Neuroimaging clinics of North America
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Intracranial pressure (ICP) is the pressure within the intracranial space. Intracranial hypotension is a clinical syndrome in which low cerebrospinal fluid volume (CSF) results in orthostatic headache. Severe cases can result in nausea, vomiting, photophobia, and, rarely, decreased level of consciousness and coma. ⋯ Symptoms include headache, nausea and vomiting, blurred vision, and in severe cases, altered level of consciousness that can progress to coma and death. Direct measurements of CSF pressure through lumbar puncture (in idiopathic intracranial hypotension) or invasive ICP monitoring (in acute intracranial hypertension) are the key diagnostic tests. Imaging is used primarily to determine treatable causes of increased ICP, to assess for impending brain herniation, and to evaluate ventricular size.
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Nontraumatic (or spontaneous) intracranial hemorrhage most commonly involves the brain parenchyma and subarachnoid space. This entity accounts for at least 10% of strokes and is a leading cause of death and disability in adults. Important causes of spontaneous intracranial hemorrhage include hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformations, and hemorrhagic infarcts (both venous and arterial). Imaging findings in common and less common causes of spontaneous intracranial hemorrhage are reviewed.
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Neuroimaging Clin. N. Am. · Nov 2010
ReviewSpine and spinal cord emergencies: vascular and infectious causes.
This content presents infectious and vascular spinal emergencies, including epidural abscess, nontraumatic epidural hematoma, vascular malformations, and spinal cord infarction. The spine is subjected to multiple potential insults, such as trauma, infection, ischemia, hemorrhage, tumor, inflammation, and degeneration. ⋯ Therefore, prompt recognition of these entities is important to reverse or minimize potential neurologic injury. The authors discuss several infectious and vascular spinal emergencies, including epidural abscess, nontraumatic epidural hematoma, vascular malformations, and spinal cord infarction.
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In this article the individual components of multimodal computed tomography and multimodal magnetic resonance imaging are discussed, the current status of neuroimaging for the evaluation of the acute ischemic stroke is presented, and the potential role of a combined multimodal stroke protocol is addressed.