Neuroradiology
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In order to reduce the recanalization rate of arteriovenous malformations and multiple dural arteriovenous fistulas, embolization was carried out with polyvinyl alcohol (PVA) particles combined with platinum fibre coils in 20 patients. The malformation was occluded more effectively than by PVA alone. ⋯ The complication rate was lower than usually reported from studies using glue as embolic agent. It was concluded that the combination of PVA and fibre coils enhances the safety and effectiveness of embolization therapy and reduces the frequency of recanalization of intracranial AVMs.
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A case where an encapsulated permanent epidural catheter for continuous analgesia caused pressure on the dural sac is presented. The clinical findings and postmyelographic computerised tomography (CT) imitated an epidural metastasis, until an epidurography via the epidural catheter revealed its true nature.
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We report two cases with subarachnoid dissemination of medulloblastoma depicted clearly by Gadolinium-DTPA enhanced MRI. We also demonstrate the superiority of Gadolinium-DTPA enhanced MRI over nonenhanced MRI, CT, myelography and postmyelographic CT for diagnosing subarachnoid dissemination and for monitoring the response to therapy.
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The cerebral fat embolism is a potentially serious complication of fractures but clinical cases often go undiagnosed. Two cases of clinically diagnosed cerebral fat embolism are reported, and MR images of these patients are described. ⋯ In one patient follow-up MR showed nearly complete resolution of the abnormal signal. MR imaging appears to be valuable for detecting the lesions in these patients.
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A young women presented with chronic headaches associated with a cyst of the right lateral ventricle. The diagnosis of intraventricular so-called "arachnoid" cyst was supported by CT scan, MRI and stereotactic puncture. MRI was of great value for demonstrating that the cyst was located within the lateral ventricule, that it was delineated by a thin wall adherent to the choroid plexus and that the cyst content was CSF-like.