Đang tải... (xem toàn văn)
(BQ) Part 2 the book Case-Based brain imaging presents the following contents: Neurodegenerative/white matter diseases/metabolic, trauma, congenital/developmental malformations and syndromes, cranial nerves.
Section IV Neurodegenerative/ White Matter Diseases/ Metabolic Tsiouris_CH85.indd 409 11/9/12 6:27 AM Tsiouris_CH85.indd 410 11/9/12 6:27 AM Case 85 Clinical Presentation A 28-year-old woman presents with leg weakness Radiologic Findings A,B C D,E F Fig 85.1 Multiple axial T2-W FLAIR images demonstrate scattered periventricular foci of T2 prolongation radiating from ventricles (A), within the left brachium pontis (B), and within the splenium of the corpus callosum (C) in a pattern typical of demyelination as seen with multiple sclerosis The lesion within the corpus callosum demonstrates enhancement on the postcontrast T1W image (D) and restricted diffusion on the DWI (E) with matching ADC (F) signal consistent with an active region of demyelination Diagnosis Multiple sclerosis (MS) Differential Diagnosis • • • • Acute disseminated encephalomyelitis (more common in children, deep gray nuclear involvement common and colossal involvement uncommon, indistinguishable from first episode of MS) Microvascular ischemic disease (older patient, typically sparing of corpus callosum and subcortical U fibers, lack of enhancement) Vasculitis (small chronic infarctions and leptomeningeal enhancement may be seen) Neoplasm (typically more mass effect, rarely involves the corpus callosum unless glioblastoma or lymphoma) 411 Tsiouris_CH85.indd 411 11/9/12 6:27 AM 412 • • CASE-BASED BRAIN IMAGING Neurosarcoidosis (may see leptomeningeal enhancement, and the corpus callosum is not typically involved) Progressive multifocal leukoencephalopathy (corpus callosum is not typically involved—only 2% of white matter diseases other than MS involve the corpus callosum, typically also involves the subcortical U fibers) Discussion Background MS is the most common neurologic disorder in young adults, generally having onset between 20 and 45 years of age, although 13% of cases present before age 20 and 15% after age 50 MS is more common in women than men with a ratio of 3:2 The clinical definition of MS requires that the patient demonstrate evidence of lesions separated in time and space Separation in time requires two attacks each lasting at least 24 hours involving different parts of the CNS and separated by at least 1 month Separation in space requires clinical evidence of distinct neurologic deficits and/or MRI evidence of separate CNS lesions Pathologically, MS is characterized acutely by inflammatory change followed by multifocal areas of demyelination with varying degrees of axonal degeneration Etiology The cause is unknown, but it is likely an autoimmune reaction to an environmental stimulus in a genetically susceptible individual Clinical Findings The presentation varies with the location of lesions Focal motor and sensory deficits are typical, with headache or seizures being less common presenting symptoms Optic nerve involvement is common, and patients may present with acute visual changes due to optic neuritis Spinal cord involvement may cause myelopathic symptoms Most patients have a chronic relapsing and remitting course, although some patients may demonstrate steady progression of deficits The McDonald Criteria are diagnostic criteria for MS First defined in 2001, the criteria were revised in 2010 to include objective criteria to demonstrate dissemination of lesions in time and space Criteria include clinical and MR imaging findings Complications Blindness, paralysis, dementia, and loss of sphincter control may develop as the disease progresses Clinical Subtypes • • • • Relapsing-remitting (RR) is the most common initial presentation of patients (85%) Secondary-progressive (SP) is considered the usual progression of disease from RR By 10 years 50% of RR and by 25 years 90% of RR patients enter SP phase Primary-progressive (PP): 5–10% of MS patients are progressive from initial presentation Progressive-relapsing (PR): rare progressive disease with clear acute relapses, with or without full recovery Periods between relapses are characterized by continuing disease progression MS Variants • • • Tsiouris_CH85.indd 412 Marburg: younger patients typically presenting with febrile prodrome and a clinically fulminant course with death in months Devic type: “neuromyelitis optica” characterized by demyelination of the optic nerves and spinal cord Schindler type: “diffuse sclerosis” characterized by extensive, confluent, asymmetric demyelination within the bilateral supratentorial and/or infratentorial parenchyma 11/9/12 6:27 AM IV NEURODEGENERATIVE/WHITE MATTER DISEASES/METABOLIC • 413 Balo's concentric sclerosis type: characterized by large lesions with alternating zones of demyelinated and myelinated white matter, monophasic, and often fatal Pathology Gross • • Acute plaques are edematous and have a pink-gray color Chronic plaques show atrophy and cystic change Microscopic • • • There is a variable degree of perivenular inflammation, macrophage infiltration, myelin loss, edema, and gliosis, with varying axonal loss Necrosis, hemorrhage, and calcification are rare Cystic change may occur in large lesions Imaging Findings Computed Tomography • • Lesions are typically isodense or hypodense on noncontrast scan Acute lesions may show enhancement postcontrast Magnetic Resonance • • • • • • • • Lesions are typically homogeneously hyperintense on T2W imaging Large acute lesions may have a “target” appearance: a hyperintense center representing demyelination with a slightly less hyperintense periphery representing vasogenic edema A rim of hypointensity separates these two regions When lesions are large and masslike with or without edema they may mimic neoplasm, tumefactive MS (see Case 86) Lesions may be iso- or hypointense on T1W imaging, and may demonstrate a rim of T1 shortening attributed to free radicals in infiltrating macrophages T1 black holes are MS plaques with decreased signal on T1 If acute and enhancing the decreased signal is likely due to edema Chronic decreased signal within a plaque on a T1W image is thought to be secondary to associated axonal loss Acute lesions often enhance following gadolinium administration, and the pattern may be nodular, arclike, or ringlike New disease inflammation disrupts the blood–brain barrier resulting in enhancement Enhancement may precede T2 abnormalities Enhancement generally lasts 4 weeks and then resolves (range 1–16 weeks) Acute lesions may demonstrate diffusion restriction, or enlargement of preexisting T2 lesions secondary to acute inflammation Lesions typically affect the corpus callosum, periventricular white matter, and arcuate fibers; they may also occur in the posterior fossa and in gray matter structures such as the basal ganglia The periventricular WM lesion are often ovoid and perpendicular to the ventricular surface “Dawson’s fingers.” Cerebral volume loss greater than expected for age is often seen and diffuse or focal loss of volume of the corpus callosum may be seen due to intrinsic corpus callosum plaques or due to axonal loss secondary to more peripheral MS plaques MR spectroscopy may demonstrate reduced NAA peaks with a reduced NAA:creatine ratio and