“The M1 segment of the middle cerebral artery precedes by a few hundred million years the appearance of the M2 segment.” -Lasjaunias, Berenstein, and Ter Brugge

The era of TNK begins! 0.25 mg/kg thelancet.com/journals/lance…

Cinematic rendering reconstruction of intracranial arteries showing right paraclinoid aneurysm Read More: ajronline.org/doi/10.2214/AJ…

New CASSISS study from China compares medical management to medicine + Wingspan stenting in patients with ICAD. ->No significant difference ->Relatively low stroke rates in both groups (see SAMMPRIS) ->Question remains:why do some patients still fail? jamanetwork.com/journals/jama/…

The U.S. neuroendovascular workforce in 2013 and 2019, respectively, was as follows: radiologists (46% vs 44%), neurosurgeons (45% vs 35%), and neurologists (9% vs 21%). jnis.bmj.com/content/early/…

Which component of Wallenberg Syndrome is the most disabling? Tough disease for such a small infarct... Most occur with V4 segment occlusion, remainder with PICA occlusion or lateral medullary arteries.

Are you at the SVIN conference in LA?! SVIN great opportunity to meet leaders/friends in the field

Thrombectomy beyond 24 hours from last known well? This study demonstrated worse outcomes overall (as one might expect), but similar hemorrhages/complications compared to the 6–24 hours group. Study by Amir Shaban, MD et al. jnis.bmj.com/content/early/…

The thalamostriate vein does not drain the thalamus

A new method for ischemic stroke treatment? “Molecularly self‐fueled nano-penetrator for nonpharmaceutical treatment of thrombosis and ischemic stroke” nature.com/articles/s4146…

Sturge-Weber Syndrome patients may present to the hospital with stroke like episodes that often fully resolve over a period of days, weeks, or months. MRI rarely shows diffusion restriction, but impaired venous drainage is common on perfusion imaging. pubmed.ncbi.nlm.nih.gov/36263782/

It appears that clots should be removed even when the core infarct is large, 2 new studies in NEJM: #thrombectomy for all nejm.org/doi/full/10.10… nejm.org/doi/full/10.10…

Important arterial connections at the skull base. Be careful with embolizations of the middle meningeal artery that may cause facial paralysis or hearing loss. ahajournals.org/doi/full/10.11…

1/ CTA. DSA. MRA. CFD. VWI. So many letters, so many ❓❓❓ & so the discussion ensues - which imaging are YOU going to use for intracranial aneurysm dx + mgt?   Luckily, Beaman et. al go thru +/- of imaging modalities - both old + new🧠   Let's begin! 👇

13% of patients will die in the hospital of aneurysmal subarachnoid hemorrhage, and up to 26% will die before arriving at the hospital. If ≥2 first-degree relatives with cerebral aneurysms -> you have a 12% chance of having one ahajournals.org/doi/epdf/10.11…

Workflow for patients with symptoms concerning for aSAH. ahajournals.org/doi/epdf/10.11…

They are limited and are only used to assist in decision making but important to be familiar with them. Clinical Scales in Aneurysm Rupture Prediction | Stroke: Vascular and Interventional Neurology ahajournals.org/doi/full/10.11…

Large vessel occlusion stroke patients should be taken for thrombectomy within 7 hours, even if imaging doesn’t look favorable…