Journal of neuroimaging : official journal of the American Society of Neuroimaging
-
It is still controversial whether intravenous (IV) thrombolysis for acute ischemic stroke increases the risk of aneurysmal bleeding. We sought to find the risk for aneurysmal bleeding after IV thrombolysis in ischemic stroke patients with unruptured cerebral aneurysms. ⋯ The results of this study suggest that IV thrombolysis might not increase the risk of aneurysmal bleeding in acute stroke patients with unruptured aneurysm < 10 mm in diameter. Further studies with a larger sample size are needed to confirm our result.
-
Patients with symptomatic intracranial neuropathology such as atherosclerotic occlusive disease or unruptured aneurysms face high risks for morbidity and mortality. Magnetic resonance angiography of the circle of Willis is an important tool used to detect and diagnose intracranial neuropathology; however, recent changes to the Medicare local coverage determinations for this procedure threaten to compromise the physician's ability to deliver this current standard of care. Physicians can assume an important role in advocating for this lifesaving procedure on behalf of this vulnerable patient population.
-
To investigate differences in T2 intensity of deep gray matter (dGM) structures by magnetic resonance imaging (MRI) in multiple sclerosis (MS) patients undergoing various immunomodulatory therapies. ⋯ Our preliminary observations suggest that long-term NAT therapy in MS patients may affect T2 intensity levels of dGM brain nuclei, hence suggesting a potential effect of NAT beyond anti-inflammatory effect. Prospective studies are warranted to provide more insights into our preliminary observations.
-
Neuroborreliosis is a rare cause of stroke in children. We aim here to demonstrate the diagnostic value of gadolinium-enhanced magnetic resonance imaging (MRI) for demonstrating vessel wall abnormality in a child with brainstem stroke. ⋯ Gadolinium-enhanced MRI provided additional information facilitating the diagnosis of vasculitis in a child with Lyme neuroborreliosis and stroke. The location of vessel wall enhancement was correlated with the topography of the acute infarct, and the lack of vessel lumen obstruction supported the diagnosis of vasculitis rather than any other cause.
-
The pathological differences underlying the clinical disease phases in multiple sclerosis (MS) are poorly characterized. We sought to explore the relationship between the distribution of white matter (WM) lesions in relapsing-remitting (RR) and secondary progressive (SP) MS and the normal regional variability of cerebral perfusion. ⋯ Chronic plaques were more prevalent in WM regions with lower relative perfusion. Lesions in more highly perfused regions were more commonly observed in early RR MS and therefore, may be more likely to successfully remyelinate and resolve.