Neuroradiology最新文献

{"title":"Normal asymmetric superior ophthalmic vein dilatation: morphological features and differentiation from carotid cavernous fistula.","authors":"Atsushi Saiga, Hajime Yokota, Hiroki Mukai, Jun Hashiba, Akiyo Takada, Takuro Horikoshi, Takashi Uno","doi":"10.1007/s00234-026-04207-1","DOIUrl":"https://doi.org/10.1007/s00234-026-04207-1","url":null,"abstract":"<p><strong>Purpose: </strong>Asymmetry of the superior ophthalmic vein (SOV) is occasionally encountered on routine imaging and may reflect either pathology or normal variation. This study aimed to characterize normal asymmetric SOV dilatation and differentiate it from pathological dilatation due to carotid cavernous fistula (CCF).</p><p><strong>Methods: </strong>We retrospectively measured SOV diameters at the distal, middle, and proximal levels on three-dimensional time-of-flight magnetic resonance angiography in 200 patients without abnormal intracranial findings and 30 patients with CCF. Significant asymmetry was defined as a side-to-side diameter difference of >0.5 mm at one or more levels. SOV hyperintensity was also assessed. Morphological features were compared between normal asymmetric and CCF-related pathological SOV dilatation.</p><p><strong>Results: </strong>Significant SOV asymmetry was observed in 31 of 200 patients (15.5%) without abnormal intracranial findings. Pathological dilatation showed significantly larger SOV diameters at all three levels than normal asymmetric dilatation. SOV hyperintensity was more frequent in pathological dilatation than in normal asymmetric dilatation (21/30 [70.0%] vs. 8/31 [25.8%], P < 0.001). Normal asymmetric SOV dilatation was more prominent at the distal and middle levels and showed relative tapering at the proximal level. For identifying normal asymmetric SOV dilatation, the middle-to-proximal ratio showed moderate discriminatory performance (area under the curve, 0.791; 95% confidence interval, 0.675-0.907; cutoff, >1.139; sensitivity, 93.5%; specificity, 63.3%).</p><p><strong>Conclusion: </strong>Proximal tapering of a dilated SOV may be a morphological feature of normal asymmetric dilatation and may serve as an adjunctive imaging clue for differentiation from CCF-related pathological dilatation.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137739","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":"Resting-state BOLD fMRI-derived cerebrovascular reactivity for detecting crossed cerebellar diaschisis.","authors":"Jie Xu, Yi Shan, Bixiao Cui, Yayan Yin, Jiayouzheng Li, Jing Liu, Yan Ma, Jie Lu","doi":"10.1007/s00234-026-04202-6","DOIUrl":"https://doi.org/10.1007/s00234-026-04202-6","url":null,"abstract":"<p><strong>Purpose: </strong>To study cerebellar cerebrovascular reactivity (CVR) derived from resting-state (RS) blood oxygen level-dependent (BOLD) as a potential imaging biomarker for crossed cerebellar diaschisis (CCD).</p><p><strong>Methods: </strong>Thirty-nine patients with symptomatic unilateral cerebrovascular occlusion and eighteen age-matched healthy subjects underwent a simultaneous PET/MR scan. CCD was diagnosed as a contralateral cerebellar metabolic reduction present on ¹⁸F-FDG PET semi-quantitatively. RS BOLD-CVR maps were derived by extracting signals within specific frequency bands of RS BOLD. The cerebellar asymmetry index (CAI) calculated from RS BOLD-CVR and ¹⁸F-FDG PET data were compared using receiver operating characteristic and Bland-Altman analysis. Neurological function was determined with NIHSS and mRS.</p><p><strong>Results: </strong>In our cohort, CCD was diagnosed in 21 of 39 (53.8%) patients on ¹⁸F-FDG PET. CCD+ patients exhibited larger infarct volume, more severe supratentorial CVR impairment, and worse functional status than CCD- patients at admission and 3.5 years follow-up. The area under the curve for RS BOLD-CVR CAI was 0.862 (95% confidence interval: 0.747-0.978) with a cutoff value of 8.2%, achieving a sensitivity of 81.0% and a specificity of 83.3% to detect CCD. The Bland-Altman analysis showed no significant proportional bias between PET CAI and CVR CAI (P = 0.848). CVR CAI was correlated with NIHSS (ρ = 0.352, p = 0.033) and mRS (ρ = 0.360, p = 0.029) at admission after adjusted for age and infarct volume.</p><p><strong>Conclusion: </strong>RS BOLD-CVR demonstrates good sensitivity and specificity to detect diaschisis-related cerebellar cerebrovascular reactivity in patients with symptomatic unilateral cerebrovascular occlusion. Furthermore, participants with cerebellar CVR impairment and metabolic reduction tended to have poorer neurological function.