Neuroradiology
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Review Case Reports
Cystic solitary intracerebral metastasis from prostate adenocarcinoma.
Brain metastases from prostate adenocarcinoma are rare; spread to brain as the only site of metastasis is even rarer. We present a patient with a large, cystic, solitary intracerebral metastasis from prostate adenocarcinoma. The pertinent literature is reviewed.
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The aim of this prospective study was to assess the feasibility and diagnostic relevance of repetitive dynamic (contrast-enhanced) CT measurements of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) in the first 3 weeks after aneurysmal subarachnoid hemorrhage (SAH). In 15 patients with SAH, 59 dynamic CT studies including 944 regions of interest (ROI) were analyzed. ⋯ Values for the entire series were 33.8+/-19.3 ml/100 g/min (CBF), 3.3+/-1.3 ml/100 g (CBV), and 7.3+/-3.9 s (MTT). Significant differences in CBF and CBV were found between ROI in grey and white matter, with time after the event, between patients with significant and absent or minor vasospasm, and between patients with and without a presumed vasospasm-related infarct.
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Clinical Trial
Potential of a new laser target system for percutaneous CT-guided nerve blocks: technical note.
A prototype of a laser target device was used for CT-guided nerve blocks in a preliminary series of nine interventions. The system provides guidance from any possible approach. High accuracy of needle insertion was achieved; the average deviation of the planned from the actual angle was 1.4 degrees. The target device is valuable for facilitating minimally invasive therapy and can decrease the time required for the procedure.
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Comparative Study
Comparison of MRI pulse sequences for investigation of lesions of the cervical spinal cord.
Small spinal cord lesions, even if clinically significant, can be due to the low sensitivity of some pulse sequences. We compared T2-weighted fast (FSE), and conventional (CSE) spin-echo and short-tau inversion-recovery (STIR)-FSE overlooked on MRI sequences to evaluate their sensitivity to and specificity for lesions of different types. We compared the three sequences in MRI of 57 patients with cervical spinal symptoms. ⋯ In two patients, STIR-FSE gave better demarcation of lesions and in one a questionable additional lesions. Group 4, 4 patients (7%) with miscellaneous final diagnoses. STIR-FSE had high sensitivity to demyelinating lesions, can be considered quite specific and should be included in spinal MRI for assessment of suspected demyelinating disease.
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We reviewed the clinical and neuroradiological features in 16 patients with serious neurological complications of lumbar epidural anaesthesia. We observed acute, transient or permanent and delayed complications. Four patients had symptoms immediately after the procedure. ⋯ The patients with arachnoiditis had a relentless progression of the disease and a poor outcome: five are confined to a wheelchair, one is bedridden. Complications of epidural anaesthesia are easily recognised when they develop immediately; their relationship to the anaesthesia may be ignored or underestimated when they appear after a delay. Awareness of the possibility of delayed complications is important.