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Heather S. Spader, Anna Ellermeier, Jonathan O'Muircheartaigh, Douglas C. Dean III, Holly Dirks, Jerrold L. Boxerman, G. Rees Cosgrove and Sean C. L. Deoni

formation and maintenance of the myelin sheath has not yet been elucidated. 21 By providing an objective biomarker to gauge disease severity, quantitative evaluation of myelin content could have widespread clinical application. In particular, this valuable metric could provide unique details regarding the spatial location of abnormalities (and the associated impacted neural systems) and be used to evaluate treatment efficacy. Imaging of Developing White Matter Aberrant myelination, or alterations in the structure, integrity, and composition of the myelin sheath

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Nicole C. H. Keong, Alonso Pena, Stephen J. Price, Marek Czosnyka, Zofia Czosnyka and John D. Pickard

infusion test was found to carry a sensitivity of 57%–100% and a positive predictive value of 75%–92%, whereas prolonged external lumbar drainage in excess of 300 ml was associated with a sensitivity of 50%–100% and a positive predictive value of 80%–100%. 50 Therefore, imaging techniques are increasingly being developed as supplementary diagnostic tests and potential prognostic tools. There is limited Class I evidence that impaired cerebral blood flow (CBF) reactivity to acetazolamide is a predictor of successful CSF shunting, but single photon emission computed

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Moaaz Soliman, Neil K. Taunk, Robert E. Simons, Joseph R. Osborne, Michelle M. Kim, Nicholas J. Szerlip and Daniel E. Spratt

spinal cord compression. Spinal metastases are typically diagnosed using CT, MRI, and/or positron emission tomography (PET) in conjunction with the presence of concerning signs and symptoms. The accuracy of each of these modalities in diagnosing skeletal metastasis has been examined in several meta-analyses using a combination of histopathological analysis, close clinical imaging and follow-up, and/or radiographic confirmation with multiple imaging techniques as the reference standard. 18 The goal of diagnostic imaging in suspected spinal metastasis is to determine

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John A. Butman, Edjah Nduom, H. Jeffrey Kim and Russell R. Lonser

. 1 , 5 While modern high-resolution imaging techniques can detect small ELSTs (3 mm or more in size), many patients have symptomatic tumors that are below the size detectable by current imaging methods. Evidence of an ELST, in patients with VHL disease and small infraradiological tumors, is then based on clinical features and imaging of associated pathophysiological findings. Three pathophysiological mechanisms underlie ELST-associated audiovestibular morbidity: otic capsule invasion, intralabyrinthine hemorrhage, and tumor-associated endolymphatic hydrops. 1

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Craig Kilburg, J. Scott McNally, Adam de Havenon, Philipp Taussky, M. Yashar S. Kalani and Min S. Park

V arious imaging modalities are routinely used in the diagnosis and management of acute ischemic stroke, including CT and MRI. In addition to confirming the presence of ischemic stroke, these techniques are useful for characterizing tissue perfusion. They allow separation of the core infarct from reversible ischemic tissue at risk, thereby indicating the potential for intervention or clot extraction. In addition, lumen imaging—CT angiography (CTA), MR angiography (MRA), or digital subtraction angiography (DSA)—is often performed in the evaluation of stroke

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Daxa M. Patel, R. Shane Tubbs, Gigi Pate, James M. Johnston Jr. and Jeffrey P. Blount

A central factor that impacts lifetime risk of developing a malignancy is radiation exposure. Although background radiation is ubiquitous, the predominant source of radiation in contemporary society is medical imaging. Since 1990, there has been an explosion in medical imaging and a resultant increase in background radiation exposure. This has led to a substantial number of publications in the medical literature addressing radiation exposure risks and alternative methods to decrease these risks. 3–5 , 23–25 Radiation exposure is particularly important

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Brian M. Howard, Ranliang Hu, Jack W. Barrow and Daniel L. Barrow

-making a challenge and imaging important in the diagnosis and management of aneurysms. SAH is a relatively uncommon but devastating type of hemorrhagic stroke. According to the World Health Organization, the incidence of SAH varies significantly across the globe, from 2.0 to 22.5 per 100,000. 16 Approximately 30,000 spontaneous SAHs occur per year in the United States. 16 Although morbidity and mortality resulting from SAH have improved over the past several decades, all-cause mortality still hovers around 30%–40%, and survivors are often plagued by chronic headaches

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Stepan Capek, Benjamin M. Howe, Kimberly K. Amrami and Robert J. Spinner

. This mechanism has been put forth for prostate, 9 , 17 , 27 , 37 bladder, 1 rectal, 18 and cervical cancer. 28 We reviewed our institutional series of cases concluded as perineural spread of pelvic malignancy in search of clinical and radiological patterns. Methods After securing an approval from the institutional review board, we retrospectively reviewed our series of perineural spread of pelvic cancer. These were defined as cases of nLSP without extensive pelvic disease that demonstrated radiological signs of perineural tumor spread. These imaging signs

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Rihan Khan, Alexander C. Mamourian and Tarek Radwan

I n the last decade, multidetector CT scanners have become widely prevalent across the US. In addition to the traditional 5-mm axial slices, thinner axial images can be created and used for diagnostic purposes. Moreover, these images can be rapidly postprocessed to create multiplanar images. Sagittal, coronal, or oblique reformatted images can be created, as can images representing combinations of these views. We present an unusual set of images of a migratory intraventricular clot that caused an exacerbation of hydrocephalus. Intraventricular hemorrhage

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Brandon W. Smith, Kate W. C. Chang, Lynda J. S. Yang and Mary Catherine Spires

T he evaluation and treatment of neonatal brachial plexus palsy (NBPP) have continued to evolve and improve over the past 30 years. However, many controversial topics remain in this field. Across the major brachial plexus clinical programs, a wide variation persists in algorithms and decision making, specifically regarding the timing of surgery, indications, procedure selection, and the incorporation of ancillary testing. Preoperative ancillary testing may include electrodiagnostic testing (EDX) and various imaging modalities. The main goals of preoperative