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ESTUDIOS


06 noviembre 2014

AMERICAN JOURNAL OF NEURORADIOLOGY. Comparison of Modern Stroke Thrombectomy Approaches Using an In Vitro Cerebrovascular Occlusion Model

M. Mokin, S.V. Setlur Nagesh, C.N. Ionita, E.I. Levy and A.H. Siddiqui

BACKGROUND AND PURPOSE: A new in vitro cerebrovascular occlusion model of the intracranial circulation was developed recently for testing thrombectomy devices. Using this model, we compared recanalization success associated with different modern endovascular thrombectomy approaches.

16 octubre 2014

AMERICAN JOURNAL OF NEURORADIOLOGY. T1ρ and T2 Mapping of the Intervertebral Disk: Comparison of Different Methods of Segmentation

R. Menezes-Reis, C.E.G. Salmon, C.S. Carvalho, G.P. Bonugli, C.B. Chung and M.H. Nogueira-Barbosa

BACKGROUND AND PURPOSE: Intervertebral disk biochemical composition could be accessed in vivo by T1ρ and T2 relaxometry. We found no studies in the literature comparing different segmentation methods for data extraction using these techniques. Our aim was to compare different manual segmentation methods used to extract T1ρ and T2 relaxation times of intervertebral disks from MR imaging. Seven different methods of partial-disk segmentation techniques were compared with whole-disk segmentation as the reference standard.

01 abril 2015

THE LANCET. Neurology. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial

The CADISS trial investigators

Background: Extracranial carotid and vertebral artery dissection is an important cause of stroke, especially in young people. In some observational studies it has been associated with a high risk of recurrent stroke. Both antiplatelet drugs and anticoagulant drugs are used to reduce risk of stroke but whether one treatment strategy is more effective than the other is unknown. We compared their efficacy in the Cervical Artery Dissection in Stroke Study (CADISS), with the additional aim of establishing the true risk of recurrent stroke.

01 mayo 2015

THE LANCET. Neurology. Association between brain imaging signs, early and late outcomes, and response to intravenous alteplase after acute ischaemic stroke in the third International Stroke Trial (IST-3): secondary analysis of a randomised controlled trial

The IST-3 collaborative group

Background: Brain scans are essential to exclude haemorrhage in patients with suspected acute ischaemic stroke before treatment with alteplase. However, patients with early ischaemic signs could be at increased risk of haemorrhage after alteplase treatment, and little information is available about whether pre-existing structural signs, which are common in older patients, affect response to alteplase. We aimed to investigate the association between imaging signs on brain CT and outcomes after alteplase.

27 febrero 2015

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Epidemiology. American Heart Association´s Life´s Simple 7 and Risk of Venous Thromboembolism: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Nels C. Olson, PhD; Mary Cushman, MSc, MD; Suzanne E. Judd, PhD; Leslie A. McClure, PhD; Susan G. Lakoski, MSc, MD; Aaron R. Folsom, MD; Monika M. Safford, MD; Neil A. Zakai, MSc, MD

Background: The American Heart Association´s Life´s Simple 7 metric is being used to track the population´s cardiovascular health (CVH) toward a 2020 goal for improvement. The metric includes body mass index (BMI), blood pressure, cholesterol, glucose, physical activity (PA), cigarette smoking, and diet. We hypothesized a lower risk of venous thromboembolism (VTE) with favorable Life´s Simple 7 scores.

01 enero 2014

CIRCULATION. Contemporary Reviews in Cardiovascular Medicine. Endovascular Therapy for Stroke. Getting to the “Heart” of the Matter

Chung-Huan J. Sun, BS; Deepak L. Bhatt, MD, MPH, FAHA; Raul G. Nogueira, MD; Rishi Gupta, MD, MBA, FANA

In the late 1970s, Gruentzig’s groundbreaking reports on a series of successfully performed coronary angioplasties created the field of endovascular medicine, setting the precedent for the Food and Drug Administration’s 510(k) approval of the procedure in 1981.

01 marzo 2015

ENDOVASCULAR TODAY. Treatment Options for Cerebral AVMs and Dural AVFs

Lyahn K. Hwang, BS; Vivek A. Kumar, PhD; Ravi R. Vissapragada, MD; Karen Y. Lui, MD; Matthew R. Fusco, MD; Christopher S. Ogilvy, MD; and Ajith J. Thomas, MD

The second of a three-part series on diagnosing, treating, and researching management options for intracranial malformations.

