European Journal of Radiology Extra最新文献

Arachnoid granulations are normal anatomical structure that allows cerebrospinal fluid (CSF) drainage from subarachnoid space into venous system. They are asymptomatic but rarely can become symptomatic when they are large enough to cause sinus occlusion. We report a rare occurrence of focal brain herniation into a giant arachnoid granulation in a pediatric patient after sustaining severe head trauma. We also highlight on the use of diffusion tensor tractography in helping to confirm the diagnosis.

We report a case of intravitreal silicone oil migration into the subarachnoid space and cerebral ventricles, as seen on CT and MRI. During several admissions over the course of 23 months, the silicone oil was seen tracking along the optic apparatus and subsequently appeared in the ventricles as free-floating droplets. The patient experienced repeated headaches, but was worked up extensively for possible intracranial hemorrhage before the correct diagnosis was recognized.

Imperforate hymen is a relatively rare congenital anomaly which may lead to the development of hematocolpos during puberty. Clinical examination reveals imperforate hymen but abdominal ultrasound and tumor markers findings may be misleading. The presented case shows how MRI may contribute to confirm this diagnosis, define the extent of the collection exclude coexisting abnormalities and avoid an unnecessary surgical intervention.

A case of an 11 years old girl is presented who was referred to our clinic with the symptoms of pelvic pain and urine retention. Transabdominal ultrasound findings of pelvic mass and an elevated tumor marker Ca 125 contributed to a referral for exploratory laparotomy with possible diagnosis of ovarian malignancy. After admission in our tertiary center a careful history raised the diagnosis of hematocolpos and the clinical examination showed an imperforate hymen. An MRI of the pelvis was performed to confirm the diagnosis of hematocolpos and exclude other coexisting congenital abnormalities. She was managed by crucial hymenectomy and drainage.

The diagnosis of hematocolpos should always be considered in the differential of lower pelvic pain in a young adolescent girl. Detailed family history and clinical examination are mandatory to establish a diagnosis. MRI of the pelvis should be performed to confirm the clinical diagnosis, not only to evaluate the extent of the collection and the presence of possible coexisting anatomic variations of the urogenital tract, but also to avoid an unnecessary surgical intervention by laparoscopy or laparotomy.

Background

Stab wounds resulting spinal cord injury (SCI) are relatively rare and typically associated with immediate neurological damage.

Objectives

We report MDCT and MRI findings of spinal injury findings following an unusual penetrating stab wound of the neck.

Case report

A 31-year-old man had a stab wound in the cervical region. CT showed linear fracture in the corpus and left lamina of fourth cervical vertebra. MRI revealed left side oriented posteroanterior penetrating linear spinal cord lesion and broad T2W hyperintensity changes representing spinal cord contusion.

Conclusion

CT and MRI allow bony injuries, foreign bodies, spinal instability and the classification of different types of lesions, ranging from spinal cord edema to complete spinal cord transection. MR imaging should be performed after acquiring negative CT imaging findings in the case of high suspicion of spinal cord trauma as seen in our present case.

A case of Klippel–Trenaunay syndrome in a 20-year-old girl was described in this article. The clinical data showed that she had suffered from circuitous and dilated veins in her right leg since birth. The radiologic investigations demonstrated multiple circuitous and dilated blood vessels above the condylus medialis femoris, and associated with secondary bone changes. It was regarded as Klippel–Trenaunay syndrome according to clinical history and imaging findings. Klippel–Trenaunay syndrome is a rare congenital peripheral vascular disease, and the relevant literature is reviewed. Klippel–Trenaunay syndrome needs to be distinguished from other vascular diseases.

Pneumocephalus is expected after any craniotomy and usually resolves without any sequelae. However if the air entering the cranial cavity gets entrapped, it can lead to tension pneumocephalus and can have disastrous consequences. It is of utmost clinical importance to differentiate a tension pneumocephalus from a non-tension pneumocephalus as the latter does not usually require decompressive surgery. CT scan is considered the gold standard and diagnostic modality of choice for the diagnosis of pneumocephalus in the post-operative period. The Peaking sign and Mount Fuji sign are proposed as fairly specific for tension pneumocephalus, the latter being the most specific and an important sign to differentiate it from non-tension pneumocephalus. We present a case of a 20 year old male whose post-operative CT brain showed the typical Mount Fuji sign suggestive of tension pneumocephalus but was managed conservatively without any decompressive surgery.