The neuroradiology journal
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Review Case Reports
Cerebral Venous Sinus Thrombosis: Successful Treatment of Two Patients Using the Penumbra System and Review of Endovascular Approaches.
Cerebral venous sinus thrombosis (CVST) is an uncommon but potentially life-threatening condition. When showing resistance to treatment or a malignant progression despite anticoagulant therapy, endovascular interventional treatment is of help. The Penumbra System (PS), a novel thrombectomy device specifically designed to remove the thrombus in acute ischemic stroke, also proved to be an effective device for mechanical recanalization of CVST. ⋯ Literature reports showed that the PS can be successfully applied for treatment of CVST, though the methods used previously were diverse. The PS has proved to be effective in the rapid recanalization of CVST, but different treatment techniques exist. The solution to these problems depends on more clinical trials as well as further improvements to devices.
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Randomized Controlled Trial
MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O2-O3 discolysis.
Evaluate the discal morpho-structural changes as a predictive sign in the clinical outcome after ozone therapy in lumbar disc herniation using the T2-shine through effect in diffusion-weighted imaging (DWI). ⋯ T2-shine through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.
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Morel-Lavallée lesions are closed soft tissue degloving injuries with a propensity to become infected, arising in the lumbosacral region or even the scalp, common anatomical locations in neuroradiological studies. The radiologist must recognize this entity, its traumatic etiology, and treatment options. Our patient's Morel-Lavallée lesion was evaluated with ultrasound and MRI, demonstrating a predominantly hemorrhagic lesion successfully managed by aspiration.
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Ocular symptoms are regularly observed in patients with cavernous sinus dural arteriovenous fistulas (cDAVF). We aimed to evaluate the long-term efficacy and safety of endovascular approaches in patients with cDAVF presenting with different ocular symptoms. In a prospective study between June 2008 and March 2013, 46 patients with ocular symptoms due to cDAVF who were not eligible for conservative therapy, met the inclusion criteria and underwent endovascular treatment. ⋯ One patient experienced intracranial dissection of the internal carotid artery and ischemic stroke with an unfinished procedure. The relief of early presentation was durable in long-term follow-up and the cured lesions were stable in angiographic controls. Favorable and durable outcomes could be obtained following endovascular approaches for cDAVF presenting with different ocular symptoms.
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Aneurysmal subarachnoid hemorrhage (SAH) may be associated with acute cardiopulmonary complications, like neurogenic pulmonary edema (NPE) and Takotsubo-like cardiomyopathy (TCM). These dysfunctions seem to result from a neurogenically induced overstimulation of the sympathetic nervous system through the brain-heart connection and often complicate poor grade aneurysmal SAH. ⋯ Herein we describe the case of a woman admitted to the emergency department with aneurysmal SAH complicated by NPE-TCM, in which early endovascular coiling was successfully performed. Our case, characterized by a favorable outcome, further supports the evidence that early endovascular treatment should be preferred in this peculiar clinical scenario.