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Brain Imaging with MRI and CT: Part 1

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(BQ) Part 1 of the document Brain Imaging with MRI and CT presents the following contents: Bilateral predominantly symmetric abnormalities, sellar, perisellar and midline lesions, parenchymal defects or abnormal volume.

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Nội dung Text: Brain Imaging with MRI and CT: Part 1

  1. BRAIN IMAGING WITH MRI AND CT An Image Pattern Approach
  2. BRAIN IMAGING WITH MRI AND CT An Image Pattern Approach Edited by Zoran Rumboldt Professor of Radiology, Neuroradiology Section Chief and Fellowship Program Director, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA Mauricio Castillo Professor of Radiology and Section Chief of Neuroradiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA Benjamin Huang Clinical Assistant Professor of Radiology in the Division of Neuroradiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA Andrea Rossi Head of the Department of Neuroradiology, G. Gaslini Children’s Research Hospital, Genoa, Italy
  3. cambridge university press Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, Sa˜o Paulo, Delhi, Mexico City Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521119443 © Cambridge University Press 2012 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2012 Printed and bound in Great Britain by the MPG Books Group A catalogue record for this publication is available from the British Library Library of Congress Cataloging-in-Publication Data Brain imaging with MRI and CT : an image pattern approach / edited by Zoran Rumboldt . . . [et al.]. p. cm. Includes bibliographical references and index. ISBN 978-0-521-11944-3 (Hardback) I. Rumboldt, Zoran. [DNLM: 1. Neuroimaging–methods. 2. Diagnosis, Differential. 3. Magnetic Resonance Imaging–methods. 4. Tomography, X-Ray Computed–methods. WL 141] 616.80 047548–dc23 2012000482 ISBN 978-0-521-11944-3 Hardback Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this book to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.
  4. CONTENTS List of contributors xi 21 Limbic Encephalitis 42 List of abbreviations xii Mauricio Castillo Preface xv 22 CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) 44 Section 1 Bilateral Predominantly Zoran Rumboldt 23 Megalencephalic Leukoencephalopathy with Symmetric Abnormalities Subcortical Cysts 46 Mariasavina Severino Cases 24 Canavan Disease 48 1 Hepatic Encephalopathy 2 Andrea Rossi and Chen Hoffman Maria Vittoria Spampinato 25 HIV Encephalopathy 50 2 Neurofibromatosis Type 1 – UBOs 4 Zoran Rumboldt and Mauricio Castillo Andrea Rossi 26 Radiation- and Chemotherapy-Induced 3 Carbon Monoxide Intoxication 6 Leukoencephalopathy 52 Benjamin Huang Maria Vittoria Spampinato 4 Pantothenate Kinase-Associated Neurodegeneration 27 Leukoaraiosis (Microangiopathy) 54 (Hallervorden–Spatz Syndrome) 8 Alessandro Cianfoni Andrea Rossi 28 Periventricular Edema in Acute 5 Methanol Intoxication 10 Hydrocephalus 56 Benjamin Huang Alessandro Cianfoni 6 Wilson Disease 12 29 Hypoglycemia 58 Benjamin Huang Benjamin Huang 7 Hypoxic Ischemic Encephalopathy in Term Neonates 14 30 X-Linked Adrenoleukodystrophy (X-ALD) 60 Mariasavina Severino Mariasavina Severino 8 Cryptococcosis 16 31 Periventricular Leukomalacia (PVL) 62 Benjamin Huang Alessandro Cianfoni 9 Gangliosidosis GM2 18 32 Posterior Reversible Encephalopathy Mariasavina Severino Syndrome (PRES, Hypertensive 10 Leigh Disease 20 Encephalopathy) 64 Mariasavina Severino Maria Vittoria Spampinato and Zoran Rumboldt 11 Deep Cerebral Vein Thrombosis (DCVT) 22 33 Alexander Disease 66 Benjamin Huang Mariasavina Severino 12 Creutzfeldt–Jakob Disease (CJD) 24 34 Metachromatic Leukodystrophy 68 Benjamin Huang Andrea Rossi and Zoran Rumboldt 13 Global Cerebral Anoxia in Mature Brain 26 35 Neurodegenerative Langerhans Cell Histiocytosis Maria Vittoria Spampinato and