Efficacy and safety of combining re-irradiation with bevacizumab compared to bevacizumab alone in the management of recurrent high-grade gliomas: a meta-analysis and systematic review.

Background: There is currently no established standard of care for recurrent glioblastoma (GBM). Re-irradiation (re-RT) and Bevacizumab (BEV) are both used in salvage treatment, but their combined efficacy remains uncertain.

Objectives: To evaluate whether combining re-irradiation with BEV improves survival outcomes compared to BEV alone in patients with recurrent high-grade gliomas (rHGG).

Early diagnosis and rapid thrombectomy with stent placement in distal vertebral artery stenosis (Mori Type C) with mild symptoms.

Vertebrobasilar artery occlusion (VBAO) is a life-threatening condition with often nonspecific symptoms, making early diagnosis challenging. Timely intervention is crucial, especially in cases involving distal vertebral artery stenosis. A 65-year-old male presented with acute vertigo, dizziness, and visual disturbances, along with ipsilateral sixth cranial nerve palsy.

Preventive clipping versus coiling in unruptured intracranial aneurysms: A comprehensive meta-analysis and systematic review to explore safety and efficacy.

Background: Surgical clipping and endovascular coiling are both effective in preventing aneurysmal subarachnoid hemorrhage, but the choice between these interventions remains controversial, leading to treatment disparities across medical centers.

Methods: A systematic review and meta-analysis were conducted, including relevant two-arm clinical trials up to September 2023, sourced from Scopus, PubMed, Web of Science, and the Cochrane Library. Our primary outcomes were complete occlusion rates during mid-term and long-term follow-ups.

Comparative Effectiveness of Intravenous Thrombolysis plus Mechanical Thrombectomy versus Mechanical Thrombectomy Alone in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Introduction: The treatment of acute ischemic stroke due to large artery vessel occlusion experienced a dramatic development within the last decade. This meta-analysis investigates the effectiveness of bridging therapy (BT) versus mechanical thrombectomy (MT) alone in treating acute ischemic stroke.

Methods: Two independent reviewers assessed two-arm clinical trials from Scopus, PubMed, Web of Science, and the Cochrane Library up to January 2024.

SLL-PEEP Ventilation to Improve Exposure in Minimally Invasive Right Anterolateral Minithoracotomy Aortic Valve Replacement.

Objective: An accepted landmark to assess feasibility of surgical aortic valve replacement (SAVR) via right anterolateral minithoracotomy (RALT) is the aortic-midpoint to right-sternal-edge distance. We aimed to evaluate single left lung positive-end-expiratory-pressure (SLL-PEEP) ventilation inducing an intraoperative rightward shift of the ascending aorta to improve exposure.

Methods: Nineteen patients with aortic stenosis undergoing SAVR via RALT were prospectively analyzed.

Minimally invasive surgical aortic valve replacement: The RALT approach.

Less-invasive techniques for cardiothoracic surgical procedures are designed to limit surgical trauma, but the technical requirements and preoperative planning are more demanding than those for conventional sternotomy. Patient selection, interdisciplinary collaboration, and surgical skills are key factors for procedural success. Aortic valve replacement is frequently performed through an upper hemisternotomy, but the right anterior minithoracotomy represents an even less traumatic, technical advancement.

Retrospective 1-year outcome follow-up in 200 patients supported with HeartMate 3 and HeartWare left ventricular assist devices in a single centre.

Objectives: Various trials have assessed the outcome and reliability of the HeartWare HVAD (HW) and HeartMate 3 (HM3) left ventricular assist devices. A direct comparison of clinical outcomes and of the complication profile of these 2 left ventricular assist devices is lacking. We present a retrospective analysis of patients supported with HM3 and HW as a left ventricular assist device.

Cytogenetic studies in acute leukemia patients relapsing after allogeneic stem cell transplantation.

We analyzed karyotype stability in 22 patients with acute leukemia at relapse or disease progression after allogeneic stem cell transplantation (allo-SCT). Karyotypes before and at relapse after allo-SCT were different in 15 patients (68%), the most frequent type being clonal evolution either alone or combined with clonal devolution (13 patients). Patients with and without a karyotype change did not differ significantly in overall survival (OS) (median, 399 vs.

Technical feasibility of 2D-3D coregistration for visualization of self-expandable microstents to facilitate coil embolization of broad-based intracranial aneurysms: an in vitro study.

Introduction: The use of self-expandable microstents for treatment of broad-based intracranial aneurysms is widely spread. However, poor fluoroscopic visibility of the stents remains disadvantageous during the coiling procedure. Flat detector angiographic computed tomography (ACT) provides high resolution imaging of microstents even though integration of this imaging modality in the neurointerventional workflow has not been widely reported.

Penumbra Stroke System as an "add-on" for the treatment of large vessel occlusive disease following thrombolysis: first results.

