Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are neurodegenerative disorders characterized by parkinsonian symptoms. PSP typically presents with supranuclear gaze palsy, postural instability, and subcortical dementia, while dysautonomia and cerebellar signs are hallmark features of MSA. We report the case of a 77-year-old male patient with a four-year history of progressive parkinsonian symptoms that have shown poor response to treatment. His clinical manifestations included bradykinesia, rigidity, swallowing difficulties, urinary frequency, nocturia, downward gaze palsy, hypometric saccades, and finger-nose dysmetria. Examination revealed increased tone in both upper extremities, more pronounced on the right side, along with bradykinesia, slow hand movements, and bilateral decrement in finger tapping. Brain magnetic resonance imaging (MRI) revealed mixed MRI findings consistent with atypical parkinsonian syndrome, showing signs of MSA-C with pontocerebellar atrophy and the "hot cross bun" sign, as well as PSP with midbrain atrophy (hummingbird sign) and tegmental hypersignal.
{"title":"Concomitant progressive supranuclear palsy and multiple system atrophy: A rare case report of tauopathy and synucleinopathy interface","authors":"Nitesh Shekhrajka, Márcio Luís Duarte, Leonardo Furtado Freitas","doi":"10.1016/j.neurad.2025.101347","DOIUrl":"10.1016/j.neurad.2025.101347","url":null,"abstract":"<div><div>Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are neurodegenerative disorders characterized by parkinsonian symptoms. PSP typically presents with supranuclear gaze palsy, postural instability, and subcortical dementia, while dysautonomia and cerebellar signs are hallmark features of MSA. We report the case of a 77-year-old male patient with a four-year history of progressive parkinsonian symptoms that have shown poor response to treatment. His clinical manifestations included bradykinesia, rigidity, swallowing difficulties, urinary frequency, nocturia, downward gaze palsy, hypometric saccades, and finger-nose dysmetria. Examination revealed increased tone in both upper extremities, more pronounced on the right side, along with bradykinesia, slow hand movements, and bilateral decrement in finger tapping. Brain magnetic resonance imaging (MRI) revealed mixed MRI findings consistent with atypical parkinsonian syndrome, showing signs of MSA-C with pontocerebellar atrophy and the \"hot cross bun\" sign, as well as PSP with midbrain atrophy (hummingbird sign) and tegmental hypersignal.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 4","pages":"Article 101347"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882204","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}
Pub Date : 2025-04-26DOI: 10.1016/j.neurad.2025.101346
Guglielmo Pero , Antonio Macera , Claudia Rollo , Amedeo Cervo , Branko Popadic , Alessandro La Camera
We report three cases of meningiomas treated with Squid 12® with their peculiar technical aspects. High-resolution 3D cone-beam CT angiography (HR 3D-CBCT) was used to evaluate the tumor’s vascular anatomy and guide embolization, revealing pial arterial supplies not readily visible on standard angiography. Squid 12® achieved deep tumor penetration, abolishing contrast enhancement on immediate post-procedural MRI. Follow-up MRIs showed progressive tumor shrinkage, with peripheral ring enhancement and decreased edema. Tumor volume was reduced by approximately 50% at the 4-6 months follow-up, leading to a delay in SRS for further stabilization and clinical improvement in the symptomatic patients.
{"title":"Evaluating the role of HR 3D-CBCT and squid 12® embolic agent in meningioma management: Insights from MRI modifications at follow-Up","authors":"Guglielmo Pero , Antonio Macera , Claudia Rollo , Amedeo Cervo , Branko Popadic , Alessandro La Camera","doi":"10.1016/j.neurad.2025.101346","DOIUrl":"10.1016/j.neurad.2025.101346","url":null,"abstract":"<div><div>We report three cases of meningiomas treated with Squid 12® with their peculiar technical aspects. High-resolution 3D cone-beam CT angiography (HR 3D-CBCT) was used to evaluate the tumor’s vascular anatomy and guide embolization, revealing pial arterial supplies not readily visible on standard angiography. Squid 12® achieved deep tumor penetration, abolishing contrast enhancement on immediate post-procedural MRI. Follow-up MRIs showed progressive tumor shrinkage, with peripheral ring enhancement and decreased edema. Tumor volume was reduced by approximately 50% at the 4-6 months follow-up, leading to a delay in SRS for further stabilization and clinical improvement in the symptomatic patients.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 4","pages":"Article 101346"},"PeriodicalIF":3.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888125","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}
Pub Date : 2025-04-14DOI: 10.1016/j.neurad.2025.101340
Joong-Goo Kim , Chul-Hoo Kang , Hong Jun Kim , Jong Kook Rhim , Jay Chol Choi , Doo Hyuk Kwon
Background and Purpose
This study examines the clinical outcomes of endovascular reperfusion therapy and emergent intracranial stenting based on the angiographically defined occlusion location of the middle cerebral artery (MCA).
Materials and Methods
We reviewed consecutive patients with acute MCA infarct associated with intracranial atherosclerotic stenosis (ICAS) who underwent rescue intracranial stenting and balloon angioplasty after initial mechanical thrombectomy. We compared patient demographics, baseline characteristics, clinical outcomes, and periprocedural complications, including in-stent thrombosis and re-occlusion, according to the MCA occlusion location. The occlusion location was categorized based on the presence of the proximal MCA stump in enrolled ICAS patients.
