Neuroradiology
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Intracranial aneurysm rupture during embolization with detachable coils is reportedly among the gravest of intraprocedural complications. We present here our experiences with this outcome, and a potential intervention for managing this life-threatening complication. ⋯ Intraprocedural aneurysm rupture during embolization is a rare, but unavoidable and life-threatening event. Proper measures should be taken to reduce and improve the outcome of this tragic occurrence. The majority of patients with an intraprocedural ruptured aneurysm can survive without severe sequelae if managed appropriately.
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Controlled Clinical Trial
Diffusion-weighted MR imaging (DWI) in spinal cord ischemia.
Spinal cord infarction is a rare clinical diagnosis characterized by a sudden onset of paralysis, bowel and bladder dysfunction, and loss of pain and temperature perception, with preservation of proprioception and vibration sense. Magnetic resonance imaging (MRI) usually demonstrates intramedullary hyperintensity on T2-weighted MR images with cord enlargement. However, in approximately 45% of patients, MR shows no abnormality. Diffusion-weighted MR imaging (DWI) has been widely used for the evaluation of a variety of brain disorders, especially for acute stroke. Preliminary data suggest that DWI has the potential to be useful in the early detection of spinal infarction. ⋯ We analyzed the imaging findings from conventional MR sequences and diffusion-weighted MR sequences in six patients with spinal cord infarction, compared the findings with those in published series, and discuss the value of DWI in spinal cord ischemia based on current experience. Although the number of patients with described DWI findings totals only 23, the results of previously published studies and those of our study suggest that DWI has the potential to be a useful and feasible technique for the detection of spinal infarction.
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We analyzed the findings of diffusion-weighted (DW) imaging using the single-shot fast spin-echo sequence in acute cervical cord injury and evaluated the usefulness of this method for predicting the prognosis. ⋯ DW imaging in acute cervical cord injury often reveals restricted diffusion. This finding may predict an unfavorable functional prognosis.
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To evaluate the clinical role of CT angiography (CTA) in patients with acute subarachnoid hemorrhage (SAH) for treatment decision-making. ⋯ CTA using a 64-slice scanner is an accurate tool for detecting and characterizing aneurysms in acute SAH. CTA is useful in the decision process whether to coil or clip an aneurysm.
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Comparative Study
Comparison of cerebral blood volume and permeability in preoperative grading of intracranial glioma using CT perfusion imaging.
Regional cerebral blood volume (rCBV) and permeability surfaces (rPS) permit in vivo assessment of glioma microvasculature, which provides quite important pathophysiological information in grading gliomas. The aim of our study was to simultaneously examine rCBV and rPS in glioma patients to determine their correlation with histological grade using CT perfusion imaging. ⋯ Perfusion CT provides useful information for glioma grading and might have the potential to significantly impact clinical management and follow-up of cerebral gliomas.