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JAAPA 2018 Apr;31(4):24-26

DJ Fenn practices emergency medicine in Mesa, Ariz. At the time this article was written, he was a postgraduate fellow in otolaryngology and head and neck surgery at the Mayo Clinic Arizona in Phoenix, Ariz. Brittany Howard is a Mayo Clinic Scholar and Joseph Hoxworth practices neuroradiology and is an assistant professor of radiology at the Mayo Clinic Arizona. Annjanette Sommers is an associate professor at Pacific University in Hillsboro, Ore. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Acute calcific longus colli tendinitis is a benign and self-limiting inflammatory disease that rarely requires aggressive intervention. However, clinicians may be unfamiliar with this condition, and it can easily be misdiagnosed for a deep neck abscess or tumor resulting in unnecessary and invasive procedures. This article describes a patient who presented to the ED with progressive odynophagia and neck pain. Read More

J Neurotrauma 2019 Apr 9. Epub 2019 Apr 9.

Johns Hopkins University School of Medicine, Neurology, Baltimore, Maryland, United States ;

Our objective was to examine associations of head injury with total and regional brain amyloid deposition. We performed cross-sectional analyses of 329 non-demented participants (81 with prior head injury) in the Atherosclerosis Risk in Communities-Positron Emission Tomography (ARIC-PET) Study who underwent 18-Florbetapir PET imaging in 2012-2014. A history of head injury was defined by self-report or emergency room/hospitalization ICD-9 codes. Read More

Stroke 2019 Mar 26:STROKEAHA118024050. Epub 2019 Mar 26.

Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston. (J.N.G.).

Background and Purpose- Early hematoma expansion after intracerebral hemorrhage is a potentially modifiable predictor of outcome and a promising therapeutic target. Radiological markers seen on noncontrast computed tomography can help predict hematoma expansion and risk stratify patients presenting with intracerebral hemorrhage. Our objective was to assess the interrater and intrarater reliability of 5 commonly reported noncontrast computed tomographic markers of hematoma expansion. Read More

Epilepsy Behav 2019 Mar 19;94:112-117. Epub 2019 Mar 19.

Department of Neurology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany; Emergency Department, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany. Electronic address:

Introduction: Data on the frequency and clinical relevance of neurogenic pulmonary edema (NPE) following epileptic seizures are limited. The aim of the present study was to analyze computed tomography (CT) examinations in patients with previous seizures.

Method: Incidence of NPE and related clinical factors were retrospectively assessed in patients admitted because of epileptic seizures who underwent thoracic CT imaging as part of emergency diagnostics. Read More

Infez Med 2019 Mar;27(1):97-102

University Department of Pediatrics, Pediatric and Infectious Diseases Unit, Bambino Gesú Children's Hospital, IRCCS, Rome, Italy.

Mild encephalopathy with a reversible splenial lesion (MERS) is an uncommon clinico-radiological entity characterized by magnetic resonance imaging (MRI) findings of a reversible lesion in the splenium of corpus callosum associated with a significant neurological manifestation of encephalopathy. The majority of reported cases involve the Asiatic population and are closely associated with infection. We report the case of an adolescent with an HHV6-related MERS presenting with hyponatremia and urinary and fecal retention. Read More

Front Neurol 2019 27;10:127. Epub 2019 Feb 27.

Department of Radiology and Neuroradiology, Alfried Krupp Krankenhaus Essen, Essen, Germany.

A tandem occlusion of the intracranial circulation and the extracranial carotid artery (ICA) occurs in 10-20% of all strokes based on large vessel occlusion (LVO). The optimal treatment strategy for those patients is unknown. We report our management strategy and the outcome in these patients in a large single-center cohort. Read More

AJNR Am J Neuroradiol 2019 Apr 7;40(4):699-702. Epub 2019 Mar 7.

From the Department of Radiology (M.K.S.H., D.V., J.R.S.), University of British Columbia, Vancouver, British Columbia, Canada.

