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O-042 Incidence of periprocedural stroke with radial access for diagnostic cerebral angiograms
ConclusionIn our experience, transradial access for diagnostic cerebral angiograms was associated with a low but not neglectable incidence of periprocedural strokes when compared to the traditional femoral approach. Patient vascular anatomy should be evaluated prior to selection of vascular access and patients should be made aware of the possibility of a slightly higher possibility of periprocedural stroke with transradial access.Abstract O-042 Table 1 Patient Age Access Vessels catheterized Catheter used Radial Medication Contrast Fluoro Time Platelet Count INR GFR COVID Status Stroke Symptoms NIHSS Imaging performed 1 5...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Kuhn, A., Singh, J., de Macedo Rodrigues, K., Massari, F., Puri, A. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

A Case Report of Dihydroergotamine Administration for Status Migrainosus in a Patient on Longstanding Citalopram Causing a Fatal Reversible Cerebral Vasoconstriction Syndrome (RCVS) (P02.027)
CONCLUSIONS: We report this case report of fatal RCVS of a patient on long standing citalopram who developed this after being administered Dihydroergotamine for status migrainosus. As this is thought to be a self-limiting in terms of clinical features. However, some patients may have more severe focal neurologic symptoms and signs, including ischemic or hemorrhagic strokes as described in our patient.Disclosure: Dr. Asi has nothing to disclose. Dr. Gomes has nothing to disclose. Dr. Dani has nothing to disclose.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Asi, K., Gomes, J., Dani, D. Tags: P02 Cerebrovascular Disease II Source Type: research

Reversible Cerebral Vasoconstriction Syndrome and Fingolimod: Culprit or Innocent Bystander (P2.224)
CONCLUSIONS:Reversible cerebral vasoconstriction syndrome may be a rare complication of Fingolimod treatment and should be considered in patients with new onset thunderclap headache. The mechanism likely involves the effects of Fingolimod on S1P(3) receptors on cerebral arteries.Disclosure: Dr. Fleming has nothing to disclose. Dr. West has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Fleming, J., West, M. Tags: MS and CNS Inflammatory Disease: Treatment Safety Source Type: research

Reversible cerebral vasoconstriction syndrome following carotid stenting
A 60-year-old woman on venlafaxine presented with headache and left-sided weakness 1 month after undergoing right common carotid artery stenting. Catheter-based angiogram identified new irregularities of the right anterior cerebral and right middle cerebral artery (figure, A–C). Investigations for vasculitis, including CSF studies, were unremarkable. The vessel irregularities and symptoms improved after administration of intra-arterial verapamil (figure, D–F). Unilateral reversible cerebral vasoconstriction syndrome has previously been described after carotid endarterectomy. The mechanism is unclear; however, i...
Source: Neurology - August 4, 2014 Category: Neurology Authors: Aghaebrahim, A., Jadhav, A. P., Saeed, Y., Totoraitis, R., Jankowitz, B. T., Jovin, T. G., Molyneaux, B. J. Tags: All Cerebrovascular disease/Stroke, Infarction NEUROIMAGES Source Type: research

Recreational drug use and RCVS: should toxicity screens become standard in RCVS diagnostics? (P2.284)
CONCLUSIONS: As we transition into a new culture of researching marijuana derivatives to treat a multitude of neurologic diseases including pain syndromes, epilepsy, and multiple sclerosis we must also consider the vasoactive properties of the substance and potential vascular complications. This also raises the importance of improving drug screening in such patients with high suspicion of RCVS on admission and identifying high risk patients to prevent further vascular complications. Study Supported by:Disclosure: Dr. Mirchandani has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Wajnsztajn has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Mirchandani, N., Khan, I., Wajnsztajn, F. Tags: Cerebrovascular Disease and Interventional Neurology: RCVS and Malignant Cerebral Edema Source Type: research

