Clinical Neuroradiology最新文献

{"title":"Mechanical Thrombectomy in the Management of Acute Ischemic Stroke Secondary to Calcified Cerebral Emboli: a Systematic Review.","authors":"Nicholas V Pavic, Shane Zhang, Alexander G Maloof, Mobin Aber, Christie Wu, Stephen D Bacchi, Vinicius Carraro Do Nascimento, Rudy Goh","doi":"10.1007/s00062-025-01611-7","DOIUrl":"10.1007/s00062-025-01611-7","url":null,"abstract":"<p><strong>Purpose: </strong>Mechanical thrombectomy (MT), in combination with intravenous thrombolysis, have been widely accepted as effective therapies for acute ischemic stroke (AIS) secondary to large vessel occlusion. However, the presence of calcified cerebral emboli (CCE) has been associated with worse angiographic and clinical outcomes. Therefore, this systematic review aimed to evaluate the efficacy and safety of MT in the management of AIS secondary to CCE.</p><p><strong>Methods: </strong>A systematic review was registered and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (CRD420251031539). PubMed, Ovid Medline, SCOPUS, The Cochrane Library and EMBASE were searched for publications until 13th April 2025.</p><p><strong>Results: </strong>The search yielded 2102 publications. 14 studies met inclusion criteria (160 patients with AIS due to CCE). Two multi-centre studies reported recanalisation rates of only 57.5% and 57% respectively across 75 participants. Only 11.1-28.0% of patients in the included case series and cohort studies had a modified rankin score 2 at 3 months, suggesting that most patients did not regain functional independence following MT for CCE. MT for CCE was also associated with a 3-month mortality rate of 0-62.5%. Haemorrhagic complications were the most common adverse effect associated with MT.</p><p><strong>Conclusion: </strong>The available evidence from 14 studies elucidated poor recanalisation rates and functional outcomes when MT was used in the management of AIS secondary to CCE. However, the available evidence is primarily low-level evidence from observational studies, hence the conclusions should be interpreted with caution.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"295-307"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068235","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}

{"title":"Reply to the Letter Regarding: \"Intravenous Tirofiban for Preventing Acute In-Stent Thrombosis in Emergent Carotid Artery Stenting\".","authors":"Anderson Matheus Pereira Silva, Ocílio de Deus, Mariana Lee Han, Filipe Virgilio Ribeiro, Luciano Falcão, Mariana Leticia de Bastos Maximiano, Christian Ken Fukunaga, Lucca Tamara Alves Carretta, Ricardo Fonseca Oliveira Suruagy Motta, Christian Ferreira","doi":"10.1007/s00062-026-01633-9","DOIUrl":"10.1007/s00062-026-01633-9","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"797-798"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311788","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":"Clinical Outcomes and Factors Associated with Reocclusion after Endovascular Therapy for Intracranial Atherothrombotic Stroke with Large Vessel Occlusion.","authors":"Hiroyuki Ikeda, Kazutaka Uchida, Masanori Kinosada, Minami Uezato, Hiroshi Yamagami, Nobuyuki Sakai, Manabu Shirakawa, Mikiya Beppu, Kazunori Toyoda, Yuji Matsumaru, Yasushi Matsumoto, Kenichi Todo, Mikito Hayakawa, Seigo Shindo, Shinzo Ota, Masafumi Morimoto, Masataka Takeuchi, Hirotoshi Imamura, Kanta Tanaka, Hideyuki Ishihara, Hiroto Kakita, Takanori Sano, Hayato Araki, Tatsufumi Nomura, Fumihiro Sakakibara, Shinichi Yoshimura, Masaki Chin","doi":"10.1007/s00062-025-01603-7","DOIUrl":"10.1007/s00062-025-01603-7","url":null,"abstract":"<p><strong>Purpose: </strong>Reocclusion after endovascular therapy (EVT) may worsen the clinical outcome of patients undergoing EVT for intracranial atherothrombotic stroke with large vessel occlusion (AT-LVO), but the details and risk factors have not been fully investigated.</p><p><strong>Methods: </strong>Patients with intracranial AT-LVO were enrolled in a multicenter retrospective registry study conducted at 51 centers in Japan and were divided into two groups based on whether reocclusion occurred within 90 days after recanalization of intracranial AT-LVO with EVT: the reocclusion group and the patent group. The primary outcome was a modified Rankin Scale score of 0-2 at 90 days after EVT. Risk factors for reocclusion were also assessed.