Neuroradiology Journal最新文献

{"title":"Acute dural venous sinus injuries: Imaging and challenges.","authors":"Ruben Gabriel Ortiz Cordero, Oswaldo André Guevara Tirado, Hrishabh Bhosale, Mayur Virarkar, Miguel Fabrega, Ryan Seiji Kitagawa, Emilio Supsupin","doi":"10.1177/19714009261467323","DOIUrl":"10.1177/19714009261467323","url":null,"abstract":"<p><p>Dural venous sinus injury (DVSI) can occur after traumatic brain injury and lead to impaired cerebral venous outflow through extrinsic compression, intraluminal thrombosis, or mixed mechanisms. It can progress to a sinus tear or transection with hemorrhage. On noncontrast-enhanced head CT, DVSI may be subtle and can be confounded by adjacent fractures, extra-axial blood products, and filling defects such as arachnoid granulations. Although the reported incidence of severe head injury is 1-4%, modern trauma imaging has revealed a substantially higher burden of DVSI and dural venous sinus thrombosis (DVST) in patients with skull base and calvarial fractures, particularly when fractures cross or overlie major sinuses or the jugular bulb. This narrative review focuses on acute post-traumatic dural venous sinus injury and synthesizes current knowledge on the angiographic anatomy. We also highlight the strengths and limitations of CT venography (CTV), MR venography (MRV), and adjunctive digital subtraction angiography in detecting DVSI, differentiating intraluminal thrombus from extrinsic compression, and characterizing collateral pathways. Finally, we review management strategies, including neurosurgical decompression for mechanically compressed sinuses, the non-standardized use of systemic anticoagulation for DVST in the presence of a hemorrhage, and the role of detailed venographic mapping for operative planning. Timely recognition of these injuries and their complications, guided by a systematic venographic approach, is essential for mechanism-based management that may reduce the risk of serious sequelae including venous infarction.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261467323"},"PeriodicalIF":1.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow diversion for intracranial aneurysms in patients with sickle cell disease.","authors":"Bluyé DeMessie, Muhammed Amir Essibayi, Alireza Karandish, Shreya Nandi, Dhrumil Vaishnav, Lyanna Gomez, Kainaat Javed, Adisson Fortunel, Nathan Farkas, Kaitlin L Strumph, Deepa G Manwani, Mandana Behbahani, Deepak Khatri, David J Altschul","doi":"10.1177/19714009261462814","DOIUrl":"10.1177/19714009261462814","url":null,"abstract":"<p><p>IntroductionSickle cell disease (SCD) confers a three-to fivefold increase in the prevalence of intracranial aneurysms (IA). Flow diversion (FD) requires mandatory dual antiplatelet therapy (DAPT), yet perioperative transfusion to reduce hemoglobin S (HbS) risks delayed hemolytic transfusion reaction (DHTR). No guidelines address this conflict between DHTR-associated coagulopathy and mandatory DAPT. We report the largest FD series in SCD.MethodsRetrospective single-center case series of SCD patients undergoing FD for IA (2017 to 2026). Of 12 SCD patients treated for aneurysms, seven received FD and comprised the analytic cohort.ResultsSeven patients (5 HbSS, 2 HbS/β⁰-thalassemia; median age 38; 71% female) harbored 29 aneurysms; 12 were treated with FD across 8 procedures using 15 devices. HbS <30% was achieved in 3 of 7 (43%); one patient underwent FD at HbS 78.5% due to alloimmunization. Clopidogrel hyporesponsiveness was identified in 2 of 4 TEG-tested patients (50%). Procedure-related mortality was 14% (1/7): fatal DHTR with DIC on postoperative day 8, the first reported DHTR-DAPT collision. Procedure-related morbidity included one intraoperative thrombus and one vasospasm episode, both resolved without sequelae (2/8 procedures, 25%). Additional events included asymptomatic in-stent stenosis and delayed stroke from SCD vasculopathy. At last follow-up, 5 of 6 survivors maintained mRS 0 to 1.Discussion and ConclusionFD is technically feasible in SCD, but the 14% procedure-related mortality from a fatal DHTR exposes the unresolved conflict between transfusion-associated hyperhemolysis and mandatory DAPT. CYP2C19-mediated clopidogrel resistance and alloimmunization pose additional challenges that require predefined protocols and prospective multicenter registries.