Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Nov 2019
ReviewLessons from Vessel Wall Imaging of Intracranial Aneurysms: New Era of Aneurysm Evaluation beyond Morphology.
Recent basic studies have clarified that aneurysmal wall inflammation plays an important role in the pathophysiology of intracranial aneurysms. However, it remains an interdisciplinary challenge to visualize aneurysm wall status in vivo. MR-vessel wall imaging (VWI) is a current topic of advanced imaging techniques since it could provide an additional value for unruptured intracranial aneurysms (UIAs) risk stratification. ⋯ However, aneurysmal wall with contrast enhancement oftentimes associated with atherosclerotic, degenerated and thickened wall structure. It remains ill defined if thin wall without wall enhancement (oftentimes invisible in VWI) could be actually safe or look over wall vulnerability. We reviewed currently available studies, especially focusing on VWI for intracranial aneurysms and discussed the clinical utility of VWI.
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Neurol. Med. Chir. (Tokyo) · Nov 2019
Computational Fluid Dynamics Analysis of the Offending Artery at Sites of Neurovascular Compression in Trigeminal Neuralgia Using Preoperative MRI Data.
This study aimed to analyze the hemodynamic features of the offending artery at sites of neurovascular compression (NVC) using computational fluid dynamics (CFD). A total of 23 patients who underwent microvascular decompression (MVD) for primary trigeminal neuralgia (TN) between January 2015 and December 2016 were enrolled in this study. The compressing vessel at the NVC site was identified microsurgically in all cases, and patients were divided into two groups based on the intraoperative findings: (1) the arterial NVC group and (2) the non-arterial NVC control group. ⋯ There were no significant intergroup differences in the other calculated parameters. High WSSR, which indicates elevated WSS at the sites of NVC, was identified as a unique parameter of arterial compression that may contribute to TN. CFD could be a useful clinical tool in determining the target of MVD under preoperative conditions.