</p><p><strong>Results: </strong>A total of 461 patients were enrolled, 66 (14.3%) in the reocclusion group and 395 (85.7%) in the patent group. Intracranial stenting and differences in antithrombotic regimens were not associated with reocclusion. The rate of patients with the primary outcome was significantly lower in the reocclusion group than in the patent group (15.4% vs. 46.4%, adjusted odds ratio 0.15 [95% confidence interval 0.06-0.33], P < 0.001). Reocclusion was associated with recurrent ischemic stroke, additional EVT or surgery, symptomatic intracranial hemorrhage, and all-cause death. Direct aspiration and vessel perforation were independent factors for reocclusion (adjusted odds ratio 1.82 [95% confidence interval 1.02-3.25], P = 0.043; adjusted odds ratio 5.91 [95% confidence interval 1.005-35.35], P = 0.049, respectively).</p><p><strong>Conclusions: </strong>Reocclusion after EVT was associated with recurrent ischemic stroke, additional EVT or surgery, symptomatic intracranial hemorrhage, and poor clinical outcome at 90 days. Direct aspiration and vessel perforation were independent risk factors for reocclusion after EVT.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"499-511"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745336","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":"De Novo Aneurysm Formation After Internal Carotid Artery Sacrifice: Impact of Aneurysmal Versus Non-Aneurysmal Etiology.","authors":"Jun Sang Yoo, Mi Hyeon Kim, Jong-Tae Yoon, Jae Ho Lee, Boseong Kwon, Yunsun Song, Deok Hee Lee","doi":"10.1007/s00062-025-01585-6","DOIUrl":"10.1007/s00062-025-01585-6","url":null,"abstract":"<p><strong>Background: </strong>Endovascular trapping of the internal carotid artery (ICA) remains a definitive treatment for both aneurysmal and non-aneurysmal conditions when vessel-preserving strategies are not feasible. However, increasing attention has been directed toward the risk of de novo aneurysm formation following ICA sacrifice, presumably due to hemodynamic alterations within the Circle of Willis. This study aimed to evaluate the incidence and potential risk factors for de novo aneurysm development and the growth of pre-existing aneurysms after ICA trapping, particularly focusing on differences based on the underlying pathology, aneurysmal versus non-aneurysmal.</p><p><strong>Methods: </strong>A retrospective, single-center study was conducted on patients who underwent unilateral endovascular ICA trapping between 2003 and 2023, with a minimum of one year of angiographic follow-up. Patients were categorized into the aneurysm-trapping (AT) or non-aneurysm-trapping (NT) group according to the underlying indication for ICA sacrifice. Clinical, angiographic, and procedural data were reviewed to evaluate the development of de novo aneurysms or the progression of pre-existing lesions.</p><p><strong>Results: </strong>Among the 47 included patients (37 and 10 in the AT and NT groups, respectively), de novo aneurysm formation or significant growth of pre-existing aneurysms was observed exclusively in the AT group (10/37, 27.0%), with no such events in the NT group (0/10), showing a statistical trend that did not reach conventional significance (p = 0.064). Most newly developed aneurysms (60%) arose at the anterior communicating artery (ACoA), predominantly in patients with well-developed ACoA collateral flow. Most lesions appeared within two years after ICA trapping. Additional treatment was required in two patients due to progressive enlargement of pre-existing aneurysms.</p><p><strong>Conclusion: </strong>De novo aneurysm formation following ICA trapping appears to occur exclusively in patients with an underlying aneurysmal etiology, particularly at sites of hemodynamic stress such as the ACoA. Close imaging surveillance is recommended during the first two years post-trapping, especially in patients with robust collateral circulation or pre-existing aneurysms.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"339-347"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453121","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":"Mechanical Thrombectomy Versus Best Medical Treatment for Patients with Acute Ischemic Stroke and Primary Distal Medium Vessel Occlusion: a Systemic Review and Meta-Analysis.","authors":"Giancarlo Salsano, Bruno Del Sette, Marco Bruzzone, Nicola Mavilio, Davide Sassos, Alessandra Murialdo, Luca Scarcia, Andrea M Alexandre, Massimo Del Sette, Lucio Castellan","doi":"10.1007/s00062-025-01599-0","DOIUrl":"10.1007/s00062-025-01599-0","url":null,"abstract":"<p><strong>Background: </strong>Distal medium vessel occlusions (DMVO) in stroke patients represent a complex clinical challenge, primarily due to lack of conclusive evidence supporting the superiority of mechanical thrombectomy (MT) over best medical therapy (BMT). This meta-analysis aims to compare clinical outcomes between these two treatment strategies, focusing on functional outcomes assessed by means of modified Rankin Scale (mRS), overall mortality, early neurological improvement (ENI), and incidence of symptomatic intracranial hemorrhage (sICH) or subarachnoid hemorrhage (SAH).