Effects of Ferulic Acid and Angelica archangelica Extract (Feru-guard ®) on Mild Cognitive Impairment: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Prospective Trial.

We conducted a multicenter, randomized, double-blind, placebo-controlled prospective trial examining a supplement containing ferulic acid and Angelica archangelica extract (Feru-guard ®) for mild cognitive impairment (MCI). In the intention-to-treat population, Mini-Mental State Examination (MMSE) scores were significantly better at 24 weeks (p = 0.041) in the active group. In the per protocol population, MMSE was significantly better in the active group at 24 weeks (p = 0.008), and mixed effect models for repeated measures (MMRM) showed significant difference (p = 0.016). ADAS-Jcog was significantly better at 24 (p = 0.035) and 48 weeks (p = 0.015) in the active group, and MMRM was significant (p = 0.031). Thus, Feru-guard ® may be useful for MCI.

Utility of crankshaft clips for middle cerebral artery aneurysms: A single-center experience of 150 cases.

BACKGROUND: Applying more than one clip for a complicated-shaped aneurysm is an established strategy, particularly for middle cerebral arteries (MCA). However, obliterating the cleft of the internal elastic lamina with a single clip is theoretically possible because the line is usually on a single plane. Crankshaft clips were reformed for that purpose decades ago, but are not widely used and have been described in almost no report ever since. METHODS: To reconsider and describe the utility of crankshaft clips for complicated MCA aneurysms and to articulate the advantages and limitations of the clips, we meticulously analyzed a series of more than 150 cases in which the crankshaft clips were used, predominantly for treatment of MCA aneurysms, at Moriyama Memorial Hospital between August 2010 and December 2015. RESULTS: Readjustment of the clip was not necessary in almost all cases, and the first application was the final one. None of the patients had morbidity or mortality related to the surgical technique. To date, we have not experienced any trouble or recurrence. CONCLUSIONS: Crankshaft clips are useful and safe for clipping of complicated MCA aneurysms.

[Stent-in-Stenting for In-Stent Stenosis after Carotid Artery Stenting:A Report of 2 Cases].

Standard strategy for the treatment of subacute in-stent stenosis after carotid artery stenting remains controversial. We report the successful application of stent-in-stenting in 2 patients with subacute in-stent stenosis of the internal carotid arteries (ICA). The postoperative courses of both patients were uneventful, and the patency of the ICA was confirmed at the 2-year follow-up. In this study, medical treatment was not effective, and therefore, stent-in-stenting was used as an alternative treatment for subacute in-stent stenosis.

[Chronic subdural hematoma organized over a short period of time with spontaneous intracranial hypotension: a case report].

Spontaneous intracranial hypotension (SIH) can develop after cerebrospinal fluid (CSF) leakage and is accompanied by various symptoms, including headache and neck pain. In recent years, cases of chronic subdural hematoma (CSDH) that develop concomitantly with SIH have been encountered occasionally. Although various reports regarding the priority of treatment exsist, a conclusive opinion has yet to be given. Here, we present a rare case of CSDH that developed concomitantly with SIH in which the hematoma became organized over a short period of time. Organized CSDH results from impairment of the microcirculation due to metabolic or circulatory dysfunction or inflammation after trepanation. The disease is believed to require craniotomy for treatment, while SIH is frequently treated with an epidural blood patch, which may require repeated procedures to achieve success. If CSF leakage cannot be improved, the concomitant CSDH may become organized. Therefore, it is important to thoroughly discuss the therapeutic options in individual cases.