Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewMyelographic Techniques for the Localization of Cerebrospinal Fluid Leaks.
Spinal cerebrospinal fluid (CSF) leaks require advanced myelographic techniques for precise localization, which is in turn necessary for optimal treatment. Here, we will discuss the various myelographic techniques that have become available in recent years for CSF leak localization. Each of these can be used to detect many different types of spinal CSF leaks, although each modality has unique advantages and disadvantages, which will be outlined here.
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewFluoroscopic, Computed Tomographic, and Magnetic Resonance Myelography.
Despite all the advantages of magnetic resonance (MR) imaging, there still exist contraindications or limitations to its use. Thus, MR imaging has not entirely replaced fluoroscopic or computed tomographic (CT) myelography to depict the outline of the spinal cord and its nerve roots after intrathecal injection of contrast medium. The growing recent interest of neuroradiologists to accurately diagnose and treat cerebrospinal fluid leaks has also driven a resurgent need for familiarity with this image-guided procedure. This article reviews the numerous technical and periprocedural aspects of fluoroscopic and CT myelography, and the use of noninvasive MR myelography in certain clinical scenarios.
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewLumbar Transforaminal Injections of Nusinersen in Spinal Muscular Atrophy Patients.
Following a review of spinal muscular atrophy pathogenesis and current therapeutics, a comprehensive review of transforaminal lumbar injections is provided. Patient preparation, special considerations, procedural technique, complications, and alternative approaches are discussed.
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewCauses of Intracranial Hypotension: Spontaneous, Traumatic, and Iatrogenic Cerebrospinal Fluid Leaks.
Cerebrospinal fluid leaks are important to recognize because they can cause debilitating symptoms for patients and have life-threatening complications. Leakage of cerebrospinal fluid (CSF) from the subarachnoid space can occur at the cranial or spinal level, with distinct clinical presentations, diagnostic evaluations, and treatment modalities depending on the type and location of the leak. Spontaneous, traumatic, and iatrogenic spinal CSF leaks cause reduced intracranial CSF volume and the clinicoradiologic syndrome commonly called "intracranial hypotension". This review discusses the clinical presentations, etiologies, and risk factors of spinal and cranial CSF leaks.