M.D. Papachristou, R. Ward, V. Agarwal, B. Branstetter
Chiari malformation type 1 is a frequently encountered but incompletely understood morphologic variant that may present with headache and lower cranial nerve symptoms. The main surgical treatment for Chiari malformation type 1 is suboccipital decompression. Further research has identified a subset of patients with Chiari malformation type 1 with radiographic findings that predispose to suboptimal outcomes from suboccipital decompression alone. This disease process has come to be referred to as complex Chiari malformation. Here, we discuss imaging findings of complex Chiari malformation, identify craniovertebral metrics used to stratify patients, and propose a reporting structure to assist our neurosurgical colleagues in the selection of appropriate treatment.Learning Objective: To understand imaging findings and radiographic metrics associated with Complex Chiari malformation and their implication on surgical management
{"title":"Complex Chiari Malformation: What the Neurosurgeon Needs to Know","authors":"M.D. Papachristou, R. Ward, V. Agarwal, B. Branstetter","doi":"10.3174/ng.2100050","DOIUrl":"https://doi.org/10.3174/ng.2100050","url":null,"abstract":"Chiari malformation type 1 is a frequently encountered but incompletely understood morphologic variant that may present with headache and lower cranial nerve symptoms. The main surgical treatment for Chiari malformation type 1 is suboccipital decompression. Further research has identified\u0000 a subset of patients with Chiari malformation type 1 with radiographic findings that predispose to suboptimal outcomes from suboccipital decompression alone. This disease process has come to be referred to as complex Chiari malformation. Here, we discuss imaging findings of complex Chiari\u0000 malformation, identify craniovertebral metrics used to stratify patients, and propose a reporting structure to assist our neurosurgical colleagues in the selection of appropriate treatment.Learning Objective: To understand imaging findings and radiographic metrics associated with Complex\u0000 Chiari malformation and their implication on surgical management","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44056081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Gala, L. Shobhavat, S. Kothari, R. Joshi, E. Gupta
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been rarely associated with neurologic complications that are more vividly described in adults. Similar literature on the pediatric population is scarce. We report multisystem inflammatory syndrome‐associated cerebral microhemorrhages in a child with COVID-19 infection.
{"title":"Multisystem Inflammatory Syndrome‐Associated Cerebral Microhemorrhages in a Child with COVID-19 Infection","authors":"F. Gala, L. Shobhavat, S. Kothari, R. Joshi, E. Gupta","doi":"10.3174/ng.2100018","DOIUrl":"https://doi.org/10.3174/ng.2100018","url":null,"abstract":"Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been rarely associated with neurologic complications that are more vividly described in adults. Similar literature on the pediatric population is scarce. We report multisystem\u0000 inflammatory syndrome‐associated cerebral microhemorrhages in a child with COVID-19 infection.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47596703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Schwannomas are benign peripheral nerve sheath tumors, of which almost half occur in the head and neck. Schwannomas may arise from any cranial, autonomic, or peripheral nerve. It is crucial to recognize the imaging features suggestive of schwannoma because the management decisions are unique due to the generally benign nature of this disease. While most nonvestibular schwannomas will be asymptomatic until they are large, tumors within or adjacent to bony structures are often associated with neurologic symptoms. This article provides a multimodality imaging review of the varied appearance of nonvestibular schwannomas in the head and neck as well as correlative discussion of the clinical presentation and management.Learning Objective: To describe the imaging appearance, critical clinical features, and management implications of nonvestibular schwannomas of the head and neck
{"title":"Nonvestibular Schwannomas of the Head and Neck","authors":"A. Duran, M. T. Starc, A. Khorsandi","doi":"10.3174/ng.2000075","DOIUrl":"https://doi.org/10.3174/ng.2000075","url":null,"abstract":"Schwannomas are benign peripheral nerve sheath tumors, of which almost half occur in the head and neck. Schwannomas may arise from any cranial, autonomic, or peripheral nerve. It is crucial to recognize the imaging features suggestive of schwannoma because the management decisions are\u0000 unique due to the generally benign nature of this disease. While most nonvestibular schwannomas will be asymptomatic until they are large, tumors within or adjacent to bony structures are often associated with neurologic symptoms. This article provides a multimodality imaging review of the\u0000 varied appearance of nonvestibular schwannomas in the head and neck as well as correlative discussion of the clinical presentation and management.Learning Objective: To describe the imaging appearance, critical clinical features, and management implications of nonvestibular schwannomas\u0000 of the head and neck","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46759754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giant cell arteritis is a common pathology in older patients, and often imaging is not necessary. However, the rare, associated orbital inflammatory disease may be the initial presenting symptom that prompts imaging; therefore, radiologists should be aware of this association and imaging features.
