Transcirculation Silk Vista Baby-assisted coiling in half-T configuration for the treatment of posterior communicating artery aneurysms associated with a fetal posterior circulation: An alternative flow diversion strategy

Flow diverter devices have become a routine first-line option for treatment of an increasing population of intracranial aneurysms at many neurovascular centers. Despite the promising results of flow diverter stents on anterior circulation, incomplete occlusion on the presence of fetal posterior circulation has been described on several reports. Here we describe a novel technical alternative to conventional flow diversion approach for this specific subgroup of aneurysms using the low-profile flow diverter, Silk Vista Baby. The device was selectively placed into the fetal type posterior cerebral artery in half-T configuration for the treatment of a posterior communicating aneurysm using a transcirculation approach through the anterior communicating artery. This represents a useful and effective technique and should be considered when encountering the above-described situation.     

Effects of DA D1 and D2 antagonists on the sensitisation to the motor effects of morphine in mice

Acute morphine administration produces hyperactivity in mice and repeated treatment induces an enhancement of this effect. In this experiment, we study the sensitisation to the hyperactivity induced by intermittent morphine administration (40 mg/kg) and the effects of dopamine (DA) antagonists on this phenomenon. Animals received three injections, separated by 48 h, and after each injection, their activity was registered between 30 and 60 min. In Experiment 1, animals were divided into two groups, which received saline and morphine (S–S–M) or only morphine (M–M–M). In Experiment 2, animals were divided into 12 groups. Half, which was designed to study the effects of DA antagonists on the acquisition of morphine sensitisation, received morphine plus 0.125, 0.25, or 0.5 mg/kg SCH 23390 or raclopride in the two first administrations and only morphine in the third (M+SCH–M+SCH–M; M+R–M+R–M). The other groups, designed to study the effects of DA antagonists on the expression of morphine sensitisation, received morphine in the two first administrations and morphine plus DA antagonists in the last injection (M–M–M+SCH; M–M–M+R). Intermittent morphine administration produces greater hyperactivity than acute morphine. DA D1 antagonists reduce acquisition and block expression of sensitisation, while DA D2 antagonists only affect expression with the intermediate and high dose. These results support the implication of DA in the behavioural sensitisation of morphine in mice.     

Role of dopamine and glutamate receptors in cocaine-induced social effects in isolated and grouped male OF1 mice

Cocaine administration in paired male mice decreases social contacts as well as increases avoidance and flee elements. As dopamine (DA) and glutamate seem to be involved in some of cocaine's effects, an attempt was made to assess whether a range of associated receptors influenced the social impacts of this drug of abuse. The NMDA antagonist memantine (10 and 40 mg/kg); the AMPA antagonist CNQX (1 and 20 mg/kg); the DA release inhibitor CGS 10746b (2 and 8 mg/kg): the DA D1 antagonist SCH 23390 (0.05 and 0.5 mg/kg); and the DA D2/D3 antagonist raclopride (0.03 and 0.3 mg/kg) were administered prior to 25 mg/kg of cocaine and behaviour was evaluated during an encounter between an experimental and a standard opponent in a neutral cage for 10 min. Memantine reverts cocaine-induced social withdrawal and the increase in avoidance and flee, CNQX being effective only in these latter actions. On the other hand, SCH 23390 counteracts the social as well as the defensive action of cocaine, raclopride being effective only in blocking the cocaine-induced increase in avoidance and flee behaviours. In conclusion, although both neurotransmitter systems are involved in the effects of cocaine on social behaviour, NMDA and D1DA receptors seem to have an important role.     

Acute behavioural and neurotoxic effects of MDMA plus cocaine in adolescent mice

The poly-drug pattern is the most common among those observed in MDMA users, with cocaine being a frequently associated drug. This study evaluates the acute effects of MDMA (5, 10 and 20 mg/kg), alone or in combination with cocaine (25 mg/kg), on motor activity, anxiety (elevated plus maze and social interaction test), memory and brain monoamines in adolescent mice. Both drugs, administered alone or concurrently, produced hyperactivity and a decrease in social contacts. However, an anxiolytic effect, studied by means of the elevated plus maze and expressed as an increase in the time spent on the open arms, was observed only in those animals treated with cocaine and MDMA. The passive avoidance task was affected only with the highest MDMA dose (20 mg/kg). Mice treated with MDMA did not present significant changes in brain monoamines, while those receiving MDMA and cocaine showed a decrease in DA in the striatum, which was accompanied by an increase in the serotonin concentration in the striatum and cortex 30 min after acute administration. In conclusion, the combined use of MDMA and cocaine produces a predominance of serotonin over DA, which is associated with an anxiolytic profile, defensive behaviours and fewer social contacts.     

