RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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Approximately 6 - 50% of all ischemic strokes are caused by intracranial arterial stenosis (IAS). Despite medical prevention, patients with symptomatic IAS have a high annual risk for recurrent ischemic stroke of about 12%, and up to 19% in the case of high-grade IAS (≥ 70%). Digital subtraction angiography remains the gold standard for the diagnosis and grading of IAS. ⋯ The rate of re-stenosis is reported between 10 and 40% depending on patient age and stenosis location. Further randomized studies comparing medical secondary prevention and endovascular therapy are currently being performed. With regard to the improvement of endovascular methods and lower complication rates, the indication for endovascular therapy in IAS could be broadened especially for stenosis in the posterior circulation.
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Radial nerve compression caused by crossing branches of the recurrent radial artery - so called hypertrophic "leash(es) of Henry" (LoH) - is rare. Nevertheless it is important to diagnose the type of compression neuropathy in the forearm. ⋯ In summary, both presented patients showed a unique topographic concordance of a textural change of the deep radial nerve (i. e., swelling and inner hypoechoic fascicular change) and the causative hypertrophic crossing artery. The use of power Doppler ultrasound in addition to caliber and texture changes shown on grayscale ultrasound and the functional visualization of pulsating vessels should be included in every sonographic examination of patients with chronic forearm pain symptoms.