Journal of neuroimaging : official journal of the American Society of Neuroimaging
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A side-to-side difference in systolic brachial arterial blood pressure is a common finding in subclavian artery stenosis and is frequently used as a screening tool for subclavian steal syndrome (SSS). It was the goal of this retrospective study to investigate the relationship between different vertebral artery waveform types and the side-to-side difference in systolic blood pressure in patients with sonographically proven SSS. ⋯ Brachial systolic blood pressure difference is related to the severity of SSS and can be used as a screening tool for SSS. However, it performed better in severe steal than milder steal phenomena.
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The authors report 2 cases of primary spinal intramedullary lymphoma and review all previously reported magnetic resonance imaging findings on this disease. The most common finding was a solid and homogeneously enhanced mass that was hyperintense on T2-weighted images, without associated syringomyelia. In a few cases, swelling of the spinal cord was minimal.
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Today's vascular laboratory technology offers broad applications throughout vascular medicine. We explore the diagnostic work-up and management of selected peripheral vascular diseases by benchmarking the institutional mix of invasive and noninvasive technology utilization and associated cost burdens. ⋯ Benchmark indices reveal near total adoption of noninvasive technology for vascular diagnostic workups at our center. The benefits to institutions of benchmarking their technology utilization mix and costs are discussed in relation to identifying potential for cost-containment from modifying technology utilization practices.
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Case Reports
Paradoxical brain embolism from thrombus associated with vena caval filter in a patient with cancer.
A 71-year-old man experienced sudden onset of hemiparesis and aphasia. He had a 4-month history of gallbladder cholangiocarcinoma, complicated with a postoperative deep-vein thrombosis (DVT) that necessitated a vena caval filter placement. Diffusion-weighted magnetic resonance imaging of the brain showed multiple hyperintense foci. ⋯ Abdominal computed tomography showed a thrombus in the inferior vena cava extending through the filters. A transcranial Doppler bubble study revealed the presence of a right-to-left shunt. Paradoxical cerebral embolism must be considered in patients with DVT who have new onset neurologic deficits even in the presence of a caval filter.