Dural carotid cavernous fistulas are usually treated via a transvenous approach through the inferior petrosal sinus. Surgical exposure and direct access to the superior ophthalmic vein have been previously described in situations in which conventional transvenous access, including the inferior petrosal sinus, is not possible. In this retrospective study of 20 patients, we report our results of imaging-guided percutaneous superior ophthalmic vein access in dural carotid cavernous fistula treatment. Read More

Clin Radiol 2019 May 28;74(5):390-398. Epub 2019 Feb 28.

Department of Neuroradiology, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, UK. Electronic address:

Aim: To investigate factors that could impact on recanalisation and reperfusion in patients undergoing mechanical thrombectomy and to assess the technical success over time.

Materials And Methods: Two hundred consecutive patients who underwent thrombectomy for a proximal anterior circulation occlusion were dichotomised into equal groups (groups 1 and 2) based on the date that immediate access to emergency general anaesthesia (GA) commenced.

Results: Recanalisation success using thrombolysis in cerebral infarction (TICI) 2b/3 or TICI 2c/3 significantly improved in group 2 (67% versus 93%, p<0. Read More

Insights Imaging 2019 Feb 15;10(1):20. Epub 2019 Feb 15.

Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany.

Muscle injuries of the hip and thigh are a highly relevant issue in competitive sports imaging. The gold standard in diagnostic imaging of muscle injuries is magnetic resonance imaging (MRI). Radiologists need to be familiar with typical MRI findings in order to accurately detect and classify muscle injuries. Read More

Neuroradiology 2019 Apr 15;61(4):443-449. Epub 2019 Feb 15.

Department of Neuroradiology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.

Purpose: There is overwhelming evidence for the clinical benefits that are derived following mechanical thrombectomy in large-vessel acute ischaemic stroke. The risk of stroke is elevated in pregnancy due to many factors. To date, there have been two reports, totalling five patients, who have undergone mechanical thrombectomy in pregnancy, thus demonstrating the feasibility of the procedure; however, there is no data on the radiation exposure to the mother or foetus related to this therapy. Read More

Emerg Radiol 2019 Feb 13. Epub 2019 Feb 13.

Harvard Medical School, Boston, MA, USA.

Visits to the emergency department by patients who have recently undergone neurosurgery are a common occurrence, and these patients frequently receive emergent cross-sectional head imaging in order to evaluate for complications. Different neurosurgical approaches may have typical postoperative imaging findings that can be confused with pathology. Furthermore, particular abnormal postoperative imaging findings may signal an evolving complication. Read More

J Craniomaxillofac Surg 2019 Apr 18;47(4):611-615. Epub 2019 Jan 18.

Department of Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany.

Introduction: Purpose of this study was to evaluate a probable risk of frontal sinus size for traumatic depressed anterior table fractures in patients with similar forehead trauma.

Methods: We conducted a retrospective case-control study with a case group of consecutive treated patients with displaced frontal sinus anterior table fractures. The control group was randomly sampled from patients who presented with a blunt forehead trauma in our institution's emergency unit. Read More

J Neuroimaging 2019 Feb 3. Epub 2019 Feb 3.

Department of Neurology, Saarland University Medical Center, Homburg, Germany.

Background And Purpose: Evaluation of the diagnostic accuracy of optic nerve sheath diameter (ONSD) and Doppler indices of central retinal arteries and veins for the detection of increased intracranial pressure (ICP) in intracerebral hemorrhage (ICH) and of the usefulness of a second assessment of these variables in the monitoring of ICH.

Methods: A total of 46 acute ICH patients with (group 1, n = 25) and without (group 2, n = 21) clinical and radiological computed tomography signs of raised ICP and 40 healthy controls were recruited. The median binocular ONSD and Doppler indices of retinal vessels including resistive index (RI) and retinal venous pulsation (RVP) were compared among groups, both at admission and later during ICH monitoring. Read More

Radiol Clin North Am 2019 Mar 15;57(2):307-318. Epub 2018 Nov 15.

Neuroradiology Division, Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, 30 North, 1900 East, #1A071, Salt Lake City, UT 84132-2140, USA.

Vascular disorders of the spine are more rare than cerebral vascular entities but can result in significant morbidity. These lesions frequently demonstrate distinguishing characteristics by imaging that are imperative for the radiologist to recognize to properly guide diagnosis and treatment. We review distinguishing imaging characteristics for spinal vascular malformations, spinal emergencies, and spinal vascular masses. Read More

JAMA Neurol 2019 Jan 22. Epub 2019 Jan 22.