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137724","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":"Postoperative venous sinus stenosis after retrosigmoid craniotomy: systematic review and illustrative case.","authors":"Jorge Eduardo Alonso-Vera, Luís Gustavo Biondi Soares, Pablo Andrés Vega-Medina, José Miguel Aiquel Bellolio, Iago Nathan Simon Petry, Luca Dannemann Andrews, Edgar Daniel Guzmán-Ríos, Gerard Delgado-Bargalló, Leandro de Assis Barbosa","doi":"10.1007/s00234-026-04192-5","DOIUrl":"https://doi.org/10.1007/s00234-026-04192-5","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative cerebral venous sinus complications in posterior fossa craniotomies are increasingly recognized but remain incompletely characterized. Although most cases are asymptomatic, impaired venous outflow may lead to intracranial hypertension. This work systematically reviews the available evidence on postoperative cerebral venous sinus complications following posterior fossa surgery, including its management; additionally, we present an illustrative case of postoperative venous sinus stenosis treated with endovascular venous sinus stenting.</p><p><strong>Methods: </strong>We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRIMA guidelines using PubMed, Embase, and SCOPUS databases to identify and characterize cerebral venous sinus-related complications following posterior fossa surgery. Additionally, we present an illustrative case.</p><p><strong>Results: </strong>Thirty-three studies comprising 4,893 patients were included. CVST was reported in 429 of 4,237 patients (10.1%), whereas CVSS was identified in 135 of 784 patients (17.2%) from studies specifically evaluating stenosis. Intraoperative venous sinus injury occurred in 55 of 1,618 patients (3.4%). Only 16 patients underwent endovascular treatment, of whom 13 received venous sinus stenting. Our illustrative case involved a 28-year-old woman who developed intracranial hypertension secondary to severe postoperative transverse-sigmoid sinus stenosis following retrosigmoid vestibular schwannoma resection. Venous manometry demonstrated a significant trans-stenotic pressure gradient, and successful endovascular stenting restored venous outflow with sustained stent patency and clinical stability at 12-month follow-up.</p><p><strong>Conclusions: </strong>Postoperative venous sinus complications following posterior fossa surgery are likely underrecognized, although clinically significant venous outflow obstruction remains uncommon. This systematic review highlights the limited evidence regarding postoperative venous sinus stenosis and its endovascular management. Venous sinus stenting may represent a promising treatment option in carefully selected patients with hemodynamically significant postoperative stenosis; however, larger prospective studies with standardized diagnostic criteria and long-term follow-up are needed to better define its role.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137678","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":"Perivascular spaces as MRI markers associated with radiation necrosis in brain metastases patients: an exploratory study.","authors":"Carlo Augusto Mallio, Gianfranco Di Gennaro, Ugo Ferrari, Caterina Bernetti, Gloria Perillo, Paolo Matteucci, Edy Ippolito, Bruno Beomonte Zobel, Sara Ramella","doi":"10.1007/s00234-026-04216-0","DOIUrl":"https://doi.org/10.1007/s00234-026-04216-0","url":null,"abstract":"<p><strong>Background and purpose: </strong>Radiation necrosis (RN) is a significant complication of stereotactic radiotherapy (SRT) for brain metastases. We investigated whether pre-treatment cerebral small vessel disease (cSVD) burden, particularly perivascular spaces (PVSs), is associated with RN risk.</p><p><strong>Materials and methods: </strong>This single-center retrospective study included 71 patients treated with fractionated SRT for brain metastases. RN was diagnosed by consensus using multiparametric MRI including DSC perfusion. Pre-treatment cSVD markers were evaluated according to STRIVE criteria, with PVSs graded using Potter's criteria in the basal ganglia (BG), centrum semiovale (CS), and midbrain (MB). Associations with RN were assessed using Firth's penalized logistic regression adjusted for age and sex.</p><p><strong>Results: </strong>RN developed in 33 patients (46.5%). Higher PVS grades in the CS were significantly associated with increased RN risk (grade 1: OR 6.35, 95% CI 1.86-21.72, p = 0.003; grade 2: OR 26.26, 95% CI 3.64-189.61, p = 0.001). Associations were also observed for higher PVS burden in the BG and MB, although these rested on small subsets with wide confidence intervals. Other cSVD markers showed no significant associations. Confidence intervals were wide due to sparse data in higher PVS grades.