Purpose: Angiographic techniques have gained increasing importance in suspected vascular disease of the spinal cord. This demands an advanced understanding of spinal cord blood vessel anatomy and its embryologically founded broad spectrum of variations. The aim of this study was to improve knowledge on contentious issues concerning the development of spinal cord arterial supply in higher mammals and to offer visual information of high didactic value.
View Article and Find Full Text PDFObject: Glomus-type spinal arteriovenous malformations (AVMs) are rare. In the literature only small series and anecdotal reports can be found, and there are no prospective series elucidating the natural course or the superiority of 1 treatment regimen over another (such as surgery versus embolization versus conservative treatment). Microsurgical treatment of spinal AVMs often seems difficult because many lesions are not anatomically suitable for primary microsurgical occlusion and are therefore treated with first-line neuroradiological interventions or not at all.
View Article and Find Full Text PDFSpinal vascular malformations are rare diseases with a wide variety of neurological presentations. In this article, arteriovenous malformations (both from the fistulous and glomerular type) and spinal dural arteriovenous fistulae are described and an overview about their imaging features on magnetic resonance imaging (MRI) and digital subtraction angiography is given. Clinical differential diagnoses, the neurological symptomatology and the potential therapeutic approaches of these diseases which vary depending on the underlying pathology are given.
View Article and Find Full Text PDFSpinal vascular diseases are rare and constitute only 1% to 2% of all vascular neurologic pathologies. In this article, the following vascular pathologies of the spine are described: spinal arterial infarcts, spinal cavernomas, and arteriovenous malformations (including perimedullary fistulae and glomerular arterivenous malformations), and spinal dural arteriovenous fistulae. This article gives an overview about their imaging features on MRI, MR angiography, and digital subtraction angiography.
View Article and Find Full Text PDFIn the present study, we were interested in distinguishing the cortical representations of within-modal and cross-modal divided attention tasks by using functional magnetic resonance imaging. Sixteen healthy male subjects aged between 21 and 30 years underwent two within-modal (auditory/auditory, visual/visual) and one cross-modal (auditory/visual) divided attention task, as well as related selective attention control conditions. After subtraction of the corresponding control task the three divided attention tasks, irrespective of sensory modality, revealed significant activation in a predominantly right hemisphere network involving the prefrontal cortex, the inferior parietal cortex, and the claustrum.
View Article and Find Full Text PDFThe classic angiographically demonstrated features of spinal dural arteriovenous fistulas are shunts of radiculomeningeal branches with radicular veins draining exclusively in the direction of perimedullary veins and thereby causing venous congestion. These shunts are located at the point where the radicular vein passes the dura mater. Spinal epidural arteriovenous shunts, however, normally do not drain into the perimedullary veins and are, therefore, asymptomatic, presumably because of a postulated reflux-impeding mechanism between the dural sleeves.
View Article and Find Full Text PDFContemporary theories of motor control assume that motor actions underlie a supervisory control system which utilizes reafferent sensory feedbacks of actions for comparison with the original motor programs. The functional network of visuomotor action monitoring is considered to include inferior parietal, lateral and medial prefrontal cortices. To study both sustained monitoring for visuomotor incongruence and the actual detection of incongruence, we used a hybrid fMRI epoch-/event-related design.
View Article and Find Full Text PDFObjective: Treatment strategies of cerebral aneurysms include surgical clipping and endovascular therapies. To determine the long-term results of these therapeutic strategies, the vessel wall reaction close to the former aneurysm was studied according to the assumption that an intact endothelial layer over the former aneurysm neck constitutes complete vessel wall reconstruction and stable aneurysm obliteration.
Methods: Aneurysms were created in 40 rabbits by intraluminal elastase incubation of the common carotid artery.
Among spinal cord vascular malformations, dural arteriovenous fistulas (DAVFs) must be distinguished from intradural malformations. The concurrence of both is extremely rare. The authors report the case of a 35-year-old man who suffered from progressive myelopathy and who harbored both a DAVF and an intradural perimedullary fistula.
View Article and Find Full Text PDFBackground And Purpose: In the anterior circulation, the hyperdense middle cerebral artery (MCA) sign is a well-established marker for early ischemia. Similarly, the hyperdense basilar artery sign or the MCA "dot" sign may be a diagnostic clue for basilar artery or distal MCA branch thrombosis. The purpose of this study was to define the hyperdense posterior cerebral artery (PCA) sign and determine its incidence, diagnostic value, and reliability as a marker for ischemia in the territory of the PCA.
View Article and Find Full Text PDFObject: Because of the rarity of spinal subdural hematomas (SDHs), the literature offers scarce estimates of the outcome and predictive factors in patients suffering from these lesions. In addition, single-institution surgical series are still lacking. Therefore, the authors retrospectively evaluated the early and long-term functional outcomes measured in eight patients with spontaneous and nonspontaneous spinal SDHs in whom the clot had been evacuated.
