Journal of neuroimaging : official journal of the American Society of Neuroimaging
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The authors describe serial positron emission tomography (PET) and magnetic resonance imaging (MRI) studies in a patient with pathologically confirmed Rasmussen Encephalitis (RE). Results of initial PET and MRI studies were normal. Subsequent studies showed involvement of the percentral and postcentral gyri and the putamen on PET, and the precentral and postcentral gyri on MRI. ⋯ The authors demonstrate the evolution of changes on PET and MR images in a patient with RE. Despite early pathologic confirmation of RE, there were no definite structural or functional imaging changes on PET or MRI until 3 years after symptom onset. These findings demonstrate the variability of imaging changes in RE, and the need to carefully correlate electro-physiologic and clinical findings to confirm the diagnosis of RE.
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The pathophysiology of focal spinal cord MRI T2 hyperintensity (SCHI) in patients with cervical spondylosis is uncertain. This study was undertaken to determine the frequency and cause of SCHI. The authors reviewed serial cervical spine magnetic resonance imaging (MRI) reports and reviewed scans with spondylosis and cord compression or SCHI. ⋯ Patients with SCHI were older (58.3 years +/- 12.8 years versus 46.8 +/- 8.1 years) (p = 0.007) and had a higher SS (5.7 +/- 2.4 versus 3.9 +/- 1.4) (p = 0.02) than patients without SCHI. The SCHI relates to the severity of cervical spondylosis. The anterior spinal artery territory location, the normal cord between SCHI and the compressive lesion, and the presence of SCHI at a distance from the compressive level all suggest an ischemic basis for SCHI.
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In this update, the main clinical applications of transcranial Doppler ultrasonography are reassessed. A specific format for technology assessment, personal experience, and an extensive review of the literature form the basis of the evaluation. The document is approved by the American Society of Neuroimaging and the Neurosonology Research Group of the World Federation of Neurology.
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Comparative Study
A new pocket-sized transcranial ultrasound device (NeuroDop): comparison with standard TCD.
The NeuroDop is a new bedside assessment tool consisting of a continuous wave ultrasound probe attached to a stethoscope earpiece. This study was designed to compare middle cerebral artery (MCA) velocity assessment obtained with the NeuroDop versus standard transcranial Doppler (TCD). TCD technologists performed continuous wave NeuroDop studies followed by standard TCD studies on 60 subjects. ⋯ This novel stethoscope-continuous wave unit has excellent sensitivity in detecting presence of MCA patency. Moreover, MCA velocities can be characterized to a reasonable degree of accuracy based on NeuroDop auditory characteristics. The NeuroDop shows promise as a tool to rapidly assess and serially monitor presence and amplitude of MCA velocity and may help guide thrombolytic and other emergency management decisions in stroke patients.
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The authors define the frequency, nature, and extent of cerebrovascular sequelae of Takayasu arteritis using functional imaging. Retrospective analysis of the cases derived from the Durban Stroke Data Bank (n = 1100) and Durban Metropolitan Vascular Surgery Database (n = 5300) consisted of evaluation by contemporary neuroimaging modalities including single positron emission computed tomography (SPECT), magnetic resonance imaging (MRI) diffusion scanning, and transcranial Doppler (TCD). Of all the patients identified with Takayasu disease (n = 142), 29 (20%) patients were identified with a primarily cerebrovascular presentation. ⋯ Single positron emission computed tomography scanning revealed areas of hypoperfusion, mostly multiple, in all of the 7 cases investigated. The cerebral perfusion index was determined in 7 patients, with a good prognosis in 2 patients and a moderate prognosis in 5. Cerebral effects of Takayasu disease are best monitored by a combination of clinical and functional imaging such as TCD and SPECT scanning.