University of Lorraine, and University Hospital of Nancy, Nancy, France.

Importance: Reperfusion is a key factor for clinical outcome in patients with acute ischemic stroke (AIS) treated with endovascular thrombectomy (EVT) for large-vessel intracranial occlusion. However, data are scarce on the association between the time from onset and reperfusion results.

Objective: To analyze the rate of reperfusion after EVT started at different intervals after symptom onset in patients with AIS. Read More

J Am Coll Radiol 2019 Jan 17. Epub 2019 Jan 17.

Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland. Electronic address:

Purpose: The ACR Appropriateness Criteria recommend performing noncontrast head CT (NCCT) for patients with sudden severe headache ("worst headache of life" [WHOL] or "thunderclap headache" [TCH]). The aim of this study was to assess the value of NCCT scanning in patients with known migraine histories and WHOL or TCH. The hypothesis was that there would be little utility in performing emergency department (ED) NCCT scans in migraineurs without other red flags, even if they had WHOL or TCH. Read More

J Neuroradiol 2019 Jan 15. Epub 2019 Jan 15.

Department of Interventional Neuroradiology Neuro Brain Vascular Center, Hopital Bicetre, AP-HP, Paris Sud Université, 94270 Le Kremlin-Bicêtre, France.

Introduction: The treatment of wide-neck bifurcation aneurysms is still challenging despite the use of new techniques, such as Y-stenting, the waffle-cone technique and intrasaccular flow disrupters, in recent years. Moreover, the use of flow diverter stents in bifurcation aneurysms has been proposed by several teams, although the results remain controversial. This study aims to evaluate the feasibility and efficacy of Y-stent assisted coiling of bifurcation aneurysms with braided stents. Read More

J Neurointerv Surg 2019 May 17;11(5):511-515. Epub 2019 Jan 17.

Department of Interventional Neuroradiology Neuro Brain Vascular Center, Hopital Bicetre, APHP, Paris Sud Université, Le Kremlin-Bicetre, Île-de-France, France.

Backround: The treatment of wide neck bifurcation aneurysms remains challenging despite the introduction of new techniques (Y stenting, waffle cone technique, or flow diverter stents). The Woven EndoBridge (WEB) device is an innovative solution for this type of cerebral aneurysm. A new WEB 17 is now available and has been designed to offer smaller sized devices to optimize navigability and delivery. Read More

J Neuroimaging 2019 Mar 8;29(2):272-273. Epub 2019 Jan 8.

Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD.

Radiographics 2019 Jan-Feb;39(1):287-288

From the Departments of Emergency Radiology (O.L., B.K.), Musculoskeletal Radiology (J.C.M., S.E.S.), and Neuroradiology (C.C.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; and Department of Radiology, Shields Health Care, Brockton, Mass (D.S.T.).

J Neurol 2019 Mar 8;266(3):625-630. Epub 2019 Jan 8.

Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, 175 Cambridge Street, #300, Boston, MA, 02114, USA.

Background: Spontaneous cerebellar-intracerebral hemorrhage (ICH) can be associated with both cerebral amyloid angiopathy (CAA) and hypertensive small vessel disease (HTN-SVD, i.e. arteriolosclerosis). Read More

Acta Neurochir Suppl 2019;125:279-288

, New York, USA.

Background: In children, when unresponsive neck rigidity and distress are observed after ear, nose and throat (ENT) surgical treatment or nasopharyngeal inflammation, Grisel's syndrome should be suspected. This is a rare syndrome involving non-traumatic rotatory subluxation of the atlantoaxial joint. Conservative management with external cervical orthoses and empirical antibiotic, muscle relaxant and analgesic therapy should be the first choice of treatment. Read More

J Med Case Rep 2018 Dec 20;12(1):374. Epub 2018 Dec 20.

Department of Neurosurgery, Carl Gustav Carus University Hospital, TU Dresden, Dresden, Germany.

