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This case demonstrates the challenge in making a diagnosis. RDD should be considered as a differential diagnosis in case of spinal lesion and non-diagnostic biopsy, especially in steroid sensitive lesions. The implications of the case are discussed.

These data suggest that ONS with rechargeable IPG may be considered the system of choice for patients undergoing ONS implant.

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BACKGROUND AND PURPOSE: Diagnosis of coronavirus disease 2019 (COVID-19) relies on clinical features and reverse-transcriptase polymerase chain reaction testing, but the sensitivity is limited. Carotid CTA is a routine acute stroke investigation and includes the lung apices. We evaluated CTA as a potential COVID-19 diagnostic imaging biomarker. MATERIALS AND METHODS: This was a multicenter, retrospective study (n ¼ 225) including CTAs of patients with suspected acute stroke from 3 hyperacute stroke units (March-April 2020). We evaluated the reliability and accuracy of candidate diagnostic imaging biomarkers. Demographics, clinical features, and risk factors for COVID-19 and stroke were analyzed using univariate and multivariate statistics. RESULTS: Apical ground-glass opacification was present in 22.2% (50/225) of patients. Ground-glass opacification had high interrater reliability (Fleiss k ¼ 0.81; 95% CI, 0.68-0.95) and, compared with reverse-transcriptase polymerase chain reaction, had good diagnostic performance (sensitivity, 75% [95% CI, 56-87]; specificity, 81% [95% CI, 71-88]; OR ¼ 11.65 [95% CI, 4.14-32.78]; P , .001) on multivariate analysis. In contrast, all other contemporaneous demographic, clinical, and imaging features available at CTA were not diagnostic for COVID-19. The presence of apical ground-glass opacification was an independent predictor of increased 30-day mortality (18.0% versus 5.7%, P ¼ .017; hazard ratio ¼ 3.51; 95% CI, 1.42-8.66; P ¼ .006). CONCLUSIONS: We identified a simple, reliable, and accurate COVID-19 diagnostic and prognostic imaging biomarker obtained from CTA lung apices: the presence or absence of ground-glass opacification. Our findings have important implications in the management of patients presenting with suspected stroke through early identification of COVID-19 and the subsequent limitation of disease transmission. ABBREVIATIONS: BSTI ¼ British Society of Thoracic Imaging; COVID-19 ¼ coronavirus disease 2019; GGO ¼ ground-glass opacification; IRR ¼ interrater reliability; RT-PCR ¼ reverse-transcriptase polymerase chain reaction; SARS-CoV-2 ¼ Severe Acute Respiratory Syndrome coronavirus 2 T he Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) was given pandemic status by the World Health Organization in March 2020. 1,2 When symptomatic, coronavirus disease 2019 (COVID-19) typically causes mild, self-limiting respiratory features. However, a severe lower respiratory and multisystem disease may occur, necessitating hospitalization. 3 Approximately 6.0% of patients with COVID-19 die, and 12% require intensive care support. 4-7 Symptoms alone are insufficient for a diagnosis due to a high prevalence of asymptomatic carriers and a variable presymptomatic incubation period (2-14 days). 8,9 The diagnostic reference standard is the reverse-transcriptase polymerase chain reaction

DERIVO 2 Embolization Device (DED2) is a new addition to the market and promises better radiopacity. 1 Aim of study The purpose of this study was to evaluate the safety and efficacy of the DED2. Methods We conducted a retrospective multicenter analysis at six interventional facilities. Patients with unruptured or ruptured intracranial aneurysms were included. The primary objective was angiographic aneurysm occlusion at 6 months as measured by the OKM grading scale. Clinical outcome according to mRS was evaluated at 6 months, with major morbidity defined as mRS 3-5. Results We included 37 patients treated with the DED2 between August 2020 and July 2021. Five patients had ruptured aneurysms. 27 patients were female, 10 male, with a medium age of 60. The median mRS was 0 (range 0-4). Average aneurysm size was 9.1 (7.9) mm, while average neck size was 6.8 (6.3) mm. In all cases the DED2 opened upon deployment. Thirty patients were eligible for clinical follow-up (81.1%). 25 (83.3%) had an mRS of 0 or 1, with no clinical deterioration in patients with pre-existing significant morbidity. Three patients died during the follow-up period, two of whom had ruptured aneurysms initially. Follow-up imaging was available in 27 patients (90%), with 23 (85.2%) demonstrating satisfactory aneurysm occlusion OKM grade C-D. Conclusion The DED2 is both safe and effective in the treatment of ruptured and unruptured intracranial aneurysms.

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