Emergency Carotid Endarterectomy Instead of Carotid Artery Stenting Reduces Delayed Hemorrhage in Thrombectomy Stroke Patients
ConclusionThe use of CEA is a  feasible alternative to CAS in acute stroke and has the advantage that DAPT/GpIIb/IIIa inhibitors are not needed. All PH2 in CEA patients occurred during the intervention, implying that hemorrhage in this group is likely to be caused by reperfusion injury, whereas delayed hemorrhage is likely to b e caused by DAPT/GpIIb/IIIa inhibitors. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - September 17, 2020 Category: Neurology Source Type: research

Performance of Automated Attenuation Measurements at Identifying Large Vessel Occlusion Stroke on CT Angiography
AbstractPurposeComputed tomography angiography (CTA) is routinely used to detect large-vessel occlusion (LVO) in patients with suspected acute ischemic stroke; however, visual analysis is time consuming and prone to error. To evaluate solutions to support imaging triage, we tested performance of automated analysis of CTA source images (CTASI) at identifying patients with LVO.MethodsStroke patients with LVO were selected from a  prospectively acquired cohort. A control group was selected from consecutive patients with clinically suspected stroke without signs of ischemia on CT perfusion (CTP) or infarct on follow-...
Source: Clinical Neuroradiology - September 16, 2020 Category: Neurology Source Type: research

Neurointervention in the 2020s: Where are We Going?
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - September 11, 2020 Category: Neurology Source Type: research

Methylenetetrahydrofolate Reductase Deficiency as a  Cause of Treatable Adult-onset Leukoencephalopathy and Myelopathy
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - September 3, 2020 Category: Neurology Source Type: research

Treatment of Ruptured and Unruptured Intracranial Aneurysms with WEB  17 Versus WEB 21 Systems
ConclusionThe use of WEB  17 expands the treatment indications for intrasaccular flow-diversion towards smaller and more distally located aneurysms with a safety profile comparable with that of the WEB 21. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - September 3, 2020 Category: Neurology Source Type: research

Expanding the Assessment of Research Activity
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - September 1, 2020 Category: Neurology Source Type: research

FLAIR Vascular Hyperintensities Indicate Slow Poststenotic Blood Flow in ICA Stenosis
In this study, we investigated the frequency and extent of FVH in the distal ICA in patients wit h proximal ICA stenosis.MethodsWe analyzed the magnetic resonance imaging (MRI) findings in 51  patients with a total of 60 cervical ICA stenoses with special focus on the frequency and extent of FVH in the area of the petrous segment of the ICA on FLAIR images and correlated these with Doppler/duplex sonography results.ResultsIn 46  (76.7%) patients with ICA stenosis, FVH could be detected in the petrous segment of the ICA: in 19 (41.3%) patients a thin hyperintense rim near the vessel wall (grade...
Source: Clinical Neuroradiology - August 31, 2020 Category: Neurology Source Type: research

Information
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - August 27, 2020 Category: Neurology Source Type: research

Role of Conventional Dynamic Myelography for Detection of High-Flow Cerebrospinal Fluid Leaks
ConclusionThe CDM procedure has a  high accuracy for spinal CSF leak localization including dural tears and spinal nerve diverticula. It is the technique with the highest temporal resolution, is robust to breathing artifacts, allows great flexibility regarding patient positioning, compares favorably to other dynamic examinations wi th respect to the radiation dose and does not require general anesthesia. For CSF venous fistulas, however, other dynamic examinations, such as digital subtraction myelography, seem more appropriate. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - August 26, 2020 Category: Neurology Source Type: research

Freiburg Neuropathology Case Conference
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - August 26, 2020 Category: Neurology Source Type: research

Not a  String, not a Tangle, not an Aneurysm
ConclusionWe have described an unusual imaging finding in a  cohort of younger patients with large-volume ICH, all of whom presented in a 2-month period to a high-volume neurovascular unit. The cause of these ICH presentations and associated imaging findings are unclear, but we encourage other clinicians to be aware of and vigilant for this rare phenomenon , especially in younger patients with such a bleeding pattern. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - August 19, 2020 Category: Neurology Source Type: research

