Neuroradiology
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Spinal epidural haematomas (SEH) are rare; most are caused by trauma, anticoagulant therapy, vascular anomalies, hypertension, blood dyscrasias, epidural anaesthesia or, rarely, spinal surgery. We report 11 cases and review the literature (16 cases). The clinical picture is that of acute spinal cord compression. ⋯ Complete neurological recovery rapidly follows laminectomy and removal of the clot. In three of our cases, the haematoma resolved spontaneously. MRI is the best examination for diagnostic and follow-up.
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We present a case of left striatocapsular infarction manifest clinically as a transient right hemiparesis. MRI showed a left striatocapsular infarct. ⋯ In order to screen the carotid vessels, cervical MR angiography (MRA) was performed during the same examination, demonstrating a left internal carotid artery occlusion, confirmed by contrast arteriography. MRA, a noninvasive modality, can be a useful adjunct to MRI, when diagnostic information concerning the cervical carotid artery is needed.
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The aim of this study was to review the imaging features in acute (< 24 h) basilar artery thrombosis. CT and MR studies in 11 patients with clinical diagnosis of acute basilar artery thrombosis were retrospectively reviewed. MR angiography was obtained in 4 patients. ⋯ Basilar artery thrombosis has fairly typical imaging features by both CT and MR. MRA may be used to confirm the diagnosis. Prompt recognition may lead to early thrombolytic treatment and may improve survival.
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Review Case Reports
Intradural chordoma: case report and review of the literature.
Chordomas are rare neoplasms arising from notochordal remnants found predominantly in the clivus and the sacrococcygeal regions. Most clivus chordomas show extradural extension and bone destruction. Such a tumour can rarely be intradural. This report is concerned with the radiological findings in prepontine intradural chordoma.
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We studied 20 patients with intraspinal tuberculosis (TB), to characterise the MRI features of tuberculous meningitis and myelitis. MRI leptomeningitis and intramedullary involvement in 11 patients, intramedullary lesions alone in 5, leptomeningitis alone in 2, and isolated extradural disease in 2. TB leptomeningitis was characterised by loculation of the cerebrospinal fluid (CSF), nerve root thickening and clumping (seen only in the lumbar region) or complete obliteration of the subarachnoid space on unenhanced images. ⋯ In seven cases of intramedullary tuberculoma multiple lesions with skip areas were seen, without significant cord swelling. One patient had an isolated lesion in the conus medullaris. The lesions were iso- or hypointense on T1-weighted images, iso-, hypo- or hyperintense on T2-weighted images and showed rim or nodular enhancement with contrast medium.