1,303 results match your criteria Emergency Neuroradiology


Personalized neurorehabilitative precision medicine: from data to therapies (MWKNeuroReha) - a multi-centre prospective observational clinical trial to predict long-term outcome of patients with acute motor stroke.

BMC Neurol 2022 Jun 30;22(1):238. Epub 2022 Jun 30.

Department for Neurology & Stroke, University Hospital of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.

Background: Stroke is one of the most frequent diseases, and half of the stroke survivors are left with permanent impairment. Prediction of individual outcome is still difficult. Many but not all patients with stroke improve by approximately 1. Read More

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Extending stroke CT angiography to the full chest allows for detection of additional pulmonary opacifications in acute stroke patients.

Curr Med Imaging 2022 Jun 29. Epub 2022 Jun 29.

Department of Diagnostic and Interventional Neuroradiology; University Hospital RWTH Aachen; Pauwelsstr. 30, 52074 Aachen, Germany.

Background And Purpose: During epidemics with an increased prevalence of pulmonary infections, extending stroke CTA examinations of acute stroke workup to the whole chest may allow for the identification of pulmonary findings that would have been missed on standard CTA examinations.

Materials And Methods: Our analysis comprised 216 patients with suspicion of stroke who received extended full-chest cerebrovascular CTA examinations from January 27th 2020 - date of the first confirmed Covid-19 case in Germany - until April 30th 2020.

Results: Consolidations and ground-glass opacifications were found in 73 of all 216 patients (34%). Read More

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Maple syrup urine disease decompensation misdiagnosed as a psychotic event.

Mol Genet Metab Rep 2022 Sep 18;32:100886. Epub 2022 Jun 18.

Children's National Rare Disease Institute, Washington, DC, United States of America.

Maple syrup urine disease (MSUD) is an autosomal recessive metabolic disease resulting in impaired or absent breakdown of branched-chain amino acids (BCAA) valine, isoleucine, and leucine. Classic MSUD often presents in post-natal periods, at times before newborn screening results, and is treated with a protein restricted diet supplemented with medical food and close follow up to prevent toxic buildup of blood leucine. Acute episodes of decompensation are prevented by early recognition and treatment. Read More

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September 2022

HIV-associated dementia presenting predominantly with clinical motor deficits: A case report.

Radiol Case Rep 2022 Sep 18;17(9):3005-3008. Epub 2022 Jun 18.

Department of Radiology, University of South Florida, Morsani College of Medicine, Tampa, FL 33612, USA.

HIV-associated dementia is commonly seen in older individuals and presents as a subcortical dementia associated with concentration, attention, and memory impairments. Motor signs, such as difficulty with gait, and mood changes are less prominent findings but are considered during diagnosis. We present a case of HIV-associated dementia in a young 29-year-old man who presented with progressive lower extremity weakness and difficulty ambulating. Read More

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September 2022

Procedural Outcome Following Stent-Assisted Coiling for Wide-Necked Aneurysms Using Three Different Stent Models: A Single-Center Experience.

J Clin Med 2022 Jun 16;11(12). Epub 2022 Jun 16.

Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte, 28205 Bremen, Germany.

Previous case series have described the safety and efficacy of different stent models for stent-assisted aneurysm coiling (SAC), but comparative analyses of procedural results are limited. This study investigates the procedural outcome and safety of three different stent models (Atlas™, LEO+™ (Baby) and Enterprise™) in the setting of elective SAC treated at a tertiary neuro-endovascular center. We retrospectively reviewed all consecutively treated patients that received endovascular SAC for intracranial aneurysms between 1 July 2013 and 31 March 2020, excluding all emergency angiographies for acute subarachnoid hemorrhage. Read More

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Acute Middle Cerebral Artery Occlusion Detection Using Mobile Non-Imaging Brain Perfusion Ultrasound-First Case.

J Clin Med 2022 Jun 13;11(12). Epub 2022 Jun 13.

Department of Neurology, Center for Vascular Neurology and Intensive Care, University of Regensburg, University Hospital Regensburg, Medbo Bezirksklinikum Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany.

Mobile brain perfusion ultrasound (BPU) is a novel non-imaging technique creating only hemispheric perfusion curves following ultrasound contrast injection and has been specifically designed for early prehospital large vessel occlusion (LVO) stroke identification. We report on the first patient investigated with the SONAS system, a portable point-of-care ultrasound system for BPU. This patient was admitted into our stroke unit about 12 h following onset of a fluctuating motor aphasia, dysarthria and facial weakness resulting in an NIHSS of 3 to 8. Read More

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Quality Assurance of a Cross-Border and Sub-Specialized Teleradiology Service.

Healthcare (Basel) 2022 May 28;10(6). Epub 2022 May 28.

European Telemedicine Clinic SL, Torre Mapfre, C/Marina 16-18, 08005 Barcelona, Spain.

