Expert second opinion for vascular conditions of the head, neck, and spine
Radiology Prime provides independent specialist neuroradiology second opinions on MRI and CT imaging of the brain, neck, and spine — including CTA and MRA sequences — covering stroke, aneurysms, AVMs, venous thrombosis, and carotid disease.
Reports are personally prepared within 24 hours by our Clinical Lead, a European-registered consultant neuroradiologist, applying ASPECTS and Spetzler-Martin scoring where relevant for your treating team.
Why vascular imaging benefits from sub-specialty review
Vascular findings in the brain, neck, and spine often come down to specific numbers — the size of an aneurysm, the percentage of a narrowed carotid artery, the extent of early stroke changes on a scan. Treating teams use these measurements and scores when weighing surveillance against medication or treatment, and a structured, scored review provides them in a format the team can work from directly.
When an independent review helps
Patients often seek a second opinion at specific moments — after a stroke or TIA when the extent of injury and the state of the vessels matter for prevention planning, when an aneurysm has been found unexpectedly and surveillance-versus-treatment is being weighed, when an AVM or similar finding needs a graded read for the neurosurgical conversation, or when carotid disease or venous thrombosis is being followed over time.
The report is written for direct use by the stroke physician, neurologist, neurosurgeon, or vascular team.
How it works
Get your expert second opinion radiology report in 3 simple steps
Upload your medical scans
Send us your scan images and specific questions, we’ll take care of the rest.
Expert radiologist review
Certified radiologists provide a detailed, easy-to-understand report with your diagnosis and treatment suggestions.
Get results within 24 hours
Receive your report quickly. Talk or message your radiologist directly to discuss your results.
Why get an independent vascular second opinion?
Independent perspective
Vascular imaging is dense with measurements and scoring that feed into the treating team’s discussion of surveillance, medication, and treatment. An independent sub-specialty review gives you a second, structured read — with framework scoring and explicit measurements — framed for your treating team.
Sub-specialty expertise
Cerebrovascular, cervicovascular, and spinal vascular conditions are a core part of our Clinical Lead’s neuroradiology practice. Reports apply the standard scoring systems used in modern stroke and neurovascular practice — including ASPECTS for stroke imaging and Spetzler-Martin for AVM characterisation — alongside structured aneurysm morphology assessment and pattern-based discussion.
Structured measurements for intervention discussions
Where a neurosurgical, interventional, or vascular consultation is being planned, measurements matter. Aneurysm size, dome-to-neck ratio, AVM nidus size and venous drainage, carotid stenosis percentage, infarct volume — these are the numbers the treating team works from when the conversation moves to intervention or surveillance. Our Clinical Lead states them explicitly, so the treating team has the specific figures rather than a narrative description.
Common challenges in vascular imaging
An independent review by our Clinical Lead provides explicit scoring, stated measurements, and structured pattern-based discussion of vascular imaging findings. Each of the common interpretive challenges below is handled through that same structured approach.
Reading stroke imaging for extent and eligibility questions
The challenge: After a stroke or TIA (transient ischaemic attack — a short episode of stroke-like symptoms that resolves), the imaging does two jobs. It characterises what’s already happened — the location and size of any infarct — and it helps the treating team plan what comes next, including stroke prevention and in some cases further intervention. The extent of early ischaemic change matters clinically and is scored explicitly on a framework called ASPECTS.
The reality: ASPECTS is a 10-point score for early ischaemic change on brain CT or MRI, assessed across ten defined regions. A higher score means less ischaemic change; a lower score reflects more extensive early injury. Beyond ASPECTS, the vessel status — whether a large vessel is blocked, whether collateral circulation is good, whether there is a bleed — shapes the onward pathway substantially.
What our review adds: Explicit ASPECTS scoring where relevant, structured review of vessel status on the CTA or MRA sequences included in the study, and a discussion of findings framed for the stroke physician or neurologist overseeing the case.
Characterising an incidentally found aneurysm
The challenge: Brain aneurysms (small outpouchings on the wall of an artery) are found incidentally on a meaningful proportion of brain MRIs and CT studies done for unrelated reasons — headaches, dizziness, unrelated workup. Most small incidental aneurysms are low-risk, but characterisation matters because size, location, and morphology all feed into the discussion of surveillance versus treatment.
The reality: The clinically relevant measurements — maximum dimension, neck width, dome-to-neck ratio, relationship to parent vessel and branches — are the specific inputs a vascular neurosurgeon or interventional neuroradiologist needs for the surveillance-versus-treatment discussion.
What our review adds: Measurements in millimetres, structured morphology description, location within the standard anatomical classification, and a discussion framed for the vascular consultation.
Grading an AVM or dural fistula
The challenge: Arteriovenous malformations (AVMs — abnormal direct connections between arteries and veins that bypass the normal capillary bed) and dural arteriovenous fistulas can cause bleeding, seizures, or progressive neurological symptoms. Treatment discussions depend on a structured grading of the lesion’s architecture.
The reality: The Spetzler-Martin grading system scores AVMs on three features — the size of the abnormal vascular bed (nidus), whether it sits in eloquent brain (brain areas with critical function), and the pattern of venous drainage. The score feeds into the risk-benefit discussion around surgery, radiosurgery, and embolisation. For dural fistulas, different classification systems (Borden, Cognard) capture the venous drainage pattern relevant to clinical risk.
What our review adds: Structured Spetzler-Martin grading of AVMs where relevant, Borden or Cognard classification of dural fistulas where relevant, with explicit measurements and discussion framed for neurosurgical and interventional review.
