Table of Contents
Editorial
Perspectives
Review Articles
Level 1 EBM Expedited Publication
Research Perspectives
Genetics Vignette
Brain
- Early Basal Ganglia Hyperperfusion on CT Perfusion in Acute Ischemic Stroke: A Marker of Irreversible Damage?
These authors found that increased cerebral blood flow and volume were seen in the basal ganglia of 4.3% of patients with ischemic strokes with CT perfusion. All patients had underlying MCA occlusions, 30% underwent hemorrhagic transformations, and the hyperperfused areas eventually became infarcted in all. Thus, acute basal ganglia hyperperfusion in patients with stroke may indicate nonviable parenchyma.
- Cost-Effectiveness of CT Angiography and Perfusion Imaging for Delayed Cerebral Ischemia and Vasospasm in Aneurysmal Subarachnoid Hemorrhage
This comparative-effectiveness and cost-effectiveness study assessed the use of CT angiography and perfusion in patients with cerebral ischemia after aneurysmal SAH. The authors found that CTA and CTP should be the preferred imaging strategy in SAH, compared with transcranial Doppler ultrasound, leading to improved clinical outcomes and lower health care costs.
- Neuroimaging Features and Predictors of Outcome in Eclamptic Encephalopathy: A Prospective Observational Study
Imaging findings in 45 patients with eclampticposterior reversible encephalopathy syndrome were assessed. The most common affected areas were the occipital, parietal, frontal, and temporal lobes. Serum creatinine, uric acid, and lactate dehydrogenase values and presence of moderate or severe PRES were significantly associated with mortality. Eclamptic PRES demonstrated a higher incidence of atypical distributions and cytotoxic edema than previously thought.
Functional
- Brain Structure and Function in Patients after Metal-on-Metal Hip Resurfacing
Malfunction of metal-on-metal hip prostheses may produce visual, hearing, and motor deficits. These authors compared brain volumes, metal deposition, and gray matter attenuation in 2 groups of patients 8 years after surgery. Whole blood cobalt and chromium levels were higher in patients with metal-on-metal prostheses and associated with subtle structural changes in the visual pathways and basal ganglia.
Interventional
Head & Neck
- Use of Non-Echo-Planar Diffusion-Weighted MR Imaging for the Detection of Cholesteatomas in High-Risk Tympanic Retraction Pockets
HASTE DWI was used to examine 16 patients before cholesteatoma surgery and the findings were compared with those seen intraoperatively. HASTE DWI showed 90% sensitivity, 100% specificity, 100% positive predictive value, and 85.7% negative predictive value in this group of patients. Only 1 false-negative finding in an infected cholesteatoma occurred.
Pediatrics
- Screening CT Angiography for Pediatric Blunt Cerebrovascular Injury with Emphasis on the Cervical “Seatbelt Sign”
The authors investigated the significance of several clinical and imaging risk factors, most specifically the “cervical seatbelt sign,” in the anterior neck in pediatric patients with suspected blunt cerebrovascular injury as seen by CTA. They found that this common indication for neck CTA was not associated with blunt cerebrovascular injury. With the exception of Glasgow Coma Scale score, no single risk factor was statistically significant in predicting vascular injury.
