Matt Bender

Delivery assist catheters widely accepted for stroke thrombectomy, but are even better for intracranial athero. Self-centering, atraumatic, visible, progressive dilation. Several nice options, but half-cath adjustable length facilitates balloon-mounted stent, as here.

Hemorrhage in moyamoya disease can be due to lenticulostriate aneurysms (LSA). In this case, LSA grew over 1mo in ICU, while pt recovered intact neuro exam. Repeat DSA shows LSA growth from 2mm to 4mm with direct arterial supply to distal MCA branches. @moyamoyafdn @cvsection

Contemplated this case while traveling to inaugural @issclsociety mtg. Pt in 20s w numb/weak BLE with bend/twist. Never HA.

Spinal extradural arachnoid cyst

Analagous to a Type II CSF leak

Straightforward OR... Resect extradural arachnoid, close small dorsal dural defect

Curious about experiences stenting IIH post-CVST?

Despite diffuse stenosis and irregular walls, even crossing jugular bulb, I've had great results in pts w recalcitrant papilledema.

Route92 half-cath w Tenzing delivery assist is transformational technology for sinus stenting.

Which of these aneurysms do you think ruptured? Based on imaging? Based on intra-op findings?

I'm still not certain. I initially deferred the basilar, ultimately took hybrid approach to cure all

@BAFOUND @cvsection @SNISinfo