ABSTRACT
Encephalo-duro-arterio-synangiosis (EDAS) is considered the surgical treatment of choice for most pediatric cases of moyamoya disease, but the success of this treatment in adults is less clear. We have compared pre- and postoperative angiograms of four adults and one adolescent with symptomatic moyamoya disease who underwent bilateral EDAS at Hermann Hospital in Houston. The postoperative follow-up period ranged from 6 to 18 months. The correlation of postoperative collateral flow and clinical course was good: of the three patients with documented collateralization, two experienced excellent clinical outcomes, and one experienced a good outcome. One patient had minimal collateralization and experienced progression of her neurologic symptoms. One patient experienced a good outcome and refused a postoperative angiogram.
ABSTRACT
Thirty-seven magnetic resonance (MR) imaging studies were performed with a 1.5-T magnet and surface coils in 27 patients with suspected spinal cord injuries. Imaging was performed 1 day to 6 weeks after injury. Cord abnormalities were seen with MR in 19 patients, while skeletal and/or ligamentous injuries were seen in 21 (78%). Three types of MR signal patterns were seen in association with cord injuries. Acute intraspinal hemorrhage was seen in five patients with cord injuries and demonstrated decreased signal intensity on T2-weighted images obtained within 24 hours of injury. Cord edema and contusion had high signal intensity on T2-weighted images and were observed in 12 cases with cord injury. Neurologic recovery, determined in 16 patients, was insignificant in patients with intraspinal hemorrhage; however, patients with cord edema or contusion recovered significant neurologic function. MR at 1.5 T is extremely useful in the diagnosis of acute cord injury and also demonstrates potential in predicting neurologic recovery.
