Stent retrievers have the potential to achieve a high rate of recanalization and functional independence whilst being relatively safe. They should be assessed in well-designed randomized controlled trials to determine their efficacy and assess whether they compare favourably with 'standard treatment' in stroke.

Functional outcome following emergent intra-arterial thrombectomy is variable and likely reflects the heterogeneous characteristics of acute stroke patients. The aims of our study were (1) to study which pre-treatment variables correlate with functional outcome and (2) to devise a tool which would reliably predict outcome. Prospective data of patients treated with intra-arterial mechanical thrombectomy in our institution between 2010 and 2012 were collected. A preliminary univariate analysis of baseline variables was performed and data outliers were identified by constructing scatter and box plots. Systematic bivariate analysis was then carried out using a linear regression model and the individual contributing weights of the variables to outcome calculated. The B and constant values from the regression were used to construct a predictive formula. Fifty-seven patients, 35 males (61.4%) and 22 females (38.6%) with a mean age of 62.3 years (range 26–87) were included in the cohort. Statistical correlations of baseline variables and functional outcome showed that age, National Institutes of Health Stroke Scale at presentation and CT leptomeningeal collaterals were strongly correlated (p<0.01), and were later included in the linear regression model. A tool was devised from the regression formula combining weighted inputs of the three variables. Regression statistics and residual analysis were then performed to assess the accuracy and reliability of the proposed tool. The proposed tool is easy to use and reliably predicts functional outcome prior to endovascular therapy. It may help clinical decision-making in the acute setting and offers ‘tailor-made’ outcome expectations.

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DESCRIPTIONA 64-year-old woman presented with progressive hearing loss. A pure-tone audiography confirmed bilateral high-frequency sensorineural hearing loss. Her medical and surgical history was unremarkable except for long-standing back pain. Neurological examination revealed mild dysmetria and gait ataxia. There was no leg weakness or sphincteric dysfunction.MRI revealed superficial siderosis lining the cerebellum and brainstem, which prompted further imaging of the entire neuraxis in order to exclude an underlying cause. A myxopapillary ependymoma seen at the level of the conus medullaris was felt to be responsible for recurrent haemorrhage within the subarachnoid space.Excision of the spinal ependymoma was performed and the patient regained near-normal hearing following a cochlear implant. DISCUSSIONSuperficial siderosis presents with slowly progressive sensorineural hearing loss, gait ataxia and cerebellar dysarthria. Involvement of other cranial nerves has also been described. Clinical history and examination often suggest a neurodegenerative disorder.1 Superficial siderosis results from haemosiderin deposition in the subpial layers of the neuraxis, and complicates chronic haemorrhage within the subarachnoid space. The posterior fossa is preferentially affected, which may in part be explained by the presence of Bergmann glia in the cerebellum that display increased ferritin synthesis.2 The long glial segment of the vestibulocochlear nerve makes it more vulnerable to axonal damage by iron deposition.1 Bilateral sensorineural hearing loss is present in 95% of affected individuals.3 Figure 1 Linear hypointensity is seen along the cerebellar folia and superior vermis on the axial gradient echo images (A) compatible with extensive haemosiderin deposition. There is also hypointense lining of the midbrain tectum and pons. The sagittal T1-weighted image (B) reveals low signal intensity of the upper cerebellum due to extensive haemosiderin preferentially deposited in the upper cerebellum and superior vermis. The linear hypointensities are also appreciated on the axial T2 sequence (C) where they clearly outline the cerebellar folia and ventral pons and reflect the characteristic subpial haemosiderin deposition. Mild underlying cerebellar atrophy is also appreciated. The radiological findings are pathognomonic of superficial siderosis.

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Primary cardiac tumours are rare; their prevalence ranges from 0.0017% to 0.28% in various autopsy series. Cardiac lipomas are well-encapsulated benign tumours typically composed of mature fat cells, and their reported size ranges from 1 to 15 cm. They are usually seen in the left ventricle and the right atrium. Lipomas are true neoplasms, as opposed to lipomatous hypertrophy of the interatrial septum, which is a nonencapsulated hyperplastic accumulation of mature and foetal adipose tissue. Cardiac lipomas occur in patients of all ages, and the frequency of occurrence has been found to be equal in both sexes. Patients are usually asymptomatic, although the manifestation of symptoms depends upon both size and location of the tumour. We present the case of a patient with an interatrial septal lipoma, causing obstruction of the superior vena cava.

A 30-year-old man presented with recurrent headaches. CT head revealed a clival chordoma (figure 1A). Chordomas originate from the embryonic remnants of the notochord and account for 2%-4% of all malignant bone tumors. They have a predilection for the axial skeleton, with 35% affecting the spheno-occipital region. The incidence peaks at ages 20-40 years. Male patients are affected twice From Mater Dei Hospital, Msida, Malta.Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.e110