Results
Of 47 patients, 30 (63.8 %) were classified as having a stump group. The initial NIHSS was more severe in the without-stump group compared to the with-stump group (13.0 [8.0–16.0] vs. 8.0 [8.0–13.0] p = 0.078). There were no significant differences in procedure time, technique, and devices. However, the successful revascularization rate was significantly lower in the without-stump group (64.7 % vs. 100 %, p = 0.002). Additionally, the immediate re-occlusion rate after the first endovascular reperfusion therapy tended to be higher in the without-stump group (76.5 % vs. 36.7 %, p = 0.02). No significant association was found between periprocedural complications, including intracerebral hemorrhage and mortality.
Conclusions
Angiographically presented MCA occlusion without a stump in acute large vessel occlusion underlying ICAS predicts more complicated intracranial stenting and poorer clinical outcomes than patients with a stump.
背景与目的本研究基于血管造影确定的大脑中动脉(MCA)闭塞位置,探讨血管内再灌注治疗和紧急颅内支架植入术的临床效果。材料和方法我们回顾了连续的急性MCA梗死合并颅内动脉粥样硬化性狭窄(ICAS)患者,这些患者在首次机械取栓后接受了颅内支架置入术和球囊血管成形术。我们比较了患者的人口统计学特征、基线特征、临床结果和围手术期并发症,包括支架内血栓形成和再闭塞,根据MCA闭塞的位置。在入组的ICAS患者中,根据MCA近端残端是否存在来分类闭塞位置。结果47例患者中30例(63.8%)为残肢组。无残肢组初始NIHSS较残肢组更严重(13.0 [8.0 - 16.0]vs. 8.0 [8.0 - 13.0] p = 0.078)。两组在手术时间、技术和设备上无显著差异。然而,无残肢组血运重建成功率明显较低(64.7% vs 100%, p = 0.002)。此外,无残端组首次血管内再灌注治疗后立即再闭塞率更高(76.5% vs 36.7%, p = 0.02)。围手术期并发症(包括脑出血)与死亡率之间无显著相关性。结论在ICAS下的急性大血管闭塞中,造影表现为无残端MCA闭塞的患者比残端患者更容易出现颅内支架置入术的并发症和更差的临床结果。
{"title":"Clinical impact of occlusion location in the middle cerebral artery during endovascular reperfusion therapy for acute ischemic stroke with underlying intracranial atherosclerotic stenosis","authors":"Joong-Goo Kim , Chul-Hoo Kang , Hong Jun Kim , Jong Kook Rhim , Jay Chol Choi , Doo Hyuk Kwon","doi":"10.1016/j.neurad.2025.101340","DOIUrl":"10.1016/j.neurad.2025.101340","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>This study examines the clinical outcomes of endovascular reperfusion therapy and emergent intracranial stenting based on the angiographically defined occlusion location of the middle cerebral artery (MCA).</div></div><div><h3>Materials and Methods</h3><div>We reviewed consecutive patients with acute MCA infarct associated with intracranial atherosclerotic stenosis (ICAS) who underwent rescue intracranial stenting and balloon angioplasty after initial mechanical thrombectomy. We compared patient demographics, baseline characteristics, clinical outcomes, and periprocedural complications, including in-stent thrombosis and re-occlusion, according to the MCA occlusion location. The occlusion location was categorized based on the presence of the proximal MCA stump in enrolled ICAS patients.</div></div><div><h3>Results</h3><div>Of 47 patients, 30 (63.8 %) were classified as having a stump group. The initial NIHSS was more severe in the without-stump group compared to the with-stump group (13.0 [8.0–16.0] vs. 8.0 [8.0–13.0] <em>p</em> = 0.078). There were no significant differences in procedure time, technique, and devices. However, the successful revascularization rate was significantly lower in the without-stump group (64.7 % vs. 100 %, <em>p</em> = 0.002). Additionally, the immediate re-occlusion rate after the first endovascular reperfusion therapy tended to be higher in the without-stump group (76.5 % vs. 36.7 %, <em>p</em> = 0.02). No significant association was found between periprocedural complications, including intracerebral hemorrhage and mortality.</div></div><div><h3>Conclusions</h3><div>Angiographically presented MCA occlusion without a stump in acute large vessel occlusion underlying ICAS predicts more complicated intracranial stenting and poorer clinical outcomes than patients with a stump.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 4","pages":"Article 101340"},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859929","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}
Pub Date : 2025-04-07DOI: 10.1016/j.neurad.2025.101339
Rahi Patel , Rikhil Makwana , Carolina Christ , Elaine Marchi , Christina Y. Miyake , Fabricio Guimaraes Goncalves , Gholson J. Lyon , Matthew T. Whitehead
Background
NAA10-related and NAA15-related neurodevelopmental (ND) syndromes present with intellectual disability, hypotonia, cardiac abnormalities, and delayed development. While data exists on the clinical manifestations of these conditions, there are few reports describing the neuroanatomical abnormalities present on imaging.
