Clinical, imaging, and management features of symptomatic carotid web: Insight from CAROWEB registry.

Background: Although carotid web (CaW) is increasingly diagnosed as a cause of cryptogenic stroke, data are still limited to monocentric small sample cohort. To broaden knowledge on symptomatic CaW, CAROWEB registry has been recently implemented.

Aims: In a large cohort of symptomatic CaW patients, we described epidemiologic characteristics, admission clinical and imaging features, and the current management including the secondary preventive strategy choice made in comprehensive French Stroke Units.

Assessment of a combined musculoskeletal and chest deep learning-based detection solution in an emergency setting.

Rationale And Objectives: Triage and diagnostic deep learning-based support solutions have started to take hold in everyday emergency radiology practice with the hope of alleviating workflows. Although previous works had proven that artificial intelligence (AI) may increase radiologist and/or emergency physician reading performances, they were restricted to finding, bodypart and/or age subgroups, without evaluating a routine emergency workflow composed of chest and musculoskeletal adult and pediatric cases. We aimed at evaluating a multiple musculoskeletal and chest radiographic findings deep learning-based commercial solution on an adult and pediatric emergency workflow, focusing on discrepancies between emergency and radiology physicians.

Intravoxel incoherent motion and diffusion kurtosis imaging at 3T MRI: Application to ischemic stroke.

Background And Purpose: The DKI-IVIM model that incorporates DKI (diffusional kurtosis imaging) into the IVIM (Intravoxel Incoherent Motion) concept was investigated to assess its utility for both enhanced diffusion characterization and perfusion measurements in ischemic stroke at 3 T.

Methods: Fifteen stroke patients (71 ± 11 years old) were enrolled and DKI-IVIM analysis was performed using 9 b-values from 0 to 1500 s/mm chosen with the Cramer-Rao-Lower-Bound optimization approach. Pseudo-diffusion coefficient D*, perfusion fraction f, blood flow-related parameter fD*, the diffusion coefficient D and an additional parameter, the kurtosis, K were determined in the ischemic lesion and controlateral normal tissue based on a region of interest approach.

Toward an Intravoxel Incoherent Motion 2-in-1 Magnetic Resonance Imaging Sequence for Ischemic Stroke Diagnosis? An Initial Clinical Experience With 1.5T Magnetic Resonance.

Objective: This initial study aimed to investigate the feasibility of simultaneously measuring perfusion and diffusion including kurtosis features in acute ischemic stroke with the combined intravoxel incoherent motion and non-Gaussian diffusional kurtosis imaging (DKI-IVIM).

Material And Methods: Five ischemic stroke patients underwent a 4-minute diffusion weighted imaging (DWI) protocol, using 8 b values chosen with the Cramer-Rao-Lower-Bound optimization approach, in addition to conventional DWI and arterial spin labeling sequences. Regions of interest in pathological and control regions were analyzed with DKI-IVIM, and parametric maps were reconstructed.

Link between COVID-19-related in-hospital mortality in continental France administrative areas and weather: an ecological study.

Objective: To assess the effect of a weather index on in-hospital COVID-19-linked deaths.

Design: Ecological study.

Setting: Continental France administrative areas (; henceforth counties).

Arterial hypertension and cerebral hemodynamics: impact of head-down tilt on cerebral blood flow (arterial spin-labeling-MRI) in healthy and hypertensive patients.

Objective: Hypertension affects cerebrovascular autoregulation and increases the risk of cerebrovascular events and dementia. Notably, it is associated with cerebrovascular remodeling and lower resting cerebral blood flow (CBF). We wanted to determine, using arterial spin-labeling-MRI, the impact of a head-down tilt (HDT) dynamic maneuver on CBF in hypertensive patients.

ICU admissions and in-hospital deaths linked to COVID-19 in the Paris region are correlated with previously observed ambient temperature.

The purpose of this ecological study was to explore the association of weather with severity indicators of coronavirus disease 2019 (COVID-19). Daily COVID-19-related intensive care unit (ICU) admissions and in-hospital deaths in the Paris region and the daily weather characteristics of Paris midtown were correlated with a time lag. We assessed different study periods (41, 45, 50, 55, and 62 days) beginning from 31 March 2020.

Advanced multiparametric magnetic resonance imaging of multinodular and vacuolating neuronal tumor.

Background And Purpose: Multinodular and vacuolating neuronal tumor (MVNT) of the cerebrum is a rare brain lesion with suggestive imaging features. The aim of our study was to report the largest series of MVNTs so far and to evaluate the utility of advanced multiparametric magnetic resonance (MR) techniques.

Methods: This multicenter retrospective study was approved by our institutional research ethics board.

Multinodular and Vacuolating Posterior Fossa Lesions of Unknown Significance.

Multinodular and vacuolating neuronal tumor of the cerebrum is a rare supratentorial brain tumor described for the first time in 2013. Here, we report 11 cases of infratentorial lesions showing similar striking imaging features consisting of a cluster of low T1-weighted imaging and high T2-FLAIR signal intensity nodules, which we referred to as multinodular and vacuolating posterior fossa lesions of unknown significance. No relationship was found between the location of the lesion and clinical symptoms.

Fulminant and fatal onset of pan-aquaporinopathy.

Early administration of high-dose steroids and plasma exchange (PE) offers the best chance of treating neuromyelitis optica spectrum disease (NMOSD) attacks, but up to 20% of patients fail to respond. We report the case of a first devastating NMOSD attack leading to death despite optimal treatment. While receiving steroids during a bilateral blinding optic neuritis, this female patient suffered a severe attack involving the spinal cord and circumventricular organs (CVOs), including the pineal gland.

