A. Amole - Academia.edu (original) (raw)

Papers by A. Amole

Seminars in Interventional Radiology, May 14, 2020

Advancements in medical imaging and device technology allow minimal invasive procedures for the d... more Advancements in medical imaging and device technology allow minimal invasive procedures for the diagnosis and treatment of various disorders. For the management of tumors in head and neck region, these image-guided interventions play essential role in the often used multidisciplinary approach. Tissue sampling under ultrasound or computed tomography guidance is generally the first step to reach a pathological diagnosis. For head and neck tumors with high vascularity, embolization using particulate matter, liquid embolic agents, or coils is used to achieve successful tumor resection with minimal blood loss. Hemorrhage related to head and neck tumors can be evaluated and managed with endovascular techniques with minimal morbidity and mortality. Intra-arterial chemotherapy, radiofrequency ablation, and cryotherapy are new techniques for the management of advanced head and neck cancer which may serve as an alternative to achieve locoregional control and survival when curative resection may not be feasible.

Journal of radiology case reports, 2024

Neurological Research, 2011

Intraspinal navigation with catheters and fiberscopes has shown feasible results for diagnosis an... more Intraspinal navigation with catheters and fiberscopes has shown feasible results for diagnosis and treatment of intraspinal and intracranial lesions. The most common approach, lumbar puncture, has allowed access to the spinal cord, however, coming with the difficulties of fiberscope damage and decreased torque for guidance. Our objective in this study is to allow an alternate access, the sacral hiatus, with guide wire assistance into the subarachnoid and intracranial structures, while easing the angle of entry and increasing torque. We advanced catheters with guide wire and fluoroscopy assistance into the sacral hiatus of three cadavers. After entry, the thecal sac was punctured and the catheter with guide wire was advanced rostrally until positioned in the basal cisterns of the brain. We confirmed catheter placement with contrast injection, autopsy, and dissection. In our study, the sacral hiatus was easily accessed, but resistance was found when attempting to puncture the thecal sac. The advancement of the catheter with guide wire assistance glided easily rostrally until some mild resistance was discovered at entry into the foramen magnum. With redirection, all catheters passed with ease into the basal cisterns. Positioning was confirmed with contrast injection with fluoroscopy evidence, autopsy, and dissection. There was no macroscopic or microscopic evidence of damage to the spinal roots, spinal cord, or cranial nerves. The sacral hiatus with guide wire assistance is an accessible conduit for uncomplicated entry into the subarachnoid and basal cistern space without damaging surrounding structures.

Dental Traumatology, 2005

CardioVascular and Interventional Radiology, 2008

Acta Neurologica Belgica, 2012

A 47-year-old African-American man with well-controlled hypertension, presented with 2-day histor... more A 47-year-old African-American man with well-controlled hypertension, presented with 2-day history of holocephalic headache. Admission blood pressure was 152/88 mmHg, and neurological examination was remarkable for mild somnolence, abulia, dysarthria, and right-sided weakness. On head CT (Fig. 1a), he had a &2 mL hemorrhage involving the medial-most aspect of the genu of the left internal capsule, abutting on the caudate head posteromedially. At its caudal end, the hemorrhage had a thin lateral arcuate extension into the putamen. There was blood in the ventricles and moderate hydrocephalus. A 4-vessel angiogram revealed occlusion of the vein of Galen with thrombosis in the falcine and straight sinuses, and contrast stagnation within the internal cerebral veins (Fig. 1b). EKG and echocardiogram showed no evidence of left ventricular hypertrophy. Investigations into the cause of cerebral venous thrombosis (CVT) yielded no abnormalities. We treated the patient with heparin infusion and warfarin. He was later discharged to inpatient rehabilitation with minimal abulia and very mild rightsided weakness. This case highlights the dilemma of the yield of vascular imaging in patients with ICH. CVT is an uncommon cause of ICH accounting for only 2 % of all ICH [1]. Conversely, 40 % of patients with CVT develop ICH, but most have an overall good prognosis. Caudate involvement is very rare, occurring in 4 % of patients when the deep venous system is thrombosed [2]. The more common presentation of deep cerebral vein thrombosis is bilateral thalamic infarcts [3]. The yield of vascular imaging in ICH depends on patient’s age, hematoma location, and history of hypertension; imaging discloses an underlying pathology in almost half of non-hypertensive patients younger than 45; on the other hand, those older than 45, hypertensive, and who have capsulo-ganglionic, posterior fossa, or thalamic ICH do not seem to benefit from vascular imaging [1]. A putaminal location in hypertensive individuals older than 55 seems to always suggest a spontaneous ICH, regardless of the size and shape of hematoma [4]. Our patient had a history of hypertension, however it seemed under good control, with no evidence of end organ damage. Thus, his young age, and mostly the oddly shaped, non-elliptical [5], medially located hematoma is what alerted us to a possible underlying vascular anomaly and prompted a cerebral angiogram. When the hematoma shape and location are unusual, an underlying vascular pathology should always be sought in patients with ICH, even those with a history of hypertension. The choice of vascular imaging should depend on the suspected anomaly. In this patient, a non-invasive modality like a CT or MR angiogram might have offered a glimpse at the diagnosis, yet conventional cerebral angiography confirmed it. S. Yaghi (&) S. G. Keyrouz Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Box 8111, St. Louis, MO 63110, USA e-mail: shadiyaghi@yahoo.com

