Patient 1. Patient 1. A, Sagittal T1-weighted image (600/8/2) shows a Chiari I malformation, with tonsillar herniation to the mid-C2 level and a pointed.

Slides:



Advertisements
Similar presentations
Patient 7. Patient 7. Sagittal postcontrast T1-weighted scan showing a large, well-delineated extra-axial mass (arrows) elevating and displacing the pons.
Advertisements

Axial T1-weighted image after contrast administration (A) and a FLAIR image (B) demonstrating a left parietal subcortical DVA with deep venous drainage.
Diagrammatic representation of syringomyelia and the “presyrinx” hypothesis in the setting of obstruction to CSF flow. Diagrammatic representation of syringomyelia.
Acquired cochlear nerve deficiency in a 14-year-old patient with hearing loss after meningococcal meningitis at the age of 6 months (patient A3). Acquired.
A 20-year-old man with HD. A, Neutral axial gradient-echo image at the C5 level demonstrates subtle bilateral LOA along the lateral aspects of the lamina.
Case 1: spontaneous spinal cord herniation.
A and B, Sagittal (A) and axial (B) fast spin-echo images of the cervical spine before treatment demonstrate diffuse increase in signal intensity (arrows)
A and B, The superior sagittal sinus (straight arrow), straight sinus (arrowhead), and vein of Galen (curved arrow) are clearly depicted, and were seen.
A, T2WI MR image demonstrates a focal dorsal indentation in the upper thoracic spinal cord (arrow). A, T2WI MR image demonstrates a focal dorsal indentation.
Patient 8, possible Joubert malformation.
9-year-old girl with hydrocephalus and hydromyelia
Patient 1. Patient 1. A, An axial T1-weighted postcontrast image with fat saturation (600/13/2 [TR/TE/excitations]) demonstrates asymmetrical enhancement.
Deficient cochlear nerve in a 60-year-old patient with a 50-year history of left hearing loss after a motor vehicle accident (patient A10). Deficient cochlear.
Differences in the tonsillar and obex positions between patients with IIH and healthy controls. Differences in the tonsillar and obex positions between.
Brain and spine MR imaging of a 48-year-old woman with Zika virus infection and encephalitis and myelitis. Brain and spine MR imaging of a 48-year-old.
Patient 5. Patient 5. A, Initial sagittal T1-weighted image (483/15/23), obtained 14 hours after the ictus, reveals a short-segment EDH that is isointense.
Patient 3. Patient 3. A, Sagittal T2-weighted image (4000/108eff /4) obtained when the patient had no symptoms referable to the spinal cord shows a mild.
Diagrammatic representation of CSF flow under normal circumstances.
Images from the case of a 50-year-old man with cerebral hydatid disease.A–C, Sagittal spin-echo T1-weighted MR images (584/12 [TR/TE]) show a multilocular.
Examples of 2 patients with lesions visible only in the DIR images and not in the T2WI TSE images. Examples of 2 patients with lesions visible only in.
A, Sagittal T2WI MR image demonstrates a typical intraspinal extramedullary arachnoid cyst. A, Sagittal T2WI MR image demonstrates a typical intraspinal.
Axial view MR images of the head, obtained at the time of second presentation.A, T1-weighted MR image (400/15) shows thickening of the dura overlying the.
A, The pathophysiology of atrophy.
Patient 6, a 35-year-old man presenting with headache and bilateral deficits of CN III, VI, VII, X, and XII. The patient had been previously treated with.
T2-weighted images of a patient with an infarction within the anterior MCA branch territory on day 5 (patient 15) show high SI changes within the ipsilateral.
Coronal FLAIR images (A–C) document decreasing left hippocampal mass effect and signal intensity over 5-year period (black arrowhead). Coronal FLAIR images.
Venous infarction in a patient with epidural and paraspinal abscesses.
A, MIP coronal 3D PSIF image showing class II injury to the right IAN with mild increase in caliber (less than 50% of the left) and signal intensity of.
