Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Noncontrast computed tomography (NCCT) has been considered the standard test for determining eligibility for thrombolysis from the beginning of the thrombolytic era. CT angiography (CTA) reveals the cranio-cervical vessel and the occlusion site. Furthermore, the source image (SI) of the CTA (CTA-SI) reflects cerebral blood volume and can detect the infarct core as hypoattenuated areas with higher sensitivity than ischemic changes on NCCT. ⋯ On the other hand, CTA-SI using standardized protocol was reported to be good predictor for final infarct extension. Imaging used in the setting of acute stroke should accurately address the presence and size of an irreversible ischemic core. Further studies are required to confirm whether another measure or adjustment in CTA-SI values can be more reliable for evaluating the infarct core.
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Hepatic encephalopathy (HE) is an uncommon complication of total parenteral nutrition (TPN). Cytotoxic edema has not been reported in children with TPN-related HE. We describe a case of TPN-related HE presenting with diffuse cytotoxic edema which reversed after liver transplantation.
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Fluid-attenuated inversion recovery imaging (FLAIR) has been suggested as a surrogate marker of lesion age in acute ischemic stroke. In a subgroup analysis, we evaluated whether the extent of perfusion deficit influences FLAIR lesion visibility and thus plays a role as a confounding variable in the interpretation of FLAIR images. ⋯ Visibility of FLAIR lesions in acute stroke imaging is influenced by lesion size and time from symptom onset to MRI, but not by the amount of perfusion deficit calculated by time-to-peak (TTP) measurements.
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To investigate the potential of the ultrasound-based evaluation of the optic nerve sheath in a patient with spontaneous intracranial hypotension due to cervical cerebrospinal fluid (CSF) leakage. ⋯ The ultrasound-based evaluation of the optic nerve sheath may be helpful in detecting CSF hypovolemia and for determination of treatment effects. This report should be seen as a basis for future investigations on the sonographic assessment of the optic nerve sheath in diagnosis and treatment of intracranial hypotension.
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Aquaporin 4 (AQP-4) is the most abundant aquaporin isoform in the brain. Alterations in its expression and distribution have been correlated with the progression of several clinical disorders; however, the specific roles of AQP-4 in those disorders are not well understood. Visualizing AQP-4 in vivo is expected to provide fresh insights into its roles in disease pathology, as well as aiding the clinical assessment of those disorders. ⋯ Based on these initial results, we believe [11C]TGN-020 PET will be valuable in determining the role of AQP-4 in disease progression, and for the clinical assessment of water homeostasis under various settings.