دانلود کتاب Practical Neuroimaging in Stroke: A Case-Based Approach

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A Case-Based Approach
Hypoxic-Ischemic Brain Damage
ADDITIONAL EXAMPLES OF GLOBAL BRAIN EDEMA
Cortical Laminar Necrosis
Basal Ganglia Involvement
W atershed Infarctions
Vulnerable Cortical Areas: Perirolandic and Occipital Cortex
False Radiological Signs: Pseudo-Subarachnoid Hemorrhage and False Middle Cer
Early and Delayed White Matter Changes: Anoxic Leukoencephalopathy
Clinical-Anatomical Syndromes of Ischemic Infarction
Alejandro A. Rabinstein and Steven J. Resnick
CAROTID BIFURCATION OCCLUSION
MIDDLE CEREBRAL ARTERY OCCLUSION
T erritorial MCA Infarction
Deep Middle Cerebral Artery Infarction
Superfi cial Divisional Middle Cerebral Artery Infarction
Superfi cial Cortical Infarctions
T ABLE 2-1. Clinical features of MCA branch infarctions.
Brain region
Arterial branches
Distinctive features
Additional signs
Hemispheric Border-Zone Infarctions
ANTERIOR CEREBRAL ARTERY OCCLUSION
ANTERIOR CHOROIDAL ARTERY OCCLUSION
POSTERIOR CEREBRAL ARTERY OCCLUSION
T ABLE 2-2. Visual fi eld disturbance caused by PCA infarction.
VERTEBROBASILAR DISEASE
T ABLE 2-3. Signs suspicious for basilar artery occlusion.
CEREBELLAR INFARCTIONS
P osterior Inferior Cerebellar Artery Infarction
Case Vignette
Anterior Inferior Cerebellar Artery Infarction
Superior Cerebellar Artery Infarction
Cerebellar Border-Zone Infarctions
BRAINSTEM INFARCTIONS
Medullary Infarctions
Case Vignette
W allenberg’s Syndrome
P ontine Infarctions
Midbrain Infarctions
Case Vignette
References
Acute Stroke Imaging
T ABLE 3-1. Indications and purposes of emergency neuroimaging in patients wi
Indication/purpose Imaging modality
COMPUTED TOMOGRAPHY
CT Signs of Acute Ischemia
Case Vignette
T ABLE 3-2. Early signs of ischemic stroke on brain CT scan.
Sign
Signifi cance
CT Perfusion
T ABLE 3-3. Relative advantages of CT perfusion and DWI-PWI MRI for the asse
CT Angiogram
MAGNETIC RESONANCE IMAGING
Diffusion-Weighted and Perfusion-Weighted Imaging
T ABLE 3-4. Main practical uses of DWI in patients with acute stroke presenta
PWI-DWI Mismatch
Direct Thrombus Visualization
MAGNETIC RESONANCE ANGIOGRAPHY
IMAGING IN STROKE EMERGENCIES
Intravenous Thrombolysis
Case Vignette
Intra-Arterial Revascularization Therapies
Massive Hemispheric Infarction
Acute Internal Carotid Artery Occlusion
Case Vignette
Basilar Artery Occlusion
Case Vignette
Massive Cerebellar Infarction
Subacute and Chronic Infarctions
Cardiac Embolism
T ABLE 4-1. Cardiac sources of embolism.
T ABLE 4-2. Radiological characteristics of cardioembolic strokes.
