AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Apr 2004
Comparative StudyFluid-attenuated inversion recovery MR imaging and subarachnoid hemorrhage: not a panacea.
Subarachnoid hemorrhage (SAH) constitutes an important neurologic emergency. Some authors have suggested that fluid-attenuated inversion recovery (FLAIR) MR imaging can detect SAH that may not be apparent on CT scans but may be revealed by lumbar puncture. We sought to determine how often FLAIR MR imaging findings are positive for SAH in cases with negative CT findings and positive lumbar puncture results. ⋯ FLAIR MR imaging cannot replace lumbar puncture to detect the presence of SAH. FLAIR MR imaging findings are infrequently positive (16.7%) when CT findings are negative for SAH. This is likely because there is a minimum concentration of RBC/cc that must be exceeded for CSF to become hyperintense on FLAIR MR images.
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AJNR Am J Neuroradiol · Apr 2004
Endovascular management of poor-grade aneurysmal subarachnoid hemorrhage in the geriatric population.
The incidence of poor-grade (Hunt and Hess grade IV and V) subarachnoid hemorrhage (SAH) is higher in elderly patients (>70 years) than in younger groups. The aim of this retrospective study was to analyze the outcome of these poor grade elderly patients after endovascular treatment. ⋯ Endovascular treatment has modified the management of poor-grade SAH in elderly patients, most of whom are high-risk surgical candidates. Endovascular treatment can be administered early after the initial ictus, reducing the risk of rebleeding and providing an option to pursue aggressive triple-H therapy. Symptomatic vasospasm can also be treated by endovascular means in the initial setting.
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AJNR Am J Neuroradiol · Apr 2004
Case ReportsThoracic intradural Aspergillus abscess formation following epidural steroid injection.
We report an extremely unusual iatrogenic infection of the spinal canal with Aspergillus fumigatus that resulted in intradural abscess formation following epidural steroid injection in an immunocompetent young individual. Although the imaging findings of the infection were relatively nonspecific, MR imaging not only allowed for a prompt diagnosis, but also helped in surgical localization to the intradural compartment. Complications from the use of these injections are briefly discussed.
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AJNR Am J Neuroradiol · Apr 2004
MR imaging and proton MR spectroscopic studies in Sjögren-Larsson syndrome: characterization of the leukoencephalopathy.
Sjögren-Larsson syndrome (SLS) is a neurocutaneous syndrome caused by a genetic enzyme deficiency in lipid metabolism. Our purpose was to characterize the nature of the cerebral involvement in SLS. ⋯ Abnormalities on MR imaging and proton MR spectroscopy emerge during the first years of life and are similar in all patients with SLS, but the severity varies. The changes are confined to cerebral white matter and suggest an accumulation of lipids, periventricular gliosis, delayed myelination, and a mild permanent myelin deficit.
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AJNR Am J Neuroradiol · Apr 2004
Whole-brain apparent diffusion coefficient in traumatic brain injury: correlation with Glasgow Coma Scale score.
Patients with traumatic brain injury (TBI) and low Glasgow coma scale (GCS) scores may have severe injury associated with cellular disruption that can be studied with whole-brain apparent diffusion coefficient (ADC) histograms. We retrospectively studied this hypothesis and correlated ADC with GCS. ⋯ Whole-brain peak ADCs and GCS scores are significantly correlated in patients with TBI. Although conventional MR images were normal, ADC independently indicated TBI and better represents the degree of neurologic dysfunction.