Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Dec 1994
Comparative Study Clinical Trial Controlled Clinical TrialComparison of magnetic resonance angiography, duplex ultrasound, and digital subtraction angiography in assessment of extracranial internal carotid artery stenosis.
The results of a prospective study comparing ultrasound, intra-arterial digital subtraction angiography, and magnetic resonance angiography in the assessment of the degree of extracranial internal carotid artery stenosis are reported in patients with symptoms of recent carotid territory ischaemia. A total of 70 patients and 137 vessels were examined by all three techniques. The results obtained by each technique were reported blind. ⋯ Increased sensitivity and specificity were obtained when analysis was confined to those vessels in which ultrasound and magnetic resonance angiography were in agreement over classification. It is thus possible to accurately categorize the degree of stenosis of the extracranial internal carotid artery from a combination of ultrasound and magnetic resonance angiography. The adoption of this combination for the investigation of patients before carotid endarterectomy removes the risk associated with conventional angiography and represents an important advance in the management of carotid stenosis.
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J. Neurol. Neurosurg. Psychiatr. · Dec 1994
Chronic idiopathic axonal polyneuropathy: a five year follow up.
Seventy five patients with chronic idiopathic axonal polyneuropathy (CIAP) were studied for five years. The standardised and quantified neurological examination shows that progression of CIAP is slow, and handicap, if present, is not severe. ⋯ At the end of the follow up CIAP was not related to malignancy or gammopathy. Routine repetition of laboratory tests was not informative and these tests should be performed on clinical grounds only.
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J. Neurol. Neurosurg. Psychiatr. · Nov 1994
Case ReportsSpontaneous thrombosis of an arteriovenous malformation.
A patient with a spontaneously thrombosed arteriovenous malformation (AVM) presented with epilepsy. The CT and MRI appearances were of an intrinsic cerebral neoplasm with extensive surrounding vasogenic cerebral oedema and a mass effect. Histopathology confirmed a large thrombosed AVM. The natural history of AVMs and spontaneous thrombosis are reviewed.
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J. Neurol. Neurosurg. Psychiatr. · Nov 1994
Optic nerve sheath decompression for the treatment of visual failure in chronic raised intracranial pressure.
The records of all patients undergoing optic nerve sheath decompression for visual failure in chronic raised intracranial pressure performed over a 15 year period have been reviewed. The aim was to study the visual outcome and relation to any shunting procedures. Fourteen patients (20 eyes) were identified in whom follow up information of at least one year was available. ⋯ It is concluded that optic nerve sheath decompression is a safe and important therapeutic option in the management of chronic raised intracranial pressure complicated by visual loss. Vision can be saved after shunt failure, and in other cases may be maintained without the need for a shunt. Shunts may still be required, however, after optic nerve sheath decompression, especially for persistent headache.