Symptomatic air trapped in the spine after lumbar epidural corticosteroid injection

2006 ◽  
Vol 5 (4) ◽  
pp. 359-361 ◽  
Author(s):  
Mario Ammirati ◽  
Florence Perino
Keyword(s):  
Computed Tomography ◽  
Mr Imaging ◽  
Corticosteroid Injection ◽  
Neurological Symptoms ◽  
Lumbar Region ◽  
Trapped Air ◽  
Dural Sac ◽  
First Case ◽  
Epidural Air

✓ The authors report the first case involving trapped epidural air in the spine that mimicked a mass lesion and caused neurological symptoms after epidural corticosteroid injection in the lumbar region. New neurological symptoms developed immediately after injection, and magnetic resonance (MR) imaging demonstrated trapped air displacing the dural sac. After the patient underwent conservative treatment, the new symptoms resolved, and follow-up MR imaging and computed tomography demonstrated resorption of the epidural air in the lumbar region. To limit this problem, the clinician should decrease the amount of air injected in the epidural space or substitute nitrous oxide for air when injecting steroid agents epidurally.

Dural damage due to a loosened hydroxyapatite intraspinous spacer after spinous process–splitting laminoplasty

2007 ◽  
Vol 7 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Atsushi Ono ◽  
Toru Yokoyama ◽  
Takuya Numasawa ◽  
Kanichiro Wada ◽  
Satoshi Toh
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Postoperative Complications ◽  
Mr Imaging ◽  
Nerve Root ◽  
Spinous Process ◽  
Imaging Studies ◽  
Dural Sac ◽  
Neck And Shoulder Pain ◽  
Axial Pain

✓Excellent results from laminoplasty for cervical spinal myelopathy have been reported in many studies. Nevertheless, C-5 nerve root palsy or axial pain such as neck and shoulder pain after laminoplasty are known postoperative complications. To the authors' knowledge, dural damage from dislocation of the hydroxyapatite intraspinous spacer due to absorption of the tip of the spinous process has not been reported. Two cases of dural damage from dislocation of the hydroxyapatite intraspinous spacer after laminoplasty are described. Radiographs, computed tomography myelography, and magnetic resonance (MR) imaging revealed the dislocation of the hydroxyapatite intraspinous spacer, the absorption of the tip of the spinous process, and dural sac compression due to the hydroxyapatite intraspinous spacer. In one patient, the MR imaging studies revealed liquorrhea around the hydroxyapatite intraspinous spacers. Both patients underwent removal of the hydroxyapatite intraspinous spacer and attained good neurological recovery. In patients with dislocation of the hydroxyapatite intraspinous spacer associated with absorption of the tip of the spinous process after spinous process–splitting laminoplasty, each case should be evaluated for aggravating symptoms of myelopathy, dural damage, and liquorrhea around the spacer.

scholarly journals MANAGEMENT OF ANTERIOR TOOTH TRAUMA, WITH 1 YEAR FOLLOW-UP, – TWO CASE REPORTS.

2021 ◽  
pp. 15-18
Author(s):  
Debaprasad Das ◽  
Anirban Bhattacharyya ◽  
Asim Bikash Maity ◽  
Soham Datta
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Case Reports ◽  
Cone Beam ◽  
Maxillofacial Region ◽  
Single Visit ◽  
Anterior Teeth ◽  
First Case ◽  
Dental Injuries

Trauma of the Oral & Maxillofacial region occurs frequently and comprises 5% of all injuries. Among all facial injuries, dental injuries are the most common, of which crown fracture & luxation occurs more frequently. This article highlighted two cases of anterior teeth trauma of which the first case is about a crown fracture of upper right lateral incisor, wherein a single visit RCT was performed and the fractured fragment was reattached directly to the tooth and the second case is about a luxation injury of both the upper central incisors, in which the luxated teeth were digitally reduced & stabilized by splinting followed by completion of endodontic treatment. Both these case reports contain a successful follow-up of 1 year clinically & radiographically. The second case (i.e., the luxation injury), was further evaluated with Cone Beam Computed Tomography after 1year to assess healing & resorption.

