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To explore the mental and physical health (MH, PH) on individuals living with brain aneurysms and to profile their differences in disease experience. In N  = 111 patients the Short Form 36 Health Survey (SF-36) was assessed via an online survey; Supplementary data included angiography and magnetic resonance imaging (MRI) findings (including AI-based brain Lesion Volume analyses in ml, or LV). Correlation and regression analyses were conducted (including biological sex, age, overall brain LV, PH, MH). Disease profiles were determined using principal component analysis. Compared to the German normative cohort, patients exhibited overall lower SF-36 scores. In regression analyses, the DW was predictable by PH (β = 0.345) and MH (β=-0.646; R  = 0.557; p  < 0.001). Vasospasm severity correlated significantly with LV ( r  = 0.242, p  = 0.043), MH ( r =-0.321, p  = 0.043), and PH ( r =-0.372, p  = 0.028). Higher LV were associated with poorer PH ( r =-0.502, p  = 0.001), unlike MH ( p  > 0.05). Main disease profiles were identified: (1) those with increased LV post-rupture (high DW); (2) older individuals with stable aneurysms (low DW); (3) revealing a sex disparity in QoL despite similar vasospasm severity; and 4), focused on chronic pain and its impact on daily tasks. Two sub-profiles highlighted trauma-induced impairments, functional disabilities from LV, and persistent anxiety. Reduced thalamic and pallidal volumes were linked to low QoL following subarachnoid hemorrhage. MH has a greater impact on life quality compared to physical disabilities, leading to prolonged DW. A singular physical impairment was rather atypical for a perceived worse outcome. Patient profiles revealed that clinical history, sex, psychological stress, and pain each contribute uniquely to QoL and work capacity. Prioritizing MH in assessing workability and rehabilitation is crucial for survivors’ long-term outcome.

ObjectivesA hard lockdown was presumed to lead to delayed diagnosis and treatment of serious diseases, resulting in higher acuity at admission. This should be elaborated based on the estimated acuity of the cases, changes in findings during hospitalisation, age structure and biological sex.DesignRetrospective monocentric cross-sectional study.SettingGerman Neuroradiology Department at a .ParticipantsIn 2019, n=1158 patients were admitted in contrast to n=884 during the first hard lockdown in 2020 (11th–13th week).Main outcome measuresThree radiologists evaluated the initial case acuity, classified them into three groups (not acute, subacute and acute), and evaluated if there was a relevant clinical deterioration. The data analysis was conducted using non-parametric methods and multivariate regression analysis.ResultsA 24% decrease in the number of examinations from 2019 to 2020 (p=0.025) was revealed. In women, the case acuity increased by 21% during the lockdown period (p=0.002). A 30% decrease in acute cases in men was observable (in women 5% decrease). Not acute cases decreased in both women and men (47%; 24%), while the subacute cases remained stable in men (0%) and decreased in women (28%). Regression analysis revealed the higher the age, the higher the acuity (p<0.001 in both sexes), particularly among women admitted during the lockdown period (p=0.006).ConclusionThe lockdown led to a decrease in neuroradiological consultations, with delays in seeking medical care. In women, the number of most severe cases remained stable, whereas the mean case acuity and age increased. This could be due to greater pandemic-related anxiety among women, however, with severe symptoms they were seeking for medical help. In contrast in men, the absolute number of most severe cases decreased, whereas the mean acuity and age remained nearly unaffected. This could be attributable to a reduced willingness to seek for medical consultation.

[This corrects the article DOI: 10.3389/fmed.2025.1580643.].

Delayed cerebral ischemia (DCI)-associated infarctions are a major complication after spontaneous subarachnoid hemorrhage (SAH). Besides cerebral pathophysiological effects, peripheral organ dysfunction has been associated with DCI. The Sequential Organ Failure Assessment (SOFA) score is used in intensive care medicine to monitor organ failure. The objective of our study was to compare the SOFA score obtained in the first 48 h post-SAH, Hunt & Hess (HH), and World Federation of Neurosurgical Societies (WFNS) scores in predicting DCI-associated infarctions and to identify the most robust parameters within the SOFA score. We retrospectively evaluated SOFA, H&H, and WFNS scores and DCI-associated infarctions in a cohort of 253 SAH patients. The ROC analysis revealed an AUC of 0.65 for the SOFA score in predicting DCI-associated infarctions (H&H: 0.64, WFNS: 0.62). The threshold that maximized the sum of sensitivity and specificity was ≥7 points (sensitivity of 0.58, specificity of 0.68, PPV of 0.20, NPV of 0.92). A simplified score using only the three most robust parameters of the SOFA score, GCS, mean arterial pressure, and the Horovitz quotient, resulted in an AUC of 0.7. The SOFA score predicted the development of DCI-associated infarctions similar to the established H&H and WFNS scores. A simplified score combining the three most robust parameters of the SOFA score was at least equal to the established scores. Therefore, the SOFA score and our simplified score could be used as an additional tool to identify SAH patients at high risk for DCI-associated infarctions.

