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Moya Moya is a rare idiopathic vasoocclusive disease characterized by progressive irreversible occlusion of main blood vessels to the brain as they enter into the skull. The occlusive process stimulates the development of an extensive network of enlarged basal, transcortical and transdural collateral vessels . In Japanese, Moya Moya means hazy. The disease derives its peculiar name from the angiographic appearance of cerebral vessels in the disease that resembles "puff of smoke". The process of blockage, once it begins tends to continue despite any known medical management unless treated with surgery.
MRI not only reveals areas of infarctions but also allows direct visualization of these collateral vessels as multiple small flow voids at the base of brain and basal ganglia. MR angiography is used to confirm the diagnosis and to see the anatomy of the vessels involved. It typically reveals the narrowing and occlusion of proximal cerebral vessels and extensive collateral flow through the perforating vessels demonstrating the classic puff of smoke appearance.
Our patient is 17 yr old female with history of recurrent seizures. MRI T1 weighted images show extensive collateralization of vessels in region of circle of willis. MRA reveals reduced luminal caliber of left internal carotid artery in petrous, cavernous and supraclinoid segments. Left MCA also shows attenuation of its luminal caliber when compared to its counterpart on right side along with collaterals at the base of the brain and basal gnaglia.
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Spinal cord hematoma or hematomyelia is an infrequently encountered condition that is the result of several unusual disease processes. The causes of spontaneous, nontraumatic spinal cord hematoma include vascular malformations of the spinal cord (the most common), clotting disorders, inflammatory myelitis, spinal cord tumors, abscess, syringomyelia, and unknown etiologies. Traumatic events, such as spinal cord injury (closed or penetrating), and operative procedures involving the spinal cord also can cause a spinal cord hematoma. Reported by Teleradiology Providers.
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Intraventricular infestation of neurocysticercosis is relatively rare, and it is usually associated with multiple sites of ventricular and parenchymal lesions. Intraventricular cysts are typically 1-2 cm in diameter and show surrounding ependymal inflammatory reaction. Note the cystic lesion in IV ventricle with turbulent flow in IV ventricle and ependymal reaction. There was resultant obstructive hydrocephalus.
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Bronchiectasis and peribronchial thickening are the most common CT findings in ABPA. ABPA typically involves the segmental and subsegmental bronchi, particularly those in the upper lobes. High-attenuating mucoid impaction is a characteristic finding. Mucus plugging of the small airways can be observed on high-resolution CT scans, with resultant centrilobular nodularity and the tree-in-bud sign.
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Patient came to us back pain and we noted a small lyic lesion in the junction of the lamina with pars interarticularis along with nidus and suspicion of osteoid osteoma was given which was later confirmed on bone scan.
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