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Section: Neuroradiology

 




Other Radiology articles from the Neuroradiology section Neuroradiology

"Mixed" trauma to the carotid artery in a mixed martial arts injury - A case report and review of the literature by Shane M Crilly et al.

Published: 2018 May
Issue: 12(5) :: Pages: 1-11


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Abstract: We present the case of a mixed martial arts (MMA) cage fighter who presented to the emergency department with a right sided common carotid artery pseudoaneurysm as a result of a neck trauma at an MMA event. We discuss the management of blunt force neck trauma, differential diagnosis, imaging findings and review the literature on blunt cerebrovascular injury following blunt force injury to the neck.


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Conventional Radiography, Computed Tomography, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Pneumorrhachis after Recreational Drug Use by Bilal A Sethi et al.

Published: 2018 Apr
Issue: 12(4) :: Pages: 1-5


Free full text article: Pneumorrhachis after Recreational Drug Use

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Abstract: Pneumorrhachis, the presence of air in the spinal canal, is an unusual and alarming radiographic finding. The etiology is most commonly traumatic or iatrogenic but it can occur as a spontaneous phenomenon in association with pneumomediastinum. We report the case of a 16 year old male who presented with throat discomfort and a feeling of altered voice after recreational drug use. Examination confirmed widespread subcutaneous emphysema above the clavicles and plain radiograph and computed tomography imaging confirmed the presence of extensive pneumomediastinum and pneumorrhachis. The patient was managed conservatively and made a full recovery. The clinical and imaging features of spontaneous pneumorrhachis are presented as well as a review of the literature with regard to pathogenesis, management and outcome. Knowledge and understanding of this unusual phenomenon is important to properly direct patient care.


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Conventional Radiography, Computed Tomography, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Clival chordoma with drop metastases by Faimee Erwan Muhamat Nor et al.

Published: 2018 Mar
Issue: 12(3) :: Pages: 1-9


Free full text article: Clival chordoma with drop metastases

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Abstract: Chordoma is a rare midline malignant tumor arising from embryonic remnants of the primitive notochord. The base of the skull is the second most common site of disease after the sacrococcygeal region. Intracranial chordoma constitutes about 30-35% of chordoma cases. Metastasis from chordoma is uncommon but if occurs, it tends to spread to the lungs. Cerebrospinal fluid seeding or drop metastasis is very rare. Here we describe a case of a clival chordoma with drop metastases.


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Magnetic Resonance Imaging, Computed Tomography, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Optic Nerve Sheath Dural Arteriovenous Fistula Misdiagnosed As A Carotid Cavernous Fistula by Elena Downs

Published: 2018 Feb
Issue: 12(2) :: Pages: 1-10


Free full text article: Optic Nerve Sheath Dural Arteriovenous Fistula Misdiagnosed As A Carotid Cavernous Fistula

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Abstract: Dural arteriovenous fistulas (dAVf) are uncommon, acquired vascular lesions. Their location and vascular anatomy produces varied signs and symptoms and are misdiagnosed as other vascular anomalies. We present an atypical case of a dAVf identified along the left optic nerve sheath. The patient presented with progressive ophthalmological signs and was initially misdiagnosed with a left carotid-cavernous fistula. The aetiology, classification and treatment options are discussed.


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Clinical image, Angiography, Interventional, Computed Tomography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Skull base and craniocervical bone pneumatisation: two case reports of differing presentations and a review of the literature by Olivia Francies et al.

Published: 2017 Nov
Issue: 11(11) :: Pages: 1-10


Free full text article: Skull base and craniocervical bone pneumatisation: two case reports of differing presentations and a review of the literature

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Abstract: We report two patients with increased central skull base and craniocervical junction bone pneumatisation complicated by extra-osseous gas. One patient presented with symptoms of increasing nasal blockage and `sinus pressure` on a background of extensive nasal polyposis. He was subsequently found to have a history of repeated Valsalva`s manoeuvre, the cessation of which resulted in a rapid decrease in the amount of extra-osseous gas on imaging. The second patient presented following a minor head trauma with dysarthria from a hypoglossal nerve palsy and neck pain, with extensive intra- and extra-cranial gas including within the spinal canal (pneumorrhachis). These radiological findings have been reported previously in patients with Eustachian tube dysfunction and/or activities leading to frequently raised middle ear pressures. We review the possible aetiologies, reported risk factors, and the range of associated imaging abnormalities that may be encountered with this rare appearance.


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Computed Tomography, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Primary extradural paraganglioma of the thoracic spine: A case report by Alexander Reddy et al.

Published: 2017 Dec
Issue: 11(12) :: Pages: 1-7


Free full text article: Primary extradural paraganglioma  of the thoracic spine: A case report

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Abstract: Paragangliomas are rare, mostly benign neuroendocrine tumors arising from autonomic paraganglia. Spinal paragangliomas are uncommon, and among these, paragangliomas of the thoracic spine are distinctly unusual. We present the case of a primary paraganglioma of the extradural thoracic spine in a 34-year-old woman.


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Magnetic Resonance Imaging, Nuclear Medicine, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Crossed Aphasia in a Patient with Anaplastic Astrocytoma of the Non-Dominant Hemisphere by Stephanie Prater et al.

Published: 2017 Sep
Issue: 11(9) :: Pages: 1-9


Free full text article: Crossed Aphasia in a Patient with Anaplastic Astrocytoma of the Non-Dominant Hemisphere

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Abstract: Aphasia describes a spectrum of speech impairments due to damage in the language centers of the brain. Insult to the inferior frontal gyrus of the dominant cerebral hemisphere results in Broca`s aphasia - the inability to produce fluent speech. The left cerebral hemisphere has historically been considered the dominant side, a characteristic long presumed to be related to a person`s "handedness". However, recent studies utilizing fMRI have shown that right hemispheric dominance occurs more frequently than previously proposed and despite a person`s handedness. Here we present a case of a right-handed patient with Broca`s aphasia caused by a right-sided brain tumor. This is significant not only because the occurrence of aphasia in right-handed-individuals with right hemispheric brain damage (so-called "crossed aphasia") is unusual but also because such findings support dissociation between hemispheric linguistic dominance and handedness.


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Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Vascular Eagle`s Syndrome: Two Cases Illustrating Distinct Mechanisms of Cerebral Ischemia by Abdulrahman Aldakkan et al.

Published: 2017 Aug
Issue: 11(8) :: Pages: 1-7


Free full text article: Vascular Eagle`s Syndrome: Two Cases Illustrating Distinct Mechanisms of Cerebral Ischemia

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Abstract: We report two cases of Vascular Eagle`s Syndrome, which demonstrate two distinct mechanisms of cerebral ischemia. In the first case, hemodynamic transient cerebral ischemia arose as a direct result of compression of the internal carotid artery (ICA). In the second, embolic large left middle cerebral artery (MCA) infarction as a result of a thrombus from a pseudoaneurysmal dilatation of the left ICA.


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Computed Tomography, Angiography, Interventional, Magnetic Resonance Imaging, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

A Case Report of Mikulicz Syndrome by Dinesh Rao et al.

Published: 2017 Jul
Issue: 11(7) :: Pages: 1-7


Free full text article: A Case Report of Mikulicz Syndrome

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Abstract: Mikulicz Syndrome (MS) is a rare chronic condition characterized by the abnormal enlargement of glandular tissue in the head and neck. Patients usually present with enlarged lacrimal and parotid glands. While this can be a benign self-limiting condition, other complex systemic diseases, such as sarcoidosis, may represent other underlying etiologies. We present a case of MS in a patient with a history of Crohn`s disease.


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Clinical image, Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Calcification of the epiglottis presenting as foreign body sensation in the neck by Sunil Jeph et al.

Published: 2017 Jun
Issue: 11(6) :: Pages: 1-5


Free full text article: Calcification of the epiglottis presenting as foreign body sensation in the neck

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Abstract: The epiglottis plays an important role in preventing food of different consistencies from entering the airway during swallowing. Calcification of epiglottis can, potentially, alter and limit its movement causing aspiration amongst other swallowing problems. Isolated calcification of the epiglottis and its clinical presentation remains a poorly understood entity for radiologists as well as clinicians. Therefore, it is important to recognize the imaging features of epiglottic calcification, and it`s known clinical presentations to help clinicians with early diagnosis and management.


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Computed Tomography, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Sporadic Hemangioblastoma Arising from the Infundibulum by Michael N Pakdaman et al.

Published: 2017 May
Issue: 11(5) :: Pages: 1-6


Free full text article: Sporadic Hemangioblastoma  Arising from the Infundibulum

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Abstract: Hemangioblastomas are rare vascular tumors most often found in the posterior fossa and cervical spinal cord and commonly associated with von Hippel-Lindau Disease. We report a case of sporadic hemangioblastoma in a patient without von Hippel-Lindau Disease. Imaging characteristics included a solid, suprasellar mass that was homogeneously enhancing. These findings most resembled a pituicytoma or choroid glioma because of the close association with the infundibulum and the homogeneous avid enhancement. Microscopically, the neoplasm was seen to be composed of vascular channels associated with foamy stromal cells, containing clear cytoplasmic vacuoles. Microscopic and immunohistochemical findings were consistent with hemangioblastoma. Hemangioblastomas are a rare form of vascular tumor most commonly associated with von-Hippel Lindau disease. Our finding of non-cystic hemangioblastoma arising from the infundibulum demonstrates that, while rare, hemangioblastomas should be considered on the differential diagnosis for an avidly enhancing suprasellar mass.


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Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Bilateral persistent primitive hypoglossal arteries associated with unilateral symptomatic carotid thromboembolism by Riddhi Patira et al.

Published: 2017 Apr
Issue: 11(4) :: Pages: 1-9


Free full text article: Bilateral persistent primitive hypoglossal arteries associated with unilateral symptomatic carotid thromboembolism

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Abstract: We report the fifth case of bilateral persistent primitive hypoglossal arteries in the literature. This is also the first such case to be demonstrated on computerized tomography angiogram (CTA) and the first case to be associated with a symptomatic carotid thrombus. The sub-occlusive thrombus was distal to the take-off of the dominant persistent hypoglossal artery (PHA) from the internal carotid artery, thus sparing involvement of posterior circulation. Timely identification of the internal carotid artery thromboembolism in the setting of a PHA is important to allow for thrombectomy. Any intervention was not done in this case as the patient was out of the window and at an additional risk of inducing intracranial thromboembolism. Symptomatic carotid stenosis at the PHA take-off is typically treated with endovascular angioplasty and stenting due to the typically high level of the bifurcation in the neck.


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Computed Tomography, Magnetic Resonance Imaging, Graph, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Imaging Findings of Ulceroglandular Tularemia by Neil Anand et al.

