| 1. |
- Cronqvist, Mats, et al.
(author)
-
Diffusion and perfusion MRI in patients with ruptured and unruptured intracranial aneurysms treated by endovascular coiling: complications, procedural results, MR findings and clinical outcome.
- 2005
-
In: Neuroradiology. - : Springer Science and Business Media LLC. - 1432-1920 .- 0028-3940. ; 47:11, s. 855-873
-
Journal article (peer-reviewed)abstract
- Our purpose was to evaluate treatment safety as well as complications frequency and management in endovascular coiling of intracerebral aneurysms using MR diffusion and perfusion imaging. In this prospective study, 77 MR examinations were performed in conjunction with 43 procedures in 40 patients, 14 patients presented with ruptured and 26 with unruptured aneurysms. Mean time interval between treatment and post-procedure MRI was 29 and 25 h for the ruptured and unruptured aneurysm group, respectively. Peri-procedural complications, including five major events and five minor transient events, occurred in 10/43 procedures (23%), necessitating thrombolytic therapy in two patients and angioplasty in one, all three within the unruptured aneurysm group. Fifty-one new lesions were found on post-treatment DWI and 47 of them were regarded as of ischemic origin. Most lesions were small (< 3 mm), ipsilateral to the treated aneurysm and asymptomatic (37/40 patients). Sixty-seven percent of the lesions were found in the ruptured and 33% in the unruptured aneurysm group. The ischemic lesions did occur more frequently in patients treated for aneurysm of large neck size and according to the remodelling technique. The overall morbidity and mortality rates were 14.6 and 7.3% whereas morbidity and mortality rates related to the technique were only 2.6 and 0%, respectively. Silent embolism seems to be more common than clinically evident and partially related to patient presentation, heparinazation and treatment strategy. The capability to depict early complications and analyse their potential causes by using MR with DWI has been of great importance in our modification and improvement of therapeutic protocols, evaluations and strategies.
|
|
| 2. |
- Larsson, Elna-Marie, et al.
(author)
-
MR-undersökning av hjärnan vid 3 tesla. Högre magnetfältsstyrka ger bättre morfologisk och funktionell bild
- 2005
-
In: Läkartidningen. - 0023-7205. ; 102:7, s. 3-460
-
Journal article (peer-reviewed)abstract
- 3T MRI offers improved morphological and functional studies of the brain compared with the more commonly used field strength 1.5T. Clinical 3T MRI of the brain is beneficial for high resolution morphological imaging, MR angiography, diffusion-MRI including diffusion tensor imaging, perfusion-MRI, functional MRI (fMRI), and MR spectroscopy. The performance is enhanced by the combination with powerful magnetic field gradients.
|
|
| 3. |
- Nilsson, P, et al.
(author)
-
Predicting the Outcome of Optic Neuritis Evaluation of risk factors after 30 years of follow-up.
- 2005
-
In: Journal of Neurology. - : Springer Science and Business Media LLC. - 1432-1459 .- 0340-5354. ; 252:4, s. 396-402
-
Journal article (peer-reviewed)abstract
- Background Multiple sclerosis ( MS) is a common disease with considerable risk for disability. Optic neuritis ( ON) is a common first symptom of MS but it can also remain an isolated episode. Therefore, predicting the outcome of ON has gained in importance, particularly in light of current discussions of early disease modifying treatments in individuals at risk of developing MS. We reported previously on our cohort of 86 patients with acute monosymptomatic unilateral ON of whom 33 had progressed to MS after up to 18 years. Three patients had died. The present study extends the observation period to 31 years. Methods Patients were followed for up to 31 years or until a diagnosis of MS was made. Cerebrospinal fluid (CSF) was examined at onset. HLA class I and II antigens were determined. Magnetic Resonance Imaging (MRI) was performed during follow up. Findings Only one of 50 patients at risk developed clinical manifestations of MS during the extended follow up period. The estimated 15-year-risk of MS was 40% ( confidence interval [CI] 31% - 52%). Most cases, 20 of 34 or 60%, occurred within three years. Among factors present at onset, CSF with mononuclear pleocytosis and/or oligoclonal Ig increased the risk for subsequent MS significantly, 49% (CI 38% - 65%) compared with 23% ( CI 12% - 44%) for those with normal CSF, p= 0.02. Younger patients and those with winter onset also had greater risk. Recurrence of ON similarly elevated the risk significantly, p< 0.001. After 19 - 31 years MRI lesions suggestive of demyelinating disease were detected in 20 of 30 individuals although no clinical manifestations of MS had occurred. Conclusion The risk of MS in this large population-based prospective ON patient series was 40% and significantly higher in those with inflammatory CSF abnormalities at onset. Clinically silent MRI lesions suggestive of MS were detected in a majority of those with "ON-only". This finding should be taken into account when discussing prognosis and early intervention in patients with clinically isolated ON.
