-
Neuroimaging Clinics of North America May 2019Review of the clinical presentation, imaging findings, and management of headache secondary to intracranial hypotension. (Review)
Review
Review of the clinical presentation, imaging findings, and management of headache secondary to intracranial hypotension.
Topics: Brain; Cerebrospinal Fluid Leak; Diagnostic Imaging; Headache; Humans; Intracranial Hypotension; Magnetic Resonance Imaging; Myelography; Tomography, X-Ray Computed
PubMed: 30926112
DOI: 10.1016/j.nic.2019.01.002 -
Radiologie (Heidelberg, Germany) Oct 2022Imaging of the postoperative spine intends to answer two main questions: It is used to assess the surgical success and to identify complications. To this end,... (Review)
Review
Imaging of the postoperative spine intends to answer two main questions: It is used to assess the surgical success and to identify complications. To this end, conventional X‑ray, computer tomography (CT), myelography, and magnetic resonance imaging (MRI) are available. The radiologist has to select the appropriate modality for sufficient diagnosis considering the preoperative situation, the performed operation, and existing postoperative symptoms. Particularly, the implantation of foreign material represents a technical challenge in the context of image acquisition. In the radiologist's report, one must differentiate between expected postoperative changes and relevant complications. Close communication with the patients and the referring clinicians is essential. Especially clinical signs of infection, new or progressive neurological deficits and cauda equina and conus medullaris syndromes require an immediate diagnosis to facilitate prompt therapy.
Topics: Cauda Equina; Humans; Musculoskeletal System; Myelography; Spinal Cord Compression; Spine; Tomography, X-Ray Computed
PubMed: 35789426
DOI: 10.1007/s00117-022-01034-2 -
World Neurosurgery: X Apr 2024To formulate the most current, evidence-based recommendations regarding the epidemiology, clinical diagnosis, and radiographic diagnosis of lumbar herniated disk (LDH). (Review)
Review
OBJECTIVE
To formulate the most current, evidence-based recommendations regarding the epidemiology, clinical diagnosis, and radiographic diagnosis of lumbar herniated disk (LDH).
METHODS
A systematic literature search in PubMed, MEDLINE, and CENTRAL was performed from 2012 to 2022 using the search terms "herniated lumbar disc", "epidemiology", "prevention" "clinical diagnosis", and "radiological diagnosis". Screening criteria resulted in 17, 16, and 90 studies respectively that were analyzed regarding epidemiology, clinical diagnosis, and radiographic diagnosis of LDH. Using the Delphi method and two rounds of voting at two separate international meetings, ten members of the WFNS (World Federation of Neurosurgical Societies) Spine Committee generated eleven final consensus statements.
RESULTS
The lifetime risk for symptomatic LDH is 1-3%; of these, 60-90% resolve spontaneously. Risk factors for LDH include genetic and environmental factors, strenuous activity, and smoking. LDH is more common in males and in 30-50 year olds. A set of clinical tests, including manual muscle testing, sensory testing, Lasegue sign, and crossed Lasegue sign are recommended to diagnose LDH. Magnetic resonance imaging (MRI) is the gold standard for confirming suspected LDH.
CONCLUSIONS
These eleven final consensus statements provide current, evidence-based guidelines on the epidemiology, clinical diagnosis, and radiographic diagnosis of LDH for practicing spine surgeons worldwide.
PubMed: 38440379
DOI: 10.1016/j.wnsx.2024.100279 -
Child's Nervous System : ChNS :... Jul 2022Perinatal brachial plexus palsy (PBPP) has a wide spectrum of clinical symptoms that can range from incomplete paresis of the affected extremity to flaccid arm... (Review)
Review
PURPOSE
Perinatal brachial plexus palsy (PBPP) has a wide spectrum of clinical symptoms that can range from incomplete paresis of the affected extremity to flaccid arm paralysis. Although there is a high rate of spontaneous recovery within the first two years of life, it remains challenging to determine which patients will benefit most from surgical intervention. The diagnostic and predictive use of various imaging modalities has been described in the literature, but there is little consensus on approach or algorithm. The anatomic, pathophysiological, and neurodevelopmental characteristics of the neonatal and infant patient population affected by PBPP necessitate thoughtful consideration prior to selecting an imaging modality.
METHODS
A systematic review was conducted using six databases. Two reviewers independently screened articles published through October 2021.
RESULTS
Literature search produced 10,329 publications, and 22 articles were included in the final analysis. These studies included 479 patients. Mean age at time of imaging ranged from 2.1 to 12.8 months and investigated imaging modalities included MRI (18 studies), ultrasound (4 studies), CT myelography (4 studies), and X-ray myelography (1 study). Imaging outcomes were compared against surgical findings (16 studies) or clinical examination (6 studies), and 87.5% of patients underwent surgery.
