Extracalvarial soft tissues in cranial computed tomography. Normal anatomy and pathology.

Computed tomography has emerged as the modality of choice for imaging soft tissues of the face and neck. However, the extracalvarial soft tissue anatomy has not been delineated. The CT appearance of normal anatomy and variants, including the cutaneous and subcutaneous tissues, muscle layers, and subgaleal space is described. A pathologic spectrum that includes congenital, inflammatory, traumatic, and neoplastic lesions is presented. When appropriate CT windows for viewing the extracalvarial soft tissues are utilized, significant clinical information may be provided.

Percutaneous vascular intervention after surgical shunting for portal hypertension.

Twenty percutaneous transluminal angioplasty (PTA) procedures and 13 percutaneous venous embolization (PVE) procedures were performed in 23 patients who either had or were at risk for the development of recurrent bleeding, hepatic encephalopathy, or both after surgical shunt placement for portal hypertension. PTA, performed in 12 patients with significant shunt stenoses, resulted in reduction or elimination of gradients in all patients; rebleeding has occurred in only one patient. Complications consisted of one fatal rupture of a mesocaval interposition vein graft and one balloon rupture requiring surgical removal. PVE, performed in 11 patients, resulted in measurable improvement in four of seven encephalopathic patients and temporary control in the two patients with intractable bleeding. Three patients underwent PVE prophylactically. PTA of graft strictures is a valuable treatment modality. Embolization may be helpful in selected cases of hepatic encephalopathy.