Objective
We aim to provide neuroimaging analyses for a subset of probands with NAA10- and NAA15-related neurodevelopmental symptoms and assess the severity and number of neuroanatomical anomalies and their associated functional impairments to better understand the pathophysiology of these disease processes.
Materials and methods
Neuroimaging studies were obtained from 26 probands (18 with pathogenic variants in NAA10, 8 with pathogenic variants in NAA15) and evaluated. In depth medical histories were also collected on probands, including genetic testing results and developmental history. The Vineland 3 Adaptive Behavior Scale was also administered to assess functional status of the probands.
Results
On average, individuals with NAA10-related ND syndrome had 5.7 anatomical abnormalities (standard deviation (SD) = 3.0), whereas those with NAA15-related ND syndrome had 2.8 (SD = 2.3, p = 0.02). Probands with a greater number of anatomical abnormalities tended to score worse on Vineland assessments. Structure and function were correlated such that individuals with greater defects on, for example, motor regions of their scans, tested worse on motor portions of the Vineland. Probands followed longitudinally demonstrated several changes between scans, most commonly in the cerebellum, brainstem, and degree of myelination. Such changes were only observed for probands with NAA10-related ND syndrome.
Conclusion
This analysis of a cohort of probands with NAA10-related ND syndrome and NAA15-related ND syndrome by two neuroradiologists has established a range of subtle abnormalities. We hope these findings guide future research and diagnostic studies for this population.
naa10相关和naa15相关的神经发育(ND)综合征表现为智力障碍、张力低下、心脏异常和发育迟缓。虽然有关于这些疾病的临床表现的数据,但很少有报道描述影像学上出现的神经解剖异常。目的:为NAA10-和naa15相关神经发育症状的先显子提供神经影像学分析,评估神经解剖异常及其相关功能损伤的严重程度和数量,以更好地了解这些疾病过程的病理生理学。材料和方法对26个先证者(18个NAA10致病变异,8个NAA15致病变异)进行神经影像学研究并进行评估。深入收集先证者的病史,包括基因检测结果和发育历史。采用Vineland 3适应行为量表评估先证者的功能状态。结果naa10相关ND综合征患者平均解剖异常5.7例(标准差(SD) = 3.0), naa15相关ND综合征患者平均解剖异常2.8例(SD = 2.3, p = 0.02)。解剖异常较多的先证者往往在Vineland评估中得分较低。结构和功能是相关的,例如,在扫描的运动区域有较大缺陷的人,在Vineland的运动部分测试中表现较差。纵向先证者在扫描之间显示出一些变化,最常见的是在小脑、脑干和髓鞘形成程度。这种变化仅在naa10相关ND综合征的先证者中观察到。结论:两位神经放射学家对naa10相关ND综合征和naa15相关ND综合征的先证者队列进行了分析,确定了一系列微妙的异常。我们希望这些发现能够指导未来对这一人群的研究和诊断研究。
{"title":"Neuroanatomical features of NAA10 and NAA15-related neurodevelopmental syndromes","authors":"Rahi Patel , Rikhil Makwana , Carolina Christ , Elaine Marchi , Christina Y. Miyake , Fabricio Guimaraes Goncalves , Gholson J. Lyon , Matthew T. Whitehead","doi":"10.1016/j.neurad.2025.101339","DOIUrl":"10.1016/j.neurad.2025.101339","url":null,"abstract":"<div><h3>Background</h3><div><em>NAA10</em>-related and <em>NAA15</em>-related neurodevelopmental (ND) syndromes present with intellectual disability, hypotonia, cardiac abnormalities, and delayed development. While data exists on the clinical manifestations of these conditions, there are few reports describing the neuroanatomical abnormalities present on imaging.</div></div><div><h3>Objective</h3><div>We aim to provide neuroimaging analyses for a subset of probands with <em>NAA10-</em> and <em>NAA15</em>-related neurodevelopmental symptoms and assess the severity and number of neuroanatomical anomalies and their associated functional impairments to better understand the pathophysiology of these disease processes.</div></div><div><h3>Materials and methods</h3><div>Neuroimaging studies were obtained from 26 probands (18 with pathogenic variants in <em>NAA10</em>, 8 with pathogenic variants in <em>NAA15</em>) and evaluated. In depth medical histories were also collected on probands, including genetic testing results and developmental history. The Vineland 3 Adaptive Behavior Scale was also administered to assess functional status of the probands.</div></div><div><h3>Results</h3><div>On average, individuals with NAA10-related ND syndrome had 5.7 anatomical abnormalities (standard deviation (SD) = 3.0), whereas those with <em>NAA15</em>-related ND syndrome had 2.8 (SD = 2.3, <em>p</em> = 0.02). Probands with a greater number of anatomical abnormalities tended to score worse on Vineland assessments. Structure and function were correlated such that individuals with greater defects on, for example, motor regions of their scans, tested worse on motor portions of the Vineland. Probands followed longitudinally demonstrated several changes between scans, most commonly in the cerebellum, brainstem, and degree of myelination. Such changes were only observed for probands with NAA10-related ND syndrome.</div></div><div><h3>Conclusion</h3><div>This analysis of a cohort of probands with NAA10-related ND syndrome and <em>NAA15</em>-related ND syndrome by two neuroradiologists has established a range of subtle abnormalities. We hope these findings guide future research and diagnostic studies for this population.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 4","pages":"Article 101339"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828242","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}
Pub Date : 2025-04-01DOI: 10.1016/j.neurad.2025.101337
Cassidy Werner, Timothy G White, Shyle H Mehta, Kevin A Shah, Judd H Fastenberg, Athos Patsalides
