AJNR. American journal of neuroradiology
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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.
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The purpose of this study was to review current treatment options in acute ischemic stroke, focusing on the latest advances in the field of mechanical recanalization. These devices recently made available for endovascular intracranial thrombectomy show great potential in acute stroke treatments. Compelling evidence of their recanalization efficacy comes from current mechanical embolectomy trials. ⋯ Therefore, these devices are particularly suitable in patients in whom thrombolytic therapy is contraindicated. IV and IA thrombolysis and bridging therapy are viable options in acute stroke treatment. Mechanical recanalization devices can potentially have a clinically relevant impact in the interventional treatment of stroke, but at the present time, a randomized study would be beneficial.
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AJNR Am J Neuroradiol · Feb 2011
Case Reports Clinical TrialDirect thrombus retrieval using the reperfusion catheter of the penumbra system: forced-suction thrombectomy in acute ischemic stroke.
Although the PS has been the most promising mechanical thrombectomy device in terms of recanalization rates, even the PS cannot recanalize all cases of occlusion. Under such circumstances, we simply modified the PS, identified certain advantages, and applied this modification as a primary technique for recanalization. Here we describe and discuss the technical details and results of our preliminary experience. ⋯ Forced-suction thrombectomy is a simple modification of the PS. On the basis of our data, this technique allows safe and effective revascularization in acute large-vessel occlusion. Thus, for achieving the best outcome, the modified PS technique is proposed as a viable option for acute stroke management, either by itself or in conjunction with other devices or drugs.
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AJNR Am J Neuroradiol · Feb 2011
Comparative StudyMR imaging of optic neuropathy with extended echo-train acquisition fluid-attenuated inversion recovery.
XETA, also known as Cube, is a relatively new 3D FSE sequence that can be used to perform whole-brain FLAIR T2-weighted imaging at isotropic high spatial resolution. This high-resolution volumetric imaging, coupled with both fat and fluid suppression, permits ideal evaluation of optic nerve anatomy and signal intensity; therefore, we hypothesized that XETA FLAIR would be useful for the detection of T2 signal-intensity abnormality in the optic nerve. Our purpose was to evaluate the sensitivity of XETA FLAIR for this abnormality and to compare it with the coronal FSE T2 FS. ⋯ XETA FLAIR was more sensitive than coronal FSE T2 FS for identifying abnormal signal intensity within the optic nerves in patients with optic neuropathy.