Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Recent reports have indicated that mechanical thrombectomy may have the potential to treat acute ischemic stroke. This study aims to describe the safety and effectiveness of Trevo Retriever, using Stentriever technology, in revascularization of patients with acute ischemic stroke. ⋯ Early clinical experience suggests that the TR can allow safe and effective revascularization in certain subjects with acute ischemic stroke.
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Insonation of the occluded target vessel (sonothrombolysis) has been reported to increase the effect of intravenous thrombolysis in ischemic stroke. Its use has predominantly been described in middle cerebral artery (MCA) occlusions. Sufficient insonation conditions are a mandatory precondition. The impact of these limitations on eligibility rates for sonothrombolysis has not been reported so far. ⋯ Conventional sonothrombolysis is restricted to a minority of stroke patients suitable for intravenous thrombolysis. Extending the applicability by utilization of ultrasound contrast agents and targeting non-MCA-occlusions warrants further evaluation.
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Reversible cerebral vasoconstriction syndrome (RCVS) is an increasingly recognized acute cerebrovascular condition that may produce myriad transient and sustained neurologic deficits as well as a host of radiologic features. We report the case of a woman with RCVS and a severe clinical syndrome with bilateral basal ganglia hemorrhages, cerebral infarctions, and marked vascular abnormalities. The patient made a near complete clinical recovery, representing an extreme and illustrative form of RCVS.
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Cerebral coenurosis due to Taenia multiceps is a rare infection with no case reports from India. A 55-year-old male patient had presented with progressive symptoms of hemiparesis of 1-year duration. Magnetic resonance imaging (MRI) with magnetic resonance spectroscopy (MRS) of the lesion was performed that showed a septated cystic lesion in left parieto-occipital lobe. ⋯ MRS showed mildly elevated choline (Cho), depressed creatine (Cr), and N-acetyl aspartate (NAA), a large peak of lactate, pyruvate, and acetate peaks. To best of our knowledge, there has been no reported case of in vivo proton MRS finding ever reported. We present MRS findings in this operatively proven case of T. multiceps cyst of the brain.
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Evidence from animal models and examination of human epilepsy surgery specimens indicates that inflammation plays an important role in epilepsy. Positron emission tomography (PET) using [C11]PK11195, a marker of activated microglia, provides a means to visualize neuroinflammation in vivo in humans. We hypothesize that in patients with active epilepsy, [C11]PK11195 PET (PK-PET) may be able to identify areas of focally increased inflammation corresponding to the seizure onset zone. ⋯ PK-PET can identify neuroinflammation associated with subtle focal cortical dysplasia, and may therefore have a clinical role in guiding epilepsy surgery for patients with difficult-to-localize seizure foci.