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We report the clinical details, imaging findings, and management of a 58-year-old female who presented with rapidly deteriorating neurological function and acute raise in intracranial pressure secondary to posterior fossa dural arteriovenous fistula (DAVF). In this report, we present the emergency management of the DAVF with single-stage combined surgical decompressive craniotomy and direct transcranial embolization.

Introduction: This multicentre randomised controlled trial investigated whether a computed tomography (CT) scan of the axilla could more accurately assess whether the axillary lymph nodes were involved with malignancy in patients with newly diagnosed breast cancer and therefore influence surgical decision-making with regard to axillary surgery. Methods: Patients with newly diagnosed breast cancer (via screening and symptomatic routes) at two NHS Trusts in the North East of England were recruited and randomised in equal numbers. Both groups received routine diagnostic and surgical care (usual care). In addition, one group received a CT scan of their axilla on the same side as the breast cancer. Results: The study recruited 297 patients, of whom 291 contributed to findings. CT scan-guided care did not result in a change in the need for a second operation, with about 20% of both groups needing further surgery. Patients within the two groups were similar before treatment, had similar types and grade of cancer, experienced similar pattern complications and reported similar experiences of care. Conclusion: New diagnostic imaging technologies regularly enter NHS centres of excellence as research tools. It is important these are evaluated rigorously before becoming routine care. In patients newly diagnosed with breast cancer, CT-augmented diagnosis of cancer in the axilla was not found to improve surgical outcomes or patient experience. O2Preoperative assessment of breast volume to aid surgical planning: comparison of software-based mammographic measurements with subsequent mastectomy volumes. Introduction: The proportion of breast volume excised during conservation surgery for breast cancer is crucial to cosmetic outcomes. Validated, expedient methods for accurate preoperative quantification of breast volume are lacking. This study evaluated breast volume measurements calculated by Volpara® breast density software, by comparing them with actual mastectomy volumes. Methods: From a prospective clinical database, 31 patients were identified for whom Volpara® (Matakina Technology Limited, New Zealand) volume measurements and mastectomy volumes were available. All patients had undergone skin-sparing mastectomy (SSM), bilateral in one case. Specimen volumes had been measured using a water-displacement technique. Volpara® volumes for the corresponding CC and MLO view of each of the 32 breasts were averaged and compared with the mastectomy volumes. Correlation was assessed using the Pearson correlation coefficient. Results: Volpara® breast volumes were, as expected, consistently higher than SSM volumes but with a very strong correlation (Pearson correlation coefficient for average Volpara® volumes and mastectomy volumes = 0.82 (P < 0.01)). Conclusion:The excellent correlation between Volpara® and SSM volumes suggests that this readily available and convenient preoperative measure of breast volume could be used as a tool to aid surgical planning in women with breast cancer, which might be particularly useful in those women not ...

Fracture and embolization of peripheral intravenous cannula is very rare. Although endovascular retrieval is the standard of care for most of the embolized intravascular devices, endovascular management of embolized peripheral intravenous cannula is technically difficult due to its radiolucent nature and it is not described previously in the literature. We describe the clinical presentation, imaging findings, and endovascular management in a middle aged male who had fractured peripheral intravenous cannula which was embolized into the pulmonary artery branch. Technical nuances associated with retrieval of this radiolucent little plastic tube have been discussed.