Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Isolated lesions of the medulla oblongata are difficult to diagnose due to their rarity and high biopsy risk. Several individual case reports have been published, but a systematic descriptive study is lacking. Our study has three objectives that 1) provide a differential diagnosis, 2) describe magnetic resonance imaging (MRI) findings, and 3) propose a stepwise MRI-based approach to the isolated lesions of the medulla oblongata in nonstroke patients. ⋯ Neoplasms are the most common cause of isolated medullary lesions in nonstroke patients. Other differential diagnoses include vascular malformations, demyelinating/inflammatory lesions, and infections. A stepwise MRI-based approach can help differentiate between various etiologies.
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Administration of intravenous tissue plasminogen activator (tPA) in the computed tomography (CT) scanner has been recently implemented at our institution, as a means to decrease door-to-needle time. This change in protocol provided us a unique opportunity to visualize imaging signs of early recanalization. ⋯ Early recanalization of large-vessel occlusion after intravenous thrombolysis results in unique imaging findings.