Digital Subtraction Myelography is Associated with Less Radiation Dose than CT-based Techniques
ConclusionThe radiation dose with DSM appears to be significantly lower than that of CTM (p = 0.0005), when looking at CTM doses both from our institution and in the published literature. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - August 17, 2020 Category: Neurology Source Type: research

Duplication of the Inferior Vena Cava Associated with Open Spinal Dysraphism
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - August 3, 2020 Category: Neurology Source Type: research

Direct Stenting of Intracranial Atherosclerosis-related Acute Large Vessel Occlusion
ConclusionDirect stenting is an effective and safe option for ICAS-related ALVO. Further studies are needed to confirm that endovascular treatments are effective and safe in patients with ALVO and underlying ICAS. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 30, 2020 Category: Neurology Source Type: research

A  Novel Imaging Grading Biomarker for Predicting Hearing Loss in Acoustic Neuromas
AbstractPurposeThe aim of this study was to investigate an imaging biomarker based on contrast enhanced T1-weighted and T2-weighted magnetic resonance imaging (MRI) to determine the hearing loss related to acoustic neuromas (AN).MethodsIn this retrospective study, 441 acoustic neuromas treated with microsurgery were included. The diagnostic and follow-up MRI and audiometry of these patients were compared.ResultsWe discovered a  new MRI grading biomarker based on the percentage of tumor filling the inner auditory canal (TFIAC classification). The area under the receiver operating characteristics (AUROC) curve was highe...
Source: Clinical Neuroradiology - July 27, 2020 Category: Neurology Source Type: research

Detection of Coalescent Acute Mastoiditis on MRI in Comparison with CT
ConclusionThe MRI did not miss coalescent mastoiditis but was inferior to CT in direct estimation of bone defects. When enhancement and diffusion characteristics are also considered, MRI enables dividing patients into low, intermediate and high-risk categories with respect to coalescent mastoiditis, where only the intermediate risk group is likely to benefit from additional CT. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 21, 2020 Category: Neurology Source Type: research

Drug-Coated Balloon Treatment in Symptomatic Intracranial High Grade Stenosis
ConclusionThis DCB-PTA cohort study showed a  relatively low intracranial complication rate of 6% with a symptomatic recurrence rate of 12%. Larger trials are needed to validate these promising observations. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 20, 2020 Category: Neurology Source Type: research

Imaging in Pediatric Multiple Sclerosis
AbstractPediatric-onset multiple sclerosis (POMS) is defined by a  first multiple sclerosis (MS) attack occurring before 18 years old and is diagnosed by demonstration of dissemination in time (DIT) and space (DIS). Although guidelines evolved over the years, they always recognized the importance of magnetic resonance imaging (MRI) for diagnosis. The 2017 McDona ld criteria are increasingly used and have been validated in several cohorts. The use of MRI is the most important tool for the early diagnosis, monitoring, and assessment of treatment response of MS and standard protocols include precontrast and postcont...
Source: Clinical Neuroradiology - July 16, 2020 Category: Neurology Source Type: research

Modeling the Optimal Transportation for Acute Stroke Treatment
ConclusionOur study showed a  considerable impact of the diurnal variations in traffic rate and direction of travel on optimal stroke transportation. Stroke systems of care should take real time traffic information into account. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 16, 2020 Category: Neurology Source Type: research

Anterior Cranial Fossa Dural Arteriovenous Fistulae – Angioarchitecture and Intervention
ConclusionThe DAVFs of the ACF are inherently high-grade lesions. Transorbital ECA-ICA branch anastomoses may be recruited as feeders. They may be best managed by multidisciplinary means personalized on an angioarchitectural basis. Endovascular embolization is safe and efficacious when performed through a  navigable feeder from the frontal division of the MMA, which according to our interpretation is in anastomosis with the anterior falcine branch of the anterior ethmoidal artery. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 14, 2020 Category: Neurology Source Type: research

