AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Aug 2004
Case ReportsEfficacy of endovascular surgery for the treatment of acute epidural hematomas.
Recent advances in the equipment and technology for endovascular surgery have led to an increasing number of patients undergoing this procedure to treat various lesions. The purpose of this study was to investigate the efficacy of early-stage endovascular surgery to treat growing acute epidural hematomas (AEDHs). ⋯ In patients with thin AEDHs in the early stage, angiography followed by endovascular intervention allows for conservative treatment. Notable clinical benefits can be achieved in patients with complicated, multiple lesions.
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AJNR Am J Neuroradiol · Aug 2004
Comparative StudyCT perfusion parameter values in regions of diffusion abnormalities.
Dynamic CT perfusion imaging is a rapid and widely available method for assessing cerebral hemodynamics in the setting of ischemia. Nevertheless, little is known about perfusion parameters within regions of diffusion abnormality. Since MR diffusion-weighted (DW) imaging is widely considered the most sensitive and specific technique to examine the ischemic core, new knowledge about CT perfusion findings in areas of abnormal diffusion would likely provide valuable information. The purpose of our study was to measure the CT-derived perfusion values within acute ischemic lesions characterized by 1) increased signal intensity on DW images and 2) decreased apparent diffusion coefficient (ADC) and compare these values with those measured in contralateral, normal brain tissue. ⋯ CT perfusion findings of decreased cerebral blood flow, mean transit time, and cerebrovascular volume correlate with areas of abnormal hyperintensity on DW images and regions of decreased ADC. These findings provide important information about perfusion changes in acute ischemia in areas of diffusion abnormality.
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AJNR Am J Neuroradiol · Aug 2004
Case ReportsPre- and postnatal MR imaging of hypothalamic hamartomas associated with arachnoid cysts.
We describe two cases of hypothalamic hamartoma associated with arachnoid cysts. One case was initially documented on prenatal MR images. ⋯ The lesion could also be confused with a cystic tumor such as pilocytic astrocytoma. Thorough evaluation is required in patients with precocious puberty, gelastic seizures, and the presence of a suprasellar arachnoid cyst.
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AJNR Am J Neuroradiol · Jun 2004
Intra-arterial nimodipine for the treatment of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage: preliminary results.
Cerebral vasospasm remains a major problem in patients recovering from aneurysmal subarachnoid hemorrhage despite advances in medical, surgical, and endovascular care. Our purpose was to assess the efficacy of intra-arterial nimodipine, a calcium-channel blocker acting mainly on cerebral vessels, in preventing delayed neurologic deficits in patients with symptomatic vasospasm. ⋯ Intra-arterial nimodipine is effective and safe for the treatment of symptomatic vasospasm after subarachnoid hemorrhage. Further prospective randomized studies of cerebral blood flow are needed to confirm these results.
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AJNR Am J Neuroradiol · Jun 2004
Case ReportsUnilateral putaminal CT, MR, and diffusion abnormalities secondary to nonketotic hyperglycemia in the setting of acute neurologic symptoms mimicking stroke.
A 75-year-old Asian man presented with two episodes of chorea associated with nonketotic hyperglycemia. His chorea rapidly resolved after restitution of a normal serum glucose level, although an MR image obtained at the time of acute symptoms demonstrated high signal intensity on T1-weighted images, low signal intensity on T2-weighted images, and restricted diffusion, all involving the left putamen. A CT scan obtained 1 month later demonstrated faint hyperattenuation of the involved putamen. The reported pathophysiologic considerations for these imaging features are reviewed, and an original explanation is proposed.