Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature.

Background: We retrospectively investigate feasibility and safety of whole brain radiotherapy (WBRT) including a simultaneous-integrated boost technique (WBRT-SIB) in a cohort of patients with a very poor prognosis suffering from multiple and/or large brain metastases, unfavorable primary histology, poor performance status and/or symptomatic BMs.

Materials And Methods: Thirty-five patients with high brain tumor burden, extracranial metastases and low life-expectancy were treated with WBRT-SIB mostly with 35-42 Gy/14 fractions. All metastases were boosted in patients with up to 12 BMs.

Rendezvous intervention using combined surgical carotid endarterectomy followed by endovascular thrombectomy in patients with acute tandem occlusions: a proof-of-concept experience at a tertiary care center.

Background: Endovascular thrombectomy (EVT) is highly effective in acute stroke patients with intracranial large vessel occlusion (LVO), however, presence of concomitant cervical occlusion of the internal carotid artery (ICA) may limit the endovascular access. This study describes feasibility and efficacy of a surgical carotid access (cutdown) to perform interdisciplinary recanalization therapy including carotid endarterectomy (CEA) followed by EVT for recanalization of intracranial LVO in stroke patients with tandem occlusions.

Methods: We identified stroke patients with tandem occlusions who underwent a combined surgical-endovascular approach over a 5-year period.

TCCD Fusion Imaging to Estimate Intracranial Pressure and Tissue Displacement with Large Hemispheric Infarction.

Background: Despite breakthroughs in stroke treatment, some patients still experience large infarctions of the cerebral hemispheres resulting in mass effect and tissue displacement. The evolution of mass effect is currently monitored using serial computed tomography (CT) imaging. However, there are patients who are ineligible for transport, and there are limited options for bedside monitoring of unilateral tissue shift.

Clinical Comparison of FD-CT and MS-CT in Aneurysmal Subarachnoid Haemorrhage: A Single Center Experience.

Single-center comparison of postinterventional multislice computed tomography (MS-CT) and flat-detector computed tomography (FD-CT) in patients with subarachnoid haemorrhage (SAH) and endovascularly treated cerebral aneurysms with a focus on detection of posttherapeutical complications. Patients with endovascularly treated aneurysmal SAH undergoing both MS-CT and FD-CT within 24 h after intervention were included. Datasets were compared regarding image quality (IQ) as well as qualitative (detection of SAH, intracerebral haemorrhage [ICH], intraventricular haemorrhage [IVH], external ventricular drain [EVD] position, acute obstructive hydrocephalus [AOH]) and quantitative (cella media distance [CMD], modified Graeb score [GS]) parameters.

Clinical Evaluation of an Innovative Metal-Artifact-Reduction Algorithm in FD-CT Angiography in Cerebral Aneurysms Treated by Endovascular Coiling or Surgical Clipping.

Treated cerebral aneurysms (IA) require follow-up imaging to ensure occlusion. Metal artifacts complicate radiologic assessment. Our aim was to evaluate an innovative metal-artifact-reduction (iMAR) algorithm for flat-detector computed tomography angiography (FD-CTA) regarding image quality (IQ) and detection of aneurysm residua/reperfusion in comparison to 2D digital subtraction angiography (DSA).

Superficial siderosis as a rare cause of visual and auditory pseudohallucinations: a case report.

Background: Superficial siderosis is a rare disease involving hemosiderin deposits on the surface of brain or spinal cord that are thought to cause clinical symptoms, which usually consist of cranial nerve dysfunction, cerebellar ataxia, or myelopathy. Pseudohallucinations have been described as the patient being aware of the nonreality of hallucination-like phenomena. Data on pseudohallucinations of cerebral somatic origin are sparse.

Case Report: A Well-Hidden Cause for Myelopathy.

Sarcoidosis is a rare, systemic inflammatory disease and can involve multiple organs, especially the lungs and lymph nodes. The nervous system is affected in <10 percent of patients, which is called neurosarcoidosis. Neurosarcoidosis can cause a multitude of symptoms and can mimic various diseases.

Evaluation After Cochlear Implant Surgery : Correlation of Clinical Outcome and Imaging Findings using Flat-detector CT.

Purpose: Assessment of the cochlear implant (CI) electrode array position using flat-detector computed tomography (FDCT) to test dependence of postoperative outcome on intracochlear electrode position.

Methods: A total of 102 patients implanted with 107 CIs underwent FDCT. Electrode position was rated as 1) scala tympani, 2) scala vestibuli, 3) scalar dislocation and 4) no deconvolution.

Stent-Assisted Coiling Using Leo+ Baby Stent : Immediate and Mid-Term Results.

Background: Stent-assisted coiling is well-established for treatment of cerebral aneurysms. The technique enables treatment of wide-neck, bifurcation and recurrent aneurysms with high packing rates. While described in extenso for laser cut stents, the results of patients treated with the Leo+ Baby (Balt, Montmorency, France) braided microstent are presented.

Antiplatelet Therapy in Primary Spontaneous and Oral Anticoagulation-Associated Intracerebral Hemorrhage.

Background and Purpose- This study determined the influence of concomitant antiplatelet therapy (APT) on hematoma characteristics and outcome in primary spontaneous intracerebral hemorrhage (ICH), vitamin K antagonist (VKA)- and non-VKA oral anticoagulant-associated ICH. Methods- Data of retrospective cohort studies and a prospective single-center study were pooled. Functional outcome, mortality, and radiological characteristics were defined as primary and secondary outcomes.

