Rare kissing antra of the maxillary sinuses: clinical implications.

Purpose: To report a rare anatomical variant of the maxillary sinuses, with radiological and clinical emphasis.

Methods: A 40-year-old male with recurrent acute rhinosinusitis presented to our center for clinical management. A computed tomography scan revealed the presence of an incidental anatomical variant of bilateral maxillary sinuses for which we coin the term "kissing antra".

Respiratory Chain Complex I Deficiency in Leber Hereditary Optic Neuropathy: Insights from Ophthalmologic and Molecular Investigations in Tunisia.

Background: Leber hereditary optic neuropathy (LHON) is a mitochondrial DNA (mtDNA) rare disease due to the pathogenic variant of the NADH dehydrogenase enzyme. LHON is characterized by a sudden central vision loss due to focal degeneration of the retinal ganglion cell layer and optic nerve. Symptoms usually appear between the age of 18 and 35 years.

Fluoroscopic, 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.

Dural Puncture Complications.

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.

Alternative Percutaneous Dural Puncture Routes: Cervical, Thoracic, Lumbar, and Sacral.

Patients requiring lumbar punctures (LPs) are frequently challenging or may be impossible to do through a standard lower lumbar route. Therefore, if clinically indicated, consideration of alternative anatomic access routes to the spinal subarachnoid space may be necessary. However, some of these approaches are unpopular or seldom used, may be challenging to perform, or are associated with potential significant complications especially when combined with limited operator experience.

Cerebrospinal Fluid Pressure Measurement and Infusion Studies Using Lumbar Puncture.

Lumbar puncture provides an easy way of accessing the subarachnoid space. Measuring of the opening cerebrospinal fluid pressure is the most commonly used method of evaluating intracranial pressure but provides basic snapshot information only. Further insights into cerebrospinal fluid dynamics can be obtained through infusion studies, which rely on measurement of the degree of pressure change in response to addition of fluid volume into the subarachnoid space.

Standard 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.

Intrathecal 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. The initial assessment of rhinorrhea or otorrhea, which may be suspected owing to an acquired skull base CSF leak, requires integration of clinical assessment and biochemical confirmation of CSF.

Imaging Anatomy of the Cerebrospinal Fluid Spaces.

The cerebrospinal fluid spaces of the spine and brain are an intricate network of tissues with complex anatomic relationships. Understanding the normal imaging anatomy and variants of these spaces is crucial for accessing the spinal subarachnoid space and evaluating patients with suspected CSF leaks. This article reviews the imaging anatomy of the cerebrospinal fluid spaces in the spine and brain with emphasis on clinically relevant anatomy for percutaneous needle access to the spinal subarachnoid space and management of patients with CSF leak.

Mucopolysaccharidosis type I: founder effect of the p.P533R mutation in North Africa.

Background: Mucopolysaccharidosis type I is a lysosomal storage disease resulting from a deficiency in alpha-L-iduronidase (IDUA), which causes the accumulation of partially degraded dermatan sulfate and heparan sulfate. This retrospective study, spanning eight years, analyzed data from 45 MPSI patients. The report aimed to explore the potential origin of the p.

External auditory canal involvement by nasopharyngeal carcinoma via eustachian tube spread: A case report.

We present the imaging findings of a 44-year-old female patient who was diagnosed with nasopharyngeal carcinoma (NPC) extending from the nasopharynx to the external auditory canal (EAC) through the Eustachian tube (ET). The patient presented with a left neck submandibular lump on initial presentation that showed NPC upon fine needle aspiration, leading to chemoradiotherapy. Despite treatment, the patient experienced multiple relapses and later presented with aural symptoms, including left ear pain, foul-smelling drainage, and trismus on recurrence, and was subsequently diagnosed through biopsy.

A comparison of antimicrobial regimen outcomes and antibiogram development in microbial keratitis: a prospective cohort study in Alexandria, Egypt.

Introduction: Antimicrobial resistance in microbial keratitis has not been previously explored in Alexandria. We aim to recommend effective therapies through identification of etiological agents, determination of antimicrobial susceptibilities, and comparing outcomes of empiric topical antimicrobials.

Methods: In this 2022 prospective cohort conducted in Alexandria Main University Hospital cornea clinic, antimicrobial susceptibilities of isolated microorganisms from corneal scrapings were detected and antibiograms were developed.

Feasibility of percutaneous dural sac puncture via a posterior trans-sacral foraminal conduit approach: a CT morphometric analysis.

We assess the theoretical feasibility of percutaneous posterior sacral foramen (pSF) needle puncture of the sacral dural sac (DS) by studying the three-dimensional imaging anatomy of pSFs relative to the sacral canal (SC). On CT images of 40 healthy subjects, we retrospectively studied sacral alae passageways from SC to pSFs in all three planes to determine if an imaginary spinal needle could theoretically traverse S1 or S2 pSFs in a straight path toward DS. If not straight, we measured multiplane angulations and morphometrics of this route.

Caudolenticular gray bridges of the brain: A magnetic resonance imaging study.

The caudolenticular (or transcapsular) gray bridges (CLGBs) connect the caudate nucleus (CN) and putamen across the internal capsule. The CLGBs function as the main efferent terminus from premotor and supplementary motor area cortex to the basal ganglia (BG). We conjectured if inherent variations in numbers and sizes of CLGBs could contribute to abnormal cortical-subcortical connectivity in Parkinson's disease (PD), a neurodegenerative disorder featuring a hindrance of BG processing.

Atavistic and vestigial anatomical structures in the head, neck, and spine: an overview.

Organisms may retain nonfunctional anatomical features as a consequence of evolutionary natural selection. Resultant atavistic and vestigial anatomical structures have long been a source of perplexity. Atavism is when an ancestral trait reappears after loss through an evolutionary change in previous generations, whereas vestigial structures are remnants that are largely or entirely functionless relative to their original roles.

Feasibility of intrathecal therapeutic injections in spinal muscular atrophy patients via a percutaneous transsacral hiatus route: An initial neuroimaging morphometric study.

Introduction/aims: Standard fluoroscopic lumbar puncture (LP) can be impossible in patients with severe spinal deformities from spinal muscular atrophy (SMA) who require intrathecal nusinersen therapy. There usually exists a straight trajectory in the lower sacral canal (SC) that could allow image-guided percutaneous transsacral hiatus puncture of the lumbosacral dural sac. In this study we determine whether sacra are comparatively straighter in SMA patients (SMAps) vs healthy controls (HCs), which may facilitate unhindered transsacral hiatus spinal needle insertion for intrathecal nusinersen therapy.

A New Nrf2 Inhibitor Enhances Chemotherapeutic Effects in Glioblastoma Cells Carrying p53 Mutations.

TP53 tumor suppressor gene is a commonly mutated gene in cancer. p53 mediated senescence is critical in preventing oncogenesis in normal cells. Since p53 is a transcription factor, mutations in its DNA binding domain result in the functional loss of p53-mediated cellular pathways.