L Miarka, U Taschner, R Rölz, M Prinz, H Urbach, D Erny, C A Taschner
{"title":"Freiburg Neuropathology Case Conference: Gait Ataxia, Segmental Hypoesthesia, and Combined Incontinence in a 57-Years-Old Patient.","authors":"L Miarka, U Taschner, R Rölz, M Prinz, H Urbach, D Erny, C A Taschner","doi":"10.1007/s00062-025-01528-1","DOIUrl":"https://doi.org/10.1007/s00062-025-01528-1","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Visualization of Culprit Perforating Artery in Subcortical Infarction Using 3D MRI and Angiography Fusion Image.","authors":"Junpei Koge, Shiori Ogura, Kanta Tanaka, Shuhei Egashira, Takeshi Yoshimoto, Masayuki Shiozawa, Yasutoshi Ohta, Tetsuya Fukuda, Masafumi Ihara, Kazunori Toyoda, Masatoshi Koga","doi":"10.1007/s00062-025-01520-9","DOIUrl":"https://doi.org/10.1007/s00062-025-01520-9","url":null,"abstract":"<p><strong>Purpose: </strong>Visualizing the culprit perforating artery in subcortical infarction using in vivo imaging is challenging. We aimed to identify the culprit perforating arteries in subcortical infarctions and assess their morphology using an image fusion technique.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients who had an ischemic stroke in the anterior circulation perforating area (caudate nucleus, lentiform nucleus, internal capsule, corona radiata, or centrum semiovale) and underwent three-dimensional rotational-angiography (3D-RA) and 3D fluid-attenuated inversion recovery MRI. Images were registered using an original fusion software. The spatial relationship between the infarction and culprit perforating artery and its morphological characteristics were analyzed in the fusion images. Stenosis was defined as > 50% luminal narrowing or a focal intraluminal defect in the perforating artery.</p><p><strong>Results: </strong>Of 118 patients, the culprit perforating artery was identified in 52 patients (44%); They tended to have younger age and had a higher baseline NIHSS score and higher prevalence of infarcts in the lentiform nucleus than did those without identified culprit perforating artery. Among the 44 patients with assessable morphology of the culprit perforating artery, 27 (61%) exhibited stenosis in the proximal segment. Atrial fibrillation was more frequent in patients without stenosis in the proximal segment of the culprit perforating artery than in those with stenosis (29% vs. 4%, P = 0.03).</p><p><strong>Conclusion: </strong>The 3D-RA and MRI fusion technique enables identification of the culprit perforating arteries in subcortical infarctions, especially in the lentiform nucleus. Morphological features of the culprit perforating artery may be associated with the etiological mechanism of stroke.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frederic De Beukelaer, Mohammed El Halal, Sophie De Beukelaer, Laura L Wuyts, Martin Wiesmann, Hani Ridwan, Charlotte S Weyland
{"title":"Photon-Counting CT-Angiography to Assess Intracranial Stents and Flow Diverters in Comparison to Digital Subtraction Angiography.","authors":"Frederic De Beukelaer, Mohammed El Halal, Sophie De Beukelaer, Laura L Wuyts, Martin Wiesmann, Hani Ridwan, Charlotte S Weyland","doi":"10.1007/s00062-025-01519-2","DOIUrl":"https://doi.org/10.1007/s00062-025-01519-2","url":null,"abstract":"<p><strong>Purpose: </strong>Photon-Counting Detector CT is characterized by enhanced image post-processing capabilities. The diagnostic accuracy of PCD-CT angiography (PCD-CTA) in assessing intracranial stents (ICS) and flow diverters (FD) has yet to be compared with digital subtraction angiography (DSA).