Zoran Rumboldt (ND-LCH) 70 14 Wernicke Encephalopathy 28 Zoran Rumboldt and Andrea Rossi Giulio Zuccoli 36 Remote Cerebellar Hemorrhage 72 15 Amyotrophic Lateral Sclerosis 30 Maria Gisele Matheus Mauricio Castillo 37 Spontaneous Intracranial Hypotension 74 16 Glutaric Aciduria Type 1 32 Maria Vittoria Spampinato Mariasavina Severino 17 Subcortical Band Heterotopia 34 Andrea Rossi Other Relevant Cases 18 Bilateral Perisylvian Polymicrogyria (BPP) 36 59 Multiple System Atrophy (MSA) 120 Mariasavina Severino Zoran Rumboldt and Mauricio Castillo 19 Lissencephaly 38 60 Maple Syrup Urine Disease (MSUD) 122 Mariasavina Severino Andrea Rossi 20 Herpes Simplex Encephalitis 40 66 Osmotic Myelinolysis 134 Mauricio Castillo and Zoran Rumboldt Mauricio Castillo v
  5. CONTENTS 87 Benign External Hydrocephalus 178 55 Aqueductal Stenosis 112 Maria Vittoria Spampinato Andrea Rossi 88 Normal Pressure Hydrocephalus 180 56 Progressive Supranuclear Palsy (PSP) 114 Alessandro Cianfoni Alessandro Cianfoni and Zoran Rumboldt 89 Alzheimer Disease 182 57 Joubert Syndrome 116 Maria Vittoria Spampinato Maria Vittoria Spampinato 90 Frontotemporal Lobar Degeneration 184 58 Rhombencephalosynapsis 118 Maria Vittoria Spampinato Chen Hoffman 91 Huntington Disease 186 59 Multiple System Atrophy (MSA) 120 Zoran Rumboldt and Benjamin Huang Zoran Rumboldt and Mauricio Castillo 184 Congenital Cytomegalovirus Infection 380 60 Maple Syrup Urine Disease (MSUD) 122 Zoran Rumboldt and Chen Hoffman Andrea Rossi 61 Chiari 2 Malformation 124 Mauricio Castillo Section 2 Sellar, Perisellar and 62 Tectal Glioma 126 Midline Lesions Maria Gisele Matheus 63 Brainstem Glioma 128 Cases Donna Roberts 38 Rathke’s Cleft Cyst 78 64 Duret Hemorrhage 130 Zoran Rumboldt Mauricio Castillo 39 Pituitary Microadenoma 80 65 Hypertrophic Olivary Degeneration 132 Matthew Omojola and Zoran Rumboldt Zoran Rumboldt and Benjamin Huang 40 Lymphocytic Hypophysitis 82 66 Osmotic Myelinolysis 134 Zoran Rumboldt and Benjamin Huang Mauricio Castillo 41 Pituitary Macroadenoma 84 67 Germinoma 136 Matthew Omojola and Zoran Rumboldt Mauricio Castillo and Zoran Rumboldt 42 Ectopic Posterior Pituitary Lobe 86 68 Pineoblastoma 138 Mauricio Castillo Mauricio Castillo and Zoran Rumboldt 43 Langerhans Cell Histiocytosis 88 69 Pineal Cyst 140 Zoran Rumboldt and Andrea Rossi Mauricio Castillo 44 Craniopharyngioma 90 70 Vein of Galen Aneurysmal Malformation (VGAM) 142 Maria Vittoria Spampinato Andrea Rossi 45 Hypothalamic Hamartoma 92 71 Corpus Callosum Dysgenesis 144 Andrea Rossi Maria Gisele Matheus 46 Optic Glioma 94 72 Septo-Optic Dysplasia 146 Maria Gisele Matheus Mariasavina Severino 47 Perisellar Meningioma 96 73 Holoprosencephaly 148 Alessandro Cianfoni Andrea Rossi 48 Hemangioma of the Cavernous Sinus 98 74 Atretic Parietal Encephalocele 150 Zoran Rumboldt Maria Gisele Matheus 49 Tolosa–Hunt Syndrome 100 75 Dermoid Cyst 152 Benjamin Huang Benjamin Huang 50 Carotid-Cavernous Sinus Fistula 102 76 Lipoma 154 Zoran Rumboldt Benjamin Huang 51 Perisellar Aneurysm 104 Alessandro Cianfoni Other Relevant Cases 52 Chordoma 106 14 Wernicke Encephalopathy 28 Alessandro Cianfoni and Zoran Rumboldt Giulio Zuccoli 53 Chondrosarcoma 108 93 Dandy–Walker Malformation 190 Zoran Rumboldt Andrea Rossi 54 Colloid Cyst 110 113 Susac Syndrome 232 Alessandro Cianfoni Mauricio Castillo vi
  6. CONTENTS Section 3 Parenchymal Defects or 59 Multiple System Atrophy (MSA) 120 Zoran Rumboldt and Mauricio Castillo Abnormal Volume 61 Chiari 2 Malformation 124 Mauricio Castillo Cases 77 Hippocampal Sclerosis 158 Alessandro Cianfoni Section 4 Abnormalities Without 78 Wallerian Degeneration 160 Significant Mass Effect Alessandro Cianfoni 79 Rasmussen Encephalitis 162 Cases Chen Hoffman and Zoran Rumboldt 80 Chronic Infarct 164 A. Primarily Non-Enhancing Alessandro Cianfoni 97 Dural Venous Sinus Thrombosis 200 81 Post-Traumatic Atrophy 166 Giulio Zuccoli Benjamin Huang 98 Dural Arteriovenous Fistula 202 82 