The detrimental clinical impact of severe angiographic vasospasm may be diminished by maximal medical therapy and intensive endovascular treatment
Conclusions An intensive endovascular approach of TBA and/or intra-arterial verapamil in combination with induced hypertension for severe aVSP may result in comparable clinical outcomes to those without vasospasm.
Source: Journal of NeuroInterventional Surgery - November 13, 2015 Category: Neurosurgery Authors: Mortimer, A. M., Steinfort, B., Faulder, K., Bradford, C., Finfer, S., Assaad, N., Harrington, T. Tags: Ischemic stroke Source Type: research

The Need for a Rational Approach to Vasoconstrictive Syndromes: Transcranial Doppler and Calcium Channel Blockade in Reversible Cerebral Vasoconstriction Syndrome
Conclusion: Though small, our cohort demonstrates potential utility of TCD to monitor RCVS, and relative superiority of extended-release verapamil over other calcium channel blockers, illustrating the need for larger randomized trials. Case Rep Neurol 2016;8:161 –171
Source: Case Reports in Neurology - July 29, 2016 Category: Neurology Source Type: research

Success of Intravenous Infusion of Verapamil for Refractory Vasospasm in aneurysmal Subarachnoid Hemorrhage (P2.291)
Conclusions:This report indicates that intravenous continuous infusion of verapamil may be used for rescue therapy in transiently responsive cerebral vasospasm to IA verapamil. This therapy did not seem to compromise hemodynamic stability or increase ICP.Disclosure: Dr. Mehta has nothing to disclose. Dr. Kulhari has nothing to disclose. Dr. Z Arango has nothing to disclose. Dr. Suhan has nothing to disclose. Dr. DeCarvalho has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Kirmani has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Mehta, S., Kulhari, A., Arango, A., Suhan, L., DeCarvalho, B., Patel, A., Kirmani, J. F. Tags: Subarachnoid Hemorrhage, Intracranial Aneurysm, and Other Cerebrovascular Malformations Source Type: research

Verapamil-induced breakdown of the blood-brain barrier presenting as a transient right middle cerebral artery syndrome.
We present an interesting case of a verapamil-induced breakdown of the blood-brain barrier and self-limited right MCA syndrome. PMID: 28956514 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - September 30, 2017 Category: Radiology Tags: Interv Neuroradiol Source Type: research

E-060 Endovascular treatment for intracranial giant cell arteritis with angioplasty, stenting, and intra-arterial calcium channel blockers
ConclusionsEndovascular treatment, including PTA (with or without stenting) and CCB infusion, may be effective in medically-refractory GCA with intracranial arterial stenosis but complication rates are considerable. The efficacy of CCB monotherapy implicates vascular smooth muscle dysfunction in the pathogenesis of intracranial GCA.Calcium-channel blocker infusion as monotherapy for intracranial giant cell arteritis. Pre-treatment angiography (lateral right internal carotid artery projection) shows severe focal supraclinoid ICA stenosis (curved white arrow, 1A). Post-verapamil infusion (20mg, 15 min delay) angiogram (1B) s...
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Caton, M., Mark, I., Baker, A., Narsinh, K., Halbach, V., Hetts, S., Cooke, D., Higashida, R., Dowd, C., Smith, W., Amans, M. Tags: Electronic poster abstracts Source Type: research

E-184 Transradial approach for pediatric diagnostic and neurointerventional surgery: single center case series and systematic review
ConclusionsOur results and the literature review demonstrate that the TRA is a safe and feasible option for pediatric patients. Routine use of ultrasound guidance, selection of appropriately sized catheters, and prophylactic use of vasodilators and antispasmodics can help ensure the success of the procedure and limit common access-site complications.Disclosures A. Baig: None. J. Neumaier: None. Y. Hashmi: None. A. Monteiro: None. M. Waqas: None. J. Cappuzzo: None. W. Khawar: None. K. Snyder: 2; C; Canon Medical Systems Corporation, Penumbra Inc., Medtronic, and Jacobs Institute. 4; C; : Boston Scientific, Access Closure In...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Baig, A., Neumaier, J., Hashmi, Y., Monteiro, A., Waqas, M., Cappuzzo, J., Khawar, W., Snyder, K., Levy, E., Siddiqui, A., Reynolds, R., Davies, J. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research