AJNR. American journal of neuroradiology
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Lack of cerebral circulation is an important confirmatory test for brain death (BD). Conventional angiography remains the standard imaging method, but CT angiography (CTA) is emerging as an alternative. France accepts BD diagnoses relying on a score based on lack of opacification of 7 intracerebral vessels in CTA images. The purpose of this study was to validate the efficiency of this score and to evaluate the sensitivity of a novel 4-point CTA score in confirming BD. ⋯ Lack of opacification in the cortical segments of the MCAs and internal veins in CTA is efficient and reliable for confirming BD.
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AJNR Am J Neuroradiol · Sep 2009
Clinical TrialEndovascular strategies for vertebrobasilar dissecting aneurysms.
Dissecting vertebrobasilar aneurysms are challenging to treat, and standard treatment modalities remain controversial. We retrospectively evaluated our experience using endovascular techniques to treat these aneurysms. ⋯ Endovascular procedures for treatment of unruptured symptomatic dissecting aneurysms resulted in favorable outcomes. Ruptured vertebrobasilar dissecting aneurysms are associated with a high risk of periprocedural complications. Risks can be managed by using appropriate endovascular techniques according to aneurysm location, configuration, and relationship with the PICA.
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AJNR Am J Neuroradiol · Sep 2009
Added value and diagnostic performance of intratumoral susceptibility signals in the differential diagnosis of solitary enhancing brain lesions: preliminary study.
It has been reported that high-resolution susceptibility-weighted imaging (HR-SWI) is a promising tool for assessing brain tumor characterization noninvasively. The purpose of this study was to determine the added value and diagnostic performance of HR-SWI for differentiating solitary enhancing brain lesions (SELs) by assessing intratumoral susceptibility signals (ITSSs). ⋯ The use of ITSSs on HR-SWIs significantly improves the accuracy for the differential diagnosis of SELs compared with the use of conventional MR imaging alone.
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AJNR Am J Neuroradiol · Sep 2009
Prediction of functional outcome in acute cerebral hemorrhage using diffusion tensor imaging at 3T: a prospective study.
Early evaluation of the pyramidal tract is a prerequisite in patients with intracerebral hemorrhage (ICH) in order to decide the optimal treatment or to assess appropriate rehabilitation. The aim of this study was to evaluate and predict the neuromotor and functional outcome of an ICH by using diffusion tensor imaging (DTI) in the acute phase. ⋯ We conclude that DTI can evaluate the motor deficit quantitatively and may predict the functional outcome in patients with an ICH who were scanned within 2 days after the ICH onset.
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Loeys-Dietz syndrome (LDS) is a recently described entity that has the triad of arterial tortuosity and aneurysms, hypertelorism, and bifid uvula or cleft palate. Its neuroradiologic manifestations have not been well delineated. We sought to describe the neuroradiologic features of LDS and to assess the manifestations that would warrant follow-up imaging. ⋯ Significant neuroradiologic manifestations are associated with LDS, predominantly arterial tortuosity. Most of the patients in this series were young and, therefore, may require serial CTA monitoring for development of intra- and extracranial dissections and aneurysms, on the basis of the fact that most of the patients with pseudoaneurysms and dissection were older at the time of imaging. Other findings of LDS such as craniosynostosis, Chiari malformation, and spinal instability may also need to be addressed.