Postoperative Defects 168 Matthew Omojola and Zoran Rumboldt Benjamin Huang 99 Subarachnoid Hemorrhage 204 83 Porencephalic Cyst 170 Matthew Omojola Benjamin Huang 100 Laminar Necrosis 206 84 Schizencephaly 172 Matthew Omojola Alessandro Cianfoni 101 Neurocutaneous Melanosis 208 85 Hemimegalencephaly 174 Majda Thurnher Andrea Rossi 102 Superficial Siderosis 210 86 Sturge–Weber Syndrome 176 Mauricio Castillo Maria Gisele Matheus 103 Polymicrogyria 212 87 Benign External Hydrocephalus 178 Maria Vittoria Spampinato Maria Vittoria Spampinato 104 Seizure-Related Changes (Peri-Ictal MRI 88 Normal Pressure Hydrocephalus 180 Abnormalities) 214 Alessandro Cianfoni Mauricio Castillo 89 Alzheimer Disease 182 105 Embolic Infarcts 216 Maria Vittoria Spampinato Benjamin Huang 90 Frontotemporal Lobar Degeneration 184 106 Focal Cortical Dysplasia 218 Maria Vittoria Spampinato Zoran Rumboldt and Maria Gisele Matheus 91 Huntington Disease 186 107 Tuberous Sclerosis Complex 220 Zoran Rumboldt and Benjamin Huang Maria Gisele Matheus 92 Congenital Muscular Dystrophies 188 108 Dysembroplastic Neuroepithelial Tumor Andrea Rossi (DNT, DNET) 222 93 Dandy–Walker Malformation 190 Giovanni Morana Andrea Rossi 109 Nonketotic Hyperglycemia With Hemichorea– 94 Microcephaly 192 Hemiballismus 224 Mariasavina Severino Zoran Rumboldt 95 Hydranencephaly 194 110 Hyperdensity Following Endovascular Andrea Rossi Intervention 226 96 Acquired Intracranial Herniations 196 Zoran Rumboldt and Benjamin Huang Benjamin Huang 111 Early (Hyperacute) Infarct 228 Benjamin Huang Other Relevant Cases 112 Acute Disseminated Encephalomyelitis (ADEM) 230 16 Glutaric Aciduria Type 1 32 Benjamin Huang Mariasavina Severino 113 Susac Syndrome 232 31 Periventricular Leukomalacia (PVL) 62 Mauricio Castillo Alessandro Cianfoni 114 Diffuse Axonal Injury 234 56 Progressive Supranuclear Palsy (PSP) 114 Majda Thurnher Alessandro Cianfoni and Zoran Rumboldt 115 Multiple Sclerosis 236 57 Joubert Syndrome 116 Matthew Omojola and Zoran Rumboldt Maria Vittoria Spampinato 116 Progressive Multifocal Leukoencephalopathy 58 Rhombencephalosynapsis 118 (PML) 238 Chen Hoffman Zoran Rumboldt vii
  7. CONTENTS 117 Nodular Heterotopia 240 131 Leptomeningeal Cyst 270 Maria Gisele Matheus Benjamin Huang 132 Epidural Hematoma 272 Other Relevant Cases Benjamin Huang 19 Lissencephaly 38 133 Subdural Hematoma 274 Mariasavina Severino Donna Roberts 20 Herpes Simplex Encephalitis 40 134 Empyema 276 Mauricio Castillo and Zoran Rumboldt Mauricio Castillo 21 Limbic Encephalitis 42 135 Secondary (Systemic) Lymphoma 278 Mauricio Castillo Zoran Rumboldt 136 Idiopathic Hypertrophic Pachymeningitis 280 B. Primarily Enhancing Zoran Rumboldt 118 Neurosarcoidosis 242 137 Olfactory Neuroblastoma 282 Zoran Rumboldt Zoran Rumboldt 119 Meningeal Carcinomatosis 244 138 Meningioma 284 Alessandro Cianfoni Alessandro Cianfoni and Zoran Rumboldt 120 Meningitis (Infectious) 246 139 Desmoplastic Infantile Ganglioglioma 286 Mauricio Castillo Giovanni Morana 121 Perineural Tumor Spread 248 140 Hemangiopericytoma 288 Zoran Rumboldt Zoran Rumboldt 122 Moyamoya 250 141 Schwannoma 290 Maria Vittoria Spampinato Giulio Zuccoli 123 Central Nervous System Vasculitis 252 142 Arachnoid Cyst 292 Giulio Zuccoli Maria Gisele Matheus 124 Subacute Infarct 254 143 Epidermoid 294 Benjamin Huang and Zoran Rumboldt Maria Gisele Matheus 125 Active Multiple Sclerosis 256 144 Aneurysm 296 Mariasavina Severino Zoran Rumboldt 126 Capillary Telangiectasia 258 145 Racemose Neurocysticercosis 298 Alessandro Cianfoni Zoran Rumboldt and Mauricio Castillo 127 Developmental Venous Anomaly 260 146 Ependymal Cyst 300 Giulio Zuccoli Giovanni Morana 128 Immune Reconstitution Inflammatory 147 Choroid Plexus Cyst 302 Syndrome (IRIS) 262 Benjamin Huang Zoran Rumboldt 148 Choroid Plexus Papilloma 304 129 Ventriculitis 264 Andrea Rossi Zoran Rumboldt and Majda Thurnher 149 Intraventricular Meningioma 306 Zoran Rumboldt 150 Central Neurocytoma 308 Other