BACKGROUND AND PURPOSE:Hippocampal malrotation (HIMAL) is a failure of hippocampal inversion that occurs during normal fetal development and has been seen on MR imaging examinations of people with epilepsy, but it has not been studied in patients without epilepsy. We intended to evaluate the prevalence of HIMAL in MR imaging examinations of patients without seizures to better understand the significance of HIMAL in the population with seizure.

Objective To assess the outcomes and safety after CTguided percutaneous sacroplasty in patients with painful sacral insufficiency fractures or pathologic sacral lesions. Methods A retrospective multicenter analysis of consecutive patients undergoing CT-guided sacroplasty for painful sacral insufficiency fractures or sacral lesions was undertaken. The inclusion criteria consisted of severe sacral pain not responding to conservative medical management with imaging evidence of unilateral or bilateral sacral insufficiency fractures or lesions. Outcome measures included hospitalization status (inpatient or outpatient), pre-treatment and posttreatment visual analog scale (VAS) scores, analgesic use and complications. Patients were followed at approximately 1 month and for at least 1 year after their sacroplasty procedure. Results Two hundred and forty-three patients were included in the study, 204 with painful sacral insufficiency fractures and 39 with symptomatic sacral lesions. The average pre-treatment VAS score of 9.261.1 was significantly improved after sacroplasty to 1.961.7 in patients with sacral insufficiency fractures (p<0.001). The average pre-treatment VAS score of 9.060.9 in patients with sacral lesions was significantly improved after sacroplasty to 2.662.4 (p<0.001). There were no major complications or procedure-related deaths. One patient who was treated for a sacral insufficiency fracture experienced radicular pain due to local extravasation of cement that subsequently required surgical decompression for symptomatic relief. Conclusions CT-guided percutaneous sacroplasty is a safe and effective procedure in the treatment of painful sacral insufficiency fractures or lesions. It is associated with prompt and durable pain relief and should be considered as an effective treatment option in this patient population.

The use of covered stents for avoidance of catastrophic hemorrhage following treatment in patients with head and neck tumors with bilaterally threatened carotid arteries was successful.

Both fluoroscopic and CT guidance may be used to perform an LP in an obese population with a short procedure time and low radiation dose.