AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · May 2005
Proton MR spectroscopic imaging depicts diffuse axonal injury in children with traumatic brain injury.
Diffuse axonal injury (DAI) after traumatic brain injury (TBI) is important in patient assessment and prognosis, yet they are underestimated with conventional imaging techniques. We used MR spectroscopic imaging (MRSI) to detect DAI and determine whether metabolite ratios are accurate in predicting long-term outcomes and to examine regional differences in injury between children with TBI and control subjects. ⋯ MRSI can depict injury in brain that appears normal on imaging and is useful for predicting long-term outcomes.
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AJNR Am J Neuroradiol · Apr 2005
ReviewHemangioblastomas of the lower spinal region: report of four cases with preoperative embolization and review of the literature.
Hemangioblastomas (HBs) are rare lesions accounting for 1-5% of all spinal cord tumors. Seventy-five percent of spinal HBs are intramedullary. Lesions of the conus medullaris and the cauda equina are uncommon, and the filum terminale location is very rare. HBs of the lower spinal region are highly vascular tumors requiring surgery that is potentially complicated by excessive bleeding. In the literature, there are few reports concerning preoperative embolization of HBs, and only few cases are reported in spinal location. Presurgical embolization of HBs located in the lower spinal region has not been described. Although lower spinal HBs are predominantly fed by the anterior spinal artery (ASA), embolization of these lesions is possible and can reduce tumor vascular supply, thus facilitating surgery. We report our experience in four rare cases of solitary HBs occurring in the lower spinal region. ⋯ Our results indicate that preoperative embolization of HBs of the lower spinal region is an useful procedure in aiding surgical resection of these highly vascular tumors. With a meticulous technique, embolization can be performed through the ASA.
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AJNR Am J Neuroradiol · Apr 2005
Diffusion tensor imaging of the corticospinal tract before and after mass resection as correlated with clinical motor findings: preliminary data.
The role of diffusion tensor imaging (DTI) in neurosurgical planning and follow-up is currently being defined and needs clinical validation. To that end, we sought correlations between preoperative and postoperative DTI and clinical motor deficits in patients with space-occupying lesions involving the corticospinal tract (CST). ⋯ Preoperative CST involvement, as determined on DTI, was predictive of the presence or absence of motor deficits, and postoperative CST normalization on DTI was predictive of clinical improvement. Further study is warranted to define the role of DTI in planning tumor resections and predicting postoperative motor function.
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AJNR Am J Neuroradiol · Apr 2005
Case ReportsPersistence of congenital mirror movements after hemiplegic stroke.
We describe a case of hereditary congenital mirror movements (MMs) in a 76-year-old man, who after an ischemic stroke, had persistence of MMs in the paretic hand during voluntary movements of the contralateral arm. By using functional MR imaging to investigate the performance of motor and sensory tasks with the affected and the unaffected hands, we found evidence for increased ipsilateral primary motor cortex activity and reduced transcallosal inhibition. Both these mechanisms are likely to be involved in the genesis of MMs.
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AJNR Am J Neuroradiol · Apr 2005
The posterior lumbar ramus: CT-anatomic correlation and propositions of new sites of infiltration.
Lumbar zypapophyseal joints are innervated by the medial branch of the posterior lumbar ramus. The aim of this work was to describe the precise course of the medial ramus on axial CT scans and to define a precise location for its selective infiltration. ⋯ The accessory process and the groove bounded laterally by the ala of the sacrum and medially by the base of the superior articular process of S1 can be easily depicted on CT images and may allow a precise and selective infiltration of the medial branch of the posterior lumbar ramus.