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Spinal Cord Herniation • 10,146 views
This is a case for Prof. Dr. Dillon. It is in press by our neurosurgeons and us, for the use of Duragen. Idiopathic herniation of the thoracic spinal cord: a case report and technique note. U...
Neuro Protocols • 7,715 views
Alisa Gean is doing a great job getting a group together to share and collaborate neuro protocols. This would be a great place from members to share protocols, and open a discussion about the best ima...
Possible SIH with Spinal Subdural Hygroma, What Next? • 6,341 views
[caption id="attachment_602" align="aligncenter" width="407" caption="Sag T1. Tonsils are not particularly low and no sagging of the base of the brain."][/caption] [caption id="attachment_603" alig...
Cervical Spine Nomenclature • 5,060 views
The ASNR/ASSR nomenclature document was specific for the lumbar spine. I would be interested in your opinion on the correct terminology for cervical spondylosis: what terms and why. Specifically, t...
Brachial Plexus MRI Protocol • 4,646 views
BP MRI Protocol Fall is upon us and so is the lecturing season! Like years before, this Fall I will be giving my brachial plexus lecture several times and the most commonly asked question by the au...
Intracranial Hypotension: Advice on Best Treatment • 4,485 views
Middle age female patient diagnosed with Spontaneous intracranial hypotension. Has multiple (approx 23) perineural cysts. Has undergone several blood patches and artificial CSF infusions without rel...
Embolization of Brain Arteriovenous Malformations for Cure • 4,180 views
The editorial comment in the AJNR of Jan 09 by Jayaraman and Cloft is worthy of careful scrutiny, I believe. Although in my personal experience with Onyx and NBCA, final cure rates of brain AVMs from ...
Aunt Mickey (They Look the Same until You Undress Them). Internal Capsule Infarct or Something Else? • 3,892 views
This 30 year old hypertensive female smoker presented with acute onset of right hemiparesis. Her history also included OCP use and dyslipidemia. MRI demonstrated an acute infarct in the posterior limb...
Liver Hemangiomas and Vascular Lesions of the Brain • 3,871 views
[gallery] I have a patient with 15 large liver hemangiomas and two partly calcified lesions in brain. Does anyone know of associated liver hemangiomas and vascular lesions in the brain?
More on DWI of Head and Neck Lesions • 3,870 views
Yesterday I wrote a short comment in the utility of DWI in the evaluation of head and neck lesions. While reading cases in the afternoon I came across a new patient with a retinoblastoma. This pa...
Monthly Archives: March 2009
Search for CNS’s Drug-Induced Changes
I’m very interested in different cases of CNS changes induced by any kind of recreational drug. Please, If you are also interested, contact me.… Continue reading >>
Willinsky RA et al, Clinical and Endovascular Follow-Up of Embolized Aneurysms
A recent article published by Dr Robert Willinsky and colleagues from Toronto is noteworthy and an excellent addition to the literature on the subject of endovascular treatment of ruptured aneurysms. This is one of the largest series on this subject and addresses, amongst other things, the important issue of rebleeding after endovascular repair.
In this large series, the rehemorrhage rate after embolization was 2.1%. The risk of rebleeding was 1.6% in the first 30 days, decreasing to 0.7% after this time. The authors use a protocol of imaging the ruptured aneurysms with enhanced MRA at the time of discharge, followed … Continue reading >>
Liver Hemangiomas and Vascular Lesions of the Brain
I have a patient with 15 large liver hemangiomas and two partly calcified lesions in brain.
Does anyone know of associated liver hemangiomas and vascular lesions in the brain?… Continue reading >>
ADC Question
I will like to know if someone can help me with some doubts I have regarding ADCs.
1. I have a sample with some ADC values obtained in 1,5 T and others obtained in 3T ( same b value). Can I use the ADC values for statistics or do you think that they cannot be compared?
2. Are the ADC values obtained using a diffusion sequence the same that the ADC values obtained in a DTI sequence with 12 directions?
Thank you in advance.… Continue reading >>
MIT Goes Open Access
In one of my previous editorials I commented on Harvard’s open access (OA) initiative (AJNR 2008; 29: 617-18). Basically, regardless of publication venue, all investigators working for that institution have to deposit a copy of their articles in a free and unrestricted site. This means that Harvard researchers, even if they have signed AJNR’s copyright agreement make their works OA through that site. For many years, this formula has been required for employees of the Military and government agencies. We at AJNR understand these policies and have adapted our copyright for those requesting it and even release ownership of articles … Continue reading >>
Midbrain Hamartoma
We have an interesting case of a 30 year old female who had an MRI study for right sensory neural hearing loss. Incidentally found on her scan was a 1.2 cm lesion in the region of the left subthalamic nucleus extending to the cerebral peduncle with mild expansion which appears isointense to gray matter on all sequences with no evidence of enhancement. Single voxel spectroscopy showed elevation of myoinositol. No decreased NAA and no increased choline. A one year follow up MRI showed no changes in size of the lesion. This lesion is felt to represent a hamartoma; however, most … Continue reading >>
Intracranial Hypotension: Advice on Best Treatment
Middle age female patient diagnosed with Spontaneous intracranial hypotension. Has multiple (approx 23) perineural cysts. Has undergone several blood patches and artificial CSF infusions without relief. Does anyone have any thoughts on other therapies, new techniques, experts in field. Appreciate the input.… Continue reading >>
Editor’s and Fellows’ Journal Club Choices, March 2009
Editor’s Choices
Differentiating between true neoplasms and lesions that look like neoplasms is difficult with conventional imaging methods. In this study, the authors investigated the clinical utility of MR spectroscopy in this setting. They examined 68 glial brain tumors and 16 pseudotumoral lesions (mostly demyelinating and infarctions). On short echo-time MR spectroscopy, pseudotumors showed higher myo-inositol than tumors, and on long echo-time MRS, tumors … Continue reading >>
Another One Bites the Dust: JCI Says Goodbye to Open Access
One of my previous editorials (AJNR 2008; 29: 1805) dealt with the issue of open access (OA) and its influence on medical journals. Although complete OA is laudable, it is a difficult economic model to sustain. The BMJ was one of the major first OA journals and also one of the first to return to a subscriber fee model. In 1996, the Journal of Clinical Investigation became OA and starting this year it returned to a subscriber model (http://scholarlykitchen.sspnet.org/2009/02/26/end-of-free-access/). Both, BMJ and JCI are prestigious, widely cited journals initially perceived as ideal models for OA. Moreover, JCI charges authors for … Continue reading >>
Thyroid Nodules and Diffusion
This month (Feb. 2009), there is an article in AJNR regarding differentiating cold thryoid nodules as benign vs. malignat on DWI. link: http://www.ajnr.org/cgi/content/full/30/2/417. A similar article by Bozgeyik et al (abstract below) appeared in the March 2009 issue of ‘Neuroradiology’ (see below). The current article in AJNR reports that malignant thyroid nodules demonstrated increased ADC values compared with benign ones, whereas the article in Neuroradiology reports lower ADC maps for malignancy. Similarly the article by Razek et al in March, 2008 AJNR (link: http://www.ajnr.org/cgi/content/full/29/3/563) reported lower ADCs for malignant nodules.
Does anyone have any thoughts on possible reasons … Continue reading >>