Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Controlled Clinical Trial
Arterial blood gas analysis of samples directly obtained beyond cerebral arterial occlusion during endovascular procedures predicts clinical outcome.
Real-time intra-procedure information about ischemic brain damage degree may help physicians in taking decisions about pursuing or not recanalization efforts. ⋯ Direct local blood sampling from ischemic brain is feasible during endovascular procedures in acute stroke patients. A gradient in oxygenation parameters was demonstrated between pre- and post-occlusion blood samples. ABG information may be used to predict clinical outcome and help in decision making in the angio-suite.
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As magnetic resonance-guided focused ultrasound (MRgFUS) sonothrombolysis relies on mechanical rather than thermal mechanisms to achieve clot lysis, thermometry is not useful for the intraoperative monitoring of clot breakdown by MRgFUS. Therefore, the purpose of this study was to evaluate the optimum imaging sequence for sonothrombolysis. ⋯ T2 is the most appropriate sequence for the evaluation of mechanical MRgFUS sonothrombolysis of an in vitro clot. These findings are consistent across the oxidative states of clot up to 48 hours.
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In this study, we sought to determine whether routine head computed tomographies (CTs) after uncomplicated coil embolization of intracranial aneurysms can add any significant clinical value. ⋯ A head CT after uncomplicated coil embolization of an intracranial aneurysm does not add any significant clinical value and should not be ordered routinely.
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Contrast neurotoxicity (CN) following exposure to iodinated contrast is uncommon, and usually presents as cortical blindness due to bilateral occipital lobe involvement. Unilateral cortical dysfunction due to CN could mimic an acute stroke and has been rarely described. We report the case of an 89-year-old female who developed a transient dense/complete left homonymous-hemianopsia and left-sided tactile extinction after undergoing a right internal carotid (ICA) artery rotational angiogram with a standard high-volume iodinated contrast injection for 3D visualization a 6×4-mm right posterior communicating artery aneurysm with a fetal posterior cerebral artery (PCA) incorporated in the neck. ⋯ The potential mechanism of CN in our case was the injection of a high volume of contrast in the ICA for the rotational angiogram. The presence of a right fetal PCA possibly allowed the contrast to reach the right occipital lobe. CN manifesting as an acute focal neurologic syndrome should be considered in the setting of recent iodinated contrast exposure.
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Orbital penetrating injuries may cause significant harm to optic nerves and eyeball as well as to the brain and cerebral vasculature. Defining surrounding neurovascular structures by CT angiography (CTA) is important for surgical removal. We present an uncommon case of a 3-year-old child with a penetrating orbital injury caused by a toothbrush. To the best of our knowledge, there is no report orbital injury with a toothbrush so far.