AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Mar 2011
Hemodynamics of cerebral aneurysm initiation: the role of wall shear stress and spatial wall shear stress gradient.
Cerebral aneurysms are preferentially located at arterial curvatures and bifurcations that are exposed to major hemodynamic forces, increasingly implicated in the life cycle of aneurysms. By observing the natural history of aneurysm formation from its preaneurysm state, we aimed to examine the hemodynamic microenvironment related to aneurysm initiation at certain arterial segments later developing an aneurysm. ⋯ The results of this hemodynamic study, in accordance with the clinical follow-up, suggest that the combination of high WSS and high positive SWSSG focused on a small segment of the arterial wall may have a role in the initiation process of aneurysm formation.
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AJNR Am J Neuroradiol · Mar 2011
Single-center experience of surgical and endovascular treatment of ruptured intracranial aneurysms.
ISAT provided valuable data on patient outcome after endovascular coiling and surgical clipping of ruptured aneurysms. The purpose of this study was to retrospectively review the ≥1-year outcome (in terms of survival, independence, and rebleeding) of patients who were treated in a routine clinical setting. ⋯ The management of patients with intracranial aneurysms in a routine clinical setting shows good and comparable rates of mortality and independence. Coiling results in lower rates of complete aneurysm occlusion. Postcoiling angiography showing a residual aneurysm is a good predictor of the risk of rebleeding.
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AJNR Am J Neuroradiol · Mar 2011
CT-guided injection of the anterior and middle scalene muscles: technique and complications.
Anterior scalene block is a helpful diagnostic test for NTOS and a good predictor of surgical outcome. The purpose of this study was to describe the technique, success rate, and complications associated with CT-guided anesthetic and botulinum toxin injection of the ASM/MSM in patients with NTOS symptoms. ⋯ CT guidance is a useful adjunct in performing accurate ASM/MSM blocks with a low rate of minor complications.