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261462814"},"PeriodicalIF":1.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfusion imaging abnormalities in acute cerebral venous sinus thrombosis: A case series.","authors":"Derek Tsang, Andrew Cho, Karthik Lalwani, Vivek Yedavalli","doi":"10.1177/19714009261460767","DOIUrl":"10.1177/19714009261460767","url":null,"abstract":"<p><p>The clinical value of perfusion imaging in arterial ischemic stroke is well established, but its interpretation in cerebral venous sinus thrombosis (CVST) remains less clearly defined. We present a case series of five patients with acute CVST who demonstrated perfusion abnormalities on initial CT perfusion (CTP) or MR perfusion (MRP). The observed findings demonstrated a spectrum of venous hemodynamic patterns. Several patients showed delayed transit metrics, including increased MTT or Tmax, with preserved or increased CBV, suggesting venous congestion or vasogenic edema rather than arterial-type ischemic penumbra. In contrast, one patient demonstrated delayed transit with decreased CBV and CBF, suggesting more advanced venous infarction or tissue-level perfusion failure. One additional patient demonstrated hyperperfusion in a non-territorial distribution, most compatible with ictal or peri-ictal hyperemia rather than a primary venous congestion pattern. Four patients had favorable neurological recovery, whereas one patient had a poor short-term outcome likely driven primarily by large baseline hemorrhage. These cases highlight that perfusion abnormalities in CVST should be interpreted differently from arterial stroke and may be most useful when stratified into venous congestion, venous infarction, and seizure-related hyperperfusion patterns.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261460767"},"PeriodicalIF":1.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing neuroradiology education with systematic image and video sequences.","authors":"Wieslaw L Nowinski","doi":"10.1177/19714009261460775","DOIUrl":"10.1177/19714009261460775","url":null,"abstract":"<p><p>Neuroanatomy remains one of the most challenging areas in medical education, including neuroradiology, due to its complexity and limitations of traditional teaching methods. This study proposes a novel approach based on systematic image and video sequences to enhance the presentation, exploration, communication, learning, and teaching of neuroanatomy. Systematic image sequences are ordered sets of spatially and contextually correlated images characterized by five features: anatomical content, parcellation, annotation, location, and dimensionality. Five elementary sequence types are introduced: appearance, contextual, multi-dimensional, dissection, and special, which can be combined into composite (homogeneous/heterogeneous, uni-view/multi-view) sequences. These sequences are presented in interactive, single multi-image, and automated modes, and extended to video formats. The sequences were created using a high-resolution, fully parcellated 3D atlas of the human brain, head, and neck. 12 image sequences (51 images) and two video sequences are presented and discussed, along with references to three major resources of ready-to-use sequences: NOW<i>in</i>BRAIN repository (over 8600 3D neuroimages), ebook <i>Neuroanatomy Made Easy</i> (over 350 sequences), and the latest edition of <i>Gray's Anatomy</i>/Chapter_28. The proposed sequences enhance visualization and understanding of anatomical structures and relationships. Appearance sequences improve recognition through parcellation and labeling, while contextual sequences reveal spatial relationships. Dissection and cortical opening sequences expose otherwise hidden structures, and multi-dimensional sequences bridge 2D radiology with 3D anatomy. Hence, the method elucidates complex anatomical organization, including cortico-vascular relationships, ventricular-venous alignment, and cranial nerve pathways. Overall, systematic image-video sequences provide a conceptually straightforward, easy-to-use, simply integrable, and cost-effective framework enhancing spatial understanding and interpretation, particularly in neuroradiology.