Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Mechanical Thrombectomy (MT) using modern devices has proved to be efficacious in re-establishing intracranial circulation and reduced procedural times. We outline a number of endovascular techniques utilizing the distal access catheter, the circumstances where they are applicable, and the outcomes achieved. ⋯ In this pictorial review, we have demonstrated techniques where distal access catheter when used as a sole suction device, or combined with a stent-retriever, has been able to provide a rapid route to successful reperfusion, with minimal complications related to our endovascular procedures.
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Glioblastomas (GBMs) that involve the subventricular zone (SVZ) have a poor prognosis, possibly due to recruitment of neural stem cells. The purpose of this study was to evaluate whether SVZ involvement by lower grade gliomas (LGG), WHO grade II and III, similarly predicts poorer outcomes. We further assessed whether tumor genetics and cellularity are associated with SVZ involvement and outcomes. ⋯ Unlike in GBM, overall SVZ involvement was not found to strongly predict poor prognosis in LGGs. However, occipital SVZ involvement, though uncommon, was prognostic and found to be associated with CDKN2A/B mutations and tumor hypercellularity. Further investigation into these molecular mechanisms underlying occipital SVZ involvement in larger cohorts is warranted.
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Children receiving chemotherapy, or immunosuppression have an increased risk for pediatric posterior reversible encephalopathy syndrome (pPRES); pPRES is scantly described in cerebral X-linked adrenoleukodystrophy (cALD) patients, for which hematopoietic stem cell transplantation improves outcomes. This study aimed to describe distinctive lesion patterns, distribution, and evolution of neuroimaging findings in PRES in a single-center pediatric cohort of cALD. ⋯ It is crucial to recognize that pPRES can occur in cALD, notably, the cortical edema and leptomeningeal enhancement can accelerate the diagnosis of superimposed pPRES, while the PVWM lesions of cALD remain following the resolution of pPRES.
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Comparative Study
The Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis Trial: Reanalysis Using the FDA "On Label" Criteria.
Due to higher rates of 1-month stroke and death with Wingspan intracranial stent placement observed in SAMMPRIS, the Food and Drug Administration (FDA) announced a more limited indication for Wingspan stent. ⋯ The new FDA "on label" criteria may identify a small group of people, who may benefit from intracranial stent placement due to higher risk of primary endpoint in those treated with best medical treatment.
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Neuromuscular ultrasound in amyotrophic lateral sclerosis (ALS) is of increasing interest. As bulbar symptoms are commonly developed by most ALS patients during disease, the aim of our study was to find possible sonographic changes of vagus nerve size in bulbar affected ALS patients. ⋯ Our study demonstrates vagus nerve atrophy in bulbar affected ALS patients. Further studies are warranted investigating the relevance of our finding for monitoring disease progression in ALS.