RESUMO
We report three patients with spontaneous intracranial hypotension in whom spinal MR imaging revealed ventral extradural fluid collections that were centered at the cervicothoracic junction in two patients and extended throughout the entire spine in the third patient. These spinal fluid collections most likely resulted from the accumulation of CSF at the site of dural leakage. Knowledge of this association can be helpful in the selection of imaging studies to facilitate diagnosis and treatment.
Assuntos
Líquido Cefalorraquidiano/fisiologia , Dura-Máter/patologia , Hipotensão Intracraniana/diagnóstico , Imageamento por Ressonância Magnética , Adulto , Placa de Sangue Epidural , Diagnóstico Diferencial , Espaço Epidural/patologia , Feminino , Humanos , Hipotensão Intracraniana/etiologia , Hipotensão Intracraniana/terapia , Pressão Intracraniana/fisiologia , Exame Neurológico , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/terapia , Coluna Vertebral/patologiaRESUMO
Fifty-six consecutive symptomatic patients with AIDS referred for gallium scintigraphy were prospectively studied with chest high-resolution computed tomography (HRCT). Results of gallium and HRCT were correlated with findings of bronchoscopy or clinical follow-up for 1 month from time of discharge. Twenty-two patients were eventually diagnosed with at least one of the following: Pneumocystis carinii, cytomegalovirus, Mycobacterium avium complex, bacteria, Kaposi's sarcoma, or lymphocytic interstitial pneumonitis. HRCT was more sensitive (82%) and more specific (91%) than gallium (59% and 75%, respectively). HRCT yielded higher positive predictive values (86%) and negative predictive values (88%) than did gallium (62% and 73%, respectively). HRCT was more helpful in guiding the method of biopsy and directing the brochoscopist to the diseased lung segment that would maximize diagnostic yield.