Neurosurgery
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The benefit of middle meningeal artery embolization (MMAE) in the treatment of chronic subdural hematoma (CSDH) has been recently demonstrated in a series of clinical trials. Whether MMAE benefits "trial-ineligible" patients remains elusive. We thus sought to explore the potential benefit of MMAE in neurologically stable (modified Rankin Scale ≤3) patients with "trial-ineligible" CSDHs because of large size: Thickness >15 mm and/or midline shift ≥5 mm. ⋯ This study emphasizes the considerable prevalence of potentially "trial-ineligible" patients with CSDHs because of large size that may still benefit from standalone MMAE.
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Ruptured aneurysms visualized by vessel wall MRI (VW-MRI) exhibit characteristic aneurysm wall enhancement (AWE). A secondary bulge of the aneurysmal wall, called a bleb, is often the site of rupture in ruptured aneurysms. We hypothesized that a higher degree of AWE would identify the rupture point in aneurysms with multiple blebs. ⋯ AWE is associated with the bleb rupture status independent of WSS. Contrast-enhanced VW-MRI may be a useful noninvasive tool for identifying the rupture point and guiding the treatment strategy.
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Linear metrics for ventricular volume play a large role in the rapid, approximate evaluation of ventricular volume. In this article, we automatically extract linear measures of ventricular volume to explore their correlation with lateral ventricular volume (LVV) in the healthy adult population and comprehensively define normal values. ⋯ ALVI is a newer index with strong correlation with LVV and has strong potential for clinical use. Both FOHR and ER show moderate correlation with LVV. Reference values for linear estimates of ventricular volume may help clinicians better identify patients with pathological ventriculomegaly.