It is thought to represent reactivation of varicella zoster virus latent in the geniculate ganglion. The hyperintense T2 signal of the white matter at the right frontal lobe (arrow in a) is suggestive of venous congestion. This practical, comprehensive and highly illustrated book will be invaluable to students and doctors of neurology and internal medicine in Africa. Effect of hyperbaric oxygen treatment in central retinal artery occlusion. They are not true neoplasms and are described in detail under the earlier section, “Inflammatory Lesions.” On CT images, epidermoids are similar to CSF in attenuation; if they are large, smooth remodeling of the adjacent petrous bone may be observed secondary to long-term pressure erosion. Sudden, painless, monocular visual loss most often results from CRAO, optic neuropathy (most often ischemic), retinal detachment, or intraocular hemorrhage. Associated stenoses of the feeder vessels are often identified, and there is extensive transdural supply to normal and abnormal brain tissue through branches of the external carotid artery. Academia.edu is a platform for academics to share research papers. The posterior wall of the middle ear cavity is irregular and includes the facial recess (also referred to as the facial nerve recess), pyramidal eminence, sinus tympani, and round window niche, from lateral to medial (Fig 3). The most important determinant of retinal damage and final visual outcome is the duration of occlusion of the central retinal artery. 2. These tumors are slow growing and locally infiltrating, growing along planes of least resistance in existing pathways in the temporal bone, and they rarely metastasize. The journal is a valuable resource for practicing radiologists, radiologists-in-training and other clinicians with an interest in imaging. Treatment of hypertension, dyslipidemia, diabetes, obesity, and obstructive sleep apnea; smoking cessation; implementation of a plant-based diet; and regular physical activity are critical for secondary prevention after CRAO and should follow established professional guidelines for cerebral ischemic stroke72 (note that ischemic stroke guidelines do not explicitly mention CRAO at present, although it is formalized in the American Heart Associationâs definition of ischemic stroke). E, Fibrin-platelet emboli in the superior branch of the retinal artery (red arrows) with slow segmental blood flow (âboxcarringâ) in distal retinal arteries (red arrowhead). Image shows an epidermoid in the CPA insinuating around the basilar artery (white arrow) and causing mass effect on the brainstem and cerebellum (black arrows). On the basis of the strength of the observational data and in the absence of other effective treatments, more than half of academic neurologists treat selected patients with acute CRAO with intravenous tPA. Middle Meningeal Artery (MMA) Embolization. The imaging differential diagnosis includes nasopharyngeal carcinoma with secondary obstruction of the eustachian tube orifice causing a secondary otomastoiditis. Congenital cholesteatoma is postulated to arise from epithelial rests in the middle ear in a child with no previous history of otorrhea, tympanic membrane perforation, or otologic procedures. From the Department of Radiology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114. Keratosis obturans.—Keratosis obturans represents an expansile accumulation of keratin debris within the EAC (8). Risk of acute stroke in patients with retinal artery occlusion: a systematic review and meta-analysis. They do not enhance. At MR imaging, a cholesteatoma is hypointense on T1-weighted images, is mildly hyperintense on T2-weighted images, and does not enhance (Fig 17). Hyperattenuation representing intraventricular hemorrhage is noted in the ventricles. (b) Extension into the middle cranial fossa is well seen on this image from the same sequence at a more cranial level (*), along with invasion of the Meckel cave (arrow) and cavernous sinus (white arrowhead). 2, Current Problems in Diagnostic Radiology, Vol. HBO therapy is used as a method of salvaging retinal tissue in acute CRAO. 132, No. 5, © 2021 Radiological Society of North America, Classification of vascular malformations of the central nervous system, Pathology of cerebral vascular malformations, Cerebral proliferative angiopathy: clinical and angiographic description of an entity different from cerebral AVMs, Surgical and endovascular flow disconnection of intracranial pial single-channel arteriovenous fistulae, Angiographic architecture of intracranial vascular malformations and fistulas: pretherapeutic aspects, Clinical practice: arteriovenous malformations of the brain, Spontaneous pial single-channel arteriovenous fistulae with angiographically occult small feeding 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