Relevant Cases Mauricio Castillo 30 X-Linked Adrenoleukodystrophy (X-ALD) 60 151 Ventricular Diverticula 310 Mariasavina Severino Zoran Rumboldt 33 Alexander Disease 66 Mariasavina Severino Other Relevant Cases 37 Spontaneous Intracranial Hypotension 74 54 Colloid Cyst 110 Maria Vittoria Spampinato Alessandro Cianfoni 86 Sturge–Weber Syndrome 176 67 Germinoma 136 Maria Gisele Matheus Mauricio Castillo and Zoran Rumboldt 68 Pineoblastoma 138 Section 5 Primarily Extra-Axial Focal Mauricio Castillo and Zoran Rumboldt 75 Dermoid Cyst 152 Space-Occupying Lesions Benjamin Huang 76 Lipoma 154 Cases Benjamin Huang 130 Arachnoid Granulations 268 93 Dandy–Walker Malformation 190 Zoran Rumboldt Andrea Rossi viii
  8. CONTENTS Section 6 Primarily Intra-Axial Masses 176 Lhermitte–Duclos (Cowden Syndrome) 362 Mauricio Castillo Cases Other Relevant Cases A. Typically Without Blood Products 62 Tectal Glioma 126 152 Acute Infarction 314 Maria Gisele Matheus Majda Thurnher 63 Brainstem Glioma 128 153 Glioblastoma Multiforme 316 Donna Roberts Zoran Rumboldt and Majda Thurnher 65 Hypertrophic Olivary Degeneration 132 154 Therapy-Induced Cerebral Necrosis (Radiation Zoran Rumboldt and Benjamin Huang Necrosis) 318 Maria Vittoria Spampinato and Zoran Rumboldt B. Typically With Blood Products 155 Non-Hemorrhagic Metastases 320 177 Hypertensive Hematoma 364 Maria Gisele Matheus Zoran Rumboldt 156 Cerebral Abscess 322 178 Amyloid Hemorrhage – Cerebral Amyloid Maria Gisele Matheus Angiopathy 366 157 Cerebral Toxoplasmosis 324 Zoran Rumboldt Benjamin Huang 179 Cortical Contusion 368 158 Primary CNS Lymphoma 326 Benjamin Huang Alessandro Cianfoni and Zoran Rumboldt 180 Hemorrhagic Neoplasms 370 159 Tumefactive Demyelinating Lesion 328 Benjamin Huang Zoran Rumboldt 181 Hemorrhagic Venous Thrombosis 372 160 Tuberculoma 330 Mauricio Castillo and Benjamin Huang Mauricio Castillo 182 Arteriovenous Malformation 374 161 Oligodendroglioma 332 Zoran Rumboldt Maria Vittoria Spampinato 183 Cavernous Angioma (Cavernoma) 376 162 Low-Grade Diffuse Astrocytoma 334 Giulio Zuccoli and Zoran Rumboldt Donna Roberts and Benjamin Huang 163 Gliomatosis Cerebri 336 Mauricio Castillo Section 7 Intracranial Calcifications 164 Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes Cases (MELAS) 338 184 Congenital Cytomegalovirus Infection 380 Mauricio Castillo Zoran Rumboldt and Chen Hoffman 165 Pleomorphic Xanthoastrocytoma (PXA) 340 185 Congenital Toxoplasmosis 382 Mauricio Castillo Chen Hoffman 166 Ganglioglioma 342 186 Aicardi–Goutie`res Syndrome 384 Giovanni Morana and Mauricio Castillo Andrea Rossi 167 Neurocysticercosis – Parenchymal 344 187 Physiologic Basal Ganglia Calcifications 386 Matthew Omojola Benjamin Huang 168 Dilated Perivascular Spaces 346 188 Hyperparathyroidism 388 Giovanni Morana Benjamin Huang 169 Neuroepithelial Cyst 348 189 Meningioangiomatosis 390 Zoran Rumboldt and Benjamin Huang Giovanni Morana 170 Subependymal Giant Cell Astrocytoma (SEGA) 350 190 Vascular Wall Calcification 392 Andrea Rossi Benjamin Huang 171 Subependymoma 352 191 Dystrophic Calcifications 394 Zoran Rumboldt Benjamin Huang 172 Ependymoma 354 192 Calcified Aneurysms 396 Donna Roberts Zoran Rumboldt 173 Pilocytic Astrocytoma 356 193 Vascular Malformations 396 Donna Roberts Zoran Rumboldt 174 Medulloblastoma 358 194 Cysticercosis 398 Donna Roberts and Zoran Rumboldt Matthew Omojola 175 Hemangioblastoma 360 195 Calcified Metastases 398 Zoran Rumboldt and Maria Gisele Matheus Benjamin Huang ix
  9. CONTENTS 196 Ganglioglioma 400 201 Lipoma With Calcification 404 Mauricio Castillo Benjamin Huang 197 Oligodendroglioma 400 202 Craniopharyngioma 406 Zoran Rumboldt Maria Vittoria Spampinato 198 Cortical Tubers in Tuberous Sclerosis 402 203 Meningioma 406 Zoran Rumboldt Alessandro Cianfoni 199 Subependymal Nodules in Tuberous 204 Teflon Granuloma 408 Sclerosis 402 Zoran Rumboldt Zoran Rumboldt 200 Ependymoma 404 Zoran Rumboldt Index 410 x