an elevated choline within plaques Treatment • • Tsiouris_CH85.indd 413 Corticosteroids, particularly acutely Beta-interferon and other immunomodulators are also used 11/9/12 6:27 AM 414 CASE-BASED BRAIN IMAGING Prognosis Highly variable depending on the form of the disease and its responsiveness to therapy PEARLS • • • • • MR is much more sensitive and specific than CT for the diagnosis of MS, as MR’s multiplanar capability better demonstrates callosal involvement and “Dawson’s fingers” (ovoid lesions with their long axis perpendicular to the ventricular surface) (Fig 85.2A, B) Gadolinium administration is not necessary for the diagnosis of MS However, it does allow differentiation between acute and chronic lesions (only acute demyelination enhances) (Fig 85.2C, D) Lesions of MS generally lack mass effect or surrounding edema even when large T2W imaging is more sensitive in evaluation of the posterior fossa for lesions than T2W FLAIR (Fig 85.2E, F) Abnormal hypointensity may be seen in the basal ganglia in patients with severe longstanding MS This is thought to be a degenerative phenomenon related to iron deposition PITFALLS • • • Tumefactive MS may mimic a brain tumor or infarction, but there is generally less mass effect than would be expected for a similarly sized tumor (Fig 85.2G–I) On CT, lesions are typically hypodense compared with isodense or hyperdense in the case of cellular tumors Additionally, the giant plaque may show an asymmetric “front” of enhancement rather than an intact ring of enhancement (Fig 85.2I) When the differential includes brain tumor and tumefactive MS, a follow-up scan may be necessary to assess for evolution and avoid an unnecessary biopsy (Fig 85.2J, K) MR spectroscopy may also aid in the diagnosis MR is highly sensitive for the detection of MS lesions, but it is nonspecific Therefore, findings must be correlated with other clinical parameters and laboratory findings such as CSF analysis Companion Cases A,B D Tsiouris_CH85.indd 414 C Fig 85.2 (A–K) Examinations from multiple patients The typical MRI appearance of “Dawson’s fingers” is shown with ovoid T2 hyperintense lesions radiating from the corpus callosum on (A) axial and (B) sagittal T2W FLAIR (C, D) The second patient illustrates the use of contrast to identify acute areas of inflammatory demyelination (D) in a patient with severe underlying chronic disease on axial T2W FLAIR (C) 11/9/12 6:27 AM IV NEURODEGENERATIVE/WHITE MATTER DISEASES/METABOLIC 415 E,F G H,I J Fig 85.2 (continued) The third patient illustrates the increased conspicuity of posterior fossa MS lesions on (F) T2W compared to T2W FLAIR images (E) (G) The fourth patient presented with a hypodense lesion in the left parietal lobe on CT This tumefactive MS case can be distinguished from tumor by its hypodensity on CT (compared to isodense or hyperdense in tumor), relative lack of mass effect on surrounding brain that would be expected for tumor on (H) axial T2W FLAIR and (I) irregular rim of enhancement on postcontrast T1W imaging (J, K) Same patient as in Fig 85.2H, I In patients where it is unclear if the lesion in tumefactive MS or tumor, follow-up imaging may be obtained Four months after treatment with steroids (and also after biopsy) (J) axial T2W FLAIR demonstrates decreased size of the lesion and nearly complete resolution of enhancement on (K) postcontrast T1W imaging K Suggested Readings Fox RJ, Rudick RA Multiple sclerosis: disease markers accelerate progress Lancet Neurol 2004;3(1):10 Gean-Marton AD, Vezina LG, Marton KI, et al Abnormal corpus callosum: a sensitive and specific indicator of multiple sclerosis Radiology 1991;180(1):215–221 Mullins ME Emergent neuroimaging of intracranial infection/inflammation Radiol Clin North Am 2011;49(1):47–62 Polman CH, Reingold SC, Banwell B, et al Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria Ann Neurol 2011;69(2):292–302 Sajja BR, Wolinsky JS, Narayana PA Proton magnetic resonance spectroscopy in multiple sclerosis Neuroimaging Clin N Am 2009;19(1):45–58 Tsiouris_CH85.indd 415 11/9/12 6:27 AM Case 86 Clinical Presentation A 28-year-old woman presents with generalized weakness Radiologic Findings A,B C D,E F Fig 86.1 (A) Axial CT demonstrates a hypodense lesion within the left posterior parietal white matter Axial (B, C) and sagittal (E) T2-FLAIR sequences demonstrate two dominant rounded T2 hyperintense white matter lesions within the left parietal lobe; these lesions demonstrate surrounding more pronounced T2 prolongation suggesting vasogenic edema Lesions have minimal local mass effect and mildly efface the regional sulci The sagittal T2-FLAIR sequence (E) also demonstrates a lamellated, or onion-skin, appearance of the more anterior lesion (D) Axial and (F) sagittal postcontrast T1W images demonstrate ringlike enhancement of these lesions A tiny contralateral periatrial white matter lesion does not enhance (C) 416 Tsiouris_CH86.indd 416 11/9/12 6:28 AM IV NEURODEGENERATIVE/WHITE MATTER DISEASES/METABOLIC 417 Diagnosis Tumefactive multiple sclerosis (MS) Differential Diagnosis • • • • • • Neoplasm (typically more mass effect, more surrounding vasogenic edema, rare to have lamellated appearance, rare to be hypodense on CT) Abscess (typically restricted diffusion centrally within the rim enhancing lesion, T2 hypointense rim with “shaggy” enhancement) Acute disseminated encephalomyelitis (more common in children, deep gray nuclear involvement common and colossal involvement uncommon, but may be indistinguishable from the first episode of MS) Vasculitis (areas of infarction and leptomeningeal enhancement are common) Encephalitis (patients are typically acutely ill with fever and alteration in consciousness) Progressive multifocal leukoencephalopathy (corpus callosum is not typically involved—only 2% of white matter diseases other than MS involve the corpus callosum, typically also involves the subcortical U fibers) Discussion Background MS is the most common neurologic disorder in young adults, generally having onset between 20 and 45 years of age, although 13% of cases present before age 20 and 15% after age 50 MS is more common in women than men with a ratio of 3:2 The clinical definition of MS requires that the patient demonstrate evidence of lesions separated in time and space Separation in time requires two attacks each lasting at least 24 hours involving different parts of the CNS and separated by at least 1 month Separation in space requires clinical evidence of distinct neurologic deficits and/or MR imaging evidence of separate CNS lesions Pathologically, MS is a disease of oligodendroglia and results in multifocal areas of well-demarcated demyelination with or without axonal degeneration Etiology The cause is unknown, but it is likely an autoimmune reaction in genetically susceptible individuals Clinical Findings The presentation varies with the location of lesions Focal motor and sensory deficits are typical, with headache or seizures being less common presenting symptoms Optic nerve involvement is common, and patients may present with acute visual changes due to optic neuritis Spinal cord involvement may cause myelopathic symptoms Most patients have a chronic relapsing and remitting course, although some patients may demonstrate steady progression of deficits Complications Blindness, paralysis, dementia, and