Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Nov 2019
ReviewImage-Guided Percutaneous Treatment of Lumbar Stenosis and Disc Degeneration.
Low back pain, radicular leg pain, and lumbar spinal stenosis are the most common of all chronic pain disorders. Discogenic pain is related to distress of annular fibers and tears, whereas spinal stenosis is related to reduction of the spinal canal dimensions and compression of the neural elements; radicular pain is mainly related to disc herniation and is initially managed conservatively. The percutaneous minimally invasive approach in discogenic and radicular pain is designed to reduce the volume of the nucleus pulposus in patients with failure of medical and physical treatment prolonged for at least 6 weeks.
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Sacral fractures result from high-impact trauma or in the form of insufficiency or pathologic fractures, resulting from osteoporosis, radiation therapy, or malignancy. In the emergency setting, the escalating use of computed tomography has substantially increased diagnosis of sacral fractures, which are frequently occult on radiographs. ⋯ Sacroplasty is a safe, minimally invasive treatment option for many types of sacral fractures. It provides rapid and durable pain relief, with a low incidence of complications.
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Normal brain development is best evaluated by MR imaging in the fetal and pediatric patient. As the developing brain grows, myelinates, and sulcates rapidly, understanding the normal appearance of the brain throughout development is critical. ⋯ Sensory axons generally myelinate before motor axons with central to peripheral and dorsal to ventral myelination gradients. By 2 years of age, the brain has a near adult appearance by conventional anatomic MR imaging.
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This article discusses the normal anatomy of the posterior fossa structures followed by a discussion of the characteristic neuroimaging features of a variety of cerebellar and brainstem malformations. In this context, the authors classify posterior fossa malformations based on the neuroimaging pattern into (1) predominantly cerebellar, (2) cerebellar and brainstem, and (3) predominantly brainstem malformations.
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Neuroimaging Clin. N. Am. · Aug 2019
ReviewDisorders of Ventral Induction/Spectrum of Holoprosencephaly.
Disorders of the ventral induction give rise to a group of congenital malformations that share in common the failure of the prosencephalon cleavage and subsequent formation of midline structures, presenting with a wide spectrum of severity. This article focuses on the imaging findings of the holoprosencephaly spectrum and septo-optic dysplasia, their epidemiology, embryology, and the common clinical associated anomalies. Knowledge of the imaging features of these disorders is necessary for a correct interpretation of findings and accurate parental counseling. Diagnostic evaluation of patients should include molecular screening and genetic counseling to characterize prognosis and risk of recurrence.