Fat emboli and critical illness-associated cerebral microbleeds (CICMs) in a patient with sickle cell disease: Do these 2 entities coexist?

We report the case of a 30-year-old female patient with sickle cell disease presenting with an acute chest syndrome and neurological deterioration. Cerebral magnetic resonance imaging revealed a handful of foci of diffusion restriction and numerous microbleeds with marked involvement of corpus callosum and subcortical white matter, with relative sparing of the cortex and deep white matter. Corpus callosum-predominant and juxtacortical microbleeds have been typically documented in cerebral fat embolism syndrome, but also in the so-called "critical-illness-associated cerebral microbleeds", a recently described entity associated with respiratory failure.

Freehand stereotactic ventricular catheter insertion for ventriculoperitoneal shunts based on individualized radio-anatomical landmarks.

Introduction: The accurate placement of the ventricular catheter (VC) is critical in reducing the incidence of proximal failure of ventriculoperitoneal shunts (VPSs). The standard freehand technique is based on validated external anatomical landmarks but remains associated with a relatively high rate of VC malposition. Already proposed alternative methods have all their specific limitations.

Structural and metabolic brain abnormalities in COVID-19 patients with sudden loss of smell.

Objectives: Sudden loss of smell is a very common symptom of coronavirus disease 19 (COVID-19). This study characterizes the structural and metabolic cerebral correlates of dysosmia in patients with COVID-19.

Methods: Structural brain magnetic resonance imaging (MRI) and positron emission tomography with [18F]-fluorodeoxyglucose (FDG-PET) were prospectively acquired simultaneously on a hybrid PET-MR in 12 patients (2 males, 10 females, mean age: 42.

Fibroma of the tendon sheath of the neck.

Introduction: Fibroma of the tendon sheath (FTS) is a rare benign tumour typically occurring in the extremities, but very rarely involving in the neck.

Case Report: A 22-year-old male presented with a large painless mass of the right oropharynx. Magnetic resonance imaging (MRI) showed a well-circumscribed 7cm lesion in the right prestyloid space.

Comprehensive management of congenital choanal atresia.

Objectives: To present results of a one-stage minimally invasive surgical procedure for congenital choanal atresia (CCA). Seven outcome measures were applied.

Materials And Methods: Retrospective study conducted between 1999 and 2015.

A case of lipoma arising in the eustachian tube.

We report a case of a lipoma inside the eustachian tube, an extremely rare location for this lesion. To the best of our knowledge, this is only the second such case that has been described in the literature. The patient was a 47-year-old man, a fighter pilot, who was referred to our hospital with a 3-year history of (1) fullness in the right ear secondary to recurrent serous otitis media and (2) right ear pain, which was especially acute during flights.

[Thyroglossal duct cyst carcinoma: The rational behind performing a total thyroidectomy].

Thyroglossal duct cysts are a common developmental abnormality but carcinoma within is rare. A 68 year old male patient was diagnosed with a thyroglossal duct cyst (TGDC) which on imaging studies demonstrated suspicious features within the cyst alone. Fine needle aspiration cytology was suspicious of papillary thyroid cancer.

MDCT imaging of traumatic brain injury.

The aim of emergency imaging is to detect treatable lesions before secondary neurological damage occurs. CT plays a primary role in the acute setting of head trauma, allowing accurate detection of lesions requiring immediate neurosurgical treatment. CT is also accurate in detecting secondary injuries and is therefore essential in follow-up.

Bony Regeneration of the Sella after Transsphenoidal Pituitary Surgery.

Objective: The purpose of this study is to demonstrate the possible bony regrowth of the sella after transsphenoidal surgery without any intraoperative sellar reconstruction.

Methods: Radiologic findings of the sella were reviewed in patients with pituitary tumors treated by transsphenoidal surgery. In 17 patients who had postoperative cranial computed tomography scans, bony regeneration of the sellar floor was evaluated by comparing immediate and late postoperative scans.

The role of interventional neuroradiology in the management of skull base tumours and related surgical complications.

The management of hypervascular skull base tumours is complex and requires a multidisciplinary approach. Skull base surgery may be challenging because of the risk of serious intra-operative bleeding and of potential injuries to lower cranial nerves and/or large cervical vessels. Over the last four decades, advances in neuro-interventional procedures have produced a range of adjunctive endovascular techniques in addition to conventional surgery.

Tolosa-Hunt syndrome in children.

We report a case of Tolosa-Hunt syndrome in a 4-year-old girl. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) revealed a left cavernous sinus involvement with internal carotid artery occlusion. Clinical signs included left ophthalmoplegia, convulsions and right hemiplegia.

¹⁸F-FDG PET/CT and MRI in the follow-up of head and neck squamous cell carcinoma.

We evaluated the diagnostic performance of (18)F-FDG PET/CT and MRI for the assessment of head and neck squamous cell carcinoma (HNSCC) relapse. Since early treatment might prevent inoperable relapse, we also evaluated THE performance of early unenhanced (18)F-FDG PET/CT in residual tumor detection. The study was prospectively performed on 32 patients who underwent (18)F-FDG PET/CT and MRI before treatment and at 4 and 12 months after treatment.

Nonsyndromic bilateral and unilateral optic nerve aplasia: first familial occurrence and potential implication of CYP26A1 and CYP26C1 genes.