Defi nite
Probable
P ossible
A TRIAL FIBRILLATION
Case Vignette
DILATED CARDIOMYOPATHY
MYOCARDIAL INFARCTION
PROSTHETIC VALVES
NONBACTERIAL THROMBOTIC ENDOCARDITIS
MITRAL STENOSIS AND ANNULAR CALCIFICATION
A TRIAL MYXOMA
P A TENT FORAMEN OVALE
Case Vignette
PROXIMAL AORTIC ATHEROSCLEROTIC PLAQUE
Case Vignette
References
Extracranial Large Artery Atherothrombosis
Sebastian Koch
ULTRASONOGRAPHY
MR AND CT ANGIOGRAPHY
CATHETER CEREBRAL ANGIOGRAPHY
Case Vignette
CLINICAL FEATURES OF CAROTID ATHEROTHROMBOSIS
Case Vignette
MECHANISMS OF INFARCTION
Atherothrombotic Embolism
Case Vignette
Hemodynamic Infarction
TREATMENT
Symptomatic Carotid Disease
Asymptomatic Carotid Artery Stenosis
Carotid Revascularization
Case Vignette
VERTEBRAL ARTERY ATHEROSCLEROSIS
Case Vignette
Intracranial Atherosclerotic Disease
Jose G. Romano
EPIDEMIOLOGY AND NATURAL HISTORY
MECHANISMS OF CEREBRAL ISCHEMIA
T ABLE 6-1. T CD and MRA cutoff parameters to detect 50% stenosis of larg
DIAGNOSIS OF INTRACRANIAL A THEROSCLEROTIC DISEASE
T CD (mean fl ow velocity)
MRA
MEDICAL THERAPY
T ABLE 6-2. Probability of stroke recurrence at 2 years in the territory of
Risk of recurrence
INTERVENTIONAL APPROACHES
Small Vessel Disease
SMALL SUBCORTICAL INFARCTIONS
LACUNAR SYNDROMES
STRIATOCAPSULAR INFARCTIONS
CAPSULAR WARNING SYNDROME
MULTIPLE LACUNAR INFARCTIONS
SILENT INFARCTIONS, WHITE MATTER DISEASE, AND DEMENTIA
References
Uncommon Causes of Stroke
CERVICOCRANIAL ARTERIAL DISSECTIONS
Case Vignette
T ABLE 8-1. Angiographic signs of cervical artery dissections.
A ORTIC DISSECTIONS
FIBROMUSCULAR DYSPLASIA
DOLICHOECTASIA
MOYAMOYA
CADASIL
MELAS
REVERSIBLE CEREBRAL VASOCONSTRICTION
HYPERCOAGULABILITY
T ABLE 8-2. Differential diagnosis of cerebral vasculitis.
V ASCULITIS
Primary Central Nervous System Angiitis
Case Vignette
Giant Cell (Temporal) Arteritis
SUSAC’S Syndrome
Infectious Vasculitis
HIV VASCULOPATHY
STROKES FROM SUBSTANCE ABUSE
SICKLE CELL DISEASE
Spinal Cord Infarction
V ASCULAR ANATOMY OF THE SPINAL CORD
MANAGEMENT AND PROGNOSIS
References
Spontaneous Intraparenchymal Hemorrhage
STRIATOCAPSULAR HEMORRHAGES
T ABLE 10-1. Anatomical classifi cation of striatocapsular hemorrhages.
T ype
Site of bleeding
Arterial territory
Lateral Putaminal Hemorrhage
Massive Striatocapsular Hemorrhage
P osterolateral Striatocapsular Hemorrhage
Middle-Posteromedial Striatocapsular Hemorrhage
Caudate Hemorrhage
Hematoma Expansion
T ABLE 10-2. Causes of lobar intracerebral hemorrhage other than primary art
Cause
Diagnosis
Case Vignette
Hydrocephalus
T emporal Hematomas
Focal Lobar Hemorrhage
Surgical Evacuation (Figure 10-12)
THALAMIC HEMORRHAGES
T ABLE 10-3. Anatomical classifi cation of thalamic hemorrhages.
T ype
Arterial territory
Global Thalamic Hematomas
Anterior Thalamic Hemorrhage
P osteromedial Thalamic Hemorrhage
P osterolateral Thalamic Hemorrhage
Dorsal Thalamic Hemorrhage
PONTINE HEMORRHAGES
T ABLE 10-4. T ypes of pontine hemorrhage.
