Neurophysiological monitoring of the spinal sensory and motor pathways during embolization of spinal arteriovenous malformations--propofol: a safe alternative.

Introduction: Embolization of a spinal cord arteriovenous malformation (AVM) is considered a high-risk procedure due to the potential risk of spinal cord injury. We present two cases illustrating the benefits of utilizing pharmacologic provocative testing under general anesthesia with continuous neurophysiologic monitoring of somatosensory evoked potentials (SSEPs) and transcranial electrical motor evoked potentials (TCeMEPs) to identify the functional territory of the catheterized vessels prior to embolization.

Clinical Presentation: Case #1: A 28-year-old male presented with a progressive right lower leg numbness followed by weakness with impaired sphincter control.

Middle cerebral artery vasospasm: transcranial color-coded duplex sonography versus conventional nonimaging transcranial Doppler sonography.

Objective: To prospectively compare accuracies of transcranial color-coded duplex sonography (TCCS) and transcranial Doppler sonography (TCD) in the diagnosis of middle cerebral artery (MCA) vasospasm.

Design: Prospective blinded head-to-head comparison TCD and TCCS methods using digital subtraction angiography (DSA) as the reference standard.

Setting: Department of Radiology in a tertiary university health center in a metropolitan area.

Carotid calcium scoring may correlate in males with the traditional Framingham epidemiologic risk variables for stroke.

Background: Coronary calcium scoring is gaining wider use as a marker of coronary heart disease. Our hypothesis is that carotid calcium scoring correlates with the10-year stroke risk.

Method: Unenhanced cervical spine CT for trauma patients 50 years and older over a 6-month period were retrospectively collected and subsequently processed to generate calcium scores.

Bilateral aortic origins of the vertebral arteries with right vertebral artery arising distal to left subclavian artery: case report.

Background: Bilateral aortic origins of the vertebral arteries are a rare anatomic variant, with fewer than 20 cases reported in the literature. This particular variant has only been reported twice.

Case Description: A 35-year-old woman presented to the emergency department after trauma to the head and a witnessed convulsion.

De novo aneurysm formation and regression after brain arteriovenous malformation embolization: case report.

Background: The formation of de novo aneurysms is a known complication of vessel occlusion (Wright RL, Sweet WH. Carotid or vertebral occlusion in the treatment of intracranial aneurysms: value of early and late readings of carotid and retinal pressures. Clin Neurosurg 1962:9;163-192).

Advanced MR imaging techniques in the diagnosis of intraaxial brain tumors in adults.

Intraaxial brain masses are a significant health problem and present several imaging challenges. The role of imaging is no longer limited to merely providing anatomic details. Sophisticated magnetic resonance (MR) imaging techniques allow insight into such processes as the freedom of water molecule movement, the microvascular integrity and hemodynamic characteristics, and the chemical makeup of certain compounds of masses.

Transient traumatic spinal venous hypertensive myelopathy.

We present a case of a reversible spinal venous hypertensive myelopathy that occurred following a traumatic mediastinal hematoma. The mediastinal hematoma caused compression of the brachiocephalic vein, resulting in elevation of the venous pressures that ultimately resulted in dilation of the epidural venous plexus and spinal cord edema. The secondary neurologic deficits were the culmination of venous outflow obstruction at the level of the spinal cord that resolved on the resolution of the mediastinal hematoma.

Perfusion CT for head and neck tumors: pilot study.

Background And Purpose: Differentiation of malignant from benign head and neck lesions is often very difficult on imaging studies, especially in patients with treated cancer. We evaluated the feasibility and reproducibility of perfusion CT (CTP) after enhanced head and neck CT and attempted to differentiate benign from malignant processes.

Methods: CTP was attempted in 17 patients after head and neck contrast-enhanced CT.

Displaced plaque in retroperitoneal adenopathy.

Background: This study was designed to determine when to consider incidental retroperitoneal masses on the basis of a displaced calcified atheromatous abdominal aorta on lateral radiographs.

Methods: We did a retrospective review of 143 normal abdominal helical computed tomography scans of individuals aged 50 years and older to measure the distance between the posterior aortic wall and anterior cortex of vertebral bodies from T12 through L3.

Results: The normal abdominal aorta maintains a close relationship to the vertebral column.

Brain abscess after endovascular coiling of a saccular aneurysm: case report.

CNS infection occurring after therapeutic angiography is rare. We present a case report of a brain abscess complicating endovascular coiling of an intracranial aneurysm. We recommend the use of prophylactic antibiotics, especially when performing therapeutic CNS angiography.