</p><p><strong>Conclusions: </strong>This exploratory study suggests a potential association between pre-treatment PVS burden and RN risk. However, sparse data, wide confidence intervals, and the absence of lesion-level dosimetric adjustment limit conclusions. These preliminary findings warrant validation in larger, prospective cohorts with comprehensive dosimetric analysis.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137708","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":"ABC/2 versus computer-assisted volumetric analysis for epidural hematoma: measurement variability, and the influence of hematoma morphology; a retrospective, multicenter, cohort study.","authors":"Segev Gabay, Katarina Horcicakova, Lottem Bergman, Melina Isabel Frech, Shirley Shechter, Dana Niry, Alon Schwartz, Daor Hayu, Moran Artzi, Ondrej Bradac, Jonathan Roth","doi":"10.1007/s00234-026-04215-1","DOIUrl":"https://doi.org/10.1007/s00234-026-04215-1","url":null,"abstract":"<p><strong>Objective: </strong>Accurate estimation of epidural hematoma (EDH) volume is critical for clinical decision-making, as current traumatic brain injury guidelines recommend surgical evacuation for EDH volumes exceeding 30 cm³. The manual ABC/2 method is widely used for rapid estimation, but its accuracy for EDH remains incompletely defined. This study evaluated the accuracy of ABC/2 compared with computer-assisted volumetric analysis (CAVA) in a large, multicenter cohort.</p><p><strong>Methods: </strong>A retrospective analysis was performed on adult patients with traumatic EDH treated at two tertiary neurosurgical centers between 2017 and 2025. Hematoma volumes were calculated using the ABC/2 method and compared with CAVA using brainlab^® or 3D-Slicer software. Correlation and agreement were assessed using Pearson correlation, paired testing, and Bland-Altman analysis, while inter-rater and intra-software reliability were assessed using intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>A total of 191 patients were included (mean age 40.0 ± 15.9 years). Bland-Altman analysis showed systematic overestimation by ABC/2 (mean bias - 13.45 mL) with wide limits of agreement. Log-transformed analysis confirmed substantial proportional variability (geometric mean ratio 0.72, 95% LoA 0.15-3.44), despite a strong overall correlation (r = 0.897, p < 0.001). Overestimation was greater in classic than irregular hematomas (16 vs. 8 mL), and classification discordance occurred in 56 patients (29.3%), including 28 (14.7%) crossing the 30-mL threshold.</p><p><strong>Conclusions: </strong>Although the ABC/2 method provides a rapid, practical estimate of EDH volume, it systematically overestimates hematoma size compared with CAVA and shows substantial shape- and patient-level variability. The two methods are not interchangeable, and volumes near commonly referenced operative thresholds should be interpreted cautiously. As CAVA tools become increasingly accessible, future studies should evaluate how CAVA-based measurements correlate with clinical presentation, treatment decisions, and patient outcomes, and determine how historical volume thresholds translate to modern volumetric techniques.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112890","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":"Direct V2 vertebral artery puncture as rescue access for basilar thrombectomy: a technical note.","authors":"François Lebeaupin, Brivaël Lemogne, Marc Lenfant, Heloïse Golea, Laura Baptiste, Frederic Ricolfi, Pierre-Olivier Comby","doi":"10.1007/s00234-026-04205-3","DOIUrl":"https://doi.org/10.1007/s00234-026-04205-3","url":null,"abstract":"<p><strong>Introduction: </strong>Basilar artery occlusion (BAO) treated with mechanical thrombectomy (MT) can be complicated by unfavorable supra-aortic anatomy precluding conventional transfemoral or trans-radial access.</p><p><strong>Methods: </strong>We describe direct percutaneous vertebral artery (VA) puncture as a rescue strategy in three patients with BAO in whom conventional access failed because of chronic vertebral artery occlusion. Roadmap-guided puncture of the V2 segment allowed stent-retriever thrombectomy through a 4 F sheath.</p><p><strong>Results: </strong>Reperfusion (mTICI 2b-2c) was achieved in all three patients, with favorable outcomes (6-month mRS 0-1) and no major access-site complications.</p><p><strong>Conclusion: </strong>Direct V2 vertebral artery puncture is a viable, technically demanding rescue option for BAO, reserved for carefully selected patients at highly experienced comprehensive stroke centers.