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Usage of MR imaging biomarkers is limited to experts. Automatic quantitative reports provide access for clinicians to data analysis. Automated data analysis was tested for usability in a small cohort of patients with hereditary spastic paraplegia type 4 (SPG4). We analyzed 3T MRI 3D-T1 datasets of n = 25 SPG4 patients and matched healthy controls using a commercial segmentation tool (AIRAscore structure 2.0.1) and standard VBM. In SPG4 total brain volume was reduced by 27.6 percentiles (p = 0.001) caused mainly by white matter loss (− 30.8th, p

Objective: Vessel wall contrast enhancement (VW-CE) has been shown to possibly predict disease progression in Moyamoya patients. Aim of this study was to investigate the predictive value of vessel wall contrast enhancement (CE) in Moyamoya Angiopathy (MMA) and its association with local disease progression [for full text, please go to the a.m. URL]

BackgroundWe hypothesized that ongoing IV thrombolysis (IVT) at flow restoration in patients with acute ischemic stroke (AIS) treated with IVT and endovascular thrombectomy (ET) is associated with improved outcome.MethodsWe included patients with IVT and successful recanalization (modified Thrombolysis in Cerebral Infarction score ≥2b) after ET from an observational multicenter cohort, the German Stroke Registry – Endovascular Treatment trial. Procedural characteristics and functional outcome at discharge and 90 days were compared between patients with and without ongoing IVT at flow restoration. To determine associations with functional outcome, adjusted ORs were calculated using ordinal multivariable logistic regression models adjusted for potential baseline confounder variables.ResultsAmong 1303 patients treated with IVT and ET who achieved successful recanalization, IVT was ongoing in 13.8% (n=180) at flow restoration. Ongoing IVT was associated with better functional outcome at discharge (adjusted OR 1.61; 95% CI 1.13 to 2.30) and at 90 days (adjusted OR 1.52; 95% CI 1.06 to 2.18).ConclusionThese results provide preliminary evidence for a benefit of ongoing IVT at flow restoration in patients with AIS treated with ET.

Objective: Vessel wall contrast enhancement has been shown to possibly predict disease progression in Moyamoya patients. Aim of this study is to investigate the natural course of vessel wall contrast enhancement in MMD and its association with local disease progression as seen in conventional angiography.[for full text, please go to the a.m. URL], 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Objective: To evaluate chronological patterns of arterial wall contrast enhancement in high resolution MRI (CE-HR-MRI) of Moyamoya patients. Methods: A blinded analysis of clinical and imaging data was performed for Moyamoya patients with CE-HR-MRI. Data were analyzed chronologically for each patient[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Patients with Moyamoya Disease (MMD) need hemodynamic evaluation of vascular territories at risk of stroke. Today’s investigative standards include H215O PET/CT with pharmacological challenges with acetazolamide (ACZ). Recent developments suggest that CO2-triggered blood-oxygen-level-dependent[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: High-field iMRI suites provide surgeons with diagnostic-quality MR scans. However, more advanced imaging, such as DWI, is highly sensitive to susceptibility artefacts. We analyzed and defined the sources of interference, compared intraoperative and postoperative MR diffusion restrictions [for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Objective: Benign intracranial hypertension (BIH), traditionally termed pseudotumor cerebri, is a challenging disease complex with diverse etiologies. Because of improved MR venography sequences and interventional angiography techniques, the focus has shifted within the last decade to an appreciation[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Chronic benign intracranial hypertension may have a variety of causes. Most frequent is this syndrome found in obese young women ('pseudotumor cerebri'), still of unknown etiology. However, venous congestion due to sinus occlusion has to be ruled out. We report a young woman with an intrasinusal meningioma of the transverse sinus and hypoplasia of the transverse sinus contralaterally. Diagnosis was achieved by MRI and angiography. Imaging signs of increased intracranial pressure comprised dilated perioptic sheaths and an empty sella. Abnormalities of the brain parenchyma or the CSF spaces were absent.

Objective: Spinal cord herniation through a dural defect is a cause of myelopathy and may occur spontaneously, after surgery or trauma. The authors report on a series of 2 patients with spontaneous thoracic cord herniation with deteriorating neurological deficits and propose a surgical strategy. [for full text, please go to the a.m. URL], 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Einleitung: Die Indikation zu einer invasiven Therapie vaskulärer Malformationen hängt nicht nur von der Beschwerdesymptomatik sondern auch von der Ausdehnung des Befundes ab. Ziel dieser Arbeit ist die Präsentation unserer Behandlungsstrategie und die Darstellung unserer Ergebnisse nach[for full text, please go to the a.m. URL], 132. Kongress der Deutschen Gesellschaft für Chirurgie

