AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Apr 2004
Case ReportsThoracic intradural Aspergillus abscess formation following epidural steroid injection.
We report an extremely unusual iatrogenic infection of the spinal canal with Aspergillus fumigatus that resulted in intradural abscess formation following epidural steroid injection in an immunocompetent young individual. Although the imaging findings of the infection were relatively nonspecific, MR imaging not only allowed for a prompt diagnosis, but also helped in surgical localization to the intradural compartment. Complications from the use of these injections are briefly discussed.
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AJNR Am J Neuroradiol · Apr 2004
MR imaging and proton MR spectroscopic studies in Sjögren-Larsson syndrome: characterization of the leukoencephalopathy.
Sjögren-Larsson syndrome (SLS) is a neurocutaneous syndrome caused by a genetic enzyme deficiency in lipid metabolism. Our purpose was to characterize the nature of the cerebral involvement in SLS. ⋯ Abnormalities on MR imaging and proton MR spectroscopy emerge during the first years of life and are similar in all patients with SLS, but the severity varies. The changes are confined to cerebral white matter and suggest an accumulation of lipids, periventricular gliosis, delayed myelination, and a mild permanent myelin deficit.
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AJNR Am J Neuroradiol · Apr 2004
Whole-brain apparent diffusion coefficient in traumatic brain injury: correlation with Glasgow Coma Scale score.
Patients with traumatic brain injury (TBI) and low Glasgow coma scale (GCS) scores may have severe injury associated with cellular disruption that can be studied with whole-brain apparent diffusion coefficient (ADC) histograms. We retrospectively studied this hypothesis and correlated ADC with GCS. ⋯ Whole-brain peak ADCs and GCS scores are significantly correlated in patients with TBI. Although conventional MR images were normal, ADC independently indicated TBI and better represents the degree of neurologic dysfunction.
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AJNR Am J Neuroradiol · Apr 2004
Detailed MR imaging anatomy of the abducent nerve: evagination of CSF into Dorello canal.
The abducent nerve is difficult to identify reliably and consistently with conventional radiologic techniques. In this study, a 3D fast asymmetrical spin-echo MR imaging technique was used to obtain detailed images of the abducent nerve in normal volunteers. ⋯ The course of the abducent nerve was reliably identified using the 3D fast asymmetrical spin-echo MR protocol and a histologically proven arachnoid envelope around the petroclival segment of the nerve was shown as CSF evagination into Dorello's canal by MR imaging.
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AJNR Am J Neuroradiol · Apr 2004
Relationship between circle of Willis morphology on 3D time-of-flight MR angiograms and transient ischemia during vascular clamping of the internal carotid artery during carotid endarterectomy.
A potential source of complication at carotid endarterectomy (CEA) is cerebral ischemia caused by hypoperfusion during clamping of the carotid artery. Configuration of primary collateral pathways may be a major risk factor for development of transient cerebral ischemia during clamping. We investigated whether circle of Willis morphology on 3D time-of-flight (TOF) MR angiograms can reliably predict transient ischemia during vascular clamping of the internal carotid artery (ICA) in patients undergoing CEA. ⋯ In patients without contralateral ICA occlusion, circle of Willis morphology on 3D TOF MR angiograms cannot predict the development of intraoperative ischemia. However, in patients with contralateral ICA occlusion, incompleteness of the posterior part of the circle of Willis is a significant risk factor for development of ischemia during vascular clamping of the ICA.