Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Case Reports
Continuous arterial spin labeling perfusion magnetic resonance imaging findings in postpartum vasculopathy.
Postpartum vasculopathy (PPV) is a rare heterogeneous nonatherosclerotic vasculopathy that occurs in the puerperium. It occurs spontaneously but may be triggered by vasoconstrictor substances. The angiographic findings vary and include narrowing of the intracranial arteries and vasospasm. ⋯ In this series of patients with PPV, CBF was close to normal. Although angiography often reveals diffuse arterial narrowing, the CBF values encountered in this study do not support a state of generalized or focal oligoemia. Vasomotor tone may change intermittently in patients with PPV.
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Stroke patients with paradoxical embolus mandate a search for deep venous thrombosis (DVT) in the lower extremities. Iliac vein compression, or May-Thumer syndrome, places certain patients at risk for development of DVT. The authors present 3 stroke patients with patient foramen ovale and paradoxical cerebral embolism, with demonstrated iliac vein compression as the presumed source of their embolus. May-Thumer syndrome should be considered a potential source of clot, as definitive therapy of this disorder can be curative.
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Comment Letter
Petrous carotid stenosis documented by catheter angiography.
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The authors establish accuracy parameters of a broad diagnostic battery for bedside transcranial Doppler (TCD) to detect flow changes due to internal carotid artery (ICA) stenosis or occlusion. ⋯ In symptomatic patients, bedside TCD can accurately detect flow changes consistent with hemodynamically significant ICA obstruction; however, TCD should not be a substitute for direct carotid evaluation. Because TCD is sensitive and specific for a > or = 70% carotid stenosis or occlusion in both extracranial and intracranial carotid segments, it can be used as a complementary test to refine other imaging findings and detect tandem lesions.
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Randomized Controlled Trial Multicenter Study Clinical Trial
SonoVue in transcranial Doppler investigations of the cerebral arteries.
The authors investigated the safety and diagnostic potential of a new ultrasound contrast agent (SonoVue) using transcranial color-coded duplex sonography (TCCS). ⋯ The results obtained from this multicenter study demonstrate that the administration of SonoVue to patients with ischemic cerebrovascular disease who undergo TCCS examination of cerebral vessels improves the visualization of intracranial arteries, providing a dose-dependent contrast enhancement and a clinically useful duration of signal enhancement related to the dose. During this multicenter study, SonoVue proved to be a safe and well-tolerated compound.