</p><p><strong>Methods: </strong>Retrospective analysis of all consecutive patients who underwent ICS or FD implantation between April 2023 and May 2024. Polyenergetic images, along with virtual monoenergetic imaging (VMI), pure lumen (PL) and iodine (IOD) reconstructions were assessed by three readers using a 5-point Likert scale and defined regions of interest (ROIs). A blinded analysis was performed to identify relevant lumen reduction. The diagnostic accuracy of PCD-CTA was compared to DSA by calculating the area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>A total of 18 patients (mean age 59 ± 13 years; 14 women) with 14 implanted ICS and 10 FD were analyzed. Across all pairwise comparisons, pooled VMI reconstructions demonstrated higher ratings and signal-to-noise ratios compared to IOD, PL and UHR reconstructions (p < 0.001 for all comparisons). In the pooled assessment of DSA of in-stent vessel lumen 18 (11%) of the 162 vessel segments and 6 (33%) of the 18 patients presented relevant narrowing of the in-stent vessel lumen. The sensitivity of PCD-CTA for detecting stenosis was 100% (18 of 18 in-stent vessel segments), while specificity was 89% (128/144 in-stent vessel segments). All readers reported a 100% negative predictive value (128/128 in-stent vessel segments).</p><p><strong>Conclusion: </strong>Photon-Counting Detector CT might provide a reliable assessment of intracranial vessels following stent or flow diverter implantation comparable to DSA in many cases.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anton Gorbatykh, Dmitry Kislitsin, Timur Shayakhmetov, Pavel Seleznev, Vadim Berestov, Nikolay Strelnikov, Jens Fiehler, Kirill Orlov
{"title":"Flow Diversion Versus Coiling in Small and Medium-sized Unruptured Aneurysms of Proximal Anterior Circulation with Complex Anatomy: a Matched-pairs Study.","authors":"Anton Gorbatykh, Dmitry Kislitsin, Timur Shayakhmetov, Pavel Seleznev, Vadim Berestov, Nikolay Strelnikov, Jens Fiehler, Kirill Orlov","doi":"10.1007/s00062-025-01518-3","DOIUrl":"https://doi.org/10.1007/s00062-025-01518-3","url":null,"abstract":"<p><strong>Background: </strong>The benefits of flow diversion (FD) versus endosaccular coiling (EC) in small and medium-sized proximal saccular aneurysms of anterior circulation, amenable to both methods, remain not well-established. This study aimed to compare the efficacy and safety of FD vs EC and evaluate the triggers of treatment modality choice in the aforementioned setting.</p><p><strong>Methods: </strong>The study had a retrospective design. Raw sample included 154 FD and 190 EC consecutively enrolled cases. All aneurysms were saccular, sized 4-14 mm, located at intradural ICA or A1/M1, not acutely ruptured and previously untreated. Median lesion size was 6.6 mm (90% < 10 mm), median neck diameter‑3.7 mm. Matched cohorts were 67 cases each, PS difference < 0.1 probit SD, all covariates: size, neck, location, shape, angle, multiplicity, rupture history, age, and incorporated arterial branch. Follow-up DSA available for 94.2% of raw sample at median 9 months.</p><p><strong>Results: </strong>In both raw and matched samples respectively, FD versus EC demonstrated higher rates of target aneurysm total occlusion (76.4% vs 53.2%, p < 0.001 and 80.3% vs 49.2%, p < 0.001), lower of rates of intraoperative technical adverse events (7.3% vs 21.4%, p < 0.001 and 9% vs 22.4%, p = 0.032) and retreatment (raw‑2.6% vs 15.4%, p < 0.001, matched‑1.5% equal). Rates of neurological morbidity and death were similar. The choice of FD was triggered by neck size and ratio, paraophthalmic location (OR = 2.57), multiplicity (OR = 4.1) and incorporated arterial branch (OR = 4.82), p < 0.001. Incorporated branch was associated with incomplete occlusion in both treatment modalities (p < 0.01).</p><p><strong>Conclusion: </strong>In this study FD demonstrated higher rates of target aneurysm total occlusion, lower rates of intraoperative technical adverse events and similar rates of neurological morbidity and death, compared to EC.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Na Wang, ChengLing Xu, XueLing Liu, SiRong Piao, Pu-Yeh Wu, LiQin Yang, XinYi Zhao, JiaJia Zhang, FengTao Liu, YuXin Li