loss of sphincter control may develop as the disease progresses Clinical Subtypes • • Tsiouris_CH86.indd 417 Relapsing-remitting (RR) is the most common initial presentation of patients (85%) Secondary-progressive (SP) is considered the usual progression of disease from RR By 10 years 50% of RR and by 25 years 90% of RR patients enter SP phase 11/9/12 6:28 AM 418 • • CASE-BASED BRAIN IMAGING Primary-progressive (PP): 5–10% of MS patients are progressive from initial presentation Progressive-relapsing (PR): rare progressive disease with clear acute relapses, with or without full recovery Periods between relapses are characterized by continuing disease progression MS Variants • • • • Marburg: younger patients typically presenting with febrile prodrome and a clinically fulminant course with death in months Neuromyelitis optica (NMO): characterized by simultaneous demyelination of the optic nerves and spinal cord; Devic type Schindler type: “diffuse sclerosis” characterized by extensive, confluent, asymmetric demyelination within bilateral supratentorial and/or infratentorial parenchyma Balo type: “concentric sclerosis” characterized by large lesions with alternating zones of demyelinated and myelinated white matter, monophasic and often fatal Pathology Gross • • Acute plaques are edematous and have a pink-gray color Chronic plaques show atrophy and cystic change Microscopic • • • There is a variable degree of perivenular inflammation, macrophage infiltration, myelin loss, edema, and gliosis, with relative sparing of axons Necrosis, hemorrhage, and calcification are rare Cystic change may occur in large lesions Imaging Findings Computed Tomography • • Lesions are typically isodense or hypodense on noncontrast scan Lesions may show enhancement postcontrast Magnetic Resonance • • • • • • Tsiouris_CH86.indd 418 Tumefactive MS lesions are typically large and hyperintense on T2W imaging Lesions may have a “target,” “onion-skin,” or lamellated appearance: a hyperintense center representing demyelination with a slightly less hyperintense periphery representing vasogenic edema A rim of hypointensity separates these two regions Lesions may be iso- or hypointense on T1W imaging, and may demonstrate a rim of T1 shortening attributed to free radicals in infiltrating macrophages Lesions often enhance following gadolinium administration, and the pattern may be nodular, arclike, or ringlike Incomplete ring is helpful in distinguishing the lesion from neoplasm Enhancement generally lasts 1 to 2 months and then resolves Additional smaller lesions more typical of MS may lead to diagnosis Susceptibility-weighted images show normal undisrupted venules within the brain crossing the plaques (Fig 86.2D), which is less likely to be seen with neoplasms 11/9/12 6:28 AM 674 CASE-BASED BRAIN IMAGING Fig 152.2 Axial NCCT shows permeative-destructive changes of the bone adjacent to the tumor centered in the left jugular foramen (index case) • • Meningioma (poorly circumscribed jugular foramen mass with permeative-sclerotic bony changes, avid enhancement, and a broad dural base; large flow voids are usually not seen) Metastasis (may be hypervascular, typically more infiltrative and destructive) Discussion Glomus tumors, also called paragangliomas or chemodectomas, are slow-growing neoplasms arising from glomus bodies (paraganglioma tissue) Glomus bodies consist of nonchromaffin cells derived from the neural crest and are normal components of the diffuse neuroendocrine system Their function is often obscure, but they likely function as chemoreceptors In the head and neck, favored locations for glomus tumors include the tympanic plexus in the middle ear cavity (glomus tympanicum), the dome of the jugular bulb (glomus jugulare), the nodose ganglion of the vagus nerve (glomus vagale), and the carotid body near the carotid bifurcation (carotid body tumor) Vagal paragangliomas are the least common, representing ~5% of head and neck paragangliomas Because of the proximity of the hypotympanum to the jugular fossa, many tumors will involve both of these locations In the temporal bone, glomus bodies (neural crest tissue) accompany the tympanic nerve (nerve of Jacobson, a branch of CN IX) and the auricular branch of the vagus nerve (nerve of Arnold) In the jugular foramen, glomus tumors arise from glomus bodies in the adventitia of the jugular bulb Depending on their location, lesions may present with symptoms of pulsatile tinnitus or hearing loss, or with symptoms due to mass effect on the lower cranial nerves These tumors may be multiple and/ or familial, and they rarely metastasize Malignant degeneration occurs in 4% of cases On CT, they typically result in permeative-destructive changes of adjacent bone (Fig 152.2) On MR, they are often irregularly marginated tumors that are intermediate-signal intensity on T1W imaging, iso- to mildly hyperintense on T2W imaging, and enhance intensely post contrast Tumors larger than 2 cm may show prominent intralesional flow voids, often referred to as a “salt and pepper” appearance In some cases, these tumoral flow voids may be visualized with MRA Conventional angiography or CTA, which is often useful for preoperative embolization, demonstrate a hypervascular mass, often supplied by ascending pharyngeal branches of the external carotid artery, with a persistent stain Suggested Readings Rao AB, Koeller KK, Adair CF; Armed Forces Institute of Pathology From the archives of the AFIP Paragangliomas of the head and neck: radiologic-pathologic correlation Radiographics 1999;19(6):1605–1632 van den Berg R Imaging and management of head and neck paragangliomas Eur Radiol 2005;15(7):1310–1318 Tsiouris_CH152.indd 674 11/9/12 7:22 AM Index Note: Page numbers followed by f and t indicate figures and tables, respectively A ACC See agenesis of corpus callosum acute cerebellitis clinical findings, 186 complications, 186 computed tomography, 187 differential diagnosis, 186 etiology, 186 magnetic resonance, 187 pathology, 186 prognosis, 187 radiologic findings, 184 treatment, 187 acute disseminated encephalomyelitis (ADEM) clinical findings, 422 complications, 422 computed tomography, 423 differential diagnosis, 422 etiology, 422 magnetic resonance, 423 pathology, 422 prognosis, 423 radiologic findings, 421 treatment, 423 ADC See Alzheimer dementia complex ADEM See acute disseminated encephalomyelitis agenesis of corpus callosum (ACC) clinical findings, 518 complications, 518 computed tomography, 520 differential diagnosis, 518 etiology, 518 magnetic resonance, 520 pathology, 518–519 prognosis, 521 radiologic findings, 517 treatment, 520 ALD See X-linked adrenoleukodystrophy alobar holoprosencephaly (HPE) clinical findings, 523 complications, 523 computed tomography, 525 differential diagnosis, 522 etiology, 523 magnetic resonance, 525 pathology, 523–524 prognosis, 525 radiologic findings, 522 treatment, 525 ALS See amyotrophic lateral sclerosis Alzheimer dementia complex (ADC) clinical findings, 463–464 computed tomography, 464 differential diagnosis, 463 etiology, 463 magnetic resonance, 464 pathology, 464 positron emission tomography, 464 prognosis, 465 radiologic findings, 462 single-photon emission CT, 464 treatment, 464–465 amyotrophic lateral sclerosis (ALS) clinical findings, 450 computed tomography, 451 