Index by author

In this retrospective cohort study, the authors evaluated 16 patients diagnosed with reversible cerebral vasoconstriction syndrome who underwent MR imaging, including MRA, within 72 hours of RCVS onset (initial MRA) and within 48 hours of thunderclap headache remission. In 14 of the 16 patients (87.5%), centripetal propagation of vasoconstriction occurred from the initial MRA to remission of thunderclap headache, with typical segmental vasoconstriction of major vessels (M1, P1, A1). The authors conclude that there is evidence of centripetal propagation of vasoconstriction on MRA performed at the time of remission of the thunderclap headache, and this time point may represent a useful opportunity to diagnose RCVS with greater confidence.

This is a retrospective subanalysis of the IntrePED study, which has beenpreviously published (AJNR Am J Neuroradiol 2015;36:108–15).Seven hundred ninety-three patients with 906 treated aneurysms were enrolled. Thirty-six (4.5%) patients had postoperative acute ischemic stroke, 21 of which occurred within 1 week of the procedure. There was no difference in the rate of acute stroke between the anterior and posterior circulations. Stroke rate was 3% in patients with 1 PED, and 7% in those with 2 PEDs. With multivariate analysis, the only variable independently associated with postoperative stroke was treatment of fusiform aneurysms. Among the patients with stroke, 10 (27.0%) died and 26 (73.0%) had major neurologic morbidity. The authors conclude that acute ischemic stroke following treatment of intracranial aneurysms with the PED is an uncommon but devastating complication, with 100% of patients having major morbidity or mortality.