The spinal cord

Magnetic resonance imaging (MRI) has become the imaging modality of choice in spinal cord diseases. Computerized tomography (CT) myelography remains a valuable alternative and may be performed even on patients with a known sensitivity to iodine contrast media. Ultrasonography provides excellent intraoperative evaluation of spinal cord injury. MRI, however, offers new knowledge about spinal cord disease, especially in trauma, ischemia and degenerative lesions; using this technique direct visualization of ischemic spinal cord lesions is presently possible. Rare infections or degenerative spinal cord lesions are imaged albeit in a non-specific manner. Cervical and thoracic disk disease may cause severe myelopathy, yet close correlation between images and symptomatology remains mandatory.     

Intracranial pressure increase and changes in cerebrovascular circulation, associated with brain death, studied by transcranial Doppler sonography

Blood flow velocity of 24 patients in state of the brain death were examined by transcranial Doppler sonography. Authors expound the characteristic velocity-pulse graphs recorded in progressively increasing intracranial pressure and their chronology as well. The different forms of the oscillating flow and their successive development are described. The oscillating flow, the systolic spikes and the so called "zero Flow" are the transcranial Doppler signs of the ceased cerebral blood flow, and these signs can be used as one of the evidence of the brain death.     

Tuberculous granuloma in haemangiomatous nasal polyp

Tuberculosis of upper respiratory tract is quite infrequent especially the nasal involvement. Isolated cases have been reported by certain authors. A ease of nasal tubercolosis is being presented for its rare site and its association with haemangioma.     

Complete Removal of Colloid Cyst via CT-Guided Stereotactic Biportal Neuroendoscopy

Four patients harbouring a colloid cyst of the 3rd ventricle were operated on endoscopically. With the "classical" monoportal technique, through a precoronal burr hole only partial removal could be achieved in the first case. As the crucial point of the procedure is the safe dissection of the cyst from the thela chorioidea and from the internal cerebral veins, adequate control of the posterior rim of the foramen of Monro and the roof of the 3rd ventricle is mandatory. Accordingly in other three cases a CT-guided biportal endoscopic technique was applied, which permitted radical removal of the entire cyst with maximum safety. CT-guidance is essential for optimal planning after careful study of the individual anatomy. In this way the rigid scopes are moved exclusively along their own axes throughout the procedure, the resulting brain damage thereby being minimal. With regard to all circumstances of the procedure, the use of flexible endoscopes appears to be inappropriate and biportal endoscopy offers itself as the method of choice.     

Ophthalmic masquerades of the atherosclerotic carotids

Patients with carotid atherosclerosis can present with ophthalmic symptoms. These symptoms and signs can be due to retinal emboli, hypoperfusion of the retina and choroid, opening up of collateral channels, or chronic hypoperfusion of the globe (ocular ischemic syndrome). These pathological mechanisms can produce many interesting signs and a careful history can bring out important past symptoms pointing toward the carotid as the source of the patient''s presenting symptom. Such patients are at high risk for an ischemic stroke, especially in the subsequent few days following their first acute symptom. It is important for clinicians to be familiar with these ophthalmic symptoms and signs caused by carotid atherosclerosis for making an early diagnosis and to take appropriate measures to prevent a stroke. This review elaborates the clinical features, importance, and implications of various ophthalmic symptoms and signs resulting from atherosclerotic carotid artery disease.     

Isolated cardiac metastasis in a patient with neuroendocrine carcinoma of pancreas discovered on 68Ga-DOTANOC PET/CT

We present an interesting image that demonstrates utility of ⁶⁸Ga-DOTANOC PET/CT for demonstrating rare metastatic sites of neuroendocrime tumor.     

Prevalence of Thoracic Aortic Aneurysms in Patients with Degenerative Abdominal Aortic Aneurysms: Results from the Prospective ACTA Study

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