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MRI with contrast enhancement is a valuable tool for detecting and characterizing disease of the cranial nerves. Abnormal cranial nerve enhancement on MRI may sometimes be the first or only indication of an underlying disease process.

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Neurocysticercosis is a leading cause of seizures and epilepsy in the developing world and is an increasingly important health issue in the United States. Recent results from the Cysticercosis Working Group in Peru provide new evidence supporting the use of antiparasitic agents in highly selected patients with active cysts and seizures.

Conclusion:Nonoperative management of carefully selected patients with blunt thoracic aortic injury is safe in the short-term, but serial imaging and long-term follow-up are necessary.Summary: Early operative repair has been standard management of blunt thoracic aortic injuries, and delayed repair has also become accepted in recent years. In this article, the authors go a step further and report deliberate nonoperative management of blunt thoracic aortic injury. Over the last decade, with improved prehospital care and imaging, a spectrum of thoracic aortic injuries can be identified. Whereas, it has now become common to treat blunt thoracic aortic injury with thoracic endovascular aneurysm repair, the authors have expressed reluctance to implant endografts in young patients with perhaps 5 or 6 decades more years of life expectancy. They have therefore adopted a deliberate strategy of nonoperative management of selected patients with blunt thoracic aortic injury. This strategy includes aggressive negative inotropic therapy, serial imaging, and close clinical observation. This report presents their results of deliberate nonoperative management of blunt thoracic aortic injury. This was a retrospective record review. The patients treated with nonoperative management for blunt thoracic aortic injury were analyzed for survival, evolution of aortic injury, and treatment failure. There were 53 patients (average age, 45 years) who presented to Stanford University School of Medicine Emergency Department with blunt thoracic aortic injury. Nearly three-quarters of these patients were transferred from other hospitals. Twenty-nine of 53 patients underwent planned nonoperative management of their blunt thoracic aortic injury. In-hospital survival for these 29 patients was 93%. No death was secondary to an aortic injury. At a median of 1.8 years (range, 0.9-7.2 years) survival was 97%. Nonoperative management failed in one patient, who underwent open repair. Serial imaging was performed in all patients (average, 107 days; median, 31 days). Stable aortic injuries without progression were noted in 21 patients, and 5 had resolution of their aortic injury. Eight patients were lost to follow-up. All patients had Social Security Numbers, and none were listed in the Social Security Death Index and, therefore, are presumed alive.Comment: Another so-called principle of trauma management has now come under question. Fifteen years ago, anyone advocating delayed and, now even nonoperative, management of thoracic aortic injury would have been hooted out of the room. The Stanford surgeons are to be congratulated for their continued contributions to the management of thoracic aortic disease and their willingness to look at the patients in their practice, and based on these observations, to then buck the current trend to reflexively treat thoracic aortic injuries with endovascular repair. Of course this is one practice where almost 75% of the patients with thoracic injury were received as transfers, and the patients are "selectively" managed. H...

If a well-demarcated, homogeneous high signal intensity lesion on T2-weighted images with a dumbbell configuration involving both parasellar and sellar regions with marked heterogeneous or homogeneous enhancement is found, the diagnosis of cavernous sinus cavernous malformation should be entertained.

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