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The authors sought to determine if Hirayama disease in North America has the same imaging findings as it does in Asia. They assessed imaging studies in 21 patients and looked for loss of attachment of posterior dura, lower cord atrophy and high T2 signal, loss of cervical lordosis, and anterior dural shift in flexion. These 4 findings were able to discriminate patients from healthy controls. MR imaging findings in white North American patients with Hirayama disease include loss of attachment on neutral images and forward displacement of the dura with flexion. Findings are often present on neutral MR images and, in the appropriate clinical scenario, should prompt flexion MR imaging to evaluate anterior dural shift.

This study addresses the relationship among procedure time, recanalization, and clinical outcomes in patients with acute ischemic stroke undergoing endovascular treatment. Demographics, NIHSS scores before and 1 day after the procedure, and modified Rankin Scale scores were assessed in 209 patients. Patients with procedure times ≤30 minutes had lower rates of unfavorable outcome at discharge compared with patients with procedure times ≥30 minutes. Rates of favorable outcomes in endovascularly treated patients after 60 minutes were lower than rates observed with placebo treatment. Unfavorable outcome was positively associated with age, admission NIHSS strata, and longer procedure times.