Neuroimaging clinics of North America
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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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Neuroimaging Clin. N. Am. · Feb 2025
ReviewImage-guided Epidural Blood Patching and Fibrin Glue Occlusion of Cerebrospinal Fluid Leaks and Venous Fistulas.
There have been major advances in the diagnosis and treatment of spontaneous intracranial hypotension (SIH). While once thought to be a rare condition, the occurrence is not uncommon if diagnosed adequately. Our greater understanding of SIH is based on three main points: (1) awareness of the various types of spontaneous spinal cerebrospinal fluid (CSF) leaks; (2) advanced myelography with the precision to detect dural tears and CSF-venous fistulas; and (3) updated treatment techniques of epidural patching, embolization, and surgery. This review discusses the various types of epidural patching for CSF leaks.
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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.