AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Feb 2007
Comparative Study Clinical TrialComparison of the temporary diagnostic relief of transforaminal epidural steroid injection approaches: conventional versus posterolateral technique.
Conventional transforaminal epidural steroid injection (TFESI) has several problems. The purpose of this study was to compare the temporary diagnostic relief and advantages of TFESI performed using the conventional and posterolateral approaches. ⋯ Our findings suggest that the posterolateral approach is an alternative method for TFESI in cases where needle tip positioning in the anterior epidural space is difficult.
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AJNR Am J Neuroradiol · Feb 2007
Controlled Clinical TrialFocal brain glucose hypometabolism in patients with neuropsychologic deficits after diffuse axonal injury.
Neuropsychologic deficits are well-known sequelae of traumatic brain injury. However, the cerebral correlates of these deficits are still unclear. The aim of the present study was to elucidate the regions of cerebral dysfunction correlated with such neuropsychologic deficits after traumatic brain injury. ⋯ Interpretation of FDG-PET using 3D-SSP facilitates the identification of regional hypometabolism in the cerebral cortex of patients after diffuse axonal injury. Dysfunction of the cingulate gyrus, lingual gyrus, and cuneus may play a crucial role in neuropsychologic deficits after traumatic brain injury.
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AJNR Am J Neuroradiol · Jan 2007
Carotid blowout syndrome in patients with head-and-neck cancers: reconstructive management by self-expandable stent-grafts.
Some reports of reconstructive management of carotid blowout syndrome (CBS) with stent-grafts are promising, but some are unfavorable. This study sought to evaluate the hemostatic efficacy, safety, and outcome of reconstructive, endovascular stent-graft placement in patients with head-and-neck cancers in association with CBS. ⋯ Although stent-grafts achieved immediate and initial hemostasis in patients with head-and-neck cancers and CBS, long-term safety, stent patency, and permanency of hemostasis appeared unfavorable. This treatment may be for temporary or emergency purposes rather than serving as a permanent measure. We suggest its applications in patients with acute CBS that precludes performance of an occlusion test, as well as when carotid occlusion poses an unusually high risk of neurologic morbidity. We also propose prophylactic antibiotic treatment and combined embolization of pathologic vascular feeders to improve outcomes.
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AJNR Am J Neuroradiol · Jan 2007
Multicenter Study Comparative StudyTreatment of unruptured intracranial aneurysms: a nationwide assessment of effectiveness.
With advances in neuroimaging, unruptured cerebral aneurysms are being diagnosed more frequently. Until 1995, surgical clipping of the aneurysm was the only treatment available. Since then, a less invasive endovascular technique has been found effective in a trial of ruptured aneurysms. No efficacy studies comparing the 2 procedures for unruptured aneurysms exist to guide clinical decisions. The objective of this study was to assess effectiveness and outcomes of endovascular versus neurosurgical treatment for unruptured intracranial aneurysms. ⋯ The current analysis indicates that endovascular therapy is associated with significantly less morbidity, less mortality, and decreased hospital resource use at discharge, compared with conventional neurosurgical treatment for all unruptured aneurysms. Endovascular therapy, as a treatment alternative to surgical clipping, should be offered as a viable therapeutic option for all patients considering treatment of an unruptured cerebral aneurysm.
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AJNR Am J Neuroradiol · Jan 2007
Double inversion recovery brain imaging at 3T: diagnostic value in the detection of multiple sclerosis lesions.
To prospectively determine the sensitivity in the detection of multiple sclerosis (MS) lesions by using double inversion recovery (DIR), fluid-attenuated inversion recovery (FLAIR), and T2-weighted turbo spin-echo (T2 TSE) MR imaging at 3T. ⋯ DIR brain imaging at 3T provides the highest sensitivity in the detection of MS lesions especially in the infratentorial region.