Background: The current literature discusses aspects of quality assurance (QA) and sub-specialization. However, the challenges of these topics in a teleradiology network have been less explored. In a project report, we aimed to review the development and enforcement of sub-specialized radiology at Telemedicine Clinic (TMC), one of the largest teleradiology providers in Europe, and to describe each step of its QA. Read More

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Artificial Intelligence-Based Detection of Pneumonia in Chest Radiographs.

Diagnostics (Basel) 2022 Jun 14;12(6). Epub 2022 Jun 14.

Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany.

Artificial intelligence is gaining increasing relevance in the field of radiology. This study retrospectively evaluates how a commercially available deep learning algorithm can detect pneumonia in chest radiographs (CR) in emergency departments. The chest radiographs of 948 patients with dyspnea between 3 February and 8 May 2020, as well as 15 October and 15 December 2020, were used. Read More

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Clinical applications of dual-energy computed tomography in neuroradiology.

Semin Ultrasound CT MR 2022 Aug 18;43(4):280-292. Epub 2022 Mar 18.

Division of Emergency Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, MA; Division of Neuroradiology, Department of Radiology, Brigham and Women's Hospital, Boston, MA.

Dual-energy computed tomography (DECT) has developed into a robust set of techniques with increasingly validated clinical applications in neuroradiology. We review some of the most common applications in neuroimaging along with demonstrative case examples that showcase the use of this technology in intracranial hemorrhage, stroke imaging, trauma imaging, artifact reduction, and tumor characterization. Read More

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An altered state of consciousness while using anticoagulants and the incidental discovery of a pituitary lesion: considering pituitary apoplexy.

Endocrinol Diabetes Metab Case Rep 2022 Jun 1;2022. Epub 2022 Jun 1.

Endocrinology Unit, Department of Clinical and Experimental Medicine.

Summary: Pituitary apoplexy (PA) is a medical emergency with complex diagnosis and management. In this study, we describe a case of PA in a 63-year-old male treated with oral anticoagulant therapy for atrial fibrillation. In the patient, PA manifested itself with asthenia and severe headache not responsive to common analgesics. Read More

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Lost to Follow-Up: A Nationwide Analysis of Patients With Transient Ischemic Attack Discharged From Emergency Departments With Incomplete Imaging.

J Am Coll Radiol 2022 Jun 17. Epub 2022 Jun 17.

Director, Health Services Research, Department of Radiology, University of Colorado Hospital, Aurora, Colorado.

Purpose: Imaging guidelines for transient ischemic attack (TIA) recommend that patients undergo urgent brain and neurovascular imaging within 48 hours of symptom onset. Prior research suggests that most patients with TIA discharged from the emergency department (ED) do not complete recommended TIA imaging workup during their ED encounters. The purpose of this study was to determine the nationwide percentage of patients with TIA discharged from EDs with incomplete imaging workup who complete recommended imaging after discharge. Read More

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Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality.

J Stroke 2022 05 31;24(2):256-265. Epub 2022 May 31.

Division de Neurologia Vascular, Departmento de Neurologia, Institute for Neurological Research - FLENI, Buenos Aires, Argentina.

Background And Purpose: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year.

Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. Read More

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Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations.

Front Neurol 2022 23;13:884449. Epub 2022 May 23.

Department of Neuroradiology, ASST Papa Giovanni XXIII, Bergamo, Italy.

It is increasingly acknowledged that Coronavirus Disease 2019 (COVID-19) can have neurological manifestations, and cerebral microbleeds (CMBs) have been observed in this setting. The aim of this study was to characterize CMBs patterns on susceptibility-weighted imaging (SWI) in hospitalized patients with COVID-19 with neurological manifestations. CMBs volume was quantified and correlated with clinical and laboratory parameters. Read More

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Imaging of cerebral amyloid angiopathy-related inflammation (CAA-ri).

Neurol Sci 2022 Jun 6. Epub 2022 Jun 6.

Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Mura delle Cappuccine 14-16128, Genoa, Italy.

CAA-ri is a reversible and rare encephalopathy that may manifest in patients with CAA. In this short article, we describe CT and MRI findings of CAA-ri in a 67-year-old man presented to emergency with sudden aphasia and acute cognitive dysfunction, underlining the pivotal role of neuroimaging in the diagnostic path. Read More

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Subhepatic perforated acute appendicitis in a patient with midgut malrotation: A case report and review of the literature.

Int J Surg Case Rep 2022 Jun 28;95:107249. Epub 2022 May 28.

General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95124 Catania, Italy.

Introduction And Importance: Subhepatic acute appendicitis (SHAA) is a very rare cause of acute abdomen, developing in association with two types of congenital anomalies like as midgut malrotation (MM) and maldescent of the caecum. Preoperative diagnosis of SHAA is a challenge because of its rarity and atypical presentation. Imaging may be helpful for determining the correct diagnosis. Read More

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Improving Visualization Methods of Utility-Weighted Disability Outcomes for Stroke Trials.

