Background and Purpose: Venous thromboembolism and ischemic stroke are associated with unfavorable fibrin clot structure and function. We hypothesized that denser fibrin networks displaying impaired lysability characterize patients with cerebral venous sinus thrombosis (CVST).
Intracranial aneurysms arise in ≈2% of the population, and their rupture causes 3% of all strokes.1 Their treatment requires safely achieving complete aneurysm occlusion while preserving blood flow in the parent, branching, and perforating vessels. For decades, this task was achieved using classic open approaches, such as the pterional craniotomy (PTC) described by Yasargil and Fox in 1975, which afforded safe and effective exposure of the Circle of Willis through the Sylvian fissure with minimal retraction on the frontal and temporal lobes.2 Supported by the introduction of the operating microscope, this approach gained popularity for treating tumors and aneurysms of the anterior circulation and the basilar tip.
Background and Purpose: The low-dose (0.6 mg/kg) alteplase strategy to treat acute ischemic stroke patients became widespread in East Asian countries, without rigorous testing against standard-dose (0.9 mg/kg) alteplase treatment. Our aim was to investigate the comparative effectiveness and safety of the low-dose versus standard-dose intravenous alteplase strategy.
Objectives: This study sought to investigate acute kidney injury (AKI) following carotid artery stenting (CAS).
A 78-year-old man presented with progressive dyspnea on exertion and syncope. His relevant history included coronary bypass surgery twice. Severe aortic stenosis with left ventricular ejection fraction of 65% was evident on echocardiography. Coronary angiogram showed patent left internal mammary artery and saphenous vein grafts with severe 3-vessel disease.
OBJECTIVE: This article reviews the physical principles of MRI-guided focused ultra-sound and discusses current and potential applications of this exciting technology.
PURPOSE: Arterial spin labeling (ASL) magnetic resonance imaging to assess cerebral blood flow (CBF) is of increasing interest in basic research and in diagnostic applications, since ASL provides similar information to positron emission tomography about perfusion in vascular territories. However, in patients with steno-occlusive arterial disease (SOAD), CBF as measured by ASL might be underestimated due to delayed bolus arrival, and thus increased spin relaxation. We aimed to estimate the extent to which bolus arrival time (BAT) was delayed in patients with SOAD and whether this resulted in underestimation of CBF.
It is important to predict the prognosis of patients with stroke by evaluating risk factors and determining treatment. Recurrent stroke is a major cause of mortality and morbidity in patients with stroke. It is known that recurrent stroke is frequent in patients with ischemic stroke (1,2). The origins of ischemic stroke are variable, and cardiogenic strokes represent 20%–30% of ischemic strokes (3).
Abstract: Imaging is important in the evaluation of patients with degenerative disease and infectious processes. There are numerous conditions that can manifest as low back pain (LBP) or neck pain in a patient, and in many cases, the cause may be multifactorial. Clinical history and physical examination are key components in the evaluation of such patients; however, physical examination has variable sensitivity and specificity.
Stroke is the leading cause of disability in the United States. Extracranial atherosclerotic disease of the carotid artery accounts for up to 20% of all strokes. For symptomatic patients with significant extracranial carotid stenosis, prior trials have found better outcomes after carotid endarterectomy (CEA) compared with best medical therapy.1-5 Numerous studies have assessed endovascular treatment as an alternative to CEA.
Recent advances in the field of functional neurosurgery have profoundly affected the treatment of neurological conditions such as Parkinson disease and epilepsy. Current techniques of brain mapping make use of penetrating cortical arrays to provide adequate spatial resolution for neural recordings and neurostimulation; however, this technique comes with significant limitations. These methods generally require a craniotomy and cause brain tissue trauma, which can result in gliosis and blood-brain barrier disruption.1 Thus, minimally invasive techniques of brain recording have emerged as an area of interest, and the use of a transvenous conduit to implant a recording device has been proposed by Oxley et al.2 In their study, the authors implanted an endovascular device, a “stentrode,” into a cerebral vein and compared the cortical recordings obtained through this device to traditional electrode arrays implanted via craniotomy.
BACKGROUND: Traditional surgical options for the treatment of symptomatic lumbar spinal stenosis include decompression alone vs decompression and fusion; both options have potential limitations.
BACKGROUND: There continues to be considerable interest in the use of decompressive hemicraniectomy in the management of malignant cerebral artery infarction; however, concerns remain about long-term outcome.
BACKGROUND AND IMPORTANCE: A porous bioresorbable polymer scaffold has previously been tested in preclinical animal models of spinal cord contusion injury to promote appositional healing, spare white matter, decrease posttraumatic cysts, and normalize intraparenchymal tissue pressure. This is the first report of its human implantation in a spinal cord injury patient during a pilot study testing the safety and feasibility of this technique (ClinicalTrials.gov Identifier: NCT02138110).
Abstract: Osteoporosis, the most common form of metabolic bone disease, leads to alterations in bone structure and density that have been shown to compromise the strength of spinal instrumentation. In addition, osteoporosis may contribute to high rates of fracture and instrumentation failure after long posterior spinal fusions, resulting in proximal junctional kyphosis and recurrent spinal deformity.
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