Neuroradiology
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The aim of this study was to introduce and assess a new magnetic resonance (MR) technique for selective peripheral nerve imaging, called "subtraction of unidirectionally encoded images for suppression of heavily isotropic objects" (SUSHI). ⋯ The SUSHI technique allows more selective visualization of the sciatic, common peroneal, and tibial nerves at the level of the knee but is less useful for brachial plexus imaging because signal intensity of the brachial plexus nerves and ganglia can considerably be decreased.
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Several methods have been used to treat cerebral vasospasm, which is a major cause of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (SAH). Here, we examined the effectiveness and safety of intra-arterial injection of milrinone for the treatment of vasospasm. ⋯ Intra-arterial milrinone was a safe and effective treatment of cerebral vasospasm following aneurysmal SAH.
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Patients with implanted SynchroMed spinal infusion pumps (Medtronic, Inc., Minneapolis, MN) routinely undergo magnetic resonance imaging at our institution. In August 2008, Medtronic issued an urgent medical device correction report regarding several pumps. Because of the rare potential "for a delay in the return of proper drug infusion" and "for a delay in the logging of motor stall events," "a patient's pump must be interrogated after MRI exposure in order to confirm proper pump functionality." This is particularly important in patients receiving intrathecal baclofen, for whom a delay in return of proper pump infusion could lead to life-threatening baclofen withdrawal syndrome. The objective of this report is to present our experience and protocol of performing magnetic resonance imaging in patients with implanted SynchroMed EL pumps. ⋯ Our data suggest that SynchroMed EL pump malfunction is indeed rare after routine clinical 1.5-T magnetic resonance imaging examinations. However, based on the Medtronic correction report, we perform pump interrogation before and after imaging.
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The displacement or stretching of coils during coiling of cerebral aneurysms is not an unusual technical complication, thus causing potentially disastrous consequences. Here, a simple technique using a wire as a snare for the removal of displaced and stretched coils is described. ⋯ This simple technique using a wire as a snare could be a useful method for removing displaced or stretched coils in selected cases.