AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Jan 2004
Case ReportsManagement of patients with stunned myocardium associated with subarachnoid hemorrhage.
Cardiac complications are well known after aneurysmal subarachnoid hemorrhage. Electrocardiographic changes occur in 50% to 100% of such cases. Arrhythmias, left ventricular dysfunction, and frank myocardial infarction are infrequently observed. ⋯ Frequent symptomatic vasospasm occurs, possibly related to poor cardiac output and the inability to optimize hyperdynamic hypervolemic therapy, particularly with compromised volume status. These patients can be treated with endovascular therapy of the aneurysms and balloon angioplasty as needed. With aggressive management, patients can recover from these reversible cardiac complications.
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AJNR Am J Neuroradiol · Jan 2004
Comparative StudyA computer-generated stereotactic "Virtual Subdural Grid" to guide resective epilepsy surgery.
In selected patients undergoing epilepsy surgery, subdural electrode grids play an important role in localizing the epileptogenic zone and identifying eloquent cortex. Determining the relationship of the electrodes to underlying brain architecture traditionally has been difficult. This report describes and validates the use of an original computer-aided method that displays a representation of the electrode positions, based on postimplantation CT or MR findings, coregistered with a 3D-rendered image of the brain, on an image-guided surgery system. ⋯ The Virtual Grid electrode positions were highly accurate in localizing the actual position of the subdural electrodes with both CT- and MR-derived images. The MR-derived electrodes demonstrated a trend toward better accuracy, but the CT images were quicker and easier to process. This technology has the potential to minimize both human and technical errors, allowing for a more precise tailoring of the cortical resection in epilepsy surgery.