Publications by authors named "Pascarella R"

Glioblastoma (GBM) displays significant gender disparities, being 1.6 times more prevalent in men, with a median survival time of 15.0 months for males compared to 25.

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Introduction: Large artery atherosclerosis is a relevant cause of ischemic stroke. Beyond carotid artery stenosis ≥ 50%, causative in etiological classification of stroke, non-stenosing plaques are an increasingly reported cause of stroke with embolic pattern.

Methods: We are presenting the case of a 56 years old woman presenting with a first symptomatic multifocal ischemic stroke in the right internal carotid artery (ICA) territory on 2018 and a finding of asymptomatic past vascular injury in the same vascular territory on neuroimaging studies.

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The so-called trigeminal pontine sign has been described as a marker of different diseases, from multiple sclerosis to herpetic infections. First, it has been proposed as linear hyperintensity in the pons on the Magnetic Resonance Imaging (MRI) of patients with multiple sclerosis and trigeminal neuralgia. After these descriptions, it has been reported as incidental findings in the same patients and in patients with HSV or VZV infections.

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Introduction: Pregnancy and postpartum are phases in the women's life where the thrombotic risk is increased both on the venous and on the arterial side.

Methods: We are presenting the case of a young woman at the third pregnancy, carried out without complications until delivery, whose postpartum was characterized by the occurrence of headache. Neuroimaging studies were performed, firstly brain computed tomography (CT) with CT Angiography and after brain Magnetic Resonance Imaging (MRI) with MR Angiography.

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Introduction: As detailed in the first part of this review, post-infectious vasculitides are a wide and complex category, including several clinical, microbiological and neuroradiological patterns. In order to raise the suspicion for diagnosis, the knowledge of two different neuroradiological issues is needed, i.e.

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Introduction: The differential diagnosis of Primary Central Nervous System Angiitis (PACNS) is complex and includes several inflammatory and non-inflammatory conditions. Among the first ones, post-infectious CNS vasculitides represent a relevant topic and they are often underdiagnosed.

Aims: The main aim of this review is to summarize the clinical and neuroimaging features of post-infectious vasculitides, highlighting the diagnostic clues and the need to carefully consider them in the differential diagnosis of PACNS.

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Background And Aims: Previous observational data indicate that young adults treated with intravenous thrombolysis (IVT) for acute ischemic stroke have more favorable outcomes and less complications when compared to older adults. Given the limited data on this topic, we aimed to provide more evidence on clinical outcomes and safety in such patients, using a large international thrombolysis registry.

Methods: In this prospective multicenter study, we used data from the Thrombolysis in Ischemic Stroke Patients (TRISP) registry from 1998 to 2020.

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Purpose: Middle cerebral artery (MCA) anomalies are a small group of congenital variants, including fenestration, duplication and Twig-like MCA. Some other variants, i.e.

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Background: Frailty, defined as multidimensional prognostic index (MPI), has been recently identified as strong predictor of disability and mortality in the elderly with acute ischemic stroke (AIS). The stress hyperglycemia ratio (SHR) is a recently introduced biomarker significantly associated with poor outcome in AIS.

Objectives: This study aimed to investigate in what extent frailty, measured by MPI, and SHR affects the 3-months outcome of patients > 65 years-old with AIS.

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Background: Acute intracranial occlusion of the internal carotid artery (ICA) can be distinguished into (a) occlusion of the terminal ICA, involving the proximal segments of the middle or anterior cerebral artery (ICA-L/-T) and (b) non-terminal intracranial occlusions of the ICA with patent circle of Willis (ICA-I). While patients with ICA-L/-T occlusion were included in all randomized controlled trials on endovascular therapy (EVT) in anterior large vessel occlusion, data on EVT in ICA-I occlusion is scarce. We thus aimed to evaluate effectiveness and safety of EVT in ICA-I occlusions in comparison to ICA-L/-T occlusions.