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261460775"},"PeriodicalIF":1.2,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferior petroclival vein arteriovenous fistula mimicking cavernous sinus dural arteriovenous fistula: A case report.","authors":"Yasuyuki Tatsuta, Hideki Endo, Tomoki Fuchizaki, Tatsuya Ogino, Hirohiko Nakamura","doi":"10.1177/19714009261460769","DOIUrl":"10.1177/19714009261460769","url":null,"abstract":"<p><p>Arteriovenous fistulas (AVFs) involving the inferior petroclival vein (IPCV) are extremely rare and may mimic cavernous sinus (CS) dural arteriovenous fistulas (DAVF) because of shared venous drainage patterns. A 72-year-old man presented with diplopia and left ocular chemosis. Carotid angiography revealed retrograde venous drainage into the superior ophthalmic vein via the inferior petrosal sinus (IPS) and CS. The initial findings suggested a CS-DAVF; however, three-dimensional angiography, including multiplanar reconstruction and maximum intensity projection analyses, identified shunt pouches in the IPCV and anterior condylar vein. Transvenous embolization via the IPS allowed the selective coil embolization of the IPCV shunt pouch while preserving the IPS. The IPCV-AVF resolved completely. Although the anterior condylar vein dural AVF remained, it was classified as Borden type I and was managed conservatively. The present case highlights the importance of detailed three-dimensional angiographic analysis to distinguish IPCV-AVF from CS-DAVF and guide effective treatment.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261460769"},"PeriodicalIF":1.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vessel wall characteristics of the middle cerebral artery on high-resolution magnetic resonance imaging in patients with acute ischemic stroke.","authors":"Thi Bich Nga Le, Thi Thuy Linh Nguyen, Duy Khoa Dao, Vinh Khang Nguyen, Phuong Truc Vo, Van Phuoc Le","doi":"10.1177/19714009261450384","DOIUrl":"10.1177/19714009261450384","url":null,"abstract":"<p><p>BackgroundIntracranial arterial stenosis is a major cause of ischemic stroke in Asian populations. High-resolution magnetic resonance imaging (HR-MRI) of the vessel wall is an emerging tool that offers valuable insights.MethodsWe conducted a retrospective study of adult patients (≥18 years) with acute ischemic stroke and M1 MCA stenosis who underwent HR-MRI at the University Medical Center Ho Chi Minh City between January 2019 and May 2025.ResultsSixty-two patients were included (mean age, 56 ± 13 years; male-to-female ratio, 2:1). The average stenosis degree was 66.3 ± 17.5, with severe stenosis in 38.7% of patients. The predominant pattern was eccentric stenosis (80.6%), more frequently observed in older patients. The mean remodeling index was 0.87 ± 0.21, and most cases showed negative remodeling. The majority of lesions at the stenotic site exhibited post-contrast enhancement, most commonly grade 2 enhancement (43.6%). The most frequent cause of stenosis was atherosclerosis (43 cases), followed by dissection (2 cases), Moyamoya disease (1 case), and indeterminate etiology (16 cases). Among infarct-associated atherosclerotic lesions, plaques with intraplaque hemorrhage (58.1%), irregular plaque surface (86.1%), and strong (grade 3) enhancement (46.5%) were observed more frequently than in the small non-infarct-associated incidental group; however, this exploratory comparison was limited by the very small size of the comparator group.ConclusionsHR-MRI of the MCA vessel wall provides detailed information on stenotic lesion characteristics, aiding in the identification of the underlying etiology. These findings highlight the potential role of HR-MRI in stroke diagnosis and risk stratification in Vietnamese patients.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261450384"},"PeriodicalIF":1.