Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Case Reports
T1 Hyperintense Prepontine Mass with Restricted Diffusion-A White Epidermoid or a Neuroenteric Cyst?
Neuroenteric cysts (NC) are benign, congenital malformation which are of endodermal origin commonly located in the central nervous system. We report a case of intracranial NC with squamous metaplasia and xanthogranulomatous response masquerading as a white epidermoid on conventional MRI sequences. Lesion showed two components on T2W-images. We observed differential diffusion characteristics including fractional anisotropy, radial diffusivity and axial diffusivity within the two components of the lesion.
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Diagnosis of cerebral cortical venous thrombosis in patients with postdural puncture headache (PDPH) is usually secondary to changes in headache pattern or cerebral infarctions. Nevertheless, incidental discovery of asymptomatic forms on brain imaging has never been reported before and its management thus remains ill-defined. We describe 2 cases of patients with asymptomatic cortical vein thrombosis in the context of PDPH. ⋯ Clinical and radiological signs resolved after bed rest, oral caffeine, and anticoagulation therapy. Asymptomatic cortical vein thrombosis may be found on radiological exploration, even basic like brain CT scan without contrast, of PDPH. Utility of anticoagulation therapy, which could increase the risk of cerebral hemorrhagic complications in this specific context, has to be assessed.
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PRES is a reversible neurotoxic state presenting with headache, altered mental status, visual loss, and seizures. Delayed diagnosis can be avoided if radiological patterns could distinguish PRES from cerebral ischemia. ⋯ If confirmed by other groups, CTP and CTA imaging in patients with acute visual loss and confusion may help to distinguish PRES from bi-occipital ischemia. These radiological parameters may identify PRES patients at risk for additional tissue infarction.
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Case Reports
Onyx-HD 500 Embolization of a Traumatic Internal Carotid Artery Pseudoaneurysm after Transsphenoidal Surgery.
Traumatic intracranial pseudoaneurysms present a challenge for treatment. Traditionally these lesions have required a deconstructive approach consisting of vessel sacrifice since their fragile nature often makes direct microsurgical repair or coil embolization hazardous. As a high-viscosity liquid embolic agent that results in immediate, vessel sparing aneurysm occlusion, Onyx-HD 500 represents a uniquely efficacious tool for this clinical situation. ⋯ This case illustrates the utility of a high-viscosity liquid embolic agent in providing immediate protection from rehemorrhage by occluding a large ruptured pseudoaneurysm of the proximal intracranial ICA, while sparing the parent artery.