Treatment of Intracranial Aneurysms with the FRED X Flow Diverter Stent: Mid-term Angiographic and Safety Results.

Purpose: The aim of our study was to assess the mid-term efficacy and safety of the FRED X flow diverting stent (FDS) in the treatment of intracranial aneurysms. The FRED X FDS is relatively new with limited data on its longer-term effectiveness and safety profile.

Methods: Patients with intracranial aneurysms treated with the FRED X FDS at two UK centres, between March 2021 and July 2022 with at least 18 months follow-up, were retrospectively reviewed.

Simultaneous bilateral application of the Scepter mini balloon microcatheter for occlusion of ethmoidal dural arteriovenous fistulas.

Ethmoidal dural arteriovenous fistulas are a rare entity accounting for 10 % of all dAVFs. Haemorrhage occurs in up to 91 % of cases, which is a particularly high risk and warrants therapeutic intervention. Endovascular treatment for these fistulas using the conventional detachable microcatheter technique is associated with certain limitations and risks; 8.

Primary endovascular embolisation of intracranial arteriovenous malformations (AVM)-UK single centre experience.

Purpose: Intracranial arteriovenous malformations (AVMs) treated at our institution with modern techniques of endovascular intervention were analysed for the rate of complete occlusion, associated morbidity, and mortality. To our knowledge, this is the first series from the UK evaluating the effectiveness of endovascular embolisation as a primary treatment for selected cases.

Methods: All newly referred AVMs between January 2017 and June 2022 were reviewed and those treated with primary endovascular intervention were identified.

Reducing radiation exposure in neurointervention through dedicated training on the biplane angiographic system.

Aim: To investigate whether the radiation dose in neurointerventional procedures is reduced if the interventionalist has a better working knowledge and skill to operate the biplane angiographic system (BAS).

Materials And Methods: It is common practice in most centres in the UK for radiographers to drive many of the functions of the BAS under the instruction of the interventionalist who performs the procedure. The dose profile of a neurointerventionalist who was trained to perform procedures while operating the BAS independently was evaluated against that of a highly experienced neurointerventionalist when operating with a radiographer-assisted BAS.

Thalamic versus midbrain tremor; two distinct types of Holmes' Tremor: a review of 17 cases.

Introduction: Holmes Tremor (HT) is a unique and debilitating movement disorder. It usually results from lesions of the midbrain and its connection but can also result from posterior thalamic injury. Clinical examination can help lesion localization between these two areas.

A case series of intracranial dural arteriovenous fistulae mimicking cervical myelitis: a diagnosis not to be missed.

Objective: To describe the diagnostic features of intracranial dural arteriovenous fistulae (DAVF) presenting with cervical cord or brainstem swelling.

Methods: Retrospective case note and neuroimaging review of patients with angiographically confirmed DAVF diagnosed during January 2015-June 2020 at a tertiary neuroscience centre (Walton Centre NHS Foundation Trust, Liverpool, UK).

Results: Six intracranial DAVF causing cervical cord or brainstem oedema (all males aged 60-69 years) and 27 spinal DAVF (88% thoracolumbar) were detected over a 5.

Is four-dimensional CT angiography as effective as digital subtraction angiography in the detection of the underlying causes of intracerebral haemorrhage: a systematic review.

Purpose: To determine whether the sensitivity and specificity of four-dimensional CTA (4D-CTA) are equivalent to digital subtraction angiography (DSA) in the detection of underlying vascular abnormalities in patients with intracerebral haemorrhage (ICH).

Methods: A systematic review of studies comparing 4D-CTA with DSA in the detection of the underlying structural causes of ICH was performed on the literature published between 1998 and 2019.

Results: We identified a total of 237 articles from PubMed, SCOPUS and Web of Science using the following Medical Subject Headings (MeSH) terms: primary intracerebral haemorrhage, 4D-CTA, DSA, cerebral haemorrhage, angiography, digital subtraction, arteriovenous malformations, 4D, CTA, dynamic-CTA and time-resolved CTA.

Urban-suburban differences in GP requests for lumbosacral spine radiographs in a primary healthcare centre in Malta.

