Journal of neuroimaging : official journal of the American Society of Neuroimaging
-
Case Reports
Carotid artery dissection due to elongated styloid process: a self-stabbing phenomenon.
Elongated styloid process (ESP) is an anatomical variant that has been described as the cause of Eagle syndrome. Until recently, the styloid process has not been appreciated as a significant contributor to carotid artery dissection (CAD), which is not part of Eagle syndrome. ⋯ Forced sustained head turning with maximal muscle contraction was the initiating event driving the styloid process into the wall of the ICA in a manner that can be likened to being stabbed with a pointed object. Knowing the association between ESP, Eagle syndrome, and CAD shall lead to increased awareness and appropriate diagnosis and treatment.
-
Case Reports
Detection of cerebral hyperperfusion syndrome after carotid endarterectomy with CT perfusion.
We present the case of a 60-year-old female patient, who developed symptomatic internal carotid artery stenosis and subsequently underwent carotid endarterectomy. Four days after an uneventful surgery the patient developed confusion, seizures, and was admitted to the ICU. CT perfusion revealed reduced ispilateral time-to-peak and mean-transient-time and increased cerebral blood volume and cerebral blood flow, confirming the diagnosis of cerebral hyperperfusion syndrome. We thus propose CT perfusion as a diagnostic means for cerebral hyperperfusion syndrome, a syndrome that remains underdiagnosed.
-
Susceptibility-weighted imaging (SWI) is a recently developed high resolution 3-dimensional gradient-echo pulse sequence that accentuates the magnetic susceptibility of blood, calcium, and nonheme iron. The clinical applications of SWI in pediatric neuroimaging have significantly expanded recently. Potential pitfalls related to blood oxygenation, blood flow, magnetic field strength, and misinterpretation of localization as well as possible mimickers may be misleading and affect the correct interpretation of SWI images. Familiarity with these potential diagnostic pitfalls is important to prevent misdiagnosis and will further enhance the ability of SWI in becoming a robust and reliable technique.
-
The diagnosis of Chiari malformation type I (CMI) relies on MRI identification of a tonsillar descent (TD) through the foramen magnum, reflecting the overcrowding of an underdeveloped posterior cranial fossa (PCF). However, TD occurs in some patients with normal-sized PCF and, conversely, some patients with borderline or no TD have small PCF. We thus sought to identify a set of prototypic PCF measures for the diagnosis of CMI. ⋯ The addition of simple morphometric measurements in the diagnostic work-up of patients with suspected CMI may facilitate radiological diagnosis. Moreover, identification of the subset of CMI that arise from basichondrocranium underdevelopment is important for both, selection of the most appropriate therapeutic approach as well as proper CMI categorization in research studies.
-
Clinical Trial
Early changes in brain FDG metabolism during anticancer therapy in patients with pharyngeal cancer.
The current study aimed to evaluate whether therapy-related changes occurred in brain metabolism at an earlier stage during the course of anticancer therapy. ⋯ The current study revealed that unappreciable changes in brain metabolism can occur during the early course of anticancer therapy, and persist even after therapy has terminated. Although the exact mechanism remains unclear, these changes may be related to the systemic effects of chemotherapy or radiotherapy as well as subclinical cancer-related depressive or adjustment mood disorder.