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Radiology Case Reports

Waseem Mehmood Nizamani
Ligamentum flavum cyst is considered as a category of juxtafacet cyst and is recognized to be rare cause of cord compression and radiculopathy. The pathogenesis of these cysts is not yet fully understood, but it has been proposed that continuous stress to this ligament due to minor repetitive trauma, such as in spondylolisthesis and degenerative disc disease, may lead to the development of cyst. Intraspinal cyst can encroach and displace neural structures that can lead to neurologic symptoms. Although a rare entity, intraspinal cyst should be included in the causative factors of neurogenic claudication or lumbar radiculopathy based on typical magnetic resonance imaging appearance...
February 2018: Radiology Case Reports
Sabine Franckenberg, Florian Berger, Sarah Schaerli, Garyfalia Ampanozi, Michael Thali
We present the rare case of a fatal anaphylactic reaction to gadobutrol, a magnetic resonance imaging contrast agent, in a 42-year-old man. The patient underwent elective magnetic resonance imaging for diagnostic clarification of a suspicious finding in the abdomen. The patient had undergone contrast-enhanced computed tomography previously without the occurrence of any adverse effects. Adverse drug reactions in gadobutrol have a very low prevalence of 0.32%-3.5%, with serious adverse drug reactions in <0...
February 2018: Radiology case reports
Gregory Wade, Jonathan Revels, Lauren Hartman, Wendy Brown
We present a case of metastatic neuroblastoma to the mandible in an 11-month-old patient presenting with worsening right-sided proptosis and scalp swelling after a fall 2 weeks prior. Initial evaluation with computed tomography of the head demonstrated soft tissue masses centered at the right sphenoid and right mandible. These masses proved to be metastatic lesions from an intra-abdominal neuroblastoma. Review of the literature revealed 20 cases of neuroblastoma metastasis to the mandible over the past 70 years...
February 2018: Radiology Case Reports
Katherine Peters, Jamie T Caracciolo, Evita Henderson-Jackson, Odion Binitie
Myopericytomas are rare, slow-growing benign perivascular tumors most commonly arising within the superficial subcutaneous soft tissues of the lower extremity. They represent one of several related perivascular tumors of myoid lineage with similar morphology and shared immunohistochemical profile including positive staining for smooth muscle actin. Histologically, myopericytoma exhibit concentric, perivascular proliferation of spindled myoid cells with bland elongated nuclei and associated blood vessels. A solitary well-demarcated nodule or mass is typically referred to as myopericytoma, whereas an infiltrative multinodular lesion has more recently been termed myopericytomatosis...
February 2018: Radiology Case Reports
Alexandra M Foust, Xuan V Nguyen, Luciano Prevedello, Eric C Bourekas, Daniel J Boulter
Cerebrospinal fluid leaks pose a serious threat to patients as they represent an unchecked communication between the subarachnoid space and the extracranial environment. Accurate localization of the leakage site is essential for treatment planning. We describe the novel utilization of dual-energy computed tomography technology in cisternography in the evaluation of a patient with a cerebrospinal fluid leak.
February 2018: Radiology Case Reports
Riccardo Draghi, Giovanna Mantovani, Letterio Runza, Giorgio Carrabba, Nicola Fusco, Paolo Rampini, Antonella Costa, Marco Locatelli
The authors present an unusual case of a patient suffering from visual deficit due to pituitary granulomatosis with polyangiitis (GPA) associated with Rathke's cleft cyst (RCC). The patient was referred to our Neurosurgery Department presenting right eye amaurosis, third cranial nerve palsy, and left temporal hemianopsia. Magnetic resonance imaging documented a sellar or suprasellar lesion with solid and cystic components. The dura mater of the skull base was also strongly enhanced. The patient underwent surgery...
February 2018: Radiology Case Reports
Temel Fatih Yılmaz, Ayse Aralasmak, Huseyin Toprak, Gulsen Kocaman, Alpay Alkan
Craniospinal hypotension is the syndrome of orthostatic headache associated with low cerebrospinal fluid pressure. Imaging findings are usually explained by Monro-Kellie hypothesis stating that the craniospinal compartment is incompressible and any increase in volume of one of the craniospinal constituents (blood, cerebrospinal fluid, and parenchyma) must be compensated by a decrease in volume of another constituent or vice versa. We report a case of craniospinal hypotension in whom drainage of subdural hematoma upon clinical impairments resulted in pontine hemorrhage, supporting Monro-Kellie hypothesis...
