November 2014 AJNR Tweet Chat: CSF Biomechanics and Imaging

The upcoming November AJNR Tweet Chat on CSF Biomechanics and Imaging was inspired by the review article from the current issue of the journal titled “Spinal Fluid Biomechanics and Imaging: An Update for Neuroradiologists”. Drs. Haughton and Mardal, the article’s authors, will be our guests for the chat November 11th at 2pm CST.

Dr. Haughton is an Emeritus Professor of Radiology at the University of Wisconsin and served as president of the ASNR in 2004. He has written extensively on imaging of the spine with recent emphasis on dynamic and quantitative imaging. Dr. Mardal is an Associate Professor at the … Continue reading >>

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Notable Essay in 2014

Do Not Brainstorm!” was chosen as a notable essay in 2014’s “Best American Essays” edited by John J. Sullivan and Robert Atwan.   This Perspective appeared in the July 2013 issue of AJNR.

In 2013, the AJNR Perspective “Smiles” was chosen as a notable essay in “Best American Essays” editor by Cheryl Strayed and Robert Atwan.

In 2012, the AJNR Perspective “The Evolution of the Page” was chosen as a notable essay for 2012 in “The Best American Essays” edited by David Brooks ans Robert Atwan.

I am honored that 3 of my essays … Continue reading >>

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Annotated Bibliography, Oct 2014

The following is a sampling of editorials and papers published in response to the ARUBA trial (listed as number 1 below). I can summarize the critics by noting that the nicest thing anyone said about the trial was that that the authors are to be “commended” for at least trying….followed by elaboration of multiple, and presumably fatal, study design flaws. The point, counter-point by Drs. Mohr and Amin-Hanjani is particularly interesting since it puts it into perspective from a specific patient standpoint.

1. Mohr JP, Parides MK, Stapf C, et al. Medical management with or without interventional therapy for unruptured Continue reading >>
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Should scientists care about the Kardashian Index?

Knowing of my interest in professional use of social media, especially Twitter, my friend and mentor, Dr Pratik Mukherjee, shared with me an interesting column from the Science magazine. I found it an interesting easy read. It can be thought provoking regardless of how you feel about social media use.

Jua You, a news intern at Science, has published a column on September 17th issue of Science magazine. She has looked at the Kardashian Index (K-index) for the “top 50 science stars of Twitter”. The controversial K-index was recently proposed by Genomicist Neil Hall, and is the ratio … Continue reading >>

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Neurointerventional Techniques: Tricks of the Trade

Gonzalez LF, Albuquerque FC, McDougall C. Neurointerventional Techniques: Tricks of the Trade. Thieme; 2014; 366 pp; 479 ill; $149.99

Neurointerventional Techniques  Trick of theTrade--GonzalezThis is a worthwhile book, of particular value to residents and fellows training in these techniques. It is comprehensive, covering the technical aspects of essentially all the common neuroendovascular procedures (plus kyphoplasty). It is not a textbook: there are no references and virtually no discussion of the nature the diseases or disorders that are amenable to endovascular therapy. The focus of this book is on the basic technical steps involved in each procedure. It is very well-illustrated, and most of … Continue reading >>

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Color Atlas of Neurology

Rohkamm R. Color Atlas of Neurology. 2nd Ed. Thieme; 2014; 540 pp; 191 ill; $54.99

Rohkamm_CA-Neurology_9783131309327This pocket-sized 540-page softcover book written by Dr. Rohkamm should have appeal to those (medical students, residents, and others) in the clinical neurosciences who wish to have in their possession a summary text of neurology. The nice part of the book is that it highlights key neurologic findings and beautifully shows color drawings of typical clinical correlations, anatomy, imaging, and other parameters used in diagnosis. The book is deliberately kept short so that the reader is not engulfed by excessive details but rather … Continue reading >>

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Orbital Lymphoproliferative Disorders (OLPDs): Value of MR Imaging for Differentiating Orbital Lymphoma from Benign OPLDs

Fellows’ Journal Club October 2014

(3 of 3)

After retrospectively analyzing MR images of 47 patients with proven orbital lymphoproliferative disease, the authors propose that ill-defined lesion margins suggest lymphoma whereas the presence of accompanying sinusitis and intralesional flow voids suggest benign lymphoproliferative disease. Lower ADC and contrast enhancement also suggest lymphoma.

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Abstract

BACKGROUND AND PURPOSE
Accurate discrimination of orbital lymphoma from benign orbital lymphoproliferative disorders is crucial for treatment planning. We evaluated MR imaging including DWI and contrast-enhanced MR imaging for differentiating orbital lymphoma from benign orbital lymphoproliferative disorders.