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Article Synopsis
  • The brain relies on a vast network of capillaries (600 km) to deliver nutrients and maintain a stable environment through the blood-brain barrier (BBB), which regulates chemical balance and protects against toxins.
  • Brain microvascular endothelial cells (BMECs) have low turnover under normal conditions but can adapt due to factors like development, aging, injury, or disease, leading to changes in vascular structure and functioning.
  • Cerebrovascular plasticity can occur quickly in response to neural activity or more gradually due to environmental factors, with different time scales influencing how the brain adapts during health, aging, and conditions like neurodegenerative diseases.
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Article Synopsis
  • Cervical artery dissection (CeAD) is a leading cause of ischemic strokes in young adults, and this study explored the effects of intravenous thrombolysis (IVT) on patients with CeAD and stroke symptoms.
  • Analyzed data from the STOP-CAD study, it found that IVT significantly improved functional independence after 90 days in patients without increasing the risk of symptomatic intracranial hemorrhage.
  • The results suggest that IVT is a beneficial treatment for eligible patients with CeAD, aligning with current medical guidelines on its use.
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Neurological manifestations are frequent in patients with SARS-CoV-2 infection and can be correlated with different pathogenic mechanisms which can be divided into two categories: direct invasion of the central nervous system by the virus and indirect effects deriving from the severity of the systemic infection and by the inflammatory response correlated with cytokine storm. Among the neurological manifestations, acute encephalopathy is very frequent and its nomenclature has recently been updated. The occurrence of a condition of altered mental status, reduced consciousness, delirium up to coma represents an element associated with a greater severity of the infection and mortality both in an Intensive Care Unit setting and in an Emergency Department setting.

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Coronavirus disease 2019 (COVID-19) has been associated with a variety of neurological manifestations (i.e., anosmia, ageusia, myalgia, headache) and neurological syndromes (i.

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Hereditary congenital facial palsy (HCFP) is a medical condition caused by dysfunction of the seventh cranial nerve. HCFP is characterized by feeding difficulties and dysmorphic features in the orofacial region. In some cases hearing loss, strabismus, limb malformations, and musculoskeletal defects may be associated.

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Article Synopsis
  • The study explores the intricate and variable blood supply to the thalamus, focusing on a specific case involving a 46-year-old patient with neurological symptoms following an ischemic stroke.
  • Advanced imaging techniques, including NCCT, CTA, and DSA, revealed a rare variant of thalamic blood supply (Percheron type III) that contributed to the patient's condition.
  • The findings suggest that better understanding thalamic vascularization through DSA can impact stroke diagnosis and differentiate between medium-sized and small vessel occlusions.
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Background: Contrast-induced encephalopathy (CIE) is a rare adverse event linked to intravascular use of iodine-containing contrast media. The prevalence of CIE could increase in the future due to growing numbers of endovascular procedures. We provide insights from a case series of 7 patients.

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Article Synopsis
  • Understanding neurovascular variants is essential for ensuring safe procedures in endovascular and neurosurgery, as these variations can impact treatment outcomes.
  • The study reviewed uncommon neurovascular variants by analyzing a maintained neurovascular database and provided pictorial evidence along with insights on their embryology, clinical significance, and potential complications.
  • The findings include a variety of anatomical anomalies both in the brain and outside of it, which can influence diagnosis and interventions; thus, raising awareness among healthcare professionals is critical for patient safety.
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Article Synopsis
  • Spontaneous convexity subarachnoid hemorrhage (cSAH) is a distinct vascular disease from aneurysmal SAH, characterized by different neuroimaging patterns, causes, and prognoses.* ! -
  • The main causes of cSAH vary by age, with cerebral amyloid angiopathy (CAA) prevalent in older individuals and reversible cerebral vasoconstriction syndrome (RCVS) more common in younger patients, highlighting the importance of specific diagnostic approaches.* ! -
  • Effective treatment begins with accurate diagnosis through various methods, including neuroimaging and lumbar puncture, as identifying the underlying cause is crucial for selecting the right therapeutic strategy.* !
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Antiphospholipid syndrome (APS) is an autoimmune prothrombotic condition characterized by venous thromboembolism, arterial thrombosis, and pregnancy morbidity. Among neurological manifestations, arterial thrombosis is only one of the possible associated clinical and neuroradiological features. The aim of this review is to address from a neurovascular point of view the multifaceted range of the arterial side of APS.

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Anderson-Fabry disease (AFD) is a genetic sphingolipidosis involving virtually the entire body. Among its manifestation, the involvement of the central and peripheral nervous system is frequent. In recent decades, it has become evident that, besides cerebrovascular damage, a pure neuronal phenotype of AFD exists in the central nervous system, which is supported by clinical, pathological, and neuroimaging data.

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Background: Whether statin use after spontaneous intracerebral haemorrhage (ICH) increases the risk of recurrent ICH is uncertain.

Methods: In the setting of the Multicentric Study on Cerebral Haemorrhage in Italy we followed up a cohort of 30-day ICH survivors, consecutively admitted from January 2002 to July 2014, to assess whether the use of statins after the acute event is associated with recurrent cerebral bleeding.

Results: 1623 patients (mean age, 73.

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