|
|
| 4. |
- Ramgren, B, et al.
(author)
-
Vertebrobasilar dissection with subarachnoid hemorrhage: a retrospective study of 29 patients.
- 2005
-
In: Neuroradiology. - : Springer Science and Business Media LLC. - 1432-1920 .- 0028-3940. ; 47:2, s. 97-104
-
Journal article (peer-reviewed)abstract
- We have reviewed initial diagnostic features, treatment, and outcome in 29 patients with acute subarachnoid hemorrhage due to non-traumatic vertebrobasilar artery dissection diagnosed in our hospital between 1993 and 2003. The dissections occurred in the vertebral artery in 19 patients, the posterior inferior cerebellar artery ( PICA) in two patients, the basilar artery in four patients, and in the vertebral artery extending into the PICA in four patients. A pseudoaneurysm was found in 20 patients. Clinical manifestations typically included sudden onset of moderate to severe headache, nuchal rigidity, and drowsiness. Fourteen patients were treated conservatively. Fifteen patients underwent endovascular treatment with either parent artery occlusion ( 13 patients) or aneurysmal coil occlusion with preservation of the parent artery ( 2 patients). Re-bleeding occurred within 12 days and before treatment in nine patients. Eight of these had a pseudoaneurysm. No patient bled after endovascular treatment. Poor grade and early re-bleeding were associated with less favorable outcome. Outcome at 6 months did not differ significantly between endovascular and conservative treatment. Altogether, good recovery was achieved for 16 patients, moderate disability was seen in one, severe disability in four, and eight patients ( 27%) died. The absence of bleeding subsequent to endovascular treatment in this study suggests that endovascular treatment may be a rational approach in these patients at high risk of re-bleeding, especially those with a pseudoaneurysm.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- van Westen, Danielle, et al.
(author)
-
Functional magnetic resonance imaging at 3T as a clinical tool in patients with intracranial tumors.
- 2005
-
In: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 46:6, s. 599-609
-
Journal article (peer-reviewed)abstract
- Purpose: To investigate the potential of functional magnetic resonance imaging (fMRI) at 3T as a clinical tool in the preoperative evaluation of patients with intracranial tumors. High magnetic field strength such as 3T is of benefit for fMRI because signal-to-noise ratio and sensitivity to susceptibility changes are field-strength-dependent. Material and Methods: Twenty patients with tumors close to eloquent sensorimotor or language areas were studied. Motor, sensory, and two language paradigms (word generation, rhyming) were used; their effectiveness was determined as the percentage of patients in whom the functional area of interest was activated. Activation maps were calculated and their quality rated as high, adequate, or insufficient. The influence of fMRI on the neurosurgical decision regarding operability, surgical approach, and extent of the resection, was assessed. Results: Paradigm effectiveness was 90% for motor and 95% for sensory stimulation, and varied from 79% to 95% for word generation and rhyming in combination. Ninety percent of the activation maps held high or adequate quality. fMRI proved useful: in the decision to operate (9 patients), in the surgical approach (13 patients), and in extent of the resection (12 patients). Conclusion: fMRI at 3T is a clinically applicable tool in the work-up of patients with intracranial tumors.
|
|