Stroke, 2017

Introduction: Endovascular therapy is the current standard of care for eligible patients with acu... more Introduction: Endovascular therapy is the current standard of care for eligible patients with acute ischemic stroke (AIS) due to large artery anterior circulation occlusion. All patients with moderate to severe symptoms and a treatable occlusion should be considered for EVT. We sought to evaluate temporal trends in the rates of EVT use at the two large academic stroke centers in the US. Methods: Using GWTG stroke registry data from MGH and UAMS, we analyzed 7,505 consecutive stroke admissions from 01/09 - 06/16. We evaluated the temporal trends in patient characteristics, clinical care and timeliness of care among the population of all patients and those treated within 6 or 12 hr from last known well (LKW). Results: Of the total 7,505 AIS patients, 3,722 (49%) presented within 12 hr of LKW and 2,716 (36%) within 6 hr. There were a total of 404 EVT performed at the two centers (334 ≤ 12 hr and 304 ≤ 6 hr). We observed a significant increase in the rates of EVTs performed over the pas...

Stroke

Introduction: An overwhelming benefit from endovascular treatment (EVT) of acute ischemic stroke ... more Introduction: An overwhelming benefit from endovascular treatment (EVT) of acute ischemic stroke (AIS) has been shown in recent trials, making it the new evidence-based standard of care for ischemic stroke due to anterior circulation large vessel occlusion. We sought to determine usage, safety and efficacy of EVT in patients ≥80 years of age. Methods: Using GWTG stroke registry data from MGH and UAMS, we analyzed 7,505 consecutive stroke admissions from 01/2009 - 06/2016. Univariate analysis was carried out to compare AIS patients < 80 vs. those ≥ 80yr. Results: Of the total 7,505 AIS patients, 3,722 presented within 12 hr of last known well and of these 334 (334/3722, 9%) underwent EVT. The majority of AIS patients undergoing EVT were younger than 80yr of age (264/334, 79%). Of the patients who underwent EVT, younger patients were more often male, Caucasian, and had stroke risk factors of atrial fibrillation, CAD, hypertension and smokers. The two groups were similar in NIHSS, i...

