Clinical anatomy of cervical spondylosis

The aim of this study is to describe the anatomical alterations in complementary tests (MRI and EMG) in patients with cervicobrachialgia according to sex and age. Retrospective study of 184 patients with cervicobrachialgia who underwent cervical MRI and EMG. The variables analyzed were gender, age, elements of spondylosis (osteophytes, arthropathy, spondylolisthesis and canal stenosis), the type of disc disease (protrusion and herniated disc) and curvature in the sagittal plane. The EMG was used to evaluate the neurogenic findings in the muscles dependent on the spinal roots of C4 to C8-T1.Average age was 53.65±11.96 years. The patients were evaluated for the presence of osteophytes (n = 111), arthropathy (n = 76), spondylolisthesis (n = 15) and stenosis of the spinal canal (n = 35). The highest incidences were osteophytes in C5-C6 (n = 108), protrusions in C5-C6 (n = 58), herniated disc in C5-C6 (n=18) and neurogenic findings in C7 (n = 130). The rectification of cervical lordosis appeared in 124 patients.S pondylosis increases with age. Disc herniations, disc protrusions and motor radiculopathy are more frequent in the 5th to 6th years of life. In patients with cervicobrachialgia, the sagittal rectification is more common than the normal lordosis

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Enfermedad de Creutzfeldt-Jakob: hallazgos en resonancia magnética / Creutzfeldt-Jakob disease: magnetic resonance imaging findings

Objetivos: Mostrar el valor de la resonancia magnética (RM) en el diagnóstico de la enfermedad de Creutzfeldt-Jakob (ACJ) y familiarizar al radiólogo con los hallazgos característicos de esta entidad. Material y métodos: Se realizó un estudio retrospectivo de 6 pacientes diagnosticados de ACJ en nuestro centro en el período 2004–2008. Se revisaron los datos clínicos, analíticos, electroencefalográficos y los hallazgos radiológicos de cada caso y se correlacionaron con los resultados de la necropsia o con los criterios de la Organización Mundial de la Salud (OMS) de ACJ en los casos en los que no se disponía del examen histopatológico. Resultados: De los 6 pacientes diagnosticados de ACJ, 4 tienen necropsia que confirma la enfermedad y en 2 no se dispone de ésta. Éstos cumplen los criterios de la OMS de ACJ, uno probable y otro posible. Resultados: En todos los casos observamos que en los estudios de RM aparecían alteraciones características de la enfermedad a nivel cortical y/o de ganglios basales. Estas alteraciones se detectaron en fases clínicas iniciales. Conclusiones: En la ACJ, la RM muestra alteraciones características que deben conocerse para poder realizar un diagnóstico precoz (AU)

Objectives: To show the usefulness of magnetic resonance imaging in the diagnosis of Creutzfeldt-Jakob disease (CDJ) and to familiarize the radiologist with the characteristic imaging findings for this entity. Results: In all cases, we observed characteristic alterations on magnetic resonance imaging at the level of the cortex and/or basal ganglia. These alterations were detected in the initial clinical phases. Conclusions: Radiologists should be familiar with the characteristic alterations of CDJ at magnetic resonance imaging to enable the early diagnosis of this entity (AU)

[Creutzfeldt-Jakob disease: magnetic resonance imaging findings]. / Enfermedad de Creutzfeldt-Jakob: hallazgos en resonancia magnética.

OBJECTIVES: To show the usefulness of magnetic resonance imaging in the diagnosis of Creutzfeldt-Jakob disease (CDJ) and to familiarize the radiologist with the characteristic imaging findings for this entity. MATERIAL AND METHODS: We retrospectively studied six patients diagnosed with Creutzfeldt-Jakob disease at our center from 2004 through 2008. We reviewed the clinical, laboratory, electroencephalographic, and imaging findings in each case, and we correlated the results with the autopsy findings or with the World Health Organization's criteria for CDJ in the cases for which histopathological data were not available. RESULTS: Of the six patients diagnosed with CDJ, autopsy findings confirming the diagnosis were available in four patients and the other two patients fulfilled the World Health Organization's criteria for the diagnosis (one classified as probable and other as possible). In all cases, we observed characteristic alterations on magnetic resonance imaging at the level of the cortex and/or basal ganglia. These alterations were detected in the initial clinical phases. CONCLUSIONS: Radiologists should be familiar with the characteristic alterations of CDJ at magnetic resonance imaging to enable the early diagnosis of this entity.

[Simultaneous suprasellar and pineal germinoma: a case report]. / Germinoma pineal y supraselar sincrónico: a propósito de un caso.

INTRODUCTION: Tumours in the pineal region are rare (0.3-2.7%) and most of the ones that do occur are germ cell tumours, of which germinoma is the most frequent. They are chiefly located in the pineal gland, the next most common being site being the suprasellar region and the fourth ventricle, although simultaneous presentation in these locations is relatively rare (5-10% of cases). The main aim of this study is to review the differential diagnosis of neoplasias in the pineal region. CASE REPORT: Here we report the case of a 20-year-old male who was admitted to hospital due to irregularities affecting the field of vision, with clinical signs and symptoms of panhypopituitarism and normal levels of tumour markers in blood and cerebrospinal fluid. Magnetic resonance imaging of the craniospinal axis was performed and results showed the presence of two masses with significant enhancement, one located in the pineal region with a signal similar to that of grey matter and the other in the hypothalamus, which had a more heterogeneous aspect with cystic areas inside it. Imaging with paramagnetic contrast agents revealed dissemination with ependymal uptake in relation to the frontal horns and in the fourth ventricle; a possible simultaneous origin was also suggested in this latter location. CONCLUSIONS: Magnetic resonance imaging plays a decisive role in establishing the diagnosis and therapy plan. The imaging factors that must be taken into account are the origin of the mass, heterogeneity, contrast enhancement, presence of fat or calcium, a signal similar to that of grey matter and possible dissemination, above all into the subarachnoid space. The patient's medical record (age, sex or tumour markers) must also be taken into consideration.

Quiste del velum interpositum / Cyst in the velum interpositum

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