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| 2. |
- Sundgren, Pia, et al.
(författare)
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Value of conventional, and diffusion- and perfusion weighted MRI in the management of patients with unclear cerebral pathology, admitted to the intensive care unit
- 2002
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Ingår i: Neuroradiology. - : Springer Science and Business Media LLC. - 1432-1920 .- 0028-3940. ; 44:8, s. 674-680
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Tidskriftsartikel (refereegranskat)abstract
- The aim of our retrospective study was to determine the extent to which diffusion- and perfusion- weighted MRI combined with conventional MRI could be helpful in the evaluation of intensive care unit (ICU) patients who have unknown or unclear cerebral pathology underlying a serious clinical condition. Twenty-one ICU patients with disparity between the findings on brain CT scan and their clinical status were studied. All patients underwent conventional MR and diffusion-weighted imaging and 14 also had MR perfusion studies. Abnormalities were present on diffusion-weighted imaging of 17 of the 21 patients and on perfusion-weighted studies of 7 of 14 patients. The MRI results changed the preliminary/working diagnosis in six patients. In eight other patients, MRI revealed additional pathology that had not been suspected clinically, and/or characterized more closely findings that had already been detected by CT or suspected clinically. MRI showed abnormalities in four of the five patients who had normal CT. MRI findings suggested a negative clinical outcome in all nine patients who subsequently died. MRI findings also suggested positive long-term outcome in five of nine patients who improved significantly as based on Glasgow and extended Glasgow outcome scales. In the three unconscious patients who had normal diffusion- and perfusion weighted imaging the clinical outcome was good. This study suggests that MRI in seriously ill ICU patients with unclear cerebral pathology can provide information that changes, characterizes, or supports diagnoses and/or prognoses and therefore facilitates further management.
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| 3. |
- Gujar, Sachin, et al.
(författare)
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Magnetic Resonance Spectroscopy.
- 2005
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Ingår i: Journal of Neuro-Ophthalmology. - 1070-8022. ; 25:3, s. 217-226
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Abul-Kasim, Kasim, et al.
(författare)
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Added diagnostic utility of CT perfusion and CT angiography in acute ischemic stroke. Evaluation of three different patient categories
- 2009
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Ingår i: Functional Neurology. - 0393-5264. ; 24:2, s. 93-98
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Tidskriftsartikel (refereegranskat)abstract
- Patients with a clinical picture of acute ischemic stroke are a heterogeneous group. The aim of this study was to evaluate the added utility of CT perfusion (CTP) and CT angiography (CTA) in the workup of three different categories of acute ischemic stroke patients. Fifty patients (61 +/- 05 years old) were included in this retrospective analysis. Twenty-nine patients had transient ischemic attacks (TIAs) (Group I), 15 were not eligible for treatment with thrombolysis (Group II) and six showed no improvement after thrombolysis (Group III). CTP and CTA provided additional information, not revealed by plain CT, in all the Group II patients and in one third of the patients belonging to the other groups. The final diagnoses were TIA (n=23), thromboembolic cerebral infarctions (n=22), carotid artery dissection (n=4) and metastases (n=1). Of the 29 patients admitted with TIA, only 22 patients still had this diagnosis on discharge from the stroke unit. Given the risk of impending stroke, it would be important to include these modalities in the initial workup of TIA.
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| 5. |
- Abul-Kasim, Kasim, et al.
