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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...
Tag Archives: Perfusion MR
Educational Presentation: Atypical Features in PRES
Atypical PRES (PPT)
Here is another presentation that I hope our readers and visitors will find useful and enjoy. We presented this as an “exhibit” at the past meeting of ASNR. The presentation deals with atypical MRI findings in posterior reversible encephalopathy syndrome.… Continue reading >>
AJNR’s New Special Collection and Podcast Survey Brain Tumor Imaging
“Brain Tumor Imaging, Volume 1: Pretherapy” is the latest Special Collection from the American Journal of Neuroradiology. Distilling the best of the many articles related to brain tumor imaging that appear in the pages of AJNR posed a daunting task, but Editor-in-Chief Mauricio Castillo knew that Collection Editor Soonmee Cha of the University of California, San Francisco would be successful. “Dr. Cha is a respected investigator, a contributor of high quality and clinically relevant articles to AJNR and other journals, and a member of our Editorial Board,” he explained. Dr. Cha chose to categorize and present this compilation of research … Continue reading >>
Aunt Mickey (They Look the Same until You Undress Them). Meningioma or Something Else?
51 year old lady presented with headache and gait disturbances. An MRI including perfusion imaging was obtained. MRI revealed an extra-axial, dural based mass of the posterior fossa which was isointense to gray matter on T1 weighted sequence and hyperintense to gray matter on T2 weighted sequence. There was no diffusion restriction. On T2 weighted sequence, there was wedge shaped area of perilesional T2 hyperintensity extending transversely and superiorly to involve vermis. With contrast, the lesion showed intense homogenous enhancement. On perfusion study, there was considerable increase in rCBV. Preoperatively it was diagnosed as meningioma and the patient was scheduled … Continue reading >>
Aunt Mickey (They Look the Same until You Undress Them). Lhermitte-Duclos or Something Else?
A young man presented with ataxia. Brain contrast enhanced MRI was done including DWI and perfusion. T2WI showed a mixed intensity lesion in the inferior right cerebellar hemisphere which contained some “dark stripes”. DWI ADC map show restricted diffusion centrally. After contrast the lesion enhanced in a striped fashion and perfusion showed low rCBV (see below). Llermitte-Duclos disease was considered in the differential diagnosis.
Further questioning of patient disclosed that the symptoms had had a sudden onset 7 days earlier. The diagnosis of subacute infarction of the right posterior inferior cerebellar artery territory was considered as the most likely cause … 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 >>
ASL Perfusion in Cortical Dysplasia
Arterial spin labeling perfusion is becoming an important clinical tool. We find it particularly useful in children in whom it is difficult to obtain contrast enhanced MR perfusion due to the smaller size of needles used. Here is a case of a balloon cell type cortical dysplasia in the right temporoparietal region 
with low cerebral blood flow on the ASL study. I think that our Blogsite is the ideal place to share these cases with the rest of the Neuroradiology community. Similar findings to the ones shown here were reported in the following article found in the publication preview section … Continue reading >>