Imaging Neurovascular Uncoupling in Acute Migraine with Aura with Susceptibility Weighted Imaging.

Purpose: Migraine with aura (MwA) in the emergency setting is common and sometimes difficult to distinguish from mimicking conditions. Susceptibility weighted imaging (SWI), a magnet resonance (MR) technique is sensitive to deoxygenated hemoglobin in cerebral veins and depicts these according to their level of oxygenation. Our study aimed at evaluating the frequency of regions of prominent focal veins (PFV) on SWI in the acute phase.

Findings in susceptibility weighted imaging in pediatric patients with migraine with aura.

Background: Migraine with aura (MwA) in pediatric patients is clinically frequent. Clinically complex symptoms need to be differentiated to exclude mimicking conditions.

Purpose: We hypothesize that MwA in children induces abnormalities readily visible in perfusion time to peak (TTP) maps as well as non-enhanced susceptibility weighted magnetic resonance imaging (SWI).

Quantification of cerebral veins in patients with acute migraine with aura: A fully automated quantification algorithm using susceptibility-weighted imaging.

Introduction: Susceptibility weighted imaging (SWI) is a very sensitive technique that often depicts prominent focal veins (PFV) in patients with acute migraine with aura (MwA). Interpretation of visual venous asymmetry (VVA) between brain hemispheres on SWI may help support the clinical diagnosis of MwA. Our goal was to develop an automated algorithm for segmentation and quantification of cerebral veins using SWI.

The index vein pointing to the origin of the migraine aura symptom: A case series.

Objective: This case series describes and discusses the potential clinical utility of a prominent vein (index vein) found on susceptibility-weighted MRI during migraine aura that drains the cortical area responsible for patients' symptoms.

Methods: Six patients with acute migraine aura had a prominent draining sulcal vein on emergency MRI done initially for suspected stroke. The location of the prominent vein was correlated to patients' symptoms, and the diameter was compared to the corresponding contralateral vein.

Symptomatic and asymptomatic intracranial atherosclerotic stenosis: 3 years' prospective study.

Background: Intracranial stenoses can cause TIA/ischaemic stroke. The purpose of this study was to assess vascular risk factors, clinical and imaging findings and outcome in Caucasians with intracranial stenosis under best prevention management.

Methods: In this prospective observational study (from 05/2012, to last follow-up 06/2017) we compared vascular risk factors, imaging findings and long-term outcome in Swiss patients with symptomatic versus asymptomatic intracranial atherosclerotic stenoses on best prevention management.

Comparison of perioperative automated versus manual two-dimensional tumor analysis in glioblastoma patients.

Objectives: Current recommendations for the measurement of tumor size in glioblastoma continue to employ manually measured 2D product diameters of enhancing tumor. To overcome the rater dependent variability, this study aimed to evaluate the potential of automated 2D tumor analysis (ATA) compared to highly experienced rater teams in the workup of pre- and postoperative image interpretation in a routine clinical setting.

Materials And Methods: From 92 patients with newly diagnosed GB and performed surgery, manual rating of the sum product diameter (SPD) of enhancing tumor on magnetic resonance imaging (MRI) contrast enhanced T1w was compared to automated machine learning-based tumor analysis using FLAIR, T1w, T2w and contrast enhanced T1w.

Differentiating enhancing multiple sclerosis lesions, glioblastoma, and lymphoma with dynamic texture parameters analysis (DTPA): A feasibility study.

Purpose: MR-imaging hallmarks of glioblastoma (GB), cerebral lymphoma (CL), and demyelinating lesions are gadolinium (Gd) uptake due to blood-brain barrier disruption. Thus, initial diagnosis may be difficult based on conventional Gd-enhanced MRI alone. Here, the added value of a dynamic texture parameter analysis (DTPA) in the differentiation between these three entities is examined.

Cluster headache and macroprolactinoma: Case report of a rare, but potential important causality.

While headache is not an uncommon symptom in patients suffering from pituitary adenomas, cluster headache (CH) has rarely been reported in such cases. Headache associated with hyperprolactinemia has been reported to be responsive to dopamine agonists (DA agonists) in many patients. We report on a patient with refractory CH secondary to a macroprolactinoma who showed immediate and permanent clinical and radiologic recovery following medical treatment with DA agonists.

Implication of cerebral circulation time in intracranial stenosis measured by digital subtraction angiography on cerebral blood flow estimation measured by arterial spin labeling.

Purpose: Arterial spin labeling (ASL) magnetic resonance imaging to assess cerebral blood flow (CBF) is of increasing interest in basic research and in diagnostic applications, since ASL provides similar information to positron emission tomography about perfusion in vascular territories. However, in patients with steno-occlusive arterial disease (SOAD), CBF as measured by ASL might be underestimated due to delayed bolus arrival, and thus increased spin relaxation. We aimed to estimate the extent to which bolus arrival time (BAT) was delayed in patients with SOAD and whether this resulted in underestimation of CBF.

Susac's syndrome: Leptomeningeal enhancement on 3D FLAIR MRI.