The POST trial: initial post-market experience of the Penumbra system: revascularization of large vessel occlusion in acute ischemic stroke in the United States and Europe.

Background And Purpose: The purpose of this study was to assess the initial post-market experience of the device and how it is compared with the Penumbra Pivotal trial used to support the 510k application.

Methods: A retrospective case review of 157 consecutive patients treated with the Penumbra system at seven international centers was performed. Primary endpoints were revascularization of the target vessel (TIMI score of 2 or 3), good functional outcome as defined by a modified Rankin scale (mRS) score of ≤2 and incidence of procedural serious adverse events.

Flat Panel Detector Computed Tomography-Guided Placement of External Ventricular Drains Using the BrainLAB Headband and Precalibrated Disposable Stylet Instrument: A Cadaveric Feasibility Study.

Background: The standard freehand method for the insertion of external ventricular drains (EVDs) is associated with high rates of incorrect placement. Use of neuronavigation has been shown to reduce the rates of inaccurately positioned EVDs. We present a novel neuronavigation-based approach for EVD placement using flat panel detector computed tomography (FDCT) imaging.

Presence of Concomitant Systemic Cancer is Not Associated with Worse Functional Long-Term Outcome in Patients with Intracerebral Hemorrhage.

Background: Data on clinical characteristics and outcome of patients with intracerebral hemorrhage (ICH) and concomitant systemic cancer disease are very limited.

Methods: Nine hundred and seventy three consecutive primary ICH patients were analyzed using our prospective institutional registry over a period of 9 years (2006-2014). We compared clinical and radiological parameters as well as outcome - scored using the modified Rankin Scale (mRS) and analyzed in a dichotomized fashion as favorable outcome (mRS = 0-3) and unfavorable outcome (mRS = 4-6) - of ICH patients with and without cancer.

Value of Flat-detector Computed Tomography Angiography with Intravenous Contrast Media Injection in the Evaluation and Treatment of Acutely Ruptured Aneurysms of the AcomA complex: A Single Center Experience in 15 Cases.

Objective: To illustrate the added value of flat-detector computed tomography angiography with intravenous contrast media injection (intravenous FDCTA) in the evaluation of complex A1/A2/AcomA aneurysms.

Patients And Methods: We retrospectively reviewed 15 patients with ruptured aneurysms. In each patient, an intravenous FDCTA was performed and its diagnostic value investigated.

Ischemic stroke associated with the use of a synthetic cannabinoid (spice).

Synthetic cannabinoids, i.e. "spice", are psychoactive drugs with increasing use worldwide.

Predictors for occlusion of cerebral AVMs following radiation therapy : Radiation dose and prior embolization, but not Spetzler-Martin grade.

Background: Intracranial arteriovenous malformations (AVMs) may show a harmful development. AVMs are treated by surgery, embolization, or radiation therapy.

Objective: This study investigated obliteration rates and side effects in patients with AVMs treated by radiation therapy.

Optimized Flat-Detector CT in Stroke Imaging: Ready for First-Line Use?

Background: Using flat-detector CT (FD-CT) for stroke imaging has the advantage that both diagnostic imaging and endovascular therapy can be performed directly within the Angio Suite without any patient transfer and time delay. Thus, stroke management could be speeded up significantly, and patient outcome might be improved. But as precondition for using FD-CT as primary imaging modality, a reliable exclusion of intracranial hemorrhage (ICH) has to be possible.

Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector CT in comparison to pre-treatment CT in patients with acute subarachnoid haemorrhage.

Objectives: Metal artefacts can impair accurate diagnosis of haemorrhage using flat detector CT (FD-CT), especially after aneurysm coiling. Within this work we evaluate a prototype metal artefact reduction algorithm by comparison of the artefact-reduced and the non-artefact-reduced FD-CT images to pre-treatment FD-CT and multi-slice CT images.

Methods: Twenty-five patients with acute aneurysmal subarachnoid haemorrhage (SAH) were selected retrospectively.

Clinical and radiological outcome after mechanical thrombectomy in acute ischemic stroke: What matters?

Objective: Recent studies have shown the efficacy of mechanical thrombectomy in acute ischemic stroke. We sought to identify prognostic parameters for clinical and radiological outcome after mechanical thrombectomy.

Methods: In 34 patients (age 72 ± 13 years, 64.

Flow-diverting stents allow efficient treatment of unruptured, intradural dissecting aneurysms of the vertebral artery: An explanatory approach using in vivo flow analysis.

Object: Our study aimed to evaluate the efficiency of flow-diverting stents (FDS) in treating unruptured, intradural dissecting aneurysms of the vertebral artery (VADAs). Additionally, the effect of FDS on the aneurysmal flow pattern was investigated by performing in vivo flow analysis using parametric color coding (PCC).

Methods: We evaluated 11 patients with unruptured, intradural VADAs, treated with FDS.

Time-Resolved C-Arm Computed Tomographic Angiography Derived From Computed Tomographic Perfusion Acquisition: New Capability for One-Stop-Shop Acute Ischemic Stroke Treatment in the Angiosuite.

Background And Purpose: Multimodal imaging using cone beam C-arm computed tomography (CT) may shorten the delay from ictus to revascularization for acute ischemic stroke patients with a large vessel occlusion. Largely because of limited temporal resolution, reconstruction of time-resolved CT angiography (CTA) from these systems has not yielded satisfactory results. We evaluated the image quality and diagnostic value of time-resolved C-arm CTA reconstructed using novel image processing algorithms.