Journal of neuroimaging : official journal of the American Society of Neuroimaging
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The venous outflow profile (VOP) is a crucial yet often overlooked aspect affecting stroke outcomes. It plays a major role in the physiopathology of acute cerebral ischemia, as it accounts for both the upstream arterial collaterals and cerebral microperfusion. This enables it to circumvent the limitations of various arterial collateral evaluation systems, which often fail to consider impaired autoregulation and its impact on cerebral blood flow at the microcirculatory levels. In this narrative review, we will highlight the different parameters and modalities used to assess the VOP in acute ischemia. ⋯ VOP parameters' significance lies in their potential to predict tissue fate and, subsequently, clinical outcomes. Recent studies indicate that favorable VOP is independently associated with slower rates of infarct edema progression, smaller infarct volumes, and higher rates of functional independence after 90 days. Moreover, it is considered a predictor of recanalization success and the first-pass effect during mechanical thrombectomy. Conversely, an unfavorable VOP predicts futile recanalization and indicates a higher risk of reperfusion hemorrhage. Our aim is to explore these prognostic implications and their relevance in determining the utility of intracranial intervention.
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Differentiation between functioning and nonfunctioning pituitary adenomas/pituitary neuroendocrine tumors (PAs) is clinically relevant. The goal of this study was to determine the feasibility of using time-dependent diffusion MRI (dMRI) for microstructural characterization of PAs. ⋯ The cADC derived from time-dependent dMRI could distinguish between functioning and nonfunctioning PAs, particularly those producing GH.
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The role of high-resolution nerve ultrasound (HRUS) in the diagnosis of chemotherapy-induced polyneuropathy is unclear. The present prospective longitudinal controlled study evaluates the utility of HRUS in vincristine-induced polyneuropathy (VIPN). ⋯ At mid-treatment, there is an increase in the total CSA at entrapment sites parallel to an increase in clinical symptoms. In individual nerve sites, HRUS does not detect significant signs of VIPN. NCSs exhibit signs of a predominantly sensory axonal polyneuropathy. The clinical examination remains the most sensitive tool in the early detection of VIPN.
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Comparative Study
Comparison of antithrombogenic coated and uncoated flow diverters in ruptured and unruptured cerebral aneurysms.
Flow diversion has become a key treatment option for complex intracranial aneurysms. Recent advancements include coated flow diverters (FDs), designed to potentially reduce the need for dual antiplatelet therapy, thereby removing the associated secondary risks while maintaining patency and low complication rates. Comparing coated and uncoated FDs may offer insights into long-term outcomes and treatment optimization. ⋯ We observed favorable occlusion rates for both coated and uncoated FDs. The role of dual antiplatelet therapy remains debated. Large multicenter studies are essential to evaluate the patency of coated compared to uncoated FDs and determine whether they can reduce thrombogenicity, potentially allowing for less or no antiplatelet therapy in emergencies.
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Tinnitus is a condition in which individuals perceive sounds, such as ringing or buzzing, without any external source. Although the exact cause is not fully understood, recent studies have indicated the involvement of nonauditory brain structures, including the limbic system. We aimed to compare the volumes of specific brain structures between patients with tinnitus and controls. ⋯ These findings indicate the involvement of the limbic system in tinnitus, and enhance our understanding of the condition. The subfield volumetry technique used in this study may aid in identifying the structural differences associated with specific neurological and psychiatric conditions.