Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Discovery of genetic abnormalities associated with neurodegeneration with brain iron accumulation (NBIA) has led to use of a genetic-based NBIA classification schema. Most NBIA subtypes demonstrate characteristic imaging abnormalities. While clinical diagnosis of NBIA is difficult, analysis of both clinical findings and characteristic imaging abnormalities allows accurate diagnosis of most of the NBIA subtypes. This article reviews recent updates in the genetic, clinical, and imaging findings of NBIA subtypes and provides a practical step-by-step clinicoradiological algorithm toward clinical diagnosis of different NBIA subtypes.
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Peripheral neuropathies are one of the most common reasons for seeking neurological care in everyday practice. Electrophysiological studies remain fundamental for the diagnosis and etiological classification of peripheral nerve impairment. The recent technological development though of high resolution ultrasound has allowed the clinician to obtain detailed structural images of peripheral nerves. ⋯ On the other hand, multifocal cross sectional area enlargement of cervical roots and/or peripheral nerves is often documented in cases of immune-mediated neuropathies. None of the later pathological ultrasound findings seem to correlate significantly with the electrophysiological parameters or the functional disability. The aim of this review is to provide a timely update on the role of neuromuscular ultrasound in the diagnostic of the most common entrapment and immune-mediated peripheral neuropathies in clinical practice.
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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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Our aim was to investigate a novel approach to perform preoperative evaluation patients who underwent middle cerebral artery (MCA) percutaneous transluminal angioplasty and stenting (PTAS). ⋯ The MOSAIC score can be reliably used in selecting patients with MCA stenosis for PTAS.
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Head rotation can cause occlusion of the vertebral artery most commonly at the atlas loop, and repetitive compression from head turning induces vertebral artery dissection (VAD). Although ultrasound examinations are useful in diagnosis, dissected lesions unaccompanied by hemodynamic changes can be overlooked. Because the narrowed, dissected vessel in the atlas loop may cause rotational occlusion, we confirmed whether adding submaximal head rotation to a cervical ultrasound examination would facilitate the detection of VAD in the atlas loop. ⋯ For posterior circulation stroke patients, adding submaximal head rotation to the cervical ultrasound examination facilitated the detection of VAD in the atlas loop.