AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Sep 2002
Intraarterially administered verapamil as adjunct therapy for cerebral vasospasm: safety and 2-year experience.
Despite the widespread use of angioplasty, adjunct chemical therapy is often needed to treat patients with cerebral vasospasm. In this study, we examined the safety of intraarterial administration of verapamil to patients with cerebral vasospasm. We herein summarize our 2-year experience with this treatment. ⋯ Low dose verapamil is safe when administered intraarterially to patients with cerebral vasospasm. Beneficial effects are achieved in some patients, prompting further study of its efficacy.
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AJNR Am J Neuroradiol · Sep 2002
Comparative StudyTranscranial doppler sonography and CT angiography in patients with atherothrombotic middle cerebral artery stroke.
Atherothrombotic disease of the middle cerebral artery (MCA) frequently occurs in Asian populations. This abnormality can be noninvasively assessed with transcranial Doppler sonography (TCD) and computed tomographic angiography (CTA). To our knowledge, the usefulness of TCD sonography compared with CTA in the diagnosis of nonembolic MCA disease has not been studied. ⋯ In this population, CTA is superior to TCD sonography in the diagnosis of MCA disease. Abnormal TCD results are highly suggestive of MCA stenosis. However, normal TCD findings do not exclude such lesions, especially in patients with distal M1 or M2 disease. Because distal M1 and M2 disease was found in half of our patients, TCD sonography should not be used as a method to screen for MCA stenosis.
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AJNR Am J Neuroradiol · Sep 2002
Human brain hemorrhage: quantification of perihematoma edema by use of diffusion-weighted MR imaging.
Animal models have clearly shown a critical role for extravascular blood in the initiation of the vasogenic edema associated with intracerebral hemorrhage (ICH). Nevertheless, the relevance of these observations to the human disease process has not been evaluated. With a prospectively collected cohort of nine patients, we report the relation between intraparenchymal blood clot volume and elevation of perihematoma brain tissue (and homologous contralateral brain tissue) apparent diffusion coefficient (ADC). ⋯ We report a significant direct correlation between ICH volume and degree of ADC elevation in perihematoma and ADC values in contralateral corresponding brain tissue. These findings suggest a dose-effect interaction between volume and concentration of blood products and intensity of response that brain tissue exhibits in blood-mediated edema. Prospective natural history and interventional studies are required to confirm this biologically meaningful correlation in patients with ICH.
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AJNR Am J Neuroradiol · Sep 2002
Multisection proton MR spectroscopy for mesial temporal lobe epilepsy.
Extensive metabolic impairments have been reported in association with mesial temporal lobe epilepsy (mTLE). We investigated whether proton MR spectroscopy ((1)H-MRS) depicts metabolic changes beyond the hippocampus in cases of mTLE and whether these changes help lateralize the seizure focus. ⋯ Multisection (1)H-MRS depicts interictal reductions of NAA in the ipsilateral temporal lobe beyond the hippocampus and accurately lateralizes seizure foci.
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AJNR Am J Neuroradiol · Aug 2002
Case ReportsSuperior petrosal sinus catheterization for transvenous embolization of a dural carotid cavernous sinus fistula.
We report the endovascular treatment of a dural carotid cavernous fistula in a 67-year-old woman in whom superior petrosal sinus catheterization was performed to access the venous site of the fistula. To our knowledge, this retrograde venous route via the superior petrosal sinus has not been previously described.