{"title":"Perioperative Management of Spinal Arteriovenous Malformation Embolization: Delayed Venous Thrombosis and Implications for Severe Back Pain","authors":"Bikei Ryu, Tatsuki Mochizuki, Shogo Shima, Shinsuke Sato, Tatsuya Inoue, Takakazu Kawamata, Yasunari Niimi","doi":"10.1007/s00062-024-01403-5","DOIUrl":"https://doi.org/10.1007/s00062-024-01403-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background and Purpose</h3><p>The prognosis of untreated spinal arteriovenous malformations (SAVMs) is poor. Embolization plays an important role in the management of intramedullary SAVMs. Delayed aggravation due to spinal venous thrombosis following successful embolization has been reported; however, perioperative management strategies to prevent thrombosis have not been explored. We present our single-center experience of SAVM embolization and perioperative management, including anticoagulation.</p><h3 data-test=\"abstract-sub-heading\">Material and Methods</h3><p>We retrospectively evaluated 18 patients with SAVMs who underwent transarterial embolization. Perioperative anticoagulation therapy was administered to selected patients. We compared the characteristics of the patients, including perioperative management procedures, between those with and without postoperative worsening following embolization.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Acute postoperative worsening within 1 week occurred in 4 (22.2%) patients. Of these, immediate worsening was observed in one patient as a procedure-related complication. Delayed worsening after 24 h was observed in 3 patients, caused by delayed venous thrombosis with severe back pain. Rescue anticoagulation for delayed worsening improved symptoms in two patients. A comparison between patients with and without acute postoperative worsening revealed significant differences in age (median 46.5 vs. 26.5 years, <i>p</i> = 0.009) and the presence of postoperative back pain (75.0% vs. 0%, <i>p</i> = 0.005); however, there was no significant difference in use of selective anticoagulation (<i>p</i> = 0.274).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The results of this study suggest that SAVM embolization can cause acute worsening due to postoperative venous thrombosis with severe back pain, which may be reversed by anticoagulation therapy. Back pain is an important finding that suggests venous thrombosis, and anticoagulation should be urgently administered.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"111 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587162","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":"Endovascular Treatment of a Wide-necked Bilobulated Bifurcation Aneurysm using the Woven EndoBridge (WEB) Device","authors":"Junhyung Kim, Sang Kyu Park, Joonho Chung","doi":"10.1007/s00062-024-01405-3","DOIUrl":"https://doi.org/10.1007/s00062-024-01405-3","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"111 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587275","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}
Jürgen Panholzer, G. Malsiner‐Walli, Bettina Grün, Ognian Kalev, Michael Sonnberger, Robert Pichler
{"title":"Correction to: Multiparametric Analysis Combining DSC-MR Perfusion and [18F]FET-PET is Superior to a Single Parameter Approach for Differentiation of Progressive Glioma from Radiation Necrosis.","authors":"Jürgen Panholzer, G. Malsiner‐Walli, Bettina Grün, Ognian Kalev, Michael Sonnberger, Robert Pichler","doi":"10.1007/s00062-024-01398-z","DOIUrl":"https://doi.org/10.1007/s00062-024-01398-z","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"5 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140736949","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}
Clinical NeuroradiologyPub Date : 2024-03-01Epub Date: 2023-06-15DOI: 10.1007/s00062-023-01321-y
Yash Verma, Sairam Ramesh, Arosh S Perera Molligoda Arachchige
{"title":"7 T Versus 3 T in the Diagnosis of Small Unruptured Intracranial Aneurysms: Reply to Radojewski et al.","authors":"Yash Verma, Sairam Ramesh, Arosh S Perera Molligoda Arachchige","doi":"10.1007/s00062-023-01321-y","DOIUrl":"10.1007/s00062-023-01321-y","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"51-52"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9634120","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}
