AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Jun 2004
Intra-arterial nimodipine for the treatment of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage: preliminary results.
Cerebral vasospasm remains a major problem in patients recovering from aneurysmal subarachnoid hemorrhage despite advances in medical, surgical, and endovascular care. Our purpose was to assess the efficacy of intra-arterial nimodipine, a calcium-channel blocker acting mainly on cerebral vessels, in preventing delayed neurologic deficits in patients with symptomatic vasospasm. ⋯ Intra-arterial nimodipine is effective and safe for the treatment of symptomatic vasospasm after subarachnoid hemorrhage. Further prospective randomized studies of cerebral blood flow are needed to confirm these results.
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AJNR Am J Neuroradiol · Jun 2004
Case ReportsUnilateral putaminal CT, MR, and diffusion abnormalities secondary to nonketotic hyperglycemia in the setting of acute neurologic symptoms mimicking stroke.
A 75-year-old Asian man presented with two episodes of chorea associated with nonketotic hyperglycemia. His chorea rapidly resolved after restitution of a normal serum glucose level, although an MR image obtained at the time of acute symptoms demonstrated high signal intensity on T1-weighted images, low signal intensity on T2-weighted images, and restricted diffusion, all involving the left putamen. A CT scan obtained 1 month later demonstrated faint hyperattenuation of the involved putamen. The reported pathophysiologic considerations for these imaging features are reviewed, and an original explanation is proposed.
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AJNR Am J Neuroradiol · Jun 2004
Reversible MR changes in the cat brain after cerebral fat embolism induced by triolein emulsion.
Clinical cerebral-fat embolism shows both reversible and irreversible changes. We used MR imaging to investigate the reversibility of embolized lesions induced with a fat-emulsion technique and to evaluate the histologic findings. ⋯ Cerebral-fat embolism induced by a triolein emulsion revealed reversible MR findings and minimal histologic findings.
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AJNR Am J Neuroradiol · Jun 2004
Distal-tip shape-consistency testing of steam-shaped microcatheters suitable for cerebral aneurysm coil placement.
Although the selection of microcatheter for endovascular aneurysmal treatment is one important factor in patient outcome, the use of steam shaping for achieving safe entry and stability during coil placement has not, to our knowledge, been systematically evaluated. The goal of this study was to compare the durability of distal microcatheter steam shaping in five different catheters with typical intraprocedural stresses that are similar to those encountered during aneurysm coil placement. ⋯ Our study shows that, although braided microcatheters are suitable for maintaining durable configurations when long distal-tip lengths are permissible, nonbraided microcatheters demonstrate the most durable distal-tip configurations when short distal-tip lengths are called for. This may be one of significant factors in catheter choice for endovascular treatment of aneurysm.
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AJNR Am J Neuroradiol · Jun 2004
Case ReportsEndovascular treatment of a ruptured giant serpentine aneurysm of the superior cerebellar artery in a patient with a Chiari II malformation.
We present a case of a ruptured giant serpentine aneurysm (GSA) of the superior cerebellar artery in a patient with a Chiari II malformation. The fusiform aneurysm was successfully treated with endovascular parent artery occlusion of the GSA by using detachable coils.