Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Transient global amnesia (TGA) is a rare clinical entity with a sudden onset of anterograde amnesia that recovers within 24 hours. The underlying pathophysiology is uncertain. Imaging studies are controversial, but diffusion-weighted images often show small diffusion-restricted lesions in the hippocampus, which may suggest ischemic damage. Thus, we conducted the first clinical study using neurite orientation dispersion and density imaging (NODDI) and arterial spin labeling (ASL) to examine whether the microstructure and perfusion status of the hippocampus are influenced by the presence of diffusion-restricted lesions. ⋯ The first NODDI and ASL study in patients after TGA demonstrated no obvious microstructural or perfusion abnormalities in the hippocampus with typical DWI-positive lesions, which may indicate that TGA does not cause destructive damage or involve baseline microstructure or perfusion abnormalities in the hippocampus in relation to diffusion-restricted lesions.
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Despite increasing demand for fluoroscopy-guided lumbar puncture (FG-LP), there is limited quantitative and epidemiological data on patients undergoing this procedure. Additionally, data are scarce on the correlation of iliac crest landmarks to the actual anatomical lumbar level (intercristal line). The aim of this study is to determine if (1) body mass index (BMI) correlates with skin to spinal canal distance (SCD) and (2) the iliac crest landmark correlates with the presumed anatomical landmark on cross-sectional imaging. ⋯ There was direct, positive linear correlation between BMI and SCD at clinically relevant lumbar disc levels. Furthermore, there is considerable anatomical variance in the intervertebral space that aligns with the superior aspect of the iliac crest.
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Glioblastomas (GBMs) that involve the subventricular zone (SVZ) have a poor prognosis, possibly due to recruitment of neural stem cells. The purpose of this study was to evaluate whether SVZ involvement by lower grade gliomas (LGG), WHO grade II and III, similarly predicts poorer outcomes. We further assessed whether tumor genetics and cellularity are associated with SVZ involvement and outcomes. ⋯ Unlike in GBM, overall SVZ involvement was not found to strongly predict poor prognosis in LGGs. However, occipital SVZ involvement, though uncommon, was prognostic and found to be associated with CDKN2A/B mutations and tumor hypercellularity. Further investigation into these molecular mechanisms underlying occipital SVZ involvement in larger cohorts is warranted.
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Sickle cell disease is the most common hereditary hemoglobinopathy, which results in abnormally shaped and rigid red blood cells. These sickle-shaped red blood cells cause vaso-occlusion and ischemic phenomena that can affect any organ in the body. As a common cause of disability, the neurological manifestations of sickle cell disease are particularly important. ⋯ Impaired blood supply to bone is associated with osteomyelitis and osteonecrosis. Fat embolization syndrome is a rare complication of osteonecrosis, which may cause devastating neurological impairment. Awareness and early recognition of the diverse manifestations of sickle cell disease on neuroimaging is crucial to ensure optimal treatment in a complex patient cohort.
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Mechanical Thrombectomy (MT) using modern devices has proved to be efficacious in re-establishing intracranial circulation and reduced procedural times. We outline a number of endovascular techniques utilizing the distal access catheter, the circumstances where they are applicable, and the outcomes achieved. ⋯ In this pictorial review, we have demonstrated techniques where distal access catheter when used as a sole suction device, or combined with a stent-retriever, has been able to provide a rapid route to successful reperfusion, with minimal complications related to our endovascular procedures.