Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Surgical decompression of the vascular loop of the vertebral artery (VA) at the left lateral medulla can reduce blood pressure (BP) in hypertension, and a larger diameter of the left VA has been found in hypertensive patients. Noninvasive evaluation of the VA in hypertension may assist selecting patients for more appropriate diagnosis and treatment. Duplex ultrasonography is used to study the relationship between VA diameter and BP. ⋯ Differences in left-right VA diameter in hypertensive subjects may be a previously unrecognized component of the vascular disturbances associated with the disease and represent an additional criterion for identifying those who may benefit from surgical and medical management.
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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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Comparative Study
Screening for intracranial stenosis with transcranial Doppler: the accuracy of mean flow velocity thresholds.
Patients with 50% intracranial arterial stenosis may require more intensive therapies for stroke prevention. Transcranial Doppler (TCD) is a convenient noninvasive screen for intracranial stenosis. The accuracy of different mean flow velocity (MFV) thresholds for determining the degree of stenosis remains uncertain. ⋯ TCD is both sensitive and specific in identifying > or = 50% intracranial arterial stenosis. A MFV threshold cutoff of 100 cm/s has an optimal sensitivity and specificity trade-off for > or = 50% MCA stenosis. To help avoid false-positive results, a prestenotic to stenotic MCA velocity ratio of 1: > or = 2 should be used in addition to the MFV threshold.