Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Ischemic stroke is a common complication of cryptococcal meningitis. Fluid attenuated inversion recovery vascular hyperintensity (FVH) is a neuroimaging marker of sluggish blood flow usually seen in the setting of acute stroke. FVH have never been described in the setting of meningitis. ⋯ In conditions with high risk of stroke, such as meningitis, the presence of FVH should alert the clinician to the possibility of impending infarction.
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Comparative Study
Variability in diagnosing Creutzfeldt-Jakob disease using standard and proposed diagnostic criteria.
Creutzfeldt-Jakob disease (CJD) is a rapidly progressive dementia with a median survival of 2-14 months. The diagnosis can only be made accurately by biopsy/autopsy. However, this is not always feasible or desirable. Thus, diagnostic criteria have been proposed by UCSF, European MRI-CJD Consortium, and WHO. We will compare these criteria. ⋯ This study illustrates the variability in diagnosing CJD and emphasizes the diagnostic utility of neuroimaging. It also highlights false-positives that occur with neuroimaging.
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Though pial arteriovenous fistulae (PAVF) are an uncommon cerebrovascular disorder, their presentation with subarachnoid hemorrhage (SAH) is not rare. PAVF near the craniocervical junction are rare and may have a worse outcome. ⋯ Cerebral angiography revealed 2 AVF, a symptomatic PAVF located at the craniocervical junction and fed from the anterior spinal artery and incidental dural AVF (DAVF) originate from the left occipital and middle meningeal arteries. These fistulae were treated with different endovascular techniques, including Onyx and platinum coil embolization into the feeding arteries of the DAVF and PAVF, respectively.
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Primary intracranial malignant fibrous histiocytoma (MFH) is an extremely rare entity. A few reported cases have been associated with factors such as a previous history of radiation therapy or surgical trauma. We report on a rare case of intracerebral MFH in a previously healthy 47-year-old man, which was initially presumed to be a high-grade glioma. Conventional as well as advanced magnetic resonance sequences, including diffusion-weighted image and perfusion-weighted image, were used in characterization of the mass.
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Lesion studies (both patients and nonhuman animals) and functional neuroimaging studies of normal, healthy subjects provide complementary, but different types of information. This article suggests that both study types are necessary for deriving inferentially sound conclusions regarding the neural basis of cognition.