differential diagnosis, 450 diffusion tensor imaging, 451 etiology, 450 magnetic resonance, 451 magnetic resonance spectroscopy, 451 pathology, 450–451 positron emission tomography, 451 prognosis, 452 radiologic findings, 449 treatment, 452 anaplastic astrocytoma advanced magnetic resonance, clinical findings, computed tomography, diagnosis, differential diagnosis, 7–8 magnetic resonance, pathology, prognosis, 11 radiologic findings, treatment, aneurysm See specific types aneurysmal subarachnoid hemorrhage (A-SAH) clinical findings, 263 complications, 263 computed tomography, 264–265 differential diagnosis, 262 digital subtraction angiography, 265 etiology, 263 magnetic resonance, 265 pathology, 264 prognosis, 266 radiologic findings, 261 treatment, 265–266 arachnoid cyst clinical findings, 108 complications, 108 computed tomography, 109–110 differential diagnosis, 108 epidermoid cyst compared with, 110t etiology, 108 magnetic resonance, 110 pathology, 108 675 Tsiouris_Index.indd 675 11/15/12 9:20 AM 676 INDEX arachnoid cyst (continued) prognosis, 110 radiologic findings, 107 treatment, 110 arterial dissection of internal carotid arteries angiography, 299 clinical findings, 297 complications, 297 computed tomography, 297 CTA, 298 differential diagnosis, 298 etiology, 297 magnetic resonance, 299 MRA, 299 prognosis, 300 radiologic findings, 297 treatment, 300 arteriovenous malformation (AVM) clinical findings, 317 computed tomography, 317 differential diagnosis, 316 magnetic resonance, 319 pathology, 317 prognosis, 321 radiologic findings, 316 treatment, 319–321 A-SAH See aneurysmal subarachnoid hemorrhage astrocytoma See also specific types clinical findings, computed tomography, diagnosis, differential diagnosis, 3–4 magnetic resonance, pathology, prognosis, radiologic findings, treatment, ataxia-telangiectasia (AT) clinical findings, 406 computed tomography, 407 differential diagnosis, 406 etiology, 406 magnetic resonance, 407 pathology, 406–407 prognosis, 407 radiologic findings, 405 treatment, 407 AVM See arteriovenous malformation B bacterial meningitis angiography, 182 clinical findings, 179 computed tomography, 179 differential diagnosis, 178 etiology, 180 magnetic resonance, 182 pathology, 181 prognosis, 182 radiologic findings, 177 treatment, 182 ultrasound, 182 Tsiouris_Index.indd 676 band heterotopias clinical findings, 597 computed tomography, 598 differential diagnosis, 596 etiology, 597 magnetic resonance, 598 pathology, 598 prognosis, 598 radiologic findings, 595 treatment, 598 basal ganglia infarctions, 179f intraparenchymal hemorrhage, 265f basilar artery thrombosis clinical findings, 294 complications, 294 computed tomography, 294–296 differential diagnosis, 293 digital subtraction angiography, 296 etiology, 294 magnetic resonance, 296 prognosis, 296 radiologic findings, 293 treatment, 296 Bell’s palsy differential diagnosis, 661 discussion, 662 radiologic findings, 661 benign enlargement of subarachnoid spaces of infancy (BESSI) clinical findings, 542 complications, 542 computed tomography, 543 differential diagnosis, 542 etiology, 542 magnetic resonance, 543 pathology, 542 prognosis, 543 radiologic findings, 541 treatment, 543 ultrasound, 543 bilateral sylvian fissures, 263f brain abscess capsule stage, 191 cerebritis stage, 191 clinical findings, 189 complications, 189f, 190 computed tomography, 191 differential diagnosis, 189 etiology, 190 magnetic resonance, 191 pathology, 191 prognosis, 191 radiologic findings, 188 treatment, 191 brainstem glioma clinical findings, 146 computed tomography, 147–148 differential diagnosis, 146 etiology, 142 magnetic resonance, 148 pathology, 146 prognosis, 148 11/15/12 9:20 AM INDEX radiologic findings, 145 treatment, 148 breast cancer See dural metastasis from stage IV breast cancer; metastatic breast cancer C CAA See cerebral amyloid angiopathy CADASIL See cerebral autosomal dominant arteriopathy with subcortical infarctions and leukoencephalopathy carbon monoxide poisoning clinical findings, 432 computed tomography, 432 differential diagnosis, 432 magnetic resonance, 432–433 pathology, 432 prognosis, 433 radiologic findings, 431 treatment, 433 carotid cavernous fistula (CCF) angiography, 328–329 clinical findings, 327 computed tomography, 328 differential diagnosis, 327 magnetic resonance, 328 prognosis, 329 radiologic findings, 326 treatment, 329 cavernous malformation clinical findings, 313 complications, 313 computed tomography, 313 differential diagnosis, 313 etiology, 313 magnetic resonance, 313–314 prognosis, 315 radiologic findings, 312 treatment, 315 cavernous sinus thrombosis differential diagnosis, 659 discussion, 659–660 radiologic findings, 658 CCF See carotid cavernous fistula central neurocytoma clinical findings, 24 complications, 24 computed tomography, 25 diagnosis, 22 differential diagnosis, 22 etiology, 24 magnetic resonance, 25 pathology, 24 prognosis, 26 radiologic findings, 21 treatment, 26 central pontine myelinolysis (CPM) See osmotic demyelination syndrome (ODMS) cerebral amyloid angiopathy (CAA) clinical findings, 392 complications, 392 computed tomography, 393 differential diagnosis, 392 magnetic resonance, 393 Tsiouris_Index.indd 677 677 pathology, 393 prognosis, 393 radiologic findings, 391 treatment, 393 cerebral autosomal dominant arteriopathy with subcortical infarctions and leukoencephalopathy (CADASIL) clinical findings, 397 complications, 397 differential diagnosis, 397 etiology, 397 magnetic resonance, 398 pathology, 398 prognosis, 399 radiologic findings, 396 treatment, 399 cerebritis secondary to systemic lupus erythematosus (SLE) cerebritis angiography, 235 clinical findings, 233 computed tomography, 235 differential diagnosis, 231 etiology, 233–234 pathogenesis, 234 pathology, 235 positron emission tomography, 235 prognosis, 236 radiologic findings, 231 treatment, 235 Chiari I malformation clinical findings, 560 computed tomography, 561 differential diagnosis, 560 etiology, 560–561 magnetic resonance, 561 prognosis, 562 radiologic findings, 559 treatment, 562 Chiari II malformation, 535f clinical findings, 566 differential diagnosis, 564 etiology, 566 imaging findings, 567 pathology, 566 prognosis, 567 radiologic findings, 564 treatment, 567 Chiari III malformation differential diagnosis, 570 discussion, 570 radiologic findings, 569 choroid plexus papilloma clinical findings, 104 complications, 104 computed tomography, 105 differential diagnosis, 103 magnetic resonance, 105 pathology, 104–105 prognosis, 105–106 radiologic findings, 103 treatment, 105 ultrasound, 105 11/15/12 9:20 AM 678 INDEX CJD See Creutzfeldt-Jakob disease colloid cyst clinical findings, 120 complications, 121 computed tomography, 121 differential diagnosis, 120 etiology, 121 magnetic resonance, 121 massive, 122f pathology, 121 prognosis, 121–122 radiologic findings, 119 treatment, 121 cortical venous thrombosis (CVT) angiography, 404 clinical findings, 402 computed tomography, 403 differential diagnosis, 401 etiology, 402 pathology, 402 prognosis, 404 radiologic findings, 401 treatment, 404 craniopharyngioma clinical findings, 91 computed tomography, 91–92 differential diagnosis, 91 magnetic resonance, 92–93 pathology, 91 prognosis, 93 radiologic findings, 90 treatment, 93 Creutzfeldt-Jakob disease (CJD) clinical findings, 454 computed tomography, 455 