Remote cerebellar hemorrhage after lumbar spinal surgery.

Remote cerebellar hemorrhage (RCH) is a rare complication after supratentorial or spinal surgery. RCH is poorly known and hence probably underdiagnosed. Diminished consciousness and headache are the most common clinical features. Computed tomography and magnetic resonance reveal a characteristic pattern of linear bleeding between the cerebellar folia. The pathophysiological mechanism is disputed but is probably venous bleeding secondary to significant intraoperative or postoperative loss of cerebrospinal fluid. Multiple risk factors have been described, but postsurgical negative pressure drainage of cerebrospinal fluid is the only clearly predisposing factor. We present a case of RCH after spinal surgery with a literature review.

Differential diagnosis of T2 hyperintense brainstem lesions: Part 1. Focal lesions.

Brainstem lesions can be classified as focal or diffuse. Magnetic resonance imaging is the most suitable imaging modality for evaluating these lesions. As a rule, focal lesions are not large and have well-defined margins. Causes include tumors, vascular malformations, demyelinating diseases, brain abscesses, hypertrophic olivary degeneration, and dilated Virchow-Robin spaces. Differential diagnoses of these numerous entities mandates a review of magnetic resonance imaging findings in conjunction with epidemiologic aspects, clinical features, and other medical test results.

Differential diagnosis of T2 hyperintense brainstem lesions: Part 2. Diffuse lesions.

Diffuse brainstem lesions are poorly defined, often large abnormalities and include tumors (gliomas and lymphomas) vasculitis (Behçet's disease), traumatic brainstem injury, degenerative disorders (Wallerian degeneration), infections, processes secondary to systemic conditions (central pontine myelinolysis, hypertensive or hepatic encephalopathy), and ischemic pathology (leukoaraiosis). Magnetic resonance imaging is the most appropriate imaging modality to use in evaluating lesions of this type, but often findings are nonspecific. Therefore, radiologists need to bear in mind such additional information as patient age and clinical features in making a differential diagnosis.

CT findings after laryngectomy.

The goal of surgical treatment of laryngeal cancer is to achieve tumor control while preserving, whenever possible, the three primary functions of the larynx: breathing, swallowing, and phonation. The surgical procedure may consist of either a partial, conservative excision (eg, cordectomy, vertical partial laryngectomy, horizontal supraglottic laryngectomy, supracricoid laryngectomy with cricohyoidopexy or cricohyoidoepiglottopexy, or near total laryngectomy) or a radical excision (total laryngectomy). The procedure depends largely on the location and extension of the tumor, the stage of disease, and the patient's needs and preferences. Familiarity with the typical imaging appearance of the larynx after each procedure is crucial for differentiating normal postsurgical changes from persistent or recurrent disease as well as for diagnosing associated second primary malignancies. Since computed tomography (CT) is often used for follow-up evaluations, an ability to interpret the characteristic CT features is particularly important.