Published: 2017 Jan
Issue: 11(1) :: Pages: 1-6


Free full text article: Imaging Findings of Ulceroglandular Tularemia

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Abstract: Francisella tularensis, the causative organism in Tularemia, is a relatively rare disease. There are a few radiological clues to elucidate its presence when suspicion arises. There should be strong consideration for Tularemia in the differential of any patient with its classic symptoms, diffuse cervical lymphadenopathy with evidence of necrosis, and enlarged adenoids. Ultrasound may demonstrate suppurative lymphadenopathy suggestive of infection, as in the case presented. CT often will demonstrate the extent of lymphadenopathy. On chest radiography, tularemia pneumonia is often the presenting finding, which may demonstrate bilateral or lobar infiltrates. Additionally, hilar lymphadenopathy and pleural effusions are often associated findings. Cavitary lesions may be present, which are better delineated on CT scan. We present a case of a 7-year-old male who presented with a painful right-sided palpable neck mass for 9 days, who was diagnosed with Tularemia after numerous admissions.


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Ultrasound, Computed Tomography, Conventional Radiography, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Cerebral Misery Perfusion on Susceptibility Weighted Imaging in Acute Carotid Dissection by Arian Mashhood et al.

Published: 2016 Oct
Issue: 10(10) :: Pages: 1-6


Free full text article: Cerebral Misery Perfusion on Susceptibility Weighted Imaging in Acute Carotid Dissection

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Abstract: The cerebral vasculature incorporates several fail-safes that must be breached before an irreversible ischemic event takes place. In particular, when autoregulatory vasodilatation fails secondary to falling cerebral perfusion pressure (CPP; stage I hemodynamic failure), increases in the oxygen extraction fraction work to maintain the cerebral metabolic rate of oxygen. Previously, failure of this mechanism, stage II hemodynamic failure, or misery perfusion, has been imaged via positron emission tomography/computed tomography (PET/CT). Current susceptibility-weighted sequences (SWI) allow for more efficient imaging of this physiology. In this case, we identify an incident of reversible ischemia caused by spontaneous carotid artery dissection using a combination of diffusion weighted imaging (DWI) and SWI. The level of hemodynamic failure identified by the imaging sequences elevated the urgency of neurointervention, expediting the patient`s arrival to the neurointerventional table and thus avoiding impending irreversible ischemia.


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Magnetic Resonance Imaging, Computed Tomography, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

ALK positive Anaplastic Large Cell Lymphoma of the Thoracic Spine by Gabriela Abrego et al.

Published: 2016 Sep
Issue: 10(9) :: Pages: 1-12


Free full text article: ALK positive Anaplastic Large Cell Lymphoma  of the Thoracic Spine

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Abstract: Primary bone lymphoma (PBL) is an uncommon extra nodal disease that represents about 1-3% of lymphoma cases. Imaging findings are variable and non-specific. Computed tomography may demonstrate lytic lesions with sequestra and periosteal reaction. On magnetic resonance imaging, lesions are T1WI hypointense and T2WI hyperintense, related to peritumoral edema or bone marrow replacement. Rarely lesions may have associated fibrosis and show a more hypointense signal pattern on T2WI. After administration of contrast, PBL tends to enhance avidly. We present a case of a 24 years old African American female patient with history of back pain. Initial imaging examinations showed lesions involving the T12 and T11 vertebral bodies with initial negative biopsy results. One month later, the patient returned with worsening back pain, and the follow up studies depicted collapse of the T12 vertebral body. A diagnosis of anaplastic large cell lymphoma in T12 was made. A brief review of the literature, imaging and pathological findings, and treatment options are also discussed.


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Computed Tomography, Magnetic Resonance Imaging, Conventional Radiography, Nuclear Medicine, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Intracranial Migration of Silicone Delaying Life Saving Surgical Management: A Mimicker of Hemorrhage by Dani Sarohia et al.

Published: 2016 Aug
Issue: 10(8) :: Pages: 1-11


Free full text article: Intracranial Migration of Silicone  Delaying Life Saving Surgical Management:  A Mimicker of Hemorrhage

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Abstract: We present a case in which intraocular silicone injection for complex retinal detachment resulted in migration and distribution of silicone along the intracranial visual pathway, and ultimately throughout the ventricular system. Misinterpretation of this material as intracranial hemorrhage on outside computed tomography imaging delayed emergent repair of a Type A aortic dissection until the diagnosis was made on repeat imaging. A discussion of this case and salient computed tomography and magnetic resonance imaging characteristics of silicone is provided.


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Computed Tomography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Diffusion, Perfusion, and Histopathologic Characteristics of Desmoplastic Infantile Ganglioglioma by Chang Y Ho et al.

Published: 2016 Jul
Issue: 10(7) :: Pages: 1-13


Free full text article: Diffusion, Perfusion, and Histopathologic Characteristics of Desmoplastic Infantile Ganglioglioma

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Abstract: We present a case series of a rare tumor, the desmoplastic infantile ganglioglioma (DIG) with MRI diffusion and perfusion imaging quantification as well as histopathologic characterization. Four cases with pathologically-proven DIG had diffusion weighted imaging (DWI) and two of the four had dynamic susceptibility contrast imaging. All four tumors demonstrate DWI findings compatible with low-grade pediatric tumors. For the two cases with perfusion imaging, a higher relative cerebral blood volume was associated with higher proliferation index on histopathology for one of the cases. Our results are discussed in conjunction with a literature review.


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Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Carotid Stent Fracture from Stylocarotid Syndrome by Jeffrey D Hooker et al.

Published: 2016 Jun
Issue: 10(6) :: Pages: 1-8


Free full text article: Carotid Stent Fracture from Stylocarotid Syndrome

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Abstract: Eagle syndrome is a rare condition resulting from elongation of the temporal styloid process or calcification of its associated stylohyoid ligaments. Although usually presenting with pain or odynophagia, Eagle syndrome has been reported to cause a multitude of neurologic symptoms or vascular complications, some of which can be life-threatening. We present a case in which an endovascularly placed internal carotid artery stent in close proximity to a calcified stylohyoid ligament resulted in stent fracture with subsequent stent and vessel occlusion. We review and discuss the presentation, diagnosis, etiology, complications and treatment options of the syndrome.


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Computed Tomography, Angiography, Interventional, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

MR Imaging Findings in Xp21.2 Duplication Syndrome by Matthew T Whitehead et al.

Published: 2016 May
Issue: 10(5) :: Pages: 9-14


Free full text article: MR Imaging Findings in  Xp21.2 Duplication Syndrome

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Abstract: Xp21.2 duplication syndrome is a rare genetic disorder of undetermined prevalence and clinical relevance. As the use of chromosomal microarray has become first line for the work-up of childhood developmental delay, more gene deletions and duplications have been recognized. To the best of our knowledge, the imaging findings of Xp21.2 duplication syndrome have not been reported. We report a case of a 33 month-old male referred for developmental delay that was found to have an Xp21.2 duplication containing IL1RAPL1 and multiple midline brain malformations.


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Magnetic Resonance Imaging, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Angioleiomyoma of the falx by Susana Calle et al.

Published: 2016 Apr
Issue: 10(4) :: Pages: 8-15


Free full text article: Angioleiomyoma of the falx

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Abstract: A 43-year-old man arrived at the emergency department following a syncopal episode. Computed tomography and magnetic resonance images demonstrated a small interhemispheric, anterior parafalcine mass that mimicked a meningioma. Surgical excision and subsequent pathologic evaluation revealed an angioleiomyoma and the patient recovered without incident. Angioleiomyomas are classified as benign smooth muscle tumors and are classically seen in adult females arising in the soft tissues of the lower extremities. Although rare, these masses have been described in various intracranial locations, usually extra-axially. A comprehensive review of the literature and discussion are provided, emphasizing histopathologic and imaging features of this uncommon intracranial neoplasm.


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Computed Tomography, Magnetic Resonance Imaging, Macroscopic pathology, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Capecitabine-induced leukoencephalopathy involving the bilateral corticospinal tracts by Mark Bang-Wei Tan et al.

Published: 2016 Mar
Issue: 10(3) :: Pages: 1-10


Free full text article: Capecitabine-induced leukoencephalopathy  involving the bilateral corticospinal tracts

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Abstract: An 80 year old lady with a history of metastatic sigmoid carcinoma presented with expressive dysphasia and unsteady gait 4 days after commencement of adjuvant capecitabine chemotherapy. MRI demonstrated restricted diffusion and T2/FLAIR hyperintensity involving the course of the bilateral corticospinal tracts, the corpus callosum and the middle cerebellar peduncles. Discontinuation of chemotherapy lead to symptom resolution in 2 days; repeat MRI at 2 months demonstrated reversal of the diffusion changes and improvement of the previous T2W/FLAIR hyperintensity. This report describes the first case of capecitabine induced leukoencephalopathy causing restricted diffusion along the corticospinal tracts, which should be differentiated from other entities that involve the corticospinal tracts (i.e. amyotrophic lateral sclerosis (ALS), primary lateral sclerosis (PLS), hypoglycemic coma, etc.)


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Magnetic Resonance Imaging, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Primary osteogenic osteosarcoma of the ethmoid sinus in an adolescent: case report by Marta E. Gonzalez et al.

Published: 2016 Feb
Issue: 10(2) :: Pages: 1-9


Free full text article: Primary osteogenic osteosarcoma of the ethmoid sinus in an adolescent: case report

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Abstract: Osteosarcomas of the craniofacial bones account for fewer than 10% of all osteosarcomas. Primary osteosarcomas of the nasal cavity and paranasal sinus are rare (0.5-8.1% of the osteosarcomas occur in this location). Because of the rarity of this presentation, we report a case of osteogenic osteosarcoma arising de novo from the ethmoid bone in a 13 year old male who presented with discharge from the right eye and headaches. We describe the imaging features of this rare tumor and provide a brief review of the literature.


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Magnetic Resonance Imaging, Nuclear Medicine, Computed Tomography, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Bilateral Thalamic and Right Fronto-temporo-parietal Gliomas in a 4 Years Old Child Diagnosed by Magnetic Resonance Imaging by Ahmed Fathy Sharaf et al.

Published: 2016 Jan
Issue: 10(1) :: Pages: 1-13


Free full text article: Bilateral Thalamic and Right Fronto-temporo-parietal Gliomas in a 4 Years Old Child Diagnosed by Magnetic Resonance Imaging

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Abstract: We report the neuroimaging findings of a 4-year-old girl with biopsy-proven bilateral thalamic and right fronto-temporo-parietal cortical gliomas, which are uncommon tumours involving the central nervous system. Despite their benignity, the prognosis is usually poor because of involvement of the thalamic nuclei and difficulty in surgical excision. These lesions have limited differential diagnoses that include metabolic, toxic, infective, vascular and neoplastic. Imaging characteristics on conventional Magnetic Resonance (MR), Magnetic Resonance Spectroscopy (MRS) and Diffusion tensor imaging (DTI) can further narrow the differential diagnosis and also provide additional information regarding the degree of involvement of adjacent brain tissue and white matter tracts around the lesions.


