Retrospective review of patients with cerebral venous thrombosis (CVT) detected by 64-slice multidetector row computed tomography (MDCT). To evaluate the role of CT scan as the primary modality of imaging in suspected cases of CVT. Between October 2006 and September 2007, 53 patients, suspected to have CVT, underwent CT scan of the brain. Out of these, 33 patients were included in the study, who underwent non-contrast CT (NCCT), CT venous angiogram (MDCTA) and magnetic resonance venogram. Two blinded readers evaluated the NCCT and MDCTA. Final diagnosis was obtained after consensus reading of all the imaging by the two readers. Out of the total 33 patients, 20 patients were detected to have thrombosis of one or more of the cerebral venous sinuses or veins, at the concluding consensus reading. MDCTA together with NCCT could identify thrombosis in all of the 20 patients, i.e., 100% sensitivity and specificity. Sixty-four-slice MDCTA together with NCCT provided 100% sensitivity and specificity for the identification of CVT. It can be considered as a cost-effective and widely available, primary imaging modality in emergency situations.
Glossopharyngeal neuralgia is a rare condition with a frequency about 1% of that of trigeminal neuralgia. Vascular compression is a common and treatable cause of glossopharyngeal neuralgia. Microvascular decompression of the glossopharyngeal nerve is an effective treatment option for patients in whom the disease is caused by compression of the nerve by a blood vessel. Pre-operative detection of the pathology on imaging has become possible with high strength MRI imaging. We describe the case of a 54-year-old man with left glossopharyngeal neuralgia. Constructive interference in steady-state (CISS) and flow sensitive Gradient Echo MRI sequences clearly demonstrated the compression of the IX nerve by the left posterior inferior cerebellar artery (PICA). The patient was operated upon and a Teflon graft was put in between the nerve and the vessel. The intra-operative photographs and post-operative images are also presented here. After surgery, the patient improved symptomatically with no recurrence of the symptoms in the follow-up period of about eight months.
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