AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Mar 2015
Patency of the anterior choroidal artery after flow-diversion treatment of internal carotid artery aneurysms.
Treatment of cerebral aneurysms with flow diverters often mandates placement of the device across the ostia of major branches of the internal carotid artery. We determined the patency rates of the anterior choroidal artery after placement of flow-diversion devices across its ostium. ⋯ In this small study, placement of a Pipeline Embolization Device across the anterior choroidal artery ostium resulted in occlusion of the artery in only 1 patient. It was not associated with ischemic changes in the distribution of the anterior choroidal artery in any patient.
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AJNR Am J Neuroradiol · Feb 2015
Imaging evidence and recommendations for traumatic brain injury: advanced neuro- and neurovascular imaging techniques.
Neuroimaging plays a critical role in the evaluation of patients with traumatic brain injury, with NCCT as the first-line of imaging for patients with traumatic brain injury and MR imaging being recommended in specific settings. Advanced neuroimaging techniques, including MR imaging DTI, blood oxygen level-dependent fMRI, MR spectroscopy, perfusion imaging, PET/SPECT, and magnetoencephalography, are of particular interest in identifying further injury in patients with traumatic brain injury when conventional NCCT and MR imaging findings are normal, as well as for prognostication in patients with persistent symptoms. ⋯ However, the data currently available confine their use to the research arena for group comparisons, and there remains insufficient evidence at the time of this writing to conclude that these advanced techniques can be used for routine clinical use at the individual patient level. TBI imaging is a rapidly evolving field, and a number of the recommendations presented will be updated in the future to reflect the advances in medical knowledge.
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AJNR Am J Neuroradiol · Feb 2015
Prediction of infarction and reperfusion in stroke by flow- and volume-weighted collateral signal in MR angiography.
In proximal anterior circulation occlusive strokes, collateral flow is essential for good outcome. Collateralized vessel intensity in TOF- and contrast-enhanced MRA is variable due to different acquisition methods. Our purpose was to quantify collateral supply by using flow-weighted signal in TOF-MRA and blood volume-weighted signal in contrast-enhanced MRA to determine each predictive contribution to tissue infarction and reperfusion. ⋯ Visual scoring of contrast-enhanced but not TOF-MRA is a reliable predictor of infarct outcome in stroke patients with proximal arterial occlusion. By atlas-based collateral assessment, TOF- and contrast-enhanced MRA both contain predictive signal information for penumbral reperfusion. This could improve risk stratification in further studies.
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AJNR Am J Neuroradiol · Feb 2015
Assessment of intracranial collaterals on CT angiography in anterior circulation acute ischemic stroke.
Intracranial collaterals influence the prognosis of patients treated with intravenous tissue plasminogen activator in acute anterior circulation ischemic stroke. We compared the methods of scoring collaterals on pre-tPA brain CT angiography for predicting functional outcomes in acute anterior circulation ischemic stroke. ⋯ Only the Miteff scoring system for intracranial collaterals is reliable for predicting favorable outcome in thrombolyzed acute anterior circulation ischemic stroke. However, poor outcomes can be predicted by most of the existing methods of scoring intracranial collaterals.
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AJNR Am J Neuroradiol · Feb 2015
Visual outcomes with flow-diverter stents covering the ophthalmic artery for treatment of internal carotid artery aneurysms.
Flow-diverting stents can be used to treat intracranial aneurysms that are not amenable to treatment with coils. We analyzed ophthalmic consequences due to coverage of the origin of the ophthalmic artery by flow-diverting stents for the treatment of internal carotid artery aneurysms. ⋯ This prospective study shows that covering the ophthalmic artery with a flow-diverting stent is not without potential complications. Ophthalmic complications can occur but are often not diagnosed. The anatomic disposition of the ophthalmic artery in relation to the carotid siphon and aneurysm should be clearly understood because some configurations have a higher risk. When not required, covering of the ophthalmic artery by flow-diverting stents should be avoided.