La gran imitadora: alteraciones mesiotemporales en RM en una presentación atípica de neurosífilis / The great imitator: Mesial temporal alterations in MRI in an atypical case of neurosyphilis

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Sintomatología derivada de los pares craneales: Clínica y topografía / Cranial nerve disorders: clinical manifestations and topography

La detección de la patología relacionada con los doce pares craneales representa un importante desafío, tanto para los clínicos como para los radiólogos. Las técnicas de imagen son fundamentales para el manejo de muchos de los pacientes. Adicionalmente al conocimiento anatómico y de las entidades patológicas que potencialmente puedan afectarlos, la evaluación por imagen de los pares craneales requiere protocolos de exploración y técnicas de adquisición y procesado específicas. En este artículo se efectúa un repaso de los principales síntomas y síndromes relacionados con los nervios craneales que pueden precisar la realización de pruebas de imagen y la patología subyacente, así como una breve revisión de la anatomía y de las técnicas de imagen más adecuadas a la indicación

The detection of pathological conditions related to the twelve cranial pairs represents a significant challenge for both clinicians and radiologists; imaging techniques are fundamental for the management of many patients with these conditions. In addition to knowledge about the anatomy and pathological entities that can potentially affect the cranial pairs, the imaging evaluation of patients with possible cranial pair disorders requires specific examination protocols, acquisition techniques, and image processing. This article provides a review of the most common symptoms and syndromes related with the cranial pairs that might require imaging tests, together with a brief overview of the anatomy, the most common underlying processes, and the most appropriate imaging tests for different indications

Cranial nerve disorders: clinical manifestations and topography. / Sintomatología derivada de los pares craneales: Clínica y topografía.

The detection of pathological conditions related to the twelve cranial pairs represents a significant challenge for both clinicians and radiologists; imaging techniques are fundamental for the management of many patients with these conditions. In addition to knowledge about the anatomy and pathological entities that can potentially affect the cranial pairs, the imaging evaluation of patients with possible cranial pair disorders requires specific examination protocols, acquisition techniques, and image processing. This article provides a review of the most common symptoms and syndromes related with the cranial pairs that might require imaging tests, together with a brief overview of the anatomy, the most common underlying processes, and the most appropriate imaging tests for different indications.

Hipopresión de líquido cefalorraquídeo como causa de trombosis de una vena cortical / Cerebrospinal fluid hypotension as a cause of cortical vein thrombosis

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Hiperintensidad de surcos en FLAIR en un caso de hipertensión intracraneal idiopática / Sulcal hyperintensity on FLAIR-MRI in a case of idiopathic intracranial hypertension

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[Transient ischemic attack: the only presenting syndrome of dural sinus thrombosis]. / Ataque isquémico transitorio como expresión de trombosis de senos venosos durales.

INTRODUCTION: Intracranial hypertension (ICHT) is the most frequent presenting syndrome of dural vein sinus thrombosis (CVT). A transient ischemic attack as an acute mode of onset is exceptional. CASE REPORT: A right handed, forty years old man with a medical history of recurrent headaches, microcephalia and calcifications in his brain, presenting to the emergency department with left paresis that lasted a few minutes and with a complete recovery. The cerebral and neck magnetic resonance (MR) including MR angiography showed superior sagittal sinus, both transverse sinuses and right sigmoid sinus thrombosis with an increase in size of superficial cerebral venous that drained to the left sigmoid sinus. There was no evidence of intracranial dural malformations. The cerebral MR did not show any abnormal parenchymal enhancement (edema, arterial or venous infarctions, hemorrhage) including diffusion-weighted IMR. The digital subtraction angiography (ADC) confirmed the same findings as the MR angiography. The diagnosis was a chronic CVT. We studied stroke in a young adult and we did not find other irregularities. The neurological examination was normal when the patient left the hospital with an antiplatelet drug. CONCLUSIONS: Focal neurological deficit is an exceptional event of a chronic vein sinus thrombosis during follow-up. Isolated cases regarding an acute time course have been described. The interest of this case lies in the fact that venous sinus thrombosis rarely has transitory focal deficit in its course and we found no such description as onset symptoms.

