EVAR does not seem to reverse PAF if this is present preoperatively and it induces this condition in approximately one sixth of patients without evidence of preoperative PAF. The potential for this adverse inflammatory local response should be taken into account when considering EVAR for treatment of aneurysms with perianeurysmal fibrosis and must be weighed against the perceived benefits of this approach.
Middle ear disease is a common clinical entity; imaging, especially High resolution Computed Tomography (HRCT), plays a crucial role in diagnosis and assessing the disease extent, helping to decide appropriate management. Temporal bone imaging is challenging and involves thorough understanding of the anatomy, especially in relation to HRCT imaging. Most of the middle ear pathologies appear as “soft tissue” on imaging. Careful analysis of the soft tissue on the HRCT is crucial in achieving the right diagnosis; clinical information is essential and the imaging findings need correlation with clinical presentation and otoscopic findings. The purpose of this pictorial essay is to enlist the pathologies that present as soft tissue in middle ear and to provide a structured and practical imaging approach that will serve as a guide for confident reporting in daily practice.
The computed tomographic (CT) appearance of chylous ascites is usually that of water with corresponding attenuation coefficients. This case report depicts the fat-fluid level sign on CT (shown by supine and decubitus scans), which is pathognomonic of chylous ascites.
A 35 month old child was referred for electrophysiology testing with pendular nystagmus, corresponding head oscillations and reduced vision. Flash visual evoked potential (VEP) revealed large responses at the right occiput (but not the left occiput) from the right eye and similar large responses at only the left occiput from the left eye, indicating absent/deficient crossover at the chiasm. A magnetic resonance imaging (MRI) scan subsequently confirmed absence of the optic chiasm. There was no other evidence of midline brain defects. Her subsequent development to age 11 has been followed. The nystagmus has remained mainly horizontal but a torsional component was noted from age 5 years and described as see-saw at age 6 years. A small right esotropia was noted at 6 years and spectacles prescribed for low hypermetropic refractive error. Bilateral superior rectus recessions at age 7 years produced an improved head posture. Her visual acuity has remained stable at around 6/24 from age 4 years. No binocularity nor stereopsis has been demonstrated over subsequent visits.
An essential introduction to the theory and practice of head and neck radiology, as well as a guide to choosing and performing imaging investigations and minimally invasive procedures.
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