Huy M Do

• M.D.
• Professor at Stanford University

Background Postdural puncture headache has been traditionally viewed as benign, self-limited, and highly responsive to epidural blood patching (EBP) when needed. A growing body of data from patients experiencing unintended dural puncture (UDP) in the setting of attempted labor epidural placement suggests a minority of patients will have more severe...

Background Balloon guide catheters (BGCs) have not been widely adopted, possibly due to the incompatibility of past-generation BGCs with large-bore intermediate catheters. The next-generation BGC is compatible with large-bore catheters. We compared outcomes of thrombectomy cases using BGCs versus conventional guide catheters. Methods We conducted...

INTRODUCTION Endovascular thrombectomy has become the standard-of-care in treatment of large-vessel occlusion. Despite evidence of enhanced clot retrieval with balloon guide catheters (BGC), their routine use is yet to be widely adopted possibly due to incompatibility of past generation BGCs with large bore intermediate catheters. The next-generati...

Background Digital subtraction angiography (DSA) is the gold-standard method of assessing arterial blood flow and blockages prior to endovascular thrombectomy. Objective To detect anatomical features and arterial occlusions with DSA using artificial intelligence techniques. Methods We included 82 patients with acute ischemic stroke who underwent...

Background High-flow fistulas related to plexiform nidi are found in 40% of large brain arteriovenous malformations (AVMs). Endovascular occlusion of intranidal fistulas before plexiform components is empirically considered safe, but potential ensuing dangerous re-routing of flow through plexiform vessels may in theory raise their rupture risk. It...

Adenoid cystic carcinoma of the lacrimal gland is an aggressive, malignant epithelial neoplasm. We report the case of a 30-year-old male with lacrimal gland adenoid cystic carcinoma treated with neoadjuvant intra-arterial chemotherapy through the internal carotid artery, followed by orbital exenteration and chemoradiation. Treatment response was ev...

Arteriovenous malformations are a vascular anomaly typically present at birth, characterized by an abnormal connection between an artery and a vein (bypassing the capillaries). These high flow lesions can vary in size and location. Therapeutic approaches are limited, and AVMs can cause significant morbidity and mortality. Here, we describe our curr...

Introduction Micro-arteriovenous malformations (microAVMs) are a subtype of cerebral AVM characterized by an arterial nidus less than 1 cm in diameter. Due to their small size, these lesions may be difficult to identify on conventional MRI. They can also be missed or occult on cerebral angiography. Arterial spin labeling (ASL) is an MRI sequence wh...

Introduction The vasa vasorum are small vessels in the adventitial and medial layers of larger vessels which nourish their walls. When large vessels are occluded, the vasa vasorum may reconstitute them. We hypothesize that their hypertrophy is associated with a hypoplastic or aplastic circulus arteriosus which may be unable to meet the ischemic dem...

Objectives To describe the method and clinical efficacy of awake CT-guided percutaneous balloon compression (PBC) as a treatment for trigeminal neuralgia (TN). Design In this case-series, TN patients were treated with awake CT-guided PBC and followed for treatment efficacy and complications for 12 months. Setting A single-center study Subjects 6...

OBJECTIVE Microsurgical resection of arteriovenous malformations (AVMs) can be aided by staged treatment consisting of stereotactic radiosurgery followed by resection in a delayed fashion. This approach is particularly useful for high Spetzler-Martin (SM) grade lesions because radiosurgery can reduce flow through the AVM, downgrade the SM rating, a...

Objective: Hemifacial spasm (HFS) is a debilitating neuromuscular disorder with limited treatment options. The current study describes a novel minimally invasive procedure that provided effective and sustained relief for patients with HFS. The authors provide a detailed description of the awake CT-guided percutaneous radiofrequency ablation (RFA)...