Clinical NeuroradiologyPub Date : 2024-03-01Epub Date: 2023-06-21DOI: 10.1007/s00062-023-01322-x
P Radojewski, T Dobrocky, M Branca, W Almiri, M Correia, A Raabe, D Bervini, J Gralla, R Wiest, P Mordasini
{"title":"Reply: Diagnosis of Small Unruptured Intracranial Aneurysms: Comparison of 7 T Versus 3 T MRI.","authors":"P Radojewski, T Dobrocky, M Branca, W Almiri, M Correia, A Raabe, D Bervini, J Gralla, R Wiest, P Mordasini","doi":"10.1007/s00062-023-01322-x","DOIUrl":"10.1007/s00062-023-01322-x","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"53-54"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9677233","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}
Clinical NeuroradiologyPub Date : 2024-03-01Epub Date: 2023-09-15DOI: 10.1007/s00062-023-01345-4
Lars Behrens, Andreas Adam, Anna Rubeck, Stefan Schiele, Gernot Müller, Yalda Abrishami, Ansgar Berlis, Christoph J Maurer
{"title":"Safety Aspects and Procedural Characteristics of Ambulatory Diagnostic Cerebral Catheter Angiography.","authors":"Lars Behrens, Andreas Adam, Anna Rubeck, Stefan Schiele, Gernot Müller, Yalda Abrishami, Ansgar Berlis, Christoph J Maurer","doi":"10.1007/s00062-023-01345-4","DOIUrl":"10.1007/s00062-023-01345-4","url":null,"abstract":"<p><strong>Purpose: </strong>Diagnostic cerebral catheter angiography is used to assess a variety of neurovascular pathologies especially in patients before and after endovascular neurointerventional treatment. In many centers diagnostic cerebral angiographies are performed with the patient staying for one night in the hospital because there are not yet sufficient data on the safety of ambulatory cerebral angiography. At the same time hospitals face a growing demand to perform ambulatory medical procedures.</p><p><strong>Methods: </strong>A total of 426 ambulatory diagnostic cerebral angiographies were retrospectively analyzed. Technical details of the angiographies were analyzed to identify procedural risk factors.</p><p><strong>Results: </strong>Out of 426 patients 14 (3.3%) had some form of complication, 3 developed minor transient neurological symptoms, 1 patient developed Quincke's edema probably as an adverse reaction to contrast agent, 1 patient had an asymptomatic carotid dissection and 1 had a fall of unknown etiology. Of the 14 complications 8 were puncture site complications with 1 re-bleeding, 1 dissection, and 6 minor complications, 421 punctures were femoral, 3 radial and 2 brachial. Out of 333 patients with magnetic resonance imaging (MRI) after angiography 21 showed focal diffusion-weighted imaging (DWI) lesions but none of these lesions were symptomatic. The rate of DWI lesions was significantly higher in selectively angiography territories than in other territories. The use of a Simmons 2 catheter significantly increased the rate of DWI lesions (p = 0.047), whereas 3D rotational angiography did not (p = 0.55). The rate of DWI lesions per selectively accessed vessel was 4.6% with a higher rate in the anterior than in the posterior circulation.</p><p><strong>Conclusion: </strong>Diagnostic cerebral catheter angiography can be safely performed in an ambulatory setting.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"155-162"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2024-03-01Epub Date: 2023-08-28DOI: 10.1007/s00062-023-01340-9
Raoul Pop, Silja Räty, Roberto Riva, Gaultier Marnat, Tomas Dobrocky, Pierre Louis Alexandre, Margaux Lefebvre, Jean Francois Albucher, Marion Boulanger, Federico Di Maria, Sébastien Richard, Sébastien Soize, Eike Immo Piechowiak, Jan Liman, Arno Reich, Marc Ribo, Thomas Meinel, Anastasios Mpotsaris, David S Liebeskind, Jan Gralla, Urs Fischer, Johannes Kaesmacher
