AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Jan 2003
Case ReportsCombined endovascular treatment for both intracranial aneurysm and symptomatic vasospasm.
The best strategy for treatment of subarachnoid hemorrhage due to ruptured cerebral aneurysm is obliteration of the aneurysm as soon as possible. Early surgery is desirable if the patient does not develop severe vasospasm or is clinically stable. However, if the patient has already developed severe vasospasm on admission, surgery may carry the risk of increasing the severity. We evaluated the safety and effectiveness of combined Guglielmi detachable coil (GDC) embolization and angioplasty in a single session for the treatment of ruptured aneurysms associated with symptomatic vasospasm. ⋯ Endovascular treatment can be the first therapeutic option for ruptured aneurysms associated with severe vasospasm on admission. It offers some advantages over surgery in this setting, but these are balanced by the risk of thromboembolism.
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AJNR Am J Neuroradiol · Jan 2003
Case ReportsContrast-enhanced MR imaging of cerebral fat embolism: case report and review of the literature.
We report a case of cerebral fat embolism (CFE) that was imaged with T2- and T2*-weighted, fluid-attenuated inversion recovery, and contrast-enhanced T1-weighted images. Multiple white matter lesions demonstrated contrast enhancement, with little evidence of hemorrhage. ⋯ CFE can cause capillary inflammation and breakdown of the blood-brain barrier, without associated hemorrhage or permanent neurologic deficit. In this case, both contrast-enhanced T1-weighted and gradient-echo T2*-weighted images were important in diagnosing CFE and in determining the severity of the patient's condition.