Introduction Dural arteriovenous fistulae (DAVF) are vascular lesions with arteriovenous shunting that may be treated with surgical obliteration or endovascular embolization. Some DAVF, such as anterior cranial fossa DAVF (AC-DAVF) derive their arterial supply from ophthalmic artery branches in nearly all cases, and trans-arterial embolization carr...

Introduction Anterior cranial fossa dural arteriovenous fistulas (dAVFs) represent up to 10% of all dAVFs and have traditionally been treated surgically. These lesions derive their arterial supply from the bilateral anterior ethmoidal arteries (ophthalmic artery branches) in nearly all cases. Embolization via the ophthalmic artery poses unique tech...

OBJECTIVE Perforator arteries, the absence of an aneurysm discrete neck, and the often-extensive nature of posterior circulation fusiform aneurysms present treatment challenges. There have been advances in microsurgical and endovascular approaches, including flow diversion, and the authors sought to review these treatments in a long-term series at...

Background Precise delivery of liquid embolic agents (LEAs) remains a challenge in the endovascular treatment of dural arteriovenous fistulae (dAVFs) and cerebral arteriovenous malformations (cAVMs). Despite significant advances in the past decade, LEA reflux and catheter navigability remain shortcomings of current endovascular technology, particul...

Introduction Acute carotid stent occlusion (CSO) is a rare complication of endovascular carotid stent placement that requires emergent intervention. We describe angioplasty or combined angioplasty and aspiration thrombectomy as a new endovascular technique for CSO treatment. The technique is compared to others previously described in the literature...

Collegiate football athletes are subject to repeated head impacts. The purpose of this study was to determine whether this exposure can lead to changes in brain structure. This prospective cohort study was conducted with up to 4 years of follow-up on 63 football (high-impact) and 34 volleyball (control) male collegiate athletes with a total of 315...

Introduction: Surgical treatment of arteriovenous malformations (AVMs), particularly higher grade lesions, can be aided by staged treatment consisting of stereotactic radiosurgery (SRS) followed by surgical resection in a delayed fashion. This strategy can be used to downgrade the AVM S-M grade, reduce blood flow through the AVM and often results i...

Background and Purpose— Imaging is frequently used to select acute stroke patients for intra-arterial therapy. Quantitative cerebral blood flow can be measured noninvasively with arterial spin labeling magnetic resonance imaging. Cerebral blood flow levels in the contralateral (unaffected) hemisphere may affect capacity for collateral flow and pati...

There are currently no in vivo techniques to accurately study dynamic equilibrium of blood flow within separate regions (compartments) of a large brain arteriovenous malformation (AVM) nidus. A greater understanding of this AVM compartmentalization, even if theoretical, would be useful for optimal planning of endovascular and multimodal AVM therapi...

Background Acute ischemic stroke patients with a large-vessel occlusion but mild symptoms (NIHSS ≤ 6) pose a treatment dilemma between medical management and endovascular thrombectomy. Aims To evaluate the differences in clinical outcomes of endovascular thrombectomy-eligible patients with target-mismatch perfusion profiles who undergo either medi...

Background: Theoretical modeling allows investigations of cerebral arteriovenous malformation (AVM) hemodynamics, but current models are too simple and not clinically representative. We developed a more realistic AVM model based on graphics processing unit (GPU) computing, to replicate highly variable and complex nidus angioarchitectures with vess...

Introduction Multiple randomized trials have shown that endovascular thrombectomy (EVT) leads to improved outcomes in acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Elderly patients were poorly represented in these trials, and the efficacy of EVT in nonagenarian patients remains uncertain. Methods We performed a retrospective coh...

Introduction Recent landmark randomized clinical trials have demonstrated that endovascular thrombectomy (EVT) leads to improved outcomes in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Although elderly patients were excluded from several of these initial trials, the available data suggests a benefit of EVT in octo...

Background The extended time window for endovascular therapy in adult stroke represents an opportunity for stroke treatment in children for whom diagnosis may be delayed. However, selection criteria for pediatric thrombectomy has not been defined. Methods We performed a retrospective cohort study of patients aged <18 years presenting within 24 hou...

