Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Case Reports
Ascent™: a novel balloon microcatheter device used as the primary coiling microcatheter of a basilar tip aneurysm.
Intracranial aneurysms undergoing balloon-assisted endovascular repair are particularly challenging given the concurrent use of one or more catheters in addition to the primary coiling microcatheter. Here, we describe a previously unreported novel device where a balloon catheter was used as the primary coiling microcatheter, thereby eliminated the need for additional catheters.
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Case Reports
Nonblinding, penetrating orbital injury with pontine and cerebellar involvement secondary to antenna trauma.
Traumatic pontine and cerebellar damage originating from ocular injury has been documented in the past; however, no report has been made about an orbital trauma causing injury to the pons and cerebellum with associated neurological symptoms while leaving the globe, visual pathway, and ocular controls intact. ⋯ Pontine and cerebellar injury can occur from trauma that originated in the orbit and traveled posteriorly through the cranium without causing any overt damage to ocular structures but still causing other associated neurological problems.
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Wernicke's encephalopathy is a metabolic disorder caused by deficiency of thiamine (vitamin B1) seen in alcoholics and even in nonalcoholic patients, classically presenting with a triad of ataxia, ophthalmoplegia, and altered mental status. Typical findings in magnetic resonance imaging are represented by symmetric signal alterations in medial thalami, mamillary bodies, tectal plate, and periaqueductal area and atypical findings involve lesions in cerebellum, midline vermis, red nuclei, dentate, caudate, cranial nerve nuclei, splenium and cerebral cortex. We report here a case of nonalcoholic starvation induced atypical WE showing symmetrical lesions in substantia nigra in addition to the classical neuroradiological findings.
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This report describes a rare complication in a woman who underwent thoracic spinal surgery. One month postoperatively, her rehabilitation was interrupted by the development of a severe headache, nausea, vomiting, and a right-side occulomotor nerve palsy. ⋯ The CSF was seen to track into the right pleural space via a dural-pleural fistula. Surgical repair of the fistula led to a definitive resolution in symptoms, thus highlighting the importance of early recognition of this highly unusual complication.
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The best therapeutic approach in patients with acute basilar artery occlusion (BAO) remains unclear. We report the results of a combined treatment approach with intravenous (IV) abciximab and intraarterial (IA) tissue plasminogen activator (tPA) in these patients. ⋯ Combined treatment with IV abciximab and IA tPA yielded a high recanalization rate in patients with BAO. However, functional outcomes were poor, potentially due to late initiation of treatment. Early treatment might improve functional outcome.