MINI PURSE ARTIFACT?

Patient came with headache. 

(A) image showed a FLAIR sequence hyperintensity but it was not seen in any other sequence, which was not normal. I suspected hemorrhage at first but without edema or mass effect I was not sure. So I asked if this was an artifact. 

The technician asked if she had dental implants, earings or keys with her. She said no, but had her mini purse with coins in her brassiere (bra). We did a control without the purse and.. (B)

This is a common thing in older patients to introduce the purse inside the bra. Apparently she forgot she had it there.

Overflow artifact?  

Simple thing to have in mind in case you see a similar one. Bye.

Band of Gennari

This is the primary visual cortex and it is found at cortical level of calcarine fissure.

So sexy..

DWI in metastatic disease / Estudio difusión en enfermedad metastásica

This is just a quick example in how DWI sequence gives paramount information in suspecting mets or as a control post treatment.

This is a 6 y/o male patient with Medulloblastoma. He had spinal leptomeningeal spread and supratentorial mets.

Post gad sequence shows minimal enhancement, but DWI is clearer in depicting how many mets he had.

Un ejemplo en el cual la secuencia de Difusión nos da importante información para detectar metástasis o como estadiaje.

Es un paciente de 6 años con Meduloblastoma con metástasis a la médula espinal y múltiples nódulos metastásicos supratentoriales.

Luego de administrar medio de contraste, no hay mucho realce, contrario a la secuencia de difusión donde delimita la cantidad total de lesiones metastásicas.





Bye

CASE # 46: SUBACUTE SUBDURAL HEMORRHAGE CAUSING HEUBNER ARTERY INFARCT

Paitent with minor head trauma 3 days ago with worsening weakness of left arm and dysarthria.

Here are the images:

DWI showing diffusion restriction of right caudate head highly suggestve of recurrent artery of Heubner stroke due to compression of subdural hemorrhage. This hemorrhage is subacute and causes considerable midline shift displacement called subfalcine herniation.


This is one of the potential complications of a non treated subdural hemorrhage.


Until next time.

CASE # 45: OPEN LIP SCHIZENCEPHALY

This is a young female patient with chronic seizures. MRI shows a cleft that communicates the ependimal layer with extra-axial subarachnoid space. It usually has an abnormal grey matter linning like in this case.

Pretty straight forward:

By the way, previous case (CASE # 44) the diagnosis is Tuberous Sclerosis.

Also previous post is the 100th! so this one is 101th.



Bye

Changes soon..

Hello!  After a long time (long in deed) I am back to post some interesting cases but also to make this blog more friendly to all interested in Medicine, mostly Neuroimaging including patients, collegues and friends.

Also, be warned that I'll be posting in spanish too. 

All of this is because I am now back from my Fellowship training in Neurointervention but I also see Diagnostic Neuroimaging in my private practice. 

Is my hope you all continue to learn as I do posting.  

Thank you

CASE 45: 7 y/o female patient with chronic seizures

Hello again!

Have a wonderful new year all over the world!. We have a neuro case again. This one is a pediatric patient.

Patient came with long standing drug resistant seizures. There are no more clinical features according to medical history. There is no failure to thrive or mental impairment.


Here are the relevant images (coronal FLAIR):

Findings?..soon conclusion.