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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: July 2009
Meningiomas: Diagnosis, Treatment, and Outcome
J.H. Lee, ed. Springer; 2008, 639 pages, 631 illustrations, $239.00.
Meningiomas: Diagnosis, Treatment, and Outcome is an expansive textbook, written by a neurosurgeon and primarily for neurosurgeons. Dr. Lee has operated on more than 600 meningiomas but has pulled together a team of authors to join him in this book. Meningioma, as the most common extra-axial neoplasm, warrants such an extensive treatise, with 64 chapters, 631 figures (160 in color), and 639 pages. Despite the focus on primary treatment with surgery, radiotherapy and ancillary chemotherapy are also discussed, albeit in lesser detail. There is much here for the neuroradiologist to … Continue reading >>
EXPERT ddx Head and Neck
H.R. Harnsberger, C.M. Glastonbury, M.A. Michel, B.L. Koch, C.D. Phillips, K. Mosier, P. Hudgins, R. Wiggins, H.C. Davidson and J. Curé. Amirsys; 2009, 800 pages, 2500 illustrations, $329.00.
In a variation on the highly popular Diagnostic Imaging: Head and Neck by Dr Harnsberger, which was written to describe and illustrate specific diseases with their differential diagnoses, this book, Expert ddx: Head and Neck, takes a different but probably more meaningful and useful approach to daily imaging and reporting. Here specific findings on MR imaging and CT are separated into groups or sections, within which the reader is presented with … Continue reading >>
Pediatric Radiology: The Requisites
J.G. Blickman, B.R. Parker, and P.D. Barnes, eds. Mosby Elsevier; 2009, 358 pages, $102.00.
In keeping with other volumes in the Requisites in Radiology series, this 358-page book, Pediatric Radiology: The Requisites, covers the major imaging issues in pediatric radiology. There are 7 authors/contributors and 9 substantive chapters: “Chest,” “Heart,” “Gastrointestinal Tract,” “Accessory Organs of Digestion,” “Genitourinary Tract,” “Skeletal System,” “Brain Imaging,” “Spine Imaging,” and “Head and Neck Imaging.” Therefore, the last 3 chapters (written by Dr Barnes), numbering 133 pages, are related to neuroradiology and are the most complete area of the book, comprising nearly 40% of its … Continue reading >>
Emergency Radiology: The Requisites and Emergency Radiology: Case Review Series
J.A. Soto and B. Lucey. Emergency Radiology: The Requisites. Mosby Elsevier; 2009, 397 pages, $102.00; and S.E. Mirvis,
K. Shanmuganathan, L.A. Miller, and C.W. Sliker. Emergency Radiology: Case Review Series. Mosby Elsevier; 2009, 432 pages, $52.95.
With the increased use of emergency departments (EDs) by patients with medical problems, whether their conditions are emergent or not, and with the need for specialized surgical care in cases of acute trauma, the ED radiologist now becomes the epicenter of patient triaging and diagnosis. When this reality is combined with the burgeoning of ED studies, particularly total body imaging with CT, it is … Continue reading >>
PET in the Evaluation of Alzheimer Disease and Related Disorders
D.H.S. Silverman, ed. Springer; 2009, 215 pages, 75 illustrations, $149.00.
As editor of the book PET in the Evaluation of Alzheimer Disease and Related Disorders, Dr. Silverman and other contributors discuss the role of positronemission tomography (PET) in the evaluation of dementia and related disorders. Dr. Silverman recognizes that although the differential diagnosis for the causes of cognitive impairment is wide and difficult to distinguish clinically, options have expanded with respect to the diagnostic and therapeutic tools available.
In chapter 1, the limitations of the clinical examination and role of structural and functional imaging in the workup of patients … Continue reading >>
Aunt Mickey (They Look the Same until You Undress Them). Internal Capsule Infarct or Something Else?
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 of the left internal capsule. ADC maps showed corresponding low ADC values. MR angiography, echocardiography, and lower extremity venous ultrasound were all normal.
Seven months later the patient re-presented to the ED with persistent waxing and waning hemiparesis, peripheral loss of sensation, and worsening ataxia. MRI at this admission demonstrated resolution of diffusion abnormalities in the left internal capsule but new right hemispheric lesions. The more inferior lesion was associated with … Continue reading >>
Crossed Cerebellar Diaschisis
A 41-year-old female with history of migraine presented to the ED with acute onset of aphasia. In addition to the aphasia, there was numbness and tingling in the right arm and face. Patient demonstrated expressive aphasia and was not able to answer questions posed in the ED. Gadolinium MR perfusion images demonstrated decreased relative cerebral blood flow (top) in the left parietal/occipital lobes and increased time-to-peak (bottom) in the contralateral cerebellar hemisphere. Although crossed cerebellar diaschisis (CCD) is seen mostly on radiotracer studies (hypometabolism on PET studies), it was nicely demonstrated in our patient. CCD occurs more often after supratentorial … Continue reading >>
Neonatal Pituitary Gland
This is a one month-old female with congenital hypothyroidism, hypoplasia of the thyroid gland, elevated TSH (eight times normal value), elevated FSH and LH (four times normal values), normal GH, without diabetes insipid. She is now being treated for the hypothyroidism, and we are waiting for hormonal follow-up; MRI follow-up in three to six month follow-up.
Has anyone an explanation for the focal bright spot on T1-weighted images in the cranial portion of the pituitary stalk, just down the median eminence, in the presence of a normal neurohypophysis?
Is it an “ectopic” adenohypophysis?
Is this a thin pituitary stalk in … Continue reading >>
CT Still Useful for Retinoblastoma?
The article “Is CT Still Useful in the Study Protocol of Retinoblastoma?“, published July 17 in the Publication Preview section of AJNR, confirms that even when high-field MRI is not available, CT can be avoided in the workup of the patient with suspected retinoblastoma, when MRI is combined with a good ophthalmoscopic exam and ocular sonography. Certainly with 3D imaging at 3T, the detection rate with MRI could reasonably be expected to be even higher, allowing us to “Image Gently” and more accurately.
The authors state that “CT is still the method of choice for detecting intraocular calcium … Continue reading >>
Exercise and Healthy Brains
In reading the newly e published article in the AJNR “The Effect of Exercise on the Cerebral Vasculature of Healthy Aged Subjects as Visualized by MR Angiography” ( Posted on July 9th), there is positive feedback for those who exercise regularly. But does good plumbing (i.e. the cerebral vasculature), equate with successful aging? Since there have been suggestions that ongoing mental challenges such as solving math problems or completing Sudoku puzzles might be of significant benefit in combating age related mental decline, does anyone think that redirecting a portion of a one hour of physical exercise to mental … Continue reading >>