Addressing Limited Generalizability in Artificial Intelligence-Based Brain Aneurysm Detection for Computed Tomography Angiography: Development of an Externally Validated Artificial Intelligence Screening Platform.

Background And Objectives: Brain aneurysm detection models, both in the literature and in industry, continue to lack generalizability during external validation, limiting clinical adoption. This challenge is largely due to extensive exclusion criteria during training data selection. The authors developed the first model to achieve generalizability using novel methodological approaches.

Risk factors of postprocedure seizures following standalone middle meningeal artery embolization of chronic subdural hematomas: a bi-institutional retrospective analysis.

Background: Seizures have been reported to arise after middle meningeal artery embolization (MMAE) for the treatment of chronic subdural hematomas (cSDH). However, the rates and factors influencing their development have been poorly established in the literature. Herein, we assess for risk factors for seizures post-MMAE.

Understanding Risk Factors for Postoperative Seizure Following Surgical Treatment and Middle Meningeal Artery Embolization of Chronic Subdural Hematomas.

Objective: Chronic subdural hematoma (cSDH) is often associated with clinical seizures, with incidence rates ranging from 2.6% to 23%. While risk factors like hematoma size and craniotomy with membranectomy are well established, the impact of middle meningeal artery embolization (MMAe) remains underexplored.

Treatment of small intracranial aneurysms using the SMALLSS scoring system: a novel system for decision making.

Background: Treatment of unruptured intracranial aneurysms (UIA) less than 7 mm is controversial. We created a scoring system to guide decision making and validated the system utilizing over 700 cases treated with microsurgery or endovascular procedures.

Methods: The scoring system SMALLSS included Size, (4-7 mm: 1 point, < 3.

Middle meningeal artery embolization for chronic subdural hematoma in the nonagenarian population.

Background: The estimated incidence of chronic subdural hematomas (cSDH) in the general population is projected to nearly double over the next decade, likely making it the most commonly treated cranial neurosurgical condition in adults by 2030. We investigated the outcomes of middle meningeal artery embolization (MMAe) as either a primary or adjunctive treatment for cSDH in nonagenarian patients.

Methods: We retrospectively reviewed all patients 90 years of age or older treated with middle meningeal artery embolization for cSDH from 2018 to 2024 at two academic institutions.

Intracranial hemorrhagic events associated with flow diversion treatment: a retrospective analysis from a single academic institution.

Intracranial hemorrhages are highly concerning but underreported complications related to flow diversion (FD) treatment of intracranial aneurysms. Herein, we aimed to characterize these complications and the factors influencing their occurrence. We retrospectively reviewed patients treated with FD from 2013 to 2023 at a single U.

Factors affecting the collateral ingrowth from the superficial temporal artery after Encephalo-Duro-Arterio-Synangiosis in adult patients with Moyamoya disease.

Background: Multiple factors have been proposed to affect the vessel ingrowth from the superficial temporal artery (STA) after Encephalo-Duro-Arterio-Synangiosis (EDAS).

Methods: This retrospective single-center analyses included patients with Moyamoya Disease (MMD) undergoing EDAS from January 1st, 2013, to December 31st, 2023. Evaluated variables included demographic characteristics, clinical presentation, technical details, modified Rankin Scale (mRS) scores, and radiographic outcomes.

Evaluating the safety and efficacy of medical management in extracranial pseudoaneurysms: a comparative study.

Objective: As endovascular interventions become safer and their use more prevalent for treating extracranial pseudoaneurysms, fewer pseudoaneurysms are treated with medical therapy alone. This study aimed to assess the indications for intervention and the safety of medical management.

Methods: A dual-center retrospective analysis was conducted on patients diagnosed with extracranial carotid and vertebral pseudoaneurysms between December 2006 and June 2023.

Characterizing Revascularization After Encephalo-Duro-Arterio-Synangiosis (EDAS) in Adult Patients With Moyamoya Disease Using the Orbital Grading System.

Background: The Matsushima grade has traditionally been used to evaluate vessel ingrowth from the superficial temporal artery after encephalo-duro-arterio-synangiosis (EDAS) for Moyamoya disease (MMD) patients. However, this grading is subjective and prone to measurement variability. Herein, we propose the orbital grading system quantifying leptomeningeal and burr hole-related vessel-ingrowth from the superficial temporal artery and/or middle meningeal artery to the middle and anterior cerebral arteries post EDAS in MMD patients.

A Novel Scoring System Predicting Aneurysm Incomplete Occlusion After Flow Diversion: A 10-Year Experience.

Background: Factors impacting the rate of aneurysm occlusion after flow diversion (FD) have been well described in the literature. In this article, we sought to evaluate those variables to develop and validate a scoring system predicting aneurysm incomplete occlusion after FD.

Methods: Retrospective review of patients with intracranial aneurysms treated with FD at a single institution between March 2013 and March 2023.

Comparison of Postoperative Seizures Between Burr-Hole Evacuation and Craniotomy in Patients With Nonacute Subdural Hematomas: A Bi-Institutional Propensity Score-Matched Analysis.

Background And Objectives: Postoperative seizures are a common complication after surgical drainage of nonacute chronic subdural hematomas (SDHs). The literature increasingly supports the use of prophylactic antiepileptic drugs for craniotomy, a procedure that is often associated with larger collections and worse clinical status at admission. This study aimed to compare the incidence of postoperative seizures in patients treated with burr-hole drainage and those treated with craniotomy through propensity score matching (PSM).

Thromboembolic Events After the Coverage of Anterior Cerebral Artery with Flow Diversion: A Single Institution Series and Systematic Review.

Background: Advances in the use of flow diversion (FD) now extend to bifurcation aneurysms; herein, we compare thromboembolic events in patients with internal carotid artery (ICA) aneurysms treated with and without exclusion of the anterior cerebral artery (ACA).

Methods: Retrospective analysis of aneurysms in the terminal ICA treated with FD from 2013 to 2023 at a single-center study. Procedures were classified according to the coverage at the origin of the ACA and compared through bivariate-analysis.

Comparison of Thromboembolic Events Between Pipeline Embolization Device (PED) Shield and PED/PED Flex: A Propensity Score-Matched Analysis.

Background And Objectives: The pipeline embolization device (PED) Flex with Shield technology is a third-generation flow diverter used for intracranial aneurysm treatment designed to decrease thrombogenicity through a phosphorylcholine coating. Herein, we aim to compare the rate of thromboembolic events in PED with Shield technology and PED without it through propensity score matching.

Methods: We conducted a retrospective analysis of aneurysms treated with PED first-generation/PED Flex and PED with Shield between 2013 and 2023 at a single academic institution.

Late-developing posttraumatic dural arteriovenous fistula of the vertebral artery: illustrative case.

Background: A dural arteriovenous fistula (dAVF) involving the vertebral artery (VA) is a rare vascular pathology that can result from damage to the VA, most frequently following cervical spine trauma. In most traumatic cases, the dAVF develops and manifests shortly after trauma.

Observations: A patient was admitted after a fall from the stairs causing neck pain.