CI ¼ confidence interval, IV ¼ intravenous, IVC ¼ inferior vena cava, TIPS ¼ transjugular intrahepatic portosystemic shunt, UAE ¼ uterine artery embolization PREAMBLE In 2010, the Society of Interventional Radiology (SIR) published its first practice guidelines regarding the use of antibiotic prophylaxis in vascular and interventional radiology (IR) (1). The present update to the original guidelines aims to address the expanding breadth of IR procedures, including the increasing prevalence of pediatric IR procedures, and the increasing repertoire of antibacterial agents. As was the case for the original guidelines (1), the availability of randomized controlled data regarding antibiotic prophylaxis is lacking in the IR literature. Much data are derived from retrospective reviews
The classic imaging findings of posterior reversible encephalopathy syndrome (PRES) are of bilateral parietal and occipital subcortical vasogenic oedema, and are well established in the literature. As experience with PRES grows, varied and atypical presentations are being increasingly described. This pictorial review illustrates the variable presentations of PRES, including cases with atypical imaging findings. We illustrate cases of PRES with varying distributions of vasogenic oedema as well as cases with atypical imaging findings, such as variations of haemorrhage and restricted diffusion. Atypical imaging findings should not dissuade the diagnosis of PRES in the appropriate clinical situation, and knowledge of the varied appearance and atypical findings of PRES allows the radiologist to make this diagnosis.
The neurological determination of death (NDD) is primarily considered to be clinical. However, situations may arise where confounding factors make this clinical assessment difficult or impossible. As a result, ancillary tests have been developed in order to aid in the confirmation of brain death. As assessment of neuronal electrical activity; electroencephalography (EEG) is no longer recommended in this determination, tools assessing cerebral perfusion, as reflected by the presence or absence of cerebral blood flow (CBF), are the mainstay of NDD. The preferred ancillary test currently is Hexamethylpropylene amine oxime-single photon emission computed tomography (HMPAO SPECT) radionuclide angiography. When this is not available, or is equivocal, 4-vessel cerebral angiography can be used to determine the presence or absence of intracranial blood flow. However, as cerebral angiography has its own limitations, other techniques are sought by physicians in the Intensive Care and Neuro-intensive Care settings to replace cerebral angiography. In this article, we briefly review the history of diagnosis of brain death, pathophysiologic issues in making this determination, and currently available CBF imaging techniques, discussing each in turn with respect to their utility in the diagnosis of brain death.
These data do not support an association between white matter integrity in the corpus callosum and self-reported postconcussion syndrome 6 to 8 weeks post-MTBI.
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