AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Mar 2003
Guglielmi detachable coil treatment of ruptured saccular cerebral aneurysms: retrospective review of a 10-year single-center experience.
We retrospectively analyzed our results with Guglielmi detachable coils (GDCs) for the endovascular occlusion of acutely ruptured saccular cerebral aneurysms over 10 years. ⋯ Endovascular treatment of ruptured cerebral aneurysms with GDCs has low morbidity, and it facilitates good overall outcomes in patients after subarachnoid hemorrhage. The short-term effectiveness of GDC occlusion in preventing aneurysmal rebleeding was excellent. Durability of the treatment in preventing long-term rebleeding as compared with direct surgical clipping warrants further study. Advances in device technology and technique may improve future outcomes.
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AJNR Am J Neuroradiol · Feb 2003
Combination of single-voxel proton MR spectroscopy and apparent diffusion coefficient calculation in the evaluation of common brain tumors.
MR spectroscopy and apparent diffusion coefficient (ADC) calculation have been used frequently for tumor grading and differentiation during the last decade. We evaluated whether the combination of these two techniques can improve the diagnostic effectiveness of MR imaging in patients with brain tumors. ⋯ Combination of calculated ADC values from tumoral core and specific relative metabolite ratios acquired by MR spectroscopy added more information to MR imaging in the differentiation and grading of brain tumors and were more useful together than each alone.
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AJNR Am J Neuroradiol · Jan 2003
Case ReportsCombined endovascular treatment for both intracranial aneurysm and symptomatic vasospasm.
The best strategy for treatment of subarachnoid hemorrhage due to ruptured cerebral aneurysm is obliteration of the aneurysm as soon as possible. Early surgery is desirable if the patient does not develop severe vasospasm or is clinically stable. However, if the patient has already developed severe vasospasm on admission, surgery may carry the risk of increasing the severity. We evaluated the safety and effectiveness of combined Guglielmi detachable coil (GDC) embolization and angioplasty in a single session for the treatment of ruptured aneurysms associated with symptomatic vasospasm. ⋯ Endovascular treatment can be the first therapeutic option for ruptured aneurysms associated with severe vasospasm on admission. It offers some advantages over surgery in this setting, but these are balanced by the risk of thromboembolism.
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AJNR Am J Neuroradiol · Jan 2003
Case ReportsContrast-enhanced MR imaging of cerebral fat embolism: case report and review of the literature.
We report a case of cerebral fat embolism (CFE) that was imaged with T2- and T2*-weighted, fluid-attenuated inversion recovery, and contrast-enhanced T1-weighted images. Multiple white matter lesions demonstrated contrast enhancement, with little evidence of hemorrhage. ⋯ CFE can cause capillary inflammation and breakdown of the blood-brain barrier, without associated hemorrhage or permanent neurologic deficit. In this case, both contrast-enhanced T1-weighted and gradient-echo T2*-weighted images were important in diagnosing CFE and in determining the severity of the patient's condition.
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AJNR Am J Neuroradiol · Nov 2002
Comparative StudyThe substantia nigra in Parkinson disease: proton density-weighted spin-echo and fast short inversion time inversion-recovery MR findings.
A reduction in the area of the substantia nigra (SN) has been shown in patients with Parkinson disease. The substantia nigra is anteroinferolateral to the red nucleus, and it is important to precisely locate its true anatomic location to accurately measure SN area. Our purpose was to determine the exact location of the substantia nigra by correlating imaging and anatomic findings. We also attempted to quantitate SN area in patients with Parkinson disease compared with that in healthy control subjects on the basis of proton density-weighted spin-echo (SE) and fast short inversion time inversion-recovery (STIR) MR imaging findings. ⋯ The SN is located mainly beneath the red nucleus. Its location cannot be determined on the basis of T2-weighted imaging results but rather on the basis of proton density-weighted SE or fast STIR findings. SN volume loss is not found in Parkinson disease, and this finding is compatible with that of recent pathology reports in the literature.