Journal of the National Medical Association, 2004

OBJECTIVE To derive a formula that defines the postvoid residual (PVR) urine volume more accurate... more OBJECTIVE To derive a formula that defines the postvoid residual (PVR) urine volume more accurately in patients with prostatic gland enlargement. DESIGN Prospective. SETTING Department of Radiology, University of Ilorin Teaching Hospital, Ilorin. SUBJECT Fifty-two consecutive patients with benign prostatic hyperplasia. The mean age was 64.98+/-9.57 years. METHOD PVR urine was evaluated by ultrasonography. Each patient had two examinations, the first of which was with a full bladder and the second of which was immediately after voiding. Two orthogonal diameters were measured on each bladder section (longitudinal and transverse) in the supine position. Fifty-two paired sets of ultrasonic measurements were thus obtained. Catheterized postvoid urine residue was regarded as the gold standard. RESULTS Using these measurements, an equation--[PVR(CUBIC)=374.057+(-196.94+V1)+(32.5539+V1(2))+(-1.1480+V1(3)) where V1=average of the length (L), width (T), and the anteroposterior distance on tra...

Neurology, 2013

OBJECTIVE: To determine predictors of a favorable CT perfusion (CTP) scan in patients with acute ... more OBJECTIVE: To determine predictors of a favorable CT perfusion (CTP) scan in patients with acute ischemic stroke evaluated onset for possible endovascular recanalization. BACKGROUND: Some centers use CTP to triage stroke patients who might benefit from endovascular therapy. There are no studies to our knowledge that identify factors associated with a favorable CTP. Those may be helpful for patients evaluated in centers where CTP is unavailable. DESIGN/METHODS: We reviewed records of patients who underwent CTP between August 2010 and September 2012. We included patients with anterior circulation strokes due to large vessel occlusion 8 hours from symptom onset, who underwent a head CT and head and neck CTA as part of our protocol. Two examiners calculated the admission ASPECTS. We defined favorable CTP as a core infarct size rd of the middle cerebral artery territory distribution and a penumbra >20% of infarct size. We divided patients into two groups based on whether they had a fa...

Seminars in Interventional Radiology

Advancements in medical imaging and device technology allow minimal invasive procedures for the d... more Advancements in medical imaging and device technology allow minimal invasive procedures for the diagnosis and treatment of various disorders. For the management of tumors in head and neck region, these image-guided interventions play essential role in the often used multidisciplinary approach. Tissue sampling under ultrasound or computed tomography guidance is generally the first step to reach a pathological diagnosis. For head and neck tumors with high vascularity, embolization using particulate matter, liquid embolic agents, or coils is used to achieve successful tumor resection with minimal blood loss. Hemorrhage related to head and neck tumors can be evaluated and managed with endovascular techniques with minimal morbidity and mortality. Intra-arterial chemotherapy, radiofrequency ablation, and cryotherapy are new techniques for the management of advanced head and neck cancer which may serve as an alternative to achieve locoregional control and survival when curative resection m...

The Internet Journal of Radiology

Proximal jejunal atresia (PJA) remains a common cause of intestinal obstruction in the newborn. D... more Proximal jejunal atresia (PJA) remains a common cause of intestinal obstruction in the newborn. Despite the need for an early surgical intervention (to preempt associated morbidity and indeed occasional mortality), a timely identification is frequently precluded by the absence of specific clinical and investigative clues. Against the background of the limitations of making a timely diagnosis of PJA in a tropical setting where opportunities for high-tech imaging tools are few, we report here the diagnostic utility of the "triple bubble" sign on the plain radiograph of a Nigerian infant. As was the case in this baby, who had non-specific symptom-complex of upper alimentary tract obstruction, the radiologic finding of the "triple bubble" sign led to an early confirmation with the more invasive barium study, and ultimately a prompt surgical extirpation. In the tropical health facility with limited radiologic service and expertise, we proffer that the presence of this sign constitutes an invaluable and nearpathognomonic clue of an anatomic/surgical, rather than a "medical" cause like neonatal sepsis. The clinical clues of PJA, possible genesis of the "triple bubble" radiologic sign, and the difference(s) from the findings in other congenital causes of anatomic obstruction of the alimentary tract are highlighted briefly under the discussion.

