AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Nov 2005
Comparative StudyIncidence of vertebral artery thrombosis in cervical spine trauma: correlation with severity of spinal cord injury.
The incidence of blunt traumatic vertebral artery dissection/thrombosis varies widely in published trauma series and is associated with spinal trauma. The purpose of this study was to determine the frequency of traumatic vertebral artery thrombosis (VAT) in cervically injured patients by using routine MR angiography (MRA) and MR imaging and identify associations with the severity of neurologic injury. ⋯ The absence of neurologic symptoms in a patient with cervical spine fracture does not preclude VAT. VAT associated with cervical spinal injury occurs with similar frequency in both neurologically intact (ASIA E) and motor-incomplete patients (ASIA C and D) but is significantly more common in motor-complete SCI (ASIA A and B).
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AJNR Am J Neuroradiol · Nov 2005
Clinical TrialIntravenous glycoprotein IIb/IIIa inhibitor (tirofiban) followed by intra-arterial urokinase and mechanical thrombolysis in stroke.
The purpose of this study was to evaluate preliminarily the efficacy and safety of intravenous tirofiban combined with intra-arterial pharmacologic and mechanical thrombolysis in patients with stroke. ⋯ The combination of intravenous tirofiban with intra-arterial urokinase and mechanical thrombolysis may be successful in reestablishing vessel patency and result in a good functional outcome in patients with major cerebral arteries occlusions.
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AJNR Am J Neuroradiol · Nov 2005
Endovascular recanalization of internal carotid artery occlusion in acute ischemic stroke.
Endovascular therapy (ET) of internal carotid artery (ICA) stenosis is equivalent to carotid endarterectomy for stroke prevention; however, patients with ICA occlusion and acute symptoms are traditionally not candidates for ET. We report our experience in endovascular recanalization of acute stroke patients with ICA occlusion. ⋯ Endovascular therapy of carotid occlusion in hyperacute stroke patients is feasible and may help to reduce stroke volume and increase good outcome in some patients.
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AJNR Am J Neuroradiol · Nov 2005
Comparative StudyStructural, immunocytochemical, and mr imaging properties of periventricular crossroads of growing cortical pathways in preterm infants.
Periventricular white matter (WM) areas are widely recognized as predilection sites for complex cellular damage after ischemia/reperfusion or inflammatory injury of the perinatal cerebrum. We analyzed histochemical and MR imaging properties of fiber architectonics and extracellular matrix (ECM) of periventricular areas to disclose the potential significance of topographically specific WM lesions for the neurodevelopmental outcome. ⋯ The correlation of MR imaging with histochemical findings demonstrated the presence of periventricular fiber crossroads rich in ECM and axonal guidance molecules. We propose that, in perinatal WM lesions, periventricular WM crossroads represent a hitherto unrecognized and vulnerable cellular and topographic target in which combined damage of association-commissural and projection fibers may explain the complexity of cognitive, sensory, and motor deficit in survivors of periventricular WM lesions.
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AJNR Am J Neuroradiol · Nov 2005
Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models.
Hemodynamic factors are thought to play an important role in the initiation, growth, and rupture of cerebral aneurysms. This report describes a pilot clinical study of the association between intra-aneurysmal hemodynamic characteristics from computational fluid dynamic models and the rupture of cerebral aneurysms. ⋯ Image-based patient-specific numeric models can be constructed in an efficient manner that allows clinical studies of intra-aneurysmal hemodynamics. A simple flow characterization system was proposed, and interesting trends in the association between hemodynamic features and aneurysmal rupture were found. Simple stable patterns, large impingement regions, and jet sizes were more commonly seen with unruptured aneurysms. By contrast, ruptured aneurysms were more likely to have disturbed flow patterns, small impingement regions, and narrow jets.