Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Silent brain infarcts (SBIs), which manifest as dot-like lesions on diffusion-weighted imaging (DWI) after endovascular procedures, are associated with an increased risk of stroke, dementia, and cognitive decline. We aimed to identify the factors associated with SBIs following middle cerebral artery (MCA) stenting or balloon angioplasty. ⋯ Stenosis diameter, stenosis length, and MCA tortuosity were significantly associated with the development of SBIs following MCA stenting.
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The venous outflow profile (VOP) is a crucial yet often overlooked aspect affecting stroke outcomes. It plays a major role in the physiopathology of acute cerebral ischemia, as it accounts for both the upstream arterial collaterals and cerebral microperfusion. This enables it to circumvent the limitations of various arterial collateral evaluation systems, which often fail to consider impaired autoregulation and its impact on cerebral blood flow at the microcirculatory levels. In this narrative review, we will highlight the different parameters and modalities used to assess the VOP in acute ischemia. ⋯ VOP parameters' significance lies in their potential to predict tissue fate and, subsequently, clinical outcomes. Recent studies indicate that favorable VOP is independently associated with slower rates of infarct edema progression, smaller infarct volumes, and higher rates of functional independence after 90 days. Moreover, it is considered a predictor of recanalization success and the first-pass effect during mechanical thrombectomy. Conversely, an unfavorable VOP predicts futile recanalization and indicates a higher risk of reperfusion hemorrhage. Our aim is to explore these prognostic implications and their relevance in determining the utility of intracranial intervention.
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Comparative Study
Comparison of antithrombogenic coated and uncoated flow diverters in ruptured and unruptured cerebral aneurysms.
Flow diversion has become a key treatment option for complex intracranial aneurysms. Recent advancements include coated flow diverters (FDs), designed to potentially reduce the need for dual antiplatelet therapy, thereby removing the associated secondary risks while maintaining patency and low complication rates. Comparing coated and uncoated FDs may offer insights into long-term outcomes and treatment optimization. ⋯ We observed favorable occlusion rates for both coated and uncoated FDs. The role of dual antiplatelet therapy remains debated. Large multicenter studies are essential to evaluate the patency of coated compared to uncoated FDs and determine whether they can reduce thrombogenicity, potentially allowing for less or no antiplatelet therapy in emergencies.
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This study presents automated atlas-based magnetization transfer (MT) measurements of the typically developing pediatric cervical spinal cord (SC). We report normative MT ratio (MTR) values from the whole cervical cord white matter (WM) and WM tracts, examining variations with age, sex, height, and weight. ⋯ This study provides an understanding of MTR values in pediatric cervical SC and their variations by sex, age, height, and weight, providing a baseline for comparisons in pediatric SC diseases.
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Accurate and consistent lesion segmentation from magnetic resonance imaging is required for longitudinal multiple sclerosis (MS) data analysis. In this work, we propose two new transfer learning-based pipelines to improve segmentation performance for subjects in longitudinal MS datasets. ⋯ The proposed method improved lesion segmentation performance and can reduce manual effort to correct the automatic segmentations for final data analysis in longitudinal studies.