Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently defined inflammatory central nervous system disorder responsive to steroids with characteristic magnetic resonance imaging (MRI) features. We report a 69-year-old man presenting with gait ataxia with the characteristic MRI features of CLIPPERS and describe the clinical, MRI, and magnetic resonance spectroscopy (MRS) follow-up after treatment with glucocorticosteroids. Brain and spine MRI showed punctate enhancement peppering the brainstem, cerebellar peduncles, and upper cervical cord. ⋯ Treatment with steroids led to rapid clinical improvement. Repeat MRI and MRS showed complete resolution of gadolinium-enhancing lesions and recovery of NAA/Cr levels in the pons and thalami. After 1 month of tapering oral steroids, weekly oral methotrexate was started and the patient has remained stable for the past 6 months.
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Controlled Clinical Trial
Arterial blood gas analysis of samples directly obtained beyond cerebral arterial occlusion during endovascular procedures predicts clinical outcome.
Real-time intra-procedure information about ischemic brain damage degree may help physicians in taking decisions about pursuing or not recanalization efforts. ⋯ Direct local blood sampling from ischemic brain is feasible during endovascular procedures in acute stroke patients. A gradient in oxygenation parameters was demonstrated between pre- and post-occlusion blood samples. ABG information may be used to predict clinical outcome and help in decision making in the angio-suite.
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Hyperpneumatization of the temporal bone with extension into the occipital bone and even the parietal bones is a rare condition. We report a case in which the patient suffered periodically from a palpable mass in the parietal-occipital region which originated from extensive occipital bone pneumatization. Computed tomography examination revealed extensive temporal and occipital pneumatization and subperiosteal pneumatoceles, which was corrected by surgery.
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In this study, we sought to determine whether routine head computed tomographies (CTs) after uncomplicated coil embolization of intracranial aneurysms can add any significant clinical value. ⋯ A head CT after uncomplicated coil embolization of an intracranial aneurysm does not add any significant clinical value and should not be ordered routinely.
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A 33-year-old woman presented a chronic headache and sore throat on the right side of her body, continuous pulsatile tinnitus with decreasing hearing in the right ear, and recurrent bleeding from the right ear. Computer tomography and magnetic resonance imaging scan depicted a mass in the external ear canal and an enlarged right jugular bulb, which was revealed on duplex ultrasound in the upper portion of the right internal jugular vein. Surgical dissection of the tumor was performed. Pathological study revealed the mass was glomus jugulare tumor.