Neuroimaging clinics of North America
-
Neuroimaging Clin. N. Am. · Nov 2013
ReviewEndovascular treatment of cerebral vasospasm: vasodilators and angioplasty.
Cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a delayed, reversible narrowing of the intracranial vasculature that occurs most commonly 4 to 14 days after aneurysmal SAH and can lead to permanent ischemic injury. Angiographic spasm occurs in up to 70% of patients following SAH, and approximately half become symptomatic. Estimates of patients who are disabled by vasospasm, or die because of it, range from 5% to 9%, with vasospasm accounting for 12% to 17% of all fatalities or cases of disability after SAH. This article discusses the multiple medical and endovascular therapies used to prevent or treat vasospasm.
-
Neuroimaging Clin. N. Am. · Nov 2013
ReviewEndovascular methods for the treatment of vascular anomalies.
Vascular malformations are congenital lesions secondary to errors in the development of arteries, capillaries, veins, or lymphatics. Most of these lesions are sporadic; however, a certain percentage present with syndromes. ⋯ The percutaneous/endovascular treatment of each of the vascular anomalies is described, and surgical and additional treatment options are discussed briefly. The clinical outcomes of the main forms of treatment and level of evidence are presented.
-
Neuroimaging Clin. N. Am. · Nov 2013
ReviewEndovascular treatment of intracranial atherosclerotic disease.
Stroke is the third leading cause of death in the United States. Intracranial atherosclerotic disease plays a role in cerebrovascular accidents, with well-characterized modifiable and nonmodifiable risk factors. ⋯ Initial reports on the results of stent placement for symptomatic high-grade intracranial atherosclerotic disease were initially encouraging. However, debate remains as to the optimal treatment of symptomatic intracranial atherosclerotic disease.
-
Neuroimaging Clin. N. Am. · Nov 2013
ReviewEndovascular treatment of adult spinal arteriovenous lesions.
Spinal arteriovenous lesions (SAVLs) are rare disorders, the diagnosis of which can be established using various imaging modalities. To discern the various types of SAVL, spinal angiography of the entire neural axis is required. ⋯ The classification, pathophysiology, epidemiology, clinical presentation, natural history, and pathophysiology of SAVLs in adults are reviewed. Finally, endovascular treatment of these lesions is discussed.