{"title":"Effect of Bridging Thrombolysis on the Efficacy of Stent Retriever Thrombectomy Techniques : Insights from the SWIFT-DIRECT trial.","authors":"Raoul Pop, Silja Räty, Roberto Riva, Gaultier Marnat, Tomas Dobrocky, Pierre Louis Alexandre, Margaux Lefebvre, Jean Francois Albucher, Marion Boulanger, Federico Di Maria, Sébastien Richard, Sébastien Soize, Eike Immo Piechowiak, Jan Liman, Arno Reich, Marc Ribo, Thomas Meinel, Anastasios Mpotsaris, David S Liebeskind, Jan Gralla, Urs Fischer, Johannes Kaesmacher","doi":"10.1007/s00062-023-01340-9","DOIUrl":"10.1007/s00062-023-01340-9","url":null,"abstract":"<p><strong>Background: </strong>There are little available data regarding the influence of intravenous thrombolysis (IVT) on the efficacy of different first line endovascular treatment (EVT) techniques.</p><p><strong>Methods: </strong>We used the dataset of the SWIFT-DIRECT trial which randomized 408 patients to IVT + EVT or EVT alone at 48 international sites. The protocol required the use of a stent retriever (SR), but concomitant use of a balloon guide catheter (BGC) and/or distal aspiration (DA) catheter was left to the discretion of the operators. Four first line techniques were applied in the study population: SR, SR + BGC, SR + DA, SR + DA + BGC. To assess whether the effect of allocation to IVT + EVT versus EVT alone was modified by the first line technique, interaction models were fitted for predefined outcomes. The primary outcome was first pass mTICI 2c‑3 reperfusion (FPR).</p><p><strong>Results: </strong>This study included 385 patients of whom 172 were treated with SR + DA, 121 with SR + DA + BGC, 57 with SR + BGC and 35 with SR. There was no evidence that the effect of IVT + EVT versus EVT alone would be modified by the choice of first line technique; however, allocation to IVT + EVT increased the odds of FPR by a factor of 1.68 (95% confidence interval, CI 1.11-2.54).</p><p><strong>Conclusion: </strong>This post hoc analysis does not suggest treatment effect heterogeneity of IVT + EVT vs EVT alone in different stent retriever techniques but provides evidence for increased FPR if bridging IVT is administered before stent retriever thrombectomy.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"93-103"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113704","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}
Clinical NeuroradiologyPub Date : 2024-03-01Epub Date: 2023-09-01DOI: 10.1007/s00062-023-01339-2
Mukesch Johannes Shah, Jürgen Beck, Stephan Meckel, Horst Urbach, Ikram Eda Duman, Manuel Christoph Ketterer, Tanja Hildenbrand
{"title":"Reliability of High-resolution Gadolinium-enhanced MR Cisternography and Gasket-seal Technique for Management of Anterior Skull Base Defects.","authors":"Mukesch Johannes Shah, Jürgen Beck, Stephan Meckel, Horst Urbach, Ikram Eda Duman, Manuel Christoph Ketterer, Tanja Hildenbrand","doi":"10.1007/s00062-023-01339-2","DOIUrl":"10.1007/s00062-023-01339-2","url":null,"abstract":"<p><strong>Purpose: </strong>Precise preoperative localization of anterior skull base defects is important to plan surgical access, increase the success rate and reduce complications. A stable closure of the defect is vital to prevent recurrence of cerebrospinal fluid (CSF) rhinorrhea. The purpose of this retrospective case series was to evaluate the reliability of a new high-resolution gadolinium-enhanced compressed-sensing SPACE technique (CS T1 SPACE) for magnetic resonance (MR) cisternography to detect cerebrospinal fluid leaks of the anterior skull base and to assess the long-term success rate of the gasket-seal technique for closure of skull base defects.</p><p><strong>Method: </strong>All patients with spontaneous or postoperative cerebrospinal fluid rhinorrhea and defects of the anterior skull base presenting to the Departments of Otorhinolaryngology and Neurosurgery between 2019 and 2020, receiving a computed tomography (CT) cisternography and MR cisternography (on a 3T whole-body MR scanner using a 64-channel head and neck coil) with CS T1 SPACE sequence and closure of the defect with the gasket-seal technique, were enrolled in the study. For the cisternography, iodinated contrast agent (15 ml Solutrast 250 M®), saline (4 mL) mixed with a 0.5 mL of gadoteridol was injected into the lumbar subarachnoid space.