Editor’s Choices
Simple fMRI Postprocessing Suffices for Normal Clinical Practice • S. González-Ortiz, L. Oleaga, T. Pujol, S. Medrano, J. Rumiá, L. Caral, T. Boget, J. Capellades, and N. Bargalló
Here, 2 postprocessing methods for fMRI were tested: a simple commercially available one against one commonly used for more advanced research. The authors compared visual concordance, image quality, voxel size, and radiologist preferences and concluded that widely available commercial fMRI software can provide reliable information for therapeutic management, meaning sophisticated, less widely available software is unnecessary in most cases. (See the accompanying commentary by Pillai.)
Safety and Efficacy of Neuroform for Treatment of Intracranial Aneurysms: A Prospective, Consecutive, French Multicentric Study • J.C. Gentric, A. Biondi, M. Piotin, C. Mounayer, K. Lobotesis, A. Bonafé, and V. Costalat , for the French SENAT Investigators
The periprocedural morbidity and mortality associated with stent treatment of unruptured wide-neck intracranial aneurysms was evaluated in 107 patients. The rate of aneurysm recurrence was nearly 10% and retreatment was needed in 4% of patients. The rates of periprocedural and longer term embolic events were 3.7% and 3.0%, respectively. Longer term morbidity and mortality were both 1%. Stent-assisted coiling with the Neuroform system provided a high level of occlusion with low rates of subsequent treatment despite a population of patients with predominantly wide-neck aneurysms.
Effect of Endovascular Treatment on Headache in Elderly Patients with Unruptured Intracranial Aneurysms • D.-Q. Gu, C.-Z. Duan, X.-F. Li, X.-Y. He, L.-F. Lai, and S.-X. Su
This study sought to determine if treating unruptured aneurysms in elderly patients has an effect on headaches, a common presenting symptom. Fifty-two of 72 subjects presented with headaches. Nearly 77% reported some improvement of their symptoms following endovascular treatment. The authors concluded that endovascular coiling of unruptured intracranial aneurysms resulted in relief of headache in most of these elderly patients.
Fellows’ Journal Club
Distributed, Limbic Gray Matter Atrophy in Patients after Bacterial Meningitis • N.K. Focke, K. Kallenberg, A. Mohr, M. Djukic, R. Nau, and H. Schmidt
It is well known that patients with bacterial meningitis have cognitive sequelae. These authors used voxel-based morphometry to assess the limbic gray matter in such patients. They found evidence of gray matter loss in the hippocampi, thalami, and cingulate gyri as well as the temporal lobes. The authors concluded that even in patients with normal routine MR imaging results, clear-cut gray matter atrophy with a mesial temporal/limbic pattern was evident. The anatomic distribution was compatible with the neuropsychological deficit commonly observed in patients after bacterial meningitis.
CT for Pediatric, Acute, Minor Head Trauma: Clinician Conformity to Published Guidelines • L.L. Linscott, M.M. Kessler, D.R. Kitchin, K.S. Quayle, C.F. Hildebolt, R.C. McKinstry, and S. Don
The authors sought to confirm the claim that 30% of CT studies in children with mild head trauma are unnecessarily obtained. They reviewed records of 182 patients admitted to an emergency department with minor head trauma and found that the percentages of head CTs did not conform to established guidelines but were better than the informally reported rate of 30%.
Spinal Meningeal Diverticula in Spontaneous Intracranial Hypotension: Analysis of Prevalence and Myelographic Appearance • P.G. Kranz, S.S. Stinnett, K.T. Huang, and L. Gray
The prevalence and appearance of spinal meningeal diverticula in patients with spontaneous intracranial hypotension and healthy controls were compared by these authors. They used CT myelograms in 19 symptomatic patients and 18 healthy controls and found no differences in the numbers and morphologies of diverticula between the groups. Thus, the role of these diverticula in intracranial hypotension is still not clear.
