- Imaging of Patients with Suspected Large-Vessel Occlusion at Primary Stroke Centers: Available Modalities and a Suggested Approach
Endovascular thrombectomy has proven efficacy for a wide range of patients with large-vessel occlusion stroke and in selected cases up to 24 hours from onset. While primary stroke centers have increased the proportion of patients withstroke receiving thrombolytic therapy, delays can be encountereduntil patients with LVO are identified and transferred from the primary stroke center to acomprehensive stroke center. Therefore, any extra steps need to be carefullyweighed. The use of CTA (especially multiphase) at the primary stroke center levelhas many advantages in expediting the transfer of appropriate patients to a comprehensive center.
- Endovascular Treatment of Unruptured MCA Bifurcation Aneurysms Regardless of Aneurysm Morphology: Short- and Long-Term Follow-Up
Between May 2008 and July 2017, endovascular treatment of 1184 aneurysms in 827 patients was performed in a single institution. Twenty-four percent of these aneurysms were located at the MCA, and 150 unruptured MCA bifurcation aneurysms treated with coiling, stent-assistedcoiling, or endovascular flow diverter (WEB device) were identified for this retrospective data analysis. The procedure-associated good clinical outcome was 89.9%, and the mortality rate was 2.7%. Short-term follow-up good clinical outcome/mortality rates were 91.3%/0.7%. At discharge, 137 patients had an mRS of 0–2 (91.3%) and 13 had an mRS of 3–6 (8.7%). The authors conclude that regardless of the architecture of MCA bifurcation aneurysms, endovascular treatment can be performed with low morbidity/mortality rates.
- 3T MRI Whole-Brain Microscopy Discrimination of Subcortical Anatomy, Part 1: Brain Stem
The authors applied an optimized TSE T2 sequence to washed postmortem brain samples to reveal exquisite and reproducible brain stem anatomic MR imaging contrast comparable with histologic atlases. Direct TSE MR imaging sequence discrimination of brain stem anatomy can help validate other MR imaging contrasts, such as diffusion tractography, or serve as a structural template for extracting quantitative MR imaging data in future postmortem investigations.
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