New Concept of Patient-specific Flow Diversion Treatment of Intracranial Aneurysms
ConclusionOur results show that there is a  technically feasible concept, which enables a more specific adjustment of functional FD parameters and more effective intra-aneurysmal flow reduction. This could potentially lead to improvements in the efficacy of aneurysm occlusion in cases with challenging fluid dynamics. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 10, 2020 Category: Neurology Source Type: research

Embolic Stroke of Undetermined Source and Carotid Intraplaque Hemorrhage on MRI
ConclusionPatients with ESUS have IPH in the carotid artery ipsilateral to the ischemic stroke in 25.8% of cases. Carotid artery vessel wall MRI should be considered as part of the standard work-up in patients with ESUS. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 9, 2020 Category: Neurology Source Type: research

High-Degree Middle Cerebral Artery Stenosis
ConclusionThe 3D DSA-MRI fusion technique enables visualization of the LSA orifice and MCA plaque and their spatial relationships. This classification of the type of spatial relationships can provide insights into the pathogenesis of MCA stroke and useful guides for treatment strategies. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 2, 2020 Category: Neurology Source Type: research

Initial Raymond –Roy Occlusion Classification but not Packing Density Defines Risk for Recurrence after Aneurysm Coiling
ConclusionIndependent risk factors for aneurysm recurrence after coil embolization with and without stent or balloon assistance were aneurysm diameter and postinterventional grading within the modified Raymond-Roy occlusion classification. Packing density interacted with the latter and was not independently associated to recurrence. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - July 1, 2020 Category: Neurology Source Type: research

Immediate Abnormal Intrinsic Brain Activity Patterns in Patients with End-stage Renal Disease During a  Single Dialysis Session
ConclusionESRD patients showed changed spontaneous brain activity and cognitive impairments. After a single HD session, patients performed better in neuropsychological test, and spontaneous brain activity changed in left putamen. Ultrafiltration volume might be associated with activity of left putamen. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - June 29, 2020 Category: Neurology Source Type: research

Acute Ischemic Stroke Hemorrhagic Transformation at Angiography Before Mechanical Thrombectomy
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - June 16, 2020 Category: Neurology Source Type: research

Roadmap-assisted V3 Vertebral Artery Interventional Approach to the Basilar Artery
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - June 16, 2020 Category: Neurology Source Type: research

Evaluation After Cochlear Implant Surgery
ConclusionThe use of FDCT is a  reliable diagnostic method to determine the position of the electrode array. In our study cohort, the electrode position had no significant impact on postoperative outcome except for non-deconvoluted electrode arrays. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - June 15, 2020 Category: Neurology Source Type: research

Deep Cerebral Venous Thrombosis Treatment
ConclusionAnticoagulation is an effective treatment strategy for deep CVT; however, patients with intracranial hemorrhage at presentation often have poorer outcomes and early endovascular strategies could be considered in this subgroup. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - June 11, 2020 Category: Neurology Source Type: research

Mechanical Thrombectomy in Acute Ischemic Stroke Using a  Manually Expandable Stent Retriever (Tigertriever)
ConclusionThe Tigertriever offers a  safe and effective treatment option in ischemic stroke due to LVOs with reperfusion rates and a safety profile similar to alternative devices. The Tigertriever is a promising bail-out tool in complex cases. Its role as a first line device has to be evaluated in further prospective studies. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - June 11, 2020 Category: Neurology Source Type: research

Optic Strut and Tuberculum Sellae as Reliable Radiological Landmarks to Predict Intradural Location of Paraclinoid Aneurysms in CT Angiography
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - June 3, 2020 Category: Neurology Source Type: research

Endovascular Treatment of a  Direct Carotid Cavernous Sinus Fistula with the Woven EndoBridge Aneurysm Embolization System
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - May 30, 2020 Category: Neurology Source Type: research

