Category Archives: Editor’s Choices

Mechanical Embolectomy for Acute Ischemic Stroke in the Anterior Cerebral Circulation: The Gothenburg Experience during 2000–2011

Editor’s Choice October 2014

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Safety and efficacy of intra-arterial treatment using the AmplatzGooseNeck device in acute anterior circulation strokes were assessed in 156 patients. High recanalization rates were obtained with the AmplatzGooseNeck snare without any device-related complications. Favorable outcome, mortality, and symptomatic intracerebral hemorrhage were comparable with results of newer embolectomy devices.

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Abstract

BACKGROUND AND PURPOSE
Intra-arterial treatment of proximal occlusions in the cerebral circulation have become an important tool in the management of acute ischemic stroke. Our goal was to evaluate the safety and efficacy of intra-arterial acute ischemic stroke treatment performed in our institution in

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Screening CT Angiography for Pediatric Blunt Cerebrovascular Injury with Emphasis on the Cervical “Seatbelt Sign”

Editor’s Choice September 2014

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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.

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Abstract

BACKGROUND AND PURPOSE
There are no standard screening guidelines to evaluate blunt cerebrovascular injury in children. The purpose of this retrospective study was

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Brain Structure and Function in Patients after Metal-on-Metal Hip Resurfacing

Editor’s Choice September 2014

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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.

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Abstract

BACKGROUND AND PURPOSE
Hip prostheses that use a metal-on-metal articulation expose the brain to elevated metal concentrations that, in acute excess due to prosthesis malfunction, is associated with neurologic damage, including visual and hearing

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Cost-Effectiveness of CT Angiography and Perfusion Imaging for Delayed Cerebral Ischemia and Vasospasm in Aneurysmal Subarachnoid Hemorrhage

Editor’s Choice September 2014

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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.

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Abstract

BACKGROUND AND PURPOSE
Delayed cerebral ischemia and vasospasm are significant complications following SAH leading to cerebral infarction, functional disability, and death. In recent years, CTA and CTP have been used to increase the detection of delayed cerebral ischemia and vasospasm. Our … Continue reading >>

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Reliability of the STIR Sequence for Acute Type II Odontoid Fractures

Editor’s Choice August 2014

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Because STIR images are routinely used for evaluation of the posttraumatic cervical spine, these authors specifically looked at the ability of this sequence to differentiate acute vs. chronic odontoid type II fractures in 75 patients and compared the imaging findings with an equal number of age-matched controls. STIR fared poorly in the detection of fractures in individuals over 57 years of age. Therefore, older patients, particularly those with osteopenia, may have acute odontoid injuries without corresponding STIR hyperintensity.

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Abstract

BACKGROUND AND PURPOSE
The STIR sequence is routinely used to assess acute traumatic osseous … Continue reading >>

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Effect of Direct Neuroradiologist Participation in Physician Marketing on Imaging Volumes in Outpatient Radiology

Editor’s Choice August 2014

(2 of 3)

This study assessed the benefits of using a sales representative and a neuroradiologistas a marketing and sales team for referrals in outpatient imaging. When referring practices were visited by the 2-person team, referral volumes were 2.5 times greater than when they were visited by the sales representative alone. This impact on imaging referral volumes with the use of the neuroradiologist for direct physician-to-physician marketing supports the concept that neuroradiologist visits are important in establishing and maintaining a relationship with the referring clinician’s office and maximizing imaging referrals.

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Abstract

BACKGROUND AND PURPOSE
Over the … Continue reading >>

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Transforaminal versus Intra-Articular Facet Corticosteroid Injections for the Treatment of Cervical Radiculopathy: A Randomized, Double-Blind, Controlled Study

Editor’s Choice August 2014

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In this prospective study, patients with cervical radicular pain were assigned to receive CT-guided transforaminal or facet dexamethasone injections and their outcomes were measured at 4 weeks postprocedure and compared with data collected prior to injections. Patients who had facet injections experienced significant pain reduction scores when compared with those who underwent transforaminal injections. Thus, facet injections are an effective treatment of cervical radiculopathy and represent a valid and safer alternative to transforaminal injections.

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Abstract

BACKGROUND AND PURPOSE
Transforaminal corticosteroid injections can be performed in the management of cervical radiculopathy but carry the
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Use of Flow-Diverting Devices in Fusiform Vertebrobasilar Giant Aneurysms: A Report on Periprocedural Course and Long-Term Follow-Up

Editor’s Choice July 2014

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This article presents the authors’ experience and long-term follow-up of 6 patients with fusiform and giant aneurysms of the vertebrobasilar system treated with flow-diverting devices. Devices were deployed uneventfully with no periprocedural complications. One year later, 3 patients had recurrent cerebral infarctions and 2 had acute thrombotic in-stent occlusions. Four patients died during the follow-up period. The authors do not intend to treat any more patients in this fashion until they have a better understanding of flow-diverting devices in this setting.

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Abstract

BACKGROUND AND PURPOSE
Fusiform vertebrobasilar giant aneurysms are a rare (<1%

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Perfusion-Based Selection for Endovascular Reperfusion Therapy in Anterior Circulation Acute Ischemic Stroke

Editor’s Choice July 2014

(2 of 3)

The authors attempted to determine if reperfusion therapy for anterior circulation acute stroke based on MR perfusion resulted in better outcomes at 3 months than that based on noncontrast CT. Perfusion imaging-selected patients had a better outcome than those selected with only noncontrast CT but MR perfusion- and CT perfusion-selected patients had similar outcomes. In this multicenter study, patients with acute stroke who underwent perfusion imaging were more than 2-fold more likely to have good outcomes following endovascular reperfusion therapy

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Abstract

BACKGROUND AND PURPOSE
Controversy exists about the role of perfusion imaging in

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Are We Effectively Informing Patients? A Quantitative Analysis of On-Line Patient Education Resources from the American Society of Neuroradiology

Editor’s Choice July 2014

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The readability of 20 patient education articles found on the ASNR Web site were evaluated using 10 quantitative readability scales and compared with those found on the Web site of the Society of Neurointerventional Surgery. The authors concluded that the patient education resources on both Web sites failed to meet the guidelines of the National Institutes of Health and American Medical Association. Members of the public may fail to fully understand these resources and would benefit from revisions that result in more comprehensible information cast in simpler language.

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Abstract

BACKGROUND AND PURPOSE
The

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