Purpose: Optic nerve aplasia (ONA, OMIM 165550) is a very rare unilateral or bilateral condition that leads to blindness in the affected eye, and is usually associated with other ocular abnormalities. Although bilateral ONA often occurs in association with severe congenital anomalies of the brain, nonsyndromic sporadic forms with bilateral ONA have been described. So far, no autosomal-dominant nonsyndromic ONA has been reported.

Bilateral Meckel's cave amyloidoma: a case report.

Primary solitary amyloidoma of Meckel's cave is rare, and a bilateral location is even more rare. To the best of our knowledge, only 12 cases in the literature have described such a primary lesion, including one case of bilateral involvement of Meckel's cave. We report here on the case of a 57-year-old woman presenting with pseudotumor masses involving both Meckel's caves and responsible for trigeminal neuropathy.

Posterior osteosynthesis of the atlas for nonconsolidated Jefferson fractures: a new surgical technique.

Study Design: Case report and surgical technique.

Objective: To describe a new technique to treat atlas burst fractures by selectively reconstructing the atlas from a posterior approach.

Summary Of Background Data: The two surgical techniques reported until now for stabilizing atlas burst fractures are associated with some drawbacks.

Ultrasound-guided fine-needle aspiration of thyroid nodules: stratification of malignancy risk using follicular proliferation grading, clinical and ultrasonographic features.

Objective: To evaluate the diagnostic value of fine-needle aspiration (FNA) cytology and the additive contribution brought by clinical and ultrasound (US) features.

Method: Cytological and histological diagnoses were compared in a series of 924 patients who underwent US-guided FNA before surgery. We additionally developed a grading system for follicular proliferation (FP) FNA diagnosis, and investigated its impact on the malignancy risk as well as the additive contribution of clinical and US features by means of decision tree analysis.

Accurate pre-operative localization of pathological parathyroid glands using 11C-methionine PET/CT.

Objective: The pre-operative technique most routinely used to localize pathological parathyroid glands (PPG), prior to minimal access surgery (MAS), relies on 99mTc-sestamibi (MIBI) scintigraphy. Positron emission tomography (PET) using the radiolabelled amino acid 11C-methionine as the tracer agent offers a technological alternative to localize PPG. In this study we evaluated the sensitivity of 11C-methionine PET/CT (MET-PET/CT) for PPG detection and the extent to which MET-PET/CT images may contribute to the planning of surgical procedures.

A de novo SOX10 mutation causing severe type 4 Waardenburg syndrome without Hirschsprung disease.

Type 4 Waardenburg syndrome represents a well define entity caused by neural crest derivatives anomalies (melanocytes, intrinsic ganglion cells, central, autonomous and peripheral nervous systems) leading, with variable expressivity, to pigmentary anomalies, deafness, mental retardation, peripheral neuropathy, and Hirschsprung disease. Autosomal dominant mode of inheritance is prevalent when Sox10 gene mutation is identified. We report the natural history of a child who presented with synophrys, vivid blue eye, deafness, bilateral complete semicircular canals agenesis with mental retardation, subtle signs for peripheral neuropathy and lack of Hirschsprung disease.

Information on heavy equipments and facilities in Belgium: gamma-knife.

Purpose: To explain the principles and indications of gamma knife radiosurgery and to illustrate the correlated neuroimaging features.

Methods And Material: Between December 1999 and July 2007, 1620 patients were treated by GK for a large variety of indications (metastasis 26%, vascular malformations 7%, trigeminal neuralgia 14%, pituitary adenoma 3%, primary CNS tumour 8%, other tumours 6%, vestibular schwannoma 19%, meningioma 17%, functional disorders <1%). The patients benefited from MRI follow-ups.

Irradiation of cochlear structures during vestibular schwannoma radiosurgery and associated hearing outcome.

Object: The purpose of this study was to measure the dose of radiation delivered to the cochlea during a Gamma knife surgery (GKS) procedure for treatment of patients with vestibular schwannomas (VSs), and to analyze the relationship between cochlear irradiation and the hearing outcome of these patients.

Methods: Eighty-two patients with VSs were treated with GKS using a marginal dose of 12 Gy. No patient had neurofibromatosis Type 2 disease, and all had a Gardner-Robertson hearing class of I to IV before treatment, and a radiological and audiological follow-up of at least 1-year after GKS.

Familial CHARGE syndrome because of CHD7 mutation: clinical intra- and interfamilial variability.

CHARGE syndrome (OMIM #214800) is a multiple malformation syndrome with distinctive diagnostic criteria, usually because of CHD7 (chromodomain helicase DNA binding 7) haploinsufficiency. Familial occurrence of CHARGE syndrome is rare. We report six patients from two Caucasian families (both with one parent and two children) affected by mild to severe CHARGE syndrome.

[An unusual case of duplication of the spinal canal].

We describe here a very rare congenital malformation, in which the vertebra Th 9 to 11 were divided into independent bodies and neural arches. The vertebral canal contained the spinal cord, whereas the space between bodies and arches was filled by nerve roots and a central remnant cord, not clearly connected to the main spinal cord. This malformation was considered as related to a fetal alcohol syndrome, with craniofacial and genitourinary abnormalities.