Neuroradiology
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We report the CT appearances of a low-velocity missile that lodged within the brain and which subsequently migrated spontaneously back along the entry path. We review the literature of similar instances of migration and draw conclusions about the presurgical radiological management.
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Case Reports
Calcified convexity dura mater and acute epidural haematoma mimicking calcified chronic subdural haematoma.
We report a patient with calcification of the convexity dura mater and an acute epidural haematoma. CT revealed a calcified layer between the haematoma and brain parenchyma, which mimicked acute bleeding into a calcified chronic subdural haematoma. The appearance of a calcified haematoma does not always mean a "chronic" lesion, and that emergency operation should not be foregone, when there is a history of acute head trauma and progressive impairment of consciousness.
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We describe thickening and contrast enhancement of the intracranial pachymeninges, revealed by MRI in a patient with presumed low-pressure headache following dural puncture and a blood patch. The clinical and radiological abnormalities resolved within 2 weeks.
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We studied 63 patients between the ages of 20 and 81 years undergoing lumbar myelography, using a 25-gauge pencil-point (Whitacre) spinal needle. With the use of a questionnaire, the incidence and severity of post-dural-puncture headache (PDPH) was investigated. There were three patients who complained of PDPH (4.7%), two of whom described their headache as moderate and one as mild on a visual analogue scale. ⋯ There were three other patients who experienced a post dural-puncture-related headache which, unlike PDPH, was not postural. Four patients had ordinary mild headache. The quality of the myelograms was good.