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J Belg Soc Radiol 2022 26;106(1):18. Epub 2022 Apr 26.

Sana Klinikum Duisburg, DE.

Purpose: To evaluate the detection rate of intracranial aneurysms on reconstructed thin slice non enhanced CT (NECT) scans.

Methods: NECT scans from 34 patients with 35 aneurysms and 35 individuals without aneurysms were collected. Thin slice maximum intensity projections of the NECT scans were reconstructed. Read More

J Neurointerv Surg 2022 May 17. Epub 2022 May 17.

Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria.

Treatment of wide-necked complex intracranial aneurysms continues to challenge neurointerventionalists. Intrasaccular flow diverters have expanded the armamentarium considerably and are now used extensively. While five types of devices have already obtained the CE mark for use within Europe, only the Woven EndoBridge (WEB) device is approved by the US Food and Drug Administration. Read More

Br J Neurosurg 2022 May 17:1-4. Epub 2022 May 17.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.

Aneurysms of the basilar trunk represent an exceptional challenge to the neurosurgeon, due to high mortality and surgical morbidity. We present a 69-year-old man with a giant dolichoectatic thrombotic basilar trunk aneurysm (BTA), who underwent right orbitozygomatic craniotomy, posterior cerebral artery (PCA) to right middle cerebral artery (MCA) bypass and trapping of the BTA. Unfortunately, patient died after surgery due to multiple foci of intraparenchymal haemorrhage and thrombosis of a short segment proximal to aneurysm trapped and his body was donated to the hospital, giving us the unique opportunity to compare intraoperative details with anatomical dissection findings, according to our previously published cadaveric neurosurgical research. Read More

J Neurointerv Surg 2022 May 13. Epub 2022 May 13.

Service de Neuroradiologie Diagnostique et Interventionnelle, Centre Hospitalier Universitaire de Nantes, Nantes, France.

Background: Geometrical parameters, including arterial bifurcation angle, tortuosity, and arterial diameters, have been associated with the pathophysiology of intracranial aneurysm (IA) formation. The aim of this study was to investigate whether these parameters were present before or if they resulted from IA formation and growth.

Methods: Patients from nine academic centers were retrospectively identified if they presented with a de novo IA or a significant IA growth on subsequent imaging. Read More

World Neurosurg 2022 May 13. Epub 2022 May 13.

Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University; Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China; Department of Neurosurgery, Tianjin Central Hospital for Neurosurgery and Neurology, Tianjin, China; Laboratory of Microneurosurgery, Tianjin Neurosurgical Institute, Tianjin, China; Tianjin Key Laboratory of Cerebral Vascular and Neural Degenerative Diseases, Tianjin, China. Electronic address:

Objective: The optimal management of giant internal carotid aneurysms (GICAs) is disputed due to their low incidence. This study presents the experience of the internal carotid artery (ICA) constriction therapeutic management of GICAs.

Methods: This is a retrospective cohort study involving analysis of data from medical histories and follow-up of 14 GICAs patients. Read More

Cureus 2022 Apr 13;14(4):e24102. Epub 2022 Apr 13.

Neurology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.

Intracranial aneurysms are typically asymptomatic. They are usually incidentally detected or detected only after rupture. Ischemic stroke or transient ischemic attack (TIA) due to unruptured intracranial aneurysms (UIAs) is rare. Read More

Polymers (Basel) 2022 Apr 26;14(9). Epub 2022 Apr 26.

Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China.

Rapid formation of innovative, inexpensive, personalized, and quickly reproducible artery bioresorbable stents (BRSs) is significantly important for treating dangerous and sometimes deadly cerebrovascular disorders. It is greatly challenging to give BRSs excellent mechanical properties, biocompatibility, and bioabsorbability. The current BRSs, which are mostly fabricated from poly-l-lactide (PLLA), are usually applied to coronary revascularization but may not be suitable for cerebrovascular revascularization. Read More

Cardiovasc Intervent Radiol 2022 May 13. Epub 2022 May 13.

