Purpose Computerized tomographic (CT) examination of patients presenting with atypical or severe headache has been essential until the last couple of years in order to rule out subarachnoid hemorrhage (SAH). However, there are studies suggesting that recently developed magnetic resonance imaging (MRI) sequences can provide more detailed information about hemorrhage and calcification compared to CT. In this study, we included SWI (Susceptibility Weighted Imaging) sequences in imaging protocol of patients in whom MRI examination was thought to be essential after presenting with acute headache. Our purpose was to determine if there is asymmetric increased signal intensity in hemispheric cortical venous network, in other words venous engorgement, in patients presenting with acute headache. Material and method 27 cases, who were admitted to the emergency department due to headache within the last one year and subsequently diagnosed with migraine, 23 cases, who were diagnosed with non-migraine headache (sinusitis, non-specific) and 19 healthy subjects were included in this study. Standard sequences of the cases were evaluated by a single reader in different time periods and hemispheric cortical venous signal intensities were compared that were defined subjectively as right or left dominant or symmetric. Results No statistically significant difference was found between the three different reading findings. When the average of three measurements are taken into consideration, venous system of both hemispheres in migraine group was symmetric in 19.75% of the cases whereas there was right hemispheric venous engorgement in 44.45% and left hemispheric venous engorgement in 35.80% of the cases. The measured values in non-migraine headache group were 85.50%, 13.00% and 1.50%; and in the control group without headache the measured values were 75.50%, 3.50% and 21.00%, respectively. Conclusion Compared to the control group and non-migraine headache group, there was increased signal intensity in hemispheric cortical venous network that was interpreted as right or left-sided asymmetric venous engorgement in patients who underwent emergency cranial MRI due to headache and in whom clinical findings were consistent with the migraine headache. It seems currently feasible to estimate the type of headache with the addition of this sequence into the imaging protocol of patients presenting with acute headache.

Purpose When performing chest radiography, a decision needs to be taken on all thoracic bone-tissue and bronchovascular markers by examining a two dimensional plane. The aim of this study was to investigate whether topogram-based assessment is equivalent to digital radiography. If so, it may be possible to continue to the exam by ultra low dose computed tomography (CT) or finish it. May the direct radiography would still be necessary if so... Materials and Methods 100 cases were included in this study. Digital antero-posterior chest radiographies and thoracic CT images (meadiastinal and parenchymal windows) taken using ultra low dose, two-tube CT scan were available for the cases. These diagnosis of the cases was based on epicrisis. The diagnosis and CT scans were considered gold standard and chest radiographies and CT topogram findings were evaluated by two independent radiology experts. For benign (hematoma, fibrous nodule and calcified nodule) and metastatic nodules, lesions with a diameter smaller and greater than 1 cm were evaluated separately. For both tests, the radiographs and CT topograms were labeled as positive (p) and negative (n) depending on the presence and absence, respectively, of the pathological abnormality. Statistical analysis was undertaken accordingly. Results While topogram findings were superior in cases of bronchiectasis, for benign and malignant nodules larger than 1 cm and for malignant nodules smaller than 1 cm, both topogram and digital chest radiography detected lesions with similar efficiency. Neither of the two methods detected ground glass opacities. For all other pathologies, information obtained via digital chest radiography was significantly superior to that obtained via topogram. Conclusion For the advanced evaluation of pulmonary pathologies, despite the fact that CT technologies are well developed, digital radiographies taken prior to topogram are not unnecessary and will possibly be used forever. While they provide similar images, for most of the important pulmonary or thoracic pathologies except bronchiectasis, digital chest radiography provides information similar or more frequently superior to topogram.

Background/Aims Relapse of Helicobacter pylori (Hp) infection is a serious problem in high prevalent regions. We aimed to determine the relapse rate of Hp infection in patients with symptoms renewing after successful eradication. Methods Successfully treated patients with first line [proton pump inhibitors (PPI)+amoxicillin+clarithromycin] or second line (PPI+Bismuth compound+metronidazole+ tetracycline) eradication regimens were enrolled into this study between 2006-2010 years. All patients received eradication 14 days and successful eradication confirmed by C-14 breath test. Patients with symptoms renewing during the follow-up period were evaluated for relapse of Hp infection by gastroscopy, histological examination and C-14 breath test. Results: Hp positive 1642 patients were treated by first and second line eradication therapy. Successful eradication rate was 89%. During the follow-up period 238/1642 patients (14.5%) of these were admitted to out-patient clinics complaining with dyspepsia and Hp infection was detected by gastroscopy/histology and breath test. Relapse rate was statistically high in third year (62%, 60%) after the treatment as comparing with first (10%, 8%) and second year (16%, 14%) (p<0.05) gastroscopy/histology and breath test control, respectively. Conclusions: Hp relapse rate was significantly higher in third year of eradication in patients with symptoms renewing.

Purpose Kimura’s disease is a rare, benign and chronic disease of unknown etiology. This pathology has 6-fold higher prevalence in males and has been initially referred to as "eosinophilic hyperplastic lymphogranuloma"; it is manifested by inflammatory thickening of subcutaneous tissue in the head and neck. In this case report, we aimed to share imaging findings of a patient with orbital involvement. Materıal and Method The patient presented with swelling of the left upper eyelid and mild pain; the patient underwent orbital MRI with contrast enhancement and biopsy was performed. She (49-year-old, female) was re-admitted 7 months later due to similar swelling in the right eye and pain; and then underwent orbital MRI and assessments were carried out on these images. Results The patient's white blood cell count was moderately high and, in contrast to the literature, eosinophil count was not markedly elevated. However, physical examination did not reveal any abnormality excluding mild pain which is in line with the literature. On the other hand, initial and control MR images have revealed inflammation of fat tissue and contrast uptake in the left anterosuperior preseptal area and in the right retroortibal space, respectively. Cross-sectional studies were consistent with orbital pseudotumor whereas extraocular muscle groups surrounded by extensive inflammatory fatty tissue were not affected and they were of normal calibration and signal intensity. Pathologic examination performed after the first admission of the patient was consistent with Kimura's disease by the appearance of vascular proliferation with eosinophylic infiltration. Conclusion In this case report of a patient who was diagnosed with Kimura's disease that represents atypical clinical and radiological characteristics, we present rare features which, however, may raise the suspicion of this disease.

Carotid blow-out syndrome (CBS) is a life-threatening condition characterized by the rupture of the carotid artery, which presents one of the most urgent situations in interventional neuroradiology. Since patients can bleed to death in minutes, prompt and adequate treatment is of great importance. Self-expanding covered stents are used in most of the reported cases and they are generally preferred to balloon-expanding stents; especially if the underlying pathology is a head and neck malignancy. Herein, we present our experience with a case of CBS caused by radiation necrosis, which was treated successfully with a balloon-expanding covered stent.

Kawasaki disease is the leading cause of acquired heart disease in childhood. Gallbladder hydrops is an uncommon manifestation of this disease, found rarely in infants. We report the case of Kawasaki disease in a 9-month-old boy with cardiac involvement and abdominal distention related to gallbladder hydrops which was diagnosed by ultrasonography and resolved spontaneously during follow-up.