Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Case Reports
Correlation of sonographic and electrophysiological findings in a patient with multifocal motor neuropathy.
Multifocal motor neuropathy (MMN) is an acquired, immune mediated, and commonly associated with antiganglioside antibodies against GM1 lower motor neuropathy, with an incidence of 1 per 100,000. The usual age of onset is between 20 and 50 years and men appear to be more often affected than women. Patients usually present with multifocal weakness that can be localized to named nerve distributions. ⋯ We draw the attention on the usefulness of ultrasonography for detecting and diagnosing segmental lesions of the peripheral nerves in MMN and other immune mediated neuropathies, especially in cases where a nervous segment cannot be easily explored in terms of inching technique.
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Case Reports
Detection of cerebral hyperperfusion syndrome after carotid endarterectomy with CT perfusion.
We present the case of a 60-year-old female patient, who developed symptomatic internal carotid artery stenosis and subsequently underwent carotid endarterectomy. Four days after an uneventful surgery the patient developed confusion, seizures, and was admitted to the ICU. CT perfusion revealed reduced ispilateral time-to-peak and mean-transient-time and increased cerebral blood volume and cerebral blood flow, confirming the diagnosis of cerebral hyperperfusion syndrome. We thus propose CT perfusion as a diagnostic means for cerebral hyperperfusion syndrome, a syndrome that remains underdiagnosed.
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Review Meta Analysis
The role of sonolysis and sonothrombolysis in acute ischemic stroke: a systematic review and meta-analysis of randomized controlled trials and case-control studies.
To assess the evidence on the safety and efficacy of sonothrombolysis in acute stroke. ⋯ This novel treatment appears safe and effective. The evidence of microsphere as an enhancement of sonothrombolysis is evolving.
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Susceptibility-weighted imaging (SWI) is a recently developed high resolution 3-dimensional gradient-echo pulse sequence that accentuates the magnetic susceptibility of blood, calcium, and nonheme iron. The clinical applications of SWI in pediatric neuroimaging have significantly expanded recently. Potential pitfalls related to blood oxygenation, blood flow, magnetic field strength, and misinterpretation of localization as well as possible mimickers may be misleading and affect the correct interpretation of SWI images. Familiarity with these potential diagnostic pitfalls is important to prevent misdiagnosis and will further enhance the ability of SWI in becoming a robust and reliable technique.
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The diagnosis of Chiari malformation type I (CMI) relies on MRI identification of a tonsillar descent (TD) through the foramen magnum, reflecting the overcrowding of an underdeveloped posterior cranial fossa (PCF). However, TD occurs in some patients with normal-sized PCF and, conversely, some patients with borderline or no TD have small PCF. We thus sought to identify a set of prototypic PCF measures for the diagnosis of CMI. ⋯ The addition of simple morphometric measurements in the diagnostic work-up of patients with suspected CMI may facilitate radiological diagnosis. Moreover, identification of the subset of CMI that arise from basichondrocranium underdevelopment is important for both, selection of the most appropriate therapeutic approach as well as proper CMI categorization in research studies.