View Article and Find Full Text PDFObjective: Although Guglielmi detachable coil systems have been widely accepted for treatment of intracranial aneurysms, primary stenting of aneurysms using porous stents, stent grafts, or implantation of coils after stent placement constitute emerging techniques in endovascular treatment. The aim of the present study was to use an animal model to investigate these different approaches to treat cerebral aneurysms with regard to the rate of closure and the histopathological changes within the aneurysm cavity and the parent vessel after stent placement.
Methods: We created aneurysms in 30 rabbits by distal ligation and intraluminal incubation of the right common carotid artery with elastase.
Motor practice induces plastic changes within the cortical motor system. Whereas rapidly evolving changes of cortical motor representations were the subject of a number of recent studies, effects of long-term practice on the motor system are so far poorly understood. In the present study pianists and nonmusicians were investigated using functional magnetic resonance imaging.
View Article and Find Full Text PDFRepetition priming denotes a behavioural change caused by prior exposure to a stimulus. The effect is known to last for weeks. This study addresses the underlying neural mechanisms for very-long-term picture priming by using event-related functional magnetic resonance imaging complemented by a behavioural paradigm.
View Article and Find Full Text PDFThe effect of newly acquired central pareses on functional MRI (fMRI) signal pattern is not known, since up to now all investigated patients were examined while they already experienced the motor weakness. We describe the first prospective and controlled study demonstrating the impact of new, acquired central pareses on fMRI motor activation pattern. Six patients suffering from a new central paresis after resection of a brain tumor infiltrating the central region were prospectively compared with a control group of five patients without postoperative paresis and a group of six healthy, age-matched controls who were investigated at two time points.
View Article and Find Full Text PDFObjectives: Comparison of two minimally invasive procedures for the treatment of intracerebral hemorrhage and subsequent lysis with regard to technical implications and clinical outcome of the patients.
Methods: Retrospective analysis of 126 patients with spontaneous supratentorial intracerebral hemorrhage treated by frame-based (n=53) or frameless (n=75) hematoma aspiration and subsequent fibrinolysis with recombinant tissue plasminogen activator (rt-PA). Data were analysed for the whole group as well as for the two subsets of patients with regard to hematoma reduction, procedure-related complications, and the early and long term clinical outcome of the patients.
Objective: This study was designed to describe regional changes in blood oxygenation level dependent signals in functional magnetic resonance images (fMRI) elicited by thermal pain in hypnotized subjects. These signals approximately identify the neural correlates of the applied stimulation to identify neuroanatomic structures involved in the putative effects of clinical hypnosis on pain perception.
Methods: After determination of the heat pain threshold of 12 healthy volunteers, fMRI scans were performed at 1.
Spinal vascular malformations are rare diseases that consist of true inborn cavernomas and arteriovenous malformations (including perimedullary fistulae, glomerular and juvenile AVMs) and presumably acquired dural arteriovenous fistulae. This review article gives an overview of the imaging features both on MRI and angiography, the differential diagnoses, the clinical symptomatology and the potential therapeutic approaches to these diseases. It is concluded that MRI is the diagnostic modality of first choice in suspected spinal vascular malformation and should be complemented by selective spinal angiography.
View Article and Find Full Text PDFBackground: Two of the most widely accepted approaches to map eloquent cortical areas preoperatively are positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). As yet, no study has compared these two modalities within the same frame of reference in tumour patients.
Aim: We employed [15O]-H2O-PET and fMRI in patients undergoing presurgical evaluation and compared the results with those obtained by direct electrical cortical stimulation (DECS).
Rationale: 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) is neurotoxic in animal studies and its use has been associated with cognitive impairments in humans.
Objective: To study hippocampal activation during the retrieval from episodic memory in polyvalent users of ecstasy.
Methods: Twelve polyvalent ecstasy users and twelve matched controls were examined by means of functional magnetic resonance imaging (fMRI) while they retrieved face-profession associations from episodic memory.
Background: Working memory processing in ecstasy (3,4-methylenedioxymethamphetamine) users is associated with neural alterations as measured by functional magnetic resonance imaging. Here, we examined whether cortical activation patterns change after prolonged periods of continued use or abstinence from ecstasy and amphetamine.
Methods: We used an n-back task and functional magnetic resonance imaging in 17 ecstasy users at baseline (t(1)) and after 18 months (t(2)).
The popular recreational drug 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) has well-recognized neurotoxic effects upon central serotonergic systems in animal studies. In humans, the use of MDMA has been linked to cognitive problems, particularly to deficits in long-term memory and learning. Recent studies with proton magnetic resonance spectroscopy (1H MRS) have reported relatively low levels of the neuronal marker N-acetylaspartate (NAA) in MDMA users, however, these results have been ambiguous.
View Article and Find Full Text PDFObjective: Neuroimaging studies have suggested an evolution of the brain activation pattern in the course of motor recovery after stroke. Initially poor motor performance is correlated with an recruitment of the uninjured hemisphere that continuously vanished until a nearly normal (contralateral) activation pattern is achieved and motor performance is good. Here we were interested in the early brain activation pattern in patients who showed a good and rapid recovery after stroke.
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