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Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

A rare case of atypical skull base meningioma with perineural spread by Henry Walton et al.

Published: 2015 Dec
Issue: 9(12) :: Pages: 1-14


Free full text article: A rare case of atypical skull base meningioma with perineural spread

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Abstract: Atypical meningioma is a rare cause of perineural tumour spread. In this report, we present the case of a 46-year-old female with an atypical meningioma of the skull base demonstrating perineural tumour spread. We describe the imaging features of this condition and its distinguishing features from other tumours exhibiting perineural spread.


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Magnetic Resonance Imaging, Computed Tomography, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Rosai-Dorfman Disease Isolated to the Thoracic Epidural Spine by Benjamin Kozak et al.

Published: 2015 Nov
Issue: 9(11) :: Pages: 6-16


Free full text article: Rosai-Dorfman Disease  Isolated to the Thoracic Epidural Spine

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Abstract: Rosai-Dorfman disease is a rare benign histiocytic disease that infrequently presents in the spine. We report a case of Rosai-Dorfman disease isolated to the epidural thoracic spine in a 26-year-old male. To our knowledge, this is the 15th reported case of isolated spinal disease and only the fourth case of isolated thoracic epidural disease. Given its rarity as well as non-specific symptoms and imaging findings, Rosai-Dorfman disease is often not considered and misdiagnosed on imaging studies. To help improve awareness of Rosai-Dorfman spinal disease, we review the literature and discuss the epidemiology, clinical presentation, imaging features, and treatment considerations for this condition.


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Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Neuroradiology section Neuroradiology

Acute Prevertebral Calcific Tendinitis by Alexander Tamm et al.

Published: 2015 Nov
Issue: 9(11) :: Pages: 1-5


Free full text article: Acute Prevertebral Calcific Tendinitis

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Abstract: We present a case of neck pain in a middle-aged woman, initially attributed to a retropharyngeal infection and treated with urgent intubation. With the help of computed tomography, the diagnosis was later revised to acute prevertebral calcific tendinitis, a self-limiting condition caused by abnormal calcium hydroxyapatite deposition in the longus colli muscles. It is critical to differentiate between these two disease entities due to dramatic differences in management. A discussion of acute prevertebral calcific tendinitis and its imaging findings is provided below.


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Conventional Radiography, Computed Tomography, Table





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Metastatic pleomorphic adenoma to the supraspinatus muscle: a case report and review of a rare aggressive clinical entity by James G McGarry et al.

Published: 2015 Oct
Issue: 9(10) :: Pages: 1-8


Free full text article: Metastatic pleomorphic adenoma  to the supraspinatus muscle: a case report and review of a rare aggressive clinical entity

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Abstract: We report a case of a 65-year-old female with a recurrent right parotid pleomorphic adenoma (PA) 24 years after initial surgical excision. Positron-emission tomography (PET) and computed tomography (CT) demonstrated an unusual suspicious FDG-avid erosive rim enhancing mass centered in the right supraspinatus muscle. Cytology from CT-guided aspiration of the mass was consistent with a histologically benign PA, and the patient was diagnosed with metastatic pleomorphic adenoma (MPA). The patient later developed diffuse pulmonary metastases and died within 3 months. MPA, although rare, is recognised as a potentially lethal malignant complication of recurrent or longstanding benign PA. As no biochemical or genetic parameters are predictive of malignant change, patients presenting with recurrent PA should be considered for screening for metastatic disease.


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Computed Tomography, Nuclear Medicine, Microscopic pathology, Table





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Diffuse Proliferative Cerebral Angiopathy: A case report and review of the literature by Rohit et al.

Published: 2015 Sep
Issue: 9(9) :: Pages: 1-10


Free full text article: Diffuse Proliferative Cerebral Angiopathy:  A case report and review of the literature

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Abstract: Diffuse proliferative cerebral angiopathy is a distinct entity from cerebral arterio-venous malformations; characterized by multiple small arterial feeders and draining veins with normal brain parenchyma seen in-between the abnormal vessels. It is usually seen in younger age group. Here we report a case of diffuse cerebral proliferative angiopathy in a 78-year-old female patient along with discussion of the neuro-imaging findings and review of the literature. It is important to recognize this entity to avoid aggressive surgery or intervention and thus preventing permanent damage to the normal intermingled brain tissue.


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Computed Tomography, Magnetic Resonance Imaging, Other, Table





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Perineural tumour spread from colon cancer, an unusual cause of trigeminal neuropathy - a case report by Kavitha Nair et al.

Published: 2015 Aug
Issue: 9(8) :: Pages: 8-15


Free full text article: Perineural tumour spread from colon cancer, an unusual cause of trigeminal neuropathy - a case report

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Abstract: Malignant trigeminal neuralgia due to perineural spread along the branches of the trigeminal nerve, is known to commonly occur secondary to squamous cell carcinomas, lymphomas and adenoid cystic carcinomas in the head and neck region. Rarely metastases to the trigeminal nerve have been reported in breast cancer, prostate cancer and colon cancer. To the best of our knowledge trigeminal neuropathy due to skull base metastases and perineural spread along the maxillary (V2) and mandibular (V3) branches of the trigeminal nerve, secondary to colon cancer, has not been previously reported. The diagnosis in our index case was made on magnetic resonance imaging, and patient was treated accordingly by fractionated stereotactic radiotherapy, with subsequent relief of her pain.


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Magnetic Resonance Imaging, Table

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Cystoid angiocentric glioma: A case report and literature review by Sainan Cheng et al.

Published: 2015 Jul
Issue: 9(7) :: Pages: 1-9


Free full text article: Cystoid angiocentric glioma:  A case report and literature review

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Abstract: Angiocentric glioma is a rare subtype of neuroepithelial tumor that is associated with a history of epilepsy. We report a case of cystoid angiocentric glioma associated with an area of calcification. This 25 year old male patient presented with tonic clonic spasm. He underwent craniotomy with complete resection of the lesion. Pathologic specimen showed monomorphous bipolar cells with angiocentric growth pattern.


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Thalamic Massa Intermedia Duplication in a Dysmorphic 14 month-old Toddler by Matthew T Whitehead

Published: 2015 Jun
Issue: 9(6) :: Pages: 1-5


Free full text article: Thalamic Massa Intermedia Duplication in a Dysmorphic 14 month-old Toddler

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Abstract: The massa intermedia is an inconstant parenchymal band connecting the medial thalami. It may be thickened in various disease processes such as Chiari II malformation or absent in other disease states. However, the massa intermedia may also be absent in up to 30% of normal human brains. To the best of my knowledge, detailed imaging findings of massa intermedia duplication have only been described in a single case report. An additional case of thalamic massa intermedia duplication discovered on a routine brain MR performed for dysmorphic facial features is reported herein.


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Internal Carotid Artery Web: Doppler Ultrasound with CT Angiography correlation by Winnie Fu et al.

Published: 2015 May
Issue: 9(5) :: Pages: 1-6


Free full text article: Internal Carotid Artery Web:  Doppler Ultrasound with CT Angiography correlation

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Abstract: We present a case of an internal carotid web, detected on duplex ultrasound and confirmed by CT angiography. To our knowledge, this is only the third reported ultrasound case in the imaging literature. This vascular abnormality can cause a clinically significant carotid stenosis and is a risk factor for recurrent embolic cerebrovascular events. Due to small size and poor awareness among radiologists, carotid webs are often under-diagnosed on non-invasive imaging modalities. Improved awareness including knowledge of salient imaging features is useful as early diagnosis leading to appropriate intervention can eliminate the risk of future cerebrovascular events.


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Congenital Midline Cervical Cleft by Javier Villanueva-Meyer et al.

Published: 2015 Mar
Issue: 9(3) :: Pages: 7-11


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Abstract: Congenital midline cervical cleft is a rare anomaly that typically presents in the neonatal period as a thin suprasternal vertical band of erythematous skin with a nipple-like projection superiorly, which may exude fluid. We present the clinical and pathophysiologic features and the imaging findings of this uncommon, and rarely described entity in a newborn girl.


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A Case of Neurocutaneous Melanosis and Neuroimaging Findings by Rahsan Gocmen et al.

Published: 2015 Mar
Issue: 9(3) :: Pages: 1-6


Free full text article: A Case of Neurocutaneous Melanosis and Neuroimaging Findings

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Abstract: Neurocutaneous melanosis is a rare congenital disorder which presents with congenital cutaneous nevi and involvement of the central nervous system. We herein present a rare case of a 2-year-old girl who had central nervous system melanosis and giant congenital melanocytic nevi. Magnetic resonance imaging, especially precontrast T1 images play a crucial role in making the diagnosis combined with the skin findings of physical examination.


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IgG4-Related Disease Presenting as a Solitary Neck Mass by Tyler McKinnon et al.

Published: 2015 Feb
Issue: 9(2) :: Pages: 1-8


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Abstract: IgG4-related disease is a newly recognized entity associated with autoimmune conditions involving almost every organ system. It is characterized by elevated serum IgG4 as well as mass like tissue infiltration by IgG4-positive plasma cells. Imaging findings are nonspecific, vary depending on the site of disease, and include mass like enlargement of the salivary or lacrimal glands and enlarged lymph nodes. Radiographic findings often mimic malignancy, necessitating tissue sampling to confirm the diagnosis. Distinguishing IgG4-related disease from malignancy is important as IgG4 responds well to steroids and conservative management.


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Solitary Fibrous Tumor of the Infratemporal Fossa by Monika E. Freiser et al.

Published: 2014 Dec
Issue: 8(12) :: Pages: 1-8


Free full text article: Solitary Fibrous Tumor of the Infratemporal Fossa

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Abstract: Solitary fibrous tumors represent fewer than 2% of all soft tissue tumors, and only about 12-15% of them occur in the head and neck. We report a case of a 38-year-old male who presented with a six-month history of increasing right cheek swelling. Computed tomography of the paranasal sinuses with contrast demonstrated a well-circumscribed avidly enhancing mass in the right retroantral fat. On magnetic resonance imaging the lesion was homogenously slightly hyperintense to muscle on T1 weighted and T2 weighted images and enhanced avidly with contrast. Surgical resection was performed and pathology was consistent with solitary fibrous tumor. There have been very few reported cases of solitary fibrous tumors in the infratemporal fossa and none described as originating in the retroantral fat.


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Atypical Imaging Features of Tuberculous Spondylitis: Case Report with Literature Review by Rita Momjian et al.

