Journal of neuroimaging : official journal of the American Society of Neuroimaging
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We hypothesized that vessel wall MR imaging (VWI) with 3D-time-of-flight magnetic resonance imaging (3D-TOF-MRA) together increases the ability to detect abnormal intracranial vessel segments compared to 3D-TOF-MRA alone. ⋯ 3D-TOF-MRA and VWI together identifies a higher number of abnormal vessel segments than 3D-TOF-MRA alone and may provide a more accurate assessment of disease burden.
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Tuberous sclerosis complex (TSC) is a rare, genetic disease that is associated with multiple manifestations including epilepsy and autism. Self-injurious behaviors (SIBs) also occur in a subset of patients. This study used diffusion tensor imaging (DTI) in children with TSC for quantitative and volumetric analysis of brain regions that have been associated with SIB in other genetic conditions. ⋯ These data support a correlation between lower volumes of the globus pallidus and caudate with SIB in children with TSC.
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Deep gray matter (DGM) atrophy has been shown at early stages of multiple sclerosis (MS) and reported as an informative marker of cognitive dysfunction and clinical progression. Therefore, accurate measurement of DGM structure volume is a key priority in MS research. Findings from prior studies have shown that hypointense T1 lesions may impact the accuracy of global brain volume measures; however, literature on the effects of hypointense T1 lesions on DGM structure volumes is sparse. ⋯ Our results suggest that lesion in-painting has a negligible impact on DGM structure volume measurement although some regions are more vulnerable to the impact of lesions than others. Furthermore, manual lesion segmentation/in-painting can be replaced by an automatic segmentation/in-painting process.
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Identifying a last known well (LKW) time surrogate for acute stroke is vital to increase stroke treatment. Diffusion-weighted imaging (DWI) signal intensity initially increases from onset of stroke but mapping a reliable time course to the signal intensity has not been demonstrated. ⋯ There is good correlation between DWI intensity and minutes from onset to MRI. This suggests a time-dependent DWI intensity response and supports the potential use of DWI intensity measurements to extrapolate an LKW time. Further studies are being pursued to increase both experience and generalizability.
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Review Case Reports
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.