AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · May 2003
Preliminary experience with endovascular reconstruction for the management of carotid blowout syndrome.
Permanent balloon occlusion (PBO) of the carotid artery has been previously shown to be an effective means to treat carotid blowout syndrome (CBS). However, despite the effectiveness of this endovascular technique, concern remains regarding its potential for producing delayed cerebral ischemic complications in 15% to 20% of patients. This significant limitation of carotid PBO led our group to evaluate an alternative management strategy, consisting of endovascular reconstruction of the carotid artery (ERCA) in patients thought to be at particularly high risk for carotid occlusion (ie, provocative balloon test occlusion, angiographic documented incomplete circle of Willis, or contralateral carotid artery occlusion). ⋯ CBS managed with ERCA can be performed safely and with efficacy of outcomes at least equivalent to those previously reported in association with conventional carotid PBO, therefore representing an excellent alternative endovascular technique for patients who are at increased risk of stroke after PBO.
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AJNR Am J Neuroradiol · Apr 2003
MR imaging enhancement patterns as predictors of hemorrhagic transformation in acute ischemic stroke.
Early parenchymal gadolinium enhancement on T1-weighted MR images is predictive of hemorrhagic transformation (HT) in rodent focal ischemia models, but its value in humans is unknown. We sought to investigate gadolinium enhancement in acute ischemic stroke patients to determine their association with subsequent HT. ⋯ Early parenchymal enhancement of stroke lesions may be a good predictor of subsequent symptomatic HT may help identify patients at risk, especially after thrombolytic therapy.
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AJNR Am J Neuroradiol · Apr 2003
MR imaging volumetry of subcortical structures and cerebellar hemispheres in normal persons.
Volume changes in subcortical structures and cerebella have been associated with localization-related epilepsy and psychiatric illnesses. This study evaluated the effect of handedness and sex on the volumes of selected subcortical structures and cerebellar hemispheres in normal persons. ⋯ These findings show that women have significantly larger subcortical structures than do men after spatial normalization to account for differences in brain size. Sex-specific normal ranges may be needed for evaluating volume changes related to epilepsy or other disease processes.
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AJNR Am J Neuroradiol · Apr 2003
Pre- and post-treatment MR imaging and single photon emission CT in patients with dural arteriovenous fistulas and retrograde leptomeningeal venous drainage.
Dural arteriovenous fistulas (DAVFs) with disturbed regional cerebral blood flow (rCBF) include retrograde leptomeningeal venous drainage (RLVD). We examined rCBF disturbances in patients with DAVFs by studying MR imaging and single photon emission CT (SPECT) changes before and after treatment. ⋯ In patients with drainage into a single venous sinus, we consistently observed areas of hyperintensity on MR images. These results and findings of hypoperfusion on SPECT scans apparently reflect venous congestion, whereas unpreserved vasoreactivity after an acetazolamide challenge on SPECT scans reflects venous infarction. The preservation of vasoreactivity after the challenge appears to be a good prognostic indicator.
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AJNR Am J Neuroradiol · Apr 2003
Diffusion-tensor imaging for the detection and quantification of treatment-induced white matter injury in children with medulloblastoma: a pilot study.
Treatment-induced white matter (WM) injury in medulloblastoma survivors, as manifested by deterioration of cognitive function, is prevalent. However, no reliable imaging method exists for early detection and quantification. Our goal was to determine whether anisotropy of WM is reduced in medulloblastoma survivors and whether fractional anisotropy (FA) can be used as an index for evaluation of treatment-induced WM injury. ⋯ DT imaging and use of the index FA is potentially useful for early detection and monitoring of treatment-induced WM injury in children with medulloblastoma.