Background: Contrast-enhanced (ce) fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) has recently been shown to identify leptomeningeal pathology in multiple sclerosis.

Objective: To demonstrate leptomeningeal enhancement on three-dimensional (3D) FLAIR in a case of Susac's syndrome.

Methods: Leptomeningeal enhancement was correlated with clinical activity over 20 months and compared to retinal fluorescein angiography.

Characterization of Enhancing MS Lesions by Dynamic Texture Parameter Analysis of Dynamic Susceptibility Perfusion Imaging.

Purpose: The purpose of this study was to investigate statistical differences with MR perfusion imaging features that reflect the dynamics of Gadolinium-uptake in MS lesions using dynamic texture parameter analysis (DTPA).

Methods: We investigated 51 MS lesions (25 enhancing, 26 nonenhancing lesions) of 12 patients. Enhancing lesions (n = 25) were prestratified into enhancing lesions with increased permeability (EL+; n = 11) and enhancing lesions with subtle permeability (EL-; n = 14).

Cognitive improvement in patients with carotid stenosis is independent of treatment type.

Treatment of carotid artery stenosis decreases the long-term risk of stroke and may enhance cerebral blood flow. It is therefore expected to have the potential to prevent cognitive decline or even improve cognition over the long-term. However, intervention itself can cause peri-interventional cerebral infarcts, possibly resulting in a decline of cognitive performance, at least for a short time.

Protected stent retriever thrombectomy prevents iatrogenic emboli in new vascular territories.

Introduction: Diagnostic tools to show emboli reliably and protection techniques against embolization when employing stent retrievers are necessary to improve endovascular stroke therapy. The aim of the present study was to investigate iatrogenic emboli using susceptibility-weighted imaging (SWI) in an open series of patients who had been treated with stent retriever thrombectomy using emboli protection techniques.

Methods: Patients with anterior circulation stroke examined with MRI before and after stent retriever thrombectomy were assessed for iatrogenic embolic events.

In-vivo phase contrast magnetic resonance angiography of the cerebrovascular system: a comparative study with duplex sonography.

Purpose: Assessment of the cerebral blood flow (CBF) is crucial in the evaluation of patients with steno-occlusive diseases of the arteries supplying the brain for prediction of stroke risk. Quantitative phase contrast magnetic resonance angiography (PC-MRA) can be utilised for noninvasive quantification of CBF. The aim of this study was to validate in-vivo PC-MRA data by comparing them with colour-coded duplex (CCD) sonography in patients with cerebrovascular disease.

Suprasellar chordoid neoplasm with expression of thyroid transcription factor 1: evidence that chordoid glioma of the third ventricle and pituicytoma may form part of a spectrum of lineage-related tumors of the basal forebrain.

Chordoid glioma of the third ventricle is a rare neuroepithelial tumor characterized by a unique histomorphology and exclusive association with the suprasellar/third ventricular compartment. Variously interpreted as either astrocytic- or ependymal-like, and speculatively ascribed to the lamina terminalis/subcommissural organ, its histogenesis remains, nevertheless, unsettled. Here, we report on a suprasellar chordoid glioma occurring in a 52-year-old man.

Multimodal 3 Tesla MRI confirms intact arterial wall in acute stroke patients after stent-retriever thrombectomy.

Background And Purpose: The aim of this prospective study was to assess vascular integrity after stent-retriever thrombectomy.

Methods: Dissection, contrast medium extravasation, and vasospasm were evaluated in 23 patients after thrombectomy with biplane or 3D-digital subtraction angiography and 3-Tesla vessel wall MRI.

Results: Vasospasm was detected angiographically in 10 patients, necessitating intra-arterial nimodipine in 2 of them.

Cognitive and emotional effects of carotid stenosis.

Principles: Patients with carotid artery stenosis (CAS) are at risk of ipsilateral stroke and chronic compromise of cerebral blood flow. It is under debate whether the hypo-perfusion or embolism in CAS is directly related to cognitive impairment. Alternatively, CAS may be a marker for underlying risk factors, which themselves influence cognition.

Leptomeningeal collateralization in acute ischemic stroke: impact on prominent cortical veins in susceptibility-weighted imaging.

Background: The extent of hypoperfusion is an important prognostic factor in acute ischemic stroke. Previous studies have postulated that the extent of prominent cortical veins (PCV) on susceptibility-weighted imaging (SWI) reflects the extent of hypoperfusion. Our aim was to investigate, whether there is an association between PCV and the grade of leptomeningeal arterial collateralization in acute ischemic stroke.

Characterization of microcirculation in multiple sclerosis lesions by dynamic texture parameter analysis (DTPA).

Objective: Texture analysis is an alternative method to quantitatively assess MR-images. In this study, we introduce dynamic texture parameter analysis (DTPA), a novel technique to investigate the temporal evolution of texture parameters using dynamic susceptibility contrast enhanced (DSCE) imaging. Here, we aim to introduce the method and its application on enhancing lesions (EL), non-enhancing lesions (NEL) and normal appearing white matter (NAWM) in multiple sclerosis (MS).