Dural puncture epidural steroid injection

This patient underwent perfusion imaging within 30 minutes of symptom onset.  CBF is low, yet CBV is very high.  Its is unusual to see such a big discrepancy — essentially implying that despite severely reduced inflow (CBF), the tissue is still able to not only normalize but increase its total measured volume (CBV).  It would seem that the situation is favorable. The artery was mecanically opened (Solitaire) within the next hour, less than 2 hours from symptom onset, yet final infarct was completely matched to the area of occlusion (CT scan below).  It may be that the scan was obtained early enough, when the brain was still alive, or perhaps not, but its vascular bed continued to allow for slow inflow.  Either way, some suggest that perfusion might not be as reliable when obtained very early in the ictus, as this case illustrates.

High dosages of oral corticosteroids taken daily for prolonged periods of time can have serious systemic side effects including bone loss ( osteoporosis), increased risk of infections and diabetes and cataracts, thinning of skin, stretch marks, increased facial/body hair growth, acne, fluid retention, weight gain with redistribution of fat (fat deposits on back and face, thinning of limbs), muscle weakness, decreased resistance to infections, stomach ulcers, mood swings, insomnia, suppression of the body's own production of cortisol, etc.

Dural puncture epidural steroid injection

dural puncture epidural steroid injection

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