3D-Visualization of Neurovascular Compression at the Ventrolateral Medulla in Patients with Arterial Hypertension
This study aimed to generate, analyze and compare different results of exact reproducible anatomical 3D-representations of the VLM in patients with HTN, based on magnetic resonance imaging (MRI).MethodsA  3T scanner provided MRI (T2-constructive interference in steady state (CISS) high resolution imaging and three-dimensional Time-of-flight (3D-TOF) angiography) from the posterior fossa of 44 patients with clinical treatment-resistant HTN. Image processing consists of segmentation of the CISS data , registration and fusion of the CISS and TOF data and visualization. For each patient two 3D-visualizations (before ...
Source: Clinical Neuroradiology - May 27, 2020 Category: Neurology Source Type: research

Freiburg Neuropathology Case Conference
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - May 25, 2020 Category: Neurology Source Type: research

Solitaire Stentectomy Using a  Stent-Retriever Technique in a Porcine Model
ConclusionStentectomy of inadvertently detached Solitaire devices using different stent retrievers is a  feasible and effective method. Rescue rates and times with the Trevo ProVue, EmboTrap II and 3D revascularization device were comparable. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - May 18, 2020 Category: Neurology Source Type: research

Long-term Kinetic Papilledema Improvement After Venous Sinus Stenting in Idiopathic Intracranial Hypertension
AbstractBackground and PurposeThe aim of this study was to assess the safety and effectiveness of lateral sinus stenosis (LSS) stenting in patients with idiopathic intracranial hypertension (IIH) who are refractory to medical treatment, particularly focusing on visual outcomes including papilledema.Material and MethodsRetrospective study of consecutive patients with IIH refractory to medical treatment who underwent LSS stenting. Clinical features, visual fields and optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thicknesses were assessed before stenting, at 1 month poststen...
Source: Clinical Neuroradiology - May 12, 2020 Category: Neurology Source Type: research

Stent-Assisted Coiling Using Leo+ Baby Stent
ConclusionThe results confirm that stent-assisted coiling with the Leo+ Baby stent is safe and efficient for treatment of wide neck or recurrent cerebral aneurysms. Spontaneous progressive aneurysm occlusion over 6  months supports the theory of considerable flow-modulating effects of Leo+ Baby. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - May 8, 2020 Category: Neurology Source Type: research

Primary Olfactory Neuroblastoma Masquerading as a  Pituitary Adenoma
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - May 8, 2020 Category: Neurology Source Type: research

Cangrelor and Stenting in Acute Ischemic Stroke
ConclusionCangrelor might be a  safe and effective antiplatelet medication owing to its on/off activity for acute stenting in the setting of acute ischemic stroke. Further investigations through randomized studies with larger samples are necessary. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - May 7, 2020 Category: Neurology Source Type: research

Notf ällige Neurointerventionen, Covid-19 und Thorax-CT: SOP und Literaturübersicht
ZusammenfassungZielsetzungAnalyse der „standard operating procedures“ (SOP) von Bildgebung und Interventionen beim akuten Schlaganfall während der Coronavirus-disease-2019(COVID-19)-Pandemie. Bestimmung des Stellenwerts der Computertomographie (CT) des Thorax innerhalb eines multimodalen Schlaganfallprotokolls.MethodenÜber den E‑Mail-Verteiler wurde ein Fragebogen an Mitglieder des Berufsverbands Deutscher Neuroradiologen e. V. verschickt. Stärken und Grenzen der Thorax-CT werden diskutiert.ErgebnisseEs gingen Antworten aus 25 Abteilungen ein. Elf Abteilungen f ühren eine Thorax-CT durch, ...
Source: Clinical Neuroradiology - May 7, 2020 Category: Neurology Source Type: research

The Central Dot Sign
ConclusionThe central dot sign is not sensitive but highly specific for ISCMs compared to primary spinal cord masses. The rim and/or flame signs may or may not be concurrently present in ISCMs. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - May 7, 2020 Category: Neurology Source Type: research

