[abstract] MAGNETIC RESONANCE IMAGING IN DECOMPRESSION ILLNESS

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[abstract] MAGNETIC RESONANCE IMAGING IN DECOMPRESSION ILLNESS

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Title: [abstract] MAGNETIC RESONANCE IMAGING IN DECOMPRESSION ILLNESS
Author: Barratt, DM; Gutierrez, A; Van Meter, KW
Abstract: Introduction: Computed tomography (CT) of the head is strongly recommended for initial evaluation of stroke. Follow-up imaging is recommended when the initial CT is negative and documentation and localization of the lesion is needed. When available, magnetic resonance imaging (MRI) is an appropriate alternative. MRI is also recommended when small ischemic lesions due to vasculitis are suspected. For acute spinal cord stroke, MRI is recommended for initial evaluation. Diffusion-weighted MRI is rapidly evolving as the standard of care in stroke. Many cases of brain or spinal cord decompression illness (DCI) fall under the definition of stroke. Previously, it was felt that MRI was insensitive to the detection of DCI. Objective: To evaluate how continually improving MRI technology is being applied to the management of DCI. Methods: A Pubmed search was conducted. Papers describing MRI of the brain and spinal cord in acute/subacute decompression illness were reviewed. Results: Combined data from two small series revealed MRI abnormalities in 75percent (9/12) and 21percent (4/19) of patients with arterial gas embolism and spinal cord DCI, respectively. Including case reports, 11 English language papers described edema or hyperintense lesions on T2-weighted and fluid attenuated inversion recovery (FLAIR) sequences in 17 cases of brain and 10 cases of spinal cord DCI. Follow-up MRI of the brain in 3 cases documented resolution of edema and regression of cerebellar lesions. After hyperbaric oxygen treatment, spinal cord edema and T2 signal abnormality decreased in 2 cases. Contrast enhancement and diffusion-weighted imaging were not utilized in the acute period. Conclusion: MRI may be used to detect and monitor the potentially reversible lesions of brain and spinal cord DCI. Future Direction: MRI image resolution has improved since publication of the 2 series cited. Prospective studies using current technology, including diffusion-weighted sequences, may help to improve understanding and management of DCI.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1123
Date: 2002

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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