Collegiate football athletes are subject to repeated traumatic brain injuriesthat may cause brain injury. The hippocampus is composed of several distinct subfields with possible differential susceptibility to injury. The aim of this study is to determine whether there are longitudinal changes in hippocampal subfield volume in collegiate football. A...

Background Endovascular treated cerebral aneurysms have a greater recurrence rate compared with microsurgical clip ligation. Despite recent endovascular advances, microsurgical clip ligation might be the treatment of choice for certain previously endovascular treated recurrent aneurysms. We report on our single-center experience with 76 previously...

Background: Traditional moyamoya disease (MMD) classification relies on morphological digital subtraction angiography (DSA) assessment, which do not reflect hemodynamic status, clinical symptoms, or surgical treatment outcome. Objective: To (1) validate the new Berlin MMD preoperative symptomatology grading system and (2) determine the clinical...

Introduction: The newly-extended time window for endovascular therapy represents a major opportunity for stroke treatment in children, for whom diagnosis is often delayed. However, no guidelines exist to determine how best to select children for thrombectomy, or if it is beneficial. We report all children presenting to our institution with large ve...

Importance: Current therapeutic options for patients with extracranial head and neck arteriovenous malformations are limited. Surgical intervention, such as sclerotherapy or resection, often result in rapid recurrence and progression of disease. Objective: To assess the efficacy and tolerability of sirolimus as an adjuvant therapy for endovascul...

OBJECTIVE Arteriovenous malformations (AVMs) of the basal ganglia and thalamus are particularly difficult lesions to treat, accounting for 3%–13% of all AVMs in surgical series and 23%–44% of malformations in radiosurgery series. The goal of this study was to report the results of multimodal management of basal ganglia and thalamic AVMs and investi...

Introduction/purpose MRI offers potential benefits over CT in selection for endovascular stroke thrombectomy. Despite this, only one-fourth of patients in the recently published DAWN and Defuse-3 trials were selected with MRI. Often, the major concern with MR utilization involves possibility of delayed treatment given the time associated with acqui...

Background and purpose: Parenchymal hemorrhage (PH) after endovascular mechanical thrombectomy in acute ischemic stroke leads to worse outcomes. Better clinical and imaging biomarkers of symptomatic reperfusion PH are needed to identify patients at risk. We identified clinical and imaging predictors of reperfusion PH after endovascular mechanical...

Trigeminal neuralgia is a facial pain syndrome characterized by excruciating, paroxysmal, electric shock-like pain attacks in the sensory distribution of the trigeminal nerve. Medical management remains the first line of treatment. When this fails, surgical management needs to be considered. Percutaneous interventional procedures such as glycerol r...

Background and purpose Acute ischemic stroke (AIS) patients who benefit from endovascular treatment have a large vessel occlusion (LVO), small core infarction, and salvageable brain. We determined if diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) alone can correctly identify and localize anterior circulation LVO and accuratel...

Background and purpose: Proximal artery vasospasm and delayed cerebral ischemia (DCI) after cerebral aneurysm rupture result in reduced cerebral perfusion and microperfusion and significant morbidity and mortality. Intravoxel incoherent motion (IVIM) magnetic resonance imaging extracts microvascular perfusion information from a multi-b value diffu...

A previously healthy 53-year-old male presented with a 2-month history of pulsatile tinnitus, worsening headaches, and neck pain. Given the clinical symptoms, a workup was initiated to assess for a vascular etiology such as a dural arteriovenous fistula.

Introduction: A paradigm shift in the management of intracerebral aneurysms occurred after the favorable outcomes of coiling were established. Over time, coiled aneurysms have shown high recurrence rates requiring retreatment. Methods: We conducted a retrospective study of all patients who underwent surgical clipping of a previously coiled recurren...