Assessing carotid and cervical vessel disease
The challenge: Narrowing of the carotid arteries in the neck (carotid stenosis) is a common cause of stroke, and discussions about surveillance, medication, and surgery depend on the measurement of how much the artery is narrowed. Related findings — vertebral artery disease, dissection (a tear in the vessel wall), and fibromuscular change — all have their own imaging patterns.
The reality: Carotid stenosis is measured using standard criteria (typically NASCET) and classified into ranges that correspond to specific treatment thresholds. Beyond simple percentage stenosis, plaque features — ulceration, haemorrhage within the plaque, surface irregularity — can add clinically relevant information. Dissection has its own recognisable imaging pattern, which is important to identify correctly because it changes management.
What our review adds: Structured percentage stenosis measurement using standard criteria, plaque characterisation, assessment for dissection and other cervical vascular pathology, and a discussion framed for the vascular or stroke team.
Following venous sinus thrombosis over time
The challenge: Cerebral venous sinus thrombosis (a blood clot in the large veins that drain the brain) is uncommon but clinically important, and imaging is used both to identify it and to monitor recanalisation (the gradual reopening of the vessel) over time on anticoagulation.
The reality: Characterising the extent of thrombus, the specific sinuses involved, any associated parenchymal change, and the degree of recanalisation on follow-up all benefit from structured comparison against earlier imaging where available.
What our review adds: Structured review of the venous system with explicit documentation of which sinuses are involved, assessment of any associated brain change, and — where earlier imaging is available — a side-by-side comparison of recanalisation, framed for the neurology or haematology team.
View a Sample Neuroradiology Report
Transparency is key to trust. View a redacted sample of an second opinion report. In this case, the MRI findings were interpreted as more consistent with a non-demyelinating process rather than active multiple sclerosis.
Conditions reviewed by our Clinical Lead
Patients often seek a second opinion for these specific situations:
Stroke and TIA imaging
Acute and subacute stroke imaging: ASPECTS scoring where relevant, infarct localisation, and vessel status review on the CTA or MRA sequences included in the study.
Post-stroke follow-up: Assessment of established infarct, review for any new ischaemic change, and structured comparison with earlier imaging.
TIA workup: Review for subtle ischaemic change and assessment of the relevant vessels on the CTA or MRA sequences included in the study.
Unexplained stroke in younger patients: Focused review for uncommon causes, including dissection, small-vessel vasculopathy, and venous contributions.
Aneurysms and subarachnoid haemorrhage
Incidentally found aneurysms: Structured measurement, morphology description, and location-based characterisation for the surveillance-versus-treatment discussion.
Post-treatment aneurysm follow-up: Assessment after coiling, clipping, or flow diversion, with structured comparison against earlier imaging.
Workup after subarachnoid haemorrhage: Review of the bleed pattern and any CTA or MRA sequences included in the study to assess the source, including multiple-aneurysm scenarios.
Surveillance of treated or untreated aneurysms: Structured serial comparison to track change over time.
AVMs, fistulas, and vascular malformations
Brain AVMs: Spetzler-Martin grading with structured description of nidus, feeders, and venous drainage.
Dural arteriovenous fistulas: Borden or Cognard classification and assessment of venous drainage patterns.
Cavernous malformations (cavernomas): Review of lesion number, location, and any associated developmental venous anomaly.
Spinal vascular malformations: Review of spinal AVMs, dural fistulas, and related lesions.
Carotid disease, dissection, and venous thrombosis
Carotid stenosis assessment: Structured percentage stenosis measurement using standard criteria, plaque characterisation, and discussion framed for the vascular consultation.
Vertebral artery disease: Assessment of stenosis, dissection, and occlusive change.
Cervical artery dissection: Pattern-based review of tear characteristics, intramural haematoma, and associated brain imaging.
Cerebral venous sinus thrombosis: Structured review of the venous system, documentation of affected sinuses, and serial comparison where follow-up imaging is available.
Frequently asked questions
A second opinion may provide a different view of your MRI or CT scan. Imaging studies are complex and can be interpreted in more than one way, especially when considered alongside your symptoms and medical history. In some cases, another review may point out subtle findings that are worth discussing further with your treating doctor before making decisions about treatment.
Yes, discussing the report with your treating physician is encouraged .
The review is provided independently but it is prepared in accordance with established European radiology standards. The analysis is structured to support your doctor’s clinical assessment and ongoing treatment planning.
No. In most regions, patients may independently request a radiology second opinion.
Our service provides an independent subspecialty radiology review of your existing MRI or CT imaging. This evaluation is designed to support and not replace your treating physician’s clinical assessment.
We encourage discussing your second-opinion report with your doctor to determine the most appropriate next steps.
Second opinions are typically delivered within 24 hours, and many cases are completed sooner. Our radiology team prioritizes timely reviews to help you receive additional diagnostic insight as efficiently as possible.
Not at all. You have every right to be proactive. You can upload your MRI or CT scans directly to our encrypted portal. Once our Senior European radiologists finish their review, you’ll have a definitive document to bring to your next appointment.
Follow-up questions are welcome after your report is delivered. If clarification is needed, you may submit questions to the radiologist who performed your review. This process is designed to help address outstanding points and support discussion with your treating physician.
You receive a detailed review of your MRI or CT scan prepared by experienced European radiologists. Beyond listing findings, the report explains how the imaging observations relate to the clinical information you provide. Each report follows established radiology standards and includes a clear summary to support discussion with your treating physician.
We provide a comprehensive clinical report written for your treating physicians, along with a clear plain-language summary. This approach is designed to help you better understand the reasoning behind the imaging findings while supporting discussion with your doctor.