The authors determined normal reference values for morphologic variants and diameter measurements of the circle of Willis specific to three dimensional time-of-flight MR angiography.

No abstract

Calcium antagonists reduce the proportion of ischemic neurologic deficits and nimodipine improves overall outcome within 3 months of aneurysmal SAH; evidence for a reduction of poor outcome from all causes by nicardipine and AT877 is inconclusive. The intermediate factors by which nimodipine exerts its beneficial effect remain uncertain.

Objectives-The long term outcome after a single symptomatic lacunar infarct may be less favourable than is generally assumed. Patients often present with complaints such as fatigue or "being diVerent from before the stroke", for which there are no obvious physical explanations. Although cognitive functioning is considered normal in most patients with lacunar infarction in the internal capsule or corona radiata, a study was carried out to determine if subclinical changes in mental or emotional function can explain these vague complaints characteristic for their disablement. Methods-Sixteen patients, each with a single symptomatic supratentorial lacunar infarct, and 16 matched healthy controls were examined with an extensive neuropsychological screening battery and a standardised questionnaire aimed at emotional problems. The mean number of correct responses was calculated for each subject and averaged within each group. Results-Although, on the whole, there were no diVerences in performance, patients' results on the following tasks in diVerent modalities showed evidence for decreased performance under relatively more demanding conditions: line orientation task (mean diVerence (MD) 261 ms; 95% confidence interval (95%CI) 94 to 428), Rey-Osterrieth delayed recall (MD−3.8, 95% CI −7.5 to 0.0), visual elevator subtest of the everyday attention task (EAT) (MD −0.7, 95% CI −1.5 to 0.1), lottery subtest of the EAT (MD −0.6, 95% CI −1.3 to 0.1) and WAIS similarities (MD −3.2 95% CI −6.3 to 0.1). Patients also more often had emotional disturbances than controls. Conclusion-Both subtle cognitive impairments and emotional disturbances may play a part in the decreased competence in everyday life of patients with a supratentorial lacunar infarct. (J Neurol Neurosurg Psychiatry 1998;65:697-702)

WMAs are independent risk factors for clinical outcome after aSAH. This relation is partly explained by a higher risk of DCI. Further study should aim at treatment strategies for these aSAH-related cardiac abnormalities to improve clinical outcome.