Category Archives: Fellows’ Journal Club

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Intra- and Extraluminal Structural and Functional Venous Anomalies in Multiple Sclerosis, as Evidenced by 2 Noninvasive Imaging Techniques • K. Dolic, K. Marr, V. Valnarov, M.G. Dwyer, E. Carl, Y. Karmon, C. Kennedy, C. Brooks, C. Kilanowski, K. Hunt, A.H. Siddiqui, D. Hojnacki, B. Weinstock-Guttman, and R. Zivadinov
Here is another article that should add to the controversy over the relationship between MS and venous anomalies. The authors assessed the utility of sonography and MRV (2 different techniques) for detecting intra- and extraluminal venous abnormalities in 150 patients with MS and 63 matched controls. Results were as follows: … Continue reading >>

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Pediatric Intracranial Aneurysms: New and Enlarging Aneurysms after Index Aneurysm Treatment or Observation • S.W. Hetts, J.D. English, C.F. Dowd, R.T. Higashida, J.T. Scanlon, and V.V. Halbach
Although de novo intracranial aneurysms are very rare, their incidence is increased in children with other aneurysms. These authors sought to determine the factors that result in new or rapidly enlarging aneurysms in children. They reviewed 114 aneurysms not associated with other vascular malformations and found that 8.4% of children developed new or enlarging aneurysms. Nearly all of these patients had originally presented with fusiform aneurysms. Other features that lead to new … Continue reading >>

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Mortality in the Vertebroplasty Population • R.J. McDonald, S.J. Achenbach, E.J. Atkinson, L.A. Gray, H.J. Cloft, L.J. Melton III, and D.F. Kallmes
More controversy with regard to vertebroplasty: Do vertebroplasties affect mortality rates? These well-seasoned investigators compared 524 vertebroplasty patients with refractory osteoporotic fractures with 589 patients not treated by the procedure. When compared with the general population, vertebroplasty patients showed 77% of the expected survival and when compared with patients with symptomatic or asymptomatic vertebral fractures, vertebroplasty recipients retained a 17% greater mortality risk. Conclusion: mortality rates were worse for vertebroplasty patients when compared with those of … Continue reading >>

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Metabolic Abnormalities in Pain-Processing Regions of Patients with Fibromyalgia: A 3T MR Spectroscopy Study • P. Feraco, A. Bacci, Fab. Pedrabissi, L. Passamonti, G. Zampogna, Fed. Pedrabissi, N. Malavolta, and M. Leonardi
As neuroradiologists we see many spine studies for fibromyalgia and wonder about the significance of this condition (is it a real disease?). Here, the authors used MR spectroscopy to assess metabolic alterations in brain regions associated with pain reception (thalami and ventrolateral prefrontal cortex). Using 3T single-voxel MRS, they studied 12 patients and 12 healthy controls and analyzed their data using an LCModel. Glx/Cr and Glu/Cr … Continue reading >>

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Microembolic Signal Monitoring after Coiling of Unruptured Cerebral Aneurysms: An Observational Analysis of 123 Cases • G.A. Schubert, C. Thomé, M. Seiz, C. Douville, and J. Eskridge
Thromboembolic complications occur during 5–60% of all aneurysm coiling procedures and 3–6% are clinically symptomatic. These authors utilized transcranial Doppler to detect microemboli after coiling and then correlated their presence with patient demographics, aneurysm size, type of procedure and complication, medication, and clinical outcome in 123 patients. Procedures involving larger aneurysms, stent assistance, and incomplete occlusions were associated with greater risk of microemboli and heparinization played an important role in prevention.… Continue reading >>

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Predictors of Unfavorable Outcome in Intracranial Angioplasty and Stenting in a Single-Center Comparison: Results from the Borgess Medical Center-Intracranial Revascularization Registry • F. Al-Ali, T. Cree, S. Hall, S. Louis, K. Major, S. Smoker, and S. Walker
Is it better to perform angioplasty or stent intracranial stenoses? In a registry of 140 patients the overall stroke rate after procedures was 13%, with the lowest rate in those treated with angioplasty only (4.5%) versus those who received stents (11–25%, depending on the technique used). Dilation success rate was higher with stenting and restenosis rate was higher with angioplasty only. … Continue reading >>

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Longitudinal Whole-Brain N-Acetylaspartate Concentration in Healthy Adults • D.J. Rigotti, I.I. Kirov, B. Djavadi, N. Perry, J.S. Babb, and O. Gonen
This article addresses the issue of neuronal changes over time. N-acetylaspartate is surrogate marker of neuronal viability and integrity as seen on hydrogen MR spectroscopy. Here, the authors utilized their own method of measuring whole-brain NAA in a small cohort of healthy adults with each receiving 4 scans (baseline and annual) during a 3-year period. The data were converted to absolute millimole concentrations of this metabolite. They found that whole-brain NAA was stable over a 3-year period in … Continue reading >>

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Acute Damage to the Posterior Limb of the Internal Capsule on Diffusion Tensor Tractography as an Early Imaging Predictor of Motor Outcome after Stroke • J. Puig, S. Pedraza, G. Blasco, J. Daunis-i-Estadella, F. Prados, S. Remollo, A. Prats-Galino, G. Soria, I. Boada, M. Castellanos, and J. Serena
Practical applications of diffusion tensor imaging are few, but this seems to be an interesting and a potentially important one: can it be used to predict motor outcome after stroke? Sixty patients within 12 hours of stroke were assessed with tractography at 5 different locations in the corticospinal tracts at admission, … Continue reading >>

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Have Referral Patterns for Vertebroplasty Changed since Publication of the Placebo-Controlled Trials? • M.T. Luetmer and D.F. Kallmes
Here is an article analyzing some of the consequences of the 2 famous (infamous?) randomized vertebroplasty trials published in the New England Journal of Medicine in August 2009. Curiously, it is by some of the same authors. They looked at monthly referral patterns for nearly 1200 patients during a 6-year period extending from 2004 to 2010. Although this article represents the experience of only 1 institution, the number of vertebroplasties dropped from 18 to 11 per month after August 2009. The … Continue reading >>