Bioinformatics analysis reveals major hub genes involved with extracellular matrix and inflammatory and endocrine pathways associated with intracranial aneurysm tissue.

BackgroundIntracranial aneurysm (IA) pathogenesis involves complex interplay between genetic predisposition and focal extracellular matrix (ECM) membrane degradation and inflammatory processes. We aimed to identify key differentially expressed genes (DEGs) that serve as hub genes (major genes with large networks) associated with IAs.MethodsWe conducted a comprehensive search of available Gene Expression Omnibus (GEO) databases for IA tissue from database inception to January 2024.

Effectiveness of subdural evacuating port system (SEPS) and middle meningeal artery embolization (MMAE) for chronic subdural hematomas.

BackgroundPerforming a craniotomy for chronic subdural hematoma (cSDH) in elderly patients with comorbidities can be challenging. The Subdural Evacuating Port System (SEPS; Medtronic, Dublin, Ireland) offers a less-invasive alternative, while middle meningeal artery embolization (MMAE) has shown effectiveness in preventing cSDH recurrence. However, the combined effectiveness of SEPS and MMAE (SEPS + MMAE) remains unclear.

Minimizing human-induced variability in quantitative angiography for a robust and explainable AI-based occlusion prediction in flow diverter-treated aneurysms.

Background: Bias from contrast injection variability is a significant obstacle to accurate intracranial aneurysm (IA) occlusion prediction using quantitative angiography (QA) and deep neural networks (DNNs). This study explores bias removal and explainable AI (XAI) for outcome prediction.

Objective: To implement an injection bias removal algorithm for reducing QA variability and examine the impact of XAI on the reliability and interpretability of deep learning models for occlusion prediction in flow diverter-treated aneurysms.

Technical Success and Clinical Outcomes of the Low-Profile Visualized Intraluminal Support EVO (LVIS EVO) Stent in the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis.

Background And Objectives: The Low-profile Visualized Intraluminal Support (LVIS) EVO (Terumo Neuro) is the latest development in a series of braided, self-expanding stents designed for intracranial aneurysms and is described as affording enhanced fluoroscopic visibility and improved delivery. Approved in Europe in 2019 and in the United States in 2024, outcomes associated with its use have been reported in few studies. In this meta-analysis, treatment-related complications (safety outcomes), aneurysm occlusion rates (effectiveness outcomes), and technical success rates of the LVIS EVO were evaluated based on the existing literature.

Hypofractionated radiosurgery for intracranial arteriovenous malformations: a systematic review and meta-analysis.

Objective: Obliteration of intracranial arteriovenous malformations (AVMs) with radiosurgery is challenging because high radiation doses prescribed for better effectiveness can increase procedural risks. To minimize adverse effects, fractionation protocols ensure delivery of equivalent or higher total radiation in manageable doses. Hypofractionated stereotactic radiosurgery (HF-SRS), a fractionation strategy using doses exceeding 2 Gy per fraction, requires fewer treatment sessions.

Comparative Analysis of Dural Venous Sinus Pressures, Gradients, and Dimensions in Idiopathic Intracranial Hypertension Between Stented and Unstented Patients.

Background And Objectives: Venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) improves venous flow in patients with high trans-stenosis pressure gradients. Variability in sinus pressure profiles prompts the need for exploration of venous sinus physiology for better understanding of these findings. Stented patients exhibit characteristic pressure patterns aiding assessments of intervention success.

Minimizing Human-Induced Variability in Quantitative Angiography for Robust and Explainable AI-Based Occlusion Prediction.

Background: Bias from contrast injection variability is a significant obstacle to accurate intracranial aneurysm (IA) occlusion prediction using quantitative angiography (QA) and deep neural networks (DNNs). This study explores bias removal and explainable AI (XAI) for outcome prediction.

Objective: Implement injection bias removal algorithm for reducing QA variability and examine XAI's impact on the reliability and interpretability of deep learning models for occlusion prediction in flow diverter-treated aneurysms.

First reported series of intracranial and carotid aneurysm embolization performed at an ambulatory neurosurgery center: preliminary experience.

Background: Intracranial aneurysm embolization is traditionally performed in a hospital setting, but there is growing interest in transforming these procedures to outpatient facilities, while ensuring patient safety and effectiveness. We present the first series of patients undergoing flow diverting embolization at an ambulatory neurosurgery center (ANSC) and assessed feasibility, safety, and patient satisfaction.

Methods: We retrospectively reviewed the medical records of patients undergoing flow diverting embolization at the ANSC between August 1, 2024, and January 3, 2025.

Illustrative case of prosopagnosia after diagnostic cerebral angiography and systematic review of transient cortical blindness after cerebral angiography.

Background: Transient cortical blindness is a rare complication after cerebral angiography. We report an unusual case of face blindness (prosopagnosia) in a patient who underwent diagnostic cerebral angiography for an incidentally discovered left middle cerebral artery aneurysm. The patient experienced difficulty recognizing faces 3 hours postprocedure, with resolution of symptoms within 24 hours.

Addressing residual and recurrent aneurysms post-Woven EndoBridge device embolization: a systematic review and meta-analysis.

Background: Early literature on the Woven EndoBridge (WEB) device reported 80-90% adequate aneurysm occlusion but low complete occlusion (40-55%). It is uncertain whether residual or recurrent aneurysms require re-treatment to prevent future rupture.

Objective: To systematically review the literature to meta-analyze occlusion and complication rates after re-treatment of these aneurysms.

Microsurgical Treatment of Intracranial Dural Arteriovenous Fistulas: A Collaborative Investigation From the Multicenter Consortium for Dural Arteriovenous Fistula Outcomes Research.