Adult cervical intramedullary teratoma: first reported immature case

2010 ◽  
Vol 13 (2) ◽  
pp. 283-287 ◽  
Author(s):  
Hong Joo Moon ◽  
Bong-Kyung Shin ◽  
Joo Han Kim ◽  
Jong-Hyun Kim ◽  
Taek-Hyun Kwon ◽  
...  
Keyword(s):  
Case Report ◽  
Adjuvant Therapy ◽  
Mr Imaging ◽  
Outpatient Clinic ◽  
Immature Teratoma ◽  
Intramedullary Tumor ◽  
Cervical Teratoma ◽  
Neurological Findings ◽  
First Case

Intramedullary teratomas, particularly adult cervicothoracic lesions, are extremely rare. Up to now only 6 cases of intramedullary cervical teratomas have been reported in adults, and all of these were histologically mature. The authors present the case of a 35-year-old man with progressive myelopathic symptoms who was admitted through an outpatient clinic and was surgically treated. The characteristics, diagnosis, epidemiology, and treatment of cervical intramedullary teratomas in adults are also reviewed. Postoperative MR imaging showed that the tumor had been near totally removed, and severely adherent tissue remained ventrocranially with tiny focal enhancement on follow-up MR imaging. Pathological examinations revealed immature teratoma without any malignant component. Adjuvant therapy was not performed. Although no change in neurological findings and symptoms was apparent postoperatively, lesion regrowth was demonstrated on MR imaging 4 months after surgery. At 8 months postoperatively, myelopathic symptoms had developed and a huge intramedullary tumor recurred according to MR imaging. This case is the seventh reported instance of intramedullary cervical teratoma in an adult, and the first case report of the immature type with malignant features.

scholarly journals TERAPI ENDOVASKULAR ANEURISMA KAROTIS KAVERNOSA DENGAN PIPELINE FLEX EMBOLIZATION DEVICE: PENGAMATAN 1 TAHUN

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Muhammad Yunus Amran ◽  
Seung Pil Ban ◽  
Ashari Bahar ◽  
O-Ki Kwon
Keyword(s):  
Computed Tomography ◽  
Treatment Options ◽  
Mass Effect ◽  
Flow Diverter ◽  
First Case ◽  
Cavernous Carotid Aneurysm ◽  
Carotid Aneurysms ◽  
The Right ◽  
Cavernous Carotid Aneurysms

    ENDOVASCULAR TREATMENT CAVERNOUS CAROTID ANEURYSM WITH PIPELINE FLEX EMBOLIZATION DEVICE: 1-YEAR FOLLOW UPABSTRACTAsymptomatic intracranial aneurysms are usually detected accidentally through neuroimaging. However, a large intracranial aneurysm (15-24mm) is more likely to manifest clinically due to its mass effect. Aneurysms in the cavernous segment of carotid artery generally exhibit occulomotor nerve palsy, headache and dizziness. The selection of endovascular therapy depends on the type and morphology of the aneurysm. Currently, the treatment options were stent-assisted coil and pipeline embolization device (PED). We reported two cases of large symptomatic unruptured cavernous carotid aneurysm (CCA), treated with the flow diverter technique using a pipeline flex embolization device (PED flex) the second generation of PED. The first case was a 59-year-old woman with complaint of diplopia and headache. Computed Tomography (CT) angiography and 3 dimensional (D) brain imaging revealed bilateral aneurysms, one was in the right cavernous carotid (16.1x16.6mm) and the other was in the left cavernous carotid (9.2x6.5mm). In second case a 67-year-old woman with complaint of headache. Magnetic resonance angiography (MRA) revealed a 15mm aneurysm in the right cavernous carotid. Both aneurysms were treated using PED flex (4.75mm diameter/25mm length and 4mm diameter/25mm length, respectively), except the left cavernous carotid aneurysm in the first case. Six month and one year follow up angiograms were obtained, and showed complete occlusion of aneurysms. Flow diverter technique using PED flex is a feasible and effective treatment for large symptomatic unruptured carotid cavernous aneurysms.Keywords: Embolization, flow-diverter, large cavernous carotid aneurysms, pipeline flex embolization device (PED flex)ABSTRAKAneurisma intrakranial asimptomatik biasanya terdeteksi secara tidak sengaja melalui pemeriksaan pencitraan neuroradiologis. Akan tetapi aneurisma intrakranial yang besar (15-24mm) cenderung memberikan gejala klinis akibat efek massa yang ditimbulkan. Apabila aneurisma terletak di arteri karotis segmen kavernosa, penderita dapat mengalami paresis nervus okulomotor dan juga terkadang memberikan gejala nyeri kepala serta rasa pusing. Pemilihan terapi endovaskuler bergantung pada tipe dan morfologi dari aneurisma. Saat ini, pemilihan terapi endovaskuler dapat berupa stent-assisted coiling dan alat embolisasi pipeline. Kami melaporkan dua kasus aneurisma karotis kavernosa (AKK) tidak pecah berukuran besar simptomatik dengan teknik flow-diverter menggunakan pipeline flex embolization device (PED flex) yang merupakan generasi kedua dari alat embolisasi pipeline. Pada kasus pertama wanita 59 tahun dengan keluhan diplopia dan nyeri kepala, pemeriksaan Computed Tomography (CT) angiografi dan 3 dimensi (D) otak ditemukan aneurisma pada karotis kavernosa bilateral, yang masing-masing berukuran (16,1x16,6mm) pada sisi kanan dan (9,2x6,5mm) pada sisi kiri. Pada kasus kedua, wanita 67 tahun dengan keluhan nyeri kepala. Pemeriksaan MRA otak ditemukan aneurisma berukuran 15mm pada karotis kavernosa sebelah kanan. Masing-masing aneurisma diterapi dengan PED flex (4,75mm diameter/25mm panjang dan 4mm diameter/25mm panjang), kecuali aneurisma pada karotis kavernosa sebelah kiri pada kasus pertama. Follow-up pada enam bulan dan satu tahun kemudian, dengan pemeriksaan angiografi, menunjukkan oklusi komplet pada masing- masing aneurisma. Terapi endovaskular dengan teknik flow-diverter menggunakan PED flex merupakan modalitas terapi yang efektif dan dapat dilaksanakan untuk aneurisma karotis kavernosa berukuran besar bergejala.Kata kunci: Aneurisma karotis kavernosa besar, embolisasi, flow-diverter, pipeline flex embolization device (PED flex) 

