Neuroradiology
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A rare case of aseptic thrombosis of the right vein of Labbé in a young woman is reported. Cerebral venous thrombosis was suggested by computed tomography and confirmed by angiography. Mild left-sided neurological deficits resolved almost completely. The combination of a nonspecific clinical picture with an atypical lesion on CT may favour the diagnosis of cortical venous thrombosis.
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Magnetic resonance angiography (MRA), combined with submillimeter magnetic resonance tomographic angiographic sections (MRTA) showed vascular compression of the 7th cranial nerve or its root exit zone (REZ) in the brain stem in 24 of 37 patients (64.86%) with hemifacial spasm. MRA alone was positive for REZ compression in only 19 (51.4%) cases, while conventional MRI was even less revealing, only 10 (27%) cases being positive.
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Co-existence of Chiari I malformation and myelomeningocele is uncommon. Syringomyelia, when associated with a Chiari I malformation, classically involves the cervical spinal cord. Intramedullary extension of lipoma is unusual in lipomyeloschisis. A patient with lumbar lipomyelomeningocele with tethered cord, lower thoracic syringomyelia and Chiari I malformation, shown by MRI is reported.
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The acute traumatic central cord syndrome (ATCCS) is commonly stated to result from an injury which affects primarily the center of the spinal cord and is frequently hemorrhagic. To test the validity of this widely disseminated hypothesis, the magnetic resonance images [MRI] of 11 consecutive cases of ATCCS caused by closed injury to the spine were analyzed and correlated with the gross pathological and histological features of 3 cervical spinal cords obtained at post mortem from patients with ATCCS, including 2 of patients studied by MRI. The MRI studies were performed acutely (18 h to 2 days after injury) in 7 patients and subacutely (3-10 days after injury) in 4. ⋯ In patients with ATCCS, the predominant loss of motor function in the distal muscles of the upper limbs may reflect the importance of the corticospinal tract for hand and finger function in the primate. In this study, the MRI and pathological observations indicate that ATCCS is predominantly a white matter injury and that intramedullary hemorrhage is not a necessary feature of the syndrome; indeed, it is probably an uncommon event in ATCCS. We suggest that the most common mechanism of injury in ATCCS may be direct compression of the cervical spinal cord by buckling of the ligamenta flava into an already narrowed cervical spinal canal; this would explain the predominance of axonal injury in the white matter of the lateral columns.
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CT studies of 50 patients with spontaneous subarachnoid haemorrhage (SAH) and 100 randomly selected patients were reviewed with regard to the size of the frontal and temporal horns of the lateral ventricles. The temporal horn was classified into four grades, based on the size of its posterior portion at the level of the midbrain. ⋯ Thus, assessment of the size of the temporal horn appears to be a simple and sensitive method for assessing ventricular dilatation. In addition, dilatation of the temporal horn may prove to be an important indirect sign suggesting SAH in patients in whom no high density clot is seen on CT.