[Stroke in octogenarians].

Stroke is one of the most common causes of disability in older adults. It remains a common cause of death and permanent functional limitation in individuals who are older than 80 years. Approximately 50% of all strokes occur in people over the age of 75, and 30% in those over 85.

[Recent clinical studies and the S3 guidelines on stroke].

Background: Treatment of patients with acute stroke requires hospitalization. Cooperation of neurologists, neuroradiologists, intensive care physicians, internists, and cardiologists is required to achieve best possible outcome.

Objective: A summary of the current recommendations for stroke treatment is provided.

[Treatment of tandem occlusions of the common and internal carotid arteries].

Background: Proximal carotid tandem lesions are defined as multilevel lesions with significant (> 50%) atherosclerotic disease involving the internal carotid artery (ICA) in combination with the proximal ipsilateral common carotid artery (CCA) or innominate artery (IA). It is a relatively rare disease with an incidence of less than 5% in all patients with carotid stenosis at the level of the bifurcation.

Methods: These patients are at high surgical risk and were, therefore, excluded from current randomized controlled trials.

CIRSE Standards of Practice on Carotid Artery Stenting.

Background: Carotid artery stenting has been used effectively to treat internal carotid artery stenosis since 1989 (Mathias et al. in World J Surg. 25(3):328-34, 2001), with refined and expanded techniques and tools presently delivering outstanding results in percutaneous endoluminal treatment of carotid artery stenosis.

Development and Evaluation of an MRI Artifact-Free Aneurysm Clip.

Background And Objectives: The digital subtraction angiography is still the gold standard in the follow-up after aneurysm surgery, although it remains a repeating invasive technique with accumulating X-ray exposure. An alternative magnetic resonance angiography has the disadvantage of metal-related artifacts. A metal-free aneurysm clip could overcome this problem.

Extracranial internal carotid aneurysm treated with a covered stent in an infant.

Background: Extracranial internal carotid aneurysms consist a rare pathology with an overall incidence less than 1% in the general population, and warrant treatment due to their association with cerebrovascular events and neurological complications. The incidence is even lower in the pediatric population.

Case Report: A 14-month infant presented in our clinic with neck swelling of unknown origin, with subsequent MR imaging revealing an extracranial internal carotid aneurysm.

Impact of cannabis use on brain metabolism using P and H magnetic resonance spectroscopy.

Purpose: This prospective cross-sectional study investigated the influence of regular cannabis use on brain metabolism in young cannabis users by using combined proton and phosphorus magnetic resonance spectroscopy.

Methods: The study was performed in 45 young cannabis users aged 18-30, who had been using cannabis on a regular basis over a period of at least 2 years and in 47 age-matched controls. We acquired 31P MRS data in different brain regions at 3T with a double-resonant 1H/31P head coil, anatomic images, and 1H MRS data with a standard 20-channel 1H head coil.

Evaluation of a novel polymer coil for endovascular occlusion of intracranial aneurysms in a rabbit model.

Background And Purpose: The results of the preclinical study of a novel polymer coil in treatment of elastase induced aneurysms will be presented in this paper.

Material And Methods: We induced 16 aneurysms in 16 New Zealand white rabbits at the origin of the right common carotid artery at the brachiocephalic trunk. Newly developed polymer coils in both groups for six aneurysms each and platinum coils for two aneurysms each were used.

[Secondary tumors following radiation therapy and chemotherapy : Incidence of cavernous hemangiomas].

Problem: There is a risk of developing secondary central nervous system (CNS) tumors after cranial radiation therapy. Meningiomas and pituitary tumors are also increasingly treated with radiation therapy, which means that the risk of secondary tumors from radiation in children and adults must be communicated.

Methods: Studies in children show that radiation causes a 7- to 10-fold increase in subsequent CNS tumors with a cumulative incidence over 20 years ranging from 1.

Recurrent reversible in-stent-stenosis after flow diverter treatment.

Flow diverter stents (FDS) are well established in the treatment of intracranial aneurysms which are difficult to treat with conventional endovascular techniques. However, they carry a relatively high risk of specific complications compared to conventional stents. A minor but frequent finding is the occurrence of reversible in-stent-stenosis (ISS) that tend to resolve spontaneously over time.

