AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Oct 2015
Meta Analysis Comparative StudyChanging Clinical and Therapeutic Trends in Tentorial Dural Arteriovenous Fistulas: A Systematic Review.
Tentorial dural arteriovenous fistulas are characterized by a high hemorrhagic risk. We evaluated trends in outcomes and management of tentorial dural arteriovenous fistulas and performed a meta-analysis evaluating clinical and angiographic outcomes by treatment technique. ⋯ Patients with tentorial dural arteriovenous fistulas are increasingly presenting with unruptured lesions, being treated endovascularly, and experiencing higher rates of good neurologic outcomes. Endovascular treatment was associated with superior neurologic outcomes but lower occlusion rates.
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AJNR Am J Neuroradiol · Oct 2015
Meta Analysis Comparative StudyMeta-Analysis of CSF Diversion Procedures and Dural Venous Sinus Stenting in the Setting of Medically Refractory Idiopathic Intracranial Hypertension.
In medically refractory idiopathic intracranial hypertension, optic nerve sheath fenestration or CSF shunting is considered the next line of management. Venous sinus stenosis has been increasingly recognized as a treatable cause of elevated intracranial pressure in a subset of patients. In this article, we present the results of the largest meta-analysis of optic nerve sheath fenestration, CSF shunting, and dural venous sinus stenting. This is the only article that compares these procedures, to our knowledge. ⋯ Patients with medically refractory idiopathic intracranial hypertension have traditionally undergone a CSF diversion procedure as the first intervention. This paradigm may need to be re-examined, given the high technical and clinical success and low complication rates with dural venous sinus stenting.
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AJNR Am J Neuroradiol · Oct 2015
Hemodynamic Differences in Intracranial Aneurysms before and after Rupture.
Rupture risk of intracranial aneurysms may depend on hemodynamic characteristics. This has been assessed by comparing hemodynamic data of ruptured and unruptured aneurysms. However, aneurysm geometry may change before, during, or just after rupture; this difference causes potential changes in hemodynamics. We assessed changes in hemodynamics in a series of intracranial aneurysms, by using 3D imaging before and after rupture. ⋯ Hemodynamic characteristics of intracranial aneurysms can be altered by geometric changes before, during, or just after rupture. Associations of hemodynamic characteristics with aneurysm rupture obtained from case-control studies comparing ruptured with unruptured aneurysms should therefore be interpreted with caution.
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AJNR Am J Neuroradiol · Oct 2015
Additional Value of Intra-Aneurysmal Hemodynamics in Discriminating Ruptured versus Unruptured Intracranial Aneurysms.
Hemodynamics are thought to play an important role in the rupture of intracranial aneurysms. We tested whether hemodynamics, determined from computational fluid dynamics models, have additional value in discriminating ruptured and unruptured aneurysms. Such discriminative power could provide better prediction models for rupture. ⋯ In this study population of patients eligible for endovascular treatment, we found no independent additional value of aneurysmal hemodynamics in discriminating rupture status, despite high univariate associations. Only traditional parameters (high-risk location and the presence of daughter sacs) were independently associated with ruptured aneurysms.
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AJNR Am J Neuroradiol · Oct 2015
EditorialSubspecialty Virtual Impact Factors within a Dedicated Neuroimaging Journal.
The growing number of subspecialties within neuroradiology compete for pages in neuroradiology journals. We performed a bibliometric analysis of the American Journal of Neuroradiology to identify the virtual Impact Factor of different journal subsections and article topics. ⋯ Citation patterns of Original Research and Review Articles in American Journal of Neuroradiology varied widely on the basis of subsections. Understanding the citation patterns of specific topics and subsections of a journal may aid authors and editors in evaluating the appropriate balance among various topics and allow authors to determine whether their articles are being cited at a level expected for similar ones in a journal.