Using Multimodal Imaging to Correlate Link Between Intracranial Aneurysms and Acute Ischemic Stroke.

Area of Science:

• Neurology
• Radiology
• Vascular Surgery

Background:

• The relationship between unruptured cerebral aneurysms and acute ischemic stroke (AIS) is recognized but causality remains uncertain.
• Distinguishing between coincidental findings and causative lesions is critical for appropriate patient management.

Purpose of the Study:

• To identify key imaging characteristics that help establish or exclude a causal link between cerebral aneurysms and AIS.
• To propose a framework for classifying aneurysms as potential causes of ischemic events.

Main Methods:

• Retrospective analysis of eight patients with AIS and aneurysms in the same vascular territory.
• Utilized computed tomography (CT), magnetic resonance imaging (MRI), digital subtraction angiography (DSA), and vessel wall imaging (VWI).

Main Results:

• Developed a classification framework categorizing aneurysms as possible, probable, or improbable causes of AIS.
• Key classification factors included aneurysm thrombosis, positive vessel wall imaging, location, and comorbidities.
• Treatment decisions were guided by the aneurysm's classified probability of causing the stroke.

Conclusions:

• Advanced imaging techniques, particularly VWI, enhance the ability to assess the likelihood of aneurysms causing thromboembolic events.
• Integrating traditional imaging with advanced sequences aids in stratifying the risk posed by cerebral aneurysms in AIS patients.