Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Feb 2014
ReviewHigh-resolution magnetic resonance neurography in upper extremity neuropathy.
The most common sites of nerve entrapment are in the upper extremity, commonly diagnosed based on clinical findings and electrophysiologic studies. Cross-sectional imaging modalities, such as ultrasonography and magnetic resonance (MR) imaging, have been used to enhance diagnostic accuracy and provide anatomic mapping of abnormalities. MR neurography offers multiplanar high-resolution imaging of upper extremity nerves as well as adjacent soft tissues, and provides an objective assessment of the neuromuscular anatomy and related abnormalities. This article reviews the normal 3-T MR neurographic appearance of the upper extremity nerves, and abnormal findings related to injury, entrapment, and other pathologic conditions.
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Neuroimaging Clin. N. Am. · Nov 2013
ReviewIntracranial endovascular balloon test occlusion: indications, methods, and predictive value.
Abrupt interruption of the internal carotid artery without a balloon test occlusion (BTO) carries a 26% risk of cerebral infarction. BTO is a test used to decrease this risk by evaluating the efficacy of the collateral circulation. Clinical tolerance of parent vessel occlusion can be assessed by a BTO with several variables, including the clinical examination, angiographic assessment, stump pressure, induced hypotension, perfusion scanning, transcranial Doppler ultrasonography, and neurophysiologic monitoring. This review discusses the indications, methods, predictive value, and complications of BTO.
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Carotid occlusive disease is one of several etiologic factors for stroke. Of all strokes, an estimated 88% are ischemic in nature. ⋯ Traditionally, carotid artery stenosis has been treated with carotid endarterectomy (CEA); however, carotid artery balloon angioplasty and stent placement has enjoyed significant technological advances over the last decade and can now offer a comparable treatment alternative to CEA. In this review, the authors concentrate their discussion on the treatment of carotid atherosclerotic disease with particular attention on the endovascular treatment.
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Acute ischemic stroke affects 3.3 of 100,000 children per year. The causes of AIS in children can be broadly divided into the following 6 categories: cardiac disese, sickle cell disease, moyamoya, arterial dissection, other arteriopathies, and other causes. ⋯ Magnetic resonance imaging (MRI) and cerebral angiography play an important role in the determining the causes of an AIS in children. Medical approaches, including anticoagulation, anti-inflammatories, and antiplatelet therapies, surgical revascularization and endovascular approaches may have a role in the management of AIS in children.
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Neuroimaging Clin. N. Am. · Nov 2013
ReviewSpontaneous cervical and cerebral arterial dissections: diagnosis and management.
Arterial dissections of head and neck arteries were first identified pathologically in the 1950s, but not until the 1970s and the 1980s did they begin to be widely recognized as a clinical entity. Carotid and vertebral artery dissections account for only 2% of all ischemic strokes, but they account for approximately 20% of thromboembolic strokes in patients younger than 45 years. The cause of supra-aortic dissections can be either spontaneous or traumatic. This article addresses spontaneous cervical and cerebral artery dissections.