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Biomedical subjects

R A Flom

Publications and source records attributed to R A Flom.

21 records · Page 2Linked to original sources

Unusual pattern of a deep developmental venous anomaly on CT and MR studies.

OBJECTIVE: This article focuses on an unusual cross-sectional imaging pattern of a deep developmental venous anomaly (DVA). Since these anomalies are nonpathologic, they must not be interpreted as a disease that requires further costly workup and potentially injurious procedures (cerebral angiography). MATERIALS AND METHODS: Two women aged 19 (Case 1) and 30 (Case 2) years sought medical evaluation for severe headaches. Both patients underwent CT, MRI, and conventional cerebral angiography. Case 1 also underwent MR venography. RESULTS: The diagnosis of an unusual DVA in Case 1 was confirmed only after conventional catheter angiography and a follow-up MR venogram. In Case 2 the diagnosis was inferred based upon the CT, MRI, and conventional angiography results and the marked similarity to Case 1. The presumptive diagnosis in Case 2 would not have been made with confidence without the prior experience of managing Case 1. CONCLUSION: DVAs (venous angiomas) are extreme variations in the pattern of intracranial venous drainage. These two case reports highlight an unusual pattern of this benign entity. Individuals interpreting cross-sectional imaging studies should be cognizant of this pattern.

Adult↗

MR assessment of myelination in infants and children: usefulness of marker sites.

A retrospective study was made of 60 patients, 1 month to 3 years old, to determine the normal progression of white matter myelination on MR imaging. All examinations were performed with a 1.5-T unit, and axial T1- and T2-weighted images were evaluated in each patient. Multiple sites in the cerebral hemisphere and cerebellum were examined in each case for the presence and degree of myelination. The results show that MR imaging is sensitive to the early changes of white matter myelination, and imaging patterns correlate with known patterns from pathologic studies. At the time of birth in a full-term infant the posterior limb of the internal capsule, central corona radiata, and cerebellar peduncles show visible myelination. Myelination in the centrum semiovale then proceeds anteriorly and posteriorly. Both T1- and T2-weighted images show these changes, which are best explained by a decrease in the water content of white matter as myelination progresses. Knowledge of these normal myelination patterns is essential in evaluating MR imaging studies in infants and children and in diagnosing delayed myelination.

Aging↗

Posttraumatic epistaxis from injury to the pterygovaginal artery.

Facial and skull base trauma can cause clinically significant epistaxis. Optimal evaluation and treatment require knowledge of the pertinent vascular and skull base anatomy. We describe a patient with extensive skull base injury and epistaxis in whom CT revealed a fracture through the roof of the nasopharynx and arteriography showed injury to the pterygovaginal (pharyngeal) artery. The fracture was successfully treated with transarterial particulate embolization.

Adolescent↗