Published: 2014 Nov
Issue: 8(11) :: Pages: 1-14


Free full text article: Atypical Imaging Features of Tuberculous Spondylitis: Case Report with Literature Review

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Abstract: Spinal tuberculosis in its typical form that shows destruction of two adjacent vertebral bodies and opposing end plates, destruction of the intervening intervertebral disc and a paravertebral or psoas abscess, is easily recognized and readily treated. Atypical tuberculous spondylitis without the above mentioned imaging features, although seen infrequently, has been well documented. We present, in this report, a case of atypical tuberculous spondylitis showing involvement of contiguous lower dorsal vertebral bodies and posterior elements with paravertebral and epidural abscess but with preserved intervertebral discs. The patient presented in advanced stage with progressive severe neurological symptoms due to spinal cord compression. Non-enhanced magnetic resonance imaging led to misdiagnosis of the lesion as a neoplastic process. It was followed by contrast enhanced computed tomography of the chest and abdomen that raised the possibility of an infectious process and, post-operatively, histopathological examination of the operative specimen confirmed tuberculosis. This case indicates the difficulty in differentiating atypical spinal tuberculosis from other diseases causing spinal cord compression. The different forms of atypical tuberculous spondylitis reported in the literature are reviewed. The role of the radiologist in tuberculous spondylitis is not only to recognize the imaging characteristics of the disease by best imaging modality, which is contrast enhanced magnetic resonance imaging, but also to be alert to the more atypical presentations to ensure early diagnosis and prompt treatment to prevent complications. However, when neither clinical examination nor magnetic resonance imaging findings are reliable in differentiating spinal infection from one another and from neoplasm, adequate biopsy, either imaging guided or surgical biopsy is essential for early diagnosis.


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Magnetic Resonance Imaging, Computed Tomography, Conventional Radiography, Microscopic pathology, Table

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Anti-NMDA Encephalitis: An Uncommon, Autoimmune Mediated Form of Encephalitis by Avetis Azizyan et al.

Published: 2014 Aug
Issue: 8(8) :: Pages: 1-6


Free full text article: Anti-NMDA Encephalitis: An Uncommon, Autoimmune Mediated Form of Encephalitis

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Abstract: We report an interesting case of a 19 year old female with findings on MRI suggestive of viral encephalitis. An extensive workup was negative for infectious causes and she was subsequently diagnosed with anti-NMDA encephalitis. Anti-NMDA encephalitis is a highly lethal but treatable form of autoimmune encephalitis that has recently been characterized. It is frequently found in young women and associated with an underlying teratoma. Although rare, this diagnosis should be considered in young females for whom a rapid onset of encephalitis cannot be explained by more common causes.


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Correlating Hemodynamic Magnetic Resonance Imaging with high-field Intracranial Vessel Wall Imaging in Stroke by Weston Langdon et al.

Published: 2014 Jun
Issue: 8(6) :: Pages: 1-10


Free full text article: Correlating Hemodynamic Magnetic Resonance Imaging with high-field Intracranial Vessel Wall Imaging in Stroke

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Abstract: Vessel wall magnetic resonance imaging at ultra-high field (7 Tesla) can be used to visualize vascular lesions noninvasively and holds potential for improving stroke-risk assessment in patients with ischemic cerebrovascular disease. We present the first multi-modal comparison of such high-field vessel wall imaging with more conventional (i) 3 Tesla hemodynamic magnetic resonance imaging and (ii) digital subtraction angiography in a 69-year-old male with a left temporal ischemic infarct.


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Delayed leukoencephalopathy after acute carbon monoxide intoxication by Ana Filipa Geraldo et al.

Published: 2014 May
Issue: 8(5) :: Pages: 1-8


Free full text article: Delayed leukoencephalopathy  after acute carbon monoxide intoxication

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Abstract: Delayed leukoencephalopathy is an uncommon complication of hypoxic-ischemic events of different etiologies, including carbon monoxide intoxication. We present a case of a 40-year-old male patient who was admitted with rapidly progressive neurocognitive and behavioral deficits. There was a history of accidental carbon monoxide intoxication one month before, presenting with loss of consciousness and short hospitalization, followed by a complete clinical recovery. The imaging studies in the delayed phase depicted confluent, symmetric supra-tentorial white matter lesions in keeping with diffuse demyelinization. Restricted diffusion and metabolite abnormalities in magnetic resonance proton spectroscopy were also seen. The diagnosis of CO-mediated delayed post-hypoxic leukoencephalopathy was assumed after exclusion of other mimickers. Hyperbaric oxygen therapy was tentatively performed and the patient had a favorable clinical and radiological evolution.


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A symptomatic Sylvian fissure lipoma in a post-traumatic patient by Rakan Farouk Bokhari et al.

Published: 2014 Apr
Issue: 8(4) :: Pages: 1-7


Free full text article: A symptomatic Sylvian fissure lipoma  in a post-traumatic patient

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Abstract: Lipomatous extra-axial lesions in the Sylvian fissure are a rare entity. Their identification, however, is usually simple if a systematic radiological approach is adopted. The best line of management for these lesions is still a matter of controversy and fraught with complications. We present a case of a Sylvian fissure lipoma referred to our neurosurgery services with symptomatic seizures and in a post-traumatic patient. The radiological differentiating features of intracranial lipomas and intracranial dermoids have been discussed. The unusual location of the lesion, in combination with the history of seizures and the nature of presentation (trauma being a red-herring) make this case an interesting find. The lesion was managed conservatively with good outcomes at follow up, on anti-epileptic medications.


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A Case of Intraventricular Primary Central Nervous System Lymphoma by Kimberly Funaro et al.

Published: 2014 Mar
Issue: 8(3) :: Pages: 1-8


Free full text article: A Case of Intraventricular Primary  Central Nervous System Lymphoma

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Abstract: We report a case of primary central nervous system lymphoma presenting as multiple intraventricular masses in an immunocompetent 68 year old man with severe headache and unsteady gait. The diagnosis was obtained by analysis of the cerebrospinal fluid and subsequent surgical biopsy. This is an unusual appearance for primary central nervous lymphoma, with the majority of the cases presenting as solitary masses.


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Imaging of Adult Ocular and Orbital Pathology - a Pictorial Review by Reuben Grech et al.

Published: 2014 Feb
Issue: 8(2) :: Pages: 1-29


Free full text article: Imaging of Adult Ocular and Orbital Pathology -  a Pictorial Review

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Abstract: Orbital pathology often presents a diagnostic challenge to the reporting radiologist. The aetiology is protean, and clinical input is therefore often necessary to narrow the differential diagnosis. With this manuscript, we provide a pictorial review of adult ocular and orbital pathology.


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Maxillary Air Cyst by Stephane Doucette-Preville et al.

Published: 2013 Dec
Issue: 7(12) :: Pages: 10-15


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Abstract: Pathologic dilatation of the maxillary sinus by air is a rare condition with unclear etiology. We present a case of a 17 year old male with a maxillary air cyst diagnosed by computed tomography. The CT demonstrated air-filled expansion of the maxillary sinus beyond the normal anatomical limits with associated cortical bone thinning. The case report highlights the pathognomonic computed tomography findings of this rare entity and discusses the perplexing nomenclature, proposed etiologies and various treatment options.


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Dysembryoplastic Neuroepithelial Tumor with Atypical Presentation: MRI and Diffusion Tensor Characteristics by Kalyan Paudel et al.

Published: 2013 Nov
Issue: 7(11) :: Pages: 7-14


Free full text article: Dysembryoplastic Neuroepithelial Tumor with Atypical Presentation: MRI and Diffusion Tensor Characteristics

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Abstract: We report the neuroimaging findings of a 26-year-old female patient with a biopsy-proven dysembryoplastic neuroepithelial tumor (DNET). DNETs are an uncommon, usually benign, glial-neural cortical neoplasm of children and young adults who typically present with intractable seizures. DNETs may occur in any region of the supratentorial cortex, but have a predilection for the temporal lobes. Accurate neuroimaging diagnosis is essential since patients with DNET benefit from complete resection. However, accurate differentiation from other cortical lesions may be challenging. Typical conventional Magnetic Resonance Imaging (MRI) features can help in the differentiation from other similar cortical tumors. Diffusion tensor imaging can also provide important additional diagnostic information regarding the degree of involvement of adjacent parenchyma and white matter tracts. In this case, tractography and fractional anisotropy maps demonstrated that fiber tracts surrounding the lesion were displaced, but fiber integrity was maintained, which is more suggestive of a DNET rather than a more aggressive neoplasm. Accurate identification of DNETs is essential for the purpose of rendering a timely diagnosis and start appropriate treatment.


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A case of septum pellucidum subependymoma with a subtle imaging appearance simulating a cavum septum pellucidum by Sawsan Taif¹*, Hunaina Al-Kindi², Renjan Varghese¹ et al.

Published: 2013 Oct
Issue: 7(10) :: Pages: 7- 16


Free full text article: A case of septum pellucidum subependymoma with a subtle imaging appearance simulating a cavum septum pellucidum

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Abstract: Subependymoma is a rare benign slowly growing tumor which usually appears as a well-defined lobulated entirely intraventricular mass, in the fourth or lateral ventricles. We report a case of subependymoma involving the septum pellucidum in a 28 year old female demonstrating a subtle and unusual radiological appearance. It showed very low attenuation on computed tomography, with very high signal on T2- and low signal on T1 weighted magnetic resonance images, merging with the ventricular wall, without definite focal mass. This appearance made the tumor difficult to differentiate from the cerebrospinal fluid and simulating a cavum septum pellucidum. The patient was treated by craniotomy and gross total resection of the mass.


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Balamuthia Mandrillaris Meningoencephalitis associated with Solid Organ Transplantation - Review of Cases by Matthew LaFleur et al.

Published: 2013 Sep
Issue: 7(9) :: Pages: 9-18


Free full text article: Balamuthia Mandrillaris Meningoencephalitis associated with Solid Organ Transplantation -  Review of Cases

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Abstract: We report the first identified transmission of Balamuthia mandrillaris through solid organ transplantation. Kidneys were transplanted from a donor with presumptive diagnosis of autoimmune encephalitis. Shortly after, the recipients developed neurologic symptoms. Magnetic Resonance Imaging of the brain from the donor and both kidney recipients demonstrated multiple ring enhancing lesions with surrounding edema and adjacent leptomeningeal extension. In addition most of the lesions demonstrated signal changes suggesting central hemorrhagic foci. Specimens were tested locally and at the Centers for Disease Control and Prevention. Histopathology revealed B. mandrillaris in either brain tissue and/or cerebral spinal fluid in the donor and recipients.


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Classic neuroimaging findings of nonketotic hyperglycemia on computed tomography and magnetic resonance imaging with absence of typical movement disorder symptoms (hemichorea-hemiballism) by Barry G. Hansford et al.