Transpalatal approach for the extracranial surgical repair of transsphenoidal cephaloceles in children

1997 ◽  
Vol 87 (5) ◽  
pp. 677-681 ◽  
Author(s):  
Erin M. Kennedy ◽  
David P. Gruber ◽  
David A. Billmire ◽  
Kerry R. Crone
Keyword(s):  
Mr Imaging ◽  
Preoperative Evaluation ◽  
Type I ◽  
Content Type ◽  
Chiari Type I Malformation ◽  
Dural Sac ◽  
Transpalatal Approach ◽  
Median Cleft ◽  
Median Cleft Face Syndrome

✓ The surgical treatment of transsphenoidal cephaloceles in children is controversial. Reduction and repair via a transcranial approach are associated with high postoperative rates of morbidity, mortality, and hypothalamic dysfunction. In this study, four patients, aged 3 to 35 months at surgery, underwent successful transpalatal repair of two encephaloceles and two meningoceles. Two patients presented with nasal obstruction in infancy, one presented with unexplained meningitis, and in one patient the lesion was found incidentally during evaluation for seizures. Two children had median cleft face syndrome, another had an associated Arnold—Chiari type I malformation, and the fourth had no other cranial abnormalities. All patients underwent preoperative evaluation including magnetic resonance (MR) imaging. Auditory, ophthalmological, genetic, endocrinological, or other evaluation was undertaken as indicated. Lesions were approached through the median raphe of the hard and soft palates. All cephaloceles were easily visualized and dissected after division of the nasal palatal mucosa. The dural sac and its contents were reduced by surface coagulation after division and dissection of the overlying mucosa. Once reduced, the bone defect was obliterated in three of four patients. The dura was not opened and anomalous neural elements were not resected. At follow-up evaluation, all patients demonstrated resolution of preoperative symptoms without evidence of infection or lasting morbidity. Follow-up MR imaging showed reduction in all cases. The authors conclude that this transpalatal approach is safe and reliable for the treatment of transsphenoidal cephaloceles in young children.

