Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Diffusion tensor imaging (DTI) quantifies the motion of water within brain tissue. Inflammation leads to tissue disruption, resulting in increased diffusivity and decreased directionality. We aimed to quantify the damage within tumefactive giant brain lesions (TGL) in multiple sclerosis (MS) using MRI and DTI methodology. ⋯ Within the spectrum of acute MS lesions, TGL present DTI metrics of an intense acute inflammatory process. Analysis of TGL progression proposes that DTI metrics sensitively detects micro-structural changes in TGL from acute inflammation towards lesion recovery and reorganization.
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Juvenile xanthogranuloma (JXG) is a disorder of non-Langerhans cell histiocytosis that usually displays as a self-limiting course in children. Rare systemic involvement implies poor prognosis. Although conventional and spectroscopic magnetic resonance imaging (MRI) findings of JXG in CNS have been described, diffusion imaging of intracranial JXG has not been reported. ⋯ Intravenous steroid therapy is initiated in intensive care setting. All of the lesions have gradually responded to steroid therapy. CNS lesion has taken the longest time to clear.
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Case Reports
Cortical activation changes in patients suffering from post-stroke arm spasticity and treated with botulinum toxin a.
Botulinum toxin (BoNT) treatment relieves focal arm spasticity after stroke, likely acting at several hierarchical levels of the motor system. The central correlate of BoNT-induced spasticity relief may be detected using repeated functional MRI (fMRI) during motor task. ⋯ Relief of post-stroke arm spasticity may be associated with changes at several hierarchical levels of the cortical sensorimotor system, including the prefrontal cortex.
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Observational Study
Black blood MRI in suspected large artery primary angiitis of the central nervous system.
Single case reports suggest that black blood MRI (T1-weighted fat and blood suppressed sequences with and without contrast injection; BB-MRI) may visualize intracranial vessel wall contrast enhancement (CE) in primary angiitis of the central nervous system (PACNS). In this single-center observational pilot study we prospectively investigated the value of BB-MRI in the diagnosis of large artery PACNS. ⋯ Our pilot study demonstrates that vessel wall CE is a frequent finding in PACNS and its mimics. Larger trials will be necessary to evaluate the utility of BB-MRI in the diagnostic workup of PACNS.
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We describe a novel technique for cerebral embolic device placement with inadvertent entrapment and subsequent rescue in the endovascular treatment of innominate artery stenosis. A 62-year-old female presented with symptomatic right-sided subclavian steal syndrome. Single-site access for revascularization of critical innominate artery stenosis with simultaneous cerebral embolic protection performed for this diagnosis has not been previously reported. ⋯ The device was retrieved through snare fixation and resheathing within a 6-French guide catheter navigated through common femoral artery access. Innominate artery balloon-mounted stent angioplasty was performed preceded by the embolic device retrieval, with complete resolution of symptoms. Endovascular distal protection device placement for prevention of cerebral atherothromboembolism during innominate artery stent angioplasty is not without risk and utilization needs to be carefully considered.