Degenerative disc disease is a common manifestation in routine imaging of the spine; this finding is partly attributable to physiological aging and partly to a pathological condition, and sometimes this distinction is simply not clear. In this review, we start focusing on disc anatomy and pathophysiology and try to correlate them with radiological aspects. Furthermore, there is a special focus on degenerative disc disease terminology, and, finally, some considerations regarding disc morphology and its specific function, as well as the way in which these aspects change in degenerative disease. Radiologists, clinicians and spine surgeons should be familiar with these aspects since they have an impact on everyday clinical practice.

Background: Castleman disease (CD) is an uncommon benign lymphoproliferative disease characterized by hypervascular lymphoid hyperplasia. We present a unique case of unicentric CD of the parotid gland treated by preoperative direct puncture embolization. Case presentation: A 27-year-old female patient was admitted for a right neck mass. Ultrasound examination and MRI scan documented a hypervascular mass within the right parotid gland. Preoperative embolization was performed by direct puncture technique: a needle was inserted into the core of the mass under both ultrasound and fluoroscopic guidance and SQUID 12 was injected into the mass under fluoroscopic control, achieving a total devascularization. Conclusion: Preoperative direct puncture embolization was safe and effective and provides excellent hemostatic control during the surgical operation, limiting the amount of intraoperative bleeding.

Purpose: The aim of this registry was to assess technical success, procedural safety and mid- to long-term follow-up results of the Silk Vista “Mama” (SVM) flow diverter (BALT, Montmorency, France) for the treatment of proximal intracranial aneurysms. Methods: Between August 2020 and March 2022, data from nine Italian neurovascular centres were collected. Data included patients’ clinical presentation, aneurysms’ size, location and status, technical details, overall complications and mid- to long-term angiographic follow-up. Results: Forty-eight aneurysms in 48 patients were treated using the SVM. Most aneurysms were small (≤ 10 mm: no. 29, 60%) and unruptured (no. 31, 65%); 13 aneurysms were recurrent after coiling or clipping. 37/48 aneurysms involved the internal carotid artery (77%). Optimal opening and complete wall apposition of the device were achieved in 46 out of 48 cases (96%). Four intra- or periprocedural complications occurred (two thrombotic complications successfully resolved, one cerebellar ischemia, one perirenal hematoma), without new neurological deficit. No significant intra-stent stenosis or stent displacement was observed during follow-up. No FD-related morbidity nor mortality was reported. At midterm (6–12 months) to long-term (> 12 months) follow-up, complete aneurysm occlusion (OKM D) was achieved in 76% of cases. Eighty-eight percent of patients had complete aneurysm occlusion or entry remnant (OKM D + C). Conclusions: Our experience suggests that the new generation of low-profile SVM flow diverter for the treatment of proximal intracranial aneurysms is safe and effective, with low rates of intraprocedural complications and acceptable mid- to long-term occlusion rate.

Objective: To evaluate the efficacy and safety of the Silk Vista flow diverter stent in treating recurrent cerebral bifurcation aneurysms, highlighting angiographic and clinical outcomes in a monocentric case series. Methods: A retrospective analysis of 12 patients (7 male, five female) with recurrent bifurcation aneurysms treated exclusively with the Silk Vista flow diverter was conducted. Aneurysms were located in the anterior communicating artery (75%), middle cerebral artery (17%), and basilar artery (8%). All patients received dual antiplatelet therapy for ten days pre-procedure and 6 months post-procedure, followed by aspirin monotherapy. The O’Kelly-Marotta (OKM) scale was used to assess aneurysm filling, where Grade D indicates complete occlusion. Clinical outcomes were measured using the modified Rankin Scale (mRS), with scores of 0–1 reflecting no or minimal disability. Results: At the end of the procedure, 75% ( n = 9) of patients exhibited stagnant contrast filling within the aneurysm sac (OKM Grade C) during the venous phase. Periprocedural thromboembolic complications occurred in 17% ( n = 2) of cases, without clinical sequelae. No post-hospital complications were observed, and all patients maintained mRS scores of 0–1 at discharge. At 1-year follow-up, complete aneurysm exclusion (OKM Grade D) was achieved in 83% ( n = 10), while minimal neck perfusion (OKM Grade C) persisted in 17% ( n = 2). No new neurological deficits or deterioration occurred. Conclusion: Despite the small sample size and single-center design, the Silk Vista flow diverter demonstrated favorable angiographic and clinical outcomes, supporting its role as a viable and safe option in this complex patient population.

Background Acute occlusions of the anterior circulation with an underlying intracranial atheromatous disease (ICAD) represent a diagnostic and therapeutic challenge. The aim of this study was to compare the results of the endovascular treatment (EVT) ± intravenous thrombolysis (IVT) and the best medical treatment (BMT ± IVT) as first-line approach in a cohort of patients with certain diagnosis of M1-Middle Cerebral Artery (M1-MCA) occlusions and underlying ICAD. Methods Patients with M1-MCA and a certain diagnosis of underlying ICAD were included in this retrospective, monocentric analysis between 2018 and April 2023. Baseline, procedural and clinico-neuroradiological follow-up data were collected. EVT ± IVT and BMT ± IVT were the two study groups. An independent core lab assessed the imaging data. The primary outcome was the rate of functional independence at 3 months (mRS0-2); secondary outcomes included the extension of the ischemic lesion (∆baseline-24 hours volume), the early neurological deterioration (END), the rate of symptomatic intracranial haemorrhages (sICH). Results Thirty-four patients were included in the study (65,7 ± 16,5 y.o.; males: 52,8%), 23 were treated by EVT ± IVT and 11 with BMT ± IVT. Functional independence was less frequent in the EVT ± IVT group compared to the BMT ± IVT (26%vs81,8%, p = 0,003). The increase of ∆ volume, the rate of END and sICH were significantly lower in the BMT ± IVT group. Conclusions EVT ± IVT (only MT) was associated with worse clinical and neuroimaging outcomes compared to BMT ± IVT. Nevertheless, a beneficial effect of primary angioplasty ± stenting should be taken in account and future studies will be necessary to investigate this therapeutic option.