Background: In the endovascular treatment of wide-necked unruptured aneurysms, there is controversy over which adjunctive device (stent vs balloon) is appropriate. At the payer level it has been posited that stents and balloons treat the same aneurysms, and, as such, the more expensive stents should not be reimbursed.
Stroke is a leading cause of morbidity and mortality and the most significant source of disability in the United States. Patients with recent transient ischemic attacks or stroke and significant intracranial stenosis are at particularly high risk of recurrent stroke. Recent trials have demonstrated that although outcomes for stroke patients are improving with aggressive medical therapy,1-3 the overall long-term prognosis is poor.
Background: Surgical treatments for deep-seated intracranial lesions have been limited by morbidities associated with resection. Real-time magnetic resonance imaging–guided focused laser interstitial thermal therapy (LITT) offers a minimally invasive surgical treatment option for such lesions.
Background: Stereotactic radiosurgery (SRS) to the resection bed of a brain metastasis is an important treatment option.
Background and Purpose: None of the randomized trials of intravenous tissue-type plasminogen activator reported vascular imaging acquired before thrombolysis. Efficacy of tissue-type plasminogen activator in stroke without arterial occlusion on vascular imaging remains unknown and speculative.
Background and Purpose: Unruptured intracranial aneurysms are increasingly being detected and are a notable healthcare burden. We investigated the long-term natural history of unruptured intracranial aneurysms and risk factors predictive of subsequent rupture.
Background and Purpose: Angiographic revascularization grading after intra-arterial stroke therapy is limited by poor standardization, making it unclear which scale is optimal for predicting outcome. Using recently standardized criteria, we sought to compare the prognostic performance of 2 commonly used reperfusion scales.
Background and Purpose: Recanalization status after intravenous thrombolysis (IVT) in patients with ischemic stroke is a reference point to proceed with a rescue reperfusion intervention, although early neurological improvement (NI) may preclude endovascular procedures. We aimed to evaluate the importance of restoration of blood flow at the arterial occlusion site in subgroups of patients with stroke stratified by early NI after IVT.
AIM: To reveal angiographic findings to predict the result of balloon test occlusion (BTO).
Spontaneous, painful vertebral fractures represent an important cause of morbidity and mortality among patients with osteoporosis. Percutaneous vertebroplasty—the injection of medical cement, or polymethylmethacrylate (PMMA) (Parallax Medical, Wilmington, Mass), into the fractured vertebral body—has gained widespread acceptance as a method of pain relief and is a part of routine therapy for osteoporotic vertebral fractures (1).
To evaluate characteristics of delayed ischemic stroke after stent-assisted coil placement in cerebral aneurysms and to determine the optimal duration of dual antiplatelet therapy for its prevention.
To evaluate characteristics of delayed ischemic stroke after stent-assisted coil placement in cerebral aneurysms and to determine the optimal duration of dual antiplatelet therapy for its prevention.
Glutamate-mediated excitotoxicity is one of the pathophysiological mechanisms of spreading brain injury in acute ischemic stroke (1,2). The overactivation of glutamate ionotropic receptors (mainly n-methyl-d-aspartate–NMDA) and metabotropic receptors leads to high intracellular calcium concentrations and initiates the process known as ischemic cascade. Increased levels of extracellular glutamate in acute cerebral ischemia are the result of presynaptic release and the failure of glutamate homeostatic transport system. Excitatory amino acid transporters, which usually uptake extracellular glutamate into neurons, glia, and endothelial cells, can contribute to the release of glutamate from intracellular spaces under ischemic conditions (3–5).
OBJECTIVE. Reducing radiation exposure through the use of low-dose protocols during cerebral endovascular procedures is recommended, but evaluation of the impact on the procedure itself is difficult and subjective. A workflow task analysis could provide an objective comparison of two different radiation exposure protocols.
Background and Purpose: Acute cocaine use has been temporally associated with aneurysmal subarachnoid hemorrhage (aSAH). This study analyzes the impact of cocaine use on patient presentation, complications, and outcomes.
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