Skull …, 2009

Objective: We present a rare case of an isolated superior orbital fissure fracture resulting from... more Objective: We present a rare case of an isolated superior orbital fissure fracture resulting from blunt injury to the face and presenting with selective cranial nerve deficits surgically treated with a neuroendoscopic approach. The anatomy of the superior orbital fissure is detailed, and the peculiarities of the surgical approach described. Method: A review of the existing literature reveals this is the first reported case of a neuronavigation-assisted endoscopic approach used in the extraction of a superior orbital fracture fragment with good outcome. Current guidelines for an endoscopic approach in orbital trauma are reviewed, and pertinent literature is discussed. Conclusion: Neuronavigation-assisted decompression should be considered as an effective means of removing superior orbital fissure fractures.

Journal of Vascular and Interventional Radiology

Journal of the National Medical Association, 2004

To derive a formula that defines the postvoid residual (PVR) urine volume more accurately in pati... more To derive a formula that defines the postvoid residual (PVR) urine volume more accurately in patients with prostatic gland enlargement. Prospective. Department of Radiology, University of Ilorin Teaching Hospital, Ilorin. Fifty-two consecutive patients with benign prostatic hyperplasia. The mean age was 64.98+/-9.57 years. PVR urine was evaluated by ultrasonography. Each patient had two examinations, the first of which was with a full bladder and the second of which was immediately after voiding. Two orthogonal diameters were measured on each bladder section (longitudinal and transverse) in the supine position. Fifty-two paired sets of ultrasonic measurements were thus obtained. Catheterized postvoid urine residue was regarded as the gold standard. Using these measurements, an equation--[PVR(CUBIC)=374.057+(-196.94+V1)+(32.5539+V1(2))+(-1.1480+V1(3)) where V1=average of the length (L), width (T), and the anteroposterior distance on transverse section (Dt) of the postvoid urinary bla...

Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria

Necrotising fasciitis is a severe life threatening bacterial infection of the fascial planes whic... more Necrotising fasciitis is a severe life threatening bacterial infection of the fascial planes which is relatively rare in the head and neck region. The hallmark of the disease is selective necrosis of the fascia overlying skin and adjacent vasculature. Primary odontogenic infection due to aerobes and obligate anaerobes and trauma amongst other factors, are frequently responsible for this condition. Similarly, affected individuals often have an underlying systemic disease, the most common of which is diabetes mellitus. Treatment usually involves appropriate antimicrobial therapy, control of systemic disease, thorough surgical debridement, gamma globulin administration and hyperbaric oxygen where facilities exist. Significant morbidity and mortality attends necrotising fasciitis when treatment is delayed due to toxaemia, dehydration and severe biochemical disturbances. Prompt diagnosis, adequate resuscitation, thorough and frequent surgical debridement remains the cornerstone to a succ...

Journal of Neuroradiology, 2014

Background and purpose: Computed tomography perfusion (CTP) is used by some stroke centers to str... more Background and purpose: Computed tomography perfusion (CTP) is used by some stroke centers to stratify stroke patients who may potentially benefit from endovascular treatment. Our aim is to identify predictors of a favorable CTP in acute ischemic stroke patients evaluated within 8 h from symptoms onset for possible endovascular treatment. Materials and methods: We reviewed records of patients who had CTP studies between August 2010 and September 2012. We included all patients with anterior circulation strokes with evidence of large vessel disease. All patients had CT head and CT angiography head and neck as part of our protocol. Favorable CTP was defined as core infarct size less than one third the middle cerebral artery distribution and penumbra > 20% of infarct size. The patients were divided into two groups based on favorable CTP or not. Baseline characteristics, time parameters, laboratory data and radiological data were compared between both groups. For statistical analysis, we used independent and Fisher's exact tests and a multivariate logistic regression model. Results: During this period, 60 patients met the inclusion criteria. Patients with favorable CTP were likely to be ≥ 80 years (33% vs 9%, P = 0.026), have Alberta Stroke Program early CT score (ASPECTS) > 7 (81% v. 21%, P ≤ 0.001) and lower mean time from symptom onset to CTP (234 ± 91 vs 305 ± 122, P = 0.015). On regression analysis, ASPECTS was the only independent predictor of a favorable CTP (OR = 16.2, CI: 4.3-62.2, P < 0.001). Conclusion: ASPECT score may be used as a tool to predict a favorable CTP. Larger studies are needed to confirm our findings.