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112840","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":"Multifocal intracranial epstein-barr virus-associated smooth muscle tumors in an HIV-positive patient: incidental discovery and treatment with staged gamma knife radiosurgery.","authors":"Ratna Sutanto, Rusli Muljadi, Ariadri Hafian Wulandaru Hakim, Gilbert Sterling Octavius","doi":"10.1007/s00234-026-04212-4","DOIUrl":"https://doi.org/10.1007/s00234-026-04212-4","url":null,"abstract":"<p><strong>Introduction: </strong>Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare mesenchymal neoplasm occurring predominantly in immunocompromised individuals, with central nervous system involvement exceptionally uncommon.</p><p><strong>Case presentation: </strong>A 36-year-old HIV-positive man underwent non-contrast head CT after a road traffic accident, which incidentally revealed multifocal extra-axial intracranial masses. MRI demonstrated avidly enhancing dural-based lesions with hemorrhagic components and venous sinus attachment, initially favoring multifocal meningioma. Subtotal resection of the dominant right parieto-occipital lesion demonstrated a low-grade spindle cell neoplasm with smooth muscle differentiation and diffuse EBER positivity, confirming EBV-SMT. All three lesions subsequently underwent two-stage Gamma Knife radiosurgery, with margin doses of 12 Gy and 14 Gy. Seven-month follow-up demonstrated relative lesion-size stability and central non-enhancing changes suggestive of treatment effect, without clinically apparent acute toxicity.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic overlap between intracranial EBV-SMT and meningioma and provides detailed documentation of staged radiosurgical treatment in multifocal disease.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112868","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":"Exploring the role of glymphatic system in Alzheimer's disease with insights from MRI-based studies: a systematic review.","authors":"Caterina Bernetti, Rosalinda Calandrelli, Fabio Pilato, Vincenzo Di Lazzaro, Bruno Beomonte Zobel, Marcello D'Amelio, Carlo Augusto Mallio","doi":"10.1007/s00234-026-04206-2","DOIUrl":"https://doi.org/10.1007/s00234-026-04206-2","url":null,"abstract":"<p><strong>Background: </strong>The glymphatic constitutes a crucial neurophysiological mechanism for the clearance of interstitial solutes and neurotoxic metabolites from the central nervous system. Dysfunction within this pathway is increasingly implicated in the etiopathogenesis of neurodegenerative diseases, notably Alzheimer's disease (AD). Advanced magnetic resonance imaging (MRI) modalities, such as diffusion tensor image analysis along the perivascular space (DTI-ALPS), have emerged as non-invasive, in vivo approaches quantifying glymphatic transport efficacy and its association with cognitive decline and AD progression.</p><p><strong>Methods: </strong>This systematic review was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. and systematic literature retrieval was executed across PubMed, Cochrane, and Scopus databases, targeting studies that employed MRI-based metrics to assess glymphatic functionality in the context of AD.</p><p><strong>Results: </strong>A total of 35 studies fulfilled the inclusion criteria. AD patients exhibited significantly reduced DTI-ALPS indices, correlating with elevated enlarged perivascular space (ePVS) volumes, neurocognitive deterioration, and cerebral atrophy. Notably ePVSs enlargement emerged as a surrogate marker of glymphatic dysfunction and a predictor of MCI-to-AD conversion. However, amyloid PET correlations exhibited inter-study heterogeneity.</p><p><strong>Conclusions: </strong>MRI derived biomarkers, particularly DTI-ALPS index and ePVSs analysis, demonstrate high potential as surrogate indicators of glymphatic impairment in AD. These findings underscore their diagnostic and prognostic value, warranting harmonization of imaging protocols and longitudinal investigations to establish their translational utility in clinical biomarker frameworks.</p><p><strong>Clinical relevance statement: </strong>MRI biomarkers of glymphatic dysfunction provide valuable insights into Alzheimer's disease pathophysiology and progression. These imaging markers may enhance early diagnosis, monitor disease progression, and evaluate treatment efficacy in AD.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112892","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":"Predictors of complete occlusion in endovascular coiling of very small intracranial aneurysms.","authors":"Ariana Chacon, Hasna Loulida, Mustafa Ismail, Norito Kenjo, Julio Isidor, Hallmon Hughes, Alejandro Spiotta","doi":"10.1007/s00234-026-04190-7","DOIUrl":"https://doi.org/10.1007/s00234-026-04190-7","url":null,"abstract":"<p><strong>Background: </strong>Very small intracranial aneurysms (VSAs ≤ 3 mm) are increasingly treated endovascularly, yet procedural fragility and long-term durability remain disputed. Device miniaturization and adjunctive balloon- or stent assistance have improved immediate occlusion, but contemporary single-center outcome data with multivariable modeling are sparse.