Spontaneous regression of a herniated cervical disc in a patient with myelopathy

1999 ◽  
Vol 90 (1) ◽  
pp. 138-140 ◽  
Author(s):  
Jun-Hyeok Song ◽  
Hyang-Kwon Park ◽  
Kyu-Man Shin
Keyword(s):  
Mr Imaging ◽  
Disc Herniation ◽  
Spontaneous Regression ◽  
Specific Treatment ◽  
Cervical Disc ◽  
Content Type ◽  
First Case ◽  
History Of ◽  
Herniated Cervical Disc

✓ The authors present a case of spontaneous regression of a herniated cervical nucleus pulposus in a patient with myelopathy. This 37-year-old woman developed sudden quadriparesis; she had reported no history of trauma. Magnetic resonance (MR) imaging revealed a large disc herniation and increased signal intensity of the cord at the C5–6 level. The extruded disc fragment was found to have resolved on follow-up MR imaging after 28 months, despite the fact that the patient had undergone no specific treatment. The patient's symptoms had subsided almost totally. This is the first case of MR-documented regression of a cervical disc herniation in a patient with myelopathy.

scholarly journals Microscopic Polyangiitis Presenting with Splenic Infarction: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 157
Author(s):  
Sang Wan Chung
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Microscopic Polyangiitis ◽  
Splenic Infarction ◽  
Vasculitic Neuropathy ◽  
Abdominal Computed Tomography ◽  
Anca Associated Vasculitis ◽  
First Case ◽  
Splenic Involvement

Microscopic polyangiitis (MPA) is an anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The splenic involvement in AAV is known to be rare, and that in MPA has not been reported to date. A 74-year-old woman was admitted owing to left arm numbness and weakness. The patient was diagnosed as MPA with vasculitic neuropathy. Her abdominal computed tomography (CT) revealed splenic infarction incidentally. The splenic infarction had been resolved at follow-up CT after treatment. If splenic involvement of MPA was not considered, treatment may have been delayed in order to differentiate other diseases. Herein, I report the first case of splenic involvement of MPA.

Multislice imaging of gastrointestinal stromal tumors

2018 ◽  
pp. 3-14
Keyword(s):  
Computed Tomography ◽  
Key Words ◽  
Gold Standard ◽  
Gastrointestinal Stromal Tumors ◽  
Mesenchymal Tumors ◽  
Stromal Tumors ◽  
Preferential Localization ◽  
Multislice Imaging ◽  
Computed Tomography Diagnosis

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract (1%). These tumors express the CD 117 in 95% of cases. The stomach is the preferential localization (70%). Diagnosis is difficult and sometimes late. Progress of imaging has greatly improved the management and the prognosis. Computed tomography (CT) is the gold standard for diagnosis, staging, and treatment follow-up. The increasing recognition of GIST’s histopathology and the prolonged survival revealed some suggestive imaging aspects. Key words: gastro-intestinal stromal tumors; computed tomography; diagnosis

Noninvasive Follow-Up of Coronary Artery Bypass Graft Patency Using Multi-Slice Computed Tomography

2006 ◽  
Vol 55 (5) ◽  
pp. 451
Author(s):  
Seung Ho Joo ◽  
Byoung Wook Choi ◽  
Jae Seung Seo ◽  
Young Jin Kim ◽  
Tae Hoon Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Graft Patency ◽  
Artery Bypass Graft

A Giant Coronary Sinus Aneurysm with Secondary Vena Cava Aneurysms

2016 ◽  
Vol 19 (1) ◽  
pp. 028
Author(s):  
Shengjun Wu ◽  
Peng Teng ◽  
Yiming Ni ◽  
Renyuan Li
Keyword(s):  
Computed Tomography ◽  
Heart Transplantation ◽  
Coronary Sinus ◽  
Unusual Case ◽  
Superior Vena ◽  
Vena Cava ◽  
Final Diagnosis ◽  
Rare Entity ◽  
First Case ◽  
Enhanced Computed Tomography

Coronary sinus aneurysm (CSA) is an extremely rare entity. Herein, we present an unusual case of an 18-year-old symptomatic female patient with a giant CSA. Secondary vena cava aneurysms were also manifested. The final diagnosis was confirmed by enhanced computed tomography (CT) and cardiac catheterization. As far as we know, it is the first case that such a giant CSA coexists with secondary vena cava aneurysms. Considering the complexity of postoperative reconstruction, we believe that heart transplantation may be the optimal way for treatment. The patient received anticoagulant due to the superior vena cava (SVC) thrombosis while waiting for a donor.

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