Seminars in Interventional Radiology, May 14, 2020

Advancements in medical imaging and device technology allow minimal invasive procedures for the d... more Advancements in medical imaging and device technology allow minimal invasive procedures for the diagnosis and treatment of various disorders. For the management of tumors in head and neck region, these image-guided interventions play essential role in the often used multidisciplinary approach. Tissue sampling under ultrasound or computed tomography guidance is generally the first step to reach a pathological diagnosis. For head and neck tumors with high vascularity, embolization using particulate matter, liquid embolic agents, or coils is used to achieve successful tumor resection with minimal blood loss. Hemorrhage related to head and neck tumors can be evaluated and managed with endovascular techniques with minimal morbidity and mortality. Intra-arterial chemotherapy, radiofrequency ablation, and cryotherapy are new techniques for the management of advanced head and neck cancer which may serve as an alternative to achieve locoregional control and survival when curative resection may not be feasible.

Journal of radiology case reports, 2024

Neurological Research, 2011

Intraspinal navigation with catheters and fiberscopes has shown feasible results for diagnosis an... more Intraspinal navigation with catheters and fiberscopes has shown feasible results for diagnosis and treatment of intraspinal and intracranial lesions. The most common approach, lumbar puncture, has allowed access to the spinal cord, however, coming with the difficulties of fiberscope damage and decreased torque for guidance. Our objective in this study is to allow an alternate access, the sacral hiatus, with guide wire assistance into the subarachnoid and intracranial structures, while easing the angle of entry and increasing torque. We advanced catheters with guide wire and fluoroscopy assistance into the sacral hiatus of three cadavers. After entry, the thecal sac was punctured and the catheter with guide wire was advanced rostrally until positioned in the basal cisterns of the brain. We confirmed catheter placement with contrast injection, autopsy, and dissection. In our study, the sacral hiatus was easily accessed, but resistance was found when attempting to puncture the thecal sac. The advancement of the catheter with guide wire assistance glided easily rostrally until some mild resistance was discovered at entry into the foramen magnum. With redirection, all catheters passed with ease into the basal cisterns. Positioning was confirmed with contrast injection with fluoroscopy evidence, autopsy, and dissection. There was no macroscopic or microscopic evidence of damage to the spinal roots, spinal cord, or cranial nerves. The sacral hiatus with guide wire assistance is an accessible conduit for uncomplicated entry into the subarachnoid and basal cistern space without damaging surrounding structures.

Dental Traumatology, 2005

CardioVascular and Interventional Radiology, 2008

Acta Neurologica Belgica, 2012

A 47-year-old African-American man with well-controlled hypertension, presented with 2-day histor... more A 47-year-old African-American man with well-controlled hypertension, presented with 2-day history of holocephalic headache. Admission blood pressure was 152/88 mmHg, and neurological examination was remarkable for mild somnolence, abulia, dysarthria, and right-sided weakness. On head CT (Fig. 1a), he had a &2 mL hemorrhage involving the medial-most aspect of the genu of the left internal capsule, abutting on the caudate head posteromedially. At its caudal end, the hemorrhage had a thin lateral arcuate extension into the putamen. There was blood in the ventricles and moderate hydrocephalus. A 4-vessel angiogram revealed occlusion of the vein of Galen with thrombosis in the falcine and straight sinuses, and contrast stagnation within the internal cerebral veins (Fig. 1b). EKG and echocardiogram showed no evidence of left ventricular hypertrophy. Investigations into the cause of cerebral venous thrombosis (CVT) yielded no abnormalities. We treated the patient with heparin infusion and warfarin. He was later discharged to inpatient rehabilitation with minimal abulia and very mild rightsided weakness. This case highlights the dilemma of the yield of vascular imaging in patients with ICH. CVT is an uncommon cause of ICH accounting for only 2 % of all ICH [1]. Conversely, 40 % of patients with CVT develop ICH, but most have an overall good prognosis. Caudate involvement is very rare, occurring in 4 % of patients when the deep venous system is thrombosed [2]. The more common presentation of deep cerebral vein thrombosis is bilateral thalamic infarcts [3]. The yield of vascular imaging in ICH depends on patient’s age, hematoma location, and history of hypertension; imaging discloses an underlying pathology in almost half of non-hypertensive patients younger than 45; on the other hand, those older than 45, hypertensive, and who have capsulo-ganglionic, posterior fossa, or thalamic ICH do not seem to benefit from vascular imaging [1]. A putaminal location in hypertensive individuals older than 55 seems to always suggest a spontaneous ICH, regardless of the size and shape of hematoma [4]. Our patient had a history of hypertension, however it seemed under good control, with no evidence of end organ damage. Thus, his young age, and mostly the oddly shaped, non-elliptical [5], medially located hematoma is what alerted us to a possible underlying vascular anomaly and prompted a cerebral angiogram. When the hematoma shape and location are unusual, an underlying vascular pathology should always be sought in patients with ICH, even those with a history of hypertension. The choice of vascular imaging should depend on the suspected anomaly. In this patient, a non-invasive modality like a CT or MR angiogram might have offered a glimpse at the diagnosis, yet conventional cerebral angiography confirmed it. S. Yaghi (&) S. G. Keyrouz Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Box 8111, St. Louis, MO 63110, USA e-mail: shadiyaghi@yahoo.com