Neuroradiologische Klinik, Kopf- und Neurozentrum, Klinikum Stuttgart, Stuttgart, Germany.

Purpose: To assess the safety and short-term occlusion rates in procedures using the p64 MW hydrophilic polymer-coated (HPC) flow diverter (FD) with prasugrel single antiplatelet therapy (SAPT) for the treatment of anterior circulation saccular aneurysms.

Methods: We retrospectively identified patients who underwent treatment of one or more intracranial anterior circulation saccular aneurysms between March 2020 and December 2021 with a p64 MW HPC FD and prasugrel SAPT with verified P2Y12 platelet receptor inhibition. Patients diagnosed with fusiform, dissecting, or recently ruptured aneurysms were excluded. Read More

Brain Neurol Disord 2022 14;5(1). Epub 2022 Mar 14.

Division of Gastroenterology, Hepatology and Nutrition, College of Medicine, University of Florida, USA.

Rupture of an aneurysm is the leading cause of subarachnoid hemorrhage (SAH) which results in accumulation of blood between the arachnoid and pia mater, consequently increasing intracranial pressure. This often results in life threatening conditions like herniation or clinical presentations including focal neurological deficits. In children, these events, although rare, have significant implications. Read More

Korean J Neurotrauma 2022 Apr 14;18(1):45-55. Epub 2022 Feb 14.

Department of Neurosurgery, Seoul Medical Center, Seoul, Korea.

Objective: The goal of the present study was to identify factors related to the growth and growth patterns of unruptured intracranial aneurysms (UIAs).

Methods: Between January 2011 and December 2018, a total of 275 patients were diagnosed with UIAs in our institution. Of them, 91 patients were evaluated using computed tomography angiography, magnetic resonance angiography, or digital subtraction angiography. Read More

World Neurosurg 2022 May 9. Epub 2022 May 9.

Department of Neurology, Neurovascular Division, University of California San Francisco.

Background: Methamphetamine (MA) use is associated with poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). MA exerts both hemodynamic and inflammatory effects, but whether these manifest with altered intracranial aneurysm (IA) remodeling is unknown. The objective of this study was to compare IA geometric and morphologic features in patients with and without MA detected on urine toxicology (Utox) at presentation. Read More

J Clin Anesth 2022 May 9:110828. Epub 2022 May 9.

Department of Anesthesiology, Showa University Hospital, Tokyo, Japan.

Aerosp Med Hum Perform 2022 May;93(5):450-457

With improved imaging technology, the number of incidental findings detected in cerebral MRI is increasing. This is a challenge that the German Air Force has to deal with in the context of standardized MRI examinations of young pilot candidates and pilots. The German Air Force Centre of Aerospace Medicine hosted a 2-d conference to develop recommendations and procedures for the handling of some of the most frequently encountered cerebral incidental findings. Read More

Clin Neuroradiol 2022 May 13. Epub 2022 May 13.

Department of Neuroradiology, Sorbonne University. APHP. Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France.

Objective: To evaluate the feasibility, safety, and rate of radial artery occlusion (RAO) after the treatment of intracranial aneurysms using a 6F Neuron MAX (Penumbra, Alameda, CA, USA) long sheath directly into the radial artery.

Methods: All consecutive patients treated for unruptured intracranial aneurysms with TRA using a 6F Neuron MAX catheter between September 2019 and May 2021 in a single tertiary center were screened. They were referred to a consultation and an ultrasound-Doppler assessment of the radial artery 3 months after treatment with the attending neuroradiologist. Read More

J Neurointerv Surg 2022 May 12. Epub 2022 May 12.

Lyerly Neurosurgery, Baptist Medical Center Downtown, Jacksonville, Florida, USA.