Introduction: Arterial spin labeling (ASL) MRI can non-invasively measure quantitative CBF. Evaluation of hemodynamics in the ipsilateral hemisphere is a common practice for selecting patients for therapy. In this study, we hypothesized that the contralateral CBF (cCBF) may identify patients with high collateral capacity and better outcome. Hypothe...

Trigeminal neuralgia is a facial pain syndrome characterized by excruciating, paroxysmal, electric shock-like pain attacks in the sensory distribution of the trigeminal nerve. Medical management remains the first line of treatment. When this fails, surgical management needs to be considered. Percutaneous interventional procedures such as glycerol r...

Objective: The feasibility and usefulness of transradial catheterization for coronary and neuro-intervention are well known. However, the anatomical change in the catheterized radial artery (RA) is not well understood. Herein, we present the results of ultrasonographic observation of the RA after routine transradial cerebral angiography (TRCA). M...

Background Intracranial atherosclerotic disease may result in ischemic infarction and has a high rate of recurrent ischemic strokes despite medical therapy. Patients who fail medical therapy may undergo endovascular treatment with cerebral artery angioplasty and possible Wingspan stent placement. We present a unique case of Wingspan delivery microc...

Background and purpose: Anterior communicating artery aneurysm rupture and treatment is associated with high rates of dependency, which are more severe after clipping compared with coiling. To determine whether ischemic injury might account for these differences, we characterized cerebral infarction burden, infarction patterns, and patient outcome...

Background Neurointerventional surgeries (NIS) benefit from supportive endovascular constructs. Sofia is a soft-tipped, flexible, braided single lumen intermediate catheter designed for NIS. Sofia advancement from the cervical to the intracranial circulation without a luminal guidewire or microcatheter construct has not been described. Objective T...

Background Subarachnoid hemorrhage (SAH) secondary to rupture of a blister aneurysm (BA) results in high morbidity and mortality. Endovascular treatment with the pipeline embolization device (PED) has been described as a new treatment strategy for these lesions. We present the first reported case of PED retraction and foreshortening after treatment...

Objectives.: Percutaneous radiofrequency ablation (RFA) of the gasserian ganglion through the foramen ovale and the glossopharyngeal nerve at the jugular foramen is a classical approach to treating trigeminal neuralgia (TN) and glossopharyngeal neuralgia (GPN), respectively. However, it can be technically challenging with serious complications. We...

Background: Embolization has been proposed to reduce the size of the AVM nidus in advance of radiosurgical treatment. However, embolization followed by radiosurgery for brain AVMs is controversial. Objective: This study assessed the impact of embolization on nidal size prior to radiosurgical treatment and evaluated cure rates and complications u...

Background The benefits of mechanical thrombectomy for emergent large vessel occlusion (ELVO) have been established. Combined mechanical/aspiration (Solumbra) and a direct aspiration as a first pass technique (ADAPT) are valid procedures requiring an intermediate catheter for clot suction. Recently, SOFIA (Soft torqueable catheter Optimized For Int...

Background Sclerotherapy is one of the most commonly used minimally invasive interventions in the treatment of macrocystic lymphatic malformations (LMs). Several different sclerosing agents and injection protocols have been reported in the literature, each with varying degrees of success. The safety and efficacy of the treatments have not been eval...

OBJECTIVE Majewski osteodysplastic primordial dwarfism Type II (MOPD II) is a rare genetic disorder. Features of it include extremely small stature, severe microcephaly, and normal or near-normal intelligence. Previous studies have found that more than 50% of patients with MOPD II have intracranial vascular anomalies, but few successful surgical re...

OBJECTIVE The impact of procedural volume on the outcomes of cerebrovascular surgery in children has not been determined. In this study, the authors investigated the association of operative volume on the outcomes of cerebrovascular neurosurgery in pediatric patients. METHODS The authors performed a cohort study of all pediatric patients who under...

A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affect...

