ABSTRACT
Objectives The objective of this study is to compare the visibility and size of Dorello's canal (DC) on magnetic resonance imaging between patients with idiopathic intracranial hypertension (IIH) and control patients, for its evaluation as a potential novel marker for chronic increased intracranial pressure (ICP). Design Retrospective blinded case-control study. Setting Tertiary care academic center. Participants Fourteen patients with spontaneous cerebrospinal fluid (CSF) rhinorrhea and diagnosed IIH, as well as an equal number of age and gender-matched controls. Main Outcome Measures Radiographic presence or absence of visible CSF sleeve within DC as well as CSF sleeve width when present. Results Following review of 28 IIH canals and 28 control canals, IIH patients were significantly more likely to have a visible CSF sleeve within DC and to have a wider measured medial entrance to DC ( p < 0.001). Conclusion Identification of CSF evagination into DC may serve as a reliable marker for increased ICP in the IIH population. This finding should be considered in the future as paradigms for diagnosis of IIH continue to evolve.
ABSTRACT
The human face is a complex anatomic structure with an equally complex embryologic development. Derangement of the developmental process can result in various structural anomalies, which range from a mainly cosmetic deformity, such as cleft lip, to potentially life-threatening conditions such as arhinia. These anomalies (a) can occur as isolated anomalies; (b) can be associated with intracranial, spinal, or dental anomalies; or (c) can be a part of various syndromes, thus serving as diagnostic clues in such cases. Proper evaluation of fetal facial deformities can help in prognostication, family counseling, and prenatal or early postnatal intervention. Ultrasonography (US) is the first line of investigation in these cases. However, when US does not allow complete evaluation of these anomalies owing to its inherent limitations, magnetic resonance (MR) imaging allows comprehensive evaluation of the anomaly itself and also evaluation of various associations and the treatment approach. The embryology of the fetal facial structures is considered with regard to the MR imaging technique and the MR imaging anatomy. The MR imaging features of various structural anomalies are described and classified into six groups, namely, orofacial clefts, orbital anomalies, nasal anomalies, facial masses, external ear anomalies, and abnormal face shape or profile. Also, the key associations and relevant treatment implications are reviewed. The article provides a "one-stop shop" review of these unique disorders-from basic understanding of the embryology to applying the knowledge in clinical practice, helping the interprofessional team and the patients alike. ©RSNA, 2018.
