Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Case Reports
Intracranial clot dissolution is associated with embolic signals on transcranial Doppler.
Reperfusion of intracranial arteries can be detected by transcranial Doppler (TCD). The authors report microembolic signals (MES) on TCD as a sign of clot dissolution and recanalization. Microembolic signals were detected during routine diagnostic TCD examination performed in the emergency room in patients eligible for thrombolytic therapy. ⋯ The patient recovered completely by the end of tissue plasminogen activator infusion. The authors conclude that embolic signals detected by TCD at the site of arterial obstruction can indicate clot dissolution. Intracranial recanalization on TCD can be associated with MES and changes in flow waveform, pulsatility, and velocity if insonation is performed at the site of arterial obstruction.
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Image registration brings images into a form in which each voxel corresponds to a predetermined anatomic entity and is necessary for comparisons of data across scans. Intrasubject registration is a matter of translating and rotating one image volume into correspondence with another. Intersubject registration is more difficult because it requires the removal of individual anatomy dependence from the data. This article describes, with the help of clinical examples, automated methods for intrasubject registration of scans within and between modalities, and intersubject registration used for registering a three-dimensional brain atlas with a patient's brain scan.
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Case Reports
Hyperkinetic movement disorders caused by corpus striatum infarcts: brain MRI/CT findings in three cases.
Three patients with hemichorea/hemiballismus/hemidystonia caused by discrete contralateral infarction of the corpus striatum are presented. The infarcts were all small on CT or MRI brain scan and were lacunar in type. ⋯ Involvement of contiguous areas, seen with larger infarcts, can suppress such movements. The infrequency of such hyperkinetic movement disorders, and the subtle infarct appearance on brain scan, can lead to a delay in the diagnosis.
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Hyperacute thrombosis of the basilar artery accompanied urgent treatment of basilar thrombosis with local thrombolytics and arterial reconstruction by balloon angioplasty. Successful placement of an endoprosthesis into the basilar artery permitted sustained restoration of blood flow. To the authors' knowledge, this is the first successful report of intracranial endoprosthesis deployment.
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The case of a young woman with basilar artery dissection, possibly precipitated by trauma, is presented, and the literature is reviewed.