AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Jun 2008
Clinical TrialIntra-arterial nimodipine for severe cerebral vasospasm after aneurysmal subarachnoid hemorrhage: influence on clinical course and cerebral perfusion.
The efficacy of intra-arterial administration of nimodipine (IAN) in patients with severe vasospasm after aneurysmal subarachnoid hemorrhage (SAH) remains unproved. The goal of the present study was to investigate the clinical effect and cerebral perfusion after IAN in patients with severe vasospasm refractory to hemodynamic treatment. ⋯ IAN in a selective patient group resulted in a positive response with reduction of angiographic vasospasm and increase in cerebral perfusion as detected by PCT after 24 hours. Therefore, IAN appears more effective than intra-arterial papaverine. Nevertheless the efficacy of IAN is temporary. Therefore, the search for more effective treatment strategies to reduce critical vasospasm and to improve cerebral perfusion must be continued.
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AJNR Am J Neuroradiol · Jun 2008
Metabolic assessment of gliomas using 11C-methionine, [18F] fluorodeoxyglucose, and 11C-choline positron-emission tomography.
Positron-emission tomography (PET) is a useful tool in oncology. The aim of this study was to assess the metabolic activity of gliomas using (11)C-methionine (MET), [(18)F] fluorodeoxyglucose (FDG), and (11)C-choline (CHO) PET and to explore the correlation between the metabolic activity and histopathologic features. ⋯ MET PET appears to be useful in evaluating grade, type, and proliferative activity of ATs. CHO PET may be useful in evaluating the potential malignancy of OTs. In terms of visual evaluation of tumor localization, MET PET is superior to FDG and CHO PET in all of the gliomas, due to its straightforward detection of "hot lesions".
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AJNR Am J Neuroradiol · May 2008
Randomized Controlled Trial Controlled Clinical TrialValue of diagnostic lumbar selective nerve root block: a prospective controlled study.
Although diagnostic lumbar selective nerve root blocks are often used to confirm the pain-generating nerve root level, the reported accuracy of these blocks has been variable and their usefulness is controversial. The purpose of this study was to evaluate the accuracy of diagnostic lumbar selective nerve root blocks to analyze potential causes of false results in a prospective, controlled, single-blinded manner. ⋯ The accuracy of diagnostic lumbar selective nerve root blocks is only moderate. To improve the accuracy, great care should be taken to avoid inadequate blocks and overflow, and to precisely interpret spot radiographs.
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AJNR Am J Neuroradiol · May 2008
Posterior reversible encephalopathy syndrome after solid organ transplantation.
Posterior reversible encephalopathy syndrome (PRES) is known to occur after solid organ transplantation (SOT), potentially associated with cyclosporine and tacrolimus. In this study, we assess the frequency and clinical and imaging characteristics of PRES after SOT. ⋯ Patients who had undergone SOTs have a similar low incidence of developing PRES. Differences between those who have had liver and kidney transplants included time after transplant, toxicity MAP, and PRES vasogenic edema noted at presentation. In patients who have undergone kidney transplants, severely elevated MAP was associated with reduced, not greater, brain edema.
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AJNR Am J Neuroradiol · May 2008
Additional value of 3D rotational angiography in angiographically negative aneurysmal subarachnoid hemorrhage: how negative is negative?
In some patients with nonperimesencephalic nontraumatic subarachnoid hemorrhage (aneurysmal SAH), no aneurysm can be found on digital subtraction angiography (DSA), and repeat DSA is advocated. 3D rotational angiography (3DRA) is considered superior to DSA in the detection of small intracranial aneurysms. In this study, we assessed the additional diagnostic value of 3DRA in detecting DSA-occult aneurysms in 23 patients with aneurysmal SAH. ⋯ In this study, 18 of 23 (78%) patients with negative findings on DSA had a small ruptured aneurysm when studied with 3DRA. These were most commonly located on the anterior communicating artery.