A  Rare Case of Glioneuronal Tumor with Neuropil-like Islands in the Spinal Cord
(Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - May 7, 2020 Category: Neurology Source Type: research

Simulation Training in Neuroangiography —Validation and Effectiveness
In this study 4 experts and 6 beginners performed 10  diagnostic angiographies on the VIST simulator (Mentice AB, Gothenburg, Sweden). Of the cases four were non-recurring, whereas three were repeated once and ten subjects performed all tasks. Additionally, another expert performed only five non-recurring cases. The simulator recorded total time, flu oroscopy time, amount of contrast medium and number of material changes. Furthermore, gaze direction and heart rate were recorded, and subjects completed a questionnaire on workload.ResultsBeginners and experts showed significant differences in total duration time, f...
Source: Clinical Neuroradiology - April 17, 2020 Category: Neurology Source Type: research

Presurgical Localization of the Primary Sensorimotor Cortex in Gliomas
This study was carried out to determine: 1)  how often fMRI adds to prediction of motor risks beyond expert neuroradiological review, 2) success rates of presurgical resting and task-based sensorimotor mapping, and 3) the impact of accelerated resting fMRI acquisitions on network detectability.MethodsData were collected at 2 centers from 71  patients with a primary brain tumor (31 women; mean age 41.9 ± 13.9 years) and 14 healthy individuals (6 women; mean age 37.9 ± 12.7 years). Preoperative 3T MRI included anatomical scans and resting fMRI ...
Source: Clinical Neuroradiology - April 9, 2020 Category: Neurology Source Type: research

Carotid Stenting as Definitive Treatment for Free Floating Thrombus —Review of 7 Cases
ConclusionFree floating thrombus of the carotid arteries can be managed with stenting. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - March 27, 2020 Category: Neurology Source Type: research

Coiling of the Internal Carotid Artery is Associated with Hypertension in Patients Suspected of Stroke
ConclusionThe main finding of this study was the significant association of hypertension with coiling of the ICA and the absence of an association with age, plaques and atherosclerotic risk factors other than hypertension. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - March 18, 2020 Category: Neurology Source Type: research

Absence of T1 Hyperintensity in the Brain of High-risk Patients After Multiple Administrations of High-dose Gadobutrol for Cardiac Magnetic Resonance
ConclusionThis article describes the lack of increased SI in T1-weighted MR images after repeated administration of gadobutrol for cardiovascular MR studies in a  high-risk population (high dose per scan, iron overload that can facilitate the transmetalation of gadolinium) scanned at 3 T and 1.5 T. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - March 17, 2020 Category: Neurology Source Type: research

Reliability of Bony Landmarks to Predict Intradural Location of Paraclinoid Aneurysms
ConclusionThe results of the study showed several disagreements when using the OS landmark. More importantly, several aneurysms were considered as extradural with at least one of these two CT bony landmarks, even though they were all associated with an SAH. More reliable and accurate landmarks are warranted. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - March 13, 2020 Category: Neurology Source Type: research

Different Rescue Approaches of Migrated Woven Endobridge (WEB) Devices: an Animal Study
ConclusionRescue of migrated WEB devices is a  feasible and effective method and 100% successful rescue rates and appropriate rescue times can be achieved for small WEBs using RCs and for larger WEBs using dedicated rescue devices (Microsnare and Alligator). (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - March 12, 2020 Category: Neurology Source Type: research

Validity of SyMRI for Assessment of the Neonatal Brain
ConclusionThe T1-weighted and T2-weighted images generated by SyMRI showed a  diagnostic accuracy comparable to that of conventionally acquired contrasts. In addition to semiquantitative imaging data, SyMRI provides diagnostic images and leads to a more efficient use of available imaging time in neonatal brain MRI. (Source: Clinical Neuroradiology)
Source: Clinical Neuroradiology - March 11, 2020 Category: Neurology Source Type: research