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The authors attempted to determine if reperfusion therapy for anterior circulation acute stroke based on MR perfusion resulted in better outcomes at 3 months than that based on noncontrast CT. Perfusion imaging-selected patients had a better outcome than those selected with only noncontrast CT but MR perfusion- and CT perfusion-selected patients had similar outcomes. In this multicenter study, patients with acute stroke who underwent perfusion imaging were more than 2-fold more likely to have good outcomes following endovascular reperfusion therapy

More than 100 conservatively managed nonstroke dissecting vertebrobasilar artery aneurysms were followed on average for 3 years. Ninety-seven percent of patients remained clinically unchanged and the 3 patients who deteriorated clinically had aneurysm enlargement. The natural course of these lesions suggests that acute intervention is not always required and close follow-up without antithrombotic therapy is reasonable. Patients with symptoms due to mass effect or aneurysms of >10 mm may require treatment.