Published: 2013 Aug
Issue: 7(8) :: Pages: 1-9


Free full text article: Classic neuroimaging findings of nonketotic hyperglycemia on computed tomography and magnetic resonance imaging with absence of typical movement disorder symptoms (hemichorea-hemiballism)

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Abstract: While there are broad differential diagnoses for either the clinical finding of hemichorea-hemiballism or the imaging finding of lateralizing/asymmetric basal ganglia lesions (hyperdense on computed tomography, hyperintense on T1 magnetic resonance imaging), the presence of both findings is highly suggestive of nonketotic hyperglycemia. We present an unusual case of a patient with vague stroke-like complaints and imaging findings notable for lateralizing basal ganglia lesions. Laboratory analysis revealed nonketotic hyperglycemia and neurologic exam failed to elicit any findings of movement disorder. As far as we know, this is the first published case of a patient with typical neuroimaging manifestations of nonketotic hyperglycemia without associated hemichorea-hemiballism (a disorder of abnormal movements comprised of more proximal, higher amplitude movements-ballismus and lower amplitude, more distal movements- chorea). This finding suggests that radiologists should be alert to the possibility of nonketotic hyperglycemia in patients with asymmetric/lateralizing basal ganglia lesions even in the absence of a movement disorder.


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Bilateral thalamic infarcts due to occlusion of the Artery of Percheron and discussion of the differential diagnosis of bilateral thalamic lesions by Eva Guy Rodriguez et al.

Published: 2013 Jul
Issue: 7(7) :: Pages: 7-14


Free full text article: Bilateral thalamic infarcts due to occlusion of the Artery of Percheron and discussion of the differential diagnosis of bilateral thalamic lesions

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Abstract: The Artery of Percheron is a rare vascular variant in which a single dominant thalamoperforating artery arises from one P1 segment and bifurcates to supply both paramedian thalami. Occlusion of this uncommon vessel results in a characteristic pattern of bilateral paramedian thalamic infarcts with or without mesencephalic infarctions. We report a case of a 31-year-old man with acute bilateral thalamic infarcts and a truncated Artery of Percheron demonstrated on magnetic resonance angiography (MRA). Occlusion of the vessel was presumably due to embolism from a patent foramen ovale that was subsequently closed. The case presentation is followed by a discussion of bilateral paramedian thalamic infarcts including the causes and clinical presentation. The differential diagnosis of vascular and nonvascular etiologies of bilateral thalamic lesions is also discussed.


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Baló`s concentric sclerosis: imaging findings and pathological correlation by Maxine Darke et al.

Published: 2013 Jun
Issue: 7(6) :: Pages: 1-8


Free full text article: Baló`s concentric sclerosis: imaging findings and pathological correlation

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Abstract: Baló`s concentric sclerosis is a primary inflammatory central nervous system demyelinating disease that is considered a rare, radiographically and pathologically distinct variant of multiple sclerosis. Baló`s concentric sclerosis is characterized by alternating rings of demyelinated and myelinated axons, and it is most frequently diagnosed postmortem by autopsy or, more recently, by magnetic resonance imaging without pathologic verification. This report is of a case of Baló`s concentric sclerosis in which the patient presented with left-sided focal sensorimotor deficits. The patient`s lesion demonstrated characteristics of Baló`s concentric sclerosis by magnetic resonance imaging, but since a neoplastic process was also suspected initially, the patient underwent a surgical biopsy. This pathology sample now provides the opportunity to correlate the tissue diagnosis of demyelination with characteristic magnetic resonance imaging findings; this comparison is infrequently found in the literature.


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Neurocandidiasis: a case report and consideration of the causes of restricted diffusion by David J. Lin et al.

Published: 2013 May
Issue: 7(5) :: Pages: 1-5


Free full text article: Neurocandidiasis: a case report and consideration of the causes of restricted diffusion

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Abstract: Diffusion weighted magnetic resonance imaging has risen to the forefront of imaging for acute stroke. However, the differential diagnosis of restricted diffusion is wide and includes ischemia, metabolic derangements, infections, and highly-cellular masses. We present a case of central nervous system (CNS) candidiasis presenting radiographically as bilateral punctate areas of restricted magnetic resonance (MR) diffusion in the basal ganglia. This case illustrates the value of carefully considering the causes of restricted diffusion in the brain, notably to be broader than acute stroke and to include invasive fungal infections.


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Cerebrotendinous xanthomatosis - The spectrum of imaging findings by Arunachalam Pudhiavan et al.

Published: 2013 Apr
Issue: 7(4) :: Pages: 1-9


Free full text article: Cerebrotendinous xanthomatosis -  The spectrum of imaging findings

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Abstract: Cerebrotendinous xanthomatosis (CTX), also known as Van Bogaert-Scherer-Epstein disease is a rare autosomal recessive genetic disorder of the lipid metabolism. To date, there are less than 300 cases reported worldwide. We present a case of a 30 year old male who presented with mental retardation and swelling of ankles, with the a spectrum of CTX imaging findings. Imaging studies were performed which included plain X-ray, Ultrasound (US) and Magnetic Resonance Imaging(MRI) of both the brain and ankles. These pointed towards the diagnosis of CTX with the entire spectrum of findings which was confirmed with biopsy and laboratory findings. CTX is a potentially treatable condition with replacement therapy, and hence early diagnosis before neurological deterioration is important. This is aided by the imaging findings which are conclusive forte diagnosis of CTX.


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Acute Watershed Infarcts with Global Cerebral Hypoperfusion in Symptomatic CADASIL by Ajeet Gordhan et al.

Published: 2013 Mar
Issue: 7(3) :: Pages: 8-15


Free full text article: Acute Watershed Infarcts with Global Cerebral Hypoperfusion in Symptomatic CADASIL

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Abstract: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common form of hereditary cerebral angiopathy. We present a case in which a pattern of diffusion signal change compatible with bihemispheric acute watershed infarcts occurred in a symptomatic patient demonstrating global hypoperfusion. To our knowledge, watershed infarcts in the clinical presentation of CADASIL have not been previously described.


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Magnetic Resonance Imaging, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Anomalous Morphology of an Ectopic Tooth in the Maxillary Sinus on Three-Dimensional Computed Tomography Images by Yee-Tak Alta Lai et al.

Published: 2013 Feb
Issue: 7(2) :: Pages: 11-16


Free full text article: Anomalous Morphology of an Ectopic Tooth in the Maxillary Sinus on Three-Dimensional Computed Tomography Images

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Abstract: We describe a case of an incidentally-diagnosed ectopic tooth showing anomalous morphology in the maxillary antrum, using three-dimensional reconstruction of computed tomography images of the tooth obtained by multi-detector computed tomography.


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Computed Tomography, Table

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Myxoma of the Vomer Bone by David Besachio et al.

Published: 2013 Jan
Issue: 7(1) :: Pages: 12-17


Free full text article: Myxoma of the Vomer Bone

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Abstract: Myxomas of bone in the head and neck are rare tumors. We present a 68 year old female with pain and epistaxis who was found to have the first reported case of a myxoma arising within the vomer bone. Some atypical magnetic resonance imaging features are described, however, myxoma imaging features are often non-specific and typically evoke a benign differential diagnosis. Surgical excision is the treatment of choice.


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Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

A rare cause of neural foraminal widening by Jonathan C. L. Rodrigues et al.

Published: 2012 Dec
Issue: 6(12) :: Pages: 1-8


Free full text article: A rare cause of neural foraminal widening

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Abstract: The differential diagnosis for lesions causing neural foraminal widening is vast. The majority are solitary benign peripheral nerve sheath tumours, such as neurofibromas or schwannomas. We present a case of a rare cause of neural foraminal expansion secondary to a posterior thoracic extradural angiolipoma. We describe the presence of chemical shift artefact on post gadolinium T1-weighted imaging as indirect evidence of a fatty component. This potentially important diagnostic sign may raise the suspicion of angiolipoma, especially in an isointense or hypointense dumbbell lesion on T1-weighted imaging, and has not been described previously in this context. Accurate radiological diagnosis of an angiolipoma is important to reduce unexpected haemorrhagic complications from biopsy or resection of the lesion.


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Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Imaging characteristics of an unusual, high-grade angiocentric glioma: A case report and review of the literature. by Hector N. Aguilar et al.

Published: 2012 Oct
Issue: 6(10) :: Pages: 1-10


Free full text article: Imaging characteristics of an unusual, high-grade angiocentric glioma: A case report and review of the literature.

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Abstract: Angiocentric gliomas have recently been reclassified as a separate central nervous system tumor. Few cases have been reported, and most of those correspond to slow-growing, low-grade neoplasms in very young pediatric patients. Here we describe magnetic resonance imaging findings (including diffusion imaging, spectroscopy and tractography) in an unusual higher-grade neoplasm with pathologic features suggestive of an angiocentric glioma in a 15-year-old male. The tumor had mild heterogeneous enhancement on magnetic resonance imaging, and a low apparent diffusion coefficient (9.9 x 10-4 mm2s-1), consistent with an intermediate-to-high cellularity tumor. Spectroscopic imaging showed elevated choline/phosphocreatine and choline/N-acetyl aspartate ratios, suggesting an unusually aggressive tumor. We conclude that angiocentric glioma should not be excluded from consideration at primary diagnosis, particularly in teenaged patients nearing adulthood.


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Magnetic Resonance Imaging, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Supine Digital Subtraction Myelography for the Demonstration of a Dorsal Cerebrospinal Fluid Leak in a Patient with Spontaneous Intracranial Hypotension: A Technical Note by Michael Carstensen et al.

Published: 2012 Sep
Issue: 6(9) :: Pages: 1-9


Free full text article: Supine Digital Subtraction Myelography for the Demonstration of a Dorsal Cerebrospinal Fluid Leak in a Patient with Spontaneous Intracranial Hypotension: A Technical Note

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Abstract: A patient with spontaneous intracranial hypotension due to a spinal cerebrospinal fluid (CSF) leak required localization of the leakage site prior to surgical management. Conventional, computed tomography and prone digital subtraction myelography failed to localize the dural tear, which was postulated to be dorsally located. We present here a digital subtraction myelographic approach to accurately localize a dorsal site of CSF leakage by injecting iodinated contrast via a lumbar drain with the patient in the supine position.


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Magnetic Resonance Imaging, Nuclear Medicine, Fluoroscopy, Computed Tomography, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Unusual Appearance and Presentation of Supratentorial Subependymoma in an Adult Patient by Ahmed K. Abdel-Aal et al.