Background: Alterations of mental status are characteristic of psychiatric disorders but may also result from a multitude of organic causes. Generally, physical examination and blood analysis are a part of basic psychiatric differential diagnostics, whereas more sophisticated procedures (for example, brain imaging) are applied only in cases with pathologic diagnostic findings. Our report challenges this approach by describing a case of glioblastoma multiforme presenting as postpartum depression without abnormalities in basic differential diagnostics. Read More

J Spine Surg 2018 Sep;4(3):616-623

Neuroradiology Service, Central Military Hospital, Bogotá DC, Colombia.

Background: In 1988, Modic and his colleagues described changes in the subchondral bone marrow of the vertebral plates in patients with degenerative disease or other pathologies, which were observed in the nuclear magnetic resonance (NMR) of the spine and were subdivided into three patterns of signal changes, called Modic type I, Modic type II and Modic type III. The main differential diagnosis of the Modic I changes of the vertebral plates due to degenerative disease in spine NMR, is infection in its early stages. In their study in 2014, Patel and collaborators, using a protocol and the concept of diffusion in spine MRI, were able to demonstrate that by means of the "claw sing", a degenerative disease with Modic type I changes, can be differentiated from an infection in early stages. Read More

J Stroke Cerebrovasc Dis 2019 Feb 24;28(2):285-287. Epub 2018 Oct 24.

Department of Neurology, University Hospital Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany. Electronic address:

Background: Intravenous thrombolysis and mechanical thrombectomy are the standard of care for patients with acute ischemic stroke with large vessel occlusion. Intracerebral hemorrhage is a main complication of intravenous thrombolysis, however, no data are available on the efficacy and safety of mechanical thrombectomy in patients with thrombolysis-associated intracerebral hemorrhage. This constellation is expected to become more frequent as increasing numbers of patients are treated under the drip-and-ship paradigm. Read More

Semin Ultrasound CT MR 2018 12 15;39(6):531. Epub 2018 Nov 15.

University of Cincinnati Medical Center, Cincinnati, OH. Electronic address:

Top Magn Reson Imaging 2018 Dec;27(6):463-477

Department of Pediatrics, Division of Child Neurology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.

Vascular injury is increasingly recognized as an important cause of mortality and morbidity in children (29 days to 18 years of age). Since vascular brain injury in children appears to be less common than in adults, the index of suspicion for vascular brain injury is usually lower. In this review article, we describe frequent and rare conditions underlying pediatric stroke including cardioembolic, viral, autoimmune, post-traumatic, and genetic etiologies. Read More

Acta Neurochir (Wien) 2019 Mar 4;161(3):493-499. Epub 2018 Dec 4.

Department of Neurosurgery, Trauma Center Murnau, Professor-Küntscher Straße 8, 82418, Murnau, Germany.

Background: Decompressive craniectomy is a commonly performed procedure. It reduces intracranial pressure, improves survival, and thus might have a positive impact on several neurosurgical diseases and emergencies. Sometimes primary skin closure is not possible due to cerebral herniation or extensive skin defects. Read More

Neurol Sci 2019 Feb 23;40(2):371-376. Epub 2018 Nov 23.

Chief Emeritus Department of Neurology, Iazzolino Hospital, Piazza Alexander Fleming 1, 89900, Vibo Valentia, Italy.

Background: The growing impact of the emergency neurology of trauma centers and of mechanical thrombectomy for the treatment of acute ischemic stroke is revolutionizing the domain of eurosciences.

Methods: A census focused on the demographic distribution of the three main cohorts of neurosciences (neurologists, neuroradiologists, and neurosurgeons) was conducted in Italy between December 2015 and February 2017, and results were compared to the estimated retirement rates and loss for other reasons.

Results: The total number of neurosciences specialists active in Italy was 4394 at the end of the period of the survey. Read More

Spinal Cord Ser Cases 2018 9;4:101. Epub 2018 Nov 9.

3King Faisal Specialist Hospital and Research Center and Alfaisal University, Riyadh, Saudi Arabia.

Introduction: Vertebro-basilar thrombosis is often lethal. We report a post-traumatic case in which logistical issues were overcome to secure prompt endovascular intervention resulting in a favourable outcome.

