AJNR. American journal of neuroradiology
-
AJNR Am J Neuroradiol · Mar 2005
Comparative StudyPhysiologic variability of single-voxel proton MR spectroscopic measurements at 3T.
Physiologic and scanner variability of proton MR spectroscopy (MRS) measurements can limit the detection of subtle metabolite fluctuations. We assessed the variability of such measurements at 3T and compared two methods to obtain absolute concentrations. ⋯ Physiologic variability is the major source of measurement variability and accounts for 12% of the variability in temporal lobe total NAA. Therefore, total NAA variations must clearly exceed this before they can reliably be attributed to an effect of disease.
-
AJNR Am J Neuroradiol · Mar 2005
Indications for CT in patients receiving anticoagulation after head trauma.
Head CT is frequently ordered for trauma patients who are receiving anticoagulation. However, whether patients with a Glasgow Coma Scale (GCS) score of 15 and normal findings on neurologic examination require CT is still debated. The purpose of our study was to assess the use of cranial CT in patients receiving anticoagulants after head trauma and to establish clinical criteria to identify those in this group who do not need emergency CT. ⋯ Patients with head injury, normal GCS scores, and no focal neurologic deficits and who are receiving the anticoagulants heparin or coumadin may not necessarily require emergency CT.
-
AJNR Am J Neuroradiol · Mar 2005
Periprocedural morbidity and mortality associated with endovascular treatment of intracranial aneurysms.
Despite experience and technological improvements, endovascular treatment of intracranial aneurysms still has inherent risks. We evaluated cerebral complications associated with this treatment. ⋯ Procedural morbidity and mortality rates were highest in ruptured aneurysms and lowest in unruptured aneurysms. Morbidity rates were highest in re-treated aneurysms and lowest in unruptured aneurysms. No procedural mortality occurred with re-treated aneurysms. The main cause of morbidity and mortality was thromboembolism.
-
AJNR Am J Neuroradiol · Mar 2005
Incorrect needle position during lumbar epidural steroid administration: inaccuracy of loss of air pressure resistance and requirement of fluoroscopy and epidurography during needle insertion.
Loss of air pressure resistance leads to a high rate (25.7%) of inaccurate needle-tip placement in the posterior soft tissues of the back during lumbar epidural steroid administration employing a 20-gauge Tuohy needle. Imaging and epidurogram are essential for confident identification of the lumbar epidural space to enable accurate location of steroid administration. Studies assessing efficacy of lumbar epidural steroid injection and individual patient treatments should ensure location of administration with epidurogram to enhance the validity of results.
-
AJNR Am J Neuroradiol · Feb 2005
Comparative StudyCerebral hyperperfusion following carotid endarterectomy: diagnostic utility of intraoperative transcranial Doppler ultrasonography compared with single-photon emission computed tomography study.
Cerebral hyperperfusion syndrome is a rare but serious complication of carotid endarterectomy (CEA). The aim of the present study was to determine whether intraoperative blood flow velocity (BFV) monitoring in the middle cerebral artery (MCA) by using transcranial Doppler ultrasonography (TCD) could be used as a reliable technique to detect cerebral hyperperfusion following CEA by comparing findings with those of brain single photon emission CT (SPECT). ⋯ Intraoperative MCA BFV monitoring by using TCD is a less reliable method to detect cerebral hyperperfusion following CEA than postoperative MCA BFV monitoring, provided adequate monitoring can be achieved.