AJNR. American journal of neuroradiology
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Restricted water diffusion has been used to distinguish pyogenic abscess from other rim-enhancing brain masses; however diffusion-weighted imaging of cerebral infection before capsule formation has rarely been described. We report a case of fungal cerebritis in which water diffusion was more restricted than that of normal contralateral brain and the measured diffusion coefficient was in the range of that reported for pyogenic brain abscess. In the proper clinical setting, cerebritis should be considered in the differential diagnosis of an ill-defined focal brain mass associated with markedly restricted water diffusion.
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AJNR Am J Neuroradiol · Jun 2003
Comparative StudyRadiation dose to the operator during vertebroplasty: prospective comparison of the use of 1-cc syringes versus an injection device.
Percutaneous vertebroplasty procedures require relatively long durations of fluoroscopic guidance, which might lead to substantial radiation dose to operators. Specialized injection devices have been proposed to limit operator exposure. Our purpose was to compare the radiation dose to the operator's hands during vertebroplasty when using 1-cc syringes versus that when using an injection device. ⋯ The use of an injection device significantly decreased the radiation dose to the operator's extremity per unit time of injection. However, total dose per injection was equivalent between groups because of significantly longer injection duration for the injection device cohort.
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AJNR Am J Neuroradiol · Jun 2003
Symptomatic cavernous sinus aneurysms: management and outcome after carotid occlusion and selective cerebral revascularization.
Therapeutic internal carotid artery (ICA) occlusion for symptomatic intracavernous artery aneurysms can result in ischemic infarction despite normal clinical balloon test occlusion (BTO). We evaluated outcomes in patients with symptomatic cavernous sinus aneurysms in whom clinical BTO was normal, who underwent carotid occlusion with selective bypass surgery guided by physiologic BTO using quantitative cerebral blood flow (CBF) analysis by means of stable xenon-enhanced CT. ⋯ In this series, BTO combined with quantitative CBF analysis was a safe and reliable technique for identification of patients at risk for ischemic infarction after carotid occlusion, despite a normal clinical BTO.
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Whether human rabies of different forms, encephalitic (furious) and paralytic (dumb), share similar MR imaging patterns is unknown. We assessed the diagnostic value of MR imaging in both forms of the disease and compared the clinical and neuroimaging findings. ⋯ Both forms of human rabies share a similar MR imaging pattern. Such pattern and the lack of enhancement in a noncomatose patient with suspected encephalitis may differentiate rabies from other viral encephalitides.
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AJNR Am J Neuroradiol · Jun 2003
Case ReportsTreatment of wide-necked intracranial aneurysms with a self-expanding stent system: initial clinical experience.
Currently available stents for intracranial use usually are balloon-expandable coronary stents that carry the risk of damaging a dysplastic segment of the artery, with potential vessel rupture. We assessed the technical feasibility and efficacy of the combined application of a flexible, self-expanding neurovascular stent and detachable coils in the management of wide-necked intracranial aneurysms in humans. ⋯ Preliminary data demonstrate that this extremely flexible stent is technically easy to deploy and can be easily and safely maneuvered through severely tortuous vessels, enabling the treatment of intracranial wide-necked aneurysms. The combination of endovascular reconstruction of the parent vessel with use of a self-expanding stent followed by coil embolization offers a promising therapeutic alternative for wide-necked aneurysms not amenable to coil embolization alone. Although immediate angiographic results are promising, long-term angiographic and clinical follow-up is essential to determine permanent vessel patency and aneurysm occlusion rate.