AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Sep 2003
Case ReportsVentriculostomy-related cerebral hemorrhages after endovascular aneurysm treatment.
Recent evidence suggests that endovascular treatment of acutely ruptured aneurysms is equivalent, if not superior, to surgical treatment. Not all patients who undergo endovascular treatment do well, however. We have identified ventriculostomy-related hemorrhage to be a potential source of morbidity and mortality. ⋯ The risk of hemorrhage must be considered when using anticoagulation and antiplatelet therapy in patients requiring ventriculostomy. Interventionalists must not only work closely with neurosurgeons when it is anticipated that a ventriculostomy may be needed but also ensure that there is good communication with the neurosurgical team during the postprocedural period.
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AJNR Am J Neuroradiol · Sep 2003
MR imaging of dural arteriovenous fistulas draining into cerebellar cortical veins.
Retrograde leptomeningeal venous drainage (RLVD) in a dural arteriovenous fistula (DAVF) is associated with intracerebral hemorrhage, nonhemorrhagic neurologic deficit, or death, and recognizing the presence of this drainage is important. We investigated the MR findings of DAVFs draining into cerebellar cortical veins and compared these findings with those of conventional angiography. ⋯ The characteristic MR findings of DAVF draining into cerebellar cortical veins represent venous congestive encephalopathy in the territory of the involved cortical vein.
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AJNR Am J Neuroradiol · Aug 2003
Multicenter Study Comparative StudyIn-hospital morbidity and mortality after endovascular treatment of unruptured intracranial aneurysms in the United States, 1996-2000: effect of hospital and physician volume.
Endovascular therapy is increasingly being used for the treatment of unruptured intracranial aneurysms. Our purpose was to determine the risk of adverse outcomes after contemporary endovascular treatment of unruptured intracranial aneurysms in the United States. Patient, treating physician, and hospital characteristics were tested as potential outcome predictors, with particular attention paid to volume of care. ⋯ For patients with unruptured aneurysms treated in the United States from 1996 to 2000, endovascular treatment at high volume institutions or by high volume physicians was associated with significantly lower morbidity rates and modestly lower mortality rates. Length of stay was shorter and total hospital charges lower at high volume centers.
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AJNR Am J Neuroradiol · Aug 2003
Comparative StudyThree-dimensional color Doppler sonography in carotid artery stenosis.
Color Doppler sonography (CDS) suffers from such disadvantages as high interobserver variability and problems with data presentation and storage. We therefore performed a prospective trial to assess the role of three-dimensional CDS (3D-CDS) in the evaluation of internal carotid artery stenosis (ICAS). ⋯ 3D-CDS findings correlate with those obtained by CDS and angiography; 3D-CDS also offers excellent interobserver correlation, positive predictive value, and specificity, approaching 100% for the detection of high-grade ICAS.