Eagle syndrome (ES) is a rare clinical syndrome characterized by the elongation of the temporal bone's styloid process, or calcification of stylohyoid ligament, compressing surrounding structures causing pharyngalgia. One of its variants, the styloid-carotid artery syndrome, produces symptoms by compression of the external or internal carotid arteries (ICA). Here, we present a case of a 43-year-old woman with ES and bilateral ICA dissections. The patient underwent staged bilateral angioplasty and covered stent placement, followed by styloidectomy. A computerized tomography angiogram revealed patency of both stents at a two-year follow-up.

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Introduction Stroke remains a primary source of functional disability and inpatient mortality in the United States (US). Recent evidence reveals declining mortality associated with stroke hospitalizations in the US. However, data updating trends in inpatient mortality is lacking. This study aims to provide a renewed inpatient stroke mortality rate in a national sample and identify common predictors of inpatient stroke mortality. Methods In this cross-sectional study, we analyzed data from a nationwide database between 2010 and 2017. We included patient encounters for both ischemic (ICD9 433–434, ICD10 I630–I639) and hemorrhagic stroke (ICD9 430–432, ICD10 I600–I629). We performed an annual comparison of in-hospital stroke mortality rates, and a cross-sectional analytic approach of multiple variables identified common predictors of inpatient stroke mortality. Results Between 2010 and 2017, we identified 518,185 total stroke admissions (86.6% ischemic stroke and 13.4% hemorrhagic strokes). Stroke admissions steadily increased during the studied period, whereas we observed a steady decline in in-hospital mortality during the same time. The inpatient stroke mortality rate gradually declined from 4.8% in 2010 (95% CI 4.6–5.1) to 2.1% in 2017 (95% CI 2.0–2.1). Predictors of higher odds of dying from ischemic stroke were female (OR 1.059, 95% CI 1.015–1.105, p = 0.008), older age (OR 1.028, 95% CI 1.026–1.029, p < 0.001), and sicker patients (OR 1.091, 95% CI 1.089–1.093, p < 0.001). Predictors of higher odds of dying from hemorrhagic stroke were Hispanic ethnicity (OR 1.459, 95% CI 1.084–1.926, p < 0.001), older age (OR 1.021, 95% CI 1.019–1.023, p < 0.001), and sicker patients (OR 1.042, 95% CI 1.039–1.045, p < 0.001). All census regions and hospital types demonstrated improvements in in-hospital mortality. Conclusion This study identified a continuous declining rate in in-hospital mortality due to stroke in the United States, and it also identified demographic and hospital predictors of inpatient stroke mortality.

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Background: Intracranial hemorrhage (ICH) requires emergent medical treatment for positive outcomes. While previous artificial intelligence (AI) solutions achieved rapid diagnostics, none were shown to improve the performance of radiologists in detecting ICHs. Here, we show that the Caire ICH artificial intelligence system enhances a radiologist's ICH diagnosis performance.Methods: A dataset of non-contrast-enhanced axial cranial computed tomography (CT) scans (n=532) were labeled for the presence or absence of an ICH. If an ICH was detected, its ICH subtype was identified. After a washout period, the three radiologists reviewed the same dataset with the assistance of the Caire ICH system. Performance was measured with respect to reader agreement, accuracy, sensitivity, and specificity when compared to the ground truth, defined as reader consensus.Results: Caire ICH improved the inter-reader agreement on average by 5.76% in a dataset with an ICH prevalence of 74.3%. Further, radiologists using Caire ICH detected an average of 18 more ICHs and significantly increased their accuracy by 6.15%, their sensitivity by 4.6%, and their specificity by 10.62%. The Caire ICH system also improved the radiologist's ability to accurately identify the ICH subtypes present. Conclusion:The Caire ICH device significantly improves the performance of a cohort of radiologists. Such a device has the potential to be a tool that can improve patient outcomes and reduce misdiagnosis of ICH.

Thrombosis of superficial cerebral veins is often a result of the expansion of a clot from one of the major cerebral venous sinuses; however, it can represent an isolated thrombosis originating in the cortical veins themselves. Isolated superficial cerebral venous thrombosis (ICVT) is an uncommon subtype of cerebral venous thrombosis (CVT) that only involves the superficial cerebral veins. 1

Introduction Endovascular treatment for venous sinus thrombosis is challenging. Commonly utilized aspiration catheters in neuro‐interventional procedures have diameters ranging from 2–3 mm and are much smaller than the average diameter of the major cerebral venous sinuses. Penumbra’s Indigo Aspiration System (Penumbra Inc., Place Alameda, CA) is a trackable, large‐lumen (Indigo System CAT7, 7F) catheter and aspiration system that is used for aspiration of thrombi and emboli involving the peripheral venous and arterial systems, as well as pulmonary emboli. Here, we show that this large‐lumen system may safely retrieve and successfully recanalize cerebral venous thrombosis (CVT), addressing the problem of available tools for complete thrombus removal. Methods Case report. I wanted to submit this abstract for: ‐Young Investigator Award ‐Best Scientific Abstract Award Results Here, we present the first reported case of successful endovascular thrombectomy of cerebral venous sinus thrombosis utilizing Penumbra’s Indigo System (Penumbra Inc., Place Alameda, CA), a minimally‐invasive system with a large‐lumen (Indigo System CAT7, 7F) catheter predominantly used for the removal of thrombi and emboli involving the peripheral arterial and venous systems and for the treatment of pulmonary embolism. A 30‐year‐old female presented with a hemorrhagic infarct of the left posterior temporal lobe secondary to an extensive cerebral venous thrombosis (CVT) extending from the left transverse sinus to the ipsilateral internal jugular bulb. In addition to a continuous heparin infusion, we performed an endovascular thrombectomy with the device mentioned above, resulting in a technically successful radiographic recanalization of the involved sinuses. The patient was discharged home in a stable condition. This case demonstrates that this trackable, atraumatic, large‐bore system can be safe and efficacious, permitting near complete thrombus removal. Conclusions Cerebral Venous Thrombosis (CVT) recanalization is an important outcome measure in trials investigating endovascular therapies for dural venous sinus clots.Most endovascular tools used for aspiration of CVT are designed for arterial, not venous, vasculature.Penumbra’s Indigo Aspiration System, a large‐lumen catheter can be considered as a valid, safe, and effective alternative for the treatment of diffuse CVT.