Front Neurol 2022 13;13:875350. Epub 2022 May 13.

Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.

Background: The modified Rankin Scale (mRS) is the most common endpoint in acute stroke trials, but its power is limited when analyzed dichotomously and its indication of effect size is challenging to interpret when analyzed ordinally. To address these issues, the utility-weighted-mRS (UW-mRS) has been developed as a patient-centered, linear scale. However, appropriate data visualizations of UW-mRS results are needed, as current stacked bar chart displays do not convey crucial utility-weighting information. Read More

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Deep Learning-Based Reconstruction vs. Iterative Reconstruction for Quality of Low-Dose Head-and-Neck CT Angiography with Different Tube-Voltage Protocols in Emergency-Department Patients.

Diagnostics (Basel) 2022 May 21;12(5). Epub 2022 May 21.

Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 10 Avenue Alain Savary, BP 47870, 21078 Dijon, France.

Objective: To compare the image quality of computed tomography angiography of the supra-aortic arteries (CTSA) at different tube voltages in low doses settings with deep learning-based image reconstruction (DLR) vs. hybrid iterative reconstruction (H-IR).

Methods: We retrospectively reviewed 102 patients who underwent CTSA systematically reconstructed with both DLR and H-IR. Read More

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Streamlining Patient Management of Suspected COVID-19 Patients in the Emergency Department: Incorporation of Pulmonary CT Angiography into the Triaging Algorithm.

Diagnostics (Basel) 2022 May 9;12(5). Epub 2022 May 9.

Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45147 Essen, Germany.

Purpose: To evaluate the use of pulmonary computed tomography (CT) angiography during initial admission at an emergency department (ED), to identify COVID-19 patients with accompanying pulmonary embolism (PE) and its impact on clinical management.

Methods: We performed a retrospective analysis of COVID-19 patients that underwent pulmonary CT angiography at the ED. CT scans were evaluated for the presence and extent of PE and for imaging changes suspicious of COVID-19. Read More

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Case 302: Supratentorial Lymphocytic Inflammation with Parenchymal Perivascular Enhancement Responsive to Steroids.

Radiology 2022 06;303(3):726-730

From the Department of Radiology, Neuroradiology Section, University of Arkansas for Medical Sciences, Little Rock, Ark (S.V.); Department of Clinical Imaging, Hamad General Hospital (L.A.), and Department of Neuroradiology, Neuroscience Institute (M.A., A.H.E.B.), Hamad Medical, PO Box 3050, Alsadd, Doha, Qatar; and Department of Clinical Radiology, Weill Cornell Medicine, Doha, Qatar (A.H.E.B.).

History: Part one of this case appeared 4 months previously and may contain larger images. A 21-year-old immunocompetent man who was a long-term resident of Qatar presented to the emergency department with recurrent episodes of unprovoked generalized tonic-clonic seizures lasting 2-3 minutes that spontaneously resolved and were associated with postictal confusion. The patient also had progressive mild diplopia, intermittent dizziness, and numbness in the left arm over the course of 3 months. Read More

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Pituitary apoplexy in an adolescent male with macroprolactinoma presenting as middle cerebral artery territory infarction.

Ann Pediatr Endocrinol Metab 2022 May 16. Epub 2022 May 16.

Department of Paediatric Endocrinology, Variety Children Hospital, King's College Hospital NHS Foundation Trust, London, UK.

Pituitary apoplexy typically presents with acute headache, vomiting, visual disturbance and confusion. We report a rare presentation of ischaemic stroke due to pituitary apoplexy. A 16. Read More

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Comparing blood biomarkers to clinical decision rules to select patients suspected of traumatic brain injury for head computed tomography.

Neuroradiol J 2022 May 19:19714009221101306. Epub 2022 May 19.

Department of Radiology, Neuroradiology Division, 6429Stanford University, Stanford, CA, USA.

Introduction: Traumatic brain injury (TBI) is a major public health concern in the U.S. Recommendations for patients admitted in the emergency department (ED) to receive head computed tomography (CT) scan are currently guided by various clinical decision rules. Read More

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Altered grey matter integrity and network vulnerability relate to epilepsy occurrence in patients with multiple sclerosis.

Eur J Neurol 2022 May 18. Epub 2022 May 18.

Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.

Background And Purpose: The aim of this study was to investigate the relevance of compartmentalized grey matter (GM) pathology and network reorganization in multiple sclerosis (MS) patients with concomitant epilepsy.