{"title":"A Case of Orbital Inflammatory Disease Related to Giant Cell Arteritis","authors":"S. S. Hashmi, K. McCullagh","doi":"10.3174/ng.2100008","DOIUrl":"https://doi.org/10.3174/ng.2100008","url":null,"abstract":"Giant cell arteritis is a common pathology in older patients, and often imaging is not necessary. However, the rare, associated orbital inflammatory disease may be the initial presenting symptom that prompts imaging; therefore, radiologists should be aware of this association and imaging\u0000 features.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47232298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Mistry, S. Ellika, E. Lin, J. Almast, G. Moonis
The anatomy of the skull base is complex and poses a daunting challenge to many radiologists and trainees. In addition to knowing major skull base passages, there are several underrecognized skull base canals, foramina, and fissures that are critical to avoid misdiagnosis, understand the spread of disease, and guide surgical management. A review of the current literature on these forgotten structures yielded numerous original articles and a few review articles, none of which were comprehensive. This article aimed to fill that void. We provide a comprehensive review of underrecognized skull base anatomic structures and their content and discuss their clinical implications.Learning Objective: Recognize uncommon skull base structures, their content, and their clinical implications
{"title":"Raiders of the Lost Canal: Review of Underrecognized Skull Base Canals, Fissures, and Foramina","authors":"D. Mistry, S. Ellika, E. Lin, J. Almast, G. Moonis","doi":"10.3174/ng.2000073","DOIUrl":"https://doi.org/10.3174/ng.2000073","url":null,"abstract":"The anatomy of the skull base is complex and poses a daunting challenge to many radiologists and trainees. In addition to knowing major skull base passages, there are several underrecognized skull base canals, foramina, and fissures that are critical to avoid misdiagnosis, understand\u0000 the spread of disease, and guide surgical management. A review of the current literature on these forgotten structures yielded numerous original articles and a few review articles, none of which were comprehensive. This article aimed to fill that void. We provide a comprehensive review of\u0000 underrecognized skull base anatomic structures and their content and discuss their clinical implications.Learning Objective: Recognize uncommon skull base structures, their content, and their clinical implications","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44547899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The facial muscles are responsible for nonverbal expression, and the manner by which these muscles function to express various emotions are reviewed. How one recognizes these various facial expressions and how individuals can alter their facial expression are discussed. The methodology for cataloging facial expressions is also presented. The embryology of the facial muscles; the facial ligaments; and the supporting superficial musculoaponeurotic system, which magnifies the muscle movements, is also reviewed as is the embryology of the facial nerve, which innervates these muscles. Also, a detailed MR imaging atlas of the facial muscles is presented.Learning Objective: The reader will learn how the facial muscles develop and how they are the means of human nonverbal emotional expression. The anatomy of the facial ligaments and the superficial musculoaponeurotic system are also discussed
{"title":"Revisiting the Embryology of the Facial Muscles, the Superficial Musculoaponeurotic System, and the Facial Nerve","authors":"P. Som, P. Taub, B. Delman","doi":"10.3174/ng.1900035","DOIUrl":"https://doi.org/10.3174/ng.1900035","url":null,"abstract":"The facial muscles are responsible for nonverbal expression, and the manner by which these muscles function to express various emotions are reviewed. How one recognizes these various facial expressions and how individuals can alter their facial expression are discussed. The methodology\u0000 for cataloging facial expressions is also presented. The embryology of the facial muscles; the facial ligaments; and the supporting superficial musculoaponeurotic system, which magnifies the muscle movements, is also reviewed as is the embryology of the facial nerve, which innervates these\u0000 muscles. Also, a detailed MR imaging atlas of the facial muscles is presented.Learning Objective: The reader will learn how the facial muscles develop and how they are the means of human nonverbal emotional expression. The anatomy of the facial ligaments and the superficial musculoaponeurotic\u0000 system are also discussed","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48132288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. R. Larsen, M. S. Rosztoczy, D. V. Tassel, C. Larson, S. A. Avedikian, D. Gridley
