Stents have become very important devices in the treatment of intracranial aneurysms. Flow diverters as high metal coverage stents are developed for hemodynamic treatment of challenging intracranial aneurysms. High level of metal coverage can also be achieved by implementing regular stents telescopically one in another. We present the case of a patient successfully treated for giant aneurysm of basilar artery bifurcation by a “Stent-within-a-Stent” technique. After stent implantation, coil embolization was performed using multiple-sized platinum helical coils. Control angiography performed at the end of the procedure revealed aneurysm occlusion. After 3 years, the patient is fully neurologically recovered, without pyramidal deficit, independently active and able to work.

Granulomatosis with polyangiitis (GPA) is a necrotizing granulomatous vasculitis affecting predominantly small vessels, typically associated with PR3-ANCA positivity. Central nervous system involvement beyond cranial nerve palsies is rare, with intracerebral granulomas being exceptionally rare and lacking specific imaging characteristics, often mimicking malignancies or other intracranial pathologies. This significantly complicates the diagnostic process, particularly in the absence of active systemic disease. We report a case of a 71-year-old woman in whom neurological symptoms and magnetic resonance imaging revealed intracerebral granulomas and led to the diagnosis of GPA. Early recognition of tumor-like brain lesions in GPA and prompt initiation of immunosuppressive and anti-edematous therapy are crucial to prevent progression and potentially life-threatening compressive complications.

Introduction: Brain metastases represent the most common intracranial malignancy in the adult population, while breast cancer represents the leading cause of brain metastases among women. Brain metastases have increased in recent years due to improved therapeutic control of systemic disease and better diagnostic tools. Stereotactic radiosurgery (SRS) is used in patients with brain tumors to achieve local disease control, preserve the quality of life, and extend patient survival. This study aimed to evaluate the effects of SRS in patients with brain metastases from breast cancer through analysis of magnetic resonance imaging (MRI) parameters of the brain. Methods: Brain MRI was conducted in 30 adult female patients before and 3-6 months after SRS treatment. Radiological analysis was used to estimate lesion volumes before and after SRS. Results: Patients were categorized into four groups based on therapeutic response: 1 - complete response (CR) with loss of the lesion, 2 - partial response (PR) with more than 50% reduction in lesion volume, 3 - disease progression (PD) with more than 25% increase in lesion volume, 4 - stable disease (SD) if the patient did not display PR or PD. Among all patients, it was found that CR was present in 0 (0%), PR in 15 (50%), PD in 1 (3%), and SD in 14 (47%) patients. Following the SRS treatment, a statistically significant reduction in tumor volume was observed (p<0.001). Conclusion: Radiological volumetric analysis of brain metastases after SRS showed a statistically significant reduction in lesion volume, demonstrating effective local disease control.