Case Presentation: We report this case to highlight (i) the need, across the United Kingdom, for rapid access to 24/7 neurointerventional services and (ii) the fact that vertebral artery injury during C-spine trauma, while not uncommon, can rarely have catastrophic complications. Read More

Neurology 2018 Dec 16;91(23):e2163-e2169. Epub 2018 Nov 16.

From the Department of Neurology and Center for Genomic Medicine (W.T.K.), and Department of Radiology, Division of Neuroradiology (J.M.R.), Massachusetts General Hospital, Boston; Divisions of Stroke, Cerebrovascular and Critical Care Neurology (M.B.B.), Brigham & Women's Hospital, Boston, MA; Department of Neuroradiology (R.v.K.), Universitätsklinikum Carl Gustav Carus, Dresden, Germany; Calgary Stroke Program (A.M.D.), Department of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Canada; Department of Public Health Sciences (J.J.E.), Medical University of South Carolina, Charleston; Department of Neurology (H.E.H.), Oregon Health Sciences University, Portland; Department of Neurology (B.J.M.), University of Pittsburgh, PA; Department of Neurosurgery (J.M.S.), University of Maryland School of Medicine, Baltimore; and Division of Neurocritical Care and Emergency Neurology (K.N.S.), Yale New Haven Hospital, CT.

Objective: In this secondary analysis of the Glyburide Advantage in Malignant Edema and Stroke (GAMES-RP) Trial, we report the effect of IV glyburide on adjudicated, edema-related endpoints.

Methods: Blinded adjudicators assigned designations for hemorrhagic transformation, neurologic deterioration, malignant edema, and edema-related death to patients from the GAMES-RP phase II randomized controlled trial of IV glyburide for large hemispheric infarct. Rates of these endpoints were compared between treatment arms in the per-protocol sample. Read More

J Stroke Cerebrovasc Dis 2019 Feb 12;28(2):259-266. Epub 2018 Nov 12.

Department of Neurology, CHRU, Gui de Chauliac Hospital, Montpellier, France. Electronic address:

Background: Mechanical thrombectomy (MT) in association with intravenous thrombolysis is recommended for treatment of acute ischemic stroke (AIS), with large vessel occlusion (LVO) in the anterior circulation. Because MT is only available in comprehensive stroke centers (CSC), the challenge of stroke organization is to ensure equitable access to the fastest endovascular suite. Our aim was to evaluate the feasibility, efficacy, and safety of MT in patients initially managed in 1 CSC (mothership), compared with patients first managed in primary stroke center (PSC), and then transferred to the CSC for MT (drip-and-ship). Read More

Ital J Pediatr 2018 Nov 16;44(Suppl 2):118. Epub 2018 Nov 16.

Neuroradiology Unit, University Hospital "Ospedali Riuniti di Ancona", Politecnica University of Marche, Ancona, Italy.

This article discusses the role of imaging modalities including radiography, multi-detector computed tomography, magnetic resonance imaging, and ultrasound in diagnosing and monitoring skeletal abnormalities in mucopolysaccharidoses (MPS). The advantages and disadvantages of these different imaging tools will be discussed, along with their feasibility in this class of patients. As the musculoskeletal involvement is common to all MPS and is one of the main reasons for seeking medical attention, an increased awareness among paediatricians, rheumatologists, orthopaedists, radiologists, and other musculoskeletal specialists on the possible spectrum of abnormalities observed could facilitate a timely diagnosis, an appropriate severity evaluation, and better management. Read More

World Neurosurg 2019 Feb 12;122:376-379. Epub 2018 Nov 12.

Division of Neurosurgery, University of Insubria-Varese, Ospedale di Circolo e Fondazione Macchi, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center, University of Insubria-Varese, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.

Background: Internal carotid artery (ICA) injury is 1 of the most feared complications in endoscopic pituitary surgery. Different endovascular techniques are available for the management of early and delayed ICA injuries.

Case Report: We report a case of emergency endovascular treatment with a flow diverter stent for an ICA injury that occurred during endoscopic transphenoidal surgery for pituitary macroadenoma in a 66-year-old man. Read More

Neurol Sci 2019 Feb 14;40(2):319-326. Epub 2018 Nov 14.