Encephalotrigeminal angiomatosis, also known as Sturge-Weber syndrome or Sturge-Weber-Dimitri disease, is a sporadic congenital neurocutaneous syndrome characterized by angiomas of the face, eyes, and meninges. The typical clinical findings include seizures, a port-wine facial nevus, hemiparesis, and developmental delay. The classic intracranial imaging features of Sturge-Weber syndrome include cerebral hemispheric atrophy, hypervascularity and/or calcification of the cortex, and ipsilateral choroid plexus enlargement. Extracranial findings primarily include the vascular abnormalities of the ocular and facial soft tissues as well as hypertrophy of the calvarial and maxillofacial osseous structures. Additionally, we report involvement of the extraocular muscles, salivary glands, and lacrimal glands, findings that have not been well described in the literature. While a developmental venous pathology underlying Sturge-Weber syndrome has been proposed resulting in many of the findings, the mechanism behind the facial soft-tissue abnormalities and the clinical sequelae associated with these glandular abnormalities is still uncertain.Learning Objective: To recognize typical clinical and various imaging manifestations of Sturge-Weber syndrome, including head and neck and intracranial imaging findings
{"title":"Encephalotrigeminal Angiomatosis: A Review with Emphasis on Head and Neck Manifestations","authors":"B. R. Larsen, M. S. Rosztoczy, D. V. Tassel, C. Larson, S. A. Avedikian, D. Gridley","doi":"10.3174/ng.2000061","DOIUrl":"https://doi.org/10.3174/ng.2000061","url":null,"abstract":"Encephalotrigeminal angiomatosis, also known as Sturge-Weber syndrome or Sturge-Weber-Dimitri disease, is a sporadic congenital neurocutaneous syndrome characterized by angiomas of the face, eyes, and meninges. The typical clinical findings include seizures, a port-wine facial nevus,\u0000 hemiparesis, and developmental delay. The classic intracranial imaging features of Sturge-Weber syndrome include cerebral hemispheric atrophy, hypervascularity and/or calcification of the cortex, and ipsilateral choroid plexus enlargement. Extracranial findings primarily include the vascular\u0000 abnormalities of the ocular and facial soft tissues as well as hypertrophy of the calvarial and maxillofacial osseous structures. Additionally, we report involvement of the extraocular muscles, salivary glands, and lacrimal glands, findings that have not been well described in the literature.\u0000 While a developmental venous pathology underlying Sturge-Weber syndrome has been proposed resulting in many of the findings, the mechanism behind the facial soft-tissue abnormalities and the clinical sequelae associated with these glandular abnormalities is still uncertain.Learning Objective:\u0000 To recognize typical clinical and various imaging manifestations of Sturge-Weber syndrome, including head and neck and intracranial imaging findings","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42520394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Head and neck tumors are a heterogeneous group of neoplasms with variable cell origin, prognosis, and treatment options. Management is related to histologic type and staging, but surgery and chemoradiation are often the main options of treatment. These treatments, though widely used, can be associated with local complications. Early complications are usually related to surgery, and late complications are related to radiation therapy. Imaging plays an important role in the diagnosis and management of these complications, and radiologists must be familiar with them. The authors describe multiple important complications of head and neck cancer treatment with corresponding imaging findings.Learning Objective: To demonstrate important complications of head and neck cancer treatment
{"title":"Imaging of Complications of Head and Neck Cancer Treatment","authors":"L. Villarinho, V. S. Macedo, C. Taylor","doi":"10.3174/ng.2000074","DOIUrl":"https://doi.org/10.3174/ng.2000074","url":null,"abstract":"Head and neck tumors are a heterogeneous group of neoplasms with variable cell origin, prognosis, and treatment options. Management is related to histologic type and staging, but surgery and chemoradiation are often the main options of treatment. These treatments, though widely used,\u0000 can be associated with local complications. Early complications are usually related to surgery, and late complications are related to radiation therapy. Imaging plays an important role in the diagnosis and management of these complications, and radiologists must be familiar with them. The\u0000 authors describe multiple important complications of head and neck cancer treatment with corresponding imaging findings.Learning Objective: To demonstrate important complications of head and neck cancer treatment","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46708201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dilated perivascular spaces in the brain have typical neuroimaging appearances. The classification of dilated perivascular spaces is based on their relationship to blood vessels and is divided into 3 subtypes. A fourth type has been described and termed “opercular perivascular space.” We report on an incidental finding of an opercular perivascular space on MR imaging. Dilated perivascular spaces are benign; it is important to be familiar with their characteristic appearance to prevent reporting them as a neoplasm.