{"title":"Direct puncture and transarterial embolization for preoperative treatment of sinonasal tumors","authors":"Cassidy Werner, Timothy G White, Shyle H Mehta, Kevin A Shah, Judd H Fastenberg, Athos Patsalides","doi":"10.1016/j.neurad.2025.101337","DOIUrl":"10.1016/j.neurad.2025.101337","url":null,"abstract":"","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 3","pages":"Article 101337"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738662","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}
Pub Date : 2025-03-31DOI: 10.1016/j.neurad.2025.101338
Thomas Marque , Victor Dumas , Thibault Agripnidis , François Zhu , Guillaume Charbonnier , Baptiste Donnard , Quentin Holay , Jean Darcourt , Luca Scarcia , Alexis Guédon , Vincent L'Allinec , Jean-Baptiste Girot , Gaultier Marnat , Géraud Forestier , Guillaume Bellanger , Quentin Alias , Louis Bonnard , Romain Bourcier , Julien Allard , Martin Bretzner , Julien Burel
Purpose
The absence of standardized guidelines for imaging follow-up of unruptured intracranial aneurysms treated with flow diverters (FD) results in significant variability across centers. This survey aims to provide a comprehensive overview of current imaging follow-up practices in French academic centers.
Methods
In April 2024, a 49-question survey was distributed to interventional neuroradiology centers in France through the trainee-led research collaborative network, Jeunes En Neuroradiologie Interventionnelle-Research Collaborative (JENI-RC). The survey covered follow-up protocols for digital subtraction angiography (DSA), magnetic resonance imaging (MRI), and computed tomography (CT), as well as potential modifications for specific cases.
Results
Twenty interventional neuroradiology centers responded to the survey. Most centers (n = 14, 70 %), conducted a single systematic DSA either at 6 or 12 months post-procedure. In most centers (n = 13, 65 %), a second DSA was scheduled only based on the results of the first, specifically in cases of non-occluded aneurysm, intimal hyperplasia, or in-stent stenosis. MRI follow-up varied, with most centers (n = 12, 60 %) performing three MRIs over five years. Only two centers included CT scans in their protocols.
Conclusion
This survey highlights the substantial heterogeneity in imaging follow-up protocols for FD-treated unruptured intracranial aneurysms among French academic centers. The findings underscore the urgent need for standardized guidelines to harmonize practices, optimize patient outcomes, and improve resource utilization. Additionally, innovations in FD technology, advancements in MRI sequences, and the advent of photon-counting CT will likely influence follow-up practices in the near future.
目的:由于血流分流器(FD)治疗未破裂颅内动脉瘤的影像学随访缺乏标准化指南,导致各中心的影像学随访存在显著差异。本调查旨在提供法国学术中心目前影像学随访实践的全面概述。方法2024年4月,通过实习生领导的研究协作网络Jeunes En Neuroradiologie interonnel - research collaborative (JENI-RC)向法国的介入神经放射学中心分发了一份49个问题的调查问卷。该调查涵盖了数字减影血管造影(DSA)、磁共振成像(MRI)和计算机断层扫描(CT)的随访方案,以及针对特定病例的潜在修改。结果20家介入神经放射学中心参与了调查。大多数中心(n = 14,70 %)在术后6个月或12个月进行了单次系统DSA。在大多数中心(n = 13,65 %),仅根据第一次DSA的结果安排第二次DSA,特别是在未闭塞的动脉瘤、内膜增生或支架内狭窄的情况下。MRI随访各不相同,大多数中心(n = 12,60 %)在五年内进行了三次MRI。只有两个中心在他们的方案中包括了CT扫描。结论:在法国各学术中心,fd治疗未破裂颅内动脉瘤的影像学随访方案存在很大的异质性。研究结果强调,迫切需要标准化的指导方针,以协调实践,优化患者的结果,并提高资源利用。此外,FD技术的创新、MRI序列的进步以及光子计数CT的出现可能会在不久的将来影响后续的实践。
{"title":"Imaging follow-up of unruptured intracranial aneurysms treated with flow diverter: Insights from a French collaborative survey","authors":"Thomas Marque , Victor Dumas , Thibault Agripnidis , François Zhu , Guillaume Charbonnier , Baptiste Donnard , Quentin Holay , Jean Darcourt , Luca Scarcia , Alexis Guédon , Vincent L'Allinec , Jean-Baptiste Girot , Gaultier Marnat , Géraud Forestier , Guillaume Bellanger , Quentin Alias , Louis Bonnard , Romain Bourcier , Julien Allard , Martin Bretzner , Julien Burel","doi":"10.1016/j.neurad.2025.101338","DOIUrl":"10.1016/j.neurad.2025.101338","url":null,"abstract":"<div><h3>Purpose</h3><div>The absence of standardized guidelines for imaging follow-up of unruptured intracranial aneurysms treated with flow diverters (FD) results in significant variability across centers. This survey aims to provide a comprehensive overview of current imaging follow-up practices in French academic centers.</div></div><div><h3>Methods</h3><div>In April 2024, a 49-question survey was distributed to interventional neuroradiology centers in France through the trainee-led research collaborative network, Jeunes En Neuroradiologie Interventionnelle-Research Collaborative (JENI-RC). The survey covered follow-up protocols for digital subtraction angiography (DSA), magnetic resonance imaging (MRI), and computed tomography (CT), as well as potential modifications for specific cases.</div></div><div><h3>Results</h3><div>Twenty interventional neuroradiology centers responded to the survey. Most centers (<em>n</em> = 14, 70 %), conducted a single systematic DSA either at 6 or 12 months post-procedure. In most centers (<em>n</em> = 13, 65 %), a second DSA was scheduled only based on the results of the first, specifically in cases of non-occluded aneurysm, intimal hyperplasia, or in-stent stenosis. MRI follow-up varied, with most centers (<em>n</em> = 12, 60 %) performing three MRIs over five years. Only two centers included CT scans in their protocols.</div></div><div><h3>Conclusion</h3><div>This survey highlights the substantial heterogeneity in imaging follow-up protocols for FD-treated unruptured intracranial aneurysms among French academic centers. The findings underscore the urgent need for standardized guidelines to harmonize practices, optimize patient outcomes, and improve resource utilization. Additionally, innovations in FD technology, advancements in MRI sequences, and the advent of photon-counting CT will likely influence follow-up practices in the near future.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 3","pages":"Article 101338"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760119","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}
