Category Archives: Editor’s Choices

Attitudes about Medical Malpractice: An American Society of Neuroradiology Survey

Editor’s Choice April 2014

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An email survey yielded over 900 responses from neuroradiologists with regard to their experiences and attitudes about the medicolegal environment. Nearly one-half of neuroradiologists had been sued once, while over 10% had been sued more than 3 times with payouts in the range of US $50,000–$150,000 and up to $1.2 million for lawsuits affecting interventional neuroradiologists. Over 80% of neuroradiologists opined that the system was weighted toward plaintiffs and nearly 20% expressed being extremely concerned about being sued.

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Abstract

The concern over medicolegal liability is pervasive among physicians. We sought, through an email … Continue reading >>

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Left Hemisphere Diffusivity of the Arcuate Fasciculus: Influences of Autism Spectrum Disorder and Language Impairment

Editor’s Choice March 2014

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The authors used DTI measurements of the arcuate fasciculus in 14 children with language impairment, in 16 autistic children with language impairment, 18 autistic children without language impairment, and 25 controls. Although white matter abnormalities appeared similar in language impairment and autism spectrum disorder when examining broad white matter measures, detailed analysis indicated different mechanisms for the white matter microstructural anomalies associated with these disorders.

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Abstract

BACKGROUND AND PURPOSE
There has been much discussion whether brain abnormalities associated with specific language impairment and autism with language impairment are shared or are disorder specific. … Continue reading >>

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Evaluation of Common Structural Brain Changes in Aging and Alzheimer Disease with the Use of an MRI-Based Brain Atrophy and Lesion Index: A Comparison Between T1WI and T2WI at 1.5T and 3T

Editor’s Choice March 2014

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This study assesses the usefulness of a set of established structural findings in Alzheimer disease with various MRI sequences at 2 different field strengths in 127 subjects. Scores of atrophy and lesion burden were reliable across sequences and unit strength and were lowest in individuals with cognitive impairment, higher in those with Alzheimer disease, and also correlated with age, cognitive performance, and amyloid-β test. Although the results were slightly better at 3T, the authors concluded that even at 1.5T scores were reliable.

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Abstract

BACKGROUND AND PURPOSE
The Brain Atrophy and Lesion Index combines … Continue reading >>

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WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Short- and Midterm Results in a European Study

Editor’s Choice March 2014

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Short- and midterm results of endovascular aneurysm treatment with the new WEB-DL device were assessed in 45 patients from 12 European centers. Of these, 42 aneurysms were unruptured and most were located either in the MCA bifurcation or the posterior circulation. Adequate occlusion was observed in 81% and 90% of aneurysms at 6 and 13 months, respectively. Results suggest that WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable.

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Abstract

BACKGROUND AND PURPOSE
Flow disruption with the WEB-DL device has been used safely … Continue reading >>

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Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke

Editor’s Choice February 2014

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Seven patients with golf-related strokes were imaged and the literature was reviewed for similar cases, which generated a total 14 such occurrences. The most common time of symptom onset occurred during the golf swing and over one-half of patients damaged an extracranial vertebral artery with most dissections involving the right side. Of a total of 14 dissections, 7 patients had complete symptom resolution and returned to normal.

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Summary

Golf-related stroke has not been systematically reviewed. The purpose of our study was to describe in detail this particular stroke syndrome. Seven patients were analyzed … Continue reading >>

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Use of FLAIR Imaging to Identify Onset Time of Cerebral Ischemia in a Canine Model

Editor’s Choice February 2014

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After an infarction-inducing procedure, 20 dogs were imaged at 3, 4, 5, 6, and 24 hours with FLAIR and DWI. A mismatch between the 2 sequences (positive DWI and negative FLAIR) was found to reliably predict the time of infarct onset. By 6 hours, 95% of dogs had FLAIR abnormalities and by 24 hours all did. However, at 3 hours only 15% of dogs showed positive FLAIR studies. These results could serve as guidelines to estimate the time of onset of ischemic events.

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Abstract

BACKGROUND AND PURPOSE
Stroke is a leading cause of

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Diffusion Measures Indicate Fight Exposure–Related Damage to Cerebral White Matter in Boxers and Mixed Martial Arts Fighters

Editor’s Choice February 2014

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Boxers and mixed martial arts athletes underwent brain DTI and the results were correlated with number of fights, knockouts, age, weight, and years of education. Total knockouts in boxers increased diffusivity in the corpus callosum, cingulate, pericalcarine, precuneus, and amygdala, while in martial arts athletes only the posterior cingulate was abnormal. Thus, fight exposure but not the number of fights can be used to predict microstructural brain damage.

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Abstract

BACKGROUND AND PURPOSE
Traumatic brain injury is common in fighting athletes such as boxers, given the frequency of blows to the head. Because DTI

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Comparative Effectiveness of Ruptured Cerebral Aneurysm Therapies: Propensity Score Analysis of Clipping versus Coiling

Editor’s Choice January 2014

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The authors evaluated a national, multihospital database containing information on over 5200 patients to examine recent trends in ruptured aneurysm therapies and to compare peri-procedural outcomes between clipping and coiling treatments. Clipping therapy frequency decreased from 27% in 2006 to 21% in 2011. Unfavorable outcomes were more common after clipping compared with coiling, including discharge to long-term care, ischemic complications, neurologic complications, and other surgical complications.

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Abstract

BACKGROUND AND PURPOSE
The relative merits of treating ruptured aneurysms with clipping versus coiling continue to be a topic of debate. We evaluated a national, multihospital

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Prevalence of Radiologically Isolated Syndrome and White Matter Signal Abnormalities in Healthy Relatives of Patients with Multiple Sclerosis

Editor’s Choice January 2014

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Healthy individuals who either had no relatives with multiple sclerosis or had a family history of it were studied and evaluated according the Okuda and Swanton criteria for radiologically isolated syndrome. These investigators found that the frequency of white matter signal abnormalities and radiologically isolated syndrome were higher in the healthy relatives of patients with multiple sclerosis compared with nonfamilial healthy control subjects. In healthy relatives of patients with MS, smoking and obesity also contributed to the presence of white matter lesions.

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Abstract

BACKGROUND AND PURPOSE
The exact prevalence of WM signal abnormalities

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Morphologic, Distributional, Volumetric, and Intensity Characterization of Periventricular Hyperintensities

Editor’s Choice January 2014

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These authors sought to characterize white matter lesions of elderly adults and determine if some were artifacts. Using FLAIR they imaged 665 subjects without dementia, carefully measured and evaluated periventricular white matter lesions, and correlated these with several aspects of cardiovascular disease. They concluded that periventricular white matter hyperintensity levels, distribution, and association with risk factors and disease suggest that in old age, these are true tissue abnormalities and therefore should not be dismissed as artifacts.

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Abstract

BACKGROUND AND PURPOSE
White matter hyperintensities are characteristic of old age and identifiable on FLAIR and … Continue reading >>

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