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The authors subjected 40 aneurysms (37 unruptured, 3 ruptured) to 4D flow MR imaging. They visualized streamlines with velocities below the threshold—that is, a percentage value of the aneurysm maximum inflow velocity—and progressively decreased the threshold to identify vortex cores as thin, streamline bundles with minimum velocities. A simple flow pattern (single vortex core) was identified in 27 aneurysms; the other 13 exhibited a complex flow pattern. The cores were stable in 32 and unstable in 8 aneurysms. Significantly more aneurysms with-than-without blebs or daughter sacs had a complex flow pattern. The identification of vortex cores on 4D flow MR imaging may help to stratify the rupture risk of unruptured cerebral aneurysms.

The authors describe the microsurgical anatomy of the great posterior radiculomedullary artery with emphasis on its morphometric parameters as well as its implications for spinal cord blood supply. The artery of Adamkiewicz in spinal cord specimens (n = 50) was injected with colored latex until the small-caliber arterial vessels were filled and the great posterior radiculomedullary artery was identified. The course, diameter, and location of great posterior radiculomedullary artery were documented. A great posterior radiculomedullary artery was identified in 36 (72%) spinal cord specimens. In 11 (22%) specimens, bilateral great posterior radiculomedullary arteries were present. In 13 cases (26%), a unilateral left-sided great posterior radiculomedullary artery was identified. In 11 cases (22%), a unilateral right-sided great posterior radiculomedullary artery was identified.

Intracranial atherosclerosis, a major risk factor for ischemic stroke, is thought to have different atherogenic mechanisms than extracranial atherosclerosis. Studies investigating their relationship in vivo are sparse and report inconsistent results. Within the Second Manifestations of ARTerial disease–Magnetic Resonance (SMART) Study, cross-sectional analyses were performed in 130 patients with a history of vascular disease and with assessable 7T intracranial vessel wall MR imaging data. Intracranial atherosclerosis burden was defined as the number of intracranial vessel wall lesions in the circle of Willis and its major branches. Significant associations were observed between higher intracranial atherosclerosis burden and carotid intima-media thickness, 50%–100% carotid stenosis versus no stenosis, ankle-brachial index, and estimated glomerular filtration rate. No significant differences in intracranial atherosclerosis burden were found among different categories of vascular disease.