Functional correlates of neurological soft signs in heavy cannabis users.

Sensorimotor dysfunction has been previously reported in persons with cannabis dependence. Such individuals can exhibit increased levels of neurological soft signs (NSS), particularly involving motor coordination, sensorimotor integration and complex motor task performance. Abnormal NSS levels can also be detected in non-dependent individuals with heavy cannabis use (HCU), yet very little is known about the functional correlates underlying such deficits.

Endovascular Treatment Strategies for Aneurysms of the Origin of the Posterior Inferior Cerebellar Artery.

Background: Treatment of aneurysms at the origin of the posterior inferior cerebellar artery (PICA) is challenging. Surgery is difficult due to the deep location and proximity to cranial nerves and endovascular treatment is complicated due to the often tortuous anatomy of the PICA and its small diameter. The purpose of this study is to report our experience with the endovascular treatment of aneurysms at the origin of the PICA.

[Interdisciplinary neurovascular conference-opportunities and benefits].

Clinical/methodological Issue: The neurovascular conference is a discussion platform for the fields of neurology, neurosurgery, vascular surgery and neuroradiology.

Methodological Innovations: Interdisciplinary exchange allows creation of individual treatment concepts for elective patients with neurovascular diseases regarding further measures for prevention, treatment and aftercare.

Achievements: Establishment of individual treatment concepts for patients with neurovascular diseases regarding treatment recommendations based on current guidelines, scientific evidence and treatment standards based on them.

A Multi-Omics Approach Reveals Features That Permit Robust and Widespread Regulation of IFN-Inducible Antiviral Effectors.

The antiviral state, an initial line of defense against viral infection, is established by a set of IFN-stimulated genes (ISGs) encoding antiviral effector proteins. The effector ISGs are transcriptionally regulated by type I IFNs mainly via activation of IFN-stimulated gene factor 3 (ISGF3). In this study, the regulatory elements of effector ISGs were characterized to determine the (epi)genetic features that enable their robust induction by type I IFNs in multiple cell types.

Treatment of Wide-Necked Cerebral Aneurysms Using the WEB Device Including Flow Alteration Assessment With Color-Coded Imaging: A Single Center Experience.

Objective: The Woven EndoBridge (WEB) device (MicroVention, Tustin, CA) has extended the treatment of cerebral aneurysms. Despite the fact that the WEB device has shown promising clinical results, little is known about the caused intra-aneurysmal flow alterations. Here we present our clinical experience with the WEB, including examining various syngo iFlow (Siemens AG, Erlangen, Germany) parameters to predict aneurysm occlusion.

Cranial MRI in Childhood Acute Leukemia during Treatment and Follow-Up Including the Impact of Intrathecal MTX-A Single-Center Study and Review of the Literature.

Due to high survival rates, long-term sequelae, especially neurotoxicity, need to be considered in childhood acute leukemias. In this retrospective analysis of morphologic changes of the brain in children treated for acute leukemias, we included 94 patients (77 ALL, 17 AML; 51 male, 43 female; median age: 5 years) from a single center. We analyzed 170 cranial MRI scans (T2, FLAIR axial) for morphologic alterations of the brain and variations of the ventricular width (GDAH).

Learning Curve for Flow Diversion of Posterior Circulation Aneurysms: A Long-Term International Multicenter Cohort Study.

Background And Purpose: Flow diversion has gradually become a standard treatment for intracranial aneurysms of the anterior circulation. Recently, the off-label use of the flow diverters to treat posterior circulation aneurysms has also increased despite initial concerns of rupture and the suboptimal results. This study aimed to explore the change in complication rates and treatment outcomes across time for posterior circulation aneurysms treated using flow diversion and to further evaluate the mechanisms and variables that could potentially explain the change and outcomes.

Schwannoma of the Hypoglossal Nerve Mimicking Carotid Body Paraganglioma.

Carotid body paragangliomas (CBPs) clinically present as highly vascularized cervical masses with a pathognomonic localization at the carotid artery bifurcation. Following ultrasonography and MRI/CT imaging, surgical resection with optional preoperative embolization is considered as the treatment of choice in most cases. We herein present the case of a 60-year-old female with characteristic clinical signs and imaging findings of a right-sided CBP who finally went to surgical treatment.