Extensive pneumocephalus extending into the lateral ventricles from a brain abscess: an intracranial complication of cholesteatoma

2012 ◽  
Vol 127 (2) ◽  
pp. 192-195
Author(s):  
Y Tamura ◽  
M Suzuki ◽  
M Yamamoto ◽  
T Yoshida
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Skull Base ◽  
Brain Abscess ◽  
Muscle Flap ◽  
Mastoid Cavity ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Lateral Ventricles

AbstractObjective:We report the case of a patient with extensive pneumocephalus extending into the lateral ventricles from a brain abscess arising from a cholesteatoma-induced defect in the skull base.Case report:A 70-year-old man with cholesteatoma presented with right-sided otalgia, otorrhoea and progressive headaches. Computed tomography showed a tegmental defect (approximately 2 × 2 cm) at the right mastoid antrum. A T1-weighted, gadolinium-enhanced magnetic resonance imaging scan showed pneumocephalus in both lateral ventricles, which was directly connected to the mastoid cavity via a brain abscess and a bone defect in the skull base. Radical mastoidectomy was performed to remove the cholesteatoma. The roof of the mastoid cavity was covered extensively with fascia and a pedicled temporalis muscle flap. One week post-operatively, computed tomography and magnetic resonance imaging showed no pneumocephalus.Conclusion:Pneumocephalus arising from a cholesteatoma-induced brain abscess and extending into the lateral ventricles is an important entity, with an atypical appearance on computed tomography and magnetic resonance imaging.

scholarly journals Impact of the COVID-19 pandemic on neuroimaging scan volumes at a teaching hospital

2021 ◽  
pp. 197140092098866
Author(s):  
Daniel Thomas Ginat ◽  
James Kenniff
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
The United States ◽  
Radiology Department ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Academic Medical Centre ◽  
Academic Medical ◽  
The Impact

Background The COVID-19 pandemic led to a widespread socioeconomic shutdown, including medical facilities in many parts of the world. The purpose of this study was to assess the impact on neuroimaging utilisation at an academic medical centre in the United States caused by this shutdown. Methods Exam volumes from 1 February 2020 to 11 August 2020 were calculated based on patient location, including outpatient, inpatient and emergency, as well as modality type, including computed tomography and magnetic resonance imaging. 13 March 2020 was designated as the beginning of the shutdown period for the radiology department and 1 May 2020 was designated as the reopening date. The scan volumes during the pre-shutdown, shutdown and post-shutdown periods were compared using t-tests. Results Overall, neuroimaging scan volumes declined significantly by 41% during the shutdown period and returned to 98% of the pre-shutdown period levels after the shutdown, with an estimated 3231 missed scans. Outpatient scan volumes were more greatly affected than inpatient scan volumes, while emergency scan volumes declined the least during the shutdown. In addition, the magnetic resonance imaging scan volumes declined to a greater degree than the computed tomography scan volumes during the shutdown. Conclusion The shutdown from the COVID-19 pandemic had a substantial but transient impact on neuroimaging utilisation overall, with variable magnitude depending on patient location and modality type.

Parasellar epidermoid cyst rupturing into the nasopharynx

2005 ◽  
Vol 119 (2) ◽  
pp. 140-143 ◽  
Author(s):  
A S Shaw ◽  
S E J Connor
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Skull Base ◽  
Epidermoid Cyst ◽  
Resonance Imaging ◽  
Intracranial Tumours ◽  
Radiological Features ◽  
Magnetic Resonance Imaging Mri

Epidermoid tumours are non-neoplastic inclusion cysts representing up to 1.1 per cent of all intracranial tumours, typically presenting with symptoms related to pressure or intracranial rupture in the fourth or fifth decade of life. The authors present a case of a parasellar epidermoid cyst which has ruptured in to the nasopharynx; to the best of their knowledge, this has not been previously reported. The computed tomography (CT) and magnetic resonance imaging (MRI) are presented. The pathology and radiological features of epidermoid tumours are discussed, particularly in relation to extracranial connections. The differential diagnosis of lesions eroding the central skull base is reviewed.

Can computed tomography and magnetic resonance imaging differentiate between malignant pathology and osteomyelitis in the central skull base?