Association of Autoantibody to Rods and Rings with Hepatitis C Outcome and Viral Load.

Despite the current availability of more potent drugs, hepatitis C virus (HCV) infection is still treated with a combination of IFN- and ribavirin in many countries. Interferon/ribavirin therapy can induce the appearance of autoantibodies to Rods and Rings (anti-RR), which have been associated to a poorer prognosis. The aim of this study was to investigate the prevalence of anti-RR antibodies before and after ribavirin therapy and to look for a possible association with HCV infection outcome.

Impact of Head-Down Position on Cerebral Blood Flow in Healthy Subjects: An Arterial Spin-Labeling MR Perfusion Study.

Background: A head-down (HD) position is used in some stroke centers to maintain cerebral perfusion (CP) in stroke patients.

Purpose: To assess CP in healthy volunteers in the supine and HD (-15°) positions.

Study Type: Prospective.

Improved detection and characterization of arterial occlusion in acute ischemic stroke using contrast enhanced MRA.

Background And Purpose: To compare the accuracy and utility of contrast enhanced magnetic resonance angiography (MRA) (CEMRA) to Time of Flight MRA (TOF MRA) during detection and evaluation of occlusions on patients diagnosed with acute ischemic stroke (AIS).

Methods: This single-center study was approved by our local institutional research ethics board. From August 2014 to July 2016, 131 consecutive adult patients with confirmed AIS were included.

Predictive value of conventional MRI parameters in first spinal attacks of neuromyelitis optica spectrum disorder.

Background: While spinal cord (SC) attacks of neuromyelitis optica spectrum disorder (NMOSD) are often devastating, signs predictive of their poor clinical outcome have been elusive until now, except for the delay in initiating plasma exchange (PE).

Objective: We studied the correlation between conventional non-standardized magnetic resonance imaging (MRI) parameters, PE treatment, and clinical data obtained at nadir and recovery.

Methods: Retrospective study of first SC attacks of NMOSD.

[Contribution of C.S. Peirce thought to the representation knowledge and medical reasoning].

Modelling knowledge and medical reasoning can be an epistemological project especially now, as medicine seems to reach a scientific status. Through his work on semiotics, abductive reasoning and pragmatism, CS Peirce (1839-1914) offers a series of original solutions. These solutions can give an account of (be considered as a theorical ground for) most of the medical activity in various fields such as the evaluation of the students, the knowledge bases and expert systems, the formal descriptions languages (ontologies), and the evidence-based medicine.

Treatment of neuromyelitis optica with rituximab: a 2-year prospective multicenter study.

Objective: Neuromyelitis optica (NMO) is a very severe autoimmune disorder of the central nervous system. It affects young subjects and has a poor prognosis both on a functional and vital level. Therefore, it is imperative to reduce the frequency of relapses.

Transoceanic Management and Treatment of Aneurysmal Subarachnoid Hemorrhage: A 10-Year Experience.

Background And Purpose: Because of the small number of yearly cases of ruptured cerebral aneurysms, endovascular treatment is not performed in Martinique. Therefore, patients from Martinique are sent 7000 km to Paris on commercial flights as soon as possible, where treatment is performed. Nontransportable patients are treated locally with either surgery or symptomatic care.

Can MRI water apparent diffusion coefficient (ADC) value discriminate between idiopathic normal pressure hydrocephalus, Alzheimer's disease and subcortical vascular dementia?

Numerous similarities in MRI and clinical symptoms exist between Alzheimer's disease (AD), subcortical vascular dementia (sVD) and possible idiopathic normal pressure hydrocephalus (iHPN). The aim of this study is to explore mean apparent coefficient diffusion (ADC) difference between theses diseases in different periventricular and deep white matter areas, as compared to healthy controls. This retrospective study analyzed mean ADC values of 120 patients in normal appearing deep white matter and lenticular nuclei, frontal, caudate nuclei corpus and parietal periventricular and deep white matter areas INPH group showed significantly lower ADC than sVD group in frontal periventricular region (1567.

Measuring Cerebral Hypoperfusion Induced by Hyperventilation Challenge With Intravoxel Incoherent Motion Magnetic Resonance Imaging in Healthy Volunteers.

Objectives: The aim of this study was to demonstrate the feasibility to assess cerebral hypoperfusion with a hyperventilation (HV) challenge protocol using intravoxel incoherent motion (IVIM) magnetic resonance imaging.

Materials And Methods: Magnetic resonance imaging experiments were performed on 10 healthy volunteers at 1.5 T, with a diffusion IVIM magnetic resonance imaging protocol using a set of b-values optimized by Cramer-Rao Lower Bound analysis.

Diffusional kurtosis imaging (DKI) incorporation into an intravoxel incoherent motion (IVIM) MR model to measure cerebral hypoperfusion induced by hyperventilation challenge in healthy subjects.

Objectives: The objectives were to investigate the diffusional kurtosis imaging (DKI) incorporation into the intravoxel incoherent motion (IVIM) model for measurements of cerebral hypoperfusion in healthy subjects.

Materials And Methods: Eight healthy subjects underwent a hyperventilation challenge with a 4-min diffusion weighted imaging protocol, using 8 b values chosen with the Cramer-Rao Lower Bound optimization approach. Four regions of interest in gray matter (GM) were analyzed with the DKI-IVIM model and the bi-exponential IVIM model, for normoventilation and hyperventilation conditions.