Black blood vessel wall MRI to identify vulnerable atherosclerotic plaque in a non-stenotic intracranial vertebral artery as a cause of acute ischaemia.

Conventional neuroimaging techniques for investigating the cause of stroke are mainly centred on investigating luminal stenosis. The pathophysiology of intracranial atherosclerotic disease (ICAD) and stroke is complex and extends beyond just vessel narrowing. The concept of the vulnerable atherosclerotic plaque, that can result in acute coronary syndromes, has been well described in the cardiac literaturealthough this concept is less well accepted among stroke physicians.

Endosaccular flow disruption: where are we now?

Endosaccular flow disruption is an innovative method of treating wide-necked complex aneurysms. Currently four types of devices have obtained the CE mark for use within Europe. These are the Woven EndoBridge device (WEB), the Luna Aneurysm Embolization System, the Medina Embolic Device (Medtronic), and the Contour Neurovascular System.

Vessel wall enhancement of a ruptured intra-nidal aneurysm in a brain arteriovenous malformation.

Ruptured arteriovenous malformations are a frequently encountered pathology with significant associated morbidity and mortality. Identifying and securing the rupture point is mandatory; however, this can often be difficult. Black blood vessel wall magnetic resonance imaging is a promising technique for identifying ruptured saccular aneurysms and has been used in cases of multiple aneurysms.