differential diagnosis, 454 etiology, 454 magnetic resonance, 455 pathology, 454 prognosis, 455 radiologic findings, 453 treatment, 455 cryptococcosis meningitis clinical findings, 225 complications, 225 computed tomography, 226 differential diagnosis, 225 etiology, 225 pathology, 225–227 prognosis, 227 radiologic findings, 224 treatment, 227–228 CVT See cortical venous thrombosis D DAI See diffuse axonal injury Dandy Walker malformation clinical findings, 573 complications, 573 computed tomography, 574 differential diagnosis, 573 etiology, 573 magnetic resonance, 574 Tsiouris_Index.indd 678 pathology, 573 prognosis, 574 radiologic findings, 572–573 treatment, 574 dAVF See dural arteriovenous fistula dermoid cyst clinical findings, 112 complex prepontine, 114f complications, 112 computed tomography, 113 differential diagnosis, 112 etiology, 113 magnetic resonance, 113 pathology, 113 prognosis, 113 radiologic findings, 111 treatment, 113 developmental venous anomaly clinical findings, 323 computed tomography, 324 differential diagnosis, 323 etiology, 323 magnetic resonance, 324 prognosis, 324 radiologic findings, 322 treatment, 324 diffuse axonal injury (DAI) clinical findings, 493 computed tomography, 494–495 differential diagnosis, 493 magnetic resonance, 495 pathology, 494 prognosis, 496 radiologic findings, 492 treatment, 495 diffuse pontine glioma, 147f diplopia, 270f DNET See dysembryoplastic neuroepithelial tumor dural arteriovenous fistula (dAVF) clinical findings, 332 complications, 332 computed tomography, 333 differential diagnosis, 331 etiology, 332 magnetic resonance, 333 pathology, 332 prognosis, 334 radiologic findings, 331 treatment, 333 dural metastasis from stage IV breast cancer See also metastatic breast cancer clinical findings, 43 computed tomography, 43 differential diagnosis, 43 etiology, 33 lung cancer from, 44f magnetic resonance, 44 pathology, 43 positron emission tomography, 45 prognosis, 46 radiologic findings, 42 treatment, 45 11/15/12 9:20 AM INDEX dysembryoplastic neuroepithelial tumor (DNET) clinical findings, 58 computed tomography, 58 differential diagnosis, 58 etiology, 58 magnetic resonance, 59 pathology, 58 prognosis, 59 radiologic findings, 57 treatment, 59 dysplastic cerebellar gangliocytoma (LhermitteDuclos Disease) clinical findings, 577 complications, 578 computed tomography, 578 differential diagnosis, 577 etiology, 578 magnetic resonance, 578 pathology, 578 prognosis, 578 radiologic findings, 576 treatment, 578 E EDH See epidural hematoma encephalomeningocele clinical findings, 536 complications, 536 computed tomography, 537 differential diagnosis, 534–535 etiology, 536 magnetic resonance, 537 pathology, 536 prognosis, 537 radiologic findings, 533 treatment, 537 endoscopic third ventriculostomy, 76f ependymoblastoma clinical findings, 62 complications, 62 computed tomography, 62 differential diagnosis, 58 etiology, 62 magnetic resonance, 64 pathology, 62 prognosis, 64 radiologic findings, 60 treatment, 64 ependymoma, 49f atypical location, 159f classic infratentorial, 158f clinical findings, 156 computed tomography, 158 differential diagnosis, 155–156 magnetic resonance, 158 pathology, 156 prognosis, 159 radiologic findings, 155 treatment, 159 epidermoid cyst arachnoid cyst compared with, 110t clinical findings, 167 computed tomography, 168 Tsiouris_Index.indd 679 679 differential diagnosis, 167 etiology, 167 magnetic resonance, 168 pathology, 168 prognosis, 169 radiologic findings, 167 treatment, 168 epidural hematoma (EDH) clinical findings, 485 complications, 485 computed tomography, 485 differential diagnosis, 484 epidemiology, 485 etiology, 485 magnetic resonance, 486 prognosis, 486 radiologic findings, 484 treatment, 486 F facial nerve canal hemangioma See hemangioma of facial nerve canal FCD See focal cortical dysplasia fibromuscular dysplasia (FMD) angiography, 344 clinical findings, 343 complications, 344 computed tomography, 344 differential diagnosis, 343 etiology, 343 magnetic resonance, 344 pathology, 344 prognosis, 346 radiologic findings, 342 treatment, 346 focal cortical dysplasia (FCD) clinical findings, 614 computed tomography, 615 differential diagnosis, 614 etiology, 614 magnetic resonance, 615 pathology, 614–615 prognosis, 616 radiologic findings, 613 treatment, 616 follicular lymphoma, 55f fungal abscess clinical findings, 208 complications, 208 differential diagnosis, 208 etiology, 208 pathology, 208 prognosis, 209 radiologic findings, 208 treatment, 209 G GABI See global anoxic brain injury ganglioglioma brainstem location of, 28f clinical findings, 29 computed tomography, 30 differential diagnosis, 27–28 11/15/12 9:20 AM 680 INDEX ganglioglioma (continued) magnetic resonance, 30 mural nodule appearance of, 29f pathology, 29 prognosis, 30 radiologic findings, 27 treatment, 30 giant aneurysm of basilar artery angiography, 269 clinical findings, 263 complications, 268 computed tomography, 268 differential diagnosis, 267 magnetic resonance, 269 pathology, 268 prognosis, 270 radiologic findings, 267 treatment, 269 glioblastoma multiforme clinical findings, 13 complications, 13 computed tomography, 14 diagnosis, 13 differential diagnosis, 13 etiology, 13 left frontal lobe, 14f magnetic resonance, 14 pathology, 13 prognosis, 15 radiologic findings, 12 transcallosal extension of, 15f treatment, 15 glioma See specific types gliomatosis cerebri clinical findings, 33 complications, 33 computed tomography, 34 differential diagnosis, 33 etiology, 33 high grade transformation of, 34f magnetic resonance, 34 pathology, 33–34 prognosis, 35 radiologic findings, 32 treatment, 35 global anoxic brain injury (GABI) clinical findings, 307 complications, 307 computed tomography, 308 differential diagnosis, 307 magnetic resonance, 309 pathophysiology, 307 prognosis, 309 radiologic findings, 306 treatment, 309 glomus jugulare tumor differential diagnosis, 673 discussion, 674 radiologic findings, 673 H hamartoma of tuber cinereum (hypothalamic hamartoma) clinical findings, 539 Tsiouris_Index.indd 680 complications, 539 computed tomography, 540 differential diagnosis, 538–539 etiology, 539 magnetic resonance, 540 magnetic resonance spectroscopy, 540 pathology, 539 prognosis, 540 radiologic findings, 538 treatment, 540 hemangioblastoma angiography, 639 clinical findings, 637 complications, 637 computed tomography, 638 differential diagnosis, 637 magnetic resonance, 639 pathology, 638 prognosis, 639 radiologic findings, 636 treatment, 639 hemangioma of facial nerve canal clinical findings, 664 computed tomography, 664 etiology, 664 magnetic resonance, 664 pathology, 664 prognosis, 664 radiologic findings, 663 treatment, 664 hematoma See specific types hemimegalencephaly clinical findings, 589 complications, 589 computed tomography, 589 differential diagnosis, 588 etiology, 589 magnetic resonance, 589 pathology, 589 prognosis, 590 radiologic findings, 587 treatment, 590 ultrasound, 589 hemorrhage See specific types herpes simplex virus type (HSV–1) encephalitis clinical findings, 174 computed tomography, 175 differential diagnosis, 174 etiology, 175 magnetic resonance, 175 pathology, 175 prognosis, 176 radiologic findings, 173 treatment, 176 HIE See neonatal hypoxic-ischemic encephalopathy HIV encephalitis clinical findings, 212 computed tomography, 213 differential diagnosis, 