Pub Date : 2025-03-23DOI: 10.1016/j.neurad.2025.101336
Hadleigh Cuthbert, Pasquale Gallo, Luke Galloway, Aimee Goel, Fardad T. Afshari, Guirish A. Solanki, Desiderio Rodrigues, Richard Gagen, Joshua Pepper
Background
There are numerous theories regarding the development of paediatric Chiari I malformation. We hypothesise a subset may be related to early calvarial suture closure, which may occur too late to cause an abnormal head shape but early enough that changes in intracranial pressure lead to the development of tonsillar descent. Isolated single suture craniosynostosis is not typically associated with Chiari I malformation. We assessed our series of children with Chiari I malformation to establish what proportion harboured an undiagnosed craniosynostosis.
Methods
This was a single-centre retrospective review of all children with Chiari I malformation from 2012 to 2022. Imaging was reviewed for the presence of a craniosynostosis. Clinical records of synostotic patients were reviewed to establish whether they had a craniofacial disorder or were under the care of the craniofacial team. If neither applied then they were considered to have an ‘incidental craniosynostosis’.
Results
The study included six-hundred-and-nineteen patients with Chiari I malformation, with a mean age at diagnosis of 8.7 years. 13.4 % of patients had radiological evidence of an incidentally-detected craniosynostosis, most commonly the sagittal suture (95.7 %). Incidental craniosynostosis was mostly observed in normocephalic children, but dolichocephaly was associated with an increased risk of concurrent sagittal craniosynostosis.
Conclusions
Craniosynostosis in normocephalic children with a Chiari I malformation is an under-diagnosed phenomenon. Given the high rate of correlation we recommend assessing specifically for craniosynostosis in all children with a ‘simple’ Chiari I malformation prior to any intervention.
{"title":"Occult craniosynostosis in normocephalic children with Chiari I malformation","authors":"Hadleigh Cuthbert, Pasquale Gallo, Luke Galloway, Aimee Goel, Fardad T. Afshari, Guirish A. Solanki, Desiderio Rodrigues, Richard Gagen, Joshua Pepper","doi":"10.1016/j.neurad.2025.101336","DOIUrl":"10.1016/j.neurad.2025.101336","url":null,"abstract":"<div><h3>Background</h3><div>There are numerous theories regarding the development of paediatric Chiari I malformation. We hypothesise a subset may be related to early calvarial suture closure, which may occur too late to cause an abnormal head shape but early enough that changes in intracranial pressure lead to the development of tonsillar descent. Isolated single suture craniosynostosis is not typically associated with Chiari I malformation. We assessed our series of children with Chiari I malformation to establish what proportion harboured an undiagnosed craniosynostosis.</div></div><div><h3>Methods</h3><div>This was a single-centre retrospective review of all children with Chiari I malformation from 2012 to 2022. Imaging was reviewed for the presence of a craniosynostosis. Clinical records of synostotic patients were reviewed to establish whether they had a craniofacial disorder or were under the care of the craniofacial team. If neither applied then they were considered to have an ‘incidental craniosynostosis’.</div></div><div><h3>Results</h3><div>The study included six-hundred-and-nineteen patients with Chiari I malformation, with a mean age at diagnosis of 8.7 years. 13.4 % of patients had radiological evidence of an incidentally-detected craniosynostosis, most commonly the sagittal suture (95.7 %). Incidental craniosynostosis was mostly observed in normocephalic children, but dolichocephaly was associated with an increased risk of concurrent sagittal craniosynostosis.</div></div><div><h3>Conclusions</h3><div>Craniosynostosis in normocephalic children with a Chiari I malformation is an under-diagnosed phenomenon. Given the high rate of correlation we recommend assessing specifically for craniosynostosis in all children with a ‘simple’ Chiari I malformation prior to any intervention.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 3","pages":"Article 101336"},"PeriodicalIF":3.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711965","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}
Pub Date : 2025-03-04DOI: 10.1016/j.neurad.2025.101335
Thomas Courret , Xavier Barreau , Julien Engelhardt , Vincent Jecko , Omer Eker , Emilie Tournaire-Marques , Thomas Tourdias , Gaultier Marnat
Background & purpose
Venous intracranial hypertension is defined as an increased intracranial pressure secondary to venous congestion. Specific causes of venous hypertension can be identified, including extrinsic venous sinus compression or invasion by intracranial tumors such as meningioma. We aimed to report a case series of four patients with symptomatic venous intracranial hypertension secondary to meningioma and treated with stenting. We also performed a systematic literature review.
