Safety and Efficacy of the FRED Jr Flow Re-Direction Endoluminal Device for Intracranial Aneurysms: Retrospective Multicenter Experience With Emphasis on Midterm Results

Background and Purpose: Flow diversion is increasingly used as an endovascular treatment for intracranial aneurysms. In this retrospective multicenter study, we analyzed the safety and efficacy of the treatment of intracranial, unruptured, or previously treated but recanalized aneurysms using Flow Re-Direction Endoluminal Device (FRED) Jr with emphasis on midterm results. Materials and Methods: Clinical and radiological records of 150 patients harboring 159 aneurysms treated with FRED Jr at six centers between October 2014 and February 2020 were reviewed and consecutively included. Clinical outcome was measured by using the modified Rankin Scale (mRS). Anatomical results were assessed according to the O’Kelly-Marotta (OKM) scale and the Cekirge-Saatci Classification (CSC) scale. Results: The overall complication rate was 24/159 (16%). Thrombotic-ischemic events occurred in 18/159 treatments (11%). These resulted in long-term neurological sequelae in two patients (1%) with worsening from pre-treatment mRS 0–2 and mRS 4 after treatment. Complete or near-complete occlusion of the treated aneurysm according to the OKM scale was reached in 54% (85/158) at 6-month, in 68% (90/133) at 1-year, and in 83% (77/93) at 2-year follow-up, respectively. The rates of narrowing or occlusion of a vessel branch originating from the treated aneurysm according to the CSC scale were 11% (12/108) at 6-month, 20% (17/87) at 1-year, and 23% (13/57) at 2-year follow-up, respectively, with all cases being asymptomatic. Conclusions: In this retrospective multicenter study, FRED Jr was safe and effective in the midterm occlusion of cerebral aneurysms. Most importantly, it was associated with a high rate of good clinical outcome

Neurobrucellosis

Brucellosis is a multisystem infection with a broad spectrum of clinical presentations. Its nervous system involvement is known as neurobrucellosis. Neurobrucellosis (NB) has neither a typical clinical picture nor specific cerebrospinal fluid (CSF) findings. Its diagnosis is based on the existence of a neurologic picture not explained by any other neurologic disease, evidenced by systemic brucellar infection and the presence of inflammatory alteration in CSF. Imaging findings of NB is divided into four categories: (1) normal, (2) inflammation (recognized by granulomas, abnormal enhancement of the meninges, perivascular space, or lumbar nerve roots), (3) white matter changes, and (4) vascular changes

Neurobrucellosis

WOS: 000297401400013PubMed ID: 22032507Brucellosis is a multisystem infection with a broad spectrum of clinical presentations. Its nervous system involvement is known as neurobrucellosis. Neurobrucellosis (NB) has neither a typical clinical picture nor specific cerebrospinal fluid (CSF) findings. Its diagnosis is based on the existence of a neurologic picture not explained by any other neurologic disease, evidenced by systemic brucellar infection and the presence of inflammatory alteration in CSF. Imaging findings of NB is divided into four categories: (1) normal, (2) inflammation (recognized by granulomas, abnormal enhancement of the meninges, perivascular space, or lumbar nerve roots), (3) white matter changes, and (4) vascular changes

Malformations of the Midbrain and Hindbrain: A Retrospective Study and Review of the Literature

We report the results of a retrospective analysis of radiological and clinical findings in 45 cases of midbrain-hindbrain anomalies and review recent advances in embryology and molecular neurogenetics. Among 45 patients with midbrain-hindbrain malformations, 16 cases of molar tooth malformation, 12 of cerebellar hypoplasia, ten of posterior fossa cyst and cerebellar vermian hypoplasia, three of rhombencephalosynapsis, two of Fukuyama congenital muscular dystrophy and two cases of isolated cerebellar dysplasia were identified. Twenty-six patients presented with motor-mental retardation, which was the most common clinical finding. Eleven patients were born to consanguineous parents. The correct diagnosis of cerebellar malformation is important for determining prognosis, the risk of recurrence and the need for genetic counselling. Integrated classification of malformations based on morphology, embryology and molecular neurogenetics may be useful

Huge Free-Floating Thrombus in the Internal Carotid Artery

Free-floating thrombus in the carotid artery is extremely rare. A 70-year-old male patient with pre-existing Crohn's disease admitted to our clinic with recurrent transient ischemic attacks. Angiography showed a huge thrombus in internal carotid artery. He responded to anticoagulation treatment and delayed endovascular intervention