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This retrospective, observational MRI study compared spinal cord critical demyelinating lesions anatomically associated with progressive motor impairment with any additional “noncritical” spinal cord demyelinating lesions. MRI characteristics that favored critical spinal cord demyelinating lesions included moderate-to-severe, focal, lesion-associated spinal cord atrophy; lateral column axial location; central region; ventral column; and larger lesion size. In particular, the presence of focal, lesion-associated atrophy, lateral column axial location, and larger lesion size may be associated with the development of progressive motor impairment in MS.

A total of 408 patients from the ESCAPE-NA1 trial were assessed for hemorrhagic transformation following endovascular treatment. At 24-hour follow-up imaging, the authors found that larger “core” volumes of relative CBF<30% were associated with an increased risk of parenchymal hemorrhage. In conjunction with other clinical and imaging variables, this metric may help estimate the risk of post-endovascular treatment hemorrhagic complications.