Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Case Reports
Correlation of sonographic and electrophysiological findings in a patient with multifocal motor neuropathy.
Multifocal motor neuropathy (MMN) is an acquired, immune mediated, and commonly associated with antiganglioside antibodies against GM1 lower motor neuropathy, with an incidence of 1 per 100,000. The usual age of onset is between 20 and 50 years and men appear to be more often affected than women. Patients usually present with multifocal weakness that can be localized to named nerve distributions. ⋯ We draw the attention on the usefulness of ultrasonography for detecting and diagnosing segmental lesions of the peripheral nerves in MMN and other immune mediated neuropathies, especially in cases where a nervous segment cannot be easily explored in terms of inching technique.
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Case Reports
Peripheral nerve sheath tumors. Benign or malignant? The role of MRI and ultrasonography in a case report.
A 31-year-old male patient admitted to another hospital for investigation of a localized painful hump in the medial surface of his left leg. The clinical examination revealed a painful palpable lump in the medial surface of left thigh that was initially thought to be a hematoma due to a history of recent trauma. However, an ultrasound was requested to exclude deep venous thrombosis (DVT). ⋯ A consequent MRI examination confirmed the presence of a fusiform tumor in the anatomic path of the saphenous nerve. This was further confirmed intraoperatively, and pathologically was diagnosed as a malignant peripheral nerve sheath tumor (MPNST). In this present study the role of ultrasonography, the correlation between MRI and ultrasonographic findings are discussed and a review of the literature is presented.
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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.
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Comparative Study
Optic nerve and its arterial-venous vascularization: an ultrasonologic study in multiple sclerosis patients and healthy controls.
Recent studies suggest that alterations in the cerebrospinal venous system may play a role in multiple sclerosis (MS) and that chronic cerebrospinal venous insufficiency correlates with clinical features of MS patients. ⋯ We found no significant alteration in the arterial-venous vascularization of both affected and unaffected ONr compared with HC. We demonstrated the possibility to detect ONr atrophy in MS patients.
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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.