Journal of clinical ultrasound : JCU
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Comparative Study
Reduced flow velocity in the internal carotid artery independently of cardiac hemodynamics in patients with cerebral ischemia.
To retrospectively investigate the relationships between carotid flow velocities, clinical features and cardiac hemodynamics to assess the meaning and significance of reduced carotid flow velocities in patients with cerebral ischemic symptoms. ⋯ Cardiac hemodynamics and carotid flow velocities are significantly related, only on the left side, probably due to larger hemodynamic stress. Increased intracerebral circulatory resistance is probably involved in the decrease in carotid flow velocity and increase in PI in patients with cerebral ischemic symptoms.
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To evaluate the accuracy of transcranial Doppler (TCD) sonography using different criteria for predicting cerebral infarction due to symptomatic vasospasm. ⋯ Vasospasm on TCD was found to be predictive of symptomatic cerebral infarction on CT, but its positive predictive value remained low despite the adoption of restrictive TCD criteria for vasospasm.
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We describe the case of a 68-year-old woman who presented with an arteriovenous fistula (AVF) between the common carotid artery and internal jugular vein following several failed attempts of right jugular catheter insertion. Sonographic examination revealed an AVF between both vessels with a high-velocity turbulent flow inside and an arterialized waveform in the jugular vein. Angiography confirmed the sonographic findings, and endovascular treatment was performed with a covered stent.
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Tuberculosis of the thyroid gland is very rare, with an acute abscess formation being the least common form of presentation. We report the sono-graphic features of two cases of tuberculous thyroid abscess that were confirmed via ultrasound-guided fine needle aspiration biopsy.
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A 46-year-old man who presented with an unruptured left paraclinoid aneurysm was treated via endovascular embolization using Guglielmi detachable coils, obtaining its complete exclusion. Within 5 hours, the patient developed a transient mild headache and moderate speech difficulty. CT scans revealed a left temporal ischemic area. ⋯ The patient underwent a second embolization procedure with additional coils for complete exclusion of the aneurysm. His postoperative course was uneventful, with no additional neurological deficits. Although TCD monitoring is not recommended as a routine procedure in such cases, and experimental studies are needed to evaluate the possible risk of rebleeding in this specific setting, it could be used to detect the hemodynamic consequences of an acute increase in intracranial pressure, as in patients at risk of subarachnoid hemorrhage after endovascular treatment.