T ype
Region involved
Massive Pontine Hemorrhage
Bilateral Tegmental Hemorrhage
Unilateral Tegmental Hemorrhage
❖ Survival is the rule. 45,46,48 CEREBELLAR HEMORRHAGES
Large Cerebellar Hematomas with Surgical Decompression
Benign Hemispheric Cerebellar Hemorrhages
V ermian Hemorrhages
INTRAVENTRICULAR HEMORRHAGES
References
Secondary Intraparenchymal Hemorrhages
CEREBRAL AMYLOID ANGIOPATHY
T ABLE 11-1. Secondary causes of intraparenchymal hemorrhage
Case Vignette
HEMORRHAGIC TRANSFORMATION
Case Vignette
HEMORRHAGIC COMPLICATIONS OF THROMBOLYSIS
Case Vignette
ANTICOAGULATION-RELATED INTRACEREBRAL HEMORRHAGE
COAGULOPATHY
SUBSTANCE ABUSE
V ASCULITIS
CEREBRAL VENOUS THROMBOSIS
Case Vignette
ARTERIOVENOUS MALFORMATIONS
CAVERNOUS MALFORMATION
DURAL ARTERIOVENOUS FISTULA
TUMOR
TRAUMA
Subarachnoid Hemorrhage
Grade
Fisher scale
Modifi ed Fisher scale
CAUSES OF EARLY DETERIORATION: REBLEEDING AND HYDROCEPHALUS
GLOBAL CEREBRAL EDEMA
CEREBRAL VASOSPASM
V ASOSPASM: ENDOVASCULAR TREATMENT
P A TTERNS OF ISCHEMIA
SUBARACHNOID HEMORRHAGE WITH NEGATIVE ANGIOGRAM
P erimesencepahlic Subarachnoid Hemorrhage
Non-Perimesencephalic Subarachnoid Hemorrhage with Negative Angiogram
CONDITIONS MIMICKING ANEURYSMAL SUBARACHNOID HEMORRHAGE
Pseudo-Subarachnoid Hemorrhage
T raumatic Subarachnoid Hemorrhage
Causes of Sulcal Subarachnoid Hemorrhage
V ascular Anomalies of the Brain
Nils Mueller-Kronast
INTRODUCTION TO ANGIOGRAPHIC MODALITIES
Catheter Angiography
Three-Dimensional Digital Subtraction Angiography
Computed Tomography Angiography
Magnetic Resonance Angiography
COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING
MRI
ANEURYSMS
General Concepts
T ypes of Aneurysms
TREATMENT
T ABLE 13-1. Five-year cumulative rupture rates according to size and locatio
7 mm
7–12 mm
13–24 mm
25 mm
Case Vignette
ARTERIOVENOUS MALFORMATIONS
General Concepts
Natural History
T reatment Options
T ABLE 13-2. Spetzler-Martin arteriovenous malformation grading system. 89
Description
P oints
Case Vignette
DURAL ARTERIOVENOUS FISTULAS
General Concepts
Cranial Dural Arteriovenous Fistulas
Cavernous Dural Arteriovenous Fistulas
T ABLE 13-3. Barrow classifi cation of carotid-cavernous sinus arteriovenous fi
Extracavernous Dural Arteriovenous Fistulas
T ABLE 13-4. Risk of intracranial hemorrhage based on venous drainage and Bor
V enous outfl ow
Borden type
Presentation 105
Natural History 1 03,106
T reatment
References
Cerebral Venous Thrombosis
Alexander Y. Zubkov, Steven J. Resnick, and Alejandro A. Rabinstein
Case Vignette
ANATOMY OF THE VENOUS SYSTEM
Dural Sinuses
Superfi cial Cerebral Veins
Deep Cerebral Veins
IMAGING CHARACTERISTICS OF CVT
Computed Tomography
Signs of Parenchymal Involvement
Magnetic Resonance Imaging
T ABLE 14-1. T emporal changes of signal intensity of intraluminal venous thr
MRI Sequence
Acute phase
( 1 wk)
Subacute phase (1–2 wks)
Late subacute and chronic phase ( 2 wks)
Signs of Parenchymal Involvement
Angiographic, Magnetic Resonance, and Computed Tomography Venograms
MR Venography
CT Venography
Conventional Angiography
SINUS OCCLUSION SYNDROMES
Superior Sagittal Sinus
T ransverse Sinus Thrombosis
Cavernous Sinus Thrombosis
Deep Vein Thrombosis
Cortical Vein Thrombosis
Atypical Presentations
MANAGEMENT AND PROGNOSIS
References