AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Nov 2005
Case ReportsEpidural blood patch at C2: diagnosis and treatment of spontaneous intracranial hypotension.
Spontaneous intracranial hypotension in a 37-year-old man with intractable headaches was diagnosed on MR imaging. A generous CSF leak was identified at C2 on CT myelography. Successful treatment was performed with CT-guided blood patch at the leakage site after the patient had failed 2 lumbar blood patches. Imaging-guided precise placement of the blood patch is safe and recommended when a lumbar blood patch away from the leakage site could be ineffective.
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AJNR Am J Neuroradiol · Nov 2005
Comparative StudySurface appearance of the vertebrobasilar artery revealed on basiparallel anatomic scanning (BPAS)-MR imaging: its role for brain MR examination.
Basiparallel anatomic scanning (BPAS)-MR imaging is a simple MR imaging technique that we designed for visualization of the surface appearance of the vertebrobasilar artery within the cistern. It can clearly show the outer contour of occluded arteries or thrombosed aneurysms. By comparing BPAS-MR imaging with 3D time-of-flight (TOF) MR angiography (MRA), we can precisely evaluate the vertebrobasilar artery condition. The purpose of this study is to determine the value of BPAS-MR imaging for brain MR examination. ⋯ The combination of the BPAS-MR imaging and the 3D TOF MRA was necessary for accurate diagnosis in 16.1% of our ordinary patients. We should evaluate not only MRA but also the vascular outer contour revealed on BPAS-MR imaging, though its application is limited to the vertebrobasilar system and the screening use.
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AJNR Am J Neuroradiol · Nov 2005
Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models.
Hemodynamic factors are thought to play an important role in the initiation, growth, and rupture of cerebral aneurysms. This report describes a pilot clinical study of the association between intra-aneurysmal hemodynamic characteristics from computational fluid dynamic models and the rupture of cerebral aneurysms. ⋯ Image-based patient-specific numeric models can be constructed in an efficient manner that allows clinical studies of intra-aneurysmal hemodynamics. A simple flow characterization system was proposed, and interesting trends in the association between hemodynamic features and aneurysmal rupture were found. Simple stable patterns, large impingement regions, and jet sizes were more commonly seen with unruptured aneurysms. By contrast, ruptured aneurysms were more likely to have disturbed flow patterns, small impingement regions, and narrow jets.
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AJNR Am J Neuroradiol · Oct 2005
Comparative StudyComparison of functional MR imaging guidance to electrical cortical mapping for targeting selective motor cortex areas in neuropathic pain: a study based on intraoperative stereotactic navigation.
To assess the concordance between data from functional MR imaging (fMRI) guidance and the intraoperative electrical cortical mapping (iCM) in targeting selective motor cortex areas in refractory neuropathic pain. ⋯ In this study, fMRI guidance provides information that matches those of an independent functional method. These data illustrate the functional accuracy of fMRI guidance for the operative targeting of selective motor cortex areas in neuropathic pain.
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AJNR Am J Neuroradiol · Oct 2005
Intracranial hemorrhage complicating acute stroke: how common is hemorrhagic stroke on initial head CT scan and how often is initial clinical diagnosis of acute stroke eventually confirmed?
Assessment of possible hemorrhage in acute stroke before appropriate therapy remains important. The aim of this study was to determine the frequency with which patients present with clinical stroke and have intracranial hemorrhage on initial noncontrast head CT scan (NCCT). In addition, we sought to determine the frequency with which initial clinical diagnosis acute stroke is confirmed in this group. ⋯ Despite frequent concerns for intracranial hemorrhage complicating acute stroke and treatment, a low percentage of patients had this complication. Moreover, our frequency is much lower than the wide ranges reported elsewhere. The most common type of intracranial hemorrhage in this cohort was intraparenchymal, but subarachnoid and subdural hemorrhages were also diagnosed and must also be considered. Twenty-eight percent of patients with initial suspicion of acute ischemic stroke are eventually given other diagnoses. These results may have implications for use of CT imaging.