Feasibility of endovascular stentectomy using a snare over stent-retriever (SOS) technique was evaluated in a silicon flow model and an in vivo swine model. In vitro, stentectomy of different intracranial stents using the SOS technique was feasible in 22 out of 24 (92%) retrieval maneuvers. In vivo, stentectomy was successful in 10 out of 10 procedures (100%). In one case self-limiting vasospasm was observed angiographically as a technique related complication in the animal model. Endovascular stentectomy using the SOS technique is feasible in an experimental setting and may be transferred to a clinical scenario.

Background Several factors are frequently considered for outcome prediction rin stroke patients. We assessed the value of digital subtraction angiography (DSA)-based brain perfusion measurements after mechanical thrombectomy (MT) for outcome prediction in acute ischaemic stroke. Methods From DSA image data ( n  = 90; 38 females; age 73.3 ± 13.1 years [mean ± standard deviation]), time-contrast agent (CA) concentration curves were acquired, and maximum slope (MS), time to peak (TTP), and maximum CA concentration (CA max ) were calculated using an arterial input function. This data was used to predict neurological deficits at 24 h and upon discharge by using multiple regression analysis; the predictive capability was compared with the predictive power of the “Thrombolysis in cerebral infarction” (TICI) score. Intraclass correlation coefficients (ICC) of the NIHSS values were analysed. Results The comparison of means revealed a linear trend after stratification into TICI classes for CA max (TICI 0: 0.07 ± 0.02 a.u. to TICI 3: 0.22 ± 0.07 a.u.; p  < 0.001), and for MS (TICI 0: 0.04 ± 0.01 a.u./s to TICI 3: 0.12 ± 0.0  a.u./s; p  < 0.001). Regression analyses demonstrated equivalent capabilities for estimating neurological deficits after 24 h and at discharge using both the TICI score and DSA-based perfusion parameters (Δ R ² ~ 0.03). Compared to the actual NIHSS, the ICC ranged from 0.55 to 0.84 for DSA-based models and from 0.6 to 0.82 for TICI-based models. Conclusion Semi-quantitative evaluation of DSA-based perfusion parameters prior to and after MT is feasible and could enhance the objectivity and comparability of MT outcome prediction. This technique may offer novel approaches in acute ischaemic stroke management and data comparability. Relevance statement DSA-based brain perfusion measurements following interventional stroke therapy could allow for an experience-independent assessment of reperfusion success. It demonstrates predictive power at least equivalent to the established methods. This could support a future automated DSA-based brain perfusion measurement method. Key Points Currently, the evaluation of stroke therapy success is based on the treating physician’s experience. The present study introduces an objective semi-quantitative evaluation method. In predicting clinical outcomes, the traditional expert-based and semi-quantitative methods are equivalent. Graphical Abstract

To explore the impact of self-reported motor skills on sex-specific training outcome in early interventional radiology (INR). Based on the population of Reder et al., the study assessed the frequency, duration, and intensity of manual-focused activities, encompassing both non-professional and professional engagements (64 participants; 25 women), using the NASA Task Load Index (NASA-TLX) scores for mental workload following a standardized INR training session for basic techniques. Spearman's correlation and multiple regression analyses with backward elimination and stepwise variable selection were conducted. Sex-specific significant differences exist for predicting objective performance (OP) based on lifetime-developed hand focus. Leisure activities revealed a positive correlation with OP in men (  = 0.526;  = 0.001), unlike women. Conversely, profession-based activities correlated negatively with OP in men (  = -0.579;  = 0.022). In women, non-profession-based and profession-based activities did not significantly correlate with achieved OP. However, self-assessed performance (NASA-TLX) correlated with OP in women (  > 0.5 and  < 0.01 each). In men, cumulative hand focus (or fine motor skills) is crucial for success, influenced negatively by excessive profession-related work load (  = 0.025). In women, only self-assessment was responsible for objectively determined success or failure. In INR training, women might benefit more from external motivation, mental training, and empowerment, while men might profit more from physical training resembling observational learning. Considering the observed negative impact of excessive profession-related work load on men, a balanced lifestyle might lead to better outcomes related to fine motor skill demanding tasks.