A, Sagittal view through the brain stem and cervical spinal cord shows the extent of T2 hyperintensities involving the pyramidal tract and posterior columns.
A and B, Axial and coronal high-resolution CT images of the larynx in a 73-year-old patient with papillary thyroid cancer and left vocal cord paralysis.
65-year old woman with multiple cerebral metastases and hydrocephalus probably secondary to carcinomatous meningitis.A, Contrast-enhanced CT scan of the.
MR images of patient 2 (with juvenile-onset DRPLA).
A, Axial T1-weighted (700/17/1) MR image shows mild asymmetry of the lower basis pontis and middle cerebellar peduncle on the left. A, Axial T1-weighted.
Patient 10. Patient 10. A, Coronal high-resolution CT scan, obtained through the sphenoid sinus, shows a defective intersphenoid septum deviated to the.
Type 1 pedicle marrow signal intensity changes associated with degenerative facet disease. Type 1 pedicle marrow signal intensity changes associated with.
A 43-year-old woman initially diagnosed with Chiari I and treated with surgical decompression. A 43-year-old woman initially diagnosed with Chiari I and.
A, Sagittal SS-FSE T2-weighted image demonstrates a small posterior fossa with displacement of the cerebellar vermis inferiorly, consistent with a Chiari.
Images reveal arachnoid granulations in a 54-year-old man with headaches who had normal results of an MR imaging study.A, Sagittal reconstruction image.
Case 1. Case 1. A, Sagittal TSE T2 image shows third ventricle enlargement with downward displacement of the floor of the third ventricle consistent with.
Patient 4: 71 year-old woman with primary angiitis of the CNS
A–C, Sagittal T1-weighted (A), sagittal T2-weighted (B), and axial T2-weighted (C) MR images of the cervical spine in a patient with severe myelopathy.
A, Sagittal fast spin-echo (FSE) T2-weighted image of the cervical and upper thoracic spine shows a mass of very low signal intensity (arrows) within the.
Sagittal noncontrast T1WI MR imaging of the cervical, thoracic, and upper lumbar spine demonstrates a circumferential high signal intensity (arrows) in.
A, The axial HRCT image of the right temporal bone in case 1 shows an erosion in the posterior temporal bone wall (arrow). A, The axial HRCT image of the.
A 47-year-old woman with a history of alcohol abuse presented with ataxia, changes in consciousness, and ocular abnormalities. A 47-year-old woman with.
Dynamic contrast-enhancement curves for patients with SLE (blue) and healthy controls (red) according to the brain regions sampled. Dynamic contrast-enhancement.
Sagittal T1-weighted MR image of the pituitary gland in a term neonate (born at gestational week 38) obtained near term (corrected age of 39 weeks; 7 days.
Sagittal T1-weighted MR image of the pituitary gland in a preterm neonate (born at gestational week 28) obtained near term (corrected age of 39 weeks;
Orbital lymphoma (A–C) compared with OIS (D–F).
Patient 1, a 50-year-old man presenting with a severe headache, diplopia, and the sensation of a “thick” tongue. Patient 1, a 50-year-old man presenting.
Fourth ventricular CSF pulsation artifact in four subjects.
Axial T2-weighted image (A) demonstrates focal cortical dysplasia (arrow) centered in the left anterior temporal lobe in a right-handed patient. Axial.
Case 1. Case 1. A, Sagittal reconstructed CT scan performed same day as vertebroplasty shows postvertebroplasty appearance with hyperattenuated bone cement.
The “white gray sign.” Axial high-resolution 3D inversion recovery fast-spoiled gradient-echo T1-weighted image demonstrates decreased gray-white contrast.
Axial T2-weighted MR image shows normal flow void in the right internal jugular vein (arrows), whereas flow-related enhancement can be seen in the left.
MR images of a 52-year-old man obtained 1 year and 3 months after surgery.A, A 3-mm-thick FSE T2-weighted image obtained at the level of the middle cerebellar.
MR images in a 69-year-old woman with cervical and thoracic back pain.
