Journal of neuroimaging : official journal of the American Society of Neuroimaging
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The breath-holding index (BHI) is a useful method to assess cerebrovascular reactivity. It is calculated based on the mean flow velocities of the middle cerebral artery (MCA) using transcranial Doppler (BHIMCA ). Therefore, it is not feasible in patients with poor temporal windows. This study tested the feasibility of a BHI using the internal carotid artery (ICA) siphon flow velocity (BHIICA ). ⋯ Our study suggests that the BHIICA is not a feasible alternative method to the BHIMCA.
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Comparative Study
The Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis Trial: Reanalysis Using the FDA "On Label" Criteria.
Due to higher rates of 1-month stroke and death with Wingspan intracranial stent placement observed in SAMMPRIS, the Food and Drug Administration (FDA) announced a more limited indication for Wingspan stent. ⋯ The new FDA "on label" criteria may identify a small group of people, who may benefit from intracranial stent placement due to higher risk of primary endpoint in those treated with best medical treatment.
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The evaluation of a suspected malfunction of a ventricular shunt is a common procedure in neurosurgery. The evaluation relies on either the interpretation of the ventricular width using cranial imaging or invasive techniques. Several attempts have been made to measure the flow velocity of cerebrospinal fluid (CSF) utilizing different phase-contrast magnet resonance imaging (PC MRI) techniques. In the present study, we evaluated 3 T (Tesla) MRI scanners for their effectiveness in determining of flow in the parenchymal portion of ventricular shunt systems with adjustable valves containing magnets. ⋯ CSF flow detected within the parenchymal portion of the shunt by PC MRI may reliably provide information about the functional status of a ventricular shunt. Even in patients whose hydrocephalus was treated with magnetic adjustable valves, the CSF flow was detectable using PC MRI sequences at 3 T field strength.
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Both clinical autonomic dysfunction and involvement of autonomic nerves have been reported in a range of peripheral nerve disorders. We employed nerve ultrasound to assess the size of the vagus nerve in a serial study of patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Charcot-Marie-Tooth type 1B (CMT1B) as compared to healthy controls (HCs). We correlated these findings with involvement of the median and ulnar nerves. ⋯ The vagus nerve was involved to a similar extent as the median and ulnar nerves in CIDP and CMT1A, although no symptoms or signs of vagus nerve involvement were found. Further study should be performed to explore the clinical relevance of vagus nerve enlargement in these disorders.
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Transcranial Doppler (TCD) helps identify patients with carotid dissections at risk of ischemic events (IEs). There is paucity of data identifying independent predictors of IE in vertebral arterial dissection (VAD). We sought to investigate the clinical and ultrasound predictors of IE. ⋯ TCD in VAD predicts patients at high risk of IE.