Journal of neuroimaging : official journal of the American Society of Neuroimaging
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The recent culmination of imaging-endowed endovascular stroke trials has decisively proven the utility of clinically relevant neuroimaging in improving the outcome of patients with potentially debilitating neurological disorders. These large multicenter trials conducted across several continents notably utilized a variety of multimodal CT/MRI modalities to rapidly identify a favorable collateral profile that presages clinically beneficial revascularization. ⋯ The next generation in stroke should not exclusively focus on whether to order a CT or MRI counting minutes at the bedside, but actively and efficiently integrate the vast wealth of information available when imaging is used in the proper clinical context. The novel endovascular era in stroke provides an ideal venue for the synergistic goals of translating research advances, improving patient outcomes and ongoing education as a modern neuroimager.
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Anomalous origin of vertebral arteries is not common and usually seen as an incidental finding on imaging. We report a case of anomalous origin of left vertebral artery from left carotid bulb ("trifurcation" of left common carotid artery) on magnetic resonance angiography in a 64-year old male who also had ipsilateral thalamic acute infarct.
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Vertebrobasilar dolichoectasia (VBD) is a dilatative arteriopathy associated with a decreased blood flow velocity. Fluid attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) is a phenomenon most likely representing slow arterial blood flow. We sought to examine the frequency and extent of FVH in VBD. ⋯ FVH may be useful to demonstrate the decreased blood flow velocity in VBD. More pronounced FVH in patients with posterior circulation TIA/stroke might reflect the underlying stroke pathomechanism.
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A 41-year-old woman presented with acute onset headache, vertigo, nausea, and gait disorder, initially interpreted as a common cold. Within 2 weeks, she developed a severe opsoclonus-myoclonus syndrome with truncal ataxia. ⋯ Corresponding PET findings were able to depict the response to therapy in the ocular muscles and the inferior vermis, whereas the deep cerebellar nuclei were still hyperactivated, however, to a lesser extent. This finding highlights the usefulness of functional/metabolic brain imaging to study the pathophysiology of this type of disorder.