2015 ◽  
Vol 129 (9) ◽  
pp. 852-859 ◽  
Author(s):  
F D Lesser ◽  
S G Derbyshire ◽  
H Lewis-Jones
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Skull Base ◽  
Resonance Imaging ◽  
Intravenous Contrast ◽  
Skull Base Osteomyelitis ◽  
Bony Destruction ◽  
Soft Tissue Masses

AbstractBackground:Central skull base osteomyelitis is clinically difficult to distinguish from malignancy.Method:The computed tomography and magnetic resonance imaging scans of six patients with central skull base osteomyelitis were compared with scans from patients with a range of skull base conditions.Results and conclusion:Computed tomography scans of central skull base osteomyelitis show much less bony destruction relative to the magnetic resonance imaging changes, whereas malignancy cases were associated with similar bony destruction on computed tomography and magnetic resonance imaging. In magnetic resonance imaging scans, it was possible to confirm previous findings of clival hypointensity on T1-weighted images relative to normal fatty marrow. In addition, there were signs of pre- and para-clival soft tissue infiltration, with the obliteration of normal fat planes and frank soft tissue masses in all six central skull base osteomyelitis patients. Signal intensity on T2-weighted images of the clivus was high in five central skull base osteomyelitis patients. With intravenous contrast, fascial plane anatomy appeared restored in central skull base osteomyelitis cases, almost in keeping with that of non-involved areas. This was not a feature in any of the malignant conditions.

Complementary Use of Computed Tomography and Magnetic Resonance Imaging in Assessing Skull Base Lesions

1992 ◽  
Vol 102 (6) ◽  
pp. 623-629 ◽  
Author(s):  
Dennis H. Kraus ◽  
Charles F. Lanzieri ◽  
John R. Wanamaker ◽  
John R. Little ◽  
Pierre Lavertu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Skull Base ◽  
Resonance Imaging ◽  
Skull Base Lesions

Pseudo-Cerebrospinal Fluid Leaks of the Anterior Skull Base: Algorithm for Diagnosis and Management

2019 ◽  
Author(s):  
Felipe Constanzo ◽  
Jaime Pinto ◽  
Sahba Sedaghat ◽  
Thomas Schmidt
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Skull Base ◽  
Nasal Endoscopy ◽  
Csf Leak ◽  
Resonance Imaging ◽  
Surgical Exploration ◽  
Anterior Cranial Base

Abstract Objective Pseudo-cerebrospinal fluid (CSF) leaks are a rare cause of unilateral, watery rhinorrhea. We proposed a step-wise approach to evaluate these cases. Design It involves a single-center retrospective cohort study. Setting The setting is that of a tertiary academic medical center. Participants Ten patients with diagnosis of pseudo-CSF leak over a 21-year period were evaluated using our proposed algorithm that includes computed tomography, magnetic resonance imaging, nasal endoscopy, β-2 transferrin, intrathecal fluorescein, and surgical exploration of the anterior cranial base. Main Outcome Measures The occurrence of intracranial infection and resolution of the symptoms were evaluated at a mean follow-up of 94.4 months. Results Eight patients had history of skull base fracture or surgery. In all patients computed tomography, magnetic resonance imaging, and nasal endoscopy did not show signs of CSF leak. Beta-2 transferrin testing was performed in five patients, being negative in all of them. Intrathecal fluorescein was performed in seven patients, being negative in five and inconclusive in two. Surgical exploration was performed in five patients, definitively ruling out CSF leak. Six patients were treated with intranasal ipratropium, resolving the symptoms in all cases. Conclusion The presented algorithm provides a step-wise approach for patients with unilateral watery rhinorrhea, allowing to safely ruling out CSF leak.

Computed tomography versus magnetic resonance imaging in paediatric cochlear implant assessment: a pilot study and our experience at Great Ormond Street Hospital

2018 ◽  
Vol 132 (06) ◽  
pp. 529-533 ◽  
Author(s):  
H Kanona ◽  
K Stephenson ◽  
F D'Arco ◽  
K Rajput ◽  
L Cochrane ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Cochlear Implant ◽  
Temporal Bone ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
High Resolution Computed Tomography ◽  
Street Hospital ◽  
Operative Assessment

AbstractBackgroundTo date, there is a lack of consensus regarding the use of both computed tomography and magnetic resonance imaging in the pre-operative assessment of cochlear implant candidates.MethodsTwenty-five patients underwent high-resolution computed tomography and magnetic resonance imaging. ‘Control scores’ describing the expected visualisation of specific features by computed tomography and magnetic resonance imaging were established. An independent radiological review of all computed tomography and magnetic resonance imaging scan features was then compared to the control scores and the findings recorded.ResultsAgreement with control scores occurred in 83 per cent (20 out of 24) of computed tomography scans and 91 per cent (21 out of 23) of magnetic resonance imaging scans. Radiological abnormalities were demonstrated in 16 per cent of brain scans and 18 per cent of temporal bone investigations.ConclusionAssessment in the paediatric setting constitutes a special situation given the likelihood of congenital temporal bone abnormalities and associated co-morbidities that may be relevant to surgery and prognosis following cochlear implantation. Both computed tomography and magnetic resonance imaging contribute valuable information and remain necessary in paediatric cochlear implant pre-operative assessment.

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