Neuroimaging clinics of North America
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Dural puncture, commonly referred to as lumbar puncture (LP), carries the risk of rare but serious complications including post-dural puncture headache, hemorrhage, herniation, and infection. These complications can lead to suboptimal patient outcomes including significant morbidity and mortality in some instances. This review comprehensively examines potential LP complications, including their incidence, pathophysiology, risk factors, clinical presentations, imaging findings, preventative measures, and treatment strategies. Familiarity with these complications will equip clinicians to effectively manage these complications through prompt recognition, timely diagnosis, and implementation of appropriate preventative measures.
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewIntrathecal Contrast-enhanced Computed Tomography and MR Cisternography for Skull Base Cerebrospinal Fluid Leaks and Other Intracranial Applications.
Acquired skull base cerebrospinal fluid (CSF) leaks can result from trauma, tumors, iatrogenic causes, or may be spontaneous. Spontaneous skull base CSF leaks are likely a manifestation of underlying idiopathic intracranial hypertension. ⋯ When leaks are multiple or if samples of fluid cannot be obtained for testing, then recourse to intrathecal contrast-enhanced cisternography may be necessary. We also review various other applications for diagnosis of intracranial abnormalities using contrast-enhanced cisternography.
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Neuroimaging Clin. N. Am. · Feb 2025
ReviewStandard Fluoroscopic and Computed Tomography-Guided Lumbar Punctures.
Image-guided lumbar puncture (LP) remains an important part of the modern practice of neuroradiology. This review outlines the relevant anatomy, safety considerations, and techniques in performing fluoroscopic and computed tomography-guided LPs.
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Intracranial arterial aneurysms in children are rare. They differ from adult aneurysms in their etiology, natural history, and management approach. ⋯ Endovascular treatment has become the primary interventional modality in children with intracranial aneurysms. The authors discuss the management approach to pediatric intracranial aneurysms.