Saturday, May 26, 2012

Diagnostic Yield of Fluoroscopy-Guided Biopsy for Infectious Spondylitis [SP...

    Sent to you by subbu via Google Reader:     Diagnostic Yield of Fluoroscopy-Guided Biopsy for Infectious Spondylitis [SPINE] via Publication Preview by Kim, B. J., Lee, J. W., Kim, S. J., Lee, G. Y., Kang, H. S. on 5/24/12 BACKGROUND AND PURPOSE:CT is currently the method of choice for guiding biopsy of lesions of the spine. However, in our hospital, fluoroscopy-guided percutaneous biopsy has been preferred for several years because of equipment availability and easy craniocaudal angulation. The aim of this study was to evaluate the efficacy of fluoroscopy-guided percutaneous biopsy in a clinical setting for diagnosing infectious spondylitis.MATERIALS AND METHODS:A retrospective study was performed to evaluate 170 fluoroscopy-guided percutaneous biopsies in 140...

CT Spotter: l5 spondylolysis

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Venous thrombosis presenting as subarachnoid hemorrhage

49 yrs, M Seizures on the morning of admission Vitals stable No focal deficit A CT done at admission showed SAH with flocculent surface hematoma in the left anterior frontal region…significantly there was no blood in the basal cisterns NCCT at admission Enlarged images of the NCCT A cerebral DSA was done which showed thrombosis of anterior part of the superior sagittal sinus, partial thrombosis of the inferior sagittal sinus with hypoplastic left transverse and sigmoid sinuses Right ICA angiogram Left ICA angiogram Left and right vertebral angiogram Right middle meningeal had anomalous origin from right petrous ICA Left ECA angiogram showed blush from the middle meningeal artery...

Tuesday, May 22, 2012

Giant Sacral Schwannoma

This is the case of a female patient with giant sacral neurogenic tumor. The patient was remarkably preserved for the tumor size and mass was found on ultrasound for gynecological evaluatio...

Friday, May 11, 2012

Ankylosing spondylitis with cervical spine fracture

A 51 years old male patient, known case of ankylosing spondylitis since many years, had severly curved totally fused spine. He suffered a minor fall followed by weakness of limbs. Due to the curvature, he did not fit in the MRI machine. A CT was done which showed frature of the lower cervical spine with displacement. CT myelogram was then tries but could not be done from the lumbar site as the needle could not be passed through the heavily calcified tissue. Then the needle was inserted through the suboccipital route and contrast injected to perform the CT-myelo.The myelogram showed partial obstruction to the contrast flow however the compression was not extremely severe. The patient was operated and the spine fix...

Granulomatous hypophysitis

A middle aged male had undergone an MRI brain for repeated headaches.There was diffuse enlargement of the pituitary with thickening of the stalk, the T1 - bright appearing posterior pituitary was however seen separately. The enlarged pituitary was isointense on T1 and bright on T2 images with intense enhancement on post-Gd images. There was no other intracranial pathology detectable.CSF examination was unremarkable, so were other general tests.The patient underwent endoscopic surgery. There were adhesions all around and the mass could be removed with great diffuculty. Intra-op there was CSF leak which was sealed.After surgery patient developed diabetes insipidus and after 7days he died.Histopathologic exam showed granulomas and the diagnosis...

Thursday, May 10, 2012

CLOTBUST sonothrombolysis therapy for acute left MCA territory stroke

CLOTBUST sonothrombolysis in acute stroke is a new addition in the armamentarium of physicians traeting these particularly challenging patients. It uses the simple premise of continuous transfer of ultrasonic wanes to the site of the clot in the blood vessel, which in a way soften ups the clot, such that intravenously given thrombolytic agents can work more effectively, resulting in better recanalisation rates, hence translating into better patient outcome. We recently performed it on a patient with 3.5 hours of acute stroke onset, patient presenting with right sided weakness and Wernicke's aphasia, MRI showing acute left MCA territory diffusion restriction. As the DWI volume was not much and ASPECTS score was good, thrombolysis was performed...

Simple coiling of a wide necked aneurysm

Wide necked aneurysms often are deemed to require assistance with balloon or stent during endovascular coiling, however, most of them do not require support as such, and well placed coils do the job. Here is an example, wherein a wide neck Acom aneurysm incorporating one of the A2 segments, was coiled well without use of any balloon/stent. ...

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