Unruptured intracranial aneurysms in pediatric sickle cell disease: clinical and MR imaging follow-up of 296 patients.

Objective: Currently available data regarding unruptured intracranial aneurysms (UIAs) in sickle cell disease (SCD) are largely based on adult patients; this has made it challenging to reach a consensus on treatment decisions and follow-up strategies for pediatric SCD patients with UIAs.

Methods: A retrospective review of 296 SCD patients (aged 18 years or younger) who underwent MRA from January 2008 to September 2022 was performed. The vessel of origin and characteristics of the UIAs, including maximum diameter, laterality, and number, were evaluated.

Pediatric brain aneurysms: a review of 1458 brain MR angiograms.

Purpose: To evaluate clinical and imaging characteristics of pediatric brain aneurysms.

Materials And Methods: A retrospective review of 1458 MR angiograms of pediatric patients (≤18 years old) obtained between 2006 and 2021 was performed. A non-infundibular arterial luminal outpouching larger than 1mm in size was identified as an "Intracranial aneurysm.

Cement Augmentation of Two-Level Lumbar Corpectomy Cage After Malposition: A Novel Salvage Procedure Technical Note.

Intervertebral cage mispositioning is an uncommon complication of a posterior lumbar corpectomy. Most frequently, cages are placed obliquely, laterally, or protruding. However, there are few reports of implanted cages that fail to contact the adjacent vertebral endplate and thus no descriptions of successful revisions.

Successful Treatment of Pediatric Holo-Spinal Epidural Abscess With Percutaneous Drainage.

Spinal epidural abscess (SEA) is a rare and potentially devastating neurologic disease that is commonly treated with neurosurgical decompression and evacuation. We describe the case of an 11-month-old immunocompetent infant who presented with a large multiloculated methicillin-resistant abscess in the left lung apex with likely mediastinal involvement, extending into the epidural space from C7 down to L2 causing cord compression which was successfully treated with percutaneous placement of an epidural drainage catheter and antibiotic therapy. Although there are rare reports of percutaneous drainage of SEAs, to our knowledge, there are no reports of successful use of percutaneous indwelling catheters resulting in the complete resolution of an SEA.

Cost-effective analysis of mechanical thrombectomy (MT) in patients with poor baseline modified Rankin Score (mRS).

Mechanical thrombectomy (MT) has been established as a standard of care for patients with acute ischemic stroke for the past five years. However, the direct benefits of this treatment in patients with baseline disability remains unclear. This study aims to elucidate the cost impact of performing MT on patients with moderate-to-severe baseline disability to work towards an optimized system of care for acute ischemic stroke.

Predictors of mortality for patients with COVID-19 and large vessel occlusion.

Background: This study evaluates the mortality risk of patients with emergent large vessel occlusion (ELVO) and COVID-19 during the pandemic.

Methods: We performed a retrospective cohort study of two cohorts of consecutive patients with ELVO admitted to a quaternary hospital from March 1 to April 17, 2020. We abstracted data from electronic health records on baseline, biomarker profiles, key time points, quality measures and radiographic data.

WITHDRAWN: Neurological examination, rather than vascular risk factor assessment, serves to distinguish strokes from stroke mimics in a population with high prevalence of vascular risk factors.

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Sacroiliac joint injections with the guidance of three-dimensional cone beam computed tomography (3D-CBCT) and fluoroscopy fusion.

Background: We describe our diagnostic sacroiliac joint (SIJ) injection technique under the guidance of three-dimensional cone beam computed tomography (3D-CBCT) fused with real-time fluoroscopy.

Methods: A retrospective review of 17 patients (mean age 55.4 (range 40-74) years) who received a total of 23 diagnostic SIJ injections between March 2016 and November 2017 were performed.

Transarterial and transvenous access for neurointerventional surgery: report of the SNIS Standards and Guidelines Committee.

The purpose of this publication is to provide a comprehensive review on the techniques and tools used for vascular access in neurointerventional procedures. Using published literature, we reviewed data on access methods, sites, tools, and techniques for neurointerventions. Recommendations are provided based on quality of data/levels of evidence and, where appropriate, expert consensus.

Percutaneous Interventional Management of Spinal Metastasis.

Spinal metastasis is usually associated with debilitating pain and results in deteriorating life quality. The role of percutaneous management of spinal metastasis has evolved from a diagnostic role to a significant part of therapeutic options in conjunction with conventional management techniques, including radiotherapy and open surgical options. Percutaneous vertebral augmentation (PVA) showed substantial pain reduction, vertebral stabilization, and improvement of quality of life.

Gray matter atrophy in multiple sclerosis despite clinical and lesion stability during natalizumab treatment.

Background: Brain volume loss is an important surrogate marker for assessing disability in MS; however, contribution of gray and white matter to the whole brain volume loss needs further examination in the context of specific MS treatment.

Objectives: To examine whole and segmented gray, white, thalamic, and corpus callosum volume loss in stable patients receiving natalizumab for 2-5 years.

Methods: This was a retrospective study of 20 patients undergoing treatment with natalizumab for 24-68 months.

Patients with cranial dural arteriovenous fistulas may benefit from expanded hypercoagulability and cancer screening.

Objective: Cranial dural arteriovenous fistulas (DAVFs) have been associated with dural sinus occlusion, and previous reports have suggested the association of hypercoagulability with some cases. But the prevalence of a hypercoagulable state has not been systematically analyzed in conjunction with laboratory markers and clinical manifestations, including history of thromboembolism or systemic malignancy. The authors hypothesize that laboratory or clinical evidence of a hypercoagulable state, including cancer, is commonly identifiable in consecutively identified patients with DAVFs, with implications for clinical management.

Aspiration Thrombectomy After Intravenous Alteplase Versus Intravenous Alteplase Alone.

Background And Purpose: Thrombectomy, primarily with stent retrievers with or without adjunctive aspiration, provided clinical benefit across multiple prospective randomized trials. Whether this benefit is exclusive to stent retrievers is unclear.

Methods: THERAPY (The Randomized, Concurrent Controlled Trial to Assess the Penumbra System's Safety and Effectiveness in the Treatment of Acute Stroke; NCT01429350) was an international, multicenter, prospective, randomized (1:1), open label, blinded end point evaluation, concurrent controlled clinical trial of aspiration thrombectomy after intravenous alteplase (IAT) administration compared with intravenous-alteplase alone in patients with large vessel ischemic stroke because of a thrombus length of ≥8 mm.