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ESTUDIOS


01 marzo 2014

NEUROSURGERY. The Neurological Emergency Room and Prehospital Stroke Alert: The Whole Is Greater Than the Sum of Its Parts

Background: Emergency medical services (EMS) prenotification to hospitals regarding the arrival of patients who have had a stroke is recommended to facilitate the workup once the patient arrives. Most hospitals have the patient enter the emergency department (ED) before obtaining a head computed tomography (CT) scan. At Capital Health, prehospital stroke-alert patients are delivered directly to CT and met by a neurological emergency team. The goal of bypassing the ED is to reduce the time to treatment.

01 marzo 2014

NEUROSURGERY. Percutaneous Stereotactic Radiofrequency Lesioning for Trigeminal Neuralgia: Determination of Minimum Clinically Important Difference in Pain Improvement for Patient-Reported Outcomes

Reddy, Vishruth K. BA*; Parker, Scott L. MD*; Lockney, Dennis T. MD*; Patrawala, Samit A. MD*; Su, Pei-Fang PhD‡,§; Mericle, Robert A. MD¶

Background: The Visual Analog Scale (VAS) and the Barrow Neurological Institute Pain Scale (BNI-PS) are 2 patient-reported outcome (PRO) tools frequently used to rate pain from trigeminal neuralgia (TN). Outcomes studies often use these patient-reported outcomes to assess treatment effectiveness, but it is unknown exactly what degree of change in the numerical scores constitutes the minimum clinically important difference (MCID). MCID remains uninvestigated for percutaneous stereotactic radiofrequency lesioning (RFL), a common surgical procedure for TN.

01 marzo 2014

NEUROSURGERY. Stereotactic Radiosurgery for Neurofibromatosis 2—Associated Vestibular Schwannomas: Toward Dose Optimization for Tumor Control and Functional Outcomes

Mallory, Grant W. MD*; Pollock, Bruce E. MD*,‡; Foote, Robert L. MD‡; Carlson, Matthew L. MD§; Driscoll, Colin L. MD*,§; Link, Michael J. MD*,§

Background: Management of neurofibromatosis type 2 (NF2)—associated vestibular schwannomas (VSs) remains controversial. Stereotactic radiosurgery (SRS) with conventional dosing is less effective for NF2-related VS compared with sporadic lesions.

17 enero 2013

STROKE. Exploring the Age of Intracranial Aneurysms Using Carbon Birth Dating

Nima Etminan, MD; Rita Dreier, PhD; Bruce A. Buchholz, PhD; Peter Bruckner, PhD; Hans-Jakob Steiger, MD; Daniel Hänggi, MD; R. Loch Macdonald, MD, PhD

Background and Purpose: There is a controversy about the time span over which cerebral aneurysms develop. In particular, it is unknown whether collagen in ruptured aneurysms undergoes more rapid turnover than in unruptured aneurysms.14C birth dating of collagen could be used to address this question.

15 marzo 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Review of 2 Decades of Aneurysm-Recurrence Literature, Part 2: Managing Recurrence after Endovascular Coiling

E. Crobeddu, G. Lanzino, D.F. Kallmes and H.J. Cloft

Summary: Cerebral aneurysms are treated to prevent hemorrhage or rehemorrhage. Angiographic recurrences following endovascular therapy have been a problem since the advent of this treatment technique, even though posttreatment hemorrhage remains rare. Notwithstanding its unclear clinical significance, angiographic recurrence remains not only a prime focus in the literature but also frequently leads to potentially risky retreatments. The literature regarding aneurysm recurrence following endovascular therapy, spanning 2 decades, is immense and immensely confusing. We review the topic of recurrence following endovascular treatment of cerebral aneurysms in an effort to distill it down to fundamental material relevant to clinical practice.

09 agosto 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Contrast-Enhanced 3T High-Resolution MR Imaging in Symptomatic Atherosclerotic Basilar Artery Stenosis

X. Lou, N. Ma, L. Ma and W.-J. Jiang

Background and Purpose: Contrast-enhanced 3T high-resolution MR imaging can be used to determine the wall enhancement pattern of the basilar artery in symptomatic atherosclerotic stenosis. We used this method to explore the relationship between wall enhancement and both recent infarction in the territory of the stenotic BA and subsequent ischemic events associated with the stenotic BA.

23 agosto 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Blood-Brain Barrier Disruption after Cardiac Surgery

J.G. Merino, L.L. Latour, A. Tso, K.Y. Lee, D.W. Kang, L.A. Davis, R.M. Lazar, K.A. Horvath, P.J. Corso and S. Warach

Background and Purpose: CNS complications are often seen after heart surgery, and postsurgical disruption of the BBB may play an etiologic role. The objective of this study was to determine the prevalence of MR imaging-detected BBB disruption (HARM) and DWI lesions after cardiac surgery.

