- Aberrant Structural Brain Connectivity in Adolescents with Attentional Problems Who Were Born Prematurely
The purpose of this study was to identify the neural correlates of attentional problems in adolescents born prematurely and determine neonatal predictors of those neural correlates and attention problems. Of the 24 subjects, 12 had attention deficits. A set of axonal pathways connecting the frontal, parietal, temporal, and occipital lobes had significantly lower fractional anisotropy in subjects with attentional problems. The temporoparietal connection between the left precuneus and left middle temporal gyrus was the most significantly underconnected interlobar axonal pathway. Low birth weight and ventriculomegaly, but not white matter injury or intraventricular hemorrhage on neonatal MR imaging, predicted temporoparietal hypoconnectivity in adolescence.
- Spinal Epidural Arteriovenous Fistula with Perimedullary Venous Reflux: Clinical and Neuroradiologic Features of an Underestimated Vascular Disorder
Thirteen consecutive patients were diagnosed with deep lumbosacral spinal dural arteriovenous fistula at a single center between 2006 and 2018. Paraparesis was present in 12 (92%) patients. Sphincter dysfunction and sensory symptoms were observed in 7 (54%) and 6 (46%) patients, respectively. The mean duration of symptoms was 6 ± 8 months. Congestive myelopathy on MR imaging was present in all patients. Prominent arterialized perimedullary veins were demonstrated in only 3 cases. Time-resolved contrast-enhanced dynamic MRA revealed arterialized perimedullary veins and an arterialized ventrolateral epidural pouch in 9/10 (90%) patients, mostly located ventrolaterally. The authors conclude that time-resolved contrast-enhanced dynamic MRA is a powerful diagnostic tool for identifying arterialized perimedullary veins as well as an arterialized ventrolateral epidural pouch.
- Fluoroscopically Guided Facet Injections: Comparison of Intra-Articular and Periarticular Steroid and Anesthetic Injection on Immediate and Short-Term Pain Relief
The authors evaluated the immediate and short-term efficacy of intra-articular and periarticular steroid/anesthetic injections for facet-mediated lumbar pain. Seventy-seven patients had 100 procedures with 205 total facet joints injected. All intra-articular, all periarticular, and partial peri-/intra-articular injections constituted 54%, 20%, and 26% of the cases, respectively. The immediate and 1-week postprocedural change in pain was -3.7 and -1.4 for the all intra-articular and -3.6 and -1.2 for the combined group. They conclude that the intra-articular and periarticular fluoroscopically guided facet injections provide statistically significant and similar pain relief both immediately and 1 week postinjection.
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