Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewFluoroscopic, Computed Tomographic, and Magnetic Resonance Myelography.
Despite all the advantages of magnetic resonance (MR) imaging, there still exist contraindications or limitations to its use. Thus, MR imaging has not entirely replaced fluoroscopic or computed tomographic (CT) myelography to depict the outline of the spinal cord and its nerve roots after intrathecal injection of contrast medium. The growing recent interest of neuroradiologists to accurately diagnose and treat cerebrospinal fluid leaks has also driven a resurgent need for familiarity with this image-guided procedure. This article reviews the numerous technical and periprocedural aspects of fluoroscopic and CT myelography, and the use of noninvasive MR myelography in certain clinical scenarios.
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewImage-guided Epidural Blood Patching and Fibrin Glue Occlusion of Cerebrospinal Fluid Leaks and Venous Fistulas.
There have been major advances in the diagnosis and treatment of spontaneous intracranial hypotension (SIH). While once thought to be a rare condition, the occurrence is not uncommon if diagnosed adequately. Our greater understanding of SIH is based on three main points: (1) awareness of the various types of spontaneous spinal cerebrospinal fluid (CSF) leaks; (2) advanced myelography with the precision to detect dural tears and CSF-venous fistulas; and (3) updated treatment techniques of epidural patching, embolization, and surgery. This review discusses the various types of epidural patching for CSF leaks.
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewLumbar Transforaminal Injections of Nusinersen in Spinal Muscular Atrophy Patients.
Following a review of spinal muscular atrophy pathogenesis and current therapeutics, a comprehensive review of transforaminal lumbar injections is provided. Patient preparation, special considerations, procedural technique, complications, and alternative approaches are discussed.