212 etiology, 213 pathology, 213 PML compared with, 214t, 219t prognosis, 214 11/15/12 9:20 AM INDEX radiologic findings, 213 treatment, 213 holoproencephaly See alobar holoprosencephaly HPE See alobar holoprosencephaly HSV-1 See herpes simplex virus type hydranencephaly clinical findings, 528 complications, 528 computed tomography, 529 differential diagnosis, 528 etiology, 528 magnetic resonance, 529 pathology, 528 prognosis, 529 radiologic findings, 527 treatment, 529 ultrasound, 529 hydrocephalus, 263f hyperacute right middle cerebral artery infarction, 283f hyperintensive hemorrhage clinical findings, 303 complications, 303 computed tomography, 304 differential diagnosis, 302 etiology, 302 left thalamic, 302f, 305f magnetic resonance, 304 prognosis, 304 radiologic findings, 301 treatment, 304 I IH See intracranial hypotension intracranial hypotension (IH) clinical findings, 256 complications, 256 computed tomography, 256 differential diagnosis, 255 etiology, 256 magnetic resonance, 256–257 pathology, 256 prognosis, 257 radiologic findings, 255 treatment, 257 J JPA See juvenile pilocytic astrocytoma jugular foramen meningioma angiography, 670 clinical findings, 668 computed tomography, 668 differential diagnosis, 668 etiology, 668 magnetic resonance, 668–669 radiologic findings, 667 treatment, 669 juvenile pilocytic astrocytoma (JPA) clinical findings, 138 computed tomography, 139 differential diagnosis, 137 etiology, 139 magnetic resonance, 140 pathology, 140 Tsiouris_Index.indd 681 681 prognosis, 140 radiologic findings, 137 treatment, 140 K Krabbe disease clinical findings, 441 computed tomography, 441 differential diagnosis, 440 etiology, 441 magnetic resonance, 441 pathology, 441 prognosis, 442 radiologic findings, 440 treatment, 441 L Langerhans cell histiocytosis (LCH) clinical findings, 239 complications, 239 computed tomography, 240 differential diagnosis, 238 etiology, 240 magnetic resonance, 240 pathology, 240 prognosis, 240 radiologic findings, 237 treatment, 240 lateral ventricular masses, 101t LCH See Langerhans cell histiocytosis left middle cerebral artery occlusion and infarction advanced imaging techniques, 283 clinical findings, 282 complications, 282 computed tomography, 283 differential diagnosis, 282 etiology, 282 magnetic resonance, 283 prognosis, 286 radiologic findings, 281 treatment, 285 leptomeningeal carcinomatosis, 48f leptomeningeal cyst associated with skull fracture clinical findings, 511 complications, 511 computed tomography, 511 differential diagnosis, 510 etiology, 511 magnetic resonance, 512 prognosis, 513 radiologic findings, 510 skull radiography, 512 treatment, 512 LH See lymphocytic hypophysitis Lhermitte-Duclos disease See dysplastic cerebellar gangliocytoma lipoma associated with partial agenesis of corpus callosum clinical findings, 128 computed tomography, 128 differential diagnosis, 128 etiology, 128 magnetic resonance, 129 pathology, 128 11/15/12 9:20 AM 682 INDEX lipoma associated with partial agenesis of corpus callosum (continued) prognosis, 129 radiologic findings, 127 treatment, 129 lissencephaly clinical findings, 601 computed tomography, 603 differential diagnosis, 600 etiology, 601 magnetic resonance, 603 pathology, 601–603 prognosis, 603 radiologic findings, 600 treatment, 603 ultrasound, 603 lung cancer, 44f metastasis, 39f lymphocytic hypophysitis (LH) clinical findings, 253 complications, 253 computed tomography, 253 differential diagnosis, 252 etiology, 253 magnetic resonance, 254 pathology, 253 prognosis, 254 radiologic findings, 251 treatment, 254 lymphoma See follicular lymphoma; primary CNS lymphoma lymphomatous meningitis (lymphomatosis) clinical findings, 48 computed tomography, 49 differential diagnosis, 48 etiology, 48 magnetic resonance, 49 pathology, 49 prognosis, 50 radiologic findings, 47 treatment, 50 M mature pineal teratoma clinical findings, 116 computed tomography, 117 differential diagnosis, 116 etiology, 116 magnetic resonance, 117–118 pathology, 117 prognosis, 118 radiologic findings, 115 treatment, 118 medulloblastoma clinical findings, 152 computed tomography, 153 differential diagnosis, 151 etiology, 152 magnetic resonance, 153 pathology, 153 prognosis, 153–154 radiologic findings, 151 treatment, 153 Tsiouris_Index.indd 682 melanoma metastasis, 38f meningioma See also jugular foramen meningioma; optic nerve sheath meningioma atypical, 97f clinical findings, 95 computed tomography, 96 differential diagnosis, 95 magnetic resonance, 97 pathology, 95 prognosis, 98 radiologic findings, 94 sinus invasion by, 96f treatment, 98 mesial temporal sclerosis (MTS) clinical findings, 243 computed tomography, 244 differential diagnosis, 243 etiology, 243 magnetic resonance, 244 pathology, 244 prognosis, 244 radiologic findings, 242 treatment, 244 metachromatic leukodystrophy (MLD) clinical findings, 435 computed tomography, 435 differential diagnosis, 435 magnetic resonance, 435–436 pathology, 435 prognosis, 435 radiologic findings, 434 treatment, 435 metastatic breast cancer See also dural metastasis from stage IV breast cancer clinical findings, 37 computed tomography, 37 differential diagnosis, 37 etiology, 33 magnetic resonance, 38–39 pathology, 37 prognosis, 40 radiologic findings, 36 treatment, 39 Metronidazole-induced encephalopathy (MIE) clinical findings, 447 computed tomography, 448 differential diagnosis, 447 etiology, 447 magnetic resonance, 448 pathogenesis, 447 pathology, 447–448 prognosis, 448 radiologic findings, 446 treatment, 448 MLD See metachromatic leukodystrophy Moyamoya disease and syndrome clinical findings, 359 complications, 359 computed tomography, 360 differential diagnosis, 358 etiology, 359 magnetic resonance, 360 11/15/12 9:20 AM INDEX pathology, 359–360 prognosis, 362–363 radiologic findings, 358 treatment, 361–362 MS See multiple sclerosis; tumefactive multiple sclerosis MSA-C See multiple system atrophy-cerebellar type MTS See mesial temporal sclerosis multi-infarct dementia differential diagnosis, 467 discussion, 467 radiologic findings, 466 multiple sclerosis (MS) See also tumefactive multiple sclerosis clinical findings, 412 companion cases, 414–415 complications, 412 computed tomography, 413 differential diagnosis, 411 etiology, 412 magnetic resonance, 413 pathology, 413 prognosis, 413–414 radiologic findings, 411 treatment, 413 multiple system atrophy-cerebellar type (MSA-C) differential diagnosis, 460 discussion, 459–460 radiologic findings, 459 mycotic aneurysm clinical findings, 273 computed tomography, 275 differential diagnosis, 272 etiology, 273 magnetic resonance, 275 pathology, 273–274 prognosis, 275 radiologic findings, 272 treatment, 275 N necrotic lung metastasis, 38f neonatal hypoxic-ischemic encephalopathy (HIE) clinical findings, 354 complications, 353 computed tomography, 354 differential diagnosis, 353 etiology, 353 magnetic resonance, 354–355 pathology, 354 prognosis, 357 radiologic findings, 352 treatment, 357 neurenteric cyst clinical findings, 124 complications, 124 computed tomography, 124 differential diagnosis, 124 etiology, 124 magnetic resonance, 125 Tsiouris_Index.indd 683 683 pathology, 124 prognosis, 125 radiologic findings, 123 treatment, 125 neurocutaneous melanosis computed tomography, 554 differential diagnosis, 553 etiology, 554 magnetic resonance, 554 pathology, 554 