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<meta name="DC.Title" content="Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke" />
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<meta name="DC.Description" content="SUMMARY: Golf-related stroke has not been systematically reviewed. The purpose of our study was to describe in detail this particular stroke syndrome. Seven patients were analyzed at a university hospital and 7 patients were reviewed from MEDLINE literature. General demographics, symptom onset, neurologic signs, radiologic findings, and outcome were investigated. A total of 14 patients including 7 patients from the MEDLINE search were analyzed; all were men, with a mean age of 46.9 ± 12.8 years. Symptom onset was classified as during the golf swing ( n = 9), unknown ( n = 3), and after playing golf ( n = 2). Most patients ( n = 12) showed involvement of the vertebral artery and 2 patients showed involvement of the internal carotid artery ( P = .008). Nine dissections were found on the right side, 3 on the left side, and 2 were bilateral ( P = .046). Twelve patients had extracranial involvement and 2 patients had intracranial involvement ( P = .008). Seven patients returned to normal, 5 returned to independence, 1 had unknown status, and 1 died. The anatomic preference of golf-related craniocervical arterial dissection is associated with the extracranial and vertebrobasilar system with a right-sided tendency as the result of stereotypical rotational movement during a golf swing.

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&lt;p&gt;Golf-related stroke has not been systematically reviewed. The purpose of our study was to describe in detail this particular stroke syndrome. Seven patients were analyzed at a university hospital and 7 patients were reviewed from MEDLINE literature. General demographics, symptom onset, neurologic signs, radiologic findings, and outcome were investigated. A total of 14 patients including 7 patients from the MEDLINE search were analyzed; all were men, with a mean age of 46.9 ± 12.8 years. Symptom onset was classified as during the golf swing (&lt;i&gt;n&lt;/i&gt; = 9), unknown (&lt;i&gt;n&lt;/i&gt; = 3), and after playing golf (&lt;i&gt;n&lt;/i&gt; = 2). Most patients (&lt;i&gt;n&lt;/i&gt; = 12) showed involvement of the vertebral artery and 2 patients showed involvement of the internal carotid artery (&lt;i&gt;P&lt;/i&gt; = .008). Nine dissections were found on the right side, 3 on the left side, and 2 were bilateral (&lt;i&gt;P&lt;/i&gt; = .046). Twelve patients had extracranial involvement and 2 patients had intracranial involvement (&lt;i&gt;P&lt;/i&gt; = .008). Seven patients returned to normal, 5 returned to independence, 1 had unknown status, and 1 died. The anatomic preference of golf-related craniocervical arterial dissection is associated with the extracranial and vertebrobasilar system with a right-sided tendency as the result of stereotypical rotational movement during a golf swing.&lt;/p&gt;" />
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<meta name="twitter:description" content="SUMMARY: Golf-related stroke has not been systematically reviewed. The purpose of our study was to describe in detail this particular stroke syndrome. Seven patients were analyzed at a university hospital and 7 patients were reviewed from MEDLINE literature. General demographics, symptom onset, neurologic signs, radiologic findings, and outcome were investigated. A total of 14 patients including 7 patients from the MEDLINE search were analyzed; all were men, with a mean age of 46.9 ± 12.8 years. Symptom onset was classified as during the golf swing ( n = 9), unknown ( n = 3), and after playing golf ( n = 2). Most patients ( n = 12) showed involvement of the vertebral artery and 2 patients showed involvement of the internal carotid artery ( P = .008). Nine dissections were found on the right side, 3 on the left side, and 2 were bilateral ( P = .046). Twelve patients had extracranial involvement and 2 patients had intracranial involvement ( P = .008). Seven patients returned to normal, 5 returned to independence, 1 had unknown status, and 1 died. The anatomic preference of golf-related craniocervical arterial dissection is associated with the extracranial and vertebrobasilar system with a right-sided tendency as the result of stereotypical rotational movement during a golf swing.

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<meta name="og-description" property="og:description" content="SUMMARY: Golf-related stroke has not been systematically reviewed. The purpose of our study was to describe in detail this particular stroke syndrome. Seven patients were analyzed at a university hospital and 7 patients were reviewed from MEDLINE literature. General demographics, symptom onset, neurologic signs, radiologic findings, and outcome were investigated. A total of 14 patients including 7 patients from the MEDLINE search were analyzed; all were men, with a mean age of 46.9 ± 12.8 years. Symptom onset was classified as during the golf swing ( n = 9), unknown ( n = 3), and after playing golf ( n = 2). Most patients ( n = 12) showed involvement of the vertebral artery and 2 patients showed involvement of the internal carotid artery ( P = .008). Nine dissections were found on the right side, 3 on the left side, and 2 were bilateral ( P = .046). Twelve patients had extracranial involvement and 2 patients had intracranial involvement ( P = .008). Seven patients returned to normal, 5 returned to independence, 1 had unknown status, and 1 died. The anatomic preference of golf-related craniocervical arterial dissection is associated with the extracranial and vertebrobasilar system with a right-sided tendency as the result of stereotypical rotational movement during a golf swing.

