Biomedical subjects
Publications and source records attributed to A Kapila.
Embolism with brain infarction rarely complicates calcific aortic stenosis (CAS). We report a case with severe CAS where the patient experienced multiple embolic strokes immediately following retrograde heart catheterization. Calcific emboli in the cerebral arteries were demonstrated by computed tomography (CT).
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Lymphomatoid granulomatosis is an uncommon disease characterized by a perivascular pleomorphic cellular infiltration and necrosis. CNS involvement occurs in 20% of the cases. CT findings have been described in five of the previously reported cases of CNS lymphomatoid granulomatosis, and include unifocal, multifocal, and diffuse contrast-enhancing supratentorial lesions. We reviewed the CT scans of three patients and the MR image of a fourth patient with histologically confirmed CNS lymphomatoid granulomatosis. The lesions were in the posterior fossa in three of the four cases. Hemorrhage, which was present in three of the four cases, was detected by imaging studies in two and at autopsy in the third. Systemic involvement was present at autopsy in three cases and was clinically suspected in the fourth. A diagnosis of CNS lymphomatoid granulomatosis should be considered when hemorrhagic or posterior fossa lesions occur in patients with constitutional symptoms.
Computed tomography in two patients who had drowned revealed bilateral basal ganglia and medial temporal lobe low densities. Postmortem examination in one case showed these areas to be necrotic, probably secondary to the hypoxia and hypotension associated with drowning.
Facial motor disorders, including facial paralysis, myokymia, dyskinesia, and hemifacial spasm, are common clinical problems in which radiographic evaluation plays a crucial role. Since every segment of the motor innervation of the face from the brain to the parotid gland can now be seen radiographically, radiologists must understand the normal anatomy, the common pathologic lesions at each level, and the clinical findings that help localize the abnormality so that the most sensitive and accurate radiographic approach can be planned. Though computed tomography alone allows for visualization of every segment, other methods such as cisternography, angiography, polytomography, sialography, and magnetic resonance imaging are complementary in specific disorders.
PURPOSE: To gain a better understanding of neurenteric (NE) cysts via correlation of imaging findings and surgical and pathologic data. METHODS: The medical records, imaging studies, surgical information, and pathologic material were retrospectively reviewed in nine patients with NE cysts, including seven proved and two very probable cases. RESULTS: NE cysts occurred in the cerebellopontine angle in one case and extended from the cerebellopontine angle to the C2 level in a second. In the latter patient and the remaining seven with intraspinal lesions, the NE cyst was always located anterior to the spinal cord. The most common myelographic and CT myelographic appearance was that of a lobulated intradural extramedullary (IDEM) mass. Two patients had an intramedullary NE cyst with a somewhat unusual appearing exophytic IDEM-appearing expansion that can be a characteristic feature of these lesions. MR imaging demonstrated the NE cyst to be isointense to hyperintense relative to cerebrospinal fluid on long TR sequences and isointense or slightly hyperintense to cerebrospinal fluid on T1-weighted images. These signal characteristics correlate with the high-protein-content fluid within the cysts, usually described at surgery as milky or mucinous in character. CONCLUSION: The diagnosis of NE cyst should be considered when imaging studies reveal the presence of a lobulated IDEM or an exophytic intramedullary cystic mass, especially in association with anterior spina bifida or other vertebral anomalies. MR can uniquely confirm the cystic nature of these masses and is the method of choice for their imaging investigation. Because cyst recurrence can occur, MR should also be used for long-term patient follow-up.