AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Mar 2005
Comparative StudyDiagnostic and prognostic value of early MR Imaging vessel signs in hyperacute stroke patients imaged <3 hours and treated with recombinant tissue plasminogen activator.
Analogous to the CT hyperattenuated vessel sign (HMCAS), MR imaging may show hypo- or hyperintense vessels in acute ischemic stroke (AIS) patients. We assessed the diagnostic and prognostic strength of early MR imaging vessel signs in AIS patients treated with intravenous thrombolysis (IVT) within 3 hours of the onset of symptoms. ⋯ Although early vessel signs can be helpful in the diagnosis of intravascular disease, they do not independently predict recanalization, ICH, or any of the three clinical outcomes in a multivariate logistic regression model. Thrombus composition as reflected by signal intensity characteristics on GRE and FLAIR does not predict the therapeutic effect of IVT.
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AJNR Am J Neuroradiol · Mar 2005
Periprocedural morbidity and mortality associated with endovascular treatment of intracranial aneurysms.
Despite experience and technological improvements, endovascular treatment of intracranial aneurysms still has inherent risks. We evaluated cerebral complications associated with this treatment. ⋯ Procedural morbidity and mortality rates were highest in ruptured aneurysms and lowest in unruptured aneurysms. Morbidity rates were highest in re-treated aneurysms and lowest in unruptured aneurysms. No procedural mortality occurred with re-treated aneurysms. The main cause of morbidity and mortality was thromboembolism.
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AJNR Am J Neuroradiol · Mar 2005
Indications for CT in patients receiving anticoagulation after head trauma.
Head CT is frequently ordered for trauma patients who are receiving anticoagulation. However, whether patients with a Glasgow Coma Scale (GCS) score of 15 and normal findings on neurologic examination require CT is still debated. The purpose of our study was to assess the use of cranial CT in patients receiving anticoagulants after head trauma and to establish clinical criteria to identify those in this group who do not need emergency CT. ⋯ Patients with head injury, normal GCS scores, and no focal neurologic deficits and who are receiving the anticoagulants heparin or coumadin may not necessarily require emergency CT.
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AJNR Am J Neuroradiol · Mar 2005
Incorrect needle position during lumbar epidural steroid administration: inaccuracy of loss of air pressure resistance and requirement of fluoroscopy and epidurography during needle insertion.
Loss of air pressure resistance leads to a high rate (25.7%) of inaccurate needle-tip placement in the posterior soft tissues of the back during lumbar epidural steroid administration employing a 20-gauge Tuohy needle. Imaging and epidurogram are essential for confident identification of the lumbar epidural space to enable accurate location of steroid administration. Studies assessing efficacy of lumbar epidural steroid injection and individual patient treatments should ensure location of administration with epidurogram to enhance the validity of results.
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AJNR Am J Neuroradiol · Mar 2005
Comparative StudyCortical lesions in multiple sclerosis: combined postmortem MR imaging and histopathology.
Cortical lesions constitute a substantial part of the total lesion load in multiple sclerosis (MS) brain. They have been related to neuropsychological deficits, epilepsy, and depression. However, the proportion of purely cortical lesions visible on MR images is unknown. The aim of this study was to determine the proportion of intracortical and mixed gray matter (GM)-white matter (WM) lesions that can be visualized with postmortem MR imaging. ⋯ In contrast to WM lesions and mixed GM-WM lesions, intracortical lesions remain largely undetected with current MR imaging resolution.