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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14291--5" data-node-nid="14291" id="top-node-14291--61676449806" data-pisa="ajnr;37/2/296" data-pisa-master="ajnr;ajnr.A4657" data-apath="/ajnr/37/2/296.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title"><em>Reply:</em></h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M.N. Rozenfeld</span>, <span class="highwire-citation-author" data-delta="1">S.A. Ansari</span>, <span class="highwire-citation-author" data-delta="2">P. Mohan</span>, <span class="highwire-citation-author" data-delta="3">A. Shaibani</span>, <span class="highwire-citation-author" data-delta="4">E.J. Russell</span> and <span class="highwire-citation-author" data-delta="5">M.C. Hurley</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">296; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4657 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14291--61676449806" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M.N. Rozenfeld </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology
Northwestern University Feinberg School of Medicine
Chicago, Illinois</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.N.%2BRozenfeld%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rozenfeld%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.N.%2BRozenfeld%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">S.A. Ansari </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology
Northwestern University Feinberg School of Medicine
Chicago, Illinois</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.A.%2BAnsari%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ansari%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.A.%2BAnsari%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P. Mohan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology
University of Miami
Miami, Florida</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BMohan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mohan%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AP.%2BMohan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A. Shaibani </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology
Northwestern University Feinberg School of Medicine
Chicago, Illinois</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BShaibani%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Shaibani%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BShaibani%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">E.J. Russell </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology
Northwestern University Feinberg School of Medicine
Chicago, Illinois</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.J.%2BRussell%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Russell%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AE.J.%2BRussell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">M.C. Hurley </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology
Northwestern University Feinberg School of Medicine
Chicago, Illinois</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.C.%2BHurley%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hurley%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.C.%2BHurley%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><p id="p-1">We would like to sincerely thank Dr Niemczyk for his commentary on our recent article. We agree that despite the increased risks of aneurysm repair in patients with autosomal dominant polycystic kidney disease (ADPCKD), aneurysm screening programs are beneficial in this population.<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup> The issue then arises of how to risk-stratify these patients once aneurysms are discovered. As Dr Niemczyk states, the aneurysms in this patient population must be treated as unique entities and the traditional risk-stratification methods may not be entirely accurate. While it is known that patients with ADPCKD present with subarachnoid hemorrhage earlier in life compared with the general population, once the aneurysm ruptures, they have mortality rates similar to those of the general population.<sup><a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2</a><a id="xref-ref-3-1" class="xref-down-link" href="#ref-3"><span>⇓</span></a><a id="xref-ref-4-1" class="xref-down-link" href="#ref-4"><span>⇓</span></a>–<a id="xref-ref-5-1" class="xref-bibr" href="#ref-5">5</a></sup> Little else is known, however, about the potentially increased risks of rupture in this patient group.</p><p id="p-2">The recently published Unruptured Intracranial Aneurysm Treatment Score lists ADPCKD as an independent risk factor for rupture, with a risk score equivalent to that of hypertension, drug abuse, and Japanese or Finnish ethnicity.<sup><a id="xref-ref-6-1" class="xref-bibr" href="#ref-6">6</a></sup> Another recently published PHASES (Population, Hypertension, Age, Size of Aneurysm, Earlier SAH, and Site of Aneurysm) scoring system does not specifically take into account ADPCKD status but does state that Finnish or Japanese ethnicity increases the risk of aneurysm rupture by 2.0–3.6 times.<sup><a id="xref-ref-7-1" class="xref-bibr" href="#ref-7">7</a></sup> These findings raise the question of whether patients with ADPCKD should be approached with a treatment paradigm similar to that in these high-risk groups.</p><p id="p-3">We recommend that all treatment-related decisions be made on an aneurysm- and patient-specific basis by multidisciplinary consensus. With this in mind, further research is needed to better risk-stratify aneurysms in patients with ADPCKD.</p><div class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.296.1" data-doi="10.3174/ajnr.A3437"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Rozenfeld</span>  <span class="cit-name-given-names">MN</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Ansari</span>  <span class="cit-name-given-names">SA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Shaibani</span>  <span class="cit-name-given-names">A</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Should patients with autosomal dominant polycystic kidney disease be screened for cerebral aneurysms?</span> <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2014</span>;<span class="cit-vol">35</span>:<span class="cit-fpage">3</span>–<span class="cit-lpage">9</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A3437</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>23292526</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo2OiIzNS8xLzMiO3M6NDoiYXRvbSI7czoxOToiL2FqbnIvMzcvMi8yOTYuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.296.2" data-doi="10.1016/0002-9343(85)90218-9"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">de la Monte</span>  <span class="cit-name-given-names">SM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Moore</span>  <span class="cit-name-given-names">GW</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Monk</span>  <span class="cit-name-given-names">MA</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Risk factors for the development and rupture of intracranial berry aneurysms</span>. <abbr class="cit-jnl-abbrev">Am J Med</abbr> <span class="cit-pub-date">1985</span>;<span class="cit-vol">78</span>(<span class="cit-issue">6 pt 1</span>):<span class="cit-fpage">957</span>–<span class="cit-lpage">64</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/0002-9343(85)90218-9</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>4014270</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/0002-9343(85)90218-9&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=4014270&amp;link_type=MED&amp;atom=%2Fajnr%2F37%2F2%2F296.