Published: 2012 Aug
Issue: 6(8) :: Pages: 8-16


Free full text article: Unusual Appearance and Presentation of Supratentorial Subependymoma in an Adult Patient

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Abstract: We report a case of a large, heterogeneously enhancing, pathologically proven, supratentorial subependymoma in a 31-year-old male patient presenting with headache, nausea and vomiting as well as gait disturbances. Although most supratentorial subependymomas have distinctive MR features, our case demonstrated imaging findings that made it indistinguishable from other more aggressive malignant supratentorial intraventricular lesions. It is of paramount importance to consider supratentorial subependymomas in the differential diagnosis of supratentorial lesions, even if their radiological features were atypical.


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Magnetic Resonance Imaging, Microscopic pathology, Table

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Radiation necrosis of the pons after radiotherapy for nasopharyngeal carcinoma: Diagnosis and treatment by Matthew N DeSalvo

Published: 2012 Jul
Issue: 6(7) :: Pages: 9-16


Free full text article: Radiation necrosis of the pons after radiotherapy for nasopharyngeal carcinoma: Diagnosis and treatment

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Abstract: We report a case of radiation necrosis in an unusual location, the pons, in a patient who had received chemoradiation for nasopharyngeal carcinoma (NPC) over one year prior to presentation. This patient presented with subacute onset of ataxic hemiparesis and slurred speech. Initial magnetic resonance imaging (MRI) studies showed two 1-2cm peripherally contrast-enhancing lesions in the pons with extensive surrounding edema. Proton magnetic resonance spectroscopy (MRS) played a key role in narrowing the differential diagnosis to radiation necrosis. The patient underwent biweekly bevacizumab therapy and has remained clinically stable with radiologic improvement of his lesion. In addition to this case, we present an overview of the use of advanced neuroimaging in distinguishing radiation necrosis of the central nervous system (CNS) from other entities as well as the role of bevacizumab in treatment.


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Magnetic Resonance Imaging, Table

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Cadaveric position of unilateral vocal cord: a case of cricoid fracture with ipsilateral arytenoid dislocation by Nirmalkumar Gopalakrishnan et al.

Published: 2012 Mar
Issue: 6(3) :: Pages: 24-31


Free full text article: Cadaveric position of unilateral vocal cord: a case of cricoid fracture with ipsilateral arytenoid dislocation

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Abstract: We report a case of cricoid cartilage fracture with unilateral arytenoid dislocation following a motorcycle accident. This 25 year old male sustained blunt injury to the head, face and neck. He presented late to the hospital with one week history of dysphonia. Laryngoscopy revealed cadaveric position of the non-functioning left vocal cord. CT and MRI showed laterally displaced left vocal cord. Displaced fractures were noted in the cricoid at the junction of lamina with the anterior arch on the left side and at the right side of the anterior arch, along with dislocated left arytenoid resulting in ipsilateral vocal cord palsy. Medialization thyroplasty was performed to improve his phonation. Laryngeal trauma warrants close monitoring because of the risk of airway compromise. Radiologists play a crucial role in early diagnosis and should always have high index of suspicion. Recognition of laryngeal injury is important for initial resuscitation as well as for long term airway and vocal function.


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Clinical image, Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Intraosseous Schwannoma of the Petrous Apex by Christopher Goiney et al.

Published: 2011 Nov
Issue: 5(11) :: Pages: 8-16


Free full text article: Intraosseous Schwannoma of the Petrous Apex

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Abstract: Primary neoplasms of the petrous apex are rare and include eosinophilic granuloma, chondroma, chondrosarcoma, chordoma, and schwannoma. We report just the second published case of an intraosseous schwannoma of the petrous apex and are the first to describe the entity using magnetic resonance imaging. By studying the computed tomography and magnetic resonance imaging features of this rare tumor, it is possible to suggest the diagnosis preoperatively.


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Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Aggressive hemangioma of the thoracic spine by Wesley B. Schrock et al.

Published: 2011 Oct
Issue: 5(10) :: Pages: 7-13


Free full text article: Aggressive hemangioma of the thoracic spine

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Abstract: Vertebral hemangiomas are common lesions and usually considered benign. A rare subset of them, however, are characterized by extra-osseous extension, bone expansion, disturbance of blood flow, and occasionally compression fractures and thereby referred to as aggressive hemangiomas. We present a case of a 67-year-old woman with progressive paraplegia and an infiltrative mass of T4 vertebra causing mass effect on the spinal cord. Multiple conventional imaging modalities were utilized to suggest the diagnosis of aggressive hemangioma. Final pathologic diagnosis after decompressive surgery confirmed the diagnosis of an osseous hemangioma.


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Magnetic Resonance Imaging, Computed Tomography, Angiography, Interventional, Microscopic pathology, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

White Matter Microsusceptibility Changes in Patients With Hepatic Encephalopathy by Adina F. Achiriloaie et al.

Published: 2011 Aug
Issue: 5(8) :: Pages: 1-7


Free full text article: White Matter Microsusceptibility Changes in Patients With Hepatic Encephalopathy

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Abstract: We report a new radiological finding in two patients with hepatic encephalopathy. A new susceptibility-weighted (SWI) magnetic resonance imaging sequence revealed multiple bilateral microsusceptibility changes in the corpus callosum and white matter, while the conventional T1 and T2 weighted images were unremarkable. We postulate that the etiology of the microsusceptibility changes may be related to hepatic coagulopathy and other factors, such as impaired cerebral blood flow and brain edema.


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Magnetic Resonance Imaging, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Plunging Ranula by Vivek Kalra et al.

Published: 2011 June
Issue: 5(6) :: Pages: 18-24


Free full text article: Plunging Ranula

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Abstract: Plunging ranulas are rare cystic masses in the neck that are mucous retention pseudocysts from an obstructed sublingual gland. They "plunge" by extending inferiorly beyond the free edge of the mylohyoid muscle, or through a dehiscence of the muscle itself, to enter the submandibular space. Imaging demonstrates a simple cystic lesion in the characteristic location and can be used to delineate relevant surgical anatomy. Surgical excision of the collection and the involved sublingual gland is performed for definitive treatment. We present a case of plunging ranula in a 44 year old female who presented with a painless, slowly enlarged neck mass. Plunging ranulas should be considered in the differential diagnosis of cystic neck masses, specifically when seen extending over, or through, the mylohyoid muscle.


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Computed Tomography, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Pediatric Holohemispheric Developmental Venous Anomaly: Definitive characterization by 3D Susceptibility Weighted Magnetic Resonance Angiography by Michael A. Casey et al.

Published: 2011 May
Issue: 5(5) :: Pages: 10-18


Free full text article: Pediatric Holohemispheric Developmental Venous Anomaly: Definitive characterization by 3D Susceptibility Weighted Magnetic Resonance Angiography

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Abstract: We present a case of an incidentally discovered holohemispheric developmental venous anomaly (DVA) in a 12 year old, conclusively characterized by 3D T2* multi-echo sequence susceptibility weighted angiographic imaging (SWAN). For the evaluation of head trauma, abnormal right intraparenchymal and periventricular vascularity was identified by a non contrast head CT scan. Conventional MRI sequences revealed prominent veins with findings suspicious of a DVA. A definitive diagnosis was made by identifying angiographic features typical for DVA by augmented susceptibility weighted angiographic imaging. Using this sequence the entire hemispheric extent of the anomaly without complicating features was definitively characterized, negating the need for a catheter based angiographic study. A holohemispheric DVA in a child to our knowledge has not been previously described.


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Computed Tomography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Ruptured intracranial dermoid cyst manifesting as new onset seizure: a case report by Jennifer Neville Kucera et al.

Published: 2011 Apr
Issue: 5(4) :: Pages: 10-18


Free full text article: Ruptured intracranial dermoid cyst manifesting as new onset seizure: a case report

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Abstract: Intracranial dermoid cysts are rare tumors derived from ectopic epithelial cells. They are slow-growing benign entities, but can cause significant morbidity through compression of neurovascular structures and, rarely, rupture into the subarachnoid space. We present a rare case of a spontaneously ruptured intracranial dermoid cyst presenting as new onset seizures due to chemical meningitis caused by dissemination of fat droplets.


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Computed Tomography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Hypertrophic Olivary Degeneration After Resection of a Pontine Cavernous Malformation: A Case Report by Joseph L. Gatlin¹*, Robert Wineman¹, Bruce Schlakman¹, Razvan Buciuc¹, Majid Khan¹ et al.

Published: 2011 Mar
Issue: 5(3) :: Pages: 24-29


Free full text article: Hypertrophic Olivary Degeneration After Resection of a Pontine Cavernous Malformation: A Case Report

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Abstract: We report the case of a 35 year old African American female who developed hypertrophic olivary degeneration secondary to resection of a pontine cavernous malformation. The patient initially complained of headaches and diplopia. Unenhanced computed tomography (CT) and magnetic resonance images (MRI) of the brain revealed a left pontine cavernous malformation with scattered foci of recent and remote hemorrhage. The patient subsequently underwent surgical resection of the lesion. Follow up MRI 7 months post surgery demonstrated hypertrophy and T2 signal hyperintensity in the ipsilateral inferior olivary nucleus secondary to hypertrophic olivary degeneration. Familiarity with this diagnosis and its imaging characteristics is required of the radiologist to prevent erroneous diagnoses of other pathology.


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Computed Tomography, Magnetic Resonance Imaging, Graph, Table

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Magnetic resonance imaging in Hirayama Disease by Maria Catalina Vargas et al.

Published: 2011 Mar
Issue: 5(3) :: Pages: 17-23


Free full text article: Magnetic resonance imaging in Hirayama Disease

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Abstract: Hirayama disease (HD) is a rare type of cervical myelopathy related to flexion of the neck characterized by progressive muscular weakness and atrophy of the distal upper limbs most frequently seen in young males. HD is thought to be secondary to an abnormal anterior displacement of the posterior dura with secondary compression of the lower cervical spinal cord and chronic injury to the anterior gray matter horns. We present two patients with HD and discuss its pathophysiology and imaging characteristics.


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Magnetic Resonance Imaging, Table

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Diffusion restriction in thrombosed superior ophthalmic veins: Two cases of diverse etiology and literature review by Hima Shriniwas Pendharkar et al.

Published: 2011 Mar
Issue: 5(3) :: Pages: 8-16


Free full text article: Diffusion restriction in thrombosed superior ophthalmic veins: Two cases of diverse etiology and literature review

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Abstract: Thrombosis of superior ophthalmic veins (SOV) is a well known entity occurring secondary to varied etiologies. We describe diffusion restriction in thrombosed SOV in two cases of different etiologies- bilateral involvement in a patient with septic cavernous sinus thrombosis (CST) and another where embolisation of an indirect carotico-cavernous fistula (CCF) resulted in complete SOV thrombosis accompanied by clinical worsening. Our cases add to the limited literature on diffusion findings in SOV thrombosis.


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Magnetic Resonance Imaging, Angiography, Interventional, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Thyroid Abscess as a Complication of Bacterial Throat Infection by Erin Bravo et al.