16 agosto 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. Endovascular Reconstruction for Treatment of Vertebrobasilar Dolichoectasia: Long-Term Outcomes

X. Wu, Y. Xu, B. Hong, W.-Y. Zhao, Q.-H. Huang and J.-M. Liu

Background and Purpose: VBD can trigger various clinical symptoms, especially ischemic stroke in the posterior circulation, but there is no effective treatment for their prevention. We aimed to validate the feasibility of coil-assisted stent reconstruction in the vascular lumen for the treatment of VBD and to evaluate its long-term effectiveness in preventing ischemic events.

22 noviembre 2012

AMERICAN JOURNAL OF NEURORADIOLOGY. A Randomized Trial Comparing 2 Techniques of Balloon Kyphoplasty and Curette Use for Obtaining Vertebral Body Height Restoration and Angular-Deformity Correction in Vertebral Compression Fractures due to Osteoporosis

L. Bastian, F. Schils, J.B. Tillman and G. Fueredi on behalf of the SCORE Investigators

Background and Purpose: Vertebral compression fractures often result in pain and vertebral deformity. We compared 2 different balloon kyphoplasty techniques both using intraoperative curettage.

23 enero 2014

AMERICAN JOURNAL OF NEURORADIOLOGY. WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Short- and Midterm Results in a European Study

B. Lubicz, J. Klisch, J.-Y. Gauvrit, I. Szikora, M. Leonardi, T. Liebig, N.P. Nuzzi, E. Boccardi, F.D. Paola, M. Holtmannspötter, W. Weber, E. Calgliari, V. Sychra, B. Mine and L. Pierot

Background and Purpose: Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data in patients treated with WEB-DL.

22 agosto 2013

AMERICAN JOURNAL OF NEURORADIOLOGY. Improved Quality and Diagnostic Confidence Achieved by Use of Dose-Reduced Gadolinium Blood-Pool Agents for Time-Resolved Intracranial MR Angiography

S. Dehkharghani, J. Kang and A.M. Saindane

Background and Purpose: Time-resolved MRA with the use of bolus injection of paramagnetic agents has proved valuable in neurovascular imaging. Standard contrast agents have limited blood-pool residence times, motivating the development of highly protein-bound blood-pool agents with greater relaxivity and longer intravascular residence, affording improved image quality at lesser doses. This study represents the first comparison of blood-pool agents to standard agents in time-resolved cerebral MRA.

07 noviembre 2013

AMERICAN JOURNAL OF NEURORADIOLOGY. Appropriate Use of CT Perfusion following Aneurysmal Subarachnoid Hemorrhage: A Bayesian Analysis Approach

R.P. Killeen, A. Gupta, H. Delaney, C.E. Johnson, A.J. Tsiouris, J. Comunale, M.E. Fink, H.S. Mangat, A.Z. Segal, A.I. Mushlin and P.C. Sanelli

Background and Purpose: In recent years CTP has been used as a complementary diagnostic tool in the evaluation of delayed cerebral ischemia and vasospasm. Our aim was to determine the test characteristics of CTP for detecting delayed cerebral ischemia and vasospasm in SAH, and then to apply Bayesian analysis to identify subgroups for its appropriate use.

25 marzo 2014

CIRCULATION. Epidemiology and Prevention. Warfarin Use and the Risk for Stroke and Bleeding in Patients With Atrial Fibrillation Undergoing Dialysis

Mitesh Shah, MBBS MSc; Meytal Avgil Tsadok, PhD; Cynthia A. Jackevicius, PharmD, MSc; Vidal Essebag, MD, PhD; Mark J. Eisenberg, MD, MPH; Elham Rahme, PhD; Karin H. Humphries, DSc; Jack V. Tu, MD, PhD; Hassan Behlouli, PhD; Helen Guo, MSc; Louise Pilote, MD, PhD

Background: Current observational studies on warfarin use and the risk for stroke and bleeding in patients with atrial fibrillation (AF) undergoing dialysis found conflicting results.

21 marzo 2014

EUROPEAN HEART JOURNAL. Device-detected atrial fibrillation and risk for stroke: an analysis of >10 000 patients from the SOS AF project (Stroke preventiOn Strategies based on Atrial Fibrillation information from implanted devices)

Giuseppe Boriani1,*, Taya V. Glotzer2, Massimo Santini3, Teena M. West4, Mirko De Melis4, Milan Sepsi5, Maurizio Gasparini6, Thorsten Lewalter7, John A. Camm8 and Daniel E. Singer9

Objective: The aim of this study was to assess the association between maximum daily atrial fibrillation (AF) burden and risk of ischaemic stroke.

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