Background: Trigeminal-cardiac reflex (TCR) from the stimulation of sensory branches of trigeminal nerve can lead to hemodynamic instability. This phenomenon has been described during ophthalmologic, craniofacial, and skull base surgeries. TCR has been reported rarely with endovascular onyx embolization of dural arteriovenous fistulas. Case descr...

Introduction Reperfusion to TICI 2 B/3 with stent retrievers has significantly improved when compared with intravenous tPA in several recent randomized controlled trials. However, at least 20% of patients did not achieve this degree of reperfusion. In prior studies, recanalization rates with tPA and early-generation thrombectomy devices (e.g. MERCI...

Introduction High flow vascular lesions of the anterior cranial fossa and orbit (HFVL) include arteriovenous malformations and dural arteriovenous fistulae located within the orbit, periorbital region, ethmoid sinuses, the anteroinferior frontal lobes, or within the dura of the anterior cranial fossa. Rupture of HFVL may result in intracranial hemo...

Introduction Endovascular therapy of acute ischemic stroke is the standard of care, but controversy exists regarding how the size of the pre-treatment infarction and patient age should influence patient selection for endovascular treatment. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) or computed tomography perfusion (CTP)...

Introduction The superiority of mechanical thrombectomy over medical management has been established in recent randomized controlled trials, however, controversy remains over the most effective and safest technique for clot retrieval. Mechanical thrombectomy for large vessel occlusion (LVO) can be performed through aspiration alone with the ADAPT t...

Introduction Mechanical thrombectomy with stent retrievers is superior to medical management in acute ischemic stroke due to large vessel occlusion (LVO). The Direct Aspiration First Pass (ADAPT) and combined mechanical/aspiration thrombectomy (Solumbra) techniques are used in endovascular stroke treatment; these techniques require an intermediate...

Introduction Subarachnoid hemorrhage (SAH) secondary to rupture of an intradural dissecting vertebral artery aneurysm (DVAA) results in significant morbidity and mortality. Prior studies suggest favorable outcomes following endovascular treatment of ruptured DVAA by parent vessel occlusion or stent-assisted coil embolization, but post-procedural ce...

Vascular malformations, including VM and LM, of the head and neck are effectively treated by percutaneous sclerotherapy with an excellent clinical response in the majority of patients. Minor complications related to treatment occur in 10-12% of patients treated with detergent sclerosants and in up to 50% of patients when absolute ethanol is used. M...

A few isolated reports have described an association between Noonan syndrome and cerebrovascular abnormalities, including moyamoya syndrome. These reports have been limited to pediatric patients presenting with recurrent transient ischemic attacks (TIA) or headaches. Management has primarily been pharmacologic, with only one prior report of surgica...

Background Cerebral arteriovenous malformations (AVMs) are uncommon vascular lesions, and hemorrhage secondary to AVM rupture results in significant morbidity and mortality. AVMs may be treated by endovascular embolization, and technical advances in microcatheter design are likely to improve the success and safety of endovascular embolization of ce...

Introduction/purpose Facial pain is a debilitating disease with 15,000 new TN cases and 500 GPN cases reported each year, and is often refractory to medical treatment. Minimally invasive rhizotomy is an excellent treatment but requires reaching a deep skull base target with a needle for radiofrequencey (RF) treatment. In this report, we highlight a...

Introduction Anterior communicating artery (Acom) aneurysm rupture and treatment is associated with cognitive and behavioral deficits after recovery. The cause of these neuropsychiatric deficits remains uncertain, but prior studies have suggested ischemic injury to the frontal cortex or striatum as a possible etiology. Surgical clipping of anterior...

PAPA (Pyogenic Arthritis, Pyoderma ganngrenosum, and Acne) syndrome is a rare autosomal-dominant auto-inflammatory disorder that affects joints and the skin and manifests as pyogenic arthritis, pyoderma gangrenosum and acne. We describe the first report of cerebral arterial vasculitis with rupture of an associated dissecting aneurysm in PAPA syndro...