Stroke, 2017

Introduction: Endovascular therapy is the current standard of care for eligible patients with acu... more Introduction: Endovascular therapy is the current standard of care for eligible patients with acute ischemic stroke (AIS) due to large artery anterior circulation occlusion. All patients with moderate to severe symptoms and a treatable occlusion should be considered for EVT. We sought to evaluate temporal trends in the rates of EVT use at the two large academic stroke centers in the US. Methods: Using GWTG stroke registry data from MGH and UAMS, we analyzed 7,505 consecutive stroke admissions from 01/09 - 06/16. We evaluated the temporal trends in patient characteristics, clinical care and timeliness of care among the population of all patients and those treated within 6 or 12 hr from last known well (LKW). Results: Of the total 7,505 AIS patients, 3,722 (49%) presented within 12 hr of LKW and 2,716 (36%) within 6 hr. There were a total of 404 EVT performed at the two centers (334 ≤ 12 hr and 304 ≤ 6 hr). We observed a significant increase in the rates of EVTs performed over the pas...

Stroke

Introduction: An overwhelming benefit from endovascular treatment (EVT) of acute ischemic stroke ... more Introduction: An overwhelming benefit from endovascular treatment (EVT) of acute ischemic stroke (AIS) has been shown in recent trials, making it the new evidence-based standard of care for ischemic stroke due to anterior circulation large vessel occlusion. We sought to determine usage, safety and efficacy of EVT in patients ≥80 years of age. Methods: Using GWTG stroke registry data from MGH and UAMS, we analyzed 7,505 consecutive stroke admissions from 01/2009 - 06/2016. Univariate analysis was carried out to compare AIS patients < 80 vs. those ≥ 80yr. Results: Of the total 7,505 AIS patients, 3,722 presented within 12 hr of last known well and of these 334 (334/3722, 9%) underwent EVT. The majority of AIS patients undergoing EVT were younger than 80yr of age (264/334, 79%). Of the patients who underwent EVT, younger patients were more often male, Caucasian, and had stroke risk factors of atrial fibrillation, CAD, hypertension and smokers. The two groups were similar in NIHSS, i...

Journal of the National Medical Association, 2004

OBJECTIVE To derive a formula that defines the postvoid residual (PVR) urine volume more accurate... more OBJECTIVE To derive a formula that defines the postvoid residual (PVR) urine volume more accurately in patients with prostatic gland enlargement. DESIGN Prospective. SETTING Department of Radiology, University of Ilorin Teaching Hospital, Ilorin. SUBJECT Fifty-two consecutive patients with benign prostatic hyperplasia. The mean age was 64.98+/-9.57 years. METHOD PVR urine was evaluated by ultrasonography. Each patient had two examinations, the first of which was with a full bladder and the second of which was immediately after voiding. Two orthogonal diameters were measured on each bladder section (longitudinal and transverse) in the supine position. Fifty-two paired sets of ultrasonic measurements were thus obtained. Catheterized postvoid urine residue was regarded as the gold standard. RESULTS Using these measurements, an equation--[PVR(CUBIC)=374.057+(-196.94+V1)+(32.5539+V1(2))+(-1.1480+V1(3)) where V1=average of the length (L), width (T), and the anteroposterior distance on tra...