</p><p><strong>Material and methods: </strong>Three investigators independently researched all main medical search engines (Medline, Scopus and Cochrane Library) to identify original papers comparing MT and BMT in patients with ischemic stroke due to primary DMVO. Primary endpoint was functional independence at 90 days (mRS 0-2), while secondary outcomes included excellent clinical outcome at 90 days (mRS 0-1), all-cause mortality, ENI, sICH and SAH.</p><p><strong>Results: </strong>A total of 28 studies (3 randomized control trials and 25 retrospective observational studies) comparing MT to BMT, involving 7512 patients were included. Our findings indicate no statistically significant differences in clinical outcomes, both for functional independence (OR: 1.05, 95% CI: 0.91-1.21) and excellent outcome (OR: 1.07, 95% CI: 0.92-1.24). No statistically significant differences were observed for overall mortality (OR: 1.01, 95% CI: 0.80-1.27), ENI (OR: 1.30, 95% CI: 0.67-2.51) and rate of sICH (OR: 0.93, 95% CI: 0.55-1.58). Statistically significant results were seen on SAH rate which was higher in the MT group (OR: 0.01, 95% CI: 0.00-0.11).</p><p><strong>Conclusions: </strong>Our meta-analysis did not support the routine use of MT in the treatment of DMVO. Rather, it indicates that MT + BMT does not lead to an increased proportion of patients achieving functional independence or excellent outcome at 3 months, nor does it reduce mortality rates compared to BMT alone.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"285-293"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716571","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":"Evaluating Unimodal and Multimodal Tracking Strategies for the Reconstruction of Language-related White Matter Tracts.","authors":"Lydia Marleen Schilling, Anna-Lena Ciesla, Julia My Van Kube, Peter Dechent, Christian Heiner Riedel, Nicole E Neef","doi":"10.1007/s00062-025-01601-9","DOIUrl":"10.1007/s00062-025-01601-9","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate reconstruction of language-related white matter pathways is essential for preoperative planning in brain surgery. While functional (f) MRI activation is often used to guide diffusion (d)MRI tractography, advanced automated protocols rely instead on subcortical anatomical priors. In this study, we evaluate the robustness of anatomically informed protocols without fMRI and compare them with fMRI-guided approaches.</p><p><strong>Methods: </strong>Twenty healthy adults (aged 18-32) underwent fMRI during a language task and dMRI on a 3T MRI scanner. Six language-associated fiber bundles were reconstructed with XTRACT using unimodal and multimodal protocols. Reconstruction similarity was assessed using cross-correlations within-subjects, within-cohort, and across-cohorts. Normalized streamline counts served as a proxy for connectivity, and t-tests were used to quantify differences between tracking protocols.</p><p><strong>Results: </strong>Protocols using anatomically informed subcortical seed and target masks, as well as their combination with functional masks, yielded higher agreement and greater normalized streamline counts than the fMRI-only protocol. The combined approach showed an additional advantage for reconstructing parieto-temporal white matter tracts.</p><p><strong>Conclusions: </strong>These comparisons underscore how protocol choice shapes the reconstruction of language pathways and highlight the need to evaluate these tractography strategies in clinical cohorts.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"485-497"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716485","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}

{"title":"CT-based Volume Measurement of Brain Calcification Is Related to Clinical Symptoms and Disease Progression in Primary Familial Brain Calcification.","authors":"Birgitta M G Snijders, Lennard Pierey, Mike J L Peters, Stéphanie V de Lange, Simone van der Star, Noah Allaerts, Marielle H Emmelot-Vonk, Pim A de Jong, Huiberdina L Koek","doi":"10.1007/s00062-025-01595-4","DOIUrl":"10.1007/s00062-025-01595-4","url":null,"abstract":"<p><strong>Purpose: </strong>Primary Familial Brain Calcification (PFBC) is a disorder characterized by basal ganglia calcification. A CT visual rating scale known as the Total Calcification Score (TCS) is often used to quantify brain calcification, but volume measurements are a novel approach. This study evaluated the association between the (modified) TCS, volume measurements, and clinical symptoms, and their ability to detect calcification progression.