Objective: The posterior circulation is often overlooked in moyamoya angiopathy. We present the clinical, neuroradiological findings and neurosurgical management of European moyamoya patients presenting with a stenosis/occlusion of the posterior cerebral artery (PCA). Method: Specific analysis[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Hintergrund: Vorhandene anatomischen Beschreibungen zum Verlauf der A. temporalis superfizialis (STA) basieren hauptsächlich auf Kadaveruntersuchungen. Analysen, welche die exakte in-vivo-Situation reflektieren sind selten. Methoden: Es erfolgte die retrospektive Auswertung digitaler Subtraktionsangiographien[for full text, please go to the a.m. URL], 45. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 19. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC), 52. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie (ÖGPRÄC)

Objective: To examine the feasibility of routine perfusion-weighted intraoperative MR imaging (iMRI) and to evaluate its usefulness as an aid to detect the residual tumor and and maximise the tumour resection extent. Method: Twenty-eight patients underwent perfusion-weighted iMRI (in a dual-room [for full text, please go to the a.m. URL], 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

A recent report of the feasibility of simultaneous PET/MR imaging of the healthy human brain has sparked excitement in the field of neuroimaging because of its potential influence and utility in clinical neuroscience research. The aim of this communication is to discuss the benefits and current drawbacks of the hybrid imaging system and to highlight some perspectives of the new technique for brain neoplasms.

Objective: Surgery of large arteriovenous malformations represents one of the most challenging tasks confronting neurosurgeons. Especially those situated in motor areas are difficult to treat due to the risk of producing severe functional impairment. Surgical indication for patients harboring AVMs in[for full text, please go to the a.m. URL], 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010

Objective: The biggest challenge in paediatric hydrocephalus is to understand the individual cause of hydrocephalus - to be able to think beyond symptomatic therapy by draining excess CSF via a shunt. Therefore we performed – in addition to standard sequences – high-resolution MR imaging[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

We here describe the case of a boy with an atypical teratoid-rhabdoid tumor (ATRT) of the 4th ventricle at 1 year of age and a local tumor recurrence at 19 months of age. Due to brainstem infiltration, only incomplete tumor resection was possible each time. High-dose chemotherapy, stem cell transplantation and irradiation resulted in complete tumor remission on a control MRI. At 8 years of age, another tumor appeared extending from the cerebellopontine angle along the right trigeminal nerve through Meckel’s cave into the cavernous sinus. The trigeminal tumor was not in continuity with the primary ATRT but was located within the field of prior irradiation, neuroradiologically mimicking a schwannoma or a meningioma. The origin of the trigeminal tumor as a late metastasis of the former ATRT or as a less likely irradiation-induced secondary ATRT and the operative approach are discussed.

Clinical neuroradiology 31(3), 799-810 (2021). doi:10.1007/s00062-021-01033-1, Published by Urban & Vogel, München

Diffusion tensor imaging (DTI) detects white matter damage in neuro-psychiatric disorders, but data on reliability of DTI measures across more than two scanners are still missing. In this study we assessed multicenter reproducibility of DTI acquisitions based on a physical phantom as well as brain scans across 16 scanners. In addition, we performed DTI scans in a group of 26 patients with clinically probable Alzheimer's disease (AD) and 12 healthy elderly controls at one single center. We determined the variability of fractional anisotropy (FA) measures using manually placed regions of interest as well as automated tract based spatial statistics and deformation based analysis. The coefficient of variation (CV) of FA was 6.9% for the physical phantom data. The mean CV across the multicenter brain scans was 14% for tract based statistics, and 29% for deformation based analysis. The degree of variation was higher in less organized fiber tracts. Our findings suggest that a clinical and physical phantom study involving more than two scanners is indispensable to detect potential sources of bias and to reliably estimate effect size in multicenter diagnostic trials using DTI.

Cross-sectional studies using diffusion tensor imaging (DTI) suggest decline of the integrity of intracortically projecting fiber tracts with aging and in neurodegenerative diseases, such as Alzheimer's disease (AD). Longitudinal studies on the change of fiber tract integrity in normal and pathological aging are still rare. Here, we prospectively studied 11 healthy elderly subjects and 14 subjects with amnestic mild cognitive impairment (MCI), a clinical risk group for AD, using high-resolution DTI and MRI at baseline and after 13 to 16 months follow-up. Fractional anisotropy (FA), a DTI measure of fiber tract integrity, was compared across time points and groups using a repeated measures linear model and tract based spatial statistics. Additionally, we determined rates of grey matter and white matter atrophy using automated deformation based morphometry. Healthy elderly subjects showed decline of FA in intracortical projecting fiber tracts, such as corpus callosum, superior longitudinal fasciculus, uncinate fasciculus, inferior fronto-occipital fasciculus, and cingulate bundle (p < 0.05, corrected for multiple comparisons). MCI subjects showed significant FA decline predominantly in the anterior corpus callosum (p < 0.05, corrected for multiple comparisons). Grey and white matter atrophy involved prefrontal, parietal, and temporal lobe areas in controls and prefrontal, cingulate, and parietal lobe areas in MCI subjects and agreed with the pattern of fiber tract changes. Our findings indicate that DTI allows detection of microstructural changes in subcortical fiber tracts over time that are related to aging as well as to early stages of AD type neurodegeneration. The underlying mechanisms for these changes are unknown.