Imaging of acute stroke and transient ischaemic attack.
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Biomedical subjects
Publications and source records attributed to C Santosh.
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STUDY DESIGN: Case report. OBJECTIVE: To report a case of spinal cord infarction after a self-inflicted needle stick injury, following an injection of heroin into the cord. SETTING: National spinal injury unit in a Scottish University teaching hospital, Glasgow, UK. CASE REPORT: A 20-year-old male, injected street heroin accidentally into the cord through the left side of the neck, leading to sudden loss of power to all four limbs. Initial magnetic resonance imaging scans showed extensive cord oedema and follow-up scans showed signal changes within the anterior horns of the spinal cord in keeping with a cord infarct. CONCLUSION: Self-inflicted spinal cord injury with a small needle is difficult, but not impossible. Cord infarct as a result of a self-inflicted injury has not been previously reported. The mechanism of the injury resulting in cord infarction is explained by the vascular anatomy of the spinal cord circulation, and this may also explain the residual neurological status of the patient.
OBJECTIVE: To assess the suitability and accuracy of magnetic resonance imaging (MRI) in measuring the swelling of the face and lingual tissues after removal of third molar teeth. DESIGN: Prospective open study. SETTING: Teaching hospital, Scotland. SUBJECTS: 5 patients 19-22 years old with bilateral mesioangular impacted wisdom teeth. INTERVENTIONS: Magnetic resonance imaging scans taken before, and 1 and 7 days after, removal of bilateral lower wisdom teeth under general anaesthesia. MAIN OUTCOME MEASURES: Amount of swelling measured postoperatively compared with preoperatively. Coefficient of analytical variation calculated for the main observer, and between him and a second observer to assess accuracy and reproducibility for each examiner and between examiners. RESULTS: Buccal swelling on the first postoperative day was significantly greater than preoperative (P < 0.01). There was no significant difference in lingual swelling. The mean coefficient of variation for the first examiner was 1.92 and there was no significant difference between the two examiners. CONCLUSIONS: Measurements on MRI scans are both recordable and reproducible for buccal swelling, but lingual swelling is more difficult to measure because of problems in defining the lateral border of the tongue. MRI scans provide an objective measurement of swelling after extraction of wisdom teeth and could be used to evaluate the efficacy of drug regimens.
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This case report concerns the spontaneous closure of a middle cerebral arteriovenous fistula, lesions which are normally treated by surgery or interventional therapy. We have been unable to find any previous report of spontaneous closure of a similar fistula.