Methods
The local case series included consecutive patients with symptomatic venous intracranial hypertension who underwent venous sinus stenting in our center between January 2010 and June 2024. Initial clinical presentation, imaging data, treatment details and long-term outcomes were presented. A systematic literature review was performed according to PRISMA guidelines up to June 2024.
Results
Four patients were treated in our center during the study period. In all cases, stenting was adequately performed without complication. Patients experienced substantial and durable clinical improvement, including papilledema resorption. Eight publications were included in the literature review (28 patients). Including our 4 reported cases, a total of 32 patients were analyzed in the systematic review. Complete symptoms recovery occurred in 25 patients (78.1 %) and a partial resolution in 7 (21.9 %). Twelve patients received adjuvant radiotherapy, two of whom also underwent surgery. Five patients presented clinical recurrence and required endovascular retreatment. No complications were reported.
Conclusion
In the setting of a compression or invasion due to a meningioma, stenting of symptomatic intracranial venous stenoses appeared as a safe and promisingly effective option.
{"title":"Endovascular stenting for intracranial venous hypertension caused by meningioma: A case series and systematic literature review","authors":"Thomas Courret , Xavier Barreau , Julien Engelhardt , Vincent Jecko , Omer Eker , Emilie Tournaire-Marques , Thomas Tourdias , Gaultier Marnat","doi":"10.1016/j.neurad.2025.101335","DOIUrl":"10.1016/j.neurad.2025.101335","url":null,"abstract":"<div><h3>Background & purpose</h3><div>Venous intracranial hypertension is defined as an increased intracranial pressure secondary to venous congestion. Specific causes of venous hypertension can be identified, including extrinsic venous sinus compression or invasion by intracranial tumors such as meningioma. We aimed to report a case series of four patients with symptomatic venous intracranial hypertension secondary to meningioma and treated with stenting. We also performed a systematic literature review.</div></div><div><h3>Methods</h3><div>The local case series included consecutive patients with symptomatic venous intracranial hypertension who underwent venous sinus stenting in our center between January 2010 and June 2024. Initial clinical presentation, imaging data, treatment details and long-term outcomes were presented. A systematic literature review was performed according to PRISMA guidelines up to June 2024.</div></div><div><h3>Results</h3><div>Four patients were treated in our center during the study period. In all cases, stenting was adequately performed without complication. Patients experienced substantial and durable clinical improvement, including papilledema resorption. Eight publications were included in the literature review (28 patients). Including our 4 reported cases, a total of 32 patients were analyzed in the systematic review. Complete symptoms recovery occurred in 25 patients (78.1 %) and a partial resolution in 7 (21.9 %). Twelve patients received adjuvant radiotherapy, two of whom also underwent surgery. Five patients presented clinical recurrence and required endovascular retreatment. No complications were reported.</div></div><div><h3>Conclusion</h3><div>In the setting of a compression or invasion due to a meningioma, stenting of symptomatic intracranial venous stenoses appeared as a safe and promisingly effective option.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 3","pages":"Article 101335"},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574490","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}
<div><h3>Introduction</h3><div>L'incidence croissante du cancer et les progrès des traitements ont entraîné une augmentation correspondante de la neurotoxicité liée à la chimiothérapie. Cette neurotoxicité est une complication importante et de plus en plus fréquente chez les patients oncologiques. Les études montrent que 19 % à plus de 85 % des personnes recevant une chimiothérapie présentent divers symptômes neurologiques. Distinguer ces symptômes de la progression tumorale ou des syndromes paranéoplasiques peut être difficile, ce qui rend l'imagerie essentielle pour gérer ces complications. Cette présentation vise à éclairer les motifs d'imagerie IRM associés à la neurotoxicité induite par la chimiothérapie et à fournir des exemples illustratifs basés sur des cas.</div><div><strong>Principaux Points Pédagogiques</strong></div><div><strong>Prévalence et défis diagnostiques :</strong></div><div>La neurotoxicité liée à la chimiothérapie affecte une part importante des patients, présentant des manifestations neurologiques variées. Ces symptômes se chevauchent souvent avec d'autres conditions telles que la progression tumorale et les syndromes paranéoplasiques, compliquant le diagnostic.</div><div><strong>Motifs d'imagerie IRM :</strong></div><div><strong>Leuco encéphalopathie aiguë-subaiguë :</strong> Ce motif, souvent associé à l'utilisation de méthotrexate, se caractérise par des changements réversibles sur l'imagerie en pondération de diffusion (DWI). L'IRM révèle des lésions aiguë à subaiguë de la matière blanche qui peuvent régresser après l'arrêt du traitement.