Introduction: Due to demographic changes, growing demands, technological developments and rising healthcare costs, analysis of resources in rural and urban primary care clinics is crucial. However, data on primary care provision in rural and suburban areas are lacking. Moreover, health inequities in small island communities tend to be reduced by social homogeneity and an almost indiscernible urban-rural difference.

A Review of the Current Evidence on Gadolinium Deposition in the Brain.

Over the past 3 years, gadolinium-based contrast agents have been linked to MRI signal changes in the brain, which have been found to be secondary to gadolinium deposition in the brain, particularly in the dentate nuclei and globus pallidus even in patients having an intact blood-brain barrier and a normal renal function. This tends to occur more in linear agents than with macrocyclic agents. Nonetheless, there has been no significant evidence that this has any clinical consequence.

Is it safe to use gadolinium-based contrast agents in MRI?

Gadolinium-based contrast agents have greatly expanded the capability of magnetic resonance imaging and have been used extensively in neuroradiology over the past 30 years. When initially developed they were thought to be relatively harmless; it was later discovered they are associated with nephrogenic systemic fibrosis and should be used with caution in certain patient groups, especially those with renal failure. Lately it has been found that the use of these contrast agents may result in deposition of gadolinium in the brain even in patients with an intact blood-brain barrier.

Perceptions of first-year medical students towards learning anatomy using cadaveric specimens through peer teaching.

During the last decade, global interest in the multiple benefits of formal peer teaching has increased. This study aimed to explore the perceptions of first-year medical students towards the use of peer teaching to learn anatomy using cadaveric specimens. A descriptive, cross-sectional, retrospective survey was carried out.

Continuous Positive Airway Pressure: Is it a route for infection in those with Obstructive Sleep Apnoea?

Introduction: Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnoea (OSA), with limited data about the prevalence of respiratory infections and microbial colonization in these patients.

Objectives: The aim of this study was to determine if CPAP use is associated with respiratory infections and to identify the organisms that colonize or infect these patients.

Method: A retrospective, case-controlled study in patients diagnosed with OSA was carried out.

Acute pulmonary oedema: not always cardiogenic.

A patient presented with fulminant pulmonary oedema and required acute intubation and ventilation. There was no history of a prior cardiac disorder. As he was weaned from sedation, following stabilisation of his pulmonary status, neurological signs suggestive of brainstem dysfunction became apparent.

An efficacy and safety comparison between different stentriever designs in acute ischaemic stroke: a systematic review and meta-analysis.

Aim: To assess the recanalisation rates and long-term functional outcomes of the Solitaire and Trevo devices; to compare these results to those from the Solitaire With the Intention For Thrombectomy (SWIFT) trial and TREVO 2 studies; and to assess for statistical differences in the outcomes between the two devices.

Materials And Methods: A systematic review and meta-analysis of studies that utilised stentrievers in the treatment of acute ischaemic stroke was conducted. The results were compared to those of the SWIFT and TREVO 2 trials and outcome differences between Trevo (Stryker, Kalamazoo, Michigan, USA) and Solitaire (ev3/Covidien, Irvine, California, USA) were analysed statistically.

Functional outcomes and recanalization rates of stent retrievers in acute ischaemic stroke: A systematic review and meta-analysis.

Background And Purpose: Intra-arterial therapy for acute ischaemic stroke has evolved rapidly in the last few years. Stent retrievers have now replaced 'first-generation' devices, which have been the principle devices tested in stroke trials.Our aims were to determine the rates of successful recanalization and functional independence in acute stroke patients treated with stent retrievers.

A local perspective to asthma management in the accident and emergency department in Malta.

Aim: This study was performed to assess the management of adult patients presenting to the Mater Dei Hospital Accident and Emergency (A&E) department with acute asthma.

Subjects And Methods: Asthmatic patients age 14 or older who presented to A&E department between January and October 2010 with asthma exacerbations were included. Data were collected from the clinical notes and analyzed.

Freedom of movement across the EU: legal and ethical issues for children with chronic disease.

While freedom of movement has been one of the most highly respected human right across the EU, there are various aspects which come into play which still need to be resolved for this to be achieved in practice. One of these key issues is cross border health care. Indeed, there is an increasing awareness of standardisation of health service provision and cross border collaboration in the EU.