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Introduction: Existing paradigms for stroke diagnosis typically involve computed tomography or magnetic resonance imaging to classify ischemic versus hemorrhagic stroke variants, as treatment for these subtypes varies widely. Delays in diagnosis and transport of unstable patients may worsen neurological status. Here, we demonstrate feasibility of rapid and accurate bedside stroke detection using a novel, handheld portable eddy current damping imaging device in live human clinical ischemic and hemorrhagic stroke settings. Methods: Copper wire was wound around an 11.4cm plastic cylinder to create a large solenoid coil and connected to an inductance-to-digital converter. Institutional Review Board approval was obtained and patients with hemorrhagic or ischemic stroke were recruited. The sensor coil was tangentially rotated across 8 rows on the patient’s head circumferentially. Data was plotted as a 2D heatmap to predict lesion type and location. For 3D figures, the 2D image was processed to convert the stroke-affected area from white to red (hemorrhage) and black to white (ischemia). Results: Consent, positioning each patient, and scanning with the sensor took roughly 15 minutes from start to end for each participant enrolled in our study and occurred at the patient bedside (n=8). Figure 1a and 1d show the location and type of lesion, Figure 1b and 1e show the 2D prediction heatmap generated after scanning hemorrhagic and ischemic stroke respectively, and Figure 1c and 1f show 3D reconstructed images of stroke location and subtype. Conclusion: We show that diagnosis of stroke may potentially be reduced from several hours to minutes, with additional spatial localization of intracranial hemorrhage, thereby rapidly guiding time-sensitive medical decisions for clinical intervention such as tPA. The sensor additionally detects ischemic and hemorrhagic lesions located deep inside the brain, and its range can be selectively tuned during sensor design and fabrication.

Arteriovenous malformations of the brain are a considerable source of morbidity and mortality for patients who harbor them. Although our understanding of this disease has improved, it remains in evolution. Advances in our ability to treat these malformations and the modes by which we address them have also improved substantially. However, the variety of patient clinical and disease scenarios often leads us into challenging and complex management algorithms as we balance the risks of treatment against the natural history of the disease. The goal of this article is to provide a focused review of the natural history of cerebral arteriovenous malformations, to examine the role of stereotactic radiosurgery, to discuss the role of endovascular therapy as it relates to stereotactic radiosurgery, and to look toward future advances.