</p><p><strong>Results: </strong>A total of four patients were included in the study and MR cisternography with CS T1 SPACE sequence was able to precisely localize CSF leaks in all patients. The imaging results correlated with intraoperative findings. All defects could be successfully closed with the gasket-seal technique. The mean follow-up was 35.25 months (range 33-37 months).</p><p><strong>Conclusion: </strong>MR cisternography with CS T1 SPACE sequence could be a promising technique for precise localization of CSF leaks and the gasket-seal technique resulted in good closure of the CSF fistula in this case series.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"115-123"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10130484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2024-03-01Epub Date: 2024-02-12DOI: 10.1007/s00062-024-01385-4
C Zander, M Diebold, M J Shah, B Malzkorn, M Prinz, H Urbach, D Erny, C A Taschner
{"title":"Freiburg Neuropathology Case Conference: : 68-Year-Old Patient with Slurred Speech, Double Vision, and Increasing Gait Disturbance.","authors":"C Zander, M Diebold, M J Shah, B Malzkorn, M Prinz, H Urbach, D Erny, C A Taschner","doi":"10.1007/s00062-024-01385-4","DOIUrl":"10.1007/s00062-024-01385-4","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"279-286"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2024-03-01Epub Date: 2023-08-07DOI: 10.1007/s00062-023-01328-5
Christoph M Mooshage, Lukas Schimpfle, Zoltan Kender, Dimitrios Tsilingiris, Taraneh Aziz-Safaie, Anja Hohmann, Julia Szendroedi, Peter Nawroth, Volker Sturm, Sabine Heiland, Martin Bendszus, Stefan Kopf, Felix T Kurz, Johann M E Jende
{"title":"Association of Small Fiber Function with Microvascular Perfusion of Peripheral Nerves in Patients with Type 2 Diabetes : Study using Quantitative Sensory Testing and Magnetic Resonance Neurography.","authors":"Christoph M Mooshage, Lukas Schimpfle, Zoltan Kender, Dimitrios Tsilingiris, Taraneh Aziz-Safaie, Anja Hohmann, Julia Szendroedi, Peter Nawroth, Volker Sturm, Sabine Heiland, Martin Bendszus, Stefan Kopf, Felix T Kurz, Johann M E Jende","doi":"10.1007/s00062-023-01328-5","DOIUrl":"10.1007/s00062-023-01328-5","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Diabetic small fiber neuropathy (SFN) is caused by damage to thinly myelinated A‑fibers (δ) and unmyelinated C‑fibers. This study aimed to assess associations between quantitative sensory testing (QST) and parameters of peripheral nerve perfusion obtained from dynamic contrast enhanced (DCE) magnetic resonance neurography (MRN) in type 2 diabetes patients with and without SFN.</p><p><strong>Methods: </strong>A total of 18 patients with type 2 diabetes (T2D, 8 with SFN, 10 without SFN) and 10 healthy controls (HC) took part in this cross-sectional single-center study and underwent QST of the right leg and DCE-MRN of the right thigh with subsequent calculation of the sciatic nerve constant of capillary permeability (K<sup>trans</sup>), extravascular extracellular volume fraction (V<sub>e</sub>), and plasma volume fraction (V<sub>p</sub>).</p><p><strong>Results: </strong>The K<sup>trans</sup> (HC 0.031 min<sup>-1</sup> ± 0.009, T2D 0.043 min<sup>-1</sup> ± 0.015; p = 0.033) and V<sub>e</sub> (HC 1.2% ± 1.5, T2D: 4.1% ± 5.1; p = 0.027) were lower in T2D patients compared to controls. In T2D patients, compound z‑scores of thermal and mechanical detection correlated with K<sup>trans</sup> (r = 0.73; p = 0.001, and r = 0.57; p = 0.018, respectively) and V<sub>e</sub> (r = 0.67; p = 0.002, and r = 0.69; p = 0.003, respectively). Compound z‑scores of thermal pain and V<sub>p</sub> (r = -0.57; p = 0.015) correlated negatively.</p><p><strong>Discussion: </strong>The findings suggest that parameters of peripheral nerve microcirculation are related to different symptoms in SFN: A reduced capillary permeability may result in a loss of function related to insufficient nutritional supply, whereas increased capillary permeability may be accompanied by painful symptoms related to a gain of function.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"55-66"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9947586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}