prognosis, 554 radiologic findings, 553 treatment, 554 neurocysticercosis clinical findings, 200 complications, 200 computed tomography, 201 differential diagnosis, 200 etiology, 195 magnetic resonance, 201 pathology, 200 prognosis, 202 radiologic findings, 199 treatment, 202 neurofibromatosis type I clinical findings, 620 complications, 621 computed tomography, 621 differential diagnosis, 620 etiology, 621 magnetic resonance, 621 pathology, 621 prognosis, 622 radiologic findings, 619 treatment, 622 neurofibromatosis type II clinical findings, 626 complications, 627 computed tomography, 627 differential diagnosis, 626 etiology, 627 magnetic resonance, 628 pathology, 627 prognosis, 628 radiologic findings, 625 treatment, 628 neurosarcoidosis (NS) clinical findings, 247 complications, 248 computed tomography, 248 differential diagnosis, 247 etiology, 248 magnetic resonance, 248–249 pathology, 249 prognosis, 250 radiologic findings, 246 treatment, 249 nonaccidental trauma clinical findings, 502 computed tomography, 503 differential diagnosis, 501 magnetic resonance, 503 prognosis, 503 11/15/12 9:20 AM 684 INDEX nonaccidental trauma (continued) radiography, 503 radiologic findings, 501 treatment, 503 non-enhancing infiltrative astrocytoma, 10f NS See neurosarcoidosis O ODMS See osmotic demyelination syndrome olfactory neuroblastoma clinical findings, 642 computed tomography, 642 differential diagnosis, 642 etiology, 642 magnetic resonance, 642 pathology, 642 prognosis, 643 radiologic findings, 641 treatment, 643 oligoastrocytoma, 5f oligodendroglioma classic, 19f clinical findings, 18 complications, 17 computed tomography, 18 diagnosis, 17 differential diagnosis, 17 magnetic resonance, 19 pathology, 18 prognosis, 20 radiologic findings, 16 treatment, 20 optic nerve glioma, 648f companion cases, 649f differential diagnosis, 648 discussion, 649 radiologic findings, 648 optic nerve sheath meningioma differential diagnosis, 649 discussion, 650 radiologic findings, 649 optic neuritis differential diagnosis, 645 discussion, 645 radiologic findings, 644 osmotic demyelination syndrome (ODMS) clinical findings, 426 complications, 426 computed tomography, 426 differential diagnosis, 426 etiology, 426 magnetic resonance, 427 pathology, 426 prognosis, 427 radiologic findings, 425 treatment, 427 P PACNS See primary angiitis of the CNS pantothenate kinase-associated neurodegeneration (PKAN) clinical findings, 457 computed tomography, 458 Tsiouris_Index.indd 684 differential diagnosis, 457 etiology, 457 magnetic resonance, 458 pathology, 457 prognosis, 458 radiologic findings, 456 treatment, 458 parenchymal hemorrhage, 304t parotid adenoid cystic carcinoma differential diagnosis, 666 discussion, 666 radiologic findings, 665 Parry-Romberg syndrome differential diagnosis, 474 discussion, 474 radiologic findings, 473 Pelizaeus-Merzbacher disease (PMD) clinical findings, 444 computed tomography, 444 differential diagnosis, 443 etiology, 444 magnetic resonance, 444 pathology, 444 prognosis, 445 radiologic findings, 443 treatment, 445 perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) clinical findings, 279 complications, 279 computed tomography, 279 differential diagnosis, 278 etiology, 279 magnetic resonance, 280 prognosis, 280 radiologic findings, 277 treatment, 280 perineural spread of parotid adenoid cystic carcinoma, 665–666 perisylvian polymicrogyria, 606f periventricular leukomalacia (PVL) clinical findings, 348 complications, 348 computed tomography, 349 differential diagnosis, 348 etiology, 348 magnetic resonance, 349 pathology, 349 prognosis, 350–351 radiologic findings, 347 treatment, 350 pineal region germinoma clinical findings, 74 computed tomography, 75 differential diagnosis, 73 etiology, 74 magnetic resonance, 75 pathology, 75 prognosis, 75 radiologic findings, 72 treatment, 75 pineoblastoma clinical findings, 69 11/15/12 9:20 AM INDEX computed tomography, 70 differential diagnosis, 69 magnetic resonance, 70 pathology, 69 prognosis, 70 radiologic findings, 68 treatment, 70 pineocytoma clinical findings, 66 computed tomography, 67 differential diagnosis, 66 magnetic resonance, 67 pathology, 66 prognosis, 67 radiologic findings, 65 treatment, 67 pituitary macroadenoma clinical findings, 83, 98f computed tomography, 84 differential diagnosis, 83 magnetic resonance, 84 pathology, 83 prognosis, 85 radiologic findings, 82 treatment, 85 pituitary microadenoma clinical findings, 78 computed tomography, 79 differential diagnosis, 78 hemorrhage with, 79f magnetic resonance, 79 pathology, 78 prognosis, 80 radiologic findings, 77 treatment, 80 PKAN See pantothenate kinase-associated neurodegeneration plexiform neurofibroma (PNF), 623f PMD See Pelizaeus-Merzbacher disease PMG See polymicrogyria PML See progressive multifocal leukoencephalopathy PNETs See primitive neuroectodermal tumors PNF See plexiform neurofibroma PNSAH See perimesencephalic nonaneurysmal subarachnoid hemorrhage polymicrogyria (PMG) bilateral perisylvian, 606f clinical findings, 606 computed tomography, 607 differential diagnosis, 606 etiology, 607 magnetic resonance, 607 pathology, 607 prognosis, 608 radiologic findings, 605 treatment, 608 porencephalic cyst clinical findings, 545 complications, 545 computed tomography, 546 differential diagnosis, 545 etiology, 545 Tsiouris_Index.indd 685 685 magnetic resonance, 546 pathology, 545 prognosis, 546 radiologic findings, 544 treatment, 546 primary angiitis of the CNS (PACNS) angiography, 339 of basal ganglia, 340f clinical findings, 338 complications, 338 computed tomography, 339 differential diagnosis, 337 etiology, 338 magnetic resonance, 339 pathology, 339 prognosis, 339 radiologic findings, 336 with subarachnoid hemorrhage, 341f treatment, 339 primary CNS lymphoma clinical findings, 52 computed tomography, 53 differential diagnosis, 52 etiology, 52 fludeoxyglucose-positron emission tomography, 53 magnetic resonance, 53 pathology, 53 prognosis, 53 radiologic findings, 51 treatment, 53 primitive neuroectodermal tumors (PNETs), 61 progressive multifocal leukoencephalopathy (PML) clinical findings, 217 computed tomography, 217 differential diagnosis, 216 etiology, 217 HIV compared with, 214t, 219t pathology, 217 prognosis, 218 radiologic findings, 215 treatment, 217 psammomatoid ossifying fibroma clinical findings, 131–132 computed tomography, 132 differential diagnosis, 131 etiology, 132 magnetic resonance, 132 pathology, 132 prognosis, 132 radiologic findings, 130 treatment, 132 pseudotumor of cavernous sinus See Tolosa-Hunt syndrome of cavernous sinus PVL See periventricular leukomalacia R Rathke cleft cyst clinical findings, 88 computed tomography, 89 differential diagnosis, 88 magnetic resonance, 89 pathology, 88 11/15/12 9:20 AM 686 INDEX Rathke cleft cyst (continued) prognosis, 89 radiologic findings, 87 treatment, 89 reversible postictal cerebral edema clinical findings, 429 computed tomography, 429 differential diagnosis, 429 magnetic resonance, 430 pathology, 429 prognosis, 430 radiologic findings, 428 treatment, 430 rhombencephalosynapsis clinical findings, 582 complications, 582 computed tomography, 582 differential diagnosis, 581 etiology, 582 magnetic resonance, 582 pathology, 582 prognosis, 583 radiologic findings, 580 treatment, 583 right lateral medullary infarction clinical findings, 671 