{"title":"Hippocampal Subfield Vulnerability and Functional Connectivity in Cognitive Decline: a Comparison Between Parkinson's Disease and Mild Cognitive Impairment.","authors":"Na Wang, ChengLing Xu, XueLing Liu, SiRong Piao, Pu-Yeh Wu, LiQin Yang, XinYi Zhao, JiaJia Zhang, FengTao Liu, YuXin Li","doi":"10.1007/s00062-025-01516-5","DOIUrl":"https://doi.org/10.1007/s00062-025-01516-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the shared and distinct alterations in hippocampal subfield atrophy and functional connectivity (FC) in Parkinson's disease (PD) with normal cognition (PD-NC), PD with mild cognitive impairment (PD-MCI) and unspecified MCI (U-MCI).</p><p><strong>Methods: </strong>A total of 294 participants were included from two centers (30 PD-NC, 86 PD-MCI, 76 U-MCI, and 102 healthy controls (HC)). Comparisons of hippocampal subfield volumes were conducted among groups. Seed-based FC was calculated to assess abnormalities between hippocampal subfields and cortical regions.</p><p><strong>Results: </strong>Compared to HC, PD-NC group showed volumetric reductions in the right cornu ammonis (CA) 2/3, granule cell layer of the dentate gyrus (GC-DG), and CA4 subfields, while PD-MCI group exhibited bilateral volumetric reductions in the same subfields. PD-MCI patients exhibited increased FC between the bilateral GC-DG/CA4 subfield and the posterior default mode network (pDMN), as well as between the right GC-DG/CA4 subfield and the calcarine, in comparison to PD-NC. U‑MCI patients displayed smaller volume in the right CA4 compared to HC. Decreased FC of the hippocampus with the widespread visual network was observed in the PD-MCI group compared to the U‑MCI group.</p><p><strong>Conclusions: </strong>PD-MCI is associated with structural vulnerability of hippocampal subfields in the CA2/3, GC-DG, and CA4 subfields, impacting FC with pDMN and visual network. Smaller scope of hippocampal subfields atrophy but weaker hippocampus-visual network FC abnormalities in U‑MCI relative to PD-MCI may suggest distinct progression mechanisms between these two conditions.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sihui Wang, Yingjie Zhang, Xiaochen Wang, Hongwei Li, Xuening Zhao, Lingxu Chen, Mengyuan Yuan, Yi Ju, Shengjun Sun
{"title":"Added Value of Cerebral Small Vascular Disease Burden Based On MRI for Prediction Poor Outcome of Intracerebral Hemorrhage.","authors":"Sihui Wang, Yingjie Zhang, Xiaochen Wang, Hongwei Li, Xuening Zhao, Lingxu Chen, Mengyuan Yuan, Yi Ju, Shengjun Sun","doi":"10.1007/s00062-025-01517-4","DOIUrl":"https://doi.org/10.1007/s00062-025-01517-4","url":null,"abstract":"<p><strong>Background: </strong>The significance between cerebral small vessel disease (CSVD) markers on MRI and clinical outcome in intracerebral hemorrhage (ICH) patients is unclear. This study aimed to explore the connection between CSVD markers and short-term outcome in ICH patients.</p><p><strong>Methods: </strong>We retrospectively included 318 ICH patients. Patients were categorized into unfavorable and favorable prognosis groups based on their 90-day modified Rankin Scale (mRS) score (mRS > 3 indicates unfavorable). We conducted an MRI-based assessment of CSVD markers and investigated the predictive power of individual markers and the overall burden on prognosis.</p><p><strong>Results: </strong>White matter hyperintensities (WMH) with a modified Fazekas score ≥ 2 (95% CI 2.367-17.421, p < 0.001), the presence of cortical superficial siderosis (CSS) (95 % CI 2.582-28.212, p < 0.001 in Model 1; 95 % CI 2.701-27.385, p < 0.001 in Model 2), and total CSVD burden (95 % CI 1.249-2.352, p < 0.05) are independent risk factors for unfavorable outcome of ICH.</p><p><strong>Conclusions: </strong>MRI-based markers of CSVD are valuable in assessing the risk of poor outcome in ICH. WMH with a modified Fazekas score ≥ 2, the presence of CSS, and higher CSVD burden are independently associated with adverse functional outcome.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
İlyas Uçar, Fatih Çiçek, Fatma Gül Ülkü Demir, Turgut Seber, Mehmet Hilmi Akdeniz, Ahmet Payas, Kerem Kökoğlu