Neurology, 2013

OBJECTIVE: To determine predictors of a favorable CT perfusion (CTP) scan in patients with acute ... more OBJECTIVE: To determine predictors of a favorable CT perfusion (CTP) scan in patients with acute ischemic stroke evaluated onset for possible endovascular recanalization. BACKGROUND: Some centers use CTP to triage stroke patients who might benefit from endovascular therapy. There are no studies to our knowledge that identify factors associated with a favorable CTP. Those may be helpful for patients evaluated in centers where CTP is unavailable. DESIGN/METHODS: We reviewed records of patients who underwent CTP between August 2010 and September 2012. We included patients with anterior circulation strokes due to large vessel occlusion 8 hours from symptom onset, who underwent a head CT and head and neck CTA as part of our protocol. Two examiners calculated the admission ASPECTS. We defined favorable CTP as a core infarct size rd of the middle cerebral artery territory distribution and a penumbra >20% of infarct size. We divided patients into two groups based on whether they had a fa...

Seminars in Interventional Radiology

Advancements in medical imaging and device technology allow minimal invasive procedures for the d... more Advancements in medical imaging and device technology allow minimal invasive procedures for the diagnosis and treatment of various disorders. For the management of tumors in head and neck region, these image-guided interventions play essential role in the often used multidisciplinary approach. Tissue sampling under ultrasound or computed tomography guidance is generally the first step to reach a pathological diagnosis. For head and neck tumors with high vascularity, embolization using particulate matter, liquid embolic agents, or coils is used to achieve successful tumor resection with minimal blood loss. Hemorrhage related to head and neck tumors can be evaluated and managed with endovascular techniques with minimal morbidity and mortality. Intra-arterial chemotherapy, radiofrequency ablation, and cryotherapy are new techniques for the management of advanced head and neck cancer which may serve as an alternative to achieve locoregional control and survival when curative resection m...

The Internet Journal of Radiology

Proximal jejunal atresia (PJA) remains a common cause of intestinal obstruction in the newborn. D... more Proximal jejunal atresia (PJA) remains a common cause of intestinal obstruction in the newborn. Despite the need for an early surgical intervention (to preempt associated morbidity and indeed occasional mortality), a timely identification is frequently precluded by the absence of specific clinical and investigative clues. Against the background of the limitations of making a timely diagnosis of PJA in a tropical setting where opportunities for high-tech imaging tools are few, we report here the diagnostic utility of the "triple bubble" sign on the plain radiograph of a Nigerian infant. As was the case in this baby, who had non-specific symptom-complex of upper alimentary tract obstruction, the radiologic finding of the "triple bubble" sign led to an early confirmation with the more invasive barium study, and ultimately a prompt surgical extirpation. In the tropical health facility with limited radiologic service and expertise, we proffer that the presence of this sign constitutes an invaluable and nearpathognomonic clue of an anatomic/surgical, rather than a "medical" cause like neonatal sepsis. The clinical clues of PJA, possible genesis of the "triple bubble" radiologic sign, and the difference(s) from the findings in other congenital causes of anatomic obstruction of the alimentary tract are highlighted briefly under the discussion.

Skull …, 2009

Objective: We present a rare case of an isolated superior orbital fissure fracture resulting from... more Objective: We present a rare case of an isolated superior orbital fissure fracture resulting from blunt injury to the face and presenting with selective cranial nerve deficits surgically treated with a neuroendoscopic approach. The anatomy of the superior orbital fissure is detailed, and the peculiarities of the surgical approach described. Method: A review of the existing literature reveals this is the first reported case of a neuronavigation-assisted endoscopic approach used in the extraction of a superior orbital fracture fragment with good outcome. Current guidelines for an endoscopic approach in orbital trauma are reviewed, and pertinent literature is discussed. Conclusion: Neuronavigation-assisted decompression should be considered as an effective means of removing superior orbital fissure fractures.