  10. CONTRIBUTORS Mauricio Castillo Donna Roberts Professor of Radiology and Section Chief, Neuroradiology, Assistant Professor, Neuroradiology, Department of University of North Carolina School of Medicine, Radiology and Radiological Science, Charleston, Chapel Hill, NC, USA SC, USA Alessandro Cianfoni Andrea Rossi Associate Professor, Neuroradiology, Image Guided Spinal Head of the Department of Neuroradiology, G. Gaslini Procedures, Department of Radiology and Radiological Children’s Research Hospital, Genoa, Italy Science, Charleston, SC, USA, and Neuroradiology Section Chief Zoran Rumboldt Neurocenter of Southern Switzerland Professor of Radiology, Neuroradiology Section Lugano, Switzerland Chief and Fellowship Program Director, Department of Radiology and Radiological Science, Medical Chen Hoffmann University of South Carolina, Charleston, Sheba Medical Center, Tel Hashomer, Sakler School of South Carolina, USA Medicine, Tel Aviv University, Tel Aviv, Israel Mariasavina Severino Benjamin Huang Department of Pediatric Neuroradiology, G. Gaslini Clinical Assistant Professor of Radiology, Division of Children’s Research Hospital, Genoa, Italy Neuroradiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA Maria Vittoria Spampinato Associate Professor, Neuroradiology, Department of Maria Gisele Matheus Radiology and Radiological Science, Charleston, Assistant Professor, Neuroradiology, Department of SC, USA Radiology and Radiological Science, Charleston, SC, USA Majda Thurnher Giovanni Morana Associate Professor of Radiology, Medical University of Department of Pediatric Neuroradiology, G. Gaslini Vienna, Vienna, Austria Children’s Research Hospital, Genoa, Italy Giulio Zuccoli Matthew Omojola Section Chief of Neuroradiology, Children’s Hospital of Professor, Section of Neuroradiology, Department of Radiology, Pittsburgh at the University of Pittsburgh Medical Center, University of Nebraska Medical Center, Omaha, NE, USA Pittsburgh, PA, USA xi
  11. ABBREVIATIONS aDG a-dystroglycan DVST dural venous sinus thrombosis AC arachnoid cyst DWM Dandy–Walker malformation ACE angiotensin-converting enzyme EC ependymal cyst AD Alexander disease ECA external carotid artery AD Alzheimer disease EDH epidural (or extradural) hematoma ADC apparent diffusion coefficient EEG electroencephalography ADEM acute disseminated encephalomyelitis ENB esthesioneuroblastoma AESD acute encephalopathy with biphasic seizures and EPPL ectopic posterior pituitary lobe late reduced diffusion ESR erythrocyte sedimentation rate AG arachnoid granulation FA fractional anisotropy AGS Aicardi–Goutie`res syndrome FASI focal areas of signal intensity ALS amytrophic lateral sclerosis FCD focal cortical dysplasia AMN adrenomyeloneuropathy FCMD Fukuyama CMD APD atypical parkinsonian disorder FDG fluorodeoxyglucose APE atretic parietal encephalocele FTD frontotemporal dementia AS aqueductal stenosis FTLD frontotemporal lobar degeneration ATRT atypical teratoid–rhabdoid tumor GBM glioblastoma multiforme AVM arteriovenous malformation GC gliomatosis cerebri BBB blood–brain barrier GCDH glutaryl-CoA dehydrogenase BCAAs branched-chain amino acids GCMN giant cutaneous melanocytic nevi BCKAs branched-chain alpha-keto acids GFAP glial fibrillary acidic protein BEH benign external hydrocephalus GG ganglioma BPP bilateral perisylvian polymicrogyria GLHS Go´mez–Lo´pez–Herna´ndez syndrome CAA cerebral amyloid angiopathy GOM granular osmiophilic material CADASIL cerebral autosomal dominant arteriopathy with GRE gradient echo subcortical infarcts and leukoencephalopathy HAART highly active antiretroviral therapy CAVE cerebro-acro-visceral early lethality HCHB hemichorea–hemiballismus CBD cortico-basal degeneration HD Huntington disease CBPS congenital bilateral perisylvian syndrome HE hepatic encephalopathy CC corpus callosum HIE hypoxic ischemic encephalopathy CC cysticercosis HII hypoxic–ischemic injury CCF carotid-cavernous sinus fistula HME hemimegalencephaly CCM