Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Dural arteriovenous fistula (DAVF) of the anterior condylar canal is a rare subgroup of posterior fossa DAVF. Successful treatment of this DAVF requires an accurate image diagnosis and the knowledge of the anatomy of the anterior condylar confluent. We present the imaging features of angiography and MR angiography of a 54-year-old man, who presented progressive right synchronous tinnitus due to a DAVF of the anterior condylar confluent, successfully treated by transvenous embolization.
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Case Reports
Vertebral artery anomaly causing C2 suboccipital neuralgia, relieved by neurovascular decompression.
We report imaging and surgical findings of a symptomatic 40-year-old male with an anomalous left vertebral artery. MR, CT myelography, angiography, and intraoperative photos demonstrate the vertebral artery entering the thecal sac at the C1-C2 intervertebral foramen and compressing the dorsal C2 nerve rootlets against the cord. ⋯ Intradural course of the vertebral artery at C2 is one of the few symptomatic developmental vertebral artery anomalies. Recognition of this condition is important because surgical intervention can alleviate associated neck pain.
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Medial lemniscus T2 hyperintensity (MLH) has been recently demonstrated as potential imaging marker for small vessel disease (SVD). Our purpose in this study is to improve accuracy of regions of interest (ROI) analysis for this imaging finding. ⋯ MLH seen on high threshold ROI analysis is a reliable radiologic marker in predicting SVD. ROI analysis of MLH should be performed by an experienced neuroradiologist.
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Case Reports
Cerebral embolus following chiropractic manipulation in a patient with a calcified carotid artery.
Dissection of the cervicocranial vessels is the principal cause of ischemic brain injury following cervical spinal manipulation. Cervical spinal manipulation leading to cerebral embolus in the absence of dissection is not described in the literature. Current case documents cerebral embolism originating from extensively calcified internal carotid artery immediately following cervical spinal manipulation in the absence of dissection. ⋯ Calcified carotid artery may be at risk for embolization following cervical spinal manipulation. Our recommendation is that, patients with extensively calcified carotid arteries should refrain from aggressive neck maneuvers and cervical spine manipulation therapy to avoid liberation of cerebral embolus.