We examined whether synchronizing and analyzing three data sources, active personal dosimeter (APD) information, in-room monitoring camera footage, and the operator’s main angiography panel video, could identify opportunities to reduce occupational radiation exposure during cerebral angiography without therapeutic intervention. We analyzed the behavior of eight physicians and radiation doses measured outside the lead apron during 12 diagnostic cerebral angiography procedures performed between January and April 2024. Appropriate use of a ceiling-suspended radiation protective shield (CSRPS) was associated with approximately 70% exposure reduction. In addition, exposure during femoral arteriography (catheter advancement from femoral artery puncture to the aortic arch) accounted for approximately 50% of the total exposure, identifying both as effective intervention points. This approach identified operators’ incorrect use of radiation protection equipment and enabled clear feedback to operators on areas for improvements in radiation protection practices.

Background: Delayed cerebrovascular complications after radiotherapy have been well-documented. However, optimal management of acute ischemic stroke secondary to radiation-induced intracranial arterial stenosis remains unclear. Case Description: A 17-year-old girl developed an acute ischemic stroke secondary to delayed middle cerebral artery stenosis following radiotherapy for recurrent craniopharyngioma after tumor resection. Intravenous alteplase (rt-PA) was administered 4 h after symptom onset, resulting in neurological improvement, and she was discharged with a modified Rankin Scale score of 0. Conclusion: This case suggests that rt-PA may be an effective treatment option for acute ischemic stroke associated with post-radiotherapy arterial stenosis, provided that the standard eligibility criteria are met.