How a Scoville aneurysm clip fought in the Cold War and helped to establish neurosurgery in Iceland

It can be said that the specialty of neurosurgery in Iceland had its beginnings on November 30, 1971, with the arrival of a huge American C-130 Hercules aircraft. It was carrying a small package containing Scoville aneurysm clips. They were sent to the late Bjarni Hannesson (1938-2013), who had received his neurosurgical training in 1967-1971 at the Dartmouth-Hitchcock Medical Center (then known as Mary Hitchcock Memorial Hospital and located in Hanover, New Hampshire). He used one to clip the right posterior communicating artery aneurysm of a 34-year-old fisherman, who recovered well. The apparent reason for the use of such a huge aircraft for such a small payload is to be found in the sociocultural politics of the Cold War. It involved the continued presence of the American base at Keflavík, where the C-130 landed. The base was under pressure to be closed by Iceland's left-leaning, nominally communist government. The C-130's arrival generated welcome publicity for the continued operation of the American base, which is still there.

[Clinical Usefulness of Ultra-short TE MRA for Follow-up Imaging after Cerebral Aneurysm Clipping]

The aims of this study were to elucidate signal pattern of cerebral aneurysm clip in brain magnetic resonance angiography (MRA) using non-contrast enhanced ultra-short echo time (UTE) sequence and to explore effective utilization of this novel technique for patients, who underwent cerebral aneurysm clipping. The clip was embedded in homemade phantom and scanned using UTE sequence. We investigated characteristic features of the artifacts derived from the clip. Besides, we compared the volume of signal loss between conventional time-of-flight (TOF) and UTE-MRA in 50 patients with the cerebral aneurysm clip. In phantom study, the clip was delineated as signal void area fully surrounded by high signal on original images. On reconstructed short-axial views for the clip, four-leaf clover pattern of artifact was observed when clip was arranged orthogonal to the static magnetic field. On the other hand, this artifact disappeared when the clip was arranged in parallel with the static magnetic field. The volume of signal loss in clinical cases was significantly reduced in UTE-MRA (P < 0.05): 1.30, 0.52-2.77 cm³ for TOF; 0.84, 0.28-1.74 cm³ for UTE (median, range). The scan time for UTE-MRA was 2 minutes and 52 seconds. To understand the characteristic feature of the artifacts from the clip could contribute to define vascular structure in image interpretation. Adding UTE-MRA to routine protocol is useful approach for follow-up imaging after cerebral aneurysm clipping with clinically acceptable prolongation of the scan time.