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.296.3"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Schievink</span>  <span class="cit-name-given-names">WI</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Torres</span>  <span class="cit-name-given-names">VE</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Piepgras</span>  <span class="cit-name-given-names">DG</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Saccular intracranial aneurysms in autosomal dominant polycystic kidney disease</span>. <abbr class="cit-jnl-abbrev">J Am Soc Nephrol</abbr> <span class="cit-pub-date">1992</span>;<span class="cit-vol">3</span>:<span class="cit-fpage">88</span>–<span class="cit-lpage">95</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>1391712</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoiam5lcGhyb2wiO3M6NToicmVzaWQiO3M6NjoiMy8xLzg4IjtzOjQ6ImF0b20iO3M6MTk6Ii9ham5yLzM3LzIvMjk2LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span></span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.296.4"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Lozano</span>  <span class="cit-name-given-names">AM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Leblanc</span>  <span class="cit-name-given-names">R</span></span></li></ol><cite>. <span class="cit-article-title">Cerebral aneurysms and polycystic kidney disease: a critical review</span>. <abbr class="cit-jnl-abbrev">Can J Neurol Sci</abbr> <span class="cit-pub-date">1992</span>;<span class="cit-vol">19</span>:<span class="cit-fpage">222</span>–<span class="cit-lpage">27</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>1623450</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=1623450&amp;link_type=MED&amp;atom=%2Fajnr%2F37%2F2%2F296.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">5.</span><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5. in text" id="ref-5">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.296.5" data-doi="10.1016/S0272-6386(12)80924-3"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Chapman</span>  <span class="cit-name-given-names">AB</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Johnson</span>  <span class="cit-name-given-names">AM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Gabow</span>  <span class="cit-name-given-names">PA</span></span></li></ol><cite>. <span class="cit-article-title">Intracranial aneurysms in patients with autosomal dominant polycystic kidney disease: how to diagnose and who to screen</span>. <abbr class="cit-jnl-abbrev">Am J Kidney Dis</abbr> <span class="cit-pub-date">1993</span>;<span class="cit-vol">22</span>:<span class="cit-fpage">526</span>–<span class="cit-lpage">31</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/S0272-6386(12)80924-3</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>8213791</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/S0272-6386(12)80924-3&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=8213791&amp;link_type=MED&amp;atom=%2Fajnr%2F37%2F2%2F296.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.296.6" data-doi="10.1212/WNL.0000000000001891"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Etminan</span>  <span class="cit-name-given-names">N</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Brown</span>  <span class="cit-name-given-names">RD</span>  <span class="cit-name-suffix">Jr</span>.</span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Beseoglu</span>  <span class="cit-name-given-names">K</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus</span>. <abbr class="cit-jnl-abbrev">Neurology</abbr> <span class="cit-pub-date">2015</span>;<span class="cit-vol">85</span>:<span class="cit-fpage">881</span>–<span class="cit-lpage">89</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1212/WNL.0000000000001891</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>26276380</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1212/WNL.0000000000001891&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=26276380&amp;link_type=MED&amp;atom=%2Fajnr%2F37%2F2%2F296.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">7.</span><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7. in text" id="ref-7">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.296.7" data-doi="10.1016/S1474-4422(13)70263-1"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Greving</span>  <span class="cit-name-given-names">JP</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wermer</span>  <span class="cit-name-given-names">MJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Brown</span>  <span class="cit-name-given-names">RD</span>  <span class="cit-name-suffix">Jr</span>.</span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies</span>. <abbr class="cit-jnl-abbrev">Lancet Neurol</abbr> <span class="cit-pub-date">2014</span>;<span class="cit-vol">13</span>:<span class="cit-fpage">59</span>–<span class="cit-lpage">66</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/S1474-4422(13)70263-1</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>24290159</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/S1474-4422(13)70263-1&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=24290159&amp;link_type=MED&amp;atom=%2Fajnr%2F37%2F2%2F296.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2016 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 37</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2016 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.N.</span> <span class="nlm-surname">Rozenfeld</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">S.A.</span> <span class="nlm-surname">Ansari</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Mohan</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Shaibani</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">E.J.</span> <span class="nlm-surname">Russell</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.C.</span> <span class="nlm-surname">Hurley</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">296; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4657 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.N.</span> <span class="nlm-surname">Rozenfeld</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">S.A.</span> <span class="nlm-surname">Ansari</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Mohan</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Shaibani</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">E.J.</span> <span class="nlm-surname">Russell</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.C.</span> <span class="nlm-surname">Hurley</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">296; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4657 </span></div>
  
  
  
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