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      <h1 class="highwire-cite-title" id="page-title">Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M.H. Choi</span>, <span class="highwire-citation-author" data-delta="1">J.M. Hong</span>, <span class="highwire-citation-author" data-delta="2">J.S. Lee</span>, <span class="highwire-citation-author" data-delta="3">D.H. Shin</span>, <span class="highwire-citation-author" data-delta="4">H.A. Choi</span> and <span class="highwire-citation-author" data-delta="5">K. Lee</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2014,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">323-326; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3768 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12799--61758284691" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M.H. Choi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology, Ajou University School of Medicine, Suwon, South Korea (M.H.C., J.M.H., J.S.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.H.%2BChoi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Choi%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.H.%2BChoi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.M. Hong </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology, Ajou University School of Medicine, Suwon, South Korea (M.H.C., J.M.H., J.S.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.M.%2BHong%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hong%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.M.%2BHong%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">J.S. Lee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology, Ajou University School of Medicine, Suwon, South Korea (M.H.C., J.M.H., J.S.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.S.%2BLee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lee%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.S.%2BLee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">D.H. Shin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurology, Gachon Gill Medical Center, Gacheon University School of Medicine, Incheon, South Korea (D.H.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.H.%2BShin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Shin%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.H.%2BShin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">H.A. Choi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neurosurgery, The University of Texas Health Science Center, Houston, Texas (H.A.C., K.L.).</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.A.%2BChoi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Choi%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AH.A.%2BChoi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">K. Lee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neurosurgery, The University of Texas Health Science Center, Houston, Texas (H.A.C., K.L.).</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2BLee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lee%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AK.%2BLee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a>

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<div class="cit ref-cit ref-journal" id="cit-35.2.323.3" data-doi="10.1016/j.surneu.2006.03.045"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Maroon</span>  <span class="cit-name-given-names">JC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Gardner</span>  <span class="cit-name-given-names">P</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Abla</span>  <span class="cit-name-given-names">AA</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">“Golfer's stroke”: golf-induced stroke from vertebral artery dissection</span>. <abbr class="cit-jnl-abbrev">Surg Neurol</abbr> <span class="cit-pub-date">2007</span>;<span class="cit-vol">67</span>:<span class="cit-fpage">163</span>–<span class="cit-lpage">68</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.surneu.2006.03.045&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17254877&amp;link_type=MED&amp;atom=%2Fajnr%2F35%2F2%2F323.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000244212200013&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a>

<div class="cit ref-cit ref-journal" id="cit-35.2.323.4" data-doi="10.1001/archneur.65.8.1122"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Choi</span>  <span class="cit-name-given-names">KD</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Oh</span>  <span class="cit-name-given-names">SJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Yang</span>  <span class="cit-name-given-names">TI</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Golfer's stroke from internal carotid artery dissection</span>. <abbr class="cit-jnl-abbrev">Arch Neurol</abbr> <span class="cit-pub-date">2008</span>;<span class="cit-vol">65</span>:<span class="cit-fpage">1122</span>–<span class="cit-lpage">23</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/archneur.65.8.1122&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=18695065&amp;link_type=MED&amp;atom=%2Fajnr%2F35%2F2%2F323.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">5.</span><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5. in text" id="ref-5">↵</a>

<div class="cit ref-cit ref-journal" id="cit-35.2.323.5" data-doi="10.1159/000084373"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Guptha</span>  <span class="cit-name-given-names">SH</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Promnitz</span>  <span class="cit-name-given-names">AD</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Warner</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">A ‘collapsing’ golfer</span>. <abbr class="cit-jnl-abbrev">Cerebrovasc Dis</abbr> <span class="cit-pub-date">2005</span>;<span class="cit-vol">19</span>:<span class="cit-fpage">281</span>–<span class="cit-lpage">82</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1159/000084373&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=15761223&amp;link_type=MED&amp;atom=%2Fajnr%2F35%2F2%2F323.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000228254300017&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a>

<div class="cit ref-cit ref-journal" id="cit-35.2.323.6" data-doi="10.1136/jnnp.2010.213777"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Hong</span>  <span class="cit-name-given-names">JM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kim</span>  <span class="cit-name-given-names">TJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lee</span>  <span class="cit-name-given-names">JS</span></span></li></ol><cite>. <span class="cit-article-title">Neurological picture: repetitive internal carotid artery compression of the hyoid: a new mechanism of golfer's stroke?</span> <abbr class="cit-jnl-abbrev">J Neurol Neurosurg Psychiatry</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">82</span>:<span class="cit-fpage">233</span>–<span class="cit-lpage">34</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiam5ucCI7czo1OiJyZXNpZCI7czo4OiI4Mi8yLzIzMyI7czo0OiJhdG9tIjtzOjE5OiIvYWpuci8zNS8yLzMyMy5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">7.</span><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7. in text" id="ref-7">↵</a>

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<div class="cit ref-cit ref-journal" id="cit-35.2.323.18"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Ono</span>  <span class="cit-name-given-names">Y</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Arai</span>  <span class="cit-name-given-names">K</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Nishino</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Bilateral dissections of the vertebral arteries followed by MRI</span>. <abbr class="cit-jnl-abbrev">Prog Comput Imaging</abbr> <span class="cit-pub-date">2000</span>;<span class="cit-vol">22</span>:<span class="cit-fpage">199</span>–<span class="cit-lpage">204</span></cite></div><div class="cit-extra"></div></div></li></ol></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 35</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2014 </div></div>
      
      
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      <div class="highwire-cite-title">Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">323-326; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3768 </span></div>
  
  
  
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      <div class="highwire-cite-title">Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.H.</span> <span class="nlm-surname">Choi</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.M.</span> <span class="nlm-surname">Hong</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">J.S.</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">D.H.</span> <span class="nlm-surname">Shin</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">H.A.</span> <span class="nlm-surname">Choi</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Lee</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">323-326; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3768 </span></div>
  
  
  
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