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Biomedical subjects

Curtis A Given

Publications and source records attributed to Curtis A Given.

11 recordsLinked to original sources

Spontaneous intracranial arterial dissection in the young: diagnosis by CT angiography.

BACKGROUND: Spontaneous carotid artery dissections have been rarely reported in children. Diagnosis has traditionally been confirmed by catheter arteriography. More recently diagnosis has been made by magnetic resonance imaging and magnetic resonance angiography; however the sensitivity of these techniques has yet to be determined. The authors are unaware of reports of carotid dissection confirmed by dynamic computed tomography (computerized tomographic arteriography) in the young. CASE PRESENTATION: We recently evaluated a fourteen year-old male following the development of transient neurologic symptoms. There was no antecedent illness or trauma. Dynamic computed tomography revealed an intracranial dissection involving the supraclinoid segment of the left internal carotid artery (confirmed by catheter arteriography). Studies for vasculitis, pro-thrombotic states, and defects of collagen were negative. CONCLUSION: Spontaneous carotid artery dissection is a potential cause of transient neurological symptoms and ischemic stroke in the pediatric population. Dynamic computed tomography appears to be a reliable diagnostic tool which can lead to early diagnosis.

Adolescent↗

Interhemispheric lipoma connected to subcutaneous lipoma via lipomatous stalk.

Lipomas are rare intracranial lesions and are generally thought to be asymptomatic. The vast majority of intracranial lipomas are viewed as incidental findings on imaging studies and treated conservatively. Intracranial lipomas are frequently accompanied by additional intracranial congenital malformations, but only rarely has an association with subcutaneous lipomas been described. We report an infant with a subgaleal lipoma in the region of the anterior fontanelle connected to a large interhemispheric (pericallosal) lipoma via a tiny lipomatous stalk. Because of this association, infants who present with a subcutaneous lipoma of the scalp might be considered for MR imaging to evaluate for an intracranial component.

Brain Neoplasms↗

Percutaneous sacroplasty for the treatment of sacral insufficiency fractures.

OBJECTIVE: The purpose of this article is to illustrate the effectiveness and utility of percutaneous sacroplasty in the treatment of sacral insufficiency fractures. We also outline the technical considerations in performing the procedure. CONCLUSION: Percutaneous sacroplasty is an effective treatment for sacral insufficiency fractures. Most patients experience significant relief within the first 48 hr.

Aged↗

Imaging of the brain, including diffusion-weighted imaging in methylmalonic acidemia.

Methylmalonic acidemia (MMA) is a multifactorial autosomal recessive inborn error of organic acid metabolism, often presenting with neurologic findings. We report the imaging findings in a case of a child with classic neurological and laboratory findings for MMA. Imaging studies demonstrated abnormalities within the basal ganglia, particularly the globi pallidi (GP). Diffusion-weighted abnormalities seen in patients with MMA during an acute episode of metabolic acidosis and at follow-up are discussed. The authors are aware of only one prior report of serial examinations demonstrating resolution of restricted diffusion in the GP. The biochemical and pathophysiologic basis of the imaging findings of MMA are explained.

Brain Diseases, Metabolic, Inborn↗

Stereotactic radiosurgery associated neurotoxicity.

Stereotactic radiosurgery (SRS) is an evolving therapeutic modality for well demarcated intracranial lesions. Since the inception of stereotactic radiosurgery the types of parenchymal CNS lesions addressed by this mode of treatment has increased. All modern stereotactic radiosurgical procedures employ several common features. Patients are fitted with a stereotactic head frame or fiducial markers followed by radiographic imaging which allows for external reference points and three-dimensional mapping of the intracranial lesion. Armed with this information a highly conformal treatment plan is developed to deliver a high dose of radiation to a sharply defined target, with rapid dose fall-off outside the lesion volume. While an extremely effective therapeutic option, SRS is not without risk of neurotoxicity, with radiation necrosis being the most commonly recognized complication. The neurotoxic effects of SRS are reviewed and discussed.

Brain↗

Pseudo-subarachnoid hemorrhage: a potential imaging pitfall associated with diffuse cerebral edema.

We report CT findings in seven patients with diffuse cerebral edema and increased attenuation in the basilar cisterns resembling subarachnoid hemorrhage. On the basis of autopsy (three cases) and lumbar puncture (four cases) findings, true subarachnoid hemorrhage was reasonably excluded. Pathophysiologic changes that occur with diffuse cerebral edema are explored, with proposed explanations for the appearance of a pseudo-subarachnoid hemorrhage.

Adult↗

Fluoroscopy fade for embolization of vein of Galen malformation.

A fluoroscopy fade technique in the embolization of a vein of Galen malformation in a 10-week-old infant is discussed herein. The availability of the fluoroscopy fade function eliminated the necessity of road mapping during the procedure and permitted minimal usage of contrast material and minimal radiation exposure for the patient. Techniques used during the embolization and the benefits of the fluoroscopy fade feature are also described.

Cerebral Veins↗

Recognition and importance of an infraoptic anterior cerebral artery: case report.

Although variations of the anterior cerebral artery (ACA)-anterior communicating artery complex are commonly identified on imaging studies, an infraoptic course of the ACA is exceedingly rare. What is believed to be the first case of an infraoptic course of the ACA discovered with MR angiography and further characterized with conventional angiography is presented. The high prevalence of associated aneurysms and the implications for surgical planning make preoperative recognition of this anomaly critical.

Anterior Cerebral Artery↗