Neuroimaging clinics of North America
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Epidural steroid injection is a safe outpatient procedure, which is performed best using image guidance in conjunction with epidurography. Using the techniques described earlier, complications are minimized, and serious complications can be avoided, in experienced hands. The author has performed several thousand procedures in an outpatient setting without any serious complications. ⋯ The use of sedation to perform these procedures is unnecessary, and deep sedation may be dangerous when injections are performed in the vicinity of the spinal cord. The author's experience, which includes clinical feedback and formal trials, shows the technique described in this article to be performed safely without sedation in an outpatient setting, with a high success rate for alleviating pain symptoms. When properly performed, epidural steroid injections have a clinically established role in the management of neck and back pain.
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The radiologist frequently is asked to contribute to the diagnosis of a patient with central nervous system infections, although radiologic findings usually are nonspecific. The radiologist can consider diagnostic possibilities with more accuracy if the clinician includes accurate demographic and epidemiologic information. This article organizes a broad range of central nervous system infections into demographic and epidemiologic perspective.
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Neurocysticercosis produces a variety of neurologic syndromes resulting from the cysticerci infestation of the central nervous system by the larvae of Taenia solium. Because of increased immigration to the United States from endemic areas, the incidence of neurocysticercosis has increased, especially in California, Texas, Arizona, and other southwestern states. Neuroimaging studies play a significant role in the diagnosis and management of patients with neurocysticercosis.
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Neuroimaging Clin. N. Am. · May 2000
ReviewEncephalitis, cerebritis, and brain abscess: pathophysiology and imaging findings.
This article discusses the imaging findings of encephalitis, cerebritis, and brain abscess in immunocompetent patients. MR imaging is the procedure of choice in evaluating suspected intracranial infections because of its inherent contrast resolution, multiplanar capability, improved sensitivity in the posterior fossa, sensitivity to the presence of subacute, and chronic hemorrhage, and its sensitivity to the detection of meningeal disease on postcontrast images. Discussion of pathologic conditions and imaging features of encephalitis are based on the most common causative agents of each type of disease. Imaging features and pathologic conditions of cerebritis and brain abscesses also are reviewed with emphasis on pyogenic bacteria.
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Neuroimaging Clin. N. Am. · May 2000
ReviewImaging of rickettsial, spirochetal, and parasitic infections.
This article reviews the clinical signs, symptoms, and neuroimaging findings of the commonly known rickettsial, spirochetal, and parasitic infections (cysticercosis is covered elsewhere in this issue). Differential diagnoses and significant imaging characteristics are reviewed to help narrow the diagnostic possibilities. Several of the infections in this disparate group are not seen as commonly as they once were because of advances in early diagnosis, treatment, improvements in sanitation, and prevention of epidemics. Many of the infections, however, are endemic to certain parts of the world and are seen with increasing frequency in immunocompromised individuals.