Table of Contents
Editorial
Perspectives
Review Articles
Expedited Publication
- MRI Surrogates for Molecular Subgroups of Medulloblastoma
These authors seek to establish the imaging features that would allow classification of medulloblastomas according to their genetic attributes. In nearly 100 tumors they found that groups 3 and 4 occurred predominantly in the fourth ventricle, wingless ones were located in the cerebellar peduncles or CPA region, and sonic hedgehog tumors were present in cerebellar hemispheres. Midline group 4 tumors showed minimal contrast enhancement. Thus, tumor location and contrast-enhancement patterns may be predictive of the molecular subtypes of medulloblastoma.
Patient Perspectives
- Are We Effectively Informing Patients? A Quantitative Analysis of On-Line Patient Education Resources from the American Society of Neuroradiology
The readability of 20 patient education articles found on the ASNR Web site were evaluated using 10 quantitative readability scales and compared with those found on the Web site of the Society of Neurointerventional Surgery. The authors concluded that the patient education resources on both Web sites failed to meet the guidelines of the National Institutes of Health and American Medical Association. Members of the public may fail to fully understand these resources and would benefit from revisions that result in more comprehensible information cast in simpler language.
Patient Safety
Brain
- Perfusion-Based Selection for Endovascular Reperfusion Therapy in Anterior Circulation Acute Ischemic Stroke
The authors attempted to determine if reperfusion therapy for anterior circulation acute stroke based on MR perfusion resulted in better outcomes at 3 months than that based on noncontrast CT. Perfusion imaging-selected patients had a better outcome than those selected with only noncontrast CT but MR perfusion- and CT perfusion-selected patients had similar outcomes. In this multicenter study, patients with acute stroke who underwent perfusion imaging were more than 2-fold more likely to have good outcomes following endovascular reperfusion therapy
Interventional
- Use of Flow-Diverting Devices in Fusiform Vertebrobasilar Giant Aneurysms: A Report on Periprocedural Course and Long-Term Follow-Up
This article presents the authors' experience and long-term follow-up of 6 patients with fusiform and giant aneurysms of the vertebrobasilar system treated with flow-diverting devices. Devices were deployed uneventfully with no periprocedural complications. One year later, 3 patients had recurrent cerebral infarctions and 2 had acute thrombotic in-stent occlusions. Four patients died during the follow-up period. The authors do not intend to treat any more patients in this fashion until they have a better understanding of flow-diverting devices in this setting.
- Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke
More than 100 conservatively managed nonstroke dissecting vertebrobasilar artery aneurysms were followed on average for 3 years. Ninety-seven percent of patients remained clinically unchanged and the 3 patients who deteriorated clinically had aneurysm enlargement. The natural course of these lesions suggests that acute intervention is not always required and close follow-up without antithrombotic therapy is reasonable. Patients with symptoms due to mass effect or aneurysms of >10 mm may require treatment.
- Influence of Patient Age on Angioarchitecture of Brain Arteriovenous Malformations
Over 800 AVMs were retrospectively reviewed to determine if clinical and angioarchitectural features varied between children and adults. The authors found that hemorrhages and exclusively deep venous drainage were more common in children but high-risk features such as venous ectasia and feeding artery aneurysm were more common in adults. Thus, these latter high-risk features may take time to develop.