February 2018: Radiology Case Reports
Song J Kim, Jonathan A Grossberg, Raul G Nogueira, Diogo C Haussen
An uncommon complication of iodinated contrast administration is the development of bilateral sialadenitis. We report a unique case of hyperacute unilateral parotiditis during diagnostic cerebral angiography of the external carotid artery, which mimicked possible iatrogenic vascular event associated with cerebral endovascular procedures. Discussion includes the differential diagnosis, diagnostic studies, and treatments for this unusual condition.
February 2018: Radiology Case Reports
Saul N Friedman, Ryan Margau, Lawrence Friedman
The diagnosis of acute calcific periarthritis is traditionally confirmed from a radiograph demonstrating periarticular calcifications in the affected area. Care must be taken when using ultrasound as the presentation of periarticular calcification is easily mistaken for a cortical avulsion fracture, requiring a radiograph to distinguish between the 2 differential diagnoses. We present the correlated ultrasound and radiographic findings of the hand of a 37-year-old man who was suffering from a dull ache in his thumb followed by acute severe pain 1 week later, and make the diagnosis of acute calcific periarthritis of the first metacarpophalangeal joint...
February 2018: Radiology case reports
Tennessee D Park, Joshua M Enyart, Terrence E Goyke, Marna Rayl Greenberg
A 23-year-old man was transported to a trauma center after injuring himself while snowboarding. He presented with bilateral shoulder pain and associated deformity to both shoulders. His exam was otherwise unremarkable, and his x-rays confirmed bilateral shoulder dislocations. Cunningham and external rotation without sedation and analgesia techniques were unsuccessful even with local anesthesia to the joint. Subsequent bilateral reduction was successful with moderate sedation using the Milch technique. Simultaneous anterior bilateral shoulder dislocations are rare and providers may need to adjust their techniques to accommodate this unusual presentation...
February 2018: Radiology case reports
Bradford Bennett, Drew Johnson, Andrew Panakos, Aleksandr Rozenberg
A 51-year-old woman with history of migraine headaches and intermittent nausea, vomiting, palpitations, and diaphoresis presented to the emergency department with hypertensive emergency 1 month after starting a beta blocker for migraine prophylaxis. Contrast-enhanced computed tomography of the chest incidentally revealed a large abdominal mass in the area of the left adrenal gland. Iodine-123 metaiodobenzylguanidine scan imaging showed localized uptake into the left adrenal gland. Along with imaging results, laboratory testing confirmed the diagnosis of pheochromocytoma...
February 2018: Radiology Case Reports
Souheil Saddekni, Amr Soliman Moustafa, Sherif Moawad, Khalid Mahmoud, Basant Farouk Hamed, Ahmed Kamel Abdel-Aal
We report a case of an 81-year-old woman with multifocal hepatocellular carcinoma who underwent transarterial chemoembolization. The patient had significant superior mesenteric artery (SMA) ostial stenosis, which led to retrograde flow in the retroportal artery to the SMA. The authors adopted several approaches to avoid potential nontarget embolization that might result from the change in the hemodynamics in the hepatoenteric arteries by initially stenting the SMA ostial stenosis as well as the use of the Surefire infusion system and balloon occlusion for delivery of chemoembolization material to tumors in the hepatic lobes...
February 2018: Radiology Case Reports
Omar Safi Zuberi, Lu Anne V Dinglasan
We report the case of a 55-year-old patient presenting with biliary obstruction caused by coil migration from a recently performed embolization of a post-traumatic gastroduodenal artery pseudoaneurysm. Based on imaging findings, biliary drain placement was initially performed and the subsequent endoscopy demonstrated coil erosion into the common bile duct and duodenum, resulting in choledochoduodenal fistula. Choledochojejunostomy was thereafter performed to bypass the area of injury.
February 2018: Radiology Case Reports
Evan Johnson, Kyle J Cooper, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Ravi N Srinivasa
Biliary stent placement is an adjunct for complex biliary intervention. Patients with benign biliary strictures or aversion to external drainage may benefit from placement of retrievable biliary stents. This report describes a patient with a working diagnosis of benign biliary stricture who underwent interventional radiology-operated endoscopy-guided transnasal placement of a fully covered retrievable biliary stent.
