BACKGROUND AND PURPOSE: Multidetector row CTA has become the primary imaging technique for detecting intracranial aneurysms. Technical progress enables the use of cerebral CTA with lower radiation doses and contrast media. We evaluated the diagnostic accuracy of 80-kV(peak) cerebral CTA with 30 mL of contrast agent for detecting intracranial aneurysms.
BACKGROUND AND PURPOSE: Reduction of CT tube current is an effective strategy to minimize radiation load. However, tube current is also a major determinant of image quality. We investigated the impact of CTA tube current on spot sign detection and diagnostic performance for intracerebral hemorrhage expansion.
BACKGROUND AND PURPOSE: Idiopathic intracranial hypertension has been associated with dural venous sinus stenosis in some patients, but the hemodynamic environment of the dural venous sinuses has not been quantitatively described. Here, we present the first such computational fluid dynamics model by using patient-specific blood pressure measurements.
BACKGROUND AND PURPOSE: Asymptomatic carotid stenosis of ≥70% increases the incidence of microembolism and/or chronic hypoperfusion, which may consequently impair neurocognition and brain connections. We sought controlled evidence for any cognitive benefit of aggressive medical therapy and combined carotid revascularization.
Introduction: Injuries to the internal carotid artery close to the cavernous sinus may result in a fistulous connection between the artery and the venous sinus. Symptoms include pulsatile tinnitus, intracranial bruit, ophthalmological symptoms, and risk of intracerebral hematoma in cases of cortical venous reflux. Previous treatment strategies have included detachable latex balloons, coils, covered stents, or combinations thereof. Today, detachable latex balloons are phased out or withdrawn from several markets. Acrylic glue is a proven stable material used for embolization of arteriovenous shunts. It is a precise, fast, and cost-effective method of endovascular embolization, and it does not cause artifacts on MRI or MRA.
Background: Many studies investigating long-term vascular disease risk associated with hypertensive pregnancies examined risks in relatively young women among whom vascular disease is uncommon. We examined the prospective relation between a history of hypertension during pregnancy and coronary heart disease (CHD) and stroke in middle-aged UK women.
Aims: Previous case series have detected silent brain infarctions in as many as one-third of patients after carotid endarterectomy (CEA) and in up to two-thirds of patients after carotid angioplasty and stenting (CAS). Sonolysis employs ultrasound to facilitate disruption of thrombi and has been shown to be safe and effective for improving long-term outcomes following acute stroke. Here, we examined whether intraoperative sonolysis alters the risk of new brain ischaemic lesions during CEA or CAS.
Background: Carotid stiffening is considered a key element in the pathogenesis of stroke. However, results of studies evaluating the association between carotid stiffness and incident stroke have been inconsistent.
The unmet need for development of new stroke therapies is enormous. Evidence generated from positive, null, or negative preclinical studies for various therapeutic agents is crucial to enhancing scientific progress. The scientific community shares a societal responsibility to practice and promote meticulous conduct and reporting of all experimental studies. A systematic survey conducted by the UK government–sponsored National Center for the Replacement, Refinement, and Reduction of Animals in Research (NC3Rs) reported that only 59% of biomedical animal studies stated the hypotheses and objectives, and ≤87% did not use randomization.1 This, in part, led to the development of the Animals in Research: Reporting In Vivo Experiments (ARRIVE) guidelines,2 modeled after the CONSORT (Consolidated Standards for Reporting Trials) statements.3
Like many disorders, the incidence of arterial ischemic stroke (AIS) throughout life is represented by a U-shaped curve. The peripartum period carries the highest risk, whereas people from 29 days to 18 years have the lowest risk. The incidence then gradually increases from adolescence to old age. Furthermore, the mechanisms of AIS are also age dependent. Placental–cerebral embolism is the most widely accepted hypothesis in perinatal AIS, whereas long-standing and diffuse arterial disease (namely, atherosclerosis) is the leading cause in adults.
Background and Purpose: Clinical identification of stroke in the pediatric emergency department is critical for improving access to hyperacute therapies. We identified key clinical features associated with childhood stroke or transient ischemic attack compared with mimics.
Background and Purpose: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic form of cerebral small vessel disease leading to early-onset stroke and dementia, with younger patients frequently showing subclinical deficits in cognition. At present, there are no targeted cognitive screening measures for this population. However, the Brief Memory and Executive Test (BMET) and the Montreal Cognitive Assessment (MoCA) have shown utility in detecting cognitive impairment in sporadic small vessel disease. This study assesses the BMET and the MoCA as clinical tools for detecting mild cognitive deficits in CADASIL.
Introduction: Aphasia significantly affects the individual, families, and communities. Timely, effective intervention is vital. Speech and language therapy (SLT) is a complex rehabilitation intervention targeting improvement in language and communication abilities (verbal comprehension, spoken language, reading, writing), activity, and participation. Therapy may vary in intervention regimen, theoretical approach, or delivery model.
Background and Purpose: Intra-arterial treatment by means of retrievable stents has been proven safe and effective. In MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), the choice of the type of thrombectomy device was left to the discretion of the interventionist. The aim of this study was to explore the differences in functional outcome, neurological recovery, reperfusion, extent of infarction, and adverse events according to stent type and make.
The recent REVASCAT trial (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within 8 Hours of Symptom Onset)1 is the latest of 5 published Prospective Randomized Open Blinded End-Point (PROBE)-designed trials of acute thrombectomy for acute, anterior circulation, large-vessel ischemic stroke serving to cap the era of equipoise for endovascular stroke therapy.2–5 The history of endovascular stroke therapy has recently been summarized.6 Following the null result of the Interventional Management of Stroke (IMS)-III trial published in 2013,7 the field transitioned to more effective removable stent (stentriever) device design8,9 and use of imaging selection (principally computed tomographic angiography with or without perfusion) rather than clinical examination. The recent 5 trials were designed around this evolution (a 6th trial has been stopped for efficacy but not yet published10).
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