Methods: From 3-T magnetic resonance imaging scans of 30 MS patients with epilepsy (MSE group; age 41 ± 15 years, 21 females, disease duration 8 ± 6 years, median Expanded Disability Status Scale [EDSS] score 3), 60 MS patients without epilepsy (MS group; age 41 ± 12 years, 35 females, disease duration 6 ± 4 years, EDSS score 2), and 60 healthy subjects (HS group; age 40 ± 13 years, 27 females) the regional volumes of GM lesions and of cortical, subcortical and hippocampal structures were quantified. Network topology and vulnerability were modelled within the graph theoretical framework. Read More

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Non-traumatic acute myelopathies: Clinical and imaging features in a real world emergency setting.

Neuroradiol J 2022 May 16:19714009221096823. Epub 2022 May 16.

Neurology Unit, S. Camillo-Forlanini Hospital.

Objective: The aetiologic diagnosis of non-traumatic acute myelopathies (AMs), and their differentiation from other mimicking conditions (i.e. 'mimics'), are clinically challenging, especially in the emergency setting. Read More

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Outcome of Endovascular Thrombectomy in Pre-stroke Dependent Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Front Neurol 2022 28;13:880046. Epub 2022 Apr 28.

Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte/Bremen-Ost, Bremen, Germany.

Introduction: Endovascular thrombectomy (EVT) is a well-established and effective therapeutic option for patients that meet certain criteria. However, this modality is not well studied in patients with pre-existing disability. The aim of the present study was to investigate the impact of mechanical thrombectomy in patients with acute onset ischemic stroke and pre-stroke dependency (PSD) in regard to their clinical outcome and mortality. Read More

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The Use of Levosimendan after Out-of-Hospital Cardiac Arrest and Its Association with Outcome-An Observational Study.

J Clin Med 2022 May 6;11(9). Epub 2022 May 6.

Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, 171 76 Stockholm, Sweden.

Background: Levosimendan improves resuscitation rates and cardiac performance in animal cardiac arrest models. The aim of this study was to describe the use of levosimendan in out-of-hospital cardiac arrest (OHCA) patients and its association with outcome.

Methods: A retrospective observational study of OHCA patients admitted to six intensive care units in Stockholm, Sweden, between 2010 and 2016. Read More

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Oxygen-Ozone Therapy Associated with Alpha Lipoic Acid Plus Palmitoylethanolamide and Myrrh versus Ozone Therapy in the Combined Treatment of Sciatic Pain Due to Herniated Discs: Observational Study on 318 Patients.

Int J Environ Res Public Health 2022 05 7;19(9). Epub 2022 May 7.

Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy.

Background: The aim of our observational study is to compare the therapeutic efficacy of combined treatment of oxygen-ozone therapy and oral treatment with alpha-lipoic acid (ALA) + palmitoylethanolamide (PEA) and myrrh in patients with peripheral neuropathic pain (sciatica) on radicular disc conflict from disc herniation and the results obtained with oxygen-ozone treatment alone.

Methods: We enrolled 318 patients with the neuroradiological diagnosis of disc herniation performed with computed tomography (CT) or magnetic resonance imaging (MRI) and symptoms characterized by low back pain complicated by sciatica, which we divided into two groups. Group A was composed of 165 patients who were treated only with oxygen-ozone therapy with CT-guided intraforaminal technique, while the remaining 153 (Group B) have undergone combined oral treatment with ALA + PEA and myrrh. Read More

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Management of paediatric traumatic brain injury in Sweden: a national cross-sectional survey.

Scand J Trauma Resusc Emerg Med 2022 May 12;30(1):35. Epub 2022 May 12.

Department of Operation and Intensive Care, Halland Hospital, Halmstad, Sweden.

Background: Previous studies have shown variations in management routines for children with traumatic brain injury (TBI) in Sweden. It is unknown if this management has changed after the publication of the Scandinavian Neurotrauma Committee guidelines in 2016 (SNC16). Also, knowledge of current practice routines may guide development of an efficient implementation strategy for the guidelines. Read More

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ACR Appropriateness Criteria® Imaging of Facial Trauma Following Primary Survey.

J Am Coll Radiol 2022 05;19(5S):S67-S86

Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia.

Maxillofacial trauma patients comprise a significant subset of patients presenting to emergency departments. Before evaluating for facial trauma, an emergency or trauma physician must perform a primary survey to ensure patient stabilization. Following this primary survey, this document discusses the following clinical scenarios for facial trauma: tenderness to palpation or contusion or edema over frontal bone (suspected frontal bone injury); pain with upper jaw manipulation or pain overlying zygoma or zygomatic deformity or facial elongation or malocclusion or infraorbital nerve paresthesia (suspected midface injury); visible nasal deformity or palpable nasal deformity or tenderness to palpation of the nose or epistaxis (suspected nasal bone injury); and trismus or malocclusion or gingival hemorrhage or mucosal hemorrhage or loose teeth or fractured teeth or displaced teeth (suspected mandibular injury). Read More

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