Journal of neuroimaging : official journal of the American Society of Neuroimaging
-
Erythropoietin (EPO) has received growing attention because of its neuroregenerative properties. Preclinical and clinical evidence supports its therapeutic potential in brain conditions like stroke, multiple sclerosis, and schizophrenia. Also, in Friedreich ataxia, clinical improvement after EPO therapy was shown. The aim of this study was to assess possible therapy-associated brain white matter changes in these patients. ⋯ To the best of our knowledge, this is the first DTI study to investigate the effects of EPO in a neurodegenerative disease. Anatomically, the diffusivity changes appear disease unspecific, and their biological underpinnings deserve further study.
-
Arterial spin labeling (ASL) MRI provides information on tissue perfusion by consecutive readout of labeled blood captured in arteries or the microvasculature without using contrast agents. ⋯ The use of ASL with multiple TI allows the contrast-free assessment of hemodynamic impairment in ischemic stroke patients. Quantitative ASL perfusion analysis reliably demonstrates areas of delayed BAT and reduced CBF matching findings of DSC.
-
Controlled Clinical Trial
Jugular valve incompetence in transient global amnesia. A problem revisited.
Previous studies have suggested that transient global amnesia (TGA) may be provoked by cerebral venous congestion due to a reflux during Valsalva maneuver (VM) caused by internal jugular venous valve incompetence (IJVVI). We investigated the hemodynamic consequences of postural changes on IJVVI and on intracranial veins in patients with TGA and control subjects. ⋯ Consistent with results of other groups, we found a significantly higher rate of IJVVI in TGA patients compared to controls. However, we found no differences of intracranial venous circulation between groups nor an effect of body position. This sheds doubt on the assumption of a causative effect of IJVVI in TGA.
-
Transcranial Doppler (TCD) is an invaluable tool allowing real-time monitoring of physiologic blood flow velocity changes. We present a case where TCD monitoring for vasospasm after subarachnoid hemorrhage identified blood flow velocity changes consistent with sudden increased intracranial pressure (ICP) due to a malfunctioning extraventricular drain. ⋯ Serial TCD monitoring allowed identification of an imminently fatal complication in time to allow a life saving intervention. TCD is a portable, inexpensive, real-time tool providing important physiologic data regarding blood flow velocities and intracranial pressure that is crucial to the care of critically ill patients.