Acute basilar artery occlusion (BAO): a pictorial review of multimodal imaging findings.

Acute basilar artery occlusion (BAO) is an uncommon cause of stroke; however, it constitutes a serious medical emergency and is associated with elevated mortality rates as well as unfavorable functional outcomes. This is especially true when it is not rapidly diagnosed, and the initiation of reperfusion therapies is delayed. Its etiology is mainly embolic or atherosclerotic, and it often presents with non-specific signs and symptoms (e.g., vertigo, cephalalgia, reduced consciousness, or hemiparesis) that can simulate an anterior circulation stroke. Therefore, obtaining imaging studies that include computed tomography (CT), computed tomography angiography (CTA), and diffusion-weighted magnetic resonance imaging (DWI MRI) as part of the diagnostic approach is crucial to make an accurate diagnosis. The main pillar of acute BAO treatment is early recanalization using intravenous thrombolysis, mechanical thrombectomy, or bridging therapy, in which both methods are used. This pictorial essay illustrates the essential role that multimodal imaging plays in the prompt diagnosis, management, and overall outcome of patients with acute BAO.

Fístula dural espinal, la importancia del diagnóstico temprano / Spinal Dural Fistula, the Importance of its Early Diagnosis

A pesar de no ser una patología común, la fístula dural espinal (FDE) es la comunicación arteriovenosa anormal más frecuente del canal espinal. Normalmente cursa como una mielopatía extensa baja, secundaria a congestión y trombosis venosa extraaxial, a su vez secundarias a la comunicación arteriovenosa anómala. Su diagnóstico oportuno se logra con imágenes diagnósticas convencionales y es, en la mayoría de los casos, sugerido inicialmente por el radiólogo. El tratamiento temprano impacta de forma positiva el pronóstico del paciente, ya que puede llegar a ser reversible. Se presenta un caso de difícil diagnóstico inicial y buena evolución clínica.

Even though it is not a common pathology, spinal dural fistula is the most frequent abnormal arteriovenous communication of the spinal canal. It usually courses as an extensive low myelopathy due to venous congestion and venous thrombosis, as a consequence of the abnormal arteriovenous shunt. Timely diagnosis is achieved with conventional imaging techniques. In most cases, it is initially suggested by the radiologist. Early treatment improves clinical prognosis, because the damage produced may be reversible. We present a case of spinal dural fistula with a difficult initial diagnosis and favorable clinical evolution.