cerebral cavernous malformations HOD hypertrophic olivary degeneration CD callosal dysgenesis HPC hemangiopericytoma CDR clinical dementia rating HPE holoprosencephaly CJD Creutzfeldt–Jakob disease HPF high power field CMB classic medulloblastoma HS hippocampal sclerosis CMD congenital muscular dystrophies HSAS hydrocephalus with stenosis of the sylvian CN cranial nerve aqueduct CNSV central nervous system vasculitis HSCT hematopoietic stem cell transplantation CPM central pontine myelinolysis HSE herpes simplex encephalitis CPP choroid plexus papilloma IAC internal auditory canal CRP C-reactive protein ICA internal carotid artery CS cavernous sinus IHP idiopathic hypertrophic pachymeningitis CST corticospinal tract iNPH idiopathic normal pressure hydrocephalus DAI diffuse axonal injury IRIS immune reconstitution inflammatory syndrome DAVF dural arteriovenous fistula JCV John Cunningham polyomavirus DCVT deep cerebral vein thrombosis JS Joubert syndrome DI diabetes insipidus JSRD Joubert syndrome related disorders DIG desmoplastic infantile gangliogliomas LA leukoaraiosis DIR double inversion recovery LAH lymphocytic adenohypophysitis DMB desmoplastic/nodular medulloblastoma LBSL leukoencephalopathy with brainstem and spinal DNET dysembryoplastic neuroepithelial tumor cord involvement and lactate elevation DNT dysembryoplastic neuroepithelial tumor LCH Langerhans cell histiocytosis DSA digital subtraction angiography LD Leigh disease DVA developmental venous anomaly LDD Lhermitte–Duclos disease xii
  12. LIST OF ABBREVIATIONS LE limbic encephalitis PNS perineural tumor spread LH lymphocytic hypophysitis PRES posterior reversible encephalopathy syndrome LIAS late-onset idiopathic aqueductal stenosis PSP progressive supranuclear palsy LINH lymphocytic infundibuloneurohypophysitis PSWCs periodic sharp and slow wave complexes LIPH lymphocytic infundibulopanhypophysitis PTFE polytetrafluoroethylene LM leptomeningeal melanocytosis PTH parathyroid hormone LN laminar necrosis PTPR papillary tumor of the pineal region LSV lenticulo-striate vasculopathy PVL periventricular leukomalacia MA meningioangiomatosis PVS perivascular spaces MB-EN medulloblastoma with extensive nodularity PXA pleomorphic xanthoastrocytoma MBS Marchiafava–Bignami syndrome rCBV relative cerebral blood volume MEB muscle–eye–brain disease RCC Rathke’s cleft cyst MELAS mitochondrial myopathy, encephalopathy, lactic RCH remote cerebellar hemorrhage acidosis, and stroke-like episodes RES rhombencephalosynapsis MIP maximum intensity projection REZ root entry zone MLC megalencephalic leukoencephalopathy with SAH subarachnoid hemorrhage subcortical cysts SAS subarachnoid spaces MLD metachromatic leukodystrophy SBH subcortical band heterotopia MMC myelomenigocele SCC squamous cell carcinoma MMSE mini mental status examination sCJD sporadic CJD MRA magnetic resonance angiography SCNSL secondary CNS lymphoma MRS MR spectroscopy SCP superior cerebellar peduncles MS multiple sclerosis SD semantic dementia MSA multiple system atrophy SEGA subependymal giant cell astrocytoma MSUD maple syrup urine disease SHD subdural hematoma MT magnetization transfer SIH spontaneous intracranial hypotension MTS mesial temporal sclerosis SNH subcortical nodular heterotopia MVD microvascular decompression SOD septo-optic dysplasia NASAH nonaneurysmal SAH SOV superior ophthalmic vein NBIA neurodegeneration with brain iron accumulation SS superficial siderosis NBO neurofibromatosis bright objects SSS superior sagittal sinus NCC neurocysticercosis SWI susceptibility-weighted images NCM neurocutaneous melanosis SWS Sturge–Weber syndrome ND-LCH neurodegenerative Langerhans cell histiocytosis T2WI T2-weighted imaging NF1 neurofibromatosis type 1 TCN therapy-induced (radiation) NH nodular heterotopia cerebral necrosis NHL non-Hodgkin lymphoma TDL tumefactive demyelinating lesion NK nonketotic TG tectal glioma NMO Neuromyelitis Optica THS Tolosa–Hunt syndrome NPH normal