Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Periventricular nodular heterotopias (PNHs) are frequently associated with drug-resistant epilepsy (DRE). Although magnetic resonance imaging (MRI) can define the morphological features of PNHs, still there is a need to assess their metabolic activity in order to provide useful information on epileptogenicity and long-term outcome. To that end, we investigated the ability of 18 F-FDG PET to identify seizure onset zone in order to assess the metabolic activity of the ectopic neurons and to provide prognostic information on the postsurgical outcome. ⋯ In PNHs-related epilepsy, FDG-PET more accurately identifies epileptogenic foci, which aids surgical planning and in postoperative seizure control.
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Aneurysm hemodynamics play an important role in aneurysm growth and subsequent rupture. Within the available hemodynamic characteristics, particle residence time (PRT) is relatively unexplored. However, some studies have shown that PRT is related to thrombus formation and inflammation. The goal of this study is to evaluate the association between PRT and aneurysm rupture and morphology. ⋯ Our study shows an influence of aneurysm morphology on PRT. Nevertheless, it suggests that PRT cannot be used to differentiate unruptured and ruptured aneurysms.
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Review
Thrombectomy of Ventricular Assist Device-Originated Embolic Stroke: A Clinical Decision Model.
The use of ventricular assist devices (VADs) for the treatment of heart failure has become increasingly common. These patients have a considerable risk of cerebral embolism. We describe such a patient and his successful treatment by thrombectomy, compare his attributes with those previously published, and describe the construct of a clinical decision model, whose results bear practical implications for patient management. ⋯ In conclusion, thrombectomy appears to be a safe and effective method (and often the only viable one) for urgent treatment of patients with VAD-originated cerebral embolism.
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Vascular aspects like global cerebral hypoperfusion are frequently reported in patients with multiple sclerosis (MS). Although mechanistic question remains unanswered, this hemodynamic impairment may be caused by a widespread endothelial dysfunction. Furthermore, impaired cerebrovascular reactivity (CVR) has been described in patients with MS by means of hypercapnic perfusion magnetic resonance imaging (MRI). We sought to further evaluate potential hemodynamic restriction in patients with MS using functional sonographic methods. ⋯ These preliminary sonographic findings appear to independently corroborate the previously reported observation of impaired CVR on brain MRI in patients with MS. However, the underlying pathophysiological mechanisms as well as the clinical impact of this observation remain elusive.
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Hemodynamic and metabolic impairment in intracranial atherosclerotic stenosis (ICAS) may promote stroke vulnerability particularly in borderzone areas. Perfusion and oxygen mapping magnetic resonance imaging (MRI) may provide useful information in this setting. ⋯ Symptomatic ICAS had no global impact on perfusion and oxygen mapping MRI at resting state. A significant increase in nCBV was found within anterior borderzone areas.