BACKGROUND AND PURPOSE: Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow–derived mononuclear cells in patients with middle cerebral artery ischemic stroke. MATERIALS AND METHODS: A prospective, randomized, open-label, blinded–end point study was performed from July 2015 to June 2016. Of 229 patients with acute stroke who presented to the hospital during this period, 20 patients who satisfied the inclusion/exclusion criteria were included and randomized into the control and intervention groups. Intra-arterial stem cell infusion into the ipsilateral MCA was performed in the patients in the intervention group at 8–15 days post-stroke ictus. Final analysis at 6 months was performed for primary (safety) and secondary outcomes (efficacy). RESULTS: When we compared the primary end point of the study, no procedure-related mortality, complication, new infarct, or symptomatic intracranial hemorrhage was seen in the intervention group. When we compared the secondary end point of good clinical outcome, 8 (80%) patients in the intervention group showed good clinical outcome (modified Rankin Scale score < 2) with 4 (40%) patients in the control group achieving this (95% confidence interval for good outcome in patients with stem cell infusion, 49.03–94.3, and without stem cell infusion, 16.82–68.73; P = .068). CONCLUSIONS: Intra-arterial infusion of stem cells can be carried out safely in the subacute stage of ischemic stroke. Improved clinical outcomes were observed with intra-arterial stem cell therapy; however, studies with larger cohorts are needed to validate the results.

Mahalingam H, et al. Korean J Urol. 2015 Aug;56(8):587-593. http://dx.doi.org/10.4111/kju.2015.56.8.587

Hepatic artery pseudoaneurysm is an infrequently encountered entity that is usually seen secondary to trauma or surgical procedures. The clinical presentation is often due to complications such as massive intrahepatic or intraperitoneal bleeding as a result of rupture of the pseudoaneurysm into the biliary tree or peritoneal cavity, respectively. Hepatic artery pseudoaneurysm, associated with a liver abscess, has very rarely been described in the literature. We present the imaging features of a case of liver abscess associated with a hepatic artery pseudoaneurysm and complicated by rupture and formation of an arteriovenous fistula. The case was successfully managed by percutaneous endovascular embolization. The association between a hepatic artery pseudoaneurysm and a liver abscess must not be overlooked, bearing in mind the potentially fatal associated complications which can be averted or treated by timely intervention.

Intense enhancement of the quadrate lobe in the arterial phase may be seen on computed tomography in patients of superior vena cava syndrome. We present this imaging finding in a case of lymphoma causing superior vena cava syndrome and discuss the physiological cause and importance of this sign.

Neurocysticercosis is the most common parasitic infestation of the central nervous system, which manifests commonly as acute-onset focal seizures. We report a rare nonepileptic manifestation of neurocysticercosis: midbrain neurocysticercosis presenting as sudden-onset ptosis in 2 children. To our knowledge, this has not been reported previously in children.

Earlier imaging techniques for coronary artery disease (CAD) focused primarily on either morphological or functional assessment of CAD. However, dual-energy computed tomography (DECT) can be used to assess myocardial blood supply both morphologically and functionally. We aimed to evaluate the diagnostic accuracy of DECT in detecting morphological and functional components of CAD, using invasive coronary angiography (ICA) and single photon emission computed tomography (SPECT) as reference standards. Twenty-five patients with known or suspicious CAD and scheduled for ICA were investigated by DECT and SPECT. DECT was performed during the resting state using retrospective electrocardiography (ECG) gating. CT coronary angiography and perfusion images were generated from the same raw data. All patients were evaluated for significant stenosis (≥50%) on both ICA and DECT coronary angiography, and for myocardial perfusion defects on SPECT and DECT perfusion. Comparison was done between ICA and DECT coronary angiography for detection of significant stenosis and between SPECT and DECT perfusion for detecting myocardial perfusion defects. Using ICA as reference standard, sensitivity, specificity, and accuracy of DECT coronary angiography in detecting ≥50% stenosis of coronary artery lumen were 81.6%, 97.8%, and 95.0%, respectively, by segment-based analysis and 92.1%, 96.1%, and 93.7%, respectively, by vessel-based analysis. Using SPECT as the reference standard, the sensitivity, specificity, and accuracy of DECT perfusion in detecting myocardial perfusion defects were 70.4%, 86.4%, and 80.6%, respectively, on per-segment analysis and 90.7%, 66.6%, and 84.7%, respectively, on per-territorial basis. DECT accurately detected coronary artery stenosis and myocardial ischemia using ICA and SPECT as reference standards. In the same scan, DECT can accurately provide integrative imaging of coronary artery morphology and myocardial perfusion.