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Spinal Cord Herniation • 10,723 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 • 8,067 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? • 6,657 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...
Brachial Plexus MRI Protocol • 5,347 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...
Cervical Spine Nomenclature • 5,217 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...
Intracranial Hypotension: Advice on Best Treatment • 5,039 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 • 4,239 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 ...
Liver Hemangiomas and Vascular Lesions of the Brain • 4,212 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?
Aunt Mickey (They Look the Same until You Undress Them). Internal Capsule Infarct or Something Else? • 4,144 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...
More on DWI of Head and Neck Lesions • 3,979 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: June 2009
Principles of Bone Biology, 3rd ed.
Principles of Bone Biology, 3rd ed. J.P. Bilezikan, L.G. Raisz, and T.J. Martin, eds. Elsevier; 2008, 1900 pages, $429.00.
Principles of Bone Biology is an excellent single-source review of the rapidly expanding knowledge base of the biology of bone. Nearly 200 authors contributed to the 90 chapters in this book. The text is authoritative, comprehensive, scholarly, and up-to-date. The editors present us with a well-constructed and well-written narrative. The first part of the book guides the reader from the very basics of cell biology, through the biochemistry, endocrinology, and homeostatic mechanisms of bone. The succeeding parts of the book focus … Continue reading >>
Osteoporosis: Two-Volume Set, 3rd ed.
Osteoporosis: Two-Volume Set, 3rd ed.
R. Marcus, D. Feldman, D.A Nelson, and C.J. Rosen, eds. Elsevier; 2007, 2016 pages, $420.00.
Osteoporosis affects a large percentage of the elderly population. Fractures incurred by these patients have significant consequences both in human and economic terms. The disease, however, is by no means restricted to this segment of the population. Osteoporosis, a third-edition 2-volume textbook edited by Marcus et al delves deeply into the subject.
With contributions from more than 150 authors and a total of 80 chapters, the book gives a thorough overview of the subject of osteoporosis. It is organized … Continue reading >>
Other Journals
I like features in the journals that keep you up to date with other literature, like the old annotated bibliography that AJNR used to have. In that spirit, I will throw out some current literature that you might not have run across:
Occurrence of Basal ganglia germ cell tumors without a mass. Arch Neurol 2009; 66(6): 789-792. Kinda scary. BG germ cell tumors, biopsy proven, presenting with volume loss and even wallerian degeneration. Also hypometabolism on PET.
The timing and influence of MRI on the management of patients with cervical facet dislocations remains highly variable. J Spinal Disord Tech 2009; … Continue reading >>
Trigeminal Cystic Schwannomas
We present two cases of cystic lesions in the Meckel’s cave, both of which showed fluid-fluid levels on MR images and are consistent with trigeminal cystic schwannomas.
Fluid-fluid levels are the result of mucinous areas or microcysts, or as a result of necrosis and hemorrhage. The fluid is unclotted blood against serous fluid. In addition, in areas of necrosis, the fluid that fills a necrotic cavity early on tends to be more proteinaceous than newer interstitial fluid. In such cases, fluid separation, based on viscosity and protein content, may occur. When fluid levels are seen in masses arising from nerves, schwannoma … Continue reading >>
AJNR’s New Impact Factor: 2.745, A Record High!
Today, the ISI Web of Knowledge released the new Journal Citation Reports which include metrics that analyze the performance of biomedical journals. AJNR’s impact factor went up from 2.338 (last year) to 2.745 with a 5-year I.F. of 3.010. These are the highest impact factors our journal has had. They are a reflection of the high quality of our original articles, great review articles and a decreased number of case reports.… Continue reading >>
Mass in Septum Pellucidum
Does anyone know what this mass could be? It was biopsied 2 years ago and pathology reported it as “normal brain tissue”.
As you can see, the lesion is hyperintense on T2, hypointense on T1 and does not enhance. No calcifications are present and no there is no restricted diffusion .
The patient is 25 year old and has loss of short term memory and seizures.
Any input into the nature of the mass is welcome.… Continue reading >>
Editor’s and Fellows’ Journal Club Choices, June/July 2008
Editor’s Choices
Apparent Diffusion Coefficient Values of Middle Ear Cholesteatoma Differ from Abscess and Cholesteatoma Admixed Infection • S. Thiriat, S. Riehm,S. Kremer, E. Martin, and F. Veillon
Lately, we have seen several articles and comments in AJNR and on the AJNR Blog about the use of diffusion-weighted imaging for middle ear cholesteatoma. In this retrospective study, the authors further refined the use of the technique in this clinical situation. They analyzed the images of 15 patients with suspected acquired middle ear cholesteatomas and found they could be divided into 3 groups according to their apparent diffusion coefficient ranges. These … Continue reading >>
Anti-NMDA Encephalitis
7-yo African-American male with seizures. No fever.
Initial CT scan and labs: normal.
EEG: diffuse slowing over the left cerebral hemisphere.
Brain Biopsy (left temporal lobe): Focal necrosis, dystrophic calcification, chronic inflammation, and microglial activation (the latter suggested an infectious etiology, such as a virus, but no infectious agent was identified).
Two weeks after initial work-up he was found to have +NMDA receptor antibodies.
As part of the search for the etiology of these NMDA receptor antibodies, a testicular ultrasound, Beta-HC, AFP, PET were performed to r/o malignancy — all of these studies were negative. CT of chest, abdomen, and … Continue reading >>
Editor’s and Fellows’ Journal Club Choices, May 2008
Editor’s Choices
The Leptomeningeal “Ivy Sign” on Fluid-Attenuated Inversion Recovery MR Imaging in Moyamoya Disease: A Sign of Decreased Cerebral Vascular Reserve? • N. Mori, S. Mugikura, S. Higano, T. Kaneta, M. Fujimura, A. Umetsu, T. Murata, and S. Takahashi
The “ivy” sign refers to increased pial and sulcal signal intensity in patients with Moyamoya disease. We know this sign is due to collateral circulation and these authors investigated the utility of the finding by reassessing it in MR studies in 48 patients with this disease. They divided the brains into 4 different regions and correlated the presence of the … Continue reading >>
New Onset Seizure Work-Up
We recently had a debate during one of our weekly Neuro meetings on the “standard of care” for work-up of a patient with new onset seizures. As a neuroradiologist I insisted that all patients with such a history undergo an MR of the brain, and that if a CT head is done through the ER, and it is negative, the conclusion in the report should read something like “an MR of the brain should be considered for further work up of seizures.” The non-neuroradiologists in the group argued that the burden of getting an MR or not should fall upon the ordering … Continue reading >>