CONCLUSION
This systematic review addresses the relative strengths and challenges of common radiologic imaging options. MRI is the most sensitive and specific for identifying preganglionic nerve injuries such as pseudomeningoceles and rootlet avulsion, the latter of which has the poorest prognosis in this patient population and often dictates the need for surgical intervention.
Topics: Brachial Plexus; Brachial Plexus Neuropathies; Humans; Infant; Infant, Newborn; Myelography; Paralysis; Sensitivity and Specificity
PubMed: 35536348
DOI: 10.1007/s00381-022-05538-z -
Acta Radiologica (Stockholm, Sweden :... Nov 2021This review focuses on the trends in contrast media (CM) research published in during the last 100 years, since the first edition in 1921. The main topics covered are... (Review)
Review
This review focuses on the trends in contrast media (CM) research published in during the last 100 years, since the first edition in 1921. The main topics covered are the developments of iodine- and gadolinium-based CM. Other topics include manganese-based CM for magnetic resonance imaging (MRI) and barium for the investigation of the alimentary tract. From a historic point of view, special CM for use in cholegraphy and myelography are addressed in the review. Today, these imaging procedures are obsolete due to the development of computed tomography, MRI, and ultrasound. The historical use of radioactive thorium-based CM for angiography is also addressed. Furthermore, publications on adverse reactions to CM are reviewed.
Topics: Barium; Bibliometrics; Bile Ducts; Contrast Media; Gadolinium; History, 20th Century; History, 21st Century; Humans; Iodine; Magnetic Resonance Imaging; Manganese; Myelography; Periodicals as Topic; Research
PubMed: 34636678
DOI: 10.1177/02841851211051014 -
Journal of the Korean Society of... Jan 2024Spontaneous intracranial hypotension (SIH), which generally presents as orthostatic headache, is increasingly being identified due to improved imaging technologies and... (Review)
Review
Spontaneous intracranial hypotension (SIH), which generally presents as orthostatic headache, is increasingly being identified due to improved imaging technologies and heightened awareness. Many prior studies have reported the characteristic brain MRI findings of SIH. However, recently, focus has shifted to spinal MRI, as SIH is believed to be caused by leakage of cerebrospinal fluid from the spinal dural sac. Advanced techniques such as ultrafast CT myelography and digital subtraction myelography have emerged as useful technique to identify the site of cerebrospinal fluid leakage. In this review, we discuss the diagnosis, spinal MRI findings, imaging techniques, and treatment of SIH.
PubMed: 38362391
DOI: 10.3348/jksr.2023.0151 -
Neurological Sciences : Official... Mar 2023To review the clinical features, proposed pathophysiology, and the role of medical imaging in the diagnosis and treatment of idiopathic intracranial hypertension and... (Review)
Review
OBJECTIVE
To review the clinical features, proposed pathophysiology, and the role of medical imaging in the diagnosis and treatment of idiopathic intracranial hypertension and spontaneous intracranial hypotension.
METHODS
The authors conducted a narrative review of the current literature on intracranial hypertension and hypotension syndromes, with a focus on imaging findings and role of neurointerventional radiology as a therapeutic option for these pathologies.
RESULTS
Idiopathic intracranial hypertension commonly presents in obese women of childbearing age, being headache and papilledema the main clinical manifestations. Characteristic radiological findings consist of increased cerebrospinal fluid around the optic nerve, partially empty sella turcica and stenosis of the transverse sinuses. Transverse sinus stenting is a treatment alternative that has proven valuable utility in the recent years. Spontaneous intracranial hypotension in most of cases presents with orthostatic headache and has predilection for female population. The typical radiological features in the brain consist of subdural fluid collections, enhancement of the dura, engorgement of the venous structures, pituitary enlargement, and sagging of the brain. In this pathology, a cerebrospinal fluid leak in the spine associated with a defect in the dura, meningeal diverticulum, or a cerebrospinal fluid-venous leak must be actively ruled out.
CONCLUSIONS
Neurologic complaints secondary to changes in intracranial pressure exhibit certain clinical features that in combination with fairly specific radiological patterns allow a highly accurate diagnosis. The diverse specialists in neurosciences should be aware of the multiple image modalities in the study of these syndromes as well as the treatment alternatives by neurointerventional radiology.