(författare)
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Reliability of Low-Radiation Dose CT in the Assessment of Screw Placement After Posterior Scoliosis Surgery, Evaluated With a New Grading System
- 2009
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Ingår i: Spine. - 0362-2436. ; 34:9, s. 941-948
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. A retrospective study. Objective. To evaluate the reliability of computed tomography (CT) with low radiation dose in the assessment of implant status in patients with adolescent idiopathic scoliosis (AIS). Summary of Background Data. The use of all-pedicle screw construct in scoliosis corrective surgery continues to gain increasing popularity since their introduction 1994 although their use in the thoracic spine carries a potential risk for neurovascular complications. CT is the method widely used to evaluate screw placement. Methods. Retrospective analysis of 46 consecutive low-dose spine CT in patients with AIS after posterior corrective surgery. Status of 809 titanium screws (642 thoracic) was evaluated. The degree of interobserver and intraobserver agreements about implant status was used as an indicator of the reliability of the low-dose spine CT in the assessment of accuracy of pedicle screw insertion. A new grading system has been developed for this purpose. Five types of misplacement have been evaluated: lateral, medial, and anterior cortical perforations; end-plate perforation; and foraminal perforation. Results. The analysis has shown a substantial interobserver and intraobserver agreements (kappa: 0.69 and 0.76, respectively) in differentiating pedicle screws with acceptable placement from screws with partial or total cortical perforation. None of the examinations was subjectively classified as unreliable. Conclusion. The study has shown that low-dose spine CT is a reliable method in evaluating screw placement in patients with AIS after posterior scoliosis surgery with titanium implants, using the here proposed grading system. The new grading system of screw misplacement was feasible and in line with the general agreement about the harmlessness of misplacement with minor pedicle breach. The reliability of low-dose spine CT in evaluation of lateral and medial cortical perforations was substantial. To reduce the radiation load, the postoperative assessment of titanium implants should be performed with low-dose CT.
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| 6. |
- Abul-Kasim, Kasim, et al.
(författare)
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The Neuroanatomic Localization of Epstein-Barr Virus Encephalitis May Be a Predictive Factor for Its Clinical Outcome: A Case Report and Review of 100 Cases in 28 Reports.
- 2009
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Ingår i: Journal of Child Neurology. - : SAGE Publications. - 1708-8283 .- 0883-0738. ; 24, s. 720-726
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Tidskriftsartikel (refereegranskat)abstract
- Encephalitis is one of the manifestations of infection with Epstein-Barr virus with clinical outcome varying from complete recovery to death. A 16-year-old boy with Epstein-Barr virus encephalitis with global cortical and subcortical gray matter involvement and a full clinical recovery is reported. The case inspired a literature review which yielded 100 cases of Epstein-Barr virus encephalitis subjected to radiological investigation and published in 28 reports. Cerebellum and basal ganglia were reported to be equally involved by Epstein-Barr virus infection, next to cerebral hemisphere. Patients with isolated hemispheric gray or white matter involvement were reported to achieve good recovery while almost half of the patients with thalamic involvement developed sequelae. The highest mortality rate was among patients with isolated brain stem involvement. In conclusion, neuroanatomic distribution of the radiological abnormalities in Epstein-Barr virus encephalitis may be useful as a prognostic marker.
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| 7. |
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| 8. |
- Sundgren, Pia, et al.
(författare)
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Brain irradiation: effects on normal brain parenchyma and radiation injury.
- 2009
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Ingår i: Neuroimaging Clinics of North America. - : Elsevier BV. - 1557-9867 .- 1052-5149. ; 19:4, s. 657-657
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Tidskriftsartikel (refereegranskat)abstract
- Radiation therapy is a major treatment modality for malignant and benign brain tumors. Concerns of radiation effects on the brain tissue and neurocognitive function and quality of life increase as survival of patients treated for brain tumors improves. In this article, the clinical and neurobehavioral symptoms and signs of radiation-induced brain injury, possible histopathology, and the potential of functional, metabolic, and molecular imaging as a biomarker for assessment and prediction of neurotoxicity after brain irradiation and imaging findings in radiation necrosis are discussed.
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| 9. |
- Larsson, Elna-Marie, et al.
(författare)
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Magnetic resonance imaging and histopathology in dementia, clinically of frontotemporal type
- 2000
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 11:3, s. 123-134
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Tidskriftsartikel (refereegranskat)abstract
- The magnetic resonance imaging (MRI) and computed tomography findings in 28 patients with the clinical diagnosis of frontotemporal dementia (FTD) were compared with the findings in a control group of 76 individuals without dementia or stroke. A pattern of frontal and temporal atrophy with predominantly frontal white matter changes was found in the FTD patients, and this was significantly different from the radiological findings in the control group. Six of the FTD patients have undergone autopsy. Histopathological evaluation showed a primary cortical degenerative disease (frontal lobe degeneration of non-Alzheimer type) in 3 of them, and primary white matter disorder, mainly frontal, of basically ischemic type (selective incomplete white matter infarction) in 3 of them. MRI could be a helpful tool to support the clinical diagnosis FTD, especially in young patients. MRI may also be helpful for the differentiation of a primary neurodegenerative from a mainly ischemic-vascular type of dementia.
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| 10. |
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