</div><div><strong>Syndrome cérébelleux aigu :</strong> La cytarabine à haute dose est connue pour induire ce syndrome, visible sur l'IRM comme une toxicité cérébelleuse aiguë réversible avec des caractéristiques spécifiques à l'imagerie.</div><div><strong>Syndrome d'encéphalopathie réversible postérieure (PRES) :</strong> L'IRM peut montrer un œdème réversible dans les régions postérieures du cerveau, généralement associé à une hypertension sévère ou à des changements rapides de fluides.</div><div><strong>Complications neurovasculaires :</strong> Les motifs incluent des anomalies liées aux perturbations vasculaires, qui peuvent se manifester sous forme de lésions ischémiques ou hémorragiques.</div><div><strong>Leuco encéphalopathie multifocale progressive (PML) :</strong> Les caractéristiques IRM de la PML incluent des lésions démyélinisantes affectant principalement la matière blanche.<strong>Toxicité de la moelle épinière :</strong> Les lésions induites par la chimiothérapie de la moelle épinière peuvent se présenter comme une myélopathie localisée ou diffuse à l'IRM.</div></div><div><h3>Conclusion</h3><div>Cette présentation souligne le rôle crucial de l'IRM dans le diagnostic et la différenciation de la neurotoxicité induite par la chimiothérapie par rapport à d'autres affections neurologiques. En présentant divers motifs d'imagerie IRM et des exemples illustratifs, elle vise à amé
{"title":"Caractéristiques IRM de la neurotoxicité centrale liée à la chimiothérapie : revue illustrée","authors":"Ismail Mohamed Halfi, Firdaous Touarsa, Mohamed Jiddane","doi":"10.1016/j.neurad.2025.101293","DOIUrl":"10.1016/j.neurad.2025.101293","url":null,"abstract":"<div><h3>Introduction</h3><div>L'incidence croissante du cancer et les progrès des traitements ont entraîné une augmentation correspondante de la neurotoxicité liée à la chimiothérapie. Cette neurotoxicité est une complication importante et de plus en plus fréquente chez les patients oncologiques. Les études montrent que 19 % à plus de 85 % des personnes recevant une chimiothérapie présentent divers symptômes neurologiques. Distinguer ces symptômes de la progression tumorale ou des syndromes paranéoplasiques peut être difficile, ce qui rend l'imagerie essentielle pour gérer ces complications. Cette présentation vise à éclairer les motifs d'imagerie IRM associés à la neurotoxicité induite par la chimiothérapie et à fournir des exemples illustratifs basés sur des cas.</div><div><strong>Principaux Points Pédagogiques</strong></div><div><strong>Prévalence et défis diagnostiques :</strong></div><div>La neurotoxicité liée à la chimiothérapie affecte une part importante des patients, présentant des manifestations neurologiques variées. Ces symptômes se chevauchent souvent avec d'autres conditions telles que la progression tumorale et les syndromes paranéoplasiques, compliquant le diagnostic.</div><div><strong>Motifs d'imagerie IRM :</strong></div><div><strong>Leuco encéphalopathie aiguë-subaiguë :</strong> Ce motif, souvent associé à l'utilisation de méthotrexate, se caractérise par des changements réversibles sur l'imagerie en pondération de diffusion (DWI). L'IRM révèle des lésions aiguë à subaiguë de la matière blanche qui peuvent régresser après l'arrêt du traitement.</div><div><strong>Syndrome cérébelleux aigu :</strong> La cytarabine à haute dose est connue pour induire ce syndrome, visible sur l'IRM comme une toxicité cérébelleuse aiguë réversible avec des caractéristiques spécifiques à l'imagerie.</div><div><strong>Syndrome d'encéphalopathie réversible postérieure (PRES) :</strong> L'IRM peut montrer un œdème réversible dans les régions postérieures du cerveau, généralement associé à une hypertension sévère ou à des changements rapides de fluides.</div><div><strong>Complications neurovasculaires :</strong> Les motifs incluent des anomalies liées aux perturbations vasculaires, qui peuvent se manifester sous forme de lésions ischémiques ou hémorragiques.</div><div><strong>Leuco encéphalopathie multifocale progressive (PML) :</strong> Les caractéristiques IRM de la PML incluent des lésions démyélinisantes affectant principalement la matière blanche.<strong>Toxicité de la moelle épinière :</strong> Les lésions induites par la chimiothérapie de la moelle épinière peuvent se présenter comme une myélopathie localisée ou diffuse à l'IRM.</div></div><div><h3>Conclusion</h3><div>Cette présentation souligne le rôle crucial de l'IRM dans le diagnostic et la différenciation de la neurotoxicité induite par la chimiothérapie par rapport à d'autres affections neurologiques. En présentant divers motifs d'imagerie IRM et des exemples illustratifs, elle vise à amé","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 2","pages":"Article 101293"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444295","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}
- Souligner les caractéristiques cliniques et pronostiques de la sclérose en plaques (SEP), de la maladie associée aux anticorps anti-glycoprotéines oligodendrocytaires de la myéline (MOGAD) et des troubles du spectre de la neuromyélite optique (NMOSD).
