Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Cerebral venous thrombosis is a rare condition. Its diagnosis and management can be difficult. Treatment options include systemically delivered anticoagulation or thrombolysis. Intrasinus thrombolysis is an increasingly used intervention but it increases the risk of hemorrhage, especially in patients who have a rapidly deteriorating neurological condition. Mechanical thrombectomy that provides rapid canalization without increased risk of hemorrhage is an attractive alternative treatment. ⋯ Intracranial hemorrhage or a rapidly deteriorating neurological condition may preclude the use of thrombolytic agents in the treatment of patients with cerebral venous sinus thrombosis. In such patients, mechanical thrombectomy offers a useful alternative.
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The prevalence and natural history of asymptomatic intracranial arterial stenosis are not very well characterized. Existing data suggest that incidentally discovered asymptomatic intracranial stenosis presents a fairly low risk of stroke, though substantial uncertainty remains. ⋯ Methods to stratify the risk of stroke with asymptomatic intracranial atherosclerotic lesions have yet to be established and validated. In general, aggressive intervention for an asymptomatic intracranial stenosis is not currently recommended.
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Intracranial stenosis is a common etiology for ischemic stroke. Due to limitations of imaging studies, there are limited data on the prevalence of symptomatic and asymptomatic intracranial stenosis. Intracranial stenosis is more prevalent in Asian, Hispanic, and African-American populations. ⋯ Angiotensin-converting enzyme polymorphisms, plasma endostatin/vascular endothelial growth factor ratio, glutathione S-transferase omega-1 gene polymorphism, and plasma homocysteine levels are non-modifiable risk factors noted to be associated with intracranial stenosis. Hypertension and serum lipid profile are major modifiable risk factors, whereas sickle cell disease is an uncommon risk factor that can be managed to reduce risk. Associations of intracranial atherosclerosis with diabetes mellitus, metabolic syndrome, Alzheimer's disease, aortic plaques, radiotherapy, and meningitis are less well documented.
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To examine the neurophysiological basis for the pronounced differences in hyperactivity and impulsiveness that distinguish the predominantly inattentive type of attention-deficit/hyperactivity disorder (ADHD-PI) from the combined type of the disorder (ADHD-C). ⋯ The results provide preliminary evidence that phenotypic differences between the ADHD-C and ADHD-PI subtypes are associated with differential activation of regions that have previously been implicated in the pathophysiology of ADHD and are thought to mediate executive and attentional processes.
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Case Reports
Variant of subclavian steal in the setting of ipsilateral common carotid artery occlusion: case report.
Subclavian steal is a well-described angiographic finding and clinical syndrome that rarely results in vertebrobasilar ischemic symptoms. In classic subclavian steal, left subclavian artery (SA) stenosis occurs proximal to the left vertebral artery (VA) origin. We report a symptomatic variant of this syndrome that occurred in the setting of left common carotid artery occlusion and anomalous origin of the left VA directly from the aortic arch. The steal and symptoms resolved after stenting of the left SA stenosis.