Recurrence in a different location of a cerebral arteriovenous malformation in a child after radiosurgery

The case of a 9-year-old girl with a right parietal arteriovenous malformation (AVM) of the brain obliterated after gamma knife (GK) radiosurgery with subsequent regrowth in a different site is reported. As far as we know, this is the first reported case of regrowth of an AVM in a different location after radiosurgery in a child. This situation has to be considered within the context of causes of unsuccessful treatment of AVMs with radiosurgery and justifies angiographic monitoring of pediatric patients until they reach adulthood. Received: 27 October 1999     

Severe cerebral vasospasm in chronic cocaine users during neurointerventional procedures: A report of two cases

Cocaine is a widespread recreational drug that has the potential to induce neurological vascular diseases, including ischaemic and haemorrhagic stroke. Although arterial vasospasm has been suggested as a pathogenic factor in the development of neurovascular complications, it remains unclear whether cocaine users carry an increased risk to suffer iatrogenic vasospasm during endovascular procedures. We report the case of two patients with a history of cocaine abuse, who developed unusual severe vasospasms during different interventional procedures. The first case occurred in a middle-aged woman with an unruptured left internal carotid artery bifurcation aneurysm who was scheduled for treatment by remodelling assisted coiling. Just after the placement of the remodelling balloon, a severe occlusive vasospasm interrupted the procedure. The second case happened to a 46-year-old man with a non-aneurysmal subarachnoid haemorrhage and a symptomatic vasospasm in the right-sided anterior circulation who developed another occlusive vasospasm after the first attempt at transluminal balloon angioplasty. Further research is needed to establish a relation between cocaine use and increased risk of iatrogenic vasospasm in endovascular procedures, but we suggest practitioners be extremely cautious when treating this subgroup of patients.     

Gestational exposure to cocaine alters cocaine reward

Exposure of the developing foetus to drugs of abuse during pregnancy may lead to persistent abnormalities of brain systems involved in drug addiction. Mice prenatally exposed to cocaine (25 mg/kg), physiological saline or non-treated during the last 7 days of pregnancy were evaluated in adulthood for the rewarding properties of cocaine (3, 25 and 50 mg/kg), using the conditioned place preference procedure. Dams treated with physiological saline gained significantly less weight over the course of gestation than controls; no other differences were observed in the maternal and offspring data. All the animals developed preference to 3 and 25 mg/kg of cocaine, but those treated prenatally with cocaine did not develop preference after receiving the highest cocaine dose. In these mice, the motor activity in response to 50 mg/kg showed a small decrease. Although a reduced response to the highest cocaine dose can be argued, we suggest that the lack of preference obtained is more likely attributable to an increased sensitivity to the environmental cues associated during training to an aversive effect of this cocaine dose. The aversive properties of cocaine seem to be more apparent and to prevail over the rewarding action of the highest dose in exposed animals. These findings indicate that recurrent gestational cocaine exposure results in permanent (mal)adaptations of the structure and function of brain reward systems.     

Gamma-hydroxybutyric acid affects the acquisition and reinstatement of cocaine-induced conditioned place preference in mice

Cocaine addicts very often use different combinations of cocaine and other drugs of abuse such as gamma-hydroxybutyric acid. The objective of the present work was to evaluate the impact of gamma-hydroxybutyric acid administration on the rewarding actions of cocaine, using the conditioned place preference procedure. Cocaine-induced conditioned place preference (50 mg/kg) was studied after pairing this drug with different gamma-hydroxybutyric acid doses (6.25, 12.5, 25, 50 and 100 mg/kg) during either the acquisition or the expression phase of the procedure. After conditioned place preference had been established, and the preference was extinguished, a reinstatement was induced by a dose of cocaine half of that used to produce conditioning, or by gamma-hydroxybutyric acid alone or by both drugs together. The doses of 12.5 and 100 mg/kg of gamma-hydroxybutyric acid blocked the acquisition of cocaine-induced conditioned place preference, and no dose affected the expression of this conditioning. Reinstatement was abolished only with the dose of 25 mg/kg gamma-hydroxybutyric acid, which did not reinstate the preference by itself. This is the first study evaluating the effects of gamma-hydroxybutyric acid on the rewarding properties of cocaine using the conditioned place preference procedure. The principal conclusion of the study is that gamma-hydroxybutyric acid does not enhance the rewarding effect of cocaine, and within a narrow margin of effective doses, blocks the acquisition and reinstatement of cocaine-induced preference.