computed tomography, 671 differential diagnosis, 671 etiology, 671 prognosis, 671 radiologic findings, 670 treatment, 671 S SCD See sickle cell disease schizencephaly clinical findings, 610 computed tomography, 611 differential diagnosis, 609 etiology, 610 magnetic resonance, 611 pathology, 611 prognosis, 611 radiologic findings, 609 treatment, 611 schwannoma of CN V differential diagnosis, 657 discussion, 657 radiologic findings, 656 septo-optic dysplasia (SOD) computed tomography, 531 differential diagnosis, 531 magnetic resonance, 532 prognosis, 532 radiologic findings, 530 treatment, 532 sickle cell disease (SCD) angiography, 373 clinical findings, 372 complications, 372 computed tomography, 373 differential diagnosis, 372 Tsiouris_Index.indd 686 etiology, 372 magnetic resonance, 373 pathophysiology, 373 prognosis, 376 radiologic findings, 371 treatment, 373 ultrasound, 373 SOD See septo-optic dysplasia spontaneous intracranial hypotension, 381f SS See superficial siderosis Sturge-Weber syndrome (SWS) clinical findings, 550 complications, 550 computed tomography, 550 differential diagnosis, 549 etiology, 550 magnetic resonance, 550 pathology, 550 prognosis, 551 radiologic findings, 548 treatment, 551 subarachnoid hemorrhage, 273f subdural empyema clinical findings, 195 complications, 195 computed tomography, 196 differential diagnosis, 195 etiology, 195 magnetic resonance, 196 pathophysiology, 195 prognosis, 198 radiologic findings, 194 treatment, 198 subdural hematoma, 273f clinical findings, 489 computed tomography, 489 differential diagnosis, 488 etiology, 488–489 magnetic resonance, 489–490 prognosis, 490 radiologic findings, 488 treatment, 490 subependymal nodular heterotopias clinical findings, 592 complications, 592 computed tomography, 593 differential diagnosis, 592 etiology, 592 magnetic resonance, 593 pathology, 592–593 prognosis, 594 radiologic findings, 591 treatment, 594 ultrasound, 594 subependymoma of fourth ventricle clinical findings, 101 complications, 101 computed tomography, 101 differential diagnosis, 99 etiology, 101 magnetic resonance, 102 pathology, 101 11/15/12 9:20 AM INDEX prognosis, 102 radiologic findings, 99 treatment, 102 subfalcine and uncal herniation clinical findings, 506 complications, 506–507 computed tomography, 507 differential diagnosis, 505 etiology, 506 magnetic resonance, 508 prognosis, 508 radiologic findings, 505 treatment, 508 superficial siderosis (SS) clinical findings, 383 computed tomography, 383 differential diagnosis, 382 etiology, 383 magnetic resonance, 384 pathology, 383 prognosis, 385 radiologic findings, 382 treatment, 385 SWS See Sturge-Weber syndrome T tectal glioma clinical findings, 142 computed tomography, 142 differential diagnosis, 141 etiology, 142 magnetic resonance, 142 pathology, 142 prognosis, 143 radiologic findings, 141 with rare transformation, 143f treatment, 143 tectal juvenile pilocytic astrocytoma (JPA), 73f temporal lobe teratoma, 117f teratoma See specific types Tolosa-Hunt syndrome of cavernous sinus clinical findings, 652 computed tomography, 652 diagnostic criteria, 652 differential diagnosis, 652 etiology, 652 magnetic resonance, 653 pathology, 652 prognosis, 653 radiologic findings, 651 treatment, 653 toxoplasmosis clinical findings, 221 complications, 221 computed tomography, 222 differential diagnosis, 221 etiology, 221 pathology, 221 prognosis, 222 radiologic findings, 220 treatment, 222 Tsiouris_Index.indd 687 687 transverse sinus thrombosis with temporal lobe hemorrhage clinical findings, 378 complications, 378 computed tomography, 379 differential diagnosis, 378 etiology, 378 magnetic resonance, 379 pathophysiology, 378–379 prognosis, 380 radiologic findings, 377 treatment, 380 traumatic parenchymal hemorrhagic contusion clinical findings, 498 complications, 499 computed tomography, 499 differential diagnosis, 497–498 magnetic resonance, 499 pathology, 499 prognosis, 499–500 radiologic findings, 497 treatment, 499 traumatic subarachnoid hemorrhage clinical findings, 480 complications, 480 computed tomography, 480 differential diagnosis, 479 magnetic resonance, 480 prognosis, 482 radiologic findings, 479 treatment, 482 trigeminal neuralgia, 654–655 TS See tuberous sclerosis tuberculoma, 206 tuberculosis meningitis clinical findings, 205 complications, 205 differential diagnosis, 204 etiology, 205 pathology, 205 prognosis, 206 radiologic findings, 203 treatment, 206 tuberculous abscess, 206 tuberculous meningitis, 206 tuberous sclerosis (TS) clinical findings, 630 complications, 630 computed tomography, 631 differential diagnosis, 630 etiology, 630 magnetic resonance, 632 pathology, 630 prognosis, 632 radiologic findings, 629 treatment, 632 tumefactive multiple sclerosis See also multiple sclerosis clinical findings, 417 complications, 417 computed tomography, 418 differential diagnosis, 417 11/15/12 9:20 AM 688 INDEX tumefactive multiple sclerosis (continued) etiology, 417 magnetic resonance, 418 pathology, 418 prognosis, 419 radiologic findings, 416 treatment, 419 U unilateral hydrocephalus, 120f V vascular compression of right trigeminal nerve (vascular loop syndrome) differential diagnosis, 655 discussion, 655 radiologic findings, 654 vasospasm clinical findings, 388 complications, 388 computed tomography, 388–389 differential diagnosis, 388 magnetic resonance, 389 pathology, 388 prognosis, 389 radiologic findings, 387 treatment, 389 vein of Galen aneurysmal malformation (VGAM) angiography, 366 clinical findings, 366 complications, 367 computed tomography, 367 differential diagnosis, 366 etiology, 366 magnetic resonance, 367 prognosis, 369 radiologic findings, 364 treatment, 368–369 vestibular schwannoma clinical findings, 163 complications, 163 computed tomography, 164 differential diagnosis, 162 etiology, 163 Tsiouris_Index.indd 688 magnetic resonance, 164 pathology, 163 prognosis, 164 radiologic findings, 161 right, 163f treatment, 164 VGAM See vein of Galen aneurysmal malformation W Walker-Warburg syndrome, 602f watershed injury clinical findings, 289 complications, 289 computed tomography, 289 differential diagnosis, 288 etiology, 289 magnetic resonance, 291 pathology, 289 prognosis, 291 radiologic findings, 287 treatment, 291 Wernicke encephalopathy (WE) clinical findings, 471 computed tomography, 471 differential diagnosis, 470 etiology, 471 magnetic resonance, 472 pathogenesis, 471 pathology, 471 prognosis, 471 radiologic findings, 469 treatment, 472 X X-linked adrenoleukodystrophy (ALD) computed tomography, 439 differential diagnosis, 437 etiology, 438 magnetic resonance, 439 pathology, 438 prognosis, 439 radiologic findings, 437 treatment, 439 11/15/12 9:20 AM ... Leukodystrophy in children: a pictorial review of MR imaging features Radiographics 20 02; 22( 3):461–476 Sener RN Metachromatic leukodystrophy: diffusion MR imaging findings AJNR Am J Neuroradiol 20 02; 23(8):1 424 –1 426 Tsiouris_CH91.indd... apparent diffusion coefficient map (bright on DWI images [not shown]) 421 Tsiouris_CH87.indd 421 11/9/ 12 6:35 AM 422 CASE-BASED BRAIN IMAGING Diagnosis Acute disseminated encephalomyelitis (ADEM) Differential... Neurol Res 20 06 ;28 (3):360–366 Ruzek KA, Campeau NG, Miller GM Early diagnosis of central pontine myelinolysis with diffusion-weighted imaging AJNR Am J Neuroradiol 20 04 ;25 (2) :21 0 21 3 Sharma P,