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To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00020.x Byline: Jeffrey J. Carlson (1), James M. Milburn (1), Gregg M. Barre (1) Keywords: Lhermitte-Duclos disease; dysplastic gangliocytoma of the cerebellum; Cowden's syndrome; posterior fossa mass Abstract: ABSTRACT Lhermitte-Duclos disease is a rare disorder with an unknown pathogenesis. A single report of a pathological proven case of Lhermitte-Duclos disease is presented with clinical, imaging, and histopathological findings. A brief review of the condition is provided with an emphasis on imaging description. Author Affiliation: (1)From the Department of Radiology (JJC, JMM) and the Department of Pathology (GMB), Ochsner Clinic Foundation, New Orleans, Louisiana. Article History: Received March 13, 2005, and in revised form July 20, 2005. Accepted for publication July 22, 2005. Article note: Address correspondence to Jeffrey J. Carlson, MD, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121. E-mail: jcarlson@ochsner.org.

The presented research paper deals with the use of penumbra 5MAX ACE catheter in the improvement of the patients with acute stroke, where the devices is used as a large vessel occlusions and is cost saving mechanical thrombectomy device.

The article presents a case study of a 49-year-old female patient with a history of hypothyroidism and hypertension who was diagnosed with multiple intracranial aneurysms and subarachnoid hemorrhage after a discussion of the principles and uses of magnetic resonance vessel wall imaging (MR-VWI).

The article presents a case study of a postterm one-year old male infant who had a seizure after delivery. He was transferred from an outside hospital, head scan showed he had a global hypoxia and hydrocephalus. The patient undergone ultrasound encephalography and magnetic resonance imaging. He was that diagnose with Lissencephaly with abnormal genitalia syndrome.

Background: Higher positioning of a large bore guide catheter during endovascular thrombectomy (EVT) is hypothesized to potentially improve thrombectomy success., Objective: To evaluate the safety and efficacy of intracranial guide catheter placement during EVT using a multicenter database., Methods: We reviewed data on consecutive patients undergoing EVT for anterior circulation large vessel occlusion (LVO) at three comprehensive stroke centers between October 2019 and December 2022. Participants were allocated to one of two cohorts: intracranial (n=141)-guide catheter tip positioned in the petrous carotid or further distal; and control (n=285)-guide catheter tip below the petrous carotid. Primary outcome was excellent reperfusion (Thrombolysis in Cerebral Ischemia (TICI) 2c or better), first pass effect (TICI 2c or better after one pass), and arterial access to final reperfusion time. The unpaired t-test, Mann-Whitney U test, and Fisher's exact test were used to compare themeans, medians and proportions of the two groups, respectively. P values & lt;0.05 were considered statistically significant two cohorts., Results: A total of 426 patients were included in the analysis. Patients with guide catheter location in the petrous segment or further distal had a significantly higher first-pass effect (111/284, 39.1% vs 37/141, 26.2%, P=0.009). There was no significant difference in final excellent recanalization rates between groups (202/285, 70.9% vs 92/141, 65.2%, P=0.266). Furthermore, intracranial positioning of the guide catheter was associated with significantly shorter time to final recanalization (median 21.0 (13.0-38.0) min vs 30.0 (17.0-48.0) min, P<0.001)., Conclusion: Positioning a large bore guide catheter in the petrous segment or further distal resulted in a significantly higher rate of first pass effect, faster procedural times, and equivalent final excellent reperfusion rates compared with more proximal guide catheter placement for patients with anterior circulation LVO., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Congress enacted the No Surprises Act (NSA) in 2021. The NSA relies on the ability for providers to appeal their out-of-network (OON) payment through an arbitration process known as Independent Dispute Resolution (IDR). This study was designed to evaluate the effective access to IDR for mechanical thrombectomy (MT)., Methods: This study uses a simulation to model the likelihood that neurointerventionalists have financially viable access to the NSA IDR process to seek adequate payment for MT OON claims., Results: When evaluating professional claims, for only batches of four or more claims, would the expected payment recovery exceed the expected IDR costs. For global claims (both professional and technical components), a batch size of two claims would be required for the expected payment recovery to exceed expected IDR costs.For the 1000 simulations at large MT centers (300 MT annually), there were no instances where it would have been financially viable to submit professional-only OON claims to the IDR process. For global claims, it would have been financially viable to submit to IDR for only 13.2% of these claims. For smaller stroke centers, there were also no instances where it would have been financially viable to submit professional-only claims. For global claims, it would have been financially viable for only 3.3-6.1% of claims., Conclusions: The NSA process was designed to protect patients from unexpected bills following non-elective medical services. Given the emergent nature of many neuroendovascular cases and the lack of access to the IDR process as this model illustrates, the field is at risk for under-reimbursement due to NSA legislation., Competing Interests: Competing interests: JAG: consulting - Cognition, Imperative; grant support EMCF, GRA, DOD, Emory Neurosurgery Catalyst; relevant volunteer position: Audit Chair, SNIS Board of Directors. JMM: Imperative Care – Consulting, Trial Steering Committee, Microvention – Consulting, Optimize Neurovascular – Scientific Advisory Board, relevant volunteer position – JNIS Associate Editor. GD: consultant for Medtronic, Microvention, Stryker, Cerenovus, Penumbra, Phenox, Route 92; relevant volunteer position – Vice President, SNIS Board of Directors. REH: Partner in Radiology Partners. JAH: Medtronic, Relievant, Sanofi—consulting, Balt, Rapid Medical—DMC Chair, Relevant volunteer positions-JNIS Deputy Editor, SNIS Chair Health Policy Committee., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: A high rate of false-negative sonographic examinations for evaluation for hepatic artery thrombosis in the setting of collateral artery vessel formation has been documented. Subacute hepatic artery compromise with collateral vessel formation can be subclinical, and we believe that this phenomenon may occur more commonly than currently appreciated., Conclusion: We discuss two cases of subacute hepatic artery compromise with collateral artery vessel formation that were prospectively diagnosed in July 2007 by sonography and confirmed by angiography. We refer to this phenomenon as "collateral transformation of the hepatic artery."