Policlinic San Martino Hospital, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy.

Background And Aims: Monitoring the quality of acute ischemic stroke (AIS) management is increasingly important since patient outcome could be improved with better access to evidence-based treatments. In this scenario, the aim of our study was to identify thrombolysis rate, reasons for undertreatment, and factors associated with better outcome.

Methods: From January to December 2016, individuals diagnosed with AIS at the Policlinic San Martino Hospital in Genoa, Italy, were prospectively included. Read More

Rofo 2018 Dec 12;190(12):1141-1151. Epub 2018 Nov 12.

Institute of Medical Physics, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany.

Purpose:  Whole-body CT (wbCT) has been established as an internationally accepted diagnostic modality in multiple trauma. Until 2011, a uniform CT scanning protocol was used for all multiple trauma patients (pat.) at our hospital (OLD protocol = OP). Read More

Eur J Neurol 2019 Mar 14;26(3):422-427. Epub 2018 Dec 14.

Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia.

Background And Purpose: The International League against Epilepsy (ILAE) updated the classifications of seizures and epilepsies in 2017. The 2017 classifications were compared with the 1980s classifications in rural China.

Methods: People with epilepsy receiving treatment under the National Epilepsy Control Programme were recruited from rural areas in China. Read More

Medicine (Baltimore) 2018 Oct;97(43):e12958

Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center, University of Goettingen, Goettingen.

Background: Continuous blockade of the femoral nerve is widely used for postoperative analgesia after hip surgery. It can be achieved by ultrasound-guided placement of a femoral nerve catheter via either the in plane (IP) or out of plane (OOP) technique. On the basis of postoperative radiographs, we evaluated the paths of femoral nerve catheters with respect to both techniques and its effect on postoperative analgesia. Read More

Curr Probl Diagn Radiol 2018 Oct 9. Epub 2018 Oct 9.

UCLA, Department of Radiology, Neuroradiology and Acute Care Imaging Sections, Los Angeles, CA.

Purpose: To quantitatively and qualitatively assess the impact of attending neuroradiology coverage on radiology resident perceptions of the on-call experience, referring physician satisfaction, and final report turnaround times.

Materials And Methods: 24/7/365 attending neuroradiologist coverage began in October 2016 at our institution. In March 2017, an online survey of referring physicians, (emergency medicine, neurosurgery, and stroke neurology) and radiology residents was administered at a large academic medical center. Read More

Pediatr Nephrol 2019 Mar 25;34(3):517-527. Epub 2018 Oct 25.

Pediatric Nephrology and Dialysis Unit, Pediatric Hospital "Giovanni XXIII", Bari, Italy.

Background: Thrombotic microangiopathy (TMA) is a clinical syndrome encompassing a large group of rare but severe disorders including thrombotic thrombocytopenic purpura (TTP) and both typical and atypical forms of hemolytic uremic syndrome (HUS). The key role of the complement system is well known in TTP and atypical HUS, but recent reports describe its involvement in the pathogenesis of HUS secondary to gastrointestinal infections due to Shiga toxin-producing Escherichia coli (STEC).

Methods: TMA mainly affects the kidney, but extra-renal complications are frequently described. Read More

Stroke 2018 Sep;49(9):2067-2073

J. P. Kistler Stroke Research Center (A.C., K.S., C.K., C.D.A., M.E.G., A.V., S.M.G., J.R., J.N.G.).

Background and Purpose- Noncontrast computed tomographic (CT) hypodensities represent an alternative to the CT angiography spot sign (SS) to predict intracerebral hemorrhage (ICH) expansion. However, previous studies suggested that these markers predicted hematoma expansion independently from each other. We investigated whether the integration of SS and hypodensity (HD) improved the stratification of ICH expansion risk. Read More

J Ultrason 2018 ;18(73):166-169

Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland.

External injuries are one of the common reasons for reporting to hospital emergency departments. Peripheral vascular injuries occur in up to about 25% of upper and lower extremity injury cases. Arteriovenous fistula is a type of arterial injury. Read More

Neurology 2018 Nov 17;91(20):e1918-e1927. Epub 2018 Oct 17.

