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Spontaneous Intracranial Hypotension: MRI Findings, Brain Sagging, and CSF Leak Treatment

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  Edited by ScholarGen MediAI Team Executive Answer Spontaneous intracranial hypotension (SIH) is a potentially treatable cause of secondary headache, most commonly associated with spinal cerebrospinal fluid (CSF) leakage or a CSF-venous fistula. The key clinical clue is an orthostatic headache that worsens when upright and improves when lying down. On contrast-enhanced brain MRI, the combination of diffuse pachymeningeal enhancement, venous sinus engorgement, pituitary enlargement, subdural collections, and brain sagging strongly supports the diagnosis. Recognizing this pattern matters because brain MRI may reveal the consequences of CSF volume loss without identifying the actual leak. Spinal imaging and, when indicated, specialized myelography help guide definitive treatment. Why This Case Matters A woman in her early 40s presented with three weeks of orthostatic headache and dizziness. Brain MRI demonstrated diffuse pachymeningeal enhancement, bilateral subdural collections, a l...
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When Chest CT Reveals a Forgotten Tuberculosis Surgery: Plombage, Pseudomonas Pneumonia, and the Limits of Radiology AI

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How Historical Lucite Ball Plombage Complicates Chest Imaging Interpretation, Infectious Disease Assessment, and AI-Assisted Radiology MediAI | Clinical Radiology Case Study · Thoracic Imaging · Diagnostic Risk · Healthcare AI Author: Ph. D. GJ Lee Executive Answer Multiple spherical structures clustered in the upper hemithorax of an elderly patient may represent extrapleural plombage , an obsolete surgical treatment for pulmonary tuberculosis. Polymethyl methacrylate (PMMA), also known as Lucite, was historically implanted into the extrapleural space to compress diseased lung tissue. This case involves a man in his 80s with remote tuberculosis treated by Lucite ball plombage who subsequently developed severe pneumonia, recurrent septic shock, and fatal Pseudomonas aeruginosa infection. The central diagnostic challenge is recognizing historical surgical material while independently evaluating acute pulmonary infection. For contemporary radiology, the case also exposes an important lim...
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PSMA PET/CT–Avid Liver Lesions in Prostate Cancer: How to Recognize Hepatic Hemangiomas and Avoid False-Positive Metastatic Staging

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  A Case-Based Review of Imaging Findings, Differential Diagnosis, Clinical Consequences, and AI-Assisted Interpretation A focal liver lesion with increased prostate-specific membrane antigen (PSMA) uptake in a patient with prostate cancer raises concern for metastatic disease. However, PSMA uptake is not synonymous with malignancy. Hepatic hemangiomas, benign vascular lesions, can demonstrate increased uptake and mimic liver metastases on PSMA positron emission tomography/computed tomography (PET/CT). The key diagnostic principle is to correlate tracer uptake with CT morphology, contrast-enhancement patterns, clinical risk, and, when necessary, liver magnetic resonance imaging (MRI). In this case, two PSMA-avid liver lesions in a man in his 60s undergoing prostate cancer staging were ultimately diagnosed as benign hemangiomas in an external pathology report. Recognizing this pitfall can prevent incorrect upstaging and unnecessary investigations or treatment. Why This Case Matters ...
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