MATERIALS AND METHODS
Forty-seven histopathologically proved orbital lymphoproliferative disorders (29

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Distinguishing Imaging Features between Spinal Hyperplastic Hematopoietic Bone Marrow and Bone Metastasis

Editor’s Choice October 2014

(3 of 3)

MR, FDG-PET, and CT images from 8 patients with proven spinal findings of hyperplastic hematopoietic bone marrow were compared with those of 24 patients with spinal metastases. If a lesion was isointense to hyperintense to normal-appearing marrow on MR imaging or had a maximum standard uptake value of >3.6, the lesion was metastatic. A normal appearance on CT or bone scintigraphy excluded metastasis.

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Abstract

BACKGROUND AND PURPOSE
Systematic investigations of the distinguishing imaging features between spinal hyperplastic hematopoietic bone marrow and bone metastasis have not been reported, to our knowledge. The purpose of

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Enhancing Brain Lesions after Endovascular Treatment of Aneurysms

Fellows’ Journal Club October 2014

(2 of 3)

These authors present MR images in 7 patients who developed enhancing lesions after endovascular therapy for intracranial aneurysms, 3 of which were symptomatic. The number of lesions increased in 2, was stable in 1, decreased in 3, and disappeared in 1 patient. The authorsput forward that the imaging and clinical characteristics suggested a foreign body reaction. They found no correlation to a specific device, but a possible source may be the generic hydrophilic coating.

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Summary

Complications of endovascular therapy of aneurysms mainly include aneurysm rupture and thromboembolic events. The widespread use of … Continue reading >>

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MR Myelography for Identification of Spinal CSF Leak in Spontaneous Intracranial Hypotension

Editor’s Choice October 2014

(2 of 3)

Twenty-four patients with intracranial hypotension received CT myelography as well asintrathecal gadolinium MR myelography. Comparisons demonstrated a higher rate of leak detection with intrathecal gadolinium MR myelography. Although intrathecal gadolinium is an FDA off-label use, all patients tolerated the medication without evidence of complications.

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Abstract

BACKGROUND AND PURPOSE
CT myelography has historically been the test of choice for localization of CSF fistula in patients with spontaneous intracranial hypotension. This study evaluates the additional benefits of intrathecal gadolinium MR myelography in the detection of CSF leak.

MATERIALS AND METHODS
We performed a retrospective review

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Calvarial Fracture Patterns on CT Imaging Predict Risk of a Delayed Epidural Hematoma following Decompressive Craniectomy for Traumatic Brain Injury

Fellows’ Journal Club October 2014

(1 of 3)

The authors assessed patterns of skull fractures that could play a role in the development of delayed epidural hematoma. All patients who developed a delayed epidural hematoma had a contralateral calvarial fracture on preoperative CT. The contralateral calvarial fracture had perfect sensitivity (100%) for subsequent development of delayed epidural hematoma and a contralateral calvarial fracture involving 2 or more bone plates was particularly significant.

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Abstract

BACKGROUND AND PURPOSE
The development of a delayed epidural hematoma as a result of decompressive craniectomy represents an urgent and potentially lethal complication in traumatic brain injury.

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Mechanical Embolectomy for Acute Ischemic Stroke in the Anterior Cerebral Circulation: The Gothenburg Experience during 2000–2011

Editor’s Choice October 2014

(1 of 3)

Safety and efficacy of intra-arterial treatment using the AmplatzGooseNeck device in acute anterior circulation strokes were assessed in 156 patients. High recanalization rates were obtained with the AmplatzGooseNeck snare without any device-related complications. Favorable outcome, mortality, and symptomatic intracerebral hemorrhage were comparable with results of newer embolectomy devices.

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Abstract

BACKGROUND AND PURPOSE
Intra-arterial treatment of proximal occlusions in the cerebral circulation have become an important tool in the management of acute ischemic stroke. Our goal was to evaluate the safety and efficacy of intra-arterial acute ischemic stroke treatment performed in our institution in

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The Aging Brain: Do Acute Infarcts Cause White Matter Disease? [Video]

White matter disease (leukoaraiosis) was long considered a normal occurrence in the aging process. Recent studies, however, have associated leukoaraiosis with dementia and disability, though how and why it develops is still unknown.

The authors of a recent paper, funded by an ASNR Scholar Award and published in Annals of Neurology, have posited one possible etiology: tiny, subclinical strokes. To investigate the relationship between acute infarct and white matter disease, the authors performed a prospective observational study, recruiting 5 subjects over a 12-month period; all subjects were older than 55 years, had had both a brain MRI within 6 months … Continue reading >>

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