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Fusiform basilar trunk artery aneurysms are rare lesions, to which stent-assisted coil embolization or flow diversion have been generally applied. When a stent is placed from the distal basilar artery or the posterior cerebral artery to the vertebral artery (VA) through a fusiform basilar artery aneurysm, the side of the VA may be determined according to its size, shape, accessibility and aneurysm projection. In the present report, we constructed stent-placement models from the distal basilar artery to either VA across the aneurysm, and investigated blood mass distribution using computational fluid dynamics. The results revealed more stagnated blood flow in the aneurysm after stenting to the left VA. According to the simulation, stent-assisted coil embolization of the aneurysm was performed, resulting in sufficient obliteration. This visualization technique could be useful for decision-making for the treatment of complicated aneurysms and has a wide range of potential applications. OBJECTIVE Several risk factors have been shown to be associated with pre- and postoperative seizures in patients undergoing neurosurgical intervention for meningiomas and other primary brain tumors. This study aimed to identify risk factors associated with pre- and postoperative seizures in patients undergoing surgery for brain metastases (BM). PATIENTS AND METHODS 286 patients who had undergone neurosurgical resection for brain metastases between 2007 and 2015 were included in this single-center retrospective cohort. Seizure incidence and patient characteristics were recorded. Univariate and multivariate logistic regression was performed for both pre- and postoperative seizures. RESULTS 16.8 % of patients presented with seizures before surgical intervention, and a further 7.7 % of patients developed seizures within 3 months of surgical resection of BM. Patient age, cerebellar location, large tumor size, and headache were negatively correlated with pre-operative seizures, whereas parietal location was positively correlated. Surgery for recurrent tumor was positively correlated with newly developed seizures after surgery. CONCLUSION Age, cerebellar location, large tumor size, and headache were negatively correlated with development of seizures while parietal location was found to be a risk factor. Lower age and resection of recurrent tumors was correlated with an increased risk of developing postoperative seizures. There was no correlation between type of primary tumor and development of seizures. V.OBJECTIVES To investigate the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) and to compare low-frequency versus high-frequency STN-DBS on hemodynamic parameters of the middle cerebral artery between patients with advanced Parkinson's disease and age-sex matched healthy controls. PATIENTS AND METHODS Eighteen patients with advanced Parkinson's disease (PD) with bilateral STN-DBS and 18 control subjects underwent Transcranial Doppler Ultrasound (TCDU) were included in the study. The hemodynamic parameters including blood flow velocity (FV), pulsatility index (PI) and, resistance index (RI) of the right middle cerebral artery (MCA) were measured and compared during the phases using TCDU. The first DBS-off, the second low-frequency DBS of 60 Hz, and the third high-frequency DBS of 130 Hz were compared. RESULTS PD patients had significantly higher MCA-PI values compared with controls (0.99 ± 0.27 vs. 0.82 ± 0.14) (p = 0.031). Also, the MCA-PI values were higher in the low-frequency DBS (0.94 ± 0.14) and high-frequency DBS (0.93 ± 0.16) than in the controls (0.82 ± 0.14) (p = 0.022 and p = 0.041, respectively). There were no significant differences of FV and RI values among the DBS-on, DBS-off and, controls. The RI values were higher in the PD patients than in the controls, although these were not statistically significant. Also, PI values of the MCA decrease in different frequencies (60 Hz or 130 Hz). CONCLUSION The results of this study showed that MCA-PI values are higher in advanced PD compared with controls. These indices indicate that MCA resistances and impedances are increased in advanced PD. Low- or high-frequency DBS treatment have beneficial effect to reduce high PI in advanced PD patients. check details OBJECTIVE Patients with a comorbid mental illness have been observed to have worse outcomes following surgery. However, little is known about the effects of mental disorders on patient outcomes following spinal surgery. In the current study, we sought to investigate the characteristics of patients with mental illness, particularly anxiety, major depressive disorder, concurrent anxiety and schizophrenia, and the impact of these comorbid conditions on outcomes of patients undergoing anterior cervical discectomy and fusion (ACDF) using a national administrative database. PATIENTS AND METHODS The National Readmissions Database (NRD) was queried for patients undergoing an ACDF between 2012 and September 30th, 2015. The presence of anxiety, major depressive disorder, concurrent anxiety and schizophrenia were captured using International Classification of Diseases, Ninth Revision (ICD-9) codes. Multivariable logistic regression was used to establish an association between a mental comorbidity and risk of 30- and 90- day readmission. RESULTS A total of 139,877 patients undergoing elective ACDF between 2012-2015 were identified, of which 15,927 (11.39 %) had anxiety, 514 (0.38 %) had major depressive disorder, 248 (0.18 %) had concurrent anxiety and major depressive disorder, and 287 (0.21 %) had schizophrenia. Upon multivariable analysis of procedural related readmissions, adjusting for an array of patient and hospital related factors, patients with schizophrenia, compared to controls, had a significantly higher risk of 30-day readmission (OR 2.62, 95 %CI 1.42-4.84, p = 0.002); moreover, schizophrenia (OR = 1.92, 95 % CI 1.13-3.25, p = 0.016) anxiety (OR = 1.13, 95 %CI 1.02-1.26, p = 0.023) were also associated with significantly higher risk of 90-day readmission. CONCLUSION Our analysis indicates that mental illness comorbidities may be associated with increased rates of procedure related readmission and longer length of stay following elective ACDF.