AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Jun 2009
Detailed MR imaging anatomy of the cisternal segments of the glossopharyngeal, vagus, and spinal accessory nerves in the posterior fossa: the use of 3D balanced fast-field echo MR imaging.
The cisternal segments of the lower cranial nerves (CNs) adjacent to the jugular foramen (JF) are difficult to identify reliably by routine MR imaging. We performed a 3D balanced fast-field echo imaging technique (3D-bFFE) to obtain detailed anatomy of the cisternal segments of CNs IX, X, and XI. ⋯ The cisternal segments of CN IX, CN X, and CN XI are well identified by using 3D-bFFE, especially by determining the angles of the CSF recesses adjacent to the JF.
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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
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
Normal findings on brain fluid-attenuated inversion recovery MR images at 3T.
Fluid attenuated inversion recovery (FLAIR) MR imaging of the brain has become a routine tool for assessing lesions in patients with suspected neurologic disorders. There is growing interest in 3T brain FLAIR MR imaging but little normative data are available. The purpose of this study was to evaluate the frequency and topography of cerebral hyperintensities seen with FLAIR MR imaging of the brain at 3T in a normal population and compare those findings to 1.5T. ⋯ Discrete and diffuse parenchymal brain white matter FLAIR hyperintensities are more common and prominent at 3T than at 1.5T in healthy volunteers.
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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.