AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · May 2011
A new simplified sonographic approach for pararadicular injections in the lumbar spine: a CT-controlled cadaver study.
Injection therapies play a major role in the treatment of lower back pain and are to date performed mainly under CT or fluoroscopic guidance. The benefits of US-guided instillation procedures have been shown in many studies. We conducted this study to simplify an US-guided approach to the lumbar spinal nerves and to assess the feasibility and preliminary accuracy by means of CT and anatomic dissection. ⋯ This modified US approach for therapeutic root injections in the lumbar spine by using the intertransverse ligament as a new anatomic landmark allows an easy and correct needle placement within the pararadicular compartment.
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AJNR Am J Neuroradiol · May 2011
ReviewEndovascular treatment of spinal arteriovenous lesions: beyond the dural fistula.
During the past few decades, there have been significant advances in the understanding of spinal vascular lesions, mainly because of the evolution of imaging technology and selective spinal angiography techniques. In this article, we discuss the classification, pathophysiology, and clinical manifestations of spinal vascular lesions other than DAVFs and provide a review of the endovascular approach to treat these lesions.
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AJNR Am J Neuroradiol · May 2011
Multimodal imaging does not delay intravenous thrombolytic therapy in acute stroke.
Patients with acute ischemic stroke require immediate medical treatment, and a CT to rule out hemorrhage is required before tPA. We adapted our protocol to include multimodal CT: unenhanced CT, CTA, and PCT. The purpose of this study was to determine whether multimodal CT imaging delays initiation of IV tPA beyond 60 minutes from hospital arrival. ⋯ In our single-center experience, the use of multimodal imaging in patients with acute stroke did not delay IV tPA beyond 60 minutes. Further study is needed to assess the feasibility of the routine use of multimodal imaging in the acute stroke setting.
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AJNR Am J Neuroradiol · May 2011
Case ReportsAn unusual cause of multiple cerebral hemorrhages: drotrecogin alpha (activated protein C).
The mortality of severe sepsis is still high, despite improved treatment modalities. It is known that treatment with DAA reduces mortality in this condition; however, major bleeding may occur as a complication. ⋯ Patients with septic shock who undergo DAA infusion should be followed closely for possible intracranial bleeding. When intracranial hemorrhage is detected in patients in the intensive care unit, treatment with DAA infusion should be questioned.
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AJNR Am J Neuroradiol · May 2011
Quantitative assessment of brain stem and cerebellar atrophy in spinocerebellar ataxia types 3 and 6: impact on clinical status.
Cerebellar and brain stem atrophy are important features in SCA3, whereas SCA6 has been regarded as a "pure" cerebellar disease. However, recent neuropathologic studies have described additional brain stem involvement in SCA6. We, therefore, aimed to investigate the occurrence and impact of regional infratentorial brain volume differences in patients with SCA3 and SCA6. ⋯ Our current findings in accordance with recent neuroradiologic and pathoanatomic studies suggest brain stem and cerebellar volume loss as attractive surrogate markers of disease severity in SCA3 and SCA6.