Correlation between balanced fast field echo sequence and intraoperative findings in the surgical treatment of an intradural spinal arachnoid cyst: illustrative case.

Background: Spinal arachnoid cysts can cause myelopathy through spinal cord compression. While MRI is the standard for diagnosis, traditional sequences may not clearly define cyst borders and septations, which are important for guiding surgical intervention. Balanced fast field echo (B-FFE) is an MRI sequence that highlights small arachnoid membranes within and at the borders of CSF spaces.

The delayed spectral sign in Post-transfer CT imaging: an imaging marker of stroke severity and hemorrhagic risk.

Purpose: Acute stroke transfer patients often undergo repeat computed tomography (CT) imaging upon arrival at a thrombectomy-capable center. Often, there is residual intravenous (IV) "contrast staining" of acute infarcts on the initial post-transfer CT head exam, which we have detected utilizing dual-layer CT spectral virtual non-contrast images. We term this the delayed spectral sign (DSS).

The evolution of pituitary cysts in growth hormone-treated children.

Objectives: We have previously shown that pituitary cysts may affect growth hormone secretion. This study sought to determine cyst evolution during growth hormone treatment in children.

Methods: Forty-nine patients with short stature, a pituitary cyst, and at least two brain MRI scans were included.

Dual-layer spectral CT virtual-non-contrast images aid in parathyroid adenoma analysis and radiation dose reduction: confirmation of findings from dual-energy CT.

4D-parathyroid CT scans have become a mainstay in the evaluation and pre-surgical planning for parathyroid adenomas. Most protocols typically rely on non-contrast images, prior to the arterial and delayed phases. Previous reports with dual-energy CT imaging have highlighted the utility of virtual non-contrast images to help reduce radiation dose while maintaining diagnostic accuracy.

Brain MRI findings in COVID-19 patients with PRES: A systematic review.

Background: Numerous case reports and case series have described brain Magnetic Resonance Imaging (MRI) findings in Coronavirus disease 2019 (COVID-19) patients with concurrent posterior reversible encephalopathy syndrome (PRES).

Purpose: We aim to compile and analyze brain MRI findings in patients with COVID-19 disease and PRES.

Methods: PubMed and Embase were searched on April 5th, 2021 using the terms "COVID-19", "PRES", "SARS-CoV-2" for peer-reviewed publications describing brain MRI findings in patients 21 years of age or older with evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and PRES.

Differentiation of hemorrhage from contrast enhancement using dual-layer spectral CT in patients transferred for acute stroke.

Acute stroke patients transferred to thrombectomy capable centers (TCC), undergo a CT head exam upon arrival at the TCC to evaluate for ASPECTS decay and intracranial hemorrhage. In patients who received iodinated contrast prior to transfer, parenchymal enhancement may simulate hemorrhage on this post-transfer CT. We report two cases utilizing CT spectral imaging to differentiate between parenchymal contrast enhancement and hemorrhage in this setting.

Case 271: Metronidazole-induced Encephalopathy.

HistoryAn 11-year-old boy taking oral antibiotics for meningitis diagnosed 3 months earlier presented to the emergency department with a 1-week history of intermittent emesis, dizziness, and vertigo and a 1-day history of wobbly gait and bilateral lower extremity paresthesia without confusion. His metabolic profile was normal. Contrast material-enhanced MRI of the brain was performed.

Case 271.

History An 11-year-old boy taking oral antibiotics for meningitis diagnosed 3 months earlier presented to the emergency department with a 1-week history of intermittent emesis, dizziness, and vertigo and a 1-day history of wobbly gait and bilateral lower extremity paresthesia without confusion. His metabolic profile was normal. Contrast material-enhanced MRI of the brain was performed, and selected images are shown ( Fig 1 - 4 ).

Retrograde cysto-myelogram: Case Report.

Background: In the scenario of blunt trauma with suspected bladder injury, conventional retrograde cystography is the gold standard for accurate diagnosis.

Case Description: The authors report the case of a 54-year-old patient who presented with pelvic and sacral fractures and a ruptured bladder after being hit by a vehicle. A retrograde computed tomography cystogram demonstrated extraperitoneal extravasation of the contrast agent, which traversed violated sacral nerve roots, resulting in contrast entering the subarachnoid space at the left sacral ala predominantly through the left L5 and S1 nerve roots.

Early angiographic occlusion of ruptured blister aneurysms of the internal carotid artery using the Pipeline Embolization Device as a primary treatment option.

Background: Data on the timing, durability and occlusion rate of treating ruptured blister cerebral aneurysms using the Pipeline Embolization Device (PED) are limited.

Clinical Presentation: Three patients who presented with subarachnoid hemorrhages from ruptured blister aneurysms of the internal carotid arteries were treated with the PED.

Results: Aneurysmal occlusion with reconstruction of the parent vessels occurred angiographically using the PED as a primary treatment modality.

Altered Fractional Anisotropy in Early Huntington's Disease.

Huntington's disease (HD) is a dominantly inherited neurodegenerative disease best known for chorea. The disorder includes numerous other clinical features including mood disorder, eye movement abnormalities, cognitive disturbance, pendular knee reflexes, motor impersistence, and postural instability. We describe a mild case of HD early in the disease course with depression and subtle neurological manifestations.

Late-onset neurodegeneration with brain iron accumulation with diffusion tensor magnetic resonance imaging.

Introduction: Neuroferritinopathy is an autosomal dominant neurodegenerative disorder that includes a movement disorder, cognitive decline, and characteristic findings on brain magnetic resonance imaging (MRI) due to abnormal iron deposition. Here, we present a late-onset case, along with diffusion tensor imaging (DTI).

Case Presentation: We report the case of a 74-year-old Caucasian female with no significant past medical history who presented for evaluation of orofacial dyskinesia, suspected to be edentulous dyskinesia given her history of ill-fitting dentures.

Optimization of postoperative computerized tomographic imaging in patients with the implanted responsive neurostimulation system.

The Responsive Neurostimulation System is currently under investigation as a neurosurgical option for medically refractory epilepsy. The device produces significant metallic artifact on conventional axial CT scans, resulting in limited diagnostic imaging options for implanted patients. We have developed a strategy to overcome this technical difficulty utilizing optimized patient positioning, thin-slice image acquisition, and postprocessing image reconstruction with commercially available software.