Globally increased ASL signal intensity due to artifact.
Short-interval follow-up cervical MR imaging of a 67-year-old male ASIA A patient with SCI. T2-weighted FSE images were obtained from an initial MR imaging.
MR images of the cervical spine
Patient 2. Patient 2. Additional MR images.A–C, Follow-up image (A) obtained 15 days after surgical intervention shows reduced size of the abscess cavity.
Persistent diffusion abnormalities in the brain stem of patient 2.
Patient 16: gestational-week fetus.
Patient 4, a 72-year-old man presenting with headache, dysphagia, and progressive hoarseness. Patient 4, a 72-year-old man presenting with headache, dysphagia,
Images in a 47-year-old woman with SAH
Patient 3. Patient 3. A, Initial sagittal T1-weighted image (600/8/2 [TR/TE/excitations]), obtained 120 hours after symptom onset, reveals a long-segment.
Isolated restricted diffusion in a patient who recovered without residual symptoms.A, DW image shows asymmetric (right greater than left) high signal intensity.
Cavernoma/telangiectasia.
Case 2. Case 2. A, Coronal unenhanced T1-weighted image through the base of the skull. The left pterygopalatine fossa appears infiltrated by soft tissue.
Sagittal scout view sequences are used as localizers to select the anatomic levels for flow quantification. Sagittal scout view sequences are used as localizers.
Presentation transcript:

Patient 1. Patient 1. A, Sagittal T1-weighted image (600/8/2) shows a Chiari I malformation, with tonsillar herniation to the mid-C2 level and a pointed configuration to the cerebellar tonsils (arrow). B, Sagittal T2-weighted image (3000/105eff /3) shows T2 prolongation within the spinal cord parenchyma at the C2–C3 level. C, Sagittal images from a cine phase-contrast flow study in systole (left panel) and diastole (right panel), sensitized to flow in the superior-to-inferior direction (see text for parameters). Note the absence of flow-related phase change at the level of the foramen magnum, as well as prominent tonsillar motion in both systole and diastole, with the curved arrows indicating the position of the tonsillar tips in systole and diastole. Subtle linear low signal is present anterior to the tonsil in diastole (right panel, straight arrow), indicating minimal flow between the fourth ventricle and the spinal subarachnoid space below the level of the foramen magnum. D, Sagittal T1-weighted image (500/14/3) obtained 6 weeks later after limited extradural decompression of the foramen magnum. Cord expansion and parenchymal hypointensity (curved arrows) are present in the upper cervical cord. E, Sagittal T2-weighted image (3000/105eff /3) corresponding to D shows marked upper cervical cord T2 prolongation. This was presumed related to ongoing or increased obstruction to CSF flow. F, Axial T1-weighted image (500/13/2) shows that the central parenchymal signal abnormality is somewhat ill-defined and not as low in signal intensity as CSF. G, Cine phase-contrast flow study sensitized to motion in the superior-to-inferior direction (see text for parameters) shows prominent downward motion of the brain stem and cerebellar tonsils (which appear white), but no definite flow of CSF at the foramen magnum. The tip of the tonsil is indicated (curved arrow). H, Sagittal T1-weighted image (600/8/2) after aggressive decompression of the foramen magnum, including duraplasty, lysis of arachnoid adhesions, and partial tonsillar resection shows that the upper cervical cord appears to be of normal caliber. Minimal parenchymal hypointensity persists in the upper cervical spinal cord (curved arrow). I, Sagittal T2-weighted image (4000/105eff /2) corresponding to H shows near-complete resolution of previously seen abnormal T2 prolongation. J, Cine phase-contrast flow study sensitized to motion in the superior-to-inferior direction (see text for parameters) no longer shows abnormal downward motion of the brain stem or residual cerebellar tonsils. CSF flow is evident at the foramen magnum (curved arrows). Nancy J. Fischbein et al. AJNR Am J Neuroradiol 1999;20:7-20 ©1999 by American Society of Neuroradiology