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Spinal Cord Herniation • 10,723 views
This is a case for Prof. Dr. Dillon. It is in press by our neurosurgeons and us, for the use of Duragen. Idiopathic herniation of the thoracic spinal cord: a case report and technique note. U...
Neuro Protocols • 8,067 views
Alisa Gean is doing a great job getting a group together to share and collaborate neuro protocols. This would be a great place from members to share protocols, and open a discussion about the best ima...
Possible SIH with Spinal Subdural Hygroma, What Next? • 6,657 views
[caption id="attachment_602" align="aligncenter" width="407" caption="Sag T1. Tonsils are not particularly low and no sagging of the base of the brain."][/caption] [caption id="attachment_603" alig...
Brachial Plexus MRI Protocol • 5,347 views
BP MRI Protocol Fall is upon us and so is the lecturing season! Like years before, this Fall I will be giving my brachial plexus lecture several times and the most commonly asked question by the au...
Cervical Spine Nomenclature • 5,217 views
The ASNR/ASSR nomenclature document was specific for the lumbar spine. I would be interested in your opinion on the correct terminology for cervical spondylosis: what terms and why. Specifically, t...
Intracranial Hypotension: Advice on Best Treatment • 5,039 views
Middle age female patient diagnosed with Spontaneous intracranial hypotension. Has multiple (approx 23) perineural cysts. Has undergone several blood patches and artificial CSF infusions without rel...
Embolization of Brain Arteriovenous Malformations for Cure • 4,239 views
The editorial comment in the AJNR of Jan 09 by Jayaraman and Cloft is worthy of careful scrutiny, I believe. Although in my personal experience with Onyx and NBCA, final cure rates of brain AVMs from ...
Liver Hemangiomas and Vascular Lesions of the Brain • 4,212 views
[gallery] I have a patient with 15 large liver hemangiomas and two partly calcified lesions in brain. Does anyone know of associated liver hemangiomas and vascular lesions in the brain?
Aunt Mickey (They Look the Same until You Undress Them). Internal Capsule Infarct or Something Else? • 4,144 views
This 30 year old hypertensive female smoker presented with acute onset of right hemiparesis. Her history also included OCP use and dyslipidemia. MRI demonstrated an acute infarct in the posterior limb...
More on DWI of Head and Neck Lesions • 3,979 views
Yesterday I wrote a short comment in the utility of DWI in the evaluation of head and neck lesions. While reading cases in the afternoon I came across a new patient with a retinoblastoma. This pa...
Category Archives: Interventional
AngioCalc.com
Cerebral Aneurysm Calculator
This recently revised website is dedicated to providing quality resources for the management of cerebral aneurysms and features an online calculator for calculating cerebral aneurysm volume and percent packing volume after coil embolization. The site now includes product information from five major coil manufacturers including newly released coils. There is also an Imaging Library featuring multiple high resolution Netter neurovascular anatomical drawings. The site is designed to aid in both daily practice and as a research tool.
A Second-Generation, Endoluminal, Flow-Disrupting Device for Treatment of Saccular Aneurysms
Satoshi Tateshima, MD, D.M.Sc., Assistant Professor-Director of the Aneurysm Program, Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center.
Gary Duckwiler, MD, Director of Clinical Affairs and Fellowship Director, Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center
Flow diversion stents and endoluminal flow-disrupting devices are new therapeutic approaches to treat challenging intracranial aneurysms [1,2]. The first generation Pipeline Embolization Device (PED) has already been used in clinical practice. The reported results of PED treatment of intracranial aneurysms appear to be promising and very encouraging for the neuro-endovascular field [1,2]. However, there has always been a lingering concern associated with … Continue reading >>
Are C1–2 Punctures for Routine Cervical Myelography below the Standard of Care?
Comment on: D.M. Yousem and S.K. Gujar Are C1–2 Punctures for Routine Cervical Myelography below the Standard of Care? AJNR Am J Neuroradiol first published on April 15, 2009 as doi: 10.3174/ajnr.A1594
In an original research article published April 15, 2009, Yousem and Gujar set out to determine the current neruradiologic practices and opinions on the performance of C1-2 punctures for routine cervical myelography. The impetus behind this investigation was a medicolegal case where the plaintiffs attorney argued that the performance of a C1-2 puncture for cervical myelography was below the standard of care.
The authors used a survey instrument … Continue reading >>
Willinsky RA et al, Clinical and Endovascular Follow-Up of Embolized Aneurysms
A recent article published by Dr Robert Willinsky and colleagues from Toronto is noteworthy and an excellent addition to the literature on the subject of endovascular treatment of ruptured aneurysms. This is one of the largest series on this subject and addresses, amongst other things, the important issue of rebleeding after endovascular repair.
In this large series, the rehemorrhage rate after embolization was 2.1%. The risk of rebleeding was 1.6% in the first 30 days, decreasing to 0.7% after this time. The authors use a protocol of imaging the ruptured aneurysms with enhanced MRA at the time of discharge, followed … Continue reading >>
Intracranial Hypotension: Advice on Best Treatment
Middle age female patient diagnosed with Spontaneous intracranial hypotension. Has multiple (approx 23) perineural cysts. Has undergone several blood patches and artificial CSF infusions without relief. Does anyone have any thoughts on other therapies, new techniques, experts in field. Appreciate the input.… Continue reading >>
Multiple Giant Aneurysms
Has anyone come across cases of multiple giant aneurysms, in middle aged adult patients, not HIV positive? I’ve seen a few recently, and am wondering whether this is a specific vasculopathic entity.… Continue reading >>
CT Cisternogram
I would like to know how much intrathecal contrast to inject for a CT cisternogram via a lumbar puncture approach. I am not sure.… Continue reading >>
AJNR Paper Points to Future of Severe Ischemic Stroke Treatment
Acute ischemic stroke remains the most important neurologic malady in the world. Severe strokes caused by artery occlusion are a minority of all strokes, but cause most of the poor outcomes and costs associated with stroke. Neurointerventionalists have effective therapies, but too few stroke patients undergo endovascular procedures. The reasons are multiple, but a major reason is that patients too frequently arrive beyond the traditional time windows for treatment. A way to break out of this dilemma is described in the paper recently ePublished in the AJNR (N. Janjua, A. El-Gengaihy, J. Pile-Spellman, and A.I. Qureshi Late Endovascular Revascularization in Acute Ischemic … Continue reading >>
Posterior Fossa Vascular Anomaly
I recently saw a patient with a solitary artery arising from the PCA on on each side coursing downwards to supply the cerebellum and the vermis on the same side. Has there been any similiar observations/publications?… Continue reading >>
Embolization of Brain Arteriovenous Malformations for Cure
The editorial comment in the AJNR of Jan 09 by Jayaraman and Cloft is worthy of careful scrutiny, I believe. Although in my personal experience with Onyx and NBCA, final cure rates of brain AVMs from embolization alone are much lower than those published in the literature, the safety record of my patient population has been good, with one major exception. A patient in her 40′s, complaining of mild headache only, no previous bleed, ruptured a large AVM in the right frontal lobe some hours after an uneventful embolization with NBCA. The impact of this catastrophe on her life has been … Continue reading >>