Self-referral of imaging does not imply overutilization.

For several years, some sectors of the specialty of Radiology have complained about the practice of self-referral, where a nonradiologist physician provides and interprets an imaging procedure. It is argued that such practice leads to increased costs since a physician will overutilize technology because of financial incentives. Here we review the literature.

Evaluating the efficacy of migraine therapy.

In patient surveys and analyses of clinical trial data, patients with migraine cite rapid and complete relief of headache pain as the single most important attribute of a migraine medication. Other desirable attributes cited by patients include lack of migraine recurrence; absence of adverse effects; and relief of associated symptoms, such as nausea, vomiting, and increased sensitivity to light and noise. Data from most clinical trials of migraine drugs use standard endpoints of level of pain relief at 2 hours and percentage of patients who are pain free at 2 hours.

Memory in a case of bilateral thalamic infarction.

The role of individual structures within the diencephalon for memory functioning is unknown. We present anatomic localization of lesions and a longitudinal neuropsychological profile of a young man who had a bilateral diencephalic stroke in the interpeduncular profundus arterial territory. MRI localized the lesions to the mamillothalamic tracts and inferior thalamic peduncle.

Relation of hyperglycemia early in ischemic brain infarction to cerebral anatomy, metabolism, and clinical outcome.

We studied the relation of serum glucose level measured in the first 12 hours of symptoms to the clinical findings, results of computed tomography (CT), and patterns of cerebral metabolism in 39 patients who had acute ischemic cerebral infarction. Structural damage was assessed by CT. Metabolic disruption was assessed using 18F-fluorodeoxyglucose and positron emission tomography (PET).

Cerebral blood flow variations in CNS lupus.

We studied the patterns of cerebral blood flow (CBF), over time, in patients with systemic lupus erythematosus and varying neurologic manifestations including headache, stroke, psychosis, and encephalopathy. For 20 paired xenon-133 CBF measurements, CBF was normal during CNS remissions, regardless of the symptoms. CBF was significantly depressed during CNS exacerbations.