Published: 2011 Mar
Issue: 5(3) :: Pages: 1-7


Free full text article: Thyroid Abscess as a Complication of Bacterial Throat Infection

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Abstract: Thyroid abscesses are rare complications of neck infections. We report the case of a teenager who developed increasing neck pain and swelling following treatment for a Streptococcus throat infection. Imaging demonstrated a complex fluid collection in the left thyroid lobe. Ultrasound guided aspiration was performed for diagnostic purposes, yielding purulent fluid that grew multiple bacterial species. Following initial antibiotic treatment, the patient underwent definitive surgical management. Underlying risk factors and imaging techniques will be reviewed.


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Computed Tomography, Ultrasound, Table

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Orbital plasmablastic lymphoma with remission following chemotherapy by Andrew J. Degnan et al.

Published: 2011 Feb
Issue: 5(2) :: Pages: 1-7


Free full text article: Orbital plasmablastic lymphoma with remission following chemotherapy

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Abstract: We report the case of a middle-aged HIV-positive man who presented with proptosis and retro-ocular pain. On CT and MR imaging, a retro-orbital enhancing mass was seen, and PET/CT revealed this lesion as well as a similarly characterized mass in the nasopharynx to be hypermetabolic. Biopsy and subsequent pathological characterization revealed this mass to be plasmablastic lymphoma (PBL), a rare form of non-Hodgkin`s lymphoma associated with HIV-infection. PBL is a diffuse B-cell lymphoma with characteristic cell marker patterns. The most common site of this malignancy is within the oral cavity. This case constitutes an unusual orbital manifestation of plasmablastic lymphoma as well as an unusual case in its response to chemotherapy. This case illustrates the importance of functional imaging with PET/CT in the diagnosis, management, and follow-up of plasmablastic lymphoma.


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Computed Tomography, Magnetic Resonance Imaging, Nuclear Medicine, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

MRI findings in herniation of the spinal cord by Yune Kwong et al.

Published: 2010 Oct
Issue: 4(10) :: Pages: 1-5


Free full text article: MRI findings in herniation of the spinal cord

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Abstract: Herniation of the spinal cord is a rare condition that causes non specific neurological deficits that are often a diagnostic challenge to clinicians. Despite several reports in the neurosurgical literature, it is only recently that the imaging appearances of this condition have come to be recognised, due mainly to the widespread adoption of spinal MRI. It is important for radiologists to recognise the telltale MRI features of this condition, as several cases have undergone initial misdiagnosis, resulting in delayed treatment We present a case with typical imaging features to familiarise radiologists with this condition, as it is likely that more cases will come to the fore, with more spinal MRIs being performed.


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Magnetic Resonance Imaging, Table

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Coexisting MS and Lhermitte-Duclos Disease by Bria K. Casperson et al.

Published: 2010 Aug
Issue: 4(8) :: Pages: 1-6


Free full text article: Coexisting MS and Lhermitte-Duclos Disease

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Abstract: ABSTRACT We report the case of a patient with pre-existing multiple sclerosis, who presented with horizontal diplopia, and a prior episode of progressive ataxia and dizziness lasting one week. While initially attributed to multiple sclerosis, subsequent imaging demonstrated a concurrent left cerebellar gangliocytoma, also known as Lhermitte-Duclos disease.


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Computed Tomography, Magnetic Resonance Imaging, Table

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Osteoblastoma of the Frontal Sinuses Presenting with Headache and Blurred Vision: Case Report and Review of the Literature by Charif A. Sidani et al.

Published: 2010 Jun
Issue: 4(6) :: Pages: 1-7


Free full text article: Osteoblastoma of the Frontal Sinuses Presenting with Headache and Blurred Vision: Case Report and Review of the Literature

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Abstract: Osteoblastoma is a rare benign bone tumor that usually arises in the vertebral column and long bones of young adults. Craniofacial involvement is extremely rare. To date, osteoblastoma of the frontal sinus has not been reported in the English literature. We report an osteoblastoma of both frontal sinuses in a 23-year-old male who presented with headache and blurry vision in the left eye. Computed tomography (CT) demonstrated an expansile lesion involving both frontal sinuses with sclerotic and fibrous components, eroding into the roof of the left orbit. On magnetic resonance imaging (MRI) the dense portion of the lesion showed signal void on all sequences, while the fibrous matrix was isointense to grey matter on T1-weighted and T2-weighted images and showed avid enhancement following intravenous contrast administration. Surgical resection was performed and histology was consistent with osteoblastoma.


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Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table

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Vascular anomaly at the craniocervical junction presenting with sub arachnoid hemorrhage: Dilemma in Imaging Diagnosis, Endovascular Management and Complications by Ajeet Gordhan

Published: 2010 May
Issue: 4(5) :: Pages: 1-6


Free full text article: Vascular anomaly at the craniocervical junction presenting with sub arachnoid hemorrhage: Dilemma in Imaging Diagnosis, Endovascular Management and Complications

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Abstract: We present a case of a ruptured vertebral artery dissecting aneurysm that mimicked a presumed vascular anomaly by CTA (Computerized Tomographic Angiography). A parenchymal arteriovenous malformation (AVM) or a dural arteriovenous fistula (DAVF) at the craniocervical junction can present with a subarachnoid hemorrhage and cannot be differentiated from a vertebral artery dissection by non invasive imaging. Catheter based cerebral angiography revealed a dissecting pseudoaneurysm of a diminutive right vertebral artery terminating in the posterior inferior cerebellar artery (PICA) that to our knowledge has not been previously reported. NBCA (N-Butyl Cyanoacrylate) embolization of the pseudoaneurysm lumen and sacrifice of the parent vessel resulted in cerebellar infarction, requiring an emergent decompressive craniectomy. The patient recovered to a functional neurologic status.


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Computed Tomography, Angiography, Interventional

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Other Radiology articles from the Neuroradiology section Neuroradiology

Opposite cerebral dominance for reading and sign language by Sirisha. T. Komakula et al.

Published: 2010 Mar
Issue: 4(3) :: Pages: 11-14


Free full text article: Opposite cerebral dominance for reading and sign language

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Abstract: We present a case of right hemispheric dominance for sign language but left hemispheric dominance for reading, in a left-handed deaf patient with epilepsy and left mesial temporal sclerosis. Atypical language laterality for ASL was determined by preoperative fMRI, and congruent with ASL modified WADA testing. We conclude that reading and sign language can have crossed dominance and preoperative fMRI evaluation of deaf patients should include both reading and sign language evaluations.


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Magnetic Resonance Imaging

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Other Radiology articles from the Neuroradiology section Neuroradiology

Orbital Roof "Blow-in" Fracture: A Case Report and Review by Austin L. Jones et al.

Published: 2009 Dec
Issue: 3(12) :: Pages: 25-30


Free full text article: Orbital Roof

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Abstract: We report a relatively rare case of an essentially isolated orbital roof "blow-in" fracture in a pediatric patient. A 13-year-old male presented with headache and nausea following blunt facial trauma sustained during a skate boarding accident. CT head revealed soft tissue swelling and an abnormal bony density in the superior, posterior right orbital region. Follow-up CT orbits revealed a comminuted orbital roof "blow-in" fracture with involvement of the ethmoid air cells and two tiny foci of intracranial air. Expert consultation revealed normal ophthalmologic and neurologic examination; conservative management was recommended. The case report is followed by a brief overview of orbital fractures including pertinent radiographic considerations.


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Computed Tomography

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Other Radiology articles from the Neuroradiology section Neuroradiology

A case report of a giant presacral cystic schwannoma with sigmoid megacolon by Vinay Nyapathy et al.

Published: 2009 Dec
Issue: 3(12) :: Pages: 31-37


Free full text article: A case report of a giant presacral cystic schwannoma with sigmoid megacolon

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Abstract: Schwannomas are peripheral nerve sheath tumours with a slow growth rate. Giant sacral schwannoma with anterior cortex erosion and associated intrapelvic extension are uncommon. Though they tend to be large when initially found, most Giant schwannomas are clinically asymptomatic. The tumour appears heterogenous due to long standing degeneration. Herein, we present a case of a large purely cystic presacral schwannoma in a patient with poliomyelitis, which has displaced adjacent organs including urinary bladder and sigmoid colon, with an initial presentation of constipation. The tumour was partially excised and diagnosis was confirmed by histo-pathology and immunohistochemistry.


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Clinical image, Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging, Macroscopic pathology, Microscopic pathology

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Other Radiology articles from the Neuroradiology section Neuroradiology

Dural Based Mass: Malignant or Benign by Kurt Scherer et al.

Published: 2009 Nov
Issue: 3(11) :: Pages: 1-12


Free full text article: Dural Based Mass: Malignant or Benign

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Abstract: In March 2007, a 68 year old female was diagnosed with colonic adenocarcinoma metastatic to the lungs and a frontoparietal parafalcine lesion suspected to be a meningioma was also noted. She denied neurologic symptoms and resection of the parafalcine lesion did not occur. For 14 months, she received chemotherapy with poor response. In June 2008, she developed multiple focal neurologic deficits. Enlargement of the parafalcine brain lesion was noted on head computerized tomography and magnetic resonance imaging. Cerebral angiogram demonstrated a parafalcine mass supplied by the middle meningeal artery. All 3 modality findings confirmed a meningioma. Embolization of the middle meningeal artery with craniotomy for excision of the suspected meningioma was performed. Pathology indicated metastatic adenocarcinoma with colonic primary without evidence of meningioma. Meningiomas are the most common dural based lesions; however, a variety of dural lesions mimic meningiomas. Dural metastatic tumors mimicking meningiomas is an uncommon phenomenon, particularly when the primary location is the colon. This paper additionally discusses the differentiation of benign dural based tumors like meningiomas from malignant findings. Multiple adjunct studies can differentiate meningiomas from metastatic tumor. The definitive diagnosis is based on histopathology.


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Magnetic Resonance Imaging, Computed Tomography, Angiography, Interventional, Microscopic pathology, Table

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Other Radiology articles from the Neuroradiology section Neuroradiology

Congenital hearing loss explained in adulthood. Computed tomography of the temporal bone in hemifacial microsomia. A case report. by Dietrich Beitzke et al.

Published: 2009 Oct
Issue: 3(10) :: Pages: 1-4


Free full text article: Congenital hearing loss explained in adulthood. Computed tomography of the temporal bone in hemifacial microsomia. A case report.

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Abstract: We present a case of complex hemifacial microsomia (HFM) which was diagnosed at the age of 46 years. Imaging findings of a complex deformity of the temporal bone are presented and connected to a broad range of clinical symptoms. Computed tomography (CT) imaging indications are discussed briefly.


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Computed Tomography, Conventional Radiography

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Other Radiology articles from the Neuroradiology section Neuroradiology

Glioblastoma of the optic pathways: An Atypical case by Rahat Brar et al.

