Stroke mechanisms in adult moyamoya disease: The association between infarction patterns and quantitative magnetic resonance angiography flow state.

Introduction: Flow augmentation is the mainstay treatment for moyamoya disease as hemodynamic failure is believed to be the dominant mechanism. We aimed to investigate the mechanisms of stroke in moyamoya disease by assessing the relationship between infarction patterns and quantitative magnetic resonance angiography flow state.

Methods: A retrospective study of adult patients with suspected MMD who presented with MRI confirmed acute ischemic stroke predating or following QMRA by a maximum of six months between 2009 and 2021 was conducted.

Association between the degree of vertebrobasilar stenosis, location, infarction pattern, and QMRA flow state.

Background And Purpose: We aimed to investigate the relationship between the degree and location of vertebrobasilar stenosis and quantitative magnetic resonance angiography (QMRA) distal flow.

Methods: We retrospectively reviewed patients who presented with acute ischemic stroke with ≥50% stenosis of the extracranial or intracranial vertebral or basilar arteries, and QMRA performed within 1 year of stroke. Standardized techniques were used to measure stenosis and to dichotomize vertebrobasilar distal flow status.

Novel Grading Scales for Static and Flexion-Extension Magnetic Resonance Imaging in Patients with Cervical Spondylotic Myelopathy.

Background: Flexion-extension magnetic resonance imaging (MRI) has potential to identify cervical pathology not detectable on conventional static MRI. Our study evaluated standard quantitative and novel subjective grading scales for assessing the severity of cervical spondylotic myelopathy in dynamic sagittal MRI as well as in static axial and sagittal images.

Methods: Forty-five patients underwent both conventional and flexion-extension MRI prior to anterior cervical discectomy and fusion from C4 through C7.

Vertebrobasilar Stroke: Association Between Infarction Patterns and Quantitative Magnetic Resonance Angiography Flow State.

Background Treatment and prognosis of vertebrobasilar atherosclerotic disease differs depending on stroke mechanism, such as artery-to-artery embolism, branch atheromatous disease, and hemodynamic ischemia. Our aim was to investigate the relationship between infarction pattern and flow status using quantitative magnetic resonance angiography (QMRA), to determine the validity of using infarction patterns to infer stroke mechanism. Methods and Results This is a retrospective study of patients with ischemic stroke with intra- or extracranial vertebrobasilar atherosclerotic stenosis, who underwent magnetic resonance imaging of the brain, neurovascular imaging, and QMRA, between 2009 and 2021.

MRI Dynamic Contrast Imaging of Oral Cavity and Oropharyngeal Tumors.

In the past decade, dynamic contrast-enhanced magnetic resonance imaging has had an increasing role in assessing the microvascular characteristics of various tumors, including head and neck cancer. Dynamic contrast-enhanced magnetic resonance imaging allows noninvasive assessment of permeability and blood flow, both important parametric features of tumor hypoxia, which is in turn a marker for treatment resistance for head and neck cancer.In this article we will provide a comprehensive review technique in evaluating tumor proliferation and application of its parameters in differentiating between various tumor types of the oral cavity and how its parameters can correlate between epidermal growth factor receptor and human papillomavirus which can have an implication in patient's overall survival rates.

Fluorescence-Guided High-Grade Glioma Surgery More Than Four Hours After 5-Aminolevulinic Acid Administration.

Fluorescence-guided surgery (FGS) using 5-aminolevulic acid (5-ALA) is a widely used strategy for delineating tumor tissue from surrounding brain intraoperatively during high-grade glioma (HGG) resection. 5-ALA reaches peak plasma levels ~4 h after oral administration and is currently approved by the FDA for use 2-4 h prior to induction to anesthesia. To demonstrate that there is adequate intraoperative fluorescence in cases undergoing surgery more than 4 h after 5-ALA administration and compare survival and radiological recurrence to previous data.

Neurolymphomatosis of the peripheral nervous system: a case report and review of the literature.

Neurolymphomatosis is a rare neurological syndrome in lymphomas. It is reported as infiltration of peripheral nerves by lymphoma. It is important to distinguish neurolymphomatosis from other types of neuropathies, particularly infectious and inflammatory conditions.

PET/CT presentation of primary effusion lymphoma-like lymphoma unrelated to human herpes virus 8, a rare NHL subtype.