{"title":"Opercular Perivascular Cyst: Old Entity, New Location","authors":"I. Page, D. McArdle, F. Gaillard","doi":"10.3174/ng.2000056","DOIUrl":"https://doi.org/10.3174/ng.2000056","url":null,"abstract":"Dilated perivascular spaces in the brain have typical neuroimaging appearances. The classification of dilated perivascular spaces is based on their relationship to blood vessels and is divided into 3 subtypes. A fourth type has been described and termed “opercular perivascular\u0000 space.” We report on an incidental finding of an opercular perivascular space on MR imaging. Dilated perivascular spaces are benign; it is important to be familiar with their characteristic appearance to prevent reporting them as a neoplasm.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44886572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Rao, I. Ikuta, A. Mahajan, A. A. Karam, V. Zohrabian
Brain tumors are a diverse group of neoplasms that are a source of substantial morbidity and mortality worldwide. Primary gliomas constitute almost all malignant brain tumors, with the most aggressive as well as most common form in adults, grade IV glioma or glioblastoma multiforme, carrying an especially poor prognosis. Neuroimaging is critical not only in the identification of CNS tumor but also in treatment-planning and assessing the response to therapy. Structured reporting continues to gain traction in radiology by reducing report ambiguity and improving consistency, while keeping referring clinicians and patients informed. The Brain Tumor Reporting and Data System (BT-RADS) is a relatively new paradigm that attempts to simplify and maximize consistency in radiologic reporting. BT-RADS incorporates MR imaging features, clinical assessment, and timing of therapy to assign each study a score or category, which is, in turn, linked to a management suggestion. The purpose of this pictorial review article is to familiarize radiologists and nonradiology neurologic specialists alike with BT-RADS, highlighting both advantages and limitations, in the hope that adoption of this system might ultimately facilitate more effective communication and improve consistency among reports.Learning Objective: To describe the features and underscore the advantages and disadvantages of the Brain Tumor Reporting and Data System (BT-RADS), a relatively new classification system that attempts to simplify and maximize consistency in radiologic reporting
{"title":"Brain Tumor Reporting and Data System: A Pictorial Review","authors":"B. Rao, I. Ikuta, A. Mahajan, A. A. Karam, V. Zohrabian","doi":"10.3174/ng.2000069","DOIUrl":"https://doi.org/10.3174/ng.2000069","url":null,"abstract":"Brain tumors are a diverse group of neoplasms that are a source of substantial morbidity and mortality worldwide. Primary gliomas constitute almost all malignant brain tumors, with the most aggressive as well as most common form in adults, grade IV glioma or glioblastoma multiforme,\u0000 carrying an especially poor prognosis. Neuroimaging is critical not only in the identification of CNS tumor but also in treatment-planning and assessing the response to therapy. Structured reporting continues to gain traction in radiology by reducing report ambiguity and improving consistency,\u0000 while keeping referring clinicians and patients informed. The Brain Tumor Reporting and Data System (BT-RADS) is a relatively new paradigm that attempts to simplify and maximize consistency in radiologic reporting. BT-RADS incorporates MR imaging features, clinical assessment, and timing of\u0000 therapy to assign each study a score or category, which is, in turn, linked to a management suggestion. The purpose of this pictorial review article is to familiarize radiologists and nonradiology neurologic specialists alike with BT-RADS, highlighting both advantages and limitations, in the\u0000 hope that adoption of this system might ultimately facilitate more effective communication and improve consistency among reports.Learning Objective: To describe the features and underscore the advantages and disadvantages of the Brain Tumor Reporting and Data System (BT-RADS), a relatively\u0000 new classification system that attempts to simplify and maximize consistency in radiologic reporting","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43418037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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