The Penumbra Stroke System (PSS) was cleared for use in patients with ischemic stroke by the FDA in January 2008. We describe our experience of using this new system in acute large vessel occlusive disease following thrombolysis. Fifteen consecutive patients (mean age 60 years) suffering from acute ischemic stroke were treated with the PSS after intravenous or intra-arterial standard treatment with tissue plasminogen activator (n = 14) or ReoPro (n = 1).

MRI criteria in MS patients with negative and positive oligoclonal bands: equal fulfillment of Barkhof's criteria but different lesion patterns.

In multiple sclerosis (MS) more than 95% of the patients have positive oligoclonal bands (OCB) in the cerebrospinal fluid (CSF). Previous studies have reported differences between patients with and without OCB mainly with regard to clinical parameters such as age, gender, disease duration, and clinical severity. However, several MRI characteristics have also been hypothesized to be distinct, and a varying lesion load in OCB-negative and -positive patients is proposed.

Early administration of low molecular weight heparin after spontaneous intracerebral hemorrhage. A safety analysis.

Background: Venous thromboembolism (VTE) is a common complication after stroke. Application of low molecular weight heparins (LMWH) has been proven to be beneficial for the prevention of VTE in ischemic stroke patients. However, there is no consensus whether and how to administer LMWH for prevention of thrombotic complications after acute spontaneous intracerebral hemorrhage (sICH), the main concern being possible hematoma growth.

Visualisation of intracerebral haemorrhage with flat-detector CT compared to multislice CT: results in 44 cases.

The aim of the study was to test the reliability of intracerebral haemorrhage (ICH) detection with C-arm-mounted flat-detector computed tomography (FD-CT) in the angio suite as compared to multislice CT (MSCT). In this study 44 patients with 45 ICH were included. All patients were investigated with MSCT and FD-CT during angiographic evaluation.

Proton magnetic resonance spectroscopy in pituitary macroadenomas: preliminary results.

Object: The aim of this study was to correlate proton MR (1H-MR) spectroscopy data with histopathological and surgical findings of proliferation and hemorrhage in pituitary macroadenomas.

Methods: Quantitative 1H-MR spectroscopy was performed on a 1.5-T unit in 37 patients with pituitary macroadenomas.

Clinical severity predicts time to hospital admission in patients with spontaneous intracerebral hemorrhage.

Background: In this study we analyzed whether demographic, clinical and neuroradiological parameters are associated with time to hospital admission in patients with spontaneous intracerebral hemorrhage (ICH). We a priori hypothesized that the earlier a patient was admitted to hospital, the worse the clinical status would be.

Methods: Demographic, clinical and neuroradiological parameters of consecutive patients with spontaneous ICH directly admitted to 2 neurological university departments were subjected to correlation, trichotomization and logistic regression analyses for prediction of (i) early hospital admission, and (ii) favorable clinical presentation at admission [dichotomized Glasgow Coma Scale (GCS) score > or =9].

[Hypoxic injury of all deep nuclei of the brain--a case report from computed tomography].

Though being inferior to magnetic resonance imaging, computed tomography (CT) of the brain is the most frequently applied imaging modality in the diagnostic workup of acute cerebral Ischaemia. We report on a case of a comatose 53-year-old man who was brought to the emergency room after cardiopulmonary resuscitation. The CT of the brain showed a diffuse brain oedema with an explicit hypodense demarcation of all deep nuclei.

Noninvasive angiography (magnetic resonance and computed tomography) in the diagnosis of ischemic cerebrovascular disease. Techniques and clinical applications.

Noninvasive diagnostic imaging of the craniocervical and intracranial vasculature is a domain of computed tomography angiography (CTA), magnetic resonance angiography (MRA) and Doppler/duplex ultrasound, the latter not being the topic of this presentation. We give a methodological background for both, CTA and MRA, followed by a critical appraisal of both imaging modalities in the diagnosis of ischemic cerebrovascular disease. The contribution of noninvasive vascular imaging to vascular malformations (including aneurysms, fistulas and cerebral-vein thrombosis) is beyond the scope of this paper and therefore not covered.

Differentiation of cytotoxic and vasogenic edema in a patient with reversible posterior leukoencephalopathy syndrome using diffusion-weighted MRI.

In recent years reversible posterior leukoencephalopathy syndrome (RPLS) has become increasingly recognized. It represents an uncommon entity related to multiple pathologies, the most common being hypertensive crisis. The underlying pathophysiological mechanism is proposed to be one of vasogenic edema, without infarction; however, differentiation from cytotoxic edema can be crucial for therapeutic and clinical outcome.

Myelography using flat panel volumetric computed tomography: a comparative study in patients with lumbar spinal stenosis.

Study Design: The technical feasibility of flat panel volumetric computed tomography (FPVCT) for lumbar myelographic imaging was evaluated in 20 patients and compared with multislice computed tomography (MSCT).

Objective: The purpose of this study was to determine the feasibility and sensitivity of FPVCT for myelographic imaging in lumbar spinal stenosis.

Summary And Background Data: In the diagnosis of spinal stenosis, myelography and myelo-computed tomography (PCT) have been performed routinely for nearly 30 years.