Journal of Vascular and Interventional Radiology

Journal of the National Medical Association, 2004

To derive a formula that defines the postvoid residual (PVR) urine volume more accurately in pati... more To derive a formula that defines the postvoid residual (PVR) urine volume more accurately in patients with prostatic gland enlargement. Prospective. Department of Radiology, University of Ilorin Teaching Hospital, Ilorin. Fifty-two consecutive patients with benign prostatic hyperplasia. The mean age was 64.98+/-9.57 years. PVR urine was evaluated by ultrasonography. Each patient had two examinations, the first of which was with a full bladder and the second of which was immediately after voiding. Two orthogonal diameters were measured on each bladder section (longitudinal and transverse) in the supine position. Fifty-two paired sets of ultrasonic measurements were thus obtained. Catheterized postvoid urine residue was regarded as the gold standard. Using these measurements, an equation--[PVR(CUBIC)=374.057+(-196.94+V1)+(32.5539+V1(2))+(-1.1480+V1(3)) where V1=average of the length (L), width (T), and the anteroposterior distance on transverse section (Dt) of the postvoid urinary bla...

Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria

Necrotising fasciitis is a severe life threatening bacterial infection of the fascial planes whic... more Necrotising fasciitis is a severe life threatening bacterial infection of the fascial planes which is relatively rare in the head and neck region. The hallmark of the disease is selective necrosis of the fascia overlying skin and adjacent vasculature. Primary odontogenic infection due to aerobes and obligate anaerobes and trauma amongst other factors, are frequently responsible for this condition. Similarly, affected individuals often have an underlying systemic disease, the most common of which is diabetes mellitus. Treatment usually involves appropriate antimicrobial therapy, control of systemic disease, thorough surgical debridement, gamma globulin administration and hyperbaric oxygen where facilities exist. Significant morbidity and mortality attends necrotising fasciitis when treatment is delayed due to toxaemia, dehydration and severe biochemical disturbances. Prompt diagnosis, adequate resuscitation, thorough and frequent surgical debridement remains the cornerstone to a succ...

Journal of Neuroradiology, 2014

Background and purpose: Computed tomography perfusion (CTP) is used by some stroke centers to str... more Background and purpose: Computed tomography perfusion (CTP) is used by some stroke centers to stratify stroke patients who may potentially benefit from endovascular treatment. Our aim is to identify predictors of a favorable CTP in acute ischemic stroke patients evaluated within 8 h from symptoms onset for possible endovascular treatment. Materials and methods: We reviewed records of patients who had CTP studies between August 2010 and September 2012. We included all patients with anterior circulation strokes with evidence of large vessel disease. All patients had CT head and CT angiography head and neck as part of our protocol. Favorable CTP was defined as core infarct size less than one third the middle cerebral artery distribution and penumbra > 20% of infarct size. The patients were divided into two groups based on favorable CTP or not. Baseline characteristics, time parameters, laboratory data and radiological data were compared between both groups. For statistical analysis, we used independent and Fisher's exact tests and a multivariate logistic regression model. Results: During this period, 60 patients met the inclusion criteria. Patients with favorable CTP were likely to be ≥ 80 years (33% vs 9%, P = 0.026), have Alberta Stroke Program early CT score (ASPECTS) > 7 (81% v. 21%, P ≤ 0.001) and lower mean time from symptom onset to CTP (234 ± 91 vs 305 ± 122, P = 0.015). On regression analysis, ASPECTS was the only independent predictor of a favorable CTP (OR = 16.2, CI: 4.3-62.2, P < 0.001). Conclusion: ASPECT score may be used as a tool to predict a favorable CTP. Larger studies are needed to confirm our findings.