AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · May 2009
Symptomatic nerve root changes on contrast-enhanced MR imaging after surgery for lumbar disk herniation.
The significance of postoperative nerve root changes (enhancement, thickening, and displacement) is still a topic of debate. The purpose of this study was to evaluate the association between nerve root changes and residual or recurrent symptoms after lumbar surgery with contrast-enhanced MR imaging. ⋯ In patients with residual or recurrent pain after surgery for lumbar disk herniation, nerve root changes on contrast-enhanced MR imaging were well associated with clinical symptoms, of which NRE was the most significant finding.
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AJNR Am J Neuroradiol · May 2009
Review Meta AnalysisEndovascular approaches to acute stroke, part 2: a comprehensive review of studies and trials.
Reperfusion remains the mainstay of acute ischemic stroke treatment. Endovascular therapy has become a promising alternative for patients who are ineligible for or have failed intravenous (IV) thrombolysis. The conviction that recanalization of properly selected patients is essential for the achievement of good clinical outcomes has led to the rapid and widespread growth in the adoption of endovascular stroke therapies. ⋯ However, such analyses disregard important differences in clot location and burden, baseline stroke severity, time from stroke onset to treatment, and patient selection in these studies. Many clinical trials are testing novel devices and drugs as well as the paradigm of physiology-based stroke imaging as a treatment-selection tool. The objective of this article is to provide a comprehensive review of the relevant past, current, and upcoming data on endovascular stroke therapy with a special focus on the prospective studies and randomized clinical trials.
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AJNR Am J Neuroradiol · May 2009
Alterations in cortical thickness and white matter integrity in mild cognitive impairment measured by whole-brain cortical thickness mapping and diffusion tensor imaging.
Mild cognitive impairment (MCI) is a risk factor for Alzheimer disease and can be difficult to diagnose because of the subtlety of symptoms. This study attempted to examine gray matter (GM) and white matter (WM) changes with cortical thickness analysis and diffusion tensor imaging (DTI) in patients with MCI and demographically matched comparison subjects to test these measurements as possible imaging markers for diagnosis. ⋯ DTI and cortical thickness analyses may both serve as imaging markers to differentiate MCI from normal aging. Combined use of these 2 methods may improve the accuracy of MCI diagnosis.
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AJNR Am J Neuroradiol · May 2009
ReviewTheoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 2: technical implementations.
CT perfusion (CTP) is a functional imaging technique that provides important information about capillary-level hemodynamics of the brain parenchyma and is a natural complement to the strengths of unenhanced CT and CT angiography in the evaluation of acute stroke, vasospasm, and other neurovascular disorders. CTP is critical in determining the extent of irreversibly infarcted brain tissue (infarct "core") and the severely ischemic but potentially salvageable tissue ("penumbra"). This is achieved by generating parametric maps of cerebral blood flow, cerebral blood volume, and mean transit time.
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AJNR Am J Neuroradiol · May 2009
Clinical TrialClinical and angiographic follow-up of ruptured intracranial aneurysms treated with endovascular embolization.
Endovascular embolization is a well-established treatment of ruptured intracranial aneurysms, but concern about its long-term stability and its ability to prevent rehemorrhage are still present. We evaluated the long-term clinical and angiographic follow-up of patients with ruptured cerebral aneurysms treated with coiling, focusing on rehemorrhage and changes in aneurysm morphologic features. ⋯ Long-term clinical and angiographic follow-up demonstrates the efficacy of endovascular treatment of ruptured intracranial aneurysms. Rebleeding after treatment is rare, with the greatest risk during the first 48 hours after treatment. Initial angiographic results are not a useful predictor of clinical outcome or rehemorrhage.