</p><p><strong>Methods: </strong>In patients with PFBC, the (modified) TCS and volumes were calculated for each brain CT. Clinical symptoms were assessed using the Montreal Cognitive Assessment (MoCA), Unified Parkinson's Disease Rating Scale (UPDRS), and Neuropsychiatric Inventory-Questionnaire (NPI-Q). Calcification progression was determined for patients with a second CT available. Annual median progression rates were calculated.</p><p><strong>Results: </strong>Of the 66 included patients (median age 60 years, 56% male), 26 had a follow-up CT after 1 year (IQR 0.5-1.3 year). The median TCS was 28.5, modified TCS was 32.5, and volume was 7.6 cm³. Volume measurements showed a significant association with clinical symptoms (MoCA β = -0.44[SE 0.02] and UPDRS β = 0.61[SE 0.04]), comparable to the (modified) TCS, and accounted for the largest proportion of explained variance (MoCA R² = 0.19, UPDRS R² = 0.37). There were no significant associations between the methods and NPI‑Q. Volume measurements showed an annual progression rate of 6.2%, whereas the (modified) TCS showed no annual change.</p><p><strong>Conclusion: </strong>Volume measurements of brain calcification were significantly associated with clinical symptoms, explained more variance, and appeared in this small sample to be better in detecting calcification progression compared with visual scores, although further diagnostic and longitudinal testing is required.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"431-438"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606327","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":"Febrile Infection-Related Epilepsy Syndrome (FIRES) in a Young Adult: A Case Report Highlighting Advanced Neuroimaging.","authors":"Evamaria Olga Riedel, Fabian Bongratz, Paul Theo Zebhauser, Mark Mühlau, Christian Wachinger, Dennis Martin Hedderich","doi":"10.1007/s00062-025-01574-9","DOIUrl":"10.1007/s00062-025-01574-9","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"771-774"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240296","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}

{"title":"Diagnostic Value of Muscle MRI in a Case of Very Late-Onset Becker Muscular Dystrophy.","authors":"Evamaria O Riedel, Vincent Gmeiner, Tobias B Haack, Jan S Kirschke, Marcus Deschauer","doi":"10.1007/s00062-026-01620-0","DOIUrl":"10.1007/s00062-026-01620-0","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"791-794"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127148","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}

{"title":"Is MR Imaging of the Cervical Spinal Cord Sufficient for Patients with Suspected Multiple Sclerosis?","authors":"Isabelle Riederer, Matthias Bussas, Markus Lauerer, Laura Harabacz, Viktor Pineker, Malek El Husseini, Nico Sollmann, Claus Zimmer, Jan S Kirschke, Mark Mühlau","doi":"10.1007/s00062-025-01613-5","DOIUrl":"10.1007/s00062-025-01613-5","url":null,"abstract":"<p><strong>Purpose: </strong>Lesions in the spinal cord (SC) can be found in up to 83% of patients with multiple sclerosis (MS). As they are mainly located in the cervical segment, many centers exclude the thoracic part from SC imaging. The aim of our study was to quantify the decrease in sensitivity resulting from this approach.</p><p><strong>Methods: </strong>MR images (3T) of 543 consecutive patients with clinically isolated syndrome (CIS) (n: 37) and MS (n: 506) were analyzed retrospectively. Lesions were segmented semi-automatically on axial T2-weighted images of the whole SC using BrainSeg3D. The volume of lesions was related to vertebral levels.</p><p><strong>Results: </strong>Altogether 1782 lesions (CIS: 19; MS: 1763) were found in 409 patients. 70% of the lesion volume was located in the SC above the 3rd thoracic vertebral body, in a segment that is commonly covered by an isolated examination of the cervical SC. However, 26 patients (6%) showed lesions exclusively below the 3rd thoracic vertebral body, thus 94% of all patients with SC lesions could be detected with isolated MR imaging of the cervical SC.</p><p><strong>Conclusion: </strong>Though the majority of lesions can be detected in an isolated examination of the upper part of the SC, some patients showed lesions exclusively below the 3rd thoracic vertebral body. We recommend routine scanning of the whole SC in suspected MS.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"577-583"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020305","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}