{"title":"Sense of Smell in Individuals with Fibromyalgia: a Tractography Study.","authors":"İlyas Uçar, Fatih Çiçek, Fatma Gül Ülkü Demir, Turgut Seber, Mehmet Hilmi Akdeniz, Ahmet Payas, Kerem Kökoğlu","doi":"10.1007/s00062-025-01515-6","DOIUrl":"https://doi.org/10.1007/s00062-025-01515-6","url":null,"abstract":"<p><strong>Purpose: </strong>The etiopathogenesis of fibromyalgia (FM), which affects millions of people worldwide, is still debated. Recent research provides significant evidence that there are changes in the functions of the central and peripheral nervous systems and the sense of smell. This study analyzed the clinical assessment results of the sense of smell in individuals with FM and examined the olfactory-related structures in the nervous system.</p><p><strong>Methods: </strong>Thirty patients with FM and 31 age- and sex-matched asymptomatic controls participated in this cross-sectional study. Participants' sense of smell was assessed with the Connecticut Chemosensory Clinical Research Center (CCCRC) including the Butanol threshold test (BET) and Smell Identification Tests. The total number of fibers, mean fiber length, the ratio of the number of fibers in this pathway to the number of fibers in the whole brain of the same individual, fractional anisotropy (FA), mean diffusion (MD), axial diffusion (AD) and radial diffusion (RD) values were calculated by tractography. Additionally, entorhinal cortex volume calculation was performed in MriStudio and MriCloud software using Diffusion tensor imaging (DTI) data in DICOM format.</p><p><strong>Results: </strong>The BET and CCCRC test scores were lower in the FM group (p < 0.05). Similarly, the mean FA values of the olfactory tract were lower on both the right and left sides in the FM group (p < 0.05). However, the entorhinal cortex volumes were similar, and there was no correlation between the right and left FA values of the olfactory tract and the BET scores or CCCRC scores in both groups (p > 0.05).</p><p><strong>Conclusion: </strong>Our study, which included participants' self-assessments and data obtained from central nervous system (CNS) images, supports the idea that individuals with FM have a decreased olfactory function. Decreased FA values in individuals with FM may be an indicator of impaired myelin structure and axonal adaptation in individuals with FM.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janet Mei, Hamza A Salim, Dhairya A Lakhani, Aneri Balar, Adam A Dmytriw, Meisam Hoseinyazdi, Licia Luna, Francis Deng, Vaibhav Vagal, Nathan Z Hyson, Adrien Guenego, Gregory W Albers, Hanzhang Lu, Victor C Urrutia, Kambiz Nael, Elisabeth B Marsh, Argye E Hillis, Raf Llinas, Max Wintermark, Jeremy J Heit, Tobias D Faizy, Vivek Yedavalli
{"title":"Prolonged Venous Transit Independently Predicts Worse Functional Outcomes at Discharge in Successfully Reperfused Patients with Large Vessel Occlusion Stroke.","authors":"Janet Mei, Hamza A Salim, Dhairya A Lakhani, Aneri Balar, Adam A Dmytriw, Meisam Hoseinyazdi, Licia Luna, Francis Deng, Vaibhav Vagal, Nathan Z Hyson, Adrien Guenego, Gregory W Albers, Hanzhang Lu, Victor C Urrutia, Kambiz Nael, Elisabeth B Marsh, Argye E Hillis, Raf Llinas, Max Wintermark, Jeremy J Heit, Tobias D Faizy, Vivek Yedavalli","doi":"10.1007/s00062-025-01509-4","DOIUrl":"https://doi.org/10.1007/s00062-025-01509-4","url":null,"abstract":"<p><strong>Background and purpose: </strong>Venous outflow (VO) impairment predicts unfavorable outcomes in patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO). Prolonged venous transit (PVT), a visual qualitative VO marker on CT perfusion (CTP) time to maximum (Tmax) maps, has been associated with 90-day mortality despite successful reperfusion. This study investigates the association between PVT and modified Rankin Scale (mRS) score at discharge among AIS-LVO patients who have undergone successful reperfusion.