A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affect...

Venous and lymphatic malformations of the head and neck can be successfully treated with percutaneous sclerotherapy. To examine the utility of three-dimensional volumetric analysis to assess these lesions and their response to therapy. Prospectively maintained procedure records were retrospectively reviewed to identify all patients with vascular ma...

INTRODUCTION: Large and complex intracranial AVMs can be challenging to treat and may require a multimodality strategy. The success rates of stereotactic radiosurgery alone for large and deep intracranial AVMs is only 25-50%. Many of these previously irradiated AVMs, with or without embolization may require additional treatment. This study hypothes...

Introduction: imaging Collaterals in Acute Stroke (iCAS) is an NIH-funded, multicenter study to determine if non-contrast arterial spin label (ASL) MRI can characterize collateral flow in patients presenting with acute large vessel stroke and whether it can identify patients who benefit from endovascular therapy. It also enables direct comparison w...

Placement of external ventricular drains (EVDs) is a common, life-saving neurosurgical procedure indicated across a variety of settings. While advances have made the procedure quite safe, the potential for iatrogenic morbidity and mortality continues. We document our experience with the endovascular management of three pseudoaneurysms associated wi...

Background and importance: Moyamoya disease is a rare cerebrovascular disorder often treated by direct and indirect revascularization bypass techniques as a result of a typically devastating disease course and poor response to medical therapy. In this report, we describe the formation and subsequent management of a de novo arteriovenous fistula id...

Over the past decade there has been a growing use of intracranial stents for the treatment of both ischemic and hemorrhagic cerebrovascular disease, including stents to assist in the remodeling of the neck of aneurysms as well as the use of flow diverting devices for aneurysm treatment. With this increase in stent usage has come a growing need for...

Traumatic dissecting pseudoaneurysms of the cervical and petrous internal carotid artery are often a result of blunt or penetrating trauma. These patients are at high risk for thromboembolic complications and are managed with antiplatelet agents. Patients who develop neurologic symptoms while on antiplatelet agents, or have interval enlargement of...

Cerebral venous sinus thrombosis (CVST) is characterized by formation of widespread thrombus within the cerebral venous sinus system. CVST can cause venous hypertension, venous infarcts, hemorrhage and seizures. It is managed in most cases with systemic anticoagulation through the use of heparin to resolve the thrombus. Patients that demonstrate cl...

Introduction Placement of external ventricular drains is a common, life-saving neurosurgical procedure indicated across a variety of settings. While advances have made the procedure quite safe, the potential for iatrogenic morbidity and mortality continues. Herein, we document our experience with the endovascular management of three pseudoaneurysms...

Introduction The utilization of cerebral angiography in the diagnosis and management of patients with unruptured cerebral aneurysms varies across the United States. Given advances in noninvasive imaging, such as CT and MR angiography, patients with unruptured aneurysms may never undergo cerebral angiography. This study explores shifting trends in t...

Introduction Acute ischemic stroke secondary to cervical carotid artery occlusion can lead to significant morbidity and mortality. Acute carotid occlusion may be managed by carotid angioplasty, stenting, or both. The use of carotid stents requires patients to be placed on dual antiplatelet agents, which may contribute to increased haemorrhage risk....

Platelet function testing is controversial and not well studied in patients with neurovascular disease. To evaluate the performance of thromboelastography (TEG) as a platelet function test in neurovascular patients treated with the Pipeline embolization device (PED). A prospective protocol was instituted for platelet function testing in patients un...

Purpose: Multimodality therapy of brain AVMs with embolization followed by radiosurgery is controversial. We present the largest case series to date of AVM patients treated with embolization and radiosurgery. Methods: Retrospective review of our institutional AVM database identified 92 patients treated from 1995-2009 with embolization followed by r...

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden-onset thunderclap headache and focal neurologic deficits. Once thought to be a rare syndrome, more advanced non-invasive imaging has led to an increase in RCVS diagnosis. Unilateral vertebral artery dissection has been described in fewer than 40% of cases of RCVS. Bilat...

