Journal of neurointerventional surgery
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Integration of data from clinical trials and advancements in technology predict a change in selection for treatment of patients with cerebral aneurysm. ⋯ The majority of unruptured aneurysms in the USA are now treated with endovascular coiling. Although surgical clipping is used for treatment of most ruptured aneurysms, its use is decreasing over time. Dissemination of endovascular procedures appears widespread across patient and hospital subgroups.
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Cerebral hyperperfusion syndrome (CHS) is an infrequent syndrome observed in carotid endarterectomy and carotid angioplasty and stenting (CAS). The case history is presented of a patient with CT perfusion imaging of non-hemorrhagic CHS and reversal following medical treatment after CAS. ⋯ This is the first report to our knowledge of CT perfusion imaging for CHS with post-symptomatic imaging following clinical resolution. Prompt CHS evaluation may include CT perfusion imaging to assist diagnostic accuracy. Rigorous blood pressure control remains the mainstay of treatment.
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Computed tomographic angiography (CTA) has recently emerged as a non-invasive alternative to digital subtraction angiography (DSA) for the detection of residual cerebral aneurysms (RA). ⋯ This meta-analysis supports CTA as an acceptable modality for postoperative detection of RA, although DSA remains the gold standard. By implementing multidetector CTA technology in experienced centers, the sensitivity and specificity of CTA may approach that of traditional DSA for detecting RA. As a cost-effective, non-invasive modality, CTA is a promising alternative to DSA for initial and long-term evaluation of RA.
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Randomized Controlled Trial
Effects of a music intervention on patients undergoing cerebral angiography: a pilot study.
To test the effect of a music intervention on procedural anxiety, stress response and medication requirements in participants with a cerebral aneurysm or arteriovenous malformation (AVM) undergoing cerebral angiography. ⋯ A music intervention on participants with a brain aneurysm or AVM undergoing cerebral angiography did not have a statistically significant impact on reducing the stress response, anxiety or medication requirements. Interestingly, participants in the control group had significantly less anxiety after their angiogram than did participants in the experimental group. This pilot study sets the stage for future research to further examine these findings.