1,720,976 research outputs found
Role of neuroradiology on evaluating cerebral aneurysms.
No full textIntracranial aneurysms are common lesions with an adult prevalence rate between one and five percent in autopsy studies. Fortunately, most aneurysms are small and an estimated 50 to 80 percent of all aneurysms do not rupture during the course of a person’s lifetime . Intracranial aneurysms are considered to be sporadically acquired lesions, although a rare familiar form has been described 3. Clinically, cerebral aneurysms can be silent or give rise to focal neurological symptoms or rupture leading to the dramatic event of subarachnoid haemorrhage
Lo “Stenting” primario nel trattamento delle stenosi e degli pseudo-aneurismi da patologia dissettiva post-traumatica del tratto extracranico della carotide interna.
No full textLa patologia dissettiva posttraumatica
della carotide è generalmente
una condizione che tende all’autoriparazione
e prevede solo una protezione del paziente
con terapia antiaggregante e/o anticoagulante.
Vi sono tuttavia una quota minoritaria
di pazienti che, nonostante la terapia,
presentano sintomi protratti nel tempo, nonostante
la terapia, legati a TIA da microembolizazione
o a sintomatologia compressiva
da parte di eventuali sacche aneurismatiche.
Scopo del nostro lavoro è l’analisi della nostra
casistica di questo tipo di pazienti, trattati
con stenting primario, con particolare
riguardo alle peculiarità tecniche
Stenting and coil embolization of a surgically treated residual aneurysm of the middle cerebral artery bifurcation associated with coil embolization of a communicating artery aneurysm. A case report.
No full textA little talk on Adamliewicz’s artery. Some practical considerations on the pre-operative identification of this artery starting from a single team experience in pre-surgical selective embolization of vascularized spinal lesions.
No full textThe major radicular artery eponymically named "Adamkiewicz's artery" (AKA) is an important vessel supplying the spinal cord, especially the lumbar enlargement. This report emphasizes the importance of anatomical knowledge of this artery and highlights the concept of the potential risk of neurological complications during different procedures: spine orthopedic/neurosurgery, aortic repair (vascular surgery) and endovascular selective embolizations performed by interventional neuro/radiologists. Anatomical considerations are made on the spinal cord arterial circulation with a special focus on the AKA. Our review of the literature considered this anatomical element essential to compare the potential risk of spinal cord ischemic damage during orthopedic/ neurosurgical spine procedures, aortic vascular surgery repair procedures and endovascular selective arterial embolizations. Evaluation of the endovascular selective arterial spine embolization risk was based on our series of 410 embolization procedures. Spinal cord infarction and transient or permanent paraplegia may result from inadvertent interruption of the AKA. The presence of intersegmental collaterals may decrease the risk of spinal cord ischemia: this is an important element to bear in mind that may help in spine surgery or aortic repair procedures performed by vascular surgeons. Nevertheless, during aortic repair (open surgery or stent-graft procedures) interruption of bilateral segmental arteries at multiple consecutive levels including that of the AKA may occur thereby increasing the ischemic spinal cord risk, annulling the benefit of intersegmental collaterals. Accidental embolizations of the AKA during endovascular spine procedures (i.e. selective arterial embolizations) performed by interventional neuro /radiologists will cause an almost certain spinal cord infarction due to the consequent embolizations of the anterior spinal artery (ASA)
Analysis of a uniform cohort of 398 patients studied by CT angiography over 24 months for steno-occlusive carotid artery disease. Epidemiological and diagnostic considerations.
No full textMultislice CT scanners are
playing an increasingly important role in
the study of steno-occlusive carotid artery
disease prior to treatment.
We used a large uniform cohort of patients
to assess the diagnostic potential of
multislice CT imaging and analyse the epidemiological
findings
CT angiography in an acute stroke protocol: Correlation between occlusion site and outcome of intravenous thrombolysis.
No full textThrombolysis with intravenous rt-PA is the current therapy for acute ischemic stroke. Unlike other outcome factors, relatively little is known about the prognostic value of the occlusion site on treatment outcome. We compared the effectiveness and safety of intravenous thrombolysis in patients with different levels of occlusion identified by CT angiography (CTA) in anterior circulation stroke, and analyzed the influence of the occlusion site on treatment outcome in relation to other outcome factors. We selected 71 patients from a stroke database collected between June 2007 and December 2011 at our hospital. All of the studied patients had anterior circulation stroke with intracranial occlusion detected by CTA and were treated with intravenous rt-PA. They were divided into two groups according to the site of occlusion along the middle cerebral artery course: proximal (carotid "T", complete M1 and mild M1 occlusions) and distal (M2/M3 occlusions). Treatment effectiveness was assessed by modified Rankin Scale (mRS) at three months, considering a positive outcome a mRS value ≤ 2. Treatment safety was assessed by evaluating the rate of hemorrhagic complications seen on unenhanced CT at 24 hours. Binary logistic regression was performed to evaluate the interaction between occlusion site and other variables such as sex, age, ASPECT score on admission and baseline NIHSS value in determining treatment outcome. The degree of effectiveness and safety differed when considering patients with proximal and distal occlusions. The percentage of successfully treated cases was 28.6% in the first group compared to 72% in the second, and the rate of hemorrhagic complications was 28.6% and 6% respectively. After adjustment for sex, age, ASPECT score on admission and baseline NIHSS value, occlusion site was the only variable significantly influencing treatment safety and, together with baseline NIHSS value, the only valid predictor of treatment effectiveness. We demonstrated a correlation between the site of arterial occlusion and outcome of intravenous thrombolysis. By helping the choice of the best therapeutic strategy depending on the identified occlusion site, CTA could be usefully added to the examinations included in the Stroke Protocol for the baseline evaluation of patients with suspected acute stroke
Complications in the treatment of intracranial aneurysms with silk stents: an analysis of 30 consecutive patients.
No full textFlow-diverting stents (Silk and PED) have radically changed the approach to intracranial aneurysm treatment from the use of endosaccular materials to use of an extraaneurysmal endoluminal device. However, much debate surrounds the most appropriate indications for the use of FD stents and the problems raised by several possible complications.We analysed our technical difficulties and the early (less than ten days after treatment) and late complications encountered in 30 aneurysms treated comprising 13 giant lesions, 12 large, five with maximum diameters <10 mm and one blister-like aneurysm. In our experience the primary indications for the use of FD stents can be the symptomatic intracavernous giant aneurysms. Although the extracavernous carotid siphon aneurysms have major risk of bleeding, FD stents are indicated clearly explaining the risks to the patient in case of severe mass effect. There is a very complex assessment for aneurysms of the vertebrobasilar circulation
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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