Published: 2009 Sep
Issue: 3(9) :: Pages: 22-28


Free full text article: Glioblastoma of the optic pathways: An Atypical case

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Abstract: We present a case of glioblastoma multiforme of the optic pathways in a 68 year old lady. Glioblastomas of the optic pathways are rare tumors; the predominant non enhancing component and the vast extent of involvement makes this a unique case. This case report further increases the database of knowledge available on the MRI characteristics of malignant optic glioma of adulthood.


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Magnetic Resonance Imaging, Microscopic pathology

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Other Radiology articles from the Neuroradiology section Neuroradiology

Extraspinal findings on lumbar spine MR imaging by Nathalie V. Gebara et al.

Published: 2009 Aug
Issue: 3(8) :: Pages: 5-13


Free full text article: Extraspinal findings on lumbar spine MR imaging

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Abstract: Interpretation of radiologic studies requires vigilance on the part of the radiologist to identify findings and abnormalities outside the region of interest. In the case of routine lumbar spine MRI for low back pain, many extraspinal abnormalities can often be identified. Some of these findings may account for low back pain. Other findings are incidental, but may have significant clinical implications, and are important to recognize. We present twenty-four examples of incidental findings from lumbar spine MRI examinations. The findings involve various organ systems, covering a broad range of clinical urgency.


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Magnetic Resonance Imaging

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Other Radiology articles from the Neuroradiology section Neuroradiology

Median Palatine Cyst by Andrew Allmendinger et al.

Published: 2009 Jul
Issue: 3(7) :: Pages: 7-10


Free full text article: Median Palatine Cyst

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Abstract: Median palatine cysts are rare, non-odontogenic fissural cysts of the hard palate. These cysts occur in the midline of the hard palate, behind the incisive canal. Only two case reports have documented these cysts on multi-detector computed tomography (MDCT), neither giving detailed descriptions of the cysts. Knowledge of their existence is important and should not be confused with malignant tumors. We present the first case describing the MDCT characteristics of the median palatine cyst.


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Computed Tomography

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Kikuchi-Fujimoto Disease with Bilateral Uveitis by Hope R. Garner et al.

Published: 2009 Jul
Issue: 3(7) :: Pages: 1-6


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Abstract: Kikuchi-Fujimoto disease (KFD), also called histiocytic necrotizing lymphadenitis, is rare condition that usually presents with lymphadenitis and fever. KFD has been associated with many infectious disease processes, predominantly viral. Association with systemic inflammatory processes has been described. Here we present a case of KFD with the rare ocular manifestation of bilateral anterior uveitis, and corresponding findings on magnetic resonance imaging (MRI).


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Clinical image, Magnetic Resonance Imaging, Microscopic pathology

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Other Radiology articles from the Neuroradiology section Neuroradiology

The role of CT imaging in the congenital absence of a cervical spine pedicle: a case report and review of the literature by Bjoern Kitzing et al.

Published: 2009 May
Issue: 3(5) :: Pages: 7-10


Free full text article: The role of CT imaging in the congenital absence of a cervical spine pedicle: a case report and review of the literature

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Abstract: The congenital absence of a cervical spine pedicle is a rare clinical condition which is usually picked up as an incidental finding on imaging studies performed on patients complaining of neck pain following trauma. It is important to recognize that the finding is not traumatic in origin as this has implications regarding the treatment. We report a case of congenital absence of a cervical spine pedicle and present a review of the literature.


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Conventional Radiography, Computed Tomography

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Other Radiology articles from the Neuroradiology section Neuroradiology

Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis by Maneesh Khanna et al.

Published: 2009 Apr
Issue: 3(4) :: Pages: 18-25


Free full text article: Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely  As Orbital Cellulitis

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Abstract: Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis.


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Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology

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Spinal MRI Findings of Guillain-Barré Syndrome by Ozlem Alkan et al.

Published: 2009 Mar
Issue: 3(3) :: Pages: 25-28


Free full text article: Spinal MRI Findings of Guillain-Barré Syndrome

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Abstract: Guillain-Barré syndrome is a relatively common, acute, and rapidly progressive, inflammatory demyelinating polyneuropathy. The diagnosis is usually established on the basis of symptoms and signs, aided by cerebrospinal fluid findings and electrophysiologic criteria. Previously, radiologic examinations have been used only to rule out other spinal abnormalities. We report a case of systemic lupus erythematosus associated with Guillain-Barré syndrome with marked enhancement of nerve roots of the conus medullaris and cauda equina on MR imaging. These MR observations may help confirm the diagnosis of Guillain-Barré syndrome.


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Magnetic Resonance Imaging

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Isolated Cortical Vein Thrombosis - The Cord Sign by Vijay K.Sharma et al.

Published: 2009 Mar
Issue: 3(3) :: Pages: 21-24


Free full text article: Isolated Cortical Vein Thrombosis - The Cord Sign

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Abstract: Isolated cortical vein thrombosis is an uncommon condition and often difficult to diagnose, both clinically and radiologically. We report a case of a 38 years old man who presented with headache of new onset and clinical examination was unremarkable. The unenhanced brain CT did not reveal any abnormality. In view of unrelenting headache and partial seizures, we performed magnetic resonance imaging (with axial T1, T2 and gradient echo sequences, coronal FLAIR, diffusion weighted imaging as well as Gadolinium contrast-enhanced images) and magnetic resonance venography of the brain that revealed an isolated parietal cortical vein thrombosis with the rarely reported `cord sign`. We report the clinical and radiological findings in our patient with isolated parietal cortical vein thrombosis.


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Computed Tomography, Magnetic Resonance Imaging

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Percutaneous vertebroplasty and spinal cord compression: a case report by Ilaria Morghen et al.

Published: 2009 Mar
Issue: 3(3) :: Pages: 17-20


Free full text article: Percutaneous vertebroplasty and spinal cord compression: a case report

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Abstract: This report describes a 60-year-old woman with intensive back pain due to metastatic vertebral body collapse, who underwent percutaneous vertebroplasty. Subsequently, the patient developed metastatic lesion extrusion into the spinal canal because of pressure of the cement, with compression of the left anterolateral spinal cord. During percutaneous vertebroplasty procedure in patient with malignant tumors, the complication rate increases owing to the risk of leakage of cement resulting from the vertebral body destruction, but as also seen in our case, for the extrusion of the neoplastic tissue and increase of the pressure in the vertebral body due to the introduction of the cement.


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Magnetic Resonance Imaging, Computed Tomography





Other Radiology articles from the Neuroradiology section Neuroradiology

Mount Fuji sign with concavo-convex appearance of epidural haematoma in a patient with tension pneumocephalus by Amit Agrawal et al.

Published: 2009 Jan
Issue: 3(1) :: Pages: 10-12


Free full text article: Mount Fuji sign with concavo-convex appearance of epidural haematoma in a patient with tension pneumocephalus

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Abstract: Intracranial pneumatocele is a non-infected accumulation of air within the cranial cavity. We report a case of a 22-year-old male who sustained a fracture of anterior cranial fossa following a motor vehicle accident and the imaging findings showed a concave-convex epidural haematoma. Simple traumatic pneumocephalus usually does not require surgical treatment and non-operative management has been advocated for small, asymptomatic convexity extradural haematomas.


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Computed Tomography, Magnetic Resonance Imaging

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Other Radiology articles from the Neuroradiology section Neuroradiology

Bilateral Carotid Artery Dissection after High Impact Road Traffic Accident by Ankur Srivastava et al.

Published: 2008 Nov
Issue: 2(5) :: Pages: 23-28


Free full text article: Bilateral Carotid Artery Dissection after High Impact Road Traffic Accident

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Abstract: A 58 year old man was involved in a high impact road traffic incident and was admitted for observation. Asymptomatic for the first 24 hours, he collapsed with symptoms and signs consistent with a cerebrovascular accident. Computed tomography angiogram (CTA) and Magnetic resonance angiogram (MRA) demonstrated bilateral internal carotid artery dissections and a left middle cerebral artery infarct. It was not considered appropriate to attempt stenting or other revascularistation. The patient was treated with heparin prior to starting warfarin. He made a partial recovery and was discharged to a rehabilitation facility. This case is a reminder of carotid dissection as an uncommon but serious complication of high speed motor vehicle accident, which may be silent initially. Literature Review suggests risk stratification before relevant radiological screening at risk patients. Significant advances in CTA have made it the diagnostic tool of choice, but ultrasound is an important screening tool.


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Computed Tomography, Magnetic Resonance Imaging, Angiography, Interventional





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Moyamoya Disease - A Vasculopathy and an Uncommon Cause of Recurrent Cerebrovascular Accidents by Yasmin S. Hamirani et al.

Published: 2008 Sep
Issue: 2(3) :: Pages: 4-10


Free full text article: Moyamoya Disease - A Vasculopathy and an Uncommon Cause of Recurrent Cerebrovascular Accidents

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Abstract: Moyamoya disease is a very rare chronic cerebrovascular disease of unknown etiology characterized by recurrent ischemic or hemorrhagic strokes. Initially diagnosed in Japan and named after finding puff of smoke like collateral blood vessels around the occluded blood vessels of circle of Willis. With increase awareness this disease is now diagnosed more often. Medical and surgical treatment have been used to treat the disease, with surgical treatment been mostly experimental. Special attention should be given to the surgical treatment which has shown to have an edge over the medical treatment in some clinical trials especially in young patients with recurrent strokes to prevent progressive cognitive decline and to improve their quality of life. In our patient, who is a young man, the diagnosis was picked up late and when surgical evaluation was performed, it was considered to be fruitless with findings of nonviable brain tissue on MRI imaging.


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Aggressive Adenoid Cystic Carcinoma With Asymptomatic Spinal Cord Compression Revealed By A "Curtain Sign" by Thariat J et al.

Published: 2008 Jul
Issue: 2(1) :: Pages: 12-15


Free full text article: Aggressive Adenoid Cystic Carcinoma With Asymptomatic Spinal Cord Compression Revealed By A

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Abstract: The authors present a case of unusually aggressive adenoid cystic carcinoma of the head and neck. The patient presented with sciatica one year after initial diagnosis. She was otherwise asymptomatic. Complete work-up for bone involvement, included bone scan and MRI. The patient had painful osteolytic sacral metastasis and asymptomatic thoracic (T5) vertebral metastasis revealed by a typical curtain sign on MRI. The curtain sign, originally described by Trolard, is due to the displacement of the Trolard’s membrane with the median ligament attaching the dura to the bone while there is a dorsal displacement and loosening of the posterior longitudinal ligament. The patient benefited from radiotherapy and did not develop respiratory distress, paraplegia or pain but died of liver metastases.


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Other, Computed Tomography, Magnetic Resonance Imaging

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