- Y Identifier les éléments distinctifs de la névrite optique (NO) à l'IRM combinée à la tomographie par cohérence optique (OCT) en introduisant les nouveaux critères diagnostiques de la SEP.
Résumé
-La NO est souvent associée à des maladies démyélinisantes, notamment la SEP, les NMOSD et les
MOGAD, les dernières médiées par des anticorps. La NO peut compliquer le diagnostic par une présentation isolée atypique. La disponibilité limitée des tests d'anticorps, leur variable sensibilité et fluctuation nécessite la différentiation précise de ces affections.
- Une combinaison d'IRM conventionnelle et non conventionnelle aux résultats d'OCT peut améliorer la précision diagnostique.
Messages à retenir
- La névrite optique en SEP est typiquement unilatérale, focale et antérieure, or, généralement bilatérale et longue; antérieure en MOGAD et postérieure en NMOSD.
- Le rapport de transfert de magnétisation ;est un marqueur de démyélinisation réduit sur l'ensemble du nerf optique qui améliore la spécificité diagnostique notamment entre SEP et NMOSD.
- L’épaisseur des fibres nerveuses rétiniennes (RNFL) et la couche plexiforme interne de cellules ganglionnaires (CGIPL) à l'OCT sont réduits dans ces pathologies démyélinisantes.
Un amincissement significatif isolé ou associés aux données IRM, améliore la précision diagnostique de MOGAD.
- Les données supplémentaires, notamment d'IRM cervicale, sont parfois nécessaires pour distinguer NMOSD et MOGAD en cas de névrite optique isolée non aiguë.
-De nouveaux critères diagnostiques sont introduits pour le diagnostic de SEP, incluant la névrite optique, les données d'OCT et le biomarqueur des chaines kappa légères d'immunoglobulines.
Conclusion
La distinction correcte entre SEP, NMOSD et MOGAD est cruciale pour une prise en charge optimale.
{"title":"SEP, NMO, MOGAD : Lever le voile sur la névrite optique","authors":"Hajar Andour , Hamza Bouayad , Louaà Seghini , Mohamed Hassan , Mohamed Jiddane , Firdaous Touarsa","doi":"10.1016/j.neurad.2025.101296","DOIUrl":"10.1016/j.neurad.2025.101296","url":null,"abstract":"<div><h3>Objectifs</h3><div>- Souligner les caractéristiques cliniques et pronostiques de la sclérose en plaques (SEP), de la maladie associée aux anticorps anti-glycoprotéines oligodendrocytaires de la myéline (MOGAD) et des troubles du spectre de la neuromyélite optique (NMOSD).</div><div>- Y Identifier les éléments distinctifs de la névrite optique (NO) à l'IRM combinée à la tomographie par cohérence optique (OCT) en introduisant les nouveaux critères diagnostiques de la SEP.</div></div><div><h3>Résumé</h3><div>-La NO est souvent associée à des maladies démyélinisantes, notamment la SEP, les NMOSD et les</div><div>MOGAD, les dernières médiées par des anticorps. La NO peut compliquer le diagnostic par une présentation isolée atypique. La disponibilité limitée des tests d'anticorps, leur variable sensibilité et fluctuation nécessite la différentiation précise de ces affections.</div><div>- Une combinaison d'IRM conventionnelle et non conventionnelle aux résultats d'OCT peut améliorer la précision diagnostique.</div></div><div><h3>Messages à retenir</h3><div>- La névrite optique en SEP est typiquement unilatérale, focale et antérieure, or, généralement bilatérale et longue; antérieure en MOGAD et postérieure en NMOSD.</div><div>- Le rapport de transfert de magnétisation ;est un marqueur de démyélinisation réduit sur l'ensemble du nerf optique qui améliore la spécificité diagnostique notamment entre SEP et NMOSD.</div><div>- L’épaisseur des fibres nerveuses rétiniennes (RNFL) et la couche plexiforme interne de cellules ganglionnaires (CGIPL) à l'OCT sont réduits dans ces pathologies démyélinisantes.</div><div>Un amincissement significatif isolé ou associés aux données IRM, améliore la précision diagnostique de MOGAD.</div><div>- Les données supplémentaires, notamment d'IRM cervicale, sont parfois nécessaires pour distinguer NMOSD et MOGAD en cas de névrite optique isolée non aiguë.</div><div>-De nouveaux critères diagnostiques sont introduits pour le diagnostic de SEP, incluant la névrite optique, les données d'OCT et le biomarqueur des chaines kappa légères d'immunoglobulines.</div></div><div><h3>Conclusion</h3><div>La distinction correcte entre SEP, NMOSD et MOGAD est cruciale pour une prise en charge optimale.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 2","pages":"Article 101296"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444298","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}