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of arterial calcification in acute ischemic stroke treated with endovascular thrombectomy: A systematic review and meta-analysis.","authors":"Marianna Leite, Luciano Falcão, Kenzo Ogasawara Donato, Ocilio Ribeiro Gonçalves, Gabriel Arruda, Mariana Lee Han, Filipe Virgilio Ribeiro, Mariana Letícia de Bastos Maximiano, Ahmet Günkan, Christian Ferreira, Michel Ferreira Machado","doi":"10.1177/19714009261456600","DOIUrl":"10.1177/19714009261456600","url":null,"abstract":"<p><p>BackgroundArterial calcification is commonly found in patients with cerebrovascular disease and may negatively affect outcomes following endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). This systematic review and meta-analysis aimed to evaluate the impact of intracranial or aortic arch calcification on procedural success and functional outcomes in AIS patients undergoing anterior circulation EVT.MethodsWe systematically searched the PubMed, EMBASE, and Cochrane databases to identify studies comparing EVT outcomes between AIS patients with and without arterial calcification. Outcomes assessed included first-pass effect (FPE), successful reperfusion at the end of the procedure, modified Rankin scale (mRS), mortality, and symptomatic intracerebral hemorrhage (sICH). Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random effects models, with heterogeneity evaluated with I² statistics.ResultsA total of six observational studies were included, with a total of 3834 patients (2303 with calcification and 1531 controls). Arterial calcification was associated with a lower chance of achieving FPE (RR: 0.50, 95% CI: 0.36-0.69, <i>p</i> < 0.001) and successful reperfusion (RR: 0.90, 95% CI: 0.86-0.94, <i>p</i> < 0.001). Patients with calcification had a greater risk of poor outcome (mRS 3-6) (RR: 1.29, 95% CI: 1.16-1.43, <i>p</i> < 0.001), mortality (RR: 1.51, 95% CI: 1.14-2.00, <i>p</i> < 0.001), and sICH (RR: 1.29, 95% CI: 1.16-1.43, <i>p</i> < 0.001). Heterogeneity was low, with <i>I</i>² ≤ 34%.ConclusionArterial calcification may be indicative of advanced vascular disease, potentially leading to diminished technical success and worse functional outcomes following EVT for AIS. These findings underscore that vascular calcification acts as an associative marker of procedural complexity and advanced vascular disease in EVT candidates.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261456600"},"PeriodicalIF":1.2,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13233601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral thalamic infarction in a young adult: The artery of Percheron conundrum.","authors":"Giovanni Failla, Francesco Tiralongo, Salvatore Dominici, Pina Crimì, Corrado Inì, Daniele Grippaldi, Renato Farina, Emanuele David, Pietro Valerio Foti, Stefano Palmucci, Antonio Basile","doi":"10.1177/19714009251371269","DOIUrl":"10.1177/19714009251371269","url":null,"abstract":"<p><p>Artery of Percheron (AOP) infarction is a rare form of ischemic stroke resulting from the occlusion of a single arterial trunk that supplies both sides of the paramedian thalamus and the midbrain. Its occlusion can lead to bilateral and symmetrical infarctions of the paramedian thalami, and occasionally, the midbrain. Due to its atypical presentation, this condition is often diagnosed late. We report a case of a 39-year-old male with no significant medical history who arrived at the emergency department with drowsiness and confusion. During the physical examination, the patient was drowsy but responsive, with poor speech. Motor deficits in all four limbs were not apparent. Vital signs, routine blood tests, and an initial CT scan were unremarkable. The diagnosis was confirmed the following day through a subsequent CT scan and brain MRI. This case emphasizes the diagnostic challenge posed by AOP infarction and highlights the importance of considering this condition even when initial CT imaging appears normal.