AJNR. American journal of neuroradiology
-
AJNR Am J Neuroradiol · May 2004
Clinical TrialPreliminary experience with intra-arterial nicardipine as a treatment for cerebral vasospasm.
Papaverine is the primary intra-arterial (IA) treatment for vasospasm after aneurysmal subarachnoid hemorrhage (SAH); however, is it limited in effect and by adverse effects. We prospectively studied the use of IA nicardipine as a treatment for vasospasm. ⋯ As shown by TCD imaging, IA nicardipine has an immediate and sustained effect on vasospasm. It does not appear to have sustained effect on ICP or cardiovascular status. This treatment warrants further study to determine its safety and efficacy.
-
AJNR Am J Neuroradiol · May 2004
Frequency of asymptomatic microbleeds on T2*-weighted MR images of patients with recurrent stroke: association with combination of stroke subtypes and leukoaraiosis.
Asymptomatic microbleeds shown by T2*-weighted MR imaging are associated with small-artery diseases, especially with intracerebral hemorrhage. Few studies have focused on the prevalence of microbleeds in patients with recurrent stroke. We investigated frequency of microbleeds in patients with recurrent stroke and association of presence of microbleeds with a combination of stroke subtypes and severity of leukoaraiosis. ⋯ Asymptomatic microbleeds are observed to occur frequently in patients with recurrent stroke, either hemorrhagic or ischemic stroke, and are closely associated with the severity of leukoaraiosis.
-
When the fellowship match for trainees entering neuroradiology programs was first proposed in 2001, the program directors in neuroradiology agreed to a 3-year trial utilizing the National Residency Match Program (NRMP) for selecting fellows. A decision as to whether to continue with the neuroradiology fellowship match was to be assessed at the 3-year mark in 2004. ⋯ Support for continuing a match system for selecting fellows remains high (85%) among neuroradiology program directors. The system is considered fair and does not harm many programs. The recruitment of fellows to neuroradiology via the match has increased over the 3 years of its existence.
-
AJNR Am J Neuroradiol · Apr 2004
Comparative StudyFluid-attenuated inversion recovery MR imaging and subarachnoid hemorrhage: not a panacea.
Subarachnoid hemorrhage (SAH) constitutes an important neurologic emergency. Some authors have suggested that fluid-attenuated inversion recovery (FLAIR) MR imaging can detect SAH that may not be apparent on CT scans but may be revealed by lumbar puncture. We sought to determine how often FLAIR MR imaging findings are positive for SAH in cases with negative CT findings and positive lumbar puncture results. ⋯ FLAIR MR imaging cannot replace lumbar puncture to detect the presence of SAH. FLAIR MR imaging findings are infrequently positive (16.7%) when CT findings are negative for SAH. This is likely because there is a minimum concentration of RBC/cc that must be exceeded for CSF to become hyperintense on FLAIR MR images.
-
AJNR Am J Neuroradiol · Apr 2004
Endovascular management of poor-grade aneurysmal subarachnoid hemorrhage in the geriatric population.
The incidence of poor-grade (Hunt and Hess grade IV and V) subarachnoid hemorrhage (SAH) is higher in elderly patients (>70 years) than in younger groups. The aim of this retrospective study was to analyze the outcome of these poor grade elderly patients after endovascular treatment. ⋯ Endovascular treatment has modified the management of poor-grade SAH in elderly patients, most of whom are high-risk surgical candidates. Endovascular treatment can be administered early after the initial ictus, reducing the risk of rebleeding and providing an option to pursue aggressive triple-H therapy. Symptomatic vasospasm can also be treated by endovascular means in the initial setting.