the presence of an intracranial aneurysm.
A higher prevalence of intracranial aneurysms was observed among acute ischemic stroke patients than among the general population. However, the variability of the general population should be considered. The functional outcomes of acute ischemic stroke patients are not affected by the presence of an intracranial aneurysm.
Ewing's sarcoma is a malignant primitive neuroectodermal tumor (PNET) of childhood and adolescence. Primary Ewing's sarcoma of the spine is uncommon, and even more rarely involves the C2 vertebra.

A 14-year-old patient was admitted with a history of chronic neck pain, which exacerbated after playing contact sports 3 weeks before presentation. On initial examination, he had pain radiating into the left upper extremity plus spasticity in all the four limbs. The cervical X-rays revealed a mixed sclerotic-lytic lesion involving the C2 vertebral body. The CT bony and soft-tissue windows documented predominant left-sided tumor invasion of the posterior elements, pedicles, and body of C2 along with extension into the spinal canal resulting in severe cord compression with peritumoral soft-tissue edema. The angiogram revealed a patent left vertebral artery entirely surrounded/encased by tumor. The PET-CT scan demonstrated no other spinal or systemic lesions. Due to his rapid neurological deterioration, the patient underwent an emergent biopsy of the tumor with posterior decompression and occipitocervical stabilization. The biopsy demonstrated a PNET (e.g., positive CD 99 MIC2 marker for Ewing's sarcoma). Following subsequent chemotherapy and radiation, the patient rapidly improved over a period of 3 months.

Primary Ewing's sarcoma involving the C2 vertebra is exceedingly rare and warrants surgical decompression with pathological confirmation to provide additional multi-modal/multi-disciplinary adjunctive radiation/chemotherapy.
Primary Ewing's sarcoma involving the C2 vertebra is exceedingly rare and warrants surgical decompression with pathological confirmation to provide additional multi-modal/multi-disciplinary adjunctive radiation/chemotherapy.
Lumbar microdiscectomy is one of the most frequently performed neurosurgical procedures. In this review, we ask why patients' outcomes vary so widely even within the same unit, with the same surgeon performing the procedure and utilizing the technique?

In a cohort of 87 patients, we investigated how/whether multiple patient variables impacted outcomes following single-level lumbar microdiscectomy. We studied whether early surgical intervention improved the patients' quality of life (QOL) versus late intervention. Furthermore, we assessed other variables that could influence patient-perceived improvement. SU5402 in vivo Preoperatively and postoperatively, we additionally utilized the following internationally standardized questionnaires (EQ-5D, Oswestry, and Core Outcome Measures Index [COMI]).

A generalized substantial improvement in QOL was identified throughout the cohort population (<0.05). There was no difference in health measurement scores for those undergoing early versus late surgery. However, there was a sus public patients suggesting that there are more subjective, complex, and psychosocial issues that influence outcome.
Atlanto-occipital dislocation (AOD) is a rare, highly morbid, and highly lethal injury that results from high-energy trauma and almost universally requires operative management for satisfactory outcomes. It can be difficult to identify the severity of injury at the time of presentation, and when diagnosis is delayed outcomes worsen significantly. Anatomic anomalies of the craniovertebral junction may further complicate its detection. When such anomalies are present either singly or in combination, they are known to cause space constraints which may increase the likelihood of spinal cord injury. Given that such anomalies and AOD are rare, few examples of patients with both are reported in the literature. Furthermore, it is not clear in what way patient management may be impacted in this context.

We will present a unique case of an 18-year-old patient with traumatic AOD and an intact neurologic examination who was found to have atlanto-occipital assimilation (AOA), platybasia, basilar invagination, and severe Chiari I malformation, who was treated effectively with non-operative management.

Our case demonstrates the successful application of a non-operative treatment strategy in a carefully selected patient with AOD in the context of AOA.
Our case demonstrates the successful application of a non-operative treatment strategy in a carefully selected patient with AOD in the context of AOA.
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