Background: The Surpass flow diverter was developed to treat intracranial aneurysms not amenable to standard treatment. Indications for use allow placement in the internal carotid artery to the terminus, including the communicating artery segment.

Methods: The Surpass Intracranial Aneurysm Embolization System Pivotal Trial to Treat Large or Giant Wide Neck Aneurysms (SCENT) trial is an international, multicenter, prospective, non-randomized trial comparing the outcomes of Surpass flow diverter treatment with historic control designed to evaluate the effectiveness and safety of Surpass for the treatment of wide neck (≥4 mm) large or giant intracranial aneurysms ≥10 mm. Read More

Front Neurol 2022 25;13:868652. Epub 2022 Apr 25.

Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

Objective: This study aimed to determine the ruptured rate and hemodynamic difference between wide-neck aneurysms (WNAs) and narrow-neck aneurysms (NNAs), as well as the hemodynamic parameters of risk factors for aneurysm rupture.

Methods: A total of 121 cases of intracranial aneurysms (IAs) were studied retrospectively between January 2019 and April 2021 at Renmin Hospital of Wuhan University. Intracranial aneurysms were classified into four types: ruptured wide-neck aneurysms (RWNAs), unruptured wide-neck aneurysms (UWNAs), ruptured narrow-neck aneurysms (RNNAs), and unruptured narrow-neck aneurysms (UNNAs). Read More

Cardiol Young 2022 May 12:1-10. Epub 2022 May 12.

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Objectives: To define the frequency and characteristics of acute neurologic complications in children hospitalised with infective endocarditis and to identify risk factors for neurologic complications.

Study Design: Retrospective cohort study of children aged 0-18 years hospitalised at a tertiary children's hospital from 1 January, 2008 to 31 December, 2017 with infective endocarditis.

Results: Sixty-eight children met Duke criteria for infective endocarditis (43 definite and 25 possible). Read More

Neurosurg Rev 2022 May 12. Epub 2022 May 12.

Department of Neurosurgery, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.

Aneurysm occlusion rate after clipping is higher than after endovascular treatment. However, a certain percentage of incompletely clipped aneurysms remains. Presurgical selection of the proper aneurysm clips could potentially reduce the rate of incomplete clippings caused by inadequate clip geometry. Read More

Stroke 2022 May 12:101161STROKEAHA121036567. Epub 2022 May 12.

Department of Neurology, Washington University School of Medicine, St. Louis, MO. (Y.W., S.F., M.M.B., Y.C., H.A., J.-M.L., A.L.F.).

Background: Individuals with sickle cell anemia have heightened risk of stroke and cognitive dysfunction. Given its high prevalence globally, whether sickle cell trait (SCT) is a risk factor for neurological injury has been of interest; however, data have been limited. We hypothesized that young, healthy adults with SCT would show normal cerebrovascular structure and hemodynamic function. Read More

Interv Neuroradiol 2022 May 11:15910199221100962. Epub 2022 May 11.

Rady Faculty of Health Sciences, Radiology Department, 8664University of Manitoba, Winnipeg, MB, Canada.

Background: Intraoperative magnetic resonance imaging system (iMRIS) surgical theatre is a highly integrated operating room with an intraoperative magnetic resonance imaging (iMRI) designed originally for brain tumour surgery. Its use in neurointerventional procedures, particularly in the setting of endovascular coiling of intracranial aneurysms, has not been discussed in the literature to date. We present our initial experience about the safety and feasibility of iMRI to assess post operative complications and provide baseline imaging post coiling of intracranial aneurysms. Read More

Sci Rep 2022 May 10;12(1):7659. Epub 2022 May 10.

Department of Neurology, Peking University Third Hospital, No. 49, North Garden Rd., Haidian District, Beijing, 100191, China.

We aimed to investigate the causality between potentially modifiable risk factors and the risk of intracranial aneurysm. Genetic instruments for 51 modifiable factors and intracranial aneurysm data were obtained from recently published genome-wide association studies. We applied two-sample Mendelian randomization methods to investigate their causal relationships. Read More

J Neurosurg 2022 Apr 29:1-8. Epub 2022 Apr 29.

1Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; and.

Objective: Stent-assisted coil (SAC) embolization has been the mainstay endovascular treatment for bifurcation aneurysms. The recent introduction of the Woven EndoBridge (WEB) device has presented an alternative endovascular treatment modality for these aneurysms. Direct comparisons of outcomes between these two modalities are limited in the literature. Read More

J Neurosurg 2022 Apr 29:1-9. Epub 2022 Apr 29.

Objective: Giant cerebral cavernous malformations (GCCMs) are rare vascular malformations. Unlike for tumors and aneurysms, there is no clear definition of a "giant" cavernous malformation (CM). As a result of variable definitions, working descriptions and outcome data of patients with GCCM are unclear. Read More

BMJ Case Rep 2022 May 9;15(5). Epub 2022 May 9.

Internal Medicine, University of Pittsburgh Medical Center Health System, McKeesport, Pennsylvania, USA.

A Caucasian man in his 60s with a medical history significant for ruptured left middle cerebral artery aneurysm status post clipping 2005 with residual right eye blindness and right leg weakness with gait instability presented with loss of balance, weakness of his legs and fatigue for 3 days. No other antecedent event was identified other than receiving Moderna COVID-19 vaccine 4 weeks before the presentation and 3 days before symptom onset. CT head and CT angiogram of the head and neck were performed and demonstrated no acute intracranial bleeding and no vascular abnormalities. Read More

World Neurosurg 2022 May 6. Epub 2022 May 6.

Medical Rehabilitation Research Center, Moscow, Russia.

Neurol India 2022 Mar-Apr;70(2):814-815

Department of Neurosurgery, Erciyes University School of Medicine, Kayseri, Turkey.

Neurol India 2022 Mar-Apr;70(2):643-651

Department of Radiodiagnosis (Former Neuroradiology Fellow), Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Background: Wide-neck intracranial aneurysms need additional devices like balloons or stent for management. Balloon-assisted coiling has evolved both with interventionalist experience and device modifications.

Objective: We discussed our experience, evolution, and complications with this novel technique. Read More

Neurol India 2022 Mar-Apr;70(2):504-509

Department of Neurosurgery, SGPGIMS, Lucknow, Uttar Pradesh, India.

Background: Anterior clinoidectomy for aneurysm clipping is generally performed intradurally. Despite obvious advantages, accidental drill slippage or indirect damage from heat and bone dust remain major drawbacks.

Objective: To demonstrate the surgical technique and utility of a combined extra- and intra-dural clinoidectomy in the clipping of dorsal wall paraclinoid internal carotid artery aneurysm. Read More

Neuroradiol J 2022 May 9:19714009221096818. Epub 2022 May 9.

Department of Neuroscience, Neuroradiological Unit, University of Turin, Azienda Ospedaliera Città della Salute e della Scienza Hospital, Turin, Italy.

In-stent caliber reduction due to neo-intimal hyperplasia (NIH) is an underestimated event that may follow flow diverter stent (FDS) implantation. Although mostly asymptomatic, this vascular reaction is a well-known risk factor for delayed ischemic strokes. Here we report on the contribution of magnetic resonance vessel wall imaging (MR-VWI), performed on a 1. Read More

Brain Behav 2022 Apr 5:e32568. Epub 2022 Apr 5.

Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Background: Aneurysm wall enhancement on high-resolution vessel wall imaging (HR-VWI) may represent vessel wall inflammation for unruptured intracranial aneurysms (UIAs). Further evidence for the role of circumferential aneurysm wall enhancement (CAWE) in evaluating the instability of UIAs is required, especially in small aneurysms (<7 mm).

Methods: We analyzed patients with saccular UIAs who prospectively underwent HR-VWI on a 3. Read More