MRA can accurately categorize the severity of carotid occlusive disease. Duplex ultrasound scan facilitates patient selection for carotid endarterectomy in most cases, but adjunct use of MRA improves diagnostic accuracy for > 75% stenoses and may obviate the need for cerebral arteriography when duplex scan results are inconclusive or demonstrate borderline disease severity.
Dilated SOV is a rare radiographic finding resulting from a wide spectrum of etiologies with clinical implications ranging from benign to sight- and life-threatening. Dilated SOV is most often found with dural-cavernous fistula or carotid-cavernous fistula, orbital or facial arteriovenous malformation, and venous thrombosis. Recognition of this finding and management of the underlying condition is critical.
We describe the histopathologic findings of perineural invasion in orbital mucormycosis in a man with diabetes in ketoacidosis. Linear enhancement on MRI beginning at the orbital apex was correlated with fungal tracking of the trigeminal and lacrimal nerves. Mucormycosis can spread considerable distances from its primary focus of infection along peripheral nerves, a phenomenon that can be identified clinically with contrast-enhanced MRI.
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