Ataque isquémico transitorio como expresión de trombosis de senos venosos durales / Transient ischemic attack: the only presenting syndrome of dural sinus thrombosis

Introducción. La forma más frecuente de expresión de la trombosis de senos venosos (TSV) durales es la hipertensión intracraneal (HTIC). Excepcionalmente puede manifestarse clínicamentre como déficit neurológico focal. Caso clínico. Paciente varón de 40 años, con antecedentes personales de cefaleas recurrentes, microcefalia y calcificaciones cerebrales que consultó por dos episodios de hemiparesia izquierda de minutos de duración con recuperación completa. La resonancia magnética (RM) craneal y cervical, incluyendo secuencias de angio-RM most´ró trombosis del seno sagital superior, ambos senos transversos y seno sigmoide derecho con marcado aumento del tamaño de venas cerebrales superficiales que drenaban en el seno sigmoide izquierdo, sin existencia de malformaciones durales intracraneales. No presentó alteración del parénquima cerebral en forma de edema, infartos, hemorragia ni infartos venosos en ninguna de las secuencias (incluida la difusión). La angiografía por sustracción digital (ADC) confirmó los hallazgos de angio-RM. Se interpretó como TSV de curso crónico, procediendo al estudio de ictus en paciente joven, no encontrando otras alteraciones significativas. La exploración neurológica a alta fue normal, pautándose tratamiento antiagregante. Conclusiones. La sintomatología focal transitoria como manifestación clínica de una TSV de curso crónico es excepcional. Se han descrito casos aislados con referencia a un curso temporal agudo. El interés del caso reside en que la trombosis de senos venosos rara vez presenta clínica focal transitoria deficitaria en su evolución y no hemos encontrado tal descripción como sintomatología de inicio

Introduction. Intracranial hypertension (ICHT) is the most frequent presentig syndrome of dural vein sinus thrombosis (CVT). A transient ischemic attack as an acute mode of onset is exceptional. Case report. A right handed, forty years old man with a medical history of recurrent headaches, microcephalia and calcifications in his brain, presenting to the emergency department with left paresis that lasted a few minutes and with a complete recovery. The cerebral and neck magnetic resonance (MR) including MR angiography showed superior sagital sinus, both transverse sinuses and right sigmoid sinus thrombosis with and increase in size of superficial cerebral venous that drained to the left sigmoid sinus. There was no evidence of intracranial dural malformations. the cerebral MR did not show any abnormal parenchymal enhancement (edema, arterial or venous infarctions, hemorrhage) including diffusion-weighted IMR. The digital subtration angiography (ADC) confirmed the same findings as the MR angiography. the diagnosis was a chronic CVT. We studied stroke in a young adult and we did not find other irregularities . the neurological examination was normal when the patients left the hospìtal with and antiplatelet drug. conclusions. focal neurological deficit is an exception event of a chronic vein sinus thrombosis during follow-up. Isolated cases regarding an acute time course have been described. The interest of this case lies in the fact that venous sinus thrombosis rarely has transitory focal deficit in its course and we found no such description as onset symptoms

[Study of aortic pathology using magnetic resonance]. / Estudio de la patología aórtica mediante resonancia magnética.

Magnetic resonance (MR) can give static, dynamic and angiographic images of the lumen and wall of the aorta and its branches, avoiding interventional procedures or ionizing radiation. Except for hemodynamically unstable patients or patients with pacemakers, MR probably is the safest and more comprehensive diagnostic imaging technique for aortic disease. Selection of appropriate imaging protocols in every clinical setting is mandatory to obtain good diagnostic information. In this paper we describe the state of the art of aortic MR examination, discussing the advantages and limitations of various pulse sequences. In an overview of aortic disease, we describe the main MR imaging findings and a suited MR protocol for each of the common pathologic entities, comparing MR with other imaging techniques.