Topics: Humans; Female; Intracranial Pressure; Intracranial Hypotension; Pseudotumor Cerebri; Syndrome; Neuroimaging; Intracranial Hypertension; Magnetic Resonance Imaging
PubMed: 36333629
DOI: 10.1007/s10072-022-06478-x -
Annals of Clinical and Translational... Feb 2021CNS vascular malformation is an umbrella term that encompasses a wide variety of pathologies, with a wide range of therapeutic and diagnostic importance. This range... (Review)
Review
CNS vascular malformation is an umbrella term that encompasses a wide variety of pathologies, with a wide range of therapeutic and diagnostic importance. This range spans lesions with a risk of devastating neurological compromise to lesions with a slow, static or benign course. Advances in neurovascular imaging along with increased utilization of these advances, have resulted in more frequent identification of these lesions. In this article, we provide an overview on definitions and classifications of CNS vascular malformations and outline the etiologic, diagnostic, prognostic, and therapeutic features for each entity. This review covers intracranial and spinal cord vascular malformations and discusses syndromes associated with CNS vascular malformations.
Topics: Central Nervous System Vascular Malformations; Cerebral Angiography; Computed Tomography Angiography; Humans; Magnetic Resonance Imaging; Myelography
PubMed: 33434339
DOI: 10.1002/acn3.51277 -
No Shinkei Geka. Neurological Surgery Nov 2021Accurate diagnosis is important for lumbar degenerative diseases. Patients' history, neurological examination, and diagnostic imaging are the three pillars for accurate...
Accurate diagnosis is important for lumbar degenerative diseases. Patients' history, neurological examination, and diagnostic imaging are the three pillars for accurate diagnosis. While collecting medical history, 5W1H of the symptoms should be considered. Muscle strength, pain and numbness, and deep tendon reflex are the basic parameters in the neurological examination. A combination of the results of each tool is needed to facilitate precise diagnosis. This should be followed by diagnostic imaging to confirm the diagnosis. We feel relieved when neurological examination and diagnostic imaging reveals congruent results. The symptoms of lumbar degenerative diseases are the results of[static factors: the stenosis of the canal/intervertebral foramen]×[dynamic factor: the instability]. The T2-weighted MRI images effectively reveal canal/intervertebral foramen stenosis. Short-T1 inversion recovery(STIR)of MRI reveals early fractures and inflammation of the spine. CT findings help to imagine the process of drilling and screw insertion. A whole spine X-ray is good to reveal spinal alignment. Roentogenkymography with anteflexion/retroflexion reveals the instability of the lumbar spine. Myelography is effective in knowing the cerebrospinal fluid flow in a standing position. Therefore, accurate diagnosis and careful treatment are needed to obtain the appropriate outcome for a prolonged period after spinal surgery.
Topics: Humans; Intervertebral Disc Degeneration; Lumbar Vertebrae; Lumbosacral Region; Magnetic Resonance Imaging; Myelography; Spinal Stenosis
PubMed: 34879343
DOI: 10.11477/mf.1436204510 -
AJNR. American Journal of Neuroradiology Apr 2023CSF-venous fistula can be diagnosed with multiple myelographic techniques; however, no prior work has characterized the time to contrast opacification and the duration... (Review)
Review
BACKGROUND AND PURPOSE
CSF-venous fistula can be diagnosed with multiple myelographic techniques; however, no prior work has characterized the time to contrast opacification and the duration of visualization. The purpose of our study was to evaluate the temporal characteristics of CSF-venous fistula on digital subtraction myelography.
MATERIALS AND METHODS
We reviewed the digital subtraction myelography images of 26 patients with CSF-venous fistulas. We evaluated how long the CSF-venous fistula took to opacify after contrast reached the spinal level of interest and how long it remained opacified. Patient demographics, CSF-venous fistula treatment, brain MR imaging findings, CSF-venous fistula spinal level, and CSF-venous fistula laterality were recorded.
RESULTS
Eight of the 26 CSF-venous fistulas were seen on both the upper- and lower-FOV digital subtraction myelography, for a total of 34 CSF-venous fistula views evaluated on digital subtraction myelography. The mean time to appearance was 9.1 seconds (range, 0-30 seconds). Twenty-two (84.6%) of the CSF-venous fistulas were on the right. The highest fistula level was C7, while the lowest was T13 (13 rib-bearing vertebral bodies). The most common CSF-venous fistula levels were T6 (4 patients) followed by T8, T10, and T11 (3 patients each). The mean age was 58.3 years (range, 31.7-87.6 years). Sixteen patients were women (61.5%).
CONCLUSIONS
This is the first study to report the temporal characteristics of CSF-venous fistulas using digital subtraction myelography. We found that on average, the CSF-venous fistula appeared 9.1 seconds (range, 0-30 seconds) after intrathecal contrast reached the spinal level.
Topics: Humans; Female; Middle Aged; Male; Myelography; Cerebrospinal Fluid Leak; Spine; Magnetic Resonance Imaging; Fistula; Intracranial Hypotension
PubMed: 36894299
DOI: 10.3174/ajnr.A7809