Cerebral vasospasm following subarachnoid hemorrhage (SAH) results in significant morbidity and mortality. Intra-arterial administration of calcium channel blockers or intracranial angioplasty may be performed when non-invasive medical management fails to prevent neurologic deterioration. Technical improvements in balloon catheters are expected to...

Introduction Venous malformations frequently occur in the head and neck, and they can require treatment for a variety of reasons. Among multiple therapeutic approaches employed, percutaneous sclerotherapy has become one of the most commonly used treatments, with numerous sclerosants successfully utilized. Ethanolamine oleate has approval from the F...

Vertebroplasty and kyphoplasty are minimally invasive image-guided procedures that involve the injection of cement (typically polymethylmethacrylate (PMMA)) into a vertebral body. Kyphoplasty involves inflation of a balloon tamp to create a cavity within the vertebral body into which cement is subsequently injected. The majority of these vertebral...

Every year almost 800 000 people in the USA suffer a new or recurrent stroke, and stroke is the third leading cause of death with over 140 000 deaths in the USA in 1995.1 Additionally, stroke is a leading cause of long-term disability with an estimated cost of $68.9 billion in 2009. The relationship between carotid artery disease and stroke was fir...

Lymphatic malformations are low flow congenital lesions that frequently occur in the head and neck, and often require treatment. Multiple therapeutic modalities exist, including percutaneous sclerotherapy, which has been performed successfully with numerous sclerosants. Few data exist on use of ethanolamine oleate to treat lymphatic malformations....

The goal of this article is to provide expert consensus recommendations for reporting standards, terminology and definitions when reporting on neurointerventional chemotherapy administration for head and neck tumors. These criteria may be used to design clinical trials, to provide definitions for patient stratification and to permit robust analysis...

Introduction/Purpose Lymphatic malformations are low-flow congenital lesions that frequently occur in the head and neck and often require treatment to address airway compromise, infection risk, bleeding, or cosmesis. Multiple treatment approaches have been employed, including resection, percutaneous sclerotherapy, laser photocoagulation, or a combi...

Introduction/Purpose Venous malformations are low-flow congenital lesions that frequently occur in the head and neck and often require treatment to address airway compromise, infection risk, bleeding, or cosmesis. Multiple treatment approaches have been employed, including resection, percutaneous sclerotherapy, laser photocoagulation, or a combinat...

Dural arteriovenous fistulae (DAVF) are cerebrovascular lesions with pathologic shunting into the venous system from arterial feeders. Digital subtraction angiography (DSA) has long been considered the gold standard for diagnosis, but advances in noninvasive imaging techniques now play a role in the diagnosis of these complex lesions. Herein, we de...

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden-onset thunderclap headache and focal neurologic deficits. Once thought to be a rare syndrome, more advanced non-invasive imaging has led to an increase in RCVS diagnosis. Unilateral vertebral artery dissection has been described in fewer than 40% of cases of RCVS. Bilat...

Background and importance: The safety of flow-diverting stents for the treatment of ruptured intracranial aneurysms is unknown. Clinical presentation: A 35-year-old woman with a ruptured dissecting aneurysm of the intradural right vertebral artery and incorporating the right posterior inferior cerebellar artery was treated with a Pipeline Emboli...

Introduction The Pipeline Embolization Device (PED) results in greater metal coverage compared with other intracranial aneurysm stents. The optimal management of anti-platelet therapy has not been well defined. We perform platelet function testing using thromboelastography (TEG) to tailor anti-platelet induction and maintenance strategy in order to...

Background Multimodality therapy for brain AVMs utilizing embolization followed by radiosurgery is controversial. We present the results of the largest case series to date of patients who have undergone AVM embolization followed by radiosurgery, in order to evaluate cure rates and complications using this modality of therapy. Methods A retrospectiv...