</p><p><strong>Methods: </strong>We retrospectively analyzed a prospectively maintained database (2013-2024) for all VSAs treated endovascularly. Demographics, aneurysm morphology, and procedural details were abstracted from digital subtraction angiography (DSA). At the last follow-up, the primary endpoint was complete occlusion; secondary endpoints were favorable functional outcomes, retreatment, and procedural complications. Multivariable logistic regression was adjusted for rupture status, aneurysm width, location, adjunct use, and immediate occlusion.</p><p><strong>Results: </strong>One-hundred-eighty-five very small intracranial aneurysms (VSAs ≤ 3 mm) (median dome 2.6 mm, 21% < 2 mm) were treated in 185 patients (median age 57.9 years, 71.9% female). 34% presented ruptured; 56% were bifurcation lesions, most commonly at the anterior communicating complex (34.6%). Balloon-assist, stent-assist, and flow diversion were used in 32.4%, 42.7%, and 4.9%, respectively. Immediate complete occlusion was achieved in 53%; at a median 12-month imaging follow-up, complete occlusion was 74.6%, and the retreatment rate was 9.7%. Procedural complications occurred in 10.8% overall, comprising major complications 2.2% (intra-operative rupture 1.1%, thromboembolism 1.1%) and other complications 8.6% ; there were no procedure-related deaths. 93% of patients had a favorable clinical outcome at 13.6-month clinical follow-up. On multivariable analysis, predictors of complete occlusion at last follow-up were complete occlusion at the end of the procedure (OR 3.53), whereas rupture, posterior-circulation location, width, and diameter < 2 mm independently reduced obliteration odds.</p><p><strong>Conclusions: </strong>Endovascular coiling of VSAs provides high occlusion and excellent clinical outcomes with minimal morbidity. Anatomical complexity (ultra-small size, posterior circulation) and incomplete initial packing remain targets for technical optimization and prospective evaluation.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112883","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":"Vein of foramen caecum and cribriform plate: CT-digital subtraction venography analysis associated with the anterior cranial fossa dural arteriovenous shunts.","authors":"Kenya Otomo, Katsuhiro Mizutani, Takahiro Iinuma, Konosuke Ishikawa, Kosei Yamamoto, Takenori Akiyama, Masahiro Toda","doi":"10.1007/s00234-026-04201-7","DOIUrl":"https://doi.org/10.1007/s00234-026-04201-7","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior cranial fossa dural arteriovenous shunts (ACFdAVS) are a subtype of dural arteriovenous shunts that affect the anterior cranial fossa. However, the venous structures around the anterior skull base that may predispose patients to ACFdAVS have been poorly characterized. This study investigated the midline and paramedian venous channels of the anterior cranial fossa and their association with ACFdAVS.</p><p><strong>Methods: </strong>We retrospectively analyzed computed tomography-digital subtraction venography data from 285 consecutive patients to identify venous channels crossing the anterior cranial fossa floor. Additionally, venous drainage in nine ACFdAVS cases were analyzed using cone beam computed tomography.</p><p><strong>Results: </strong>We identified two veins piercing the anterior cranial fossa floor: the vein of the foramen caecum (VFC) running through the midline foramen caecum in six cases (2.1%) and the veins piercing the paramedian cribriform plate, here termed the veins of the cribriform plate (VCP), in 19 cases (6.7%). The VFC typically drains directly into the superior sagittal sinus and infrequently into the frontal pial veins, whereas the VCP connected to the frontal pial veins, and drained into the superior sagittal sinus or olfactory veins. Both drained the nasal cavity and were occasionally connected to the facial veins. In all ACFdAVSs, the venous drainage arose from the paramedian region of the cribriform plate, corresponding to the intracranial segment of the VCPs, while the nasal segment was absent.</p><p><strong>Conclusion: </strong>The VCPs may play a key role in the pathogenesis of ACFdAVS, and thrombosis or occlusion in their extracranial segment may trigger the development of ACFdAVS.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112888","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}