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🧠 The Circle of Willis may be a foundational structure, but variations are the rule, not the exception. From hypoplasia to persistent fetal patterns, these anomalies shape collateral flow & stroke presentations Let’s dive into the ones you’ll encounter 👇 #NeuroXtorial

⭐️ Imaging of Moyamoya disease/syndrome 🔷Imaging: Thread-like intracranial ICA/MCA with attenuated branches and “puff of smoke” appearance on DSA 🔷Complications: ▶️Ischemia (classically watershed) ▶️Hemorrhage Learning points in 🧵 🧠 #Neurosurgery #Neurology #stroke

Intraluminal thrombi are seen in about 2-5% of patients with ischemic stroke and are associated with increased risk of recurrence and surgical complication. Most are related to underlying atherosclerosis but it can also be seen in dissection, webs, and hypercoagulable disorders.

"11 per 10,000" "After a diagnosis of CAA, absolute risks of ischemic stroke and intracerebral hemorrhage were broadly similar."

For a woman with device-detected atrial fibrillation, would you initiate anticoagulant therapy or recommend continuation of antiplatelet therapy? Read the case vignette and essays on both treatment options and cast your vote: nej.md/4lQzxTA #Afib

𝑃𝑟𝑖𝑛𝑐𝑖𝑝𝑙𝑒 - 72ᵇʳᵃⁱⁿ ᶜᵒᵘʳˢᵉ Tʜᴇ 𝘽𝙧𝙖𝙞𝙣 𝘼𝙑𝙈 𝙜𝙧𝙖𝙙𝙞𝙣𝙜 𝙨𝙘𝙖𝙡𝙚𝙨. 🅰︎. Spetzler-Martin Grading System (0–5 points total) 1. 𝐒𝐢𝐳𝐞 of 𝐍𝐮𝐝𝐢𝐬: Small (<3 cm) → 1 point Medium (3–6 cm) → 2 points Large (>6 cm) → 3 points 2. Brain

Happy Thrombectomy Day! SVIN AshuJadhav Alexandra Czap Fawaz Al-Mufti, MD, FSVIN Dan Harrison, MD Casey Albin, MD Richard Choi, DO, FNCS Diogo Haussen Sitara Koneru, MD Mikayel Grigoryan Junaid Ansari Giana Dawod, MD Ameer E. Hassan Andreas Charidimou MD, PhD

Anyone can see the bright spot of diffusion imaging! What sets you apart is your ability to tell them where it is—what vascular territory Here are the vascular territories you need to know: * Posterior Inferior Cerebellar Artery (PICA) Soft under surface of the cerebellum *

Attention Neurology Educators! Applications for our next cohort are due 6/30. Join, learn and be part of this fantastic community! (Link in the comments)

This week’s SPIN-POV: A lenticulostriate territory infarct with focal narrowing of the distal ICA on TOF angiography in a child? Think Focal cerebral arteriopathy. Don’t forget the T1 FS black blood sequence — it helps demonstrate the wall thickening and concentric enhancement.

‼️JULY 2025-2026 OPEN FELLOWSHIP POSITION ‼️ Unexpected first year neurointerventional surgery position open at Montefiore Medical Center 🧠 Come join an amazing team of neurosurgeons, NIRs, and stroke neurologists this summer for a CAST-certified 2 year position (2025-2027)

Cortical vein thrombosis is a very challenging diagnosis to make. Imaging findings = hyperdense cortical vein & cashew nut sign (juxta-cortical hemorrhage) on CT. MRI with SWI is the gold standard (below). Make sure to look carefully at all cuts including topmost! #stroke #CVT

#MondayTip #DWI_negative AIS 📊Meta-analysis, 3,236pt➡️6.8% had clinical diagnosis of AIS w/DWI (-) 🔑Post. circulation is key: 5x greater odds of (-) DWI vs anterior strokes ⏰Timing & size matter ☝️While DWI is highly sensitive, it can still be falsely (-) in selected AIS cases

Considering Prestroke Disability in EVT Candidates: Lessons from the Italian Endovascular Stroke Registry In this #BloggingStroke post, Johanna Seiden, MD MPH discusses #Stroke article by Naldi et al. #AHAJournals ahajournals.org/do/10.1161/blo…

In this real world study of ESUS patients with AIS, anticoagulation was found to be associated with a reduction in recurrent stroke, as opposed to anti-platelet therapy, among those with left ventricular wall motion abnormalities neurology.org/doi/10.1212/WN…