</p><p><strong>Methods: </strong>We performed a retrospective analysis of prospectively collected data from consecutive adult AIS-LVO patients with successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b/2c/3). PVT+ was defined as Tmax ≥ 10 s in at least one of the following locations: superior sagittal sinus and/or torcula. The primary outcome was dichotomous mRS scores at discharge (favorable: mRS 0-2; unfavorable: mRS 3-6). Regression analyses were performed to assess the effect of PVT on discharge mRS.</p><p><strong>Results: </strong>In 119 patients of median (IQR) age 71 (63-81) years, a significantly higher proportion of PVT+ patients exhibited unfavorable mRS scores compared to PVT- patients (88.8% vs. 62.7%, p = 0.004). After adjusting for age, sex, hyperlipidemia, diabetes, history of stroke or transient ischemic attack (TIA), tobacco use, administration of intravenous thrombolysis (IVT), admission National Institutes of Health Stroke Scale (NIHSS), Alberta Stroke Program Early CT (ASPECTS) score, and ischemic core volume, the PVT+ remains significantly associated with unfavorable mRS (OR = 0.231, 95%CI 0.054-0.980, p = 0.047).</p><p><strong>Conclusions: </strong>PVT+ was significantly associated with unfavorable mRS at discharge despite successful reperfusion in AIS-LVO patients, underscoring the importance of VO impairment in short-term functional outcomes. PVT serves as a valuable adjunct imaging biomarker derived from CTP for assessing VO profiles in AIS-LVO.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Niclas Launhardt, Jessica Jesser, Dimah Hasan, Rebecca May, Omid Nikoubashman, Martin Wiesmann, Thanh N Nguyen, Markus A Möhlenbruch, Julius Kernbach, Charlotte S Weyland
{"title":"DWI Reversibility in Acute Ischemic Stroke Due to Basilar Artery Occlusion Following Successful Recanalization.","authors":"Niclas Launhardt, Jessica Jesser, Dimah Hasan, Rebecca May, Omid Nikoubashman, Martin Wiesmann, Thanh N Nguyen, Markus A Möhlenbruch, Julius Kernbach, Charlotte S Weyland","doi":"10.1007/s00062-025-01512-9","DOIUrl":"https://doi.org/10.1007/s00062-025-01512-9","url":null,"abstract":"<p><strong>Purpose: </strong>Diffusion Weighted Imaging (DWI) represents the infarct core in acute ischemic stroke. DWI reversibility is a phenomenon reported for the anterior circulation affecting small brain areas of the white matter. This study aims to define DWI reversibility in the posterior circulation after successful recanalization of basilar artery occlusion (BAO) and its influence on patient outcome.</p><p><strong>Methods: </strong>This was a retrospective analysis of two tertiary stroke-centers analyzing stroke patients between January 2015 and December 2022. Inclusion criteria were available MRI before and after acute stroke treatment and successful BAO recanalization. Brain areas were defined as brainstem, cerebellum and supratentorial brain areas supplied by the posterior circulation. These areas were compared in univariate analysis. Secondarily, patient outcome was compared between patients with DWI reversibility and patients without in univariate analysis with good outcome as primary endpoint (mRS 90d 0 to 2).</p><p><strong>Results: </strong>In total, 5/28 of included patients (21.74%) showed DWI reversibility, which was exclusively found in the brainstem. The overall extent of brainstem infarction correlated better with patient outcome compared to cerebellar or supratentorial infarction (Spearman's ρ = 0.757; p < 0.001). Good outcome was more frequent in patients with DWI reversibility compared to those without (mRS 0-2, DWI+ n = 4, 80% vs. DWI- n = 6, 26%, p = 0.023).</p><p><strong>Conclusion: </strong>DWI restriction reversibility was observed in the brainstem of acute stroke patients with BAO. In this study, patient outcome correlates stronger with the extent of brainstem infarction compared to cerebellar or supratentorial infarction.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}