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This article, titled "Role of Ultrasound-Guided Trucut Nerve Biopsy in the Diagnosis of Pure Neuritic Leprosy: The Way Forward," discusses the use of ultrasound-guided trucut nerve biopsy as an alternative to invasive open nerve biopsy for diagnosing pure neuritic leprosy (PNL). The study conducted six cases of PNL and found that trucut nerve biopsy was minimally invasive, had few patient complications, and was well-accepted by patients. The biopsy samples were examined histopathologically and through PCR testing, with positive results for acid-fast bacilli (M. leprae) in two cases. The authors conclude that trucut nerve biopsy may be a viable alternative to open nerve biopsies for diagnosing PNL. [Extracted from the article]

This article from the Arab Journal of Interventional Radiology discusses the use of balloon-assisted chemoembolization (C-TACE) in the treatment of hepatocellular carcinoma (HCC) with arterioportal fistula and portal invasion. Arterioportal shunts can complicate the use of C-TACE by causing embolizing agents to flow away from the HCC and potentially cause nontarget embolization. The article presents a case study of a 45-year-old male with liver SOL and Hepatitis B +VE Chronic Liver Disease who underwent balloon-assisted C-TACE. The procedure was successful, and the patient ultimately underwent live donor liver transplantation. The authors conclude that balloon-assisted C-TACE can be selectively used in cases of arterioportal fistula to reduce nontarget embolization and safely shrink the tumor. [Extracted from the article]

We report a case of a 13-year-old girl with Hallervorden-Spatz disease (HSD) or pantothenate kinase-2 associated neurodegeneration (PKAN). HSD is a rare neurodegenerative disorder, which is characterized by a rapidly progressive extrapyramidal syndrome, dementia with optic atrophy, and retinal degeneration. It is associated with accumulation of cysteine--iron complex in the globus pallidi and substantia nigra. The MRI "eye of the tiger" sign is the characteristic. MRI spectroscopy is also characteristic. It shows markedly decreased NAA/ Cr values in the globus pallidi and substantia nigra with increased mI/Cr values that suggest of gliosis. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Technical Note: MRI Lymphangiography of the Lower Limb in Secondary Lymphedema," by R. B. Kamble, R. Shetty, N. Diwakar, and G. Madhusudan, which appeared in one of the 2011 issues.

The middle cerebral artery (MCA) usually bifurcates into a superior or frontal and inferior or temporal branch. However, it may have various branching pattern, and there may be additional arteries from the anterior circulation supplying its territory. The majority of them remain asymptomatic. Some cases may have aneurismal dilatation due to turbulent blood flow or the weak arterial wall. The surgical approach in these cases may be challenging due to complex anatomical pattern of MCA. In this report, we have described a distinct pattern of left MCA with an aneurysm which was not clear in computed tomography angiogram and further confirmed on digital subtraction angiography. The different anatomical patterns of MCA and their surgical implications have also been discussed. [ABSTRACT FROM AUTHOR]

Background: Spontaneous intracerebral hemorrhage (SICH) is a form of cerebrovascular accident with a very high rate of morbidity and mortality. The determinants of prognosis include the demographic, clinical, laboratory, and radiologic factors. It is long known that the hematoma size has a negative impact on the outcome in SICH. The influence of perihematomal edema (PHE) is not established to the extent same as that of hematoma volume. Hence, we planned this study to determine as to what role does PHE plays in the outcome in SICH. Aim of the Study: To evaluate the prognostic influence of absolute and relative edema (ratio of absolute edema to hematoma volume) in the patients of SICH. Materials and Methods: This is a prospective case controlled study. A total of 44 patients were enrolled after excluding the confounding factors. The patients were evaluated and their disability was assessed using modified Rankin scale (MRS). The imaging was done in the interval between 24 and 72 h and the hematoma volume, absolute edema volume, and the relative edema were calculated. The outcome was reassessed at 12 weeks and defined as favorable if MRS < 3. Results: A total of 69 patients were found to be having SICH on imaging; however, 25 patients were excluded as they had one of the criterion for exclusion. Hence, only 44 patients were included in the study. On univariate analysis, none of the demographic characteristics of the patients, vascular risk factors, presenting complaints, blood pressure, Glasgow coma scale, and MRS at admission, laboratory parameters were not significantly different in the two outcome groups. The hematoma volume was significantly higher in the poor outcome group (P < 0.0001) and the relative edema was associated with a favorable outcome at 12 weeks (P < 0.0001). On multivariate logistic regression, the hematoma volume and relative edema were found to have effect on the outcome similar to that seen on univariate analysis. Conclusion: In SICH, a larger hematoma volume is a predictor of poor outcome and a relative edema is associated with a better functional status. [ABSTRACT FROM AUTHOR]