February 2018: Radiology Case Reports
Ravi N Srinivasa, William M Sherk, Jeffrey Forris Beecham Chick, Kyle Cooper, Joseph J Gemmete
Placement of percutaneous jejunostomy tubes using fluoroscopy may be technically challenging because of the peristaltic motion of small bowel loops within the peritoneum. Furthermore, fluoroscopic jejunostomy placement has an inherent risk of complications, including peritonitis and death. A transnasal snare technique to facilitate direct jejunostomy in patients with a surgically altered gastric anatomy has been previously reported. This report describes a patient with gastroparesis and a chronic nasojejunal tube who underwent a percutaneous transgastric snare technique to facilitate the placement of a direct jejunostomy...
February 2018: Radiology Case Reports
William Wong, Mohammed F Loya, Alexander Martynov, Salman S Shah, Dean Berman
Benign parotid lesions can grow to be a cosmetic deformation with psychological sequelae for a patient. Although surgical resection is the treatment of choice, cyst aspiration has also been attempted. This, however, has been shown to recur, requiring repeat intervention. An alternative therapeutic method not as widely recognized, but which has been reported to be both effective and less invasive than surgery for treating parotid cyst lesions, is sclerotherapy. Here we describe a report of a patient with a benign, localized, cystic neck mass refractory to 2 trials of fine needle aspiration...
February 2018: Radiology Case Reports
Jeffrey Forris Beecham Chick, James Shields, Joseph J Gemmete, Anthony Hage, Ravi N Srinivasa
Enteral access is one of the most common procedures performed in abdominal and interventional radiology. The surgical anatomy of the postoperative stomach may, however, make enteral access challenging. This report describes a patient with a pancreaticoduodenectomy complicated by a gastrojejunostomy leak who underwent 2 unsuccessful transoral endoscopic nasojejunal tube placements and 2 failed percutaneous gastrojejunostomy tube placements. Eventually, a gastrojejunostomy tube was placed utilizing percutaneous techniques with fluoroscopy assistance and gastrojejunoscopy guidance...
February 2018: Radiology Case Reports
Nishant Patel, Ravi N Srinivasa, Joseph J Gemmete, Jeffrey Forris Beecham Chick
Biliary interventions are commonplace in interventional radiology. Occasionally, an anastomotic occlusion is encountered that cannot be traversed with fluoroscopy alone. Endoscopy is a tool that should be added to the interventional radiology armamentarium. Unfortunately, most departments do not have endoscopes regularly available for use by nonendoscopists. The disposable single-use flexible LithoVue scope has the potential to provide many applications for interventional radiologists. It is relatively low cost and is easy to use with a simple setup for novice endoscopists...
February 2018: Radiology Case Reports
Antonio Borzelli, Andrea Paladini, Francesco Giurazza, Salvatore Tecame, Flavio Giordano, Enrico Cavaglià, Francesco Amodio, Fabio Corvino, Daniela Beomonte Zobel, Giulia Frauenfelder, Anna Giacoma Tucci, Raffaella Niola
Pulmonary sequestration is a congenital malformation characterized by dysplastic pulmonary tissue which receives blood supply by arterial systemic system, not in communication with tracheobronchial tree. Although it could be asymptomatic, it can also cause recurrent infections and hemoptysis, rarely massive and fatal. The conventional treatment consists in surgical resection of the pulmonary sequestration, but in the last few years endovascular embolization has been proposed as a valid therapeutic alternative...
February 2018: Radiology Case Reports
Joseph Y Shen, Neal D Futran, Maya G Sardesai
Craniofacial Actinomyces osteomyelitis progression is rare, as patients are soon treated. A 56-year-old male smoker presented with sinusitis and was managed medically. This patient failed to follow up and presented 1 year later with erosive bony disease. He was managed medically and surgically; however, his disease evolved to include his midface, skull base, and cranium. He underwent staged debridement and free tissue reconstruction. His disease is controlled but not cured. The literature includes case reports and small series describing limited disease treated successfully with surgical and medical management...
February 2018: Radiology Case Reports
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