From the Departments of Neurology (M.G.A.V.C., M.D.) and Neuroradiology (S.D., O.N., M.W.), University Clinic RWTH Aachen, Germany.

Objective: To study the diagnostic value of volume perfusion CT (VPCT) in patients with transient focal neurologic deficits following and during epileptic seizures, that mimic symptoms of stroke.

Methods: A retrospective case-control study was performed on 159 patients who presented with a seizure and received an emergency VPCT within the first 3.5 hours of admission, after being misjudged to have an acute stroke. Read More

J Neurointerv Surg 2018 Oct 16. Epub 2018 Oct 16.

Radiology Department, Perpignan, France.

Background And Purpose: Inter-hospital transfer for mechanical thrombectomy (MT) might result in the transfer of patients who finally will not undergo MT (ie, futile transfers [FT]). This study evaluated FT frequency in a primary stroke center (PSC) in a semi-rural area and at 156 km from the comprehensive stroke center (CSC).

Methodology: Retrospective analysis of data collected in a 6-year prospective registry concerning patients admitted to our PSC within 4. Read More

Neuroimaging Clin N Am 2018 Nov 15;28(4):573-584. Epub 2018 Sep 15.

Neuroradiology, Massachusetts General Hospital, Harvard Medical School, Gray 241 MGH, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Acute stroke caused by large vessel occlusions (LVOs) are common. The time window to treat is up to 24 hours, and the most important factor is the size of the ischemic core. If the core is small (<70-100 mL), the penumbra must be large; penumbral imaging is unnecessary. Read More

J Stroke Cerebrovasc Dis 2018 Dec 12;27(12):3578-3586. Epub 2018 Oct 12.

Department of Emergency, Section of Neurology, Santa Chiara Hospital, Trento, Italy; Department of Medicine, Unit of Neurology, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy.

Introduction And Study Aim: Embolic strokes of undetermined source (ESUS) represent a rather recent diagnostic entity under clinical research for relapse prevention in cryptogenic stroke patients. Despite strict diagnostic criteria, ESUS definition ignores major clinical and radiological aspects, so including heterogeneous cases and probably influencing trial results. This study researches clinically relevant phenotypes among ESUS patients. Read More

Eur J Neurol 2019 Mar 18;26(3):428-e33. Epub 2018 Nov 18.

Department of Neurology, RWTH Aachen University, Aachen, Germany.

Background And Purpose: In 1995 intravenous recombinant tissue plasminogen activator (IVRTPA) was the first reperfusion therapy to be approved in patients with acute ischaemic stroke (AIS). The significance and impact of IVRTPA in times of modern endovascular stroke treatment (EST) were analysed in a German academic stroke centre.

Methods: A retrospective observational cohort analysis of 1034 patients with suspected AIS presenting at the emergency department in 2014 was performed. Read More

J Neurointerv Surg 2019 Apr 5;11(4):386-389. Epub 2018 Oct 5.

Department of Interventional Neuroradiology, Neuro Brain Vascular Center, Hopital Bicetre, APHP, Paris Sud Université, Paris, France.

Background: Woven EndoBridge (WEB) deployment remains challenging in aneurysms with a complex shape or orientation.

Objective: To show that embolization of wide-neck bifurcation aneurysms using the WEB device balloon remodeling-assisted technique is a feasible and elegant endovascular solution compared with other techniques, such as balloon remodeling or stent-assisted coiling.

Materials And Methods: 10 cases (10 aneurysms in 9 patients) of balloon remodeling-assisted WEB treatment of unruptured complex bifurcation aneurysms were treated in our institution and retrospectively analyzed. Read More

BMC Neurol 2018 Oct 3;18(1):164. Epub 2018 Oct 3.

Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.

Background: Studying the impact of demographic changes and progress in the management of stroke patients is necessary in order to organize care structures for the coming years. Consequently, we analyzed the prognostic trends of patients admitted to the Stroke Unit of a tertiary hospital in the last ten years.

Methods: The University Clinical Hospital of Santiago de Compostela is the referral hospital for stroke in a catchment area that accounts for 16. Read More