01 mayo 2014

RSNA: Radiology. Accurate Diagnosis of Small Cerebral Aneurysms ≤5 mm in Diameter with 3.0-T MR Angiography

Ming-Hua Li, MD, PhD, Yong-Dong Li, MD, PhD, Bin-Xian Gu, MD, Ying-Sheng Cheng, MD, PhD, Wu Wang, MD, Hua-Qiao Tan, MD, PhD, Yuan-Chang Chen, MD, PhD, From the Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People’s Hospital, Shanghai Jiao Tong University, 600 Yi Shan Rd, Shanghai 200233, China.

Introduction: Because of rapid improvements in imaging techniques, increasing numbers of cerebral aneurysms are now detected with computed tomographic (CT) angiography and magnetic resonance (MR) angiography (1–8). The reported accuracy of MR angiography in the detection of cerebral aneurysms is approximately 90%, with better results for larger aneurysms and poorer results for smaller aneurysms (1,9,10). Small cerebral aneurysms are generally classified as those with a diameter of 5 mm or less (11), and they present particular technical challenges for the neuroradiologist. Early MR angiography studies have shown limited diagnostic accuracy in the detection of small cerebral aneurysms (12,13).

01 mayo 2015

NEUROSURGERY. Unruptured Intracranial Aneurysms in Children With Sickle Cell Disease: Analysis of 18 Aneurysms in 5 Patients

Saini, Surbhi MD*,‡; Speller-Brown, Barbara DNP*; Wyse, Emily BS§; Meier, Emily R. MD*,‡; Carpenter, Jessica MD‡,¶; Fasano, Ross M. MD*,‡; Pearl, Monica S. MD§,‖

BACKGROUND: Intracranial aneurysms (IAs) are rare in the general pediatric population and account for <2% of all cerebral aneurysms. Only 7 children with sickle hemoglobinopathy and IAs have been reported, the majority of which were discovered after rupture.

01 mayo 2015

NEUROSURGERY. Treatment Outcomes of Unruptured Arteriovenous Malformations With a Subgroup Analysis of ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-Eligible Patients

Nerva, John D. MD*; Mantovani, Alessandra MD*; Barber, Jason MS*; Kim, Louis J. MD*,‡; Rockhill, Jason K. MD, PhD*,§; Hallam, Danial K. MD*,‡; Ghodke, Basavaraj V. MD*,‡; Sekhar, Laligam N. MD*,‡

BACKGROUND: The design and conclusions of A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA) trial are controversial, and its structure limits analysis of patients who could potentially benefit from treatment.

01 mayo 2015

NEUROSURGERY. Long-term Functional Outcomes and Predictors of Shunt-Dependent Hydrocephalus After Treatment of Ruptured Intracranial Aneurysms in the BRAT Trial: Revisiting the Clip vs Coil Debate

Zaidi, Hasan A. MD; Montoure, Andrew BS; Elhadi, Ali MD, PhD; Nakaji, Peter MD; McDougall, Cameron G. MD; Albuquerque, Felipe C. MD; Spetzler, Robert F. MD; Zabramski, Joseph M. MD

BACKGROUND: Acute hydrocephalus is a well-known sequela of aneurysmal subarachnoid hemorrhage (SAH). Controversy exists about whether open microsurgical methods serve to reduce shunt dependency compared with endovascular techniques.

01 abril 2015

NEUROSURGERY. A Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke Caused by Proximal Arterial Occlusion in the Anterior Circulation

Starke, Robert M. MD, MSc; Connolly, E. Sander MD; Komotar, Ricardo J. MD

Significant time and expenditure have been devoted to therapies for acute ischemic stroke, a worldwide leading cause of morbidity and mortality.1,2 Currently, there are limited therapies approved for ischemic stroke, including care at a stroke center, initiation of aspirin, and revascularization with recombinant tissue-type plasminogen activator.

01 abril 2015

NEUROSURGERY. Stereotactic Radiosurgery for Intracranial Meningiomas: Current Concepts and Future Perspectives

Mansouri, Alireza MD*,‡; Guha, Daipayan MD*,‡; Klironomos, George MD, PhD*,‡; Larjani, Soroush BSc‡; Zadeh, Gelareh MD, PhD*,‡; Kondziolka, Douglas MD, Msc§

Abstract: Meningiomas are among the most common adult brain tumors. Although the optimal management of meningiomas would provide complete elimination of the lesion, this cannot always be accomplished safely through resection. Therefore, other therapeutic modalities, such as stereotactic radiosurgery (as primary or adjunctive therapy), have emerged. In the current review, we have provided an overview of the historical outcomes of various radiosurgical modalities applied in the management of meningiomas. Furthermore, we provide a discussion on key factors (eg World Health Organization grade, lesion size, and lesion location) that affect tumor control and adverse event rates. We discuss recent changes in our understanding of meningiomas, based on molecular and genetic markers, and how these will change our perspective on the management of meningiomas. We conclude by outlining the areas in which knowledge gaps persist and provide suggestions as to how these can be addressed

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