pressure hydrocephalus TIA transient ischemic attack ONB olfactory neuroblastoma TSC tuberous sclerosis complex OPG optic pathway gliomas UBO unidentified bright object PA pilocytic astrocytomas vCJD variant CJD PACNS primary angiitis of the CNS VGAM vein of Galen aneurysmal malformation PCNSL primary CNS lymphoma VHL von Hippel–Lindau disease PCR polymerase chain reaction VLCFA very long chain fatty acids PD Parkinson disease WBRT whole brain radiation therapy/treatment PET positron emission tomography WBRT whole-brain radiotherapy PKAN pantothenate kinase-associated WD Wallerian degeneration neurodegeneration WD Wilson disease PLIC posterior limb of the internal capsule WE Wernicke encephalopathy PML progressive multifocal leukoencephalopathy WMH white matter hyperintensities PNFA progressive nonfluent aphasia WWS Walker–Warburg syndrome PNH periventricular nodular heterotopia X-ALD X-linked adrenoleukodystrophy xiii
  13. PREFACE This book was conceived based on the requests and suggestions diagnosis sections; as a test (with the right-hand page covered), from radiology residents and neuroradiology fellows (especially and even as a regular book from the beginning to the end. once they actually started practicing) and on my own interest in This volume is certainly not aimed at replacing textbooks, but writing a different kind of book. There are already somewhat should rather be viewed as a complementary source. It is an similar volumes with a differential diagnosis instead of a textbook attempt at pattern-based approach, not perfect and definitely format; however, the pattern approach, by which the entities are not all encompassing. There are entities that are not included as grouped into categories based solely on the imaging findings, separate cases, such as Krabbe disease, neuromyelitis optica, and represents a novel concept. lacunar infarcts, to name a few, which were for different reasons The goal of this work is to be useful in real life clinical practice initially considered. They are, however, listed and briefly (as well as the board exams) – it is not intended just for neuro- described under the differential diagnosis sections. The objective radiologists, but probably even more so for practicing general was a book of a reasonable size that would more thoroughly cover radiologists, neurologists, neurosurgeons, pediatricians and other the majority of the common and/or radiologically characteristic physicians. The book starts with the bilateral symmetric and entities. At some point adding new cases and images, revising midline lesion patterns, as these are the easiest ones to miss, text, and updating references had to stop. especially by relatively inexperienced readers. I would like to thank all the contributors, especially my The design has been standardized with images on the left-hand co-editors and friends Mauricio, Ben and Andrea. I would also page and the text on the right, and I am personally responsible for like to acknowledge the colleagues from around the world who the layouts of well over 1500 pictures. Every attempt has been have generously provided their excellent cases: Angelika Guten- made to include at least two different patients with each entity, berg, Chung-Ping Lo, Pranshu Sharma, Se Jeong Jeon, Yasuhiro and there are only a few with a single one, while frequently the Nakata and Zolta´n Patay. I would like to thank everybody at cases comprise images from three or more individuals. The text is Cambridge University Press for enabling me to publish the book concise and broken down into smaller sections, stressing the which I wanted to write for years. distinguishing features, both imaging and clinical, with links to Finally, my special thanks go to my parents, Mirjana and other similar cases under the differential diagnosis section. Zvonko, for their continuous support and promotion of aca- The book may be used in different ways: by comparing the demic activity, and to my wife Tihana and daughters Rita, Frida pattern(s) with an actual clinical case; when looking for charac- and Zora for their patience and understanding. teristics of a certain disease process or a normal variant; for jumping from one case to another through the differential Zoran Rumboldt xv