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"384-391"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of the pipeline vantage flow diverter for the treatment of saccular aneurysms in the posterior cerebral circulation.","authors":"Omar Abu-Fares, Antonis Adamou, Peter Raab, Heinrich Lanfermann, Alexander Sirakov, Marie Middendorff, Harold F Hounchonou, Joachim K Krauss, Shadi Al-Afif","doi":"10.1177/19714009251373070","DOIUrl":"10.1177/19714009251373070","url":null,"abstract":"<p><p>IntroductionPosterior circulation aneurysms are particularly challenging to treat due to their anatomical complexity and the high perforator density within this region. The pipeline vantage flow diverter (PVFD) has shown promising results in treating anterior circulation aneurysms. However, its efficacy and safety in treating posterior circulation saccular aneurysms are not well investigated.MethodsSingle-center study reviewed patients with posterior circulation aneurysms treated with the PVFD between September 2021 and March 2024. Patients and aneurysm characteristics, clinical results, and radiological results were documented.Results22 patients harboring 24 aneurysms were identified. All aneurysms had a saccular morphology. Complications included ischemic events in two patients (8.3%), one leading to mRS deterioration from 0 to 3. One cerebral hemorrhage leading to mRS shift from 0 to 1 was also documented. At the latest imaging follow-up available (median 14.3 months), complete aneurysm occlusion (Class I, Raymond-Roy occlusion classification (RROC) was achieved in 50% of the cases, residual neck (Class II) in 41.7%, and residual aneurysm (Class III) in 8.3%. Basilar bifurcation aneurysms had lower complete occlusion rates (RROC I: 33.3%) and higher complication rates (16.7% with mRS shift) compared to other locations. In-stent stenosis was rare (4.5%). A limitation of the study is the retrospective, single-center study design.ConclusionThe PVFD demonstrates high occlusion rates and a favorable safety profile in the treatment of saccular aneurysms in the posterior circulation. However, treatment of basilar bifurcation aneurysms with the PVFD remains challenging due to the complex anatomy and high-flow dynamics in this location.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"315-321"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ticagrelor use in ruptured aneurysms: A retrospective cohort study.","authors":"Nourou Dine Adeniran Bankole, Baptiste Donnard, Gregoire Boulouis, Yohann Nalbach, Axel Masson, Kevin Janot, Heloise Ifergan, Fouzi Bala, Richard Bibi","doi":"10.1177/19714009251389566","DOIUrl":"10.1177/19714009251389566","url":null,"abstract":"<p><p>BackgroundThe acute management of ruptured intracranial aneurysms sometimes requires stent placement, which necessitates the prompt initiation of an antiplatelet (APT) regimen, including Ticagrelor at our center.ObjectiveThis study aimed to assess patients with ruptured intracranial aneurysms who received Ticagrelor prior to or during aneurysm embolization. We evaluated procedural safety and clinical and imaging outcomes at 6 months follow-up.Patients and MethodsWe analyzed patients with aneurysmal subarachnoid hemorrhage treated with endovascular therapy (EVT) under a dual antiplatelet therapy (DAPT) regimen between January 2015 and January 2023, excluding those managed with surgical clipping. Safety profiles and clinical outcomes were systematically assessed.ResultsA total of 23 patients (69.6% female, mean age 58.6 ± 12.2 years) with ruptured aneurysms and subarachnoid hemorrhage underwent EVT with DAPT (Ticagrelor + Aspirin). Aneurysms were primarily located on the carotid (39.1%) and anterior communicating arteries (30.4%), with a median size of 5 mm. The median time from rupture to treatment was 1.5 days. Ischemic complications occurred in 30.4%, including procedure-related ischemia (21.7%) and post-procedure vasospasm (8.7%). Hemorrhagic complications were observed in 8.7%, with two patients experiencing asymptomatic post-procedure hemorrhage. Functional outcomes at 6 months showed 56.5% of patients with excellent recovery (mRS <2), while 17.4% died (mRS = 6), resulting in a 17.4% mortality rate.ConclusionTicagrelor appears feasible and generally safe for acute-phase management of aneurysmal subarachnoid hemorrhage, though complications and mortality highlight the need for cautious patient selection and further investigation.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"360-366"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}