We present a 71-year-old female with human herpes virus 8 (HHV8)-unrelated primary effusion lymphoma (PEL)-like lymphoma. Dyspnea and pericardial effusion led to pericardiocentesis, diagnosing diffuse large B-cell lymphoma. She underwent positron emission tomography/computed tomography (PET/CT), which demonstrated hypermetabolic pericardial, pleural, and ascites fluid without lymphadenopathy elsewhere.

Extreme clinical presentations of venous stasis: coronary sinus thrombosis.

Sixty six year old male with history of heart failure was admitted for dysphagia, weight loss. CT scan chest revealed diffuse oesophageal wall thickening. Upper endoscopy, oesophagogram confirmed diagnosis of achalasia.

"How we do it" - a practical approach to hepatic metastases ablation techniques.

Secondary liver malignancies are associated with significant mortality and morbidity if left untreated. Colorectal cancer is the most frequent origin of hepatic metastases. A multidisciplinary approach to the treatment of hepatic metastases includes medical, surgical, radiation and interventional oncology.

Mycobacterial pseudotumor of the plantar fascia: how common is it?

Mycobacterial spindle cell pseudotumor (MSCP) is an extremely rare complication of mycobacterial infections. It has been reported to occur in various sites such as skin, lymph nodes, bone marrow, lungs, and spleen. This tumor-like lesion can be confused clinically as well as radiographically with dermatofibroma, nodular fasciitis, xanthogranuloma, and Kaposi's sarcoma.

Simultaneous presentation in the neck and abdomen of malignant peripheral nerve sheath tumors involving two different nerve tracts.

Neurofibromatosis-1 (NF-1) is a relatively common autosomal dominant disease and it is caused by mutation of the NF-1 tumor suppressor gene; hence, the individuals affected have increased risk for developing familial cancer. Abdominal cavity neurofibromas are common but the simultaneous occurrence of a malignant peripheral nerve sheath tumor (MPNST) in the chest and in the abdomen is rare. Here, we present a patient with MPNST (spindle cell sarcoma) affecting simultaneously the vagus nerve in the head and neck region, mediastinum, pleura as well as celiac plexus branches near the stomach.

Radionuclide therapy of painful bone metastases--a comparative study between consecutive radionuclide infusions, combination with chemotherapy, and radionuclide infusions alone: an in vivo comparison of their effectiveness.

Radionuclides have been long used for the palliation of skeletal-related metastatic pain. They are almost invariably used as the last resource for pain palliation. Their use as single agents with dose escalations, in combination with biphosphonates or chemotherapy is well known in the peer-reviewed literature; however, little is known about the combination between different agents.

Middle cerebral artery involvement in systemic lupus erythematosus presenting as a stroke--an unusual initial presentation of the disease.

Systemic lupus erythematosus (SLE) disproportionately affects the African American population and usually presents with a constellation of symptoms. Along with hematologic, musculoskeletal, serous and skin involvement, the most common causes of morbidity are attributed to altered blood rheology causing accelerated atherosclerotic vascular disease (ASVD). ASVD occurs in predominantly premenopausal women at an age where ASVD is rare or uncommon.

Ablation for the management of pulmonary malignancies.

Objective: Surgical resection remains the treatment of choice for patients with early-stage primary lung cancer and selected patients with limited metastatic lung disease. However, surgery is a high-risk treatment for patients with coexisting morbidities, severe chronic obstructive pulmonary disease, a single lung, or a history of prior resection. The indications for and outcomes of ablative therapies performed for the management of pulmonary malignancies are discussed.

Superselective internal radiation with yttrium-90 microspheres in the management of a chemorefractory testicular liver metastasis.

We treated a patient with biopsy-proven, chemotherapy-resistant testicular cancer liver metastasis using Y-90 selective internal radiation treatment. We chose yttrium-90 rather than surgery and ablation due to tumor location and size as well as the patient's clinical history. The result was marked tumor response by positron emission tomography and computed tomography as well as significant improvement of the patient's quality of life accompanied by a substantial decrease of his tumor markers.

FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease.

The term extranodal disease refers to lymphomatous infiltration of anatomic sites other than the lymph nodes. Almost any organ can be affected by lymphoma, with the most common extranodal sites of involvement being the stomach, spleen, Waldeyer ring, central nervous system, lung, bone, and skin. The prevalence of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease has increased in the past decade.