Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Review Multicenter Study
Endovascular management of symptomatic extracranial stenosis associated with secondary intracranial tandem stenosis. A multicenter review.
Several studies have reported variable rates of perioperative risk of stroke in individuals with tandem stenoses after carotid endarterectomy. Endovascular treatment of extracranial lesions associated with tandem lesions is limited to case reports and small case series. ⋯ The high risk of postprocedural stroke and/or death observed in this series requires careful assessment of the risk/benefit ratio of endovascular procedures in patients with tandem stenosis.
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Transcranial Doppler (TCD) and near-infrared spectroscopy (NIRS) are two noninvasive diagnostic tools that have been shown to evaluate cerebral vasomotor reactivity by measuring changes in mean cerebral blood flow velocities (MCBFV) of proximal intracranial arteries and absolute brain-tissue oxygen-saturation (TOS) in microcirculation, respectively, during hemodynamic challenge. We evaluated the potential correlation between TCD and NIRS measurements of vasomotor reactivity (VMR) in patients with carotid artery disease (CARAD). ⋯ Circulatory assessment of VMR in proximal cerebral vessels by TCD correlates positively to functional measurements of VMR in microcirculation by NIRS in CARAD patients.
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Review
[123I]FP-CIT (DaTscan) SPECT brain imaging in patients with suspected parkinsonian syndromes.
To review [(123)I]FP-CIT (Ioflupane I 123, DaTscan) SPECT imaging and its role in clinical practice. ⋯ [(123)I]FP-CIT SPECT brain imaging is used to assist in the evaluation of adult patients with suspected PS and may help differentiate ET from PS as an adjunct to other diagnostic evaluations.
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A 48-year-old woman presented with a growing palpable mass at the left frontal area. The imaging studies and histopathological examination of the mass was consistent with dural-based Rosai-Dorfman disease with unusual transcranial extension. We reported this case not only because of its rarity, but also because of the infiltrative pattern. The infiltrative nature presented in this case may be taken into consideration for surgical treatment of intracranial Rosai-Dorfman disease.
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The second most frequently affected organ in mitochondrial disorders (MIDs) is the central nervous system (CNS). One of the most frequent CNS abnormalities on imaging is the affection of the white matter (WMLs) for which the term, leukoencephalopathies in mitochondrial disorders (LEM), is proposed. The morphology of LEM on imaging is quite variable even within the same type of MID and the same family. ⋯ WMLs in MIDs frequently give rise to misinterpretation, particularly if the mitochondrial defect is not evident in organs other than the CNS or if the presence of WMLs does not induce consideration of a MID as a differential. The diagnosis of a LEM requires the diagnosis of an MID, the detection of WMLs on imaging, and the exclusion of all possible differentials. Because the presence of LEM has an impact on the prognosis of an MID, all MID patients should undergo cerebral imaging even in the absence of clinical CNS manifestations.