  14. SECTION 1 Bilateral Predominantly Symmetric Abnormalities Cases 24 Canavan Disease 1 Hepatic Encephalopathy Andrea Rossi and Chen Hoffman Maria Vittoria Spampinato 25 HIV Encephalopathy 2 Neurofibromatosis Type 1 – UBOs Zoran Rumboldt and Mauricio Castillo Andrea Rossi 26 Radiation- and Chemotherapy-Induced Leukoencephalopathy 3 Carbon Monoxide Intoxication Maria Vittoria Spampinato Benjamin Huang 27 Leukoaraiosis (Microangiopathy) 4 Pantothenate Kinase-Associated Neurodegeneration Alessandro Cianfoni (Hallervorden–Spatz Syndrome) 28 Periventricular Edema in Acute Hydrocephalus Andrea Rossi Alessandro Cianfoni 5 Methanol Intoxication 29 Hypoglycemia Benjamin Huang Benjamin Huang 6 Wilson Disease 30 X-linked Adrenoleukodystrophy (X-ALD) Benjamin Huang Mariasavina Severino 7 Hypoxic Ischemic Encephalopathy in Term Neonates 31 Periventricular Leukomalacia (PVL) Mariasavina Severino Alessandro Cianfoni 8 Cryptococcosis 32 Posterior Reversible Encephalopathy Syndrome (PRES, Benjamin Huang Hypertensive Encephalopathy) 9 Gangliosidosis GM2 Maria Vittoria Spampinato and Zoran Rumboldt Mariasavina Severino 33 Alexander Disease 10 Leigh Disease Mariasavina Severino Mariasavina Severino 34 Metachromatic Leukodystrophy 11 Deep Cerebral Vein Thrombosis (DCVT) Andrea Rossi and Zoran Rumboldt Benjamin Huang 35 Neurodegenerative Langerhans Cell Histiocytosis (ND-LCH) 12 Creutzfeldt–Jakob Disease (CJD) Zoran Rumboldt and Andrea Rossi Benjamin Huang 36 Remote Cerebellar Hemorrhage 13 Global Cerebral Anoxia in Mature Brain Maria Gisele Matheus Maria Vittoria Spampinato and Zoran Rumboldt 37 Spontaneous Intracranial Hypotension 14 Wernicke Encephalopathy Maria Vittoria Spampinato Giulio Zuccoli 15 Amyotrophic Lateral Sclerosis Other Relevant Cases Mauricio Castillo 59 Multiple System Atrophy (MSA) 16 Glutaric Aciduria Type 1 Zoran Rumboldt and Mauricio Castillo Mariasavina Severino 60 Maple Syrup Urine Disease (MSUD) 17 Subcortical Band Heterotopia Andrea Rossi Andrea Rossi 66 Osmotic Myelinolysis 18 Bilateral Perisylvian Polymicrogyria (BPP) Mauricio Castillo Mariasavina Severino 87 Benign External Hydrocephalus 19 Lissencephaly Maria Vittoria Spampinato Mariasavina Severino 88 Normal Pressure Hydrocephalus 20 Herpes Simplex Encephalitis Alessandro Cianfoni Mauricio Castillo and Zoran Rumboldt 89 Alzheimer Disease 21 Limbic Encephalitis Maria Vittoria Spampinato Mauricio Castillo 90 Frontotemporal Lobar Dementia 22 CADASIL (Cerebral Autosomal Dominant Arteriopathy with Maria Vittoria Spampinato Subcortical Infarcts and Leukoencephalopathy) 91 Huntington Disease Zoran Rumboldt Zoran Rumboldt and Benjamin Huang 23 Megalencephalic Leukoencephalopathy with Subcortical Cysts 184 Congenital Cytomegalovirus Infection Mariasavina Severino Zoran Rumboldt and Chen Hoffman
  15. SECTION 1 Bilateral Predominantly Symmetric Abnormalities A B Figure 1. Sagittal non-contrast T1WI (A) demonstrates hyperintensity of the globus pallidus (arrow). A more medial sagittal T1WI (B) shows increased signal in the substantia nigra (arrow), dorsal brainstem (white arrowhead), and cerebellum (black arrowhead). Figure 2. Axial non-contrast T1WI through the basal ganglia (A) shows bilateral bright globus pallidus (arrows). Axial T1WI image through the pons (B) reveals hyperintensity involving superior cerebellar peduncles (arrows) and tectum (arrowheads). A B Figure 3. Axial non-contrast T1WI (A) shows a more subtle globus pallidus hyperintensity (arrows). Sagittal T1WI (B) demonstrates high signal in the region of the dentate nucleus (arrowheads) in addition to globus pallidus (arrows). A B 2
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