We sought to study the accuracy of dual-energy computed tomographic angiography (DE-CTA) for the assessment of symptomatic peripheral arterial occlusive disease of the lower extremity by using the dual-energy bone removal technique compared with a commercially available conventional bone removal tool. Twenty patients underwent selective digital subtraction angiography and DE-CTA of the pelvis and lower extremities. CTA data were postprocessed with two different applications: conventional bone removal and dual-energy bone removal. All data were reconstructed and evaluated as 3D maximum-intensity projections. Time requirements for reconstruction were documented. Sensitivity, specificity, accuracy, and concordance of DE-CTA regarding degree of stenosis and vessel wall calcification were calculated. A total of 359 vascular segments were analyzed. Compared with digital subtraction angiography, sensitivity, specificity, and accuracy, respectively, of CTA was 97.2%, 94.1%, and 94.7% by the dual-energy bone removal technique. The conventional bone removal tool delivered a sensitivity of 77.1%, a specificity of 70.7%, and an accuracy of 72.0%. Best results for both postprocessing methods were achieved in the vascular segments of the upper leg. In severely calcified segments, sensitivity, specificity, and accuracy stayed above 90% by the dual-energy bone removal technique, whereas the conventional bone removal technique showed a substantial decrease of sensitivity, specificity, and accuracy. DE-CTA is a feasible and accurate diagnostic method in the assessment of symptomatic peripheral arterial occlusive disease. Results obtained by DE-CTA are superior to the conventional bone removal technique and less dependent on vessel wall calcifications.

Purpose Mice are often used as small animal models of brain ischemia, venous thrombosis, or vasospasm. This article aimed at providing an overview of the currently available methodologies for in vivo imaging of the murine cerebrovasculature and comparing the capabilities and limitations of the different methods. Methods Micro-computed tomography angiography (CTA) was performed during intra-arterial and intravenous administration of a contrast agent bolus. Digital subtraction angiography (DSA) was performed during intra-arterial administration of contrast agent using the micro-CT scanner. Time-of-flight (ToF) magnetic resonance (MR) angiography was performed using a small animal scanner (9.4 T) equipped with a cryogenic transceive quadrature coil. Datasets were compared for scan time, contrast-to-noise ratio (CNR), temporal and spatial resolution, radiation dose, contrast agent dose and detailed recognition of cerebrovascular structures. Results Highest spatial resolution was achieved using micro-CTA (16 ´ 16 ´ 16 µm) and DSA (14 ´ 14 µm). Compared to micro-CTA (20–40 s) and ToF-MRA (57 min), DSA provided highest temporal resolutions (30 fps) allowing analyses of the cerebrovascular blood flow. Highest mean CNR was reached using ToF-MRA (50.7 ± 15.0), while CNR of micro-CTA depended on the intra-arterial (19.0 ± 1.0) and intravenous (1.3 ± 0.4) use of agents. The CNR of DSA was 10.0 ± 1.8. Conclusions The use of dedicated small animal scanners allows cerebrovascular imaging in live animals as small as mice. As each of the methods analyzed has its advantages and limitations, choosing the best suited imaging modality for a defined question is of great importance. By this means the aforementioned methods offer a great potential for future projects in preclinical cerebrovascular research including ischemic stroke or vasospasm.

Objectives Gender differences have been reported to influence medical training. We investigated gender differences encountered during training in interventional radiology maneuvers. Methods Catheter handling was analyzed under standardized conditions in 64 participants naïve to endovascular procedures (26 women, 38 men). Objective (e.g., catheter pathway, catheter movements, required time) and subjective parameters (stress level) were recorded. The NASA-Task Load Index (NASA-TLX; 1–20 points) was used to assess participants’ stress levels and perceived workload. Results In the easier tasks, no significant differences between male and female participants regarding catheter handling were observed. In the most complex task, female participants took themselves more time (688 ± 363 vs. 501 ± 230 s; p  = 0.02), asked for help more frequently ( n  = 19 vs. n  = 8) and earlier than men (203 ± 94 vs. 305 ± 142 s; p  = 0.049), whereas men stood out by more agitated catheter handling (6.0 ± 1.8 vs. 4.8 ± 1.6 movements/s; p  = 0.005). Overall, female participants perceived tasks to be more difficult (11.5 ± 4.2 vs. 9.6 ± 3.3; p  = 0.016), perceived higher stress levels (8.9 ± 4.9 vs. 6.3 ± 4.4; p  = 0.037), and rated their own performance lower (9.12 ± 3.3 vs. 11.3 ± 3.3; p  = 0.009). However, female participants were able to correlate self-assessed with objective parameters correctly ( r between −0.555 and −0.469; p  = 0.004–0.018), whereas male participants failed to correctly rate their performance ( p between 0.34 and 0.73). Stress levels correlated with objective parameters in males ( r between 0.4 and 0.587; p  < 0.005), but not in female participants. Conclusion Perceived stress levels, self-evaluation skills, and catheter handling differ greatly between untrained male and female participants trying to solve interventional radiological tasks. These gender-specific differences should be considered in interventional radiology training. Clinical relevance statement As psychological aspects may influence individual working strategies gender-specific differences in self-perception while learning interventional radiology maneuvers could be essential regarding success in teaching and treatment outcomes. Key Points • After performing standardized training, 38 male and 26 female volunteers showed significant differences regarding objective and self-assessed performance, as well as in perceived workload while performing simulated endovascular catheter maneuvers. • After solving simulated endovascular radiological tasks, female participants were able to self-assess their objective performance much more accurately than male participants. • Women took more time to solve simulated endovascular tasks and asked earlier and more frequently for help than men.