AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Apr 1999
Epidurography and therapeutic epidural injections: technical considerations and experience with 5334 cases.
Even in experienced hands, blind epidural steroid injections result in inaccurate needle placement in up to 30% of cases. The use of fluoroscopy and radiologic contrast material provides confirmation of accurate needle placement within the epidural space. We describe our technique and experience with contrast epidurography and therapeutic epidural steroid injections, and review the frequency of systemic and neurologic complications. ⋯ Epidurography in conjunction with epidural steroid injections provides for safe and accurate therapeutic injection and is associated with an exceedingly low frequency of untoward sequelae. It can be performed safely on an outpatient basis and does not require sedation or special monitoring.
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AJNR Am J Neuroradiol · Apr 1999
Transluminal angioplasty for middle cerebral artery stenosis in patients with acute ischemic stroke.
Precutaneous transluminal angioplasty (PTA) is currently performed to treat supraaortic atherosclerotic lesions. Our purpose was to evaluate the safety and efficacy of PTA for middle cerebral artery (MCA) stenosis in patients with acute ischemic stroke. ⋯ PTA of the proximal portion of the MCA seems to be a safe and effective therapeutic technique for the prevention of secondary ischemic stroke.
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AJNR Am J Neuroradiol · Mar 1999
Case ReportsPulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty.
A pulmonary embolus of acrylic cement was present in a 41-year-old woman with Langerhans' cell vertebral histiocytosis (LCH) after percutaneous vertebroplasty. Chest radiograph and CT confirmed pulmonary infarction and the presence of cement in the pulmonary arteries. ⋯ This rare complication occurred because perivertebral venous migration was not recognized during vertebroplasty. Adequate preparation of cement and biplane fluoroscopy are recommended for vertebroplasty.
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AJNR Am J Neuroradiol · Mar 1999
Atrophy of the posterior cricoarytenoid muscle as an indicator of recurrent laryngeal nerve palsy.
The posterior cricoarytenoid (PCA) muscle is one of the intrinsic muscles of the larynx innervated by the recurrent laryngeal nerve. As such, recurrent laryngeal nerve palsy should not only result in paralysis of the true vocal cord or thyroarytenoid muscle but also in a similar change in the PCA muscle. The ability of CT and MR imaging to depict denervation atrophy in the PCA muscle in patients with recurrent laryngeal nerve palsy was evaluated. ⋯ Atrophy of the PCA muscle may be commonly documented on CT and MR studies in patients with recurrent laryngeal nerve palsy and vocal cord paralysis, and therefore should be part of the constellation of imaging features of vocal cord paralysis. This finding is particularly useful when other imaging findings of vocal cord paralysis are absent or equivocal.
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AJNR Am J Neuroradiol · Feb 1999
Case ReportsEndovascular treatment of ruptured, peripheral cerebral aneurysms: parent artery occlusion with short Guglielmi detachable coils.
We report two cases of distal cerebral aneurysms that were treated by parent artery occlusion with short Guglielmi detachable coils (GDCs). One patient had a presumed mycotic aneurysm of the distal left posterior cerebral artery, and the other had a partially clipped aneurysm of the distal right anterior inferior cerebellar artery that had hemorrhaged. Short GDCs allow controlled, accurate occlusion of the parent artery at the aneurysmal neck.