Background And Objectives: First-line therapy for most intracranial dural arteriovenous fistulas (dAVFs) is endovascular embolization, but some require microsurgical ligation due to limited endovascular accessibility, anticipated lower cure rates, or unacceptable risk profiles. We investigated the most common surgically treated dAVF locations and the approaches and outcomes of each.

Methods: The Consortium for Dural Arteriovenous Fistula Outcomes Research database was retrospectively reviewed.

Association Between Moyamoya Revascularization Surgery and Neurologic Events During Pregnancy: Systematic Review.

Background And Objectives: The management of moyamoya disease during pregnancy and recommendations for the mode of delivery remain controversial. We investigated factors associated with neurologic events during pregnancy in women with moyamoya disease and its association with prepregnancy surgical revascularization.

Methods: We performed a literature search from January 1, 1970, through September 30, 2021, using Embase, Web of Science, Medline, and Cochrane to identify cases of moyamoya disease with pregnancy.

Plasma Estrogen Levels and Aneurysmal Subarachnoid Hemorrhage in Women.

Objective: Aneurysmal subarachnoid hemorrhage (aSAH) is more prevalent in postmenopausal women, and it has been postulated that this relationship is hormonally driven by lower circulating levels of estrogens. We examined the association between circulating plasma estrogen levels and subsequent development of aSAH in women.

Methods: Women from the Nurses' Health Study with confirmed aSAH (n = 38) were matched with controls (n = 38) on age, smoking, menopausal status, and other reproductive factors.

First Reported Series of Cerebral Angiography Performed at an Outpatient Center: Safety and Satisfaction Results.

Background And Objective: Ambulatory surgery centers (ASCs) are increasingly common venues for same-day neurosurgical procedures, allowing for cost-effective, high-quality patient care. We present the first and largest series of patients undergoing diagnostic cerebral angiography at an ASC to demonstrate the effectiveness, safety, and efficiency of outpatient endovascular care.

Methods: We retrospectively reviewed data for consecutive patients who underwent diagnostic cerebral angiography at our ASC between January 1, 2024, and May 29, 2024.

Family history as the strongest predictor of aortic and peripheral aneurysms in patients with intracranial aneurysms.

Objective: Intracranial aneurysms (IA) and aortic aneurysms (AA) are both abnormal dilations of arteries with familial predisposition and have been proposed to share co-prevalence and pathophysiology. Associations of IA and non-aortic peripheral aneurysms are less well-studied. The goal of the study was to understand the patterns of aortic and peripheral (extracranial) aneurysms in patients with IA, and risk factors associated with the development of these aneurysms.

Global Disparities in the Presentation and Management of Aneurysmal Subarachnoid Hemorrhage: A Review and Analysis.

Objective: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality rates. There is a significant gap in the literature describing global disparities in demographics, management, and outcomes among patients with aSAH. We aimed to conduct a systematic review and meta-analysis to assess global disparities in aSAH presentation and management.

Residual In-Stent Carotid Stenosis and Cigarette Smoking are Independent Predictors of Carotid Restenosis After Carotid Artery Stenting-Results from 738 Carotid Artery Stenting Procedures at a Single Center.

Background And Objectives: Carotid artery stenting (CAS) has become a viable alternative to carotid endarterectomy for the management of carotid stenosis. Our aim was to determine the rate of radiographic restenosis after CAS and clinical, radiographic, and procedural predictors of in-stent restenosis.

Methods: Our single-center, prospectively maintained database was retrospectively reviewed for CAS procedures performed in symptomatic and asymptomatic patients over 12 years (2010-2022).

Expansion and Subsequent Rupture of Carotid Pseudoaneurysm After Tandem Carotid and Middle Cerebral Artery Occlusion Treated With Mechanical Thrombectomy and Carotid Stenting.

Background And Importance: Extracranial carotid artery pseudoaneurysm is a rare entity with potential etiologies including infection, blunt trauma, postsurgical atherosclerotic disease, and invasive neoplasia. Although the natural history of carotid pseudoaneurysm is difficult to determine because of its rarity, complications such as stroke, rupture, and local mass effect may occur at staggering rates.

Clinical Presentation: In this case, a middle-aged man presented with a tandem carotid, middle cerebral artery occlusion that was treated with a carotid stent and mechanical thrombectomy.

Hyperacute stenting and angioplasty for acute extracranial non-tandem internal carotid artery strokes within the first 48 h: A 20-year experience and a systematic review and meta-analysis.

BackgroundAcute strokes involving complete, isolated occlusion of the extracranial cervical internal carotid artery (EC-ICA) with no intracranial clot burden account for a minority of stroke cases that are managed variably. Here we present our two-decade experience and a systematic review of endovascular management of acute isolated EC-ICA strokes in the hyperacute phase (<48 h) and attempt to evaluate clinical effectiveness and safety.MethodsOur prospectively maintained database was retrospectively searched for patients who presented between January 1, 2003 and December 31, 2022 with acute cervical ICA stroke confirmed on angiography.

The VEBAS score: a practical scoring system for intracranial dural arteriovenous fistula obliteration.

Background: Tools predicting intracranial dural arteriovenous fistulas (dAVFs) treatment outcomes remain scarce. This study aimed to use a multicenter database comprising more than 1000 dAVFs to develop a practical scoring system that predicts treatment outcomes.

Methods: Patients with angiographically confirmed dAVFs who underwent treatment within the Consortium for Dural Arteriovenous Fistula Outcomes Research-participating institutions were retrospectively reviewed.