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Central Nervous System - James M. Provenzale, MD

1. Skull fractures

2. Extra-axial hemorrhages

        a. subdural hematoma
        b. epidural hematoma

3. Parenchymal injuries
        a. cortical contusion
        b. diffuse axonal injury
        c. deep gray matter injury
        d. brainstem injury

4. Subarachnoid hemorrhage

5. Vascular injuries

6. Penetrating injuries

7. Herniation syndromes

8. Cerebral infarction
       b. venous infarction
       c. diffusion imaging appearance
       d. perfusion imaging appearance

       a. subarachnoid hemorrhage
       b. parenchymal hemorrhage

10. Central nervous system infections
       a. meningitis
       b. encephalitis
       c. abscess/cerebritis
       d. subdural empyema
       e. spinal epidural abscess
       f. osteomyelitis/discitis

11. Dural sinus thrombosis

12. Reversible posterior leukoencephalopathy syndrome

13. Pituitary apoplexy

14. Spinal trauma
       a. spinal cord contusion
       b. spinal epidural hematoma
       c. nerve root avulsion



                                                                  ALEXANDER B. BAXTER, MD

Suggested ReadingS:

Cerebral Infarction

Sorensen AG, Bounanno FS, Gonzalez RG, et al. Hyperacute stroke: evaluation with combined multisection diffusion-weighted and hemodynanically weighted echo planar MR imaging. Radiology 1996; 199:391-401

Truwit CL, Barkovich AJ, Gean-Marton A, Hibri , Norman D. Loss of the insular ribbon: another early CT sign of acute middle cerebral artery infarction. Radiology 1990; 176: 801-806

Tomsick TA, Brott TG, Chambers AA, et al. Hyperdense middle cerebral artery sign on CT: efficacy in detecting middle cerebral artery thrombosis. AJNR 1990; 11: 473-477

Elster AD, Moody DM. Early cerebral infarction: Gadopentate dimeglumine enhancement. Radiology 1990; 177: 627-632

Provenzale JM, Sorensen AG. Diffusion-weighted MR imaging in acute stroke: Theoretical considerations and clinical applications. AJR 1999; 173:1459-1468

Carotid and Vertebral Artery Dissection

Levy C, Laissy JP, Raveau V, et al. Carotid and vertebral artery dissections: Three-dimensional time-of-flight MR angiography and MR imaging versus conventional angiography. Radiology 1994; 190:97-103

Leclerc X, Godefroy O, Salhi A, Lucas C, Leys D, Pruvo JP. Helical CT for the diagnosis of extracranial carotid artery dissection. Stroke 1996; 27:461-466

Provenzale JM. Dissection of the internal carotid and vertebral arteries: Imaging findings. AJR 1995; 165:1099-1104

Intracranial Hemorrhage

Weisberg LA. Subcortical lobar intracerebral hemorrhage: clinical-computed tomographic correlations. J Neurol Neurosurg Psychiatry 1985; 48:1078

Kase CS, Caplan LR (eds). Intracerebral hemorrhage. Butterworth-Heinemann, Boston, 1994

Meyer JT, Gorey MT. Differential diagnosis of nontraumatic intracranial hemorrhage. Neuroimaging Clin North Am 1998;8:263-293

Dural Sinus Thrombosis

Zimmerman RD, Ernst RJ. Neuroimaging of cerebral venous thrombosis. Neuroimaging Clin North Am 1992;2:463-485

Virapongse C, Cazenave C, Quisling R, Sarwar M, Hunter S. The empty delta sign: Frequency and significance in 76 cases of dural sinus thrombosis. Radiology 1987;162:779-785

Casey SO, Alberico RA, Patel M, et al. Cerebral CT venography. Radiology 1996;198:163-170

Provenzale JM, Joseph GJ, Barboriak DP. Dural sinus thrombosis: findings on CT and MR imaging and diagnostic pitfalls. AJR 1998;170:777-783

Reversible Posterior Leukoencephalopathy Syndrome (Hypertensive Encephalopathy)

Hinchey J, Chaves C, Appignani B, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med 1996;334:494-500

Schwartz RB, Mulkern RV, Gudbjartsson H, Jolesz F. Diffusion-weighted MR imaging in hypertensive encephalopathy: Clues to pathogenesis. AJNR 1998; 19:859-862

Brain and Spine Trauma

Gentry LR, Godersky JC, Thompson B. MR imaging of head trauma: Review of the distribution and radiopathologic features of traumatic lesions. AJNR 1988; 9:101-110

Gentry LR. Godersky JC. Thompson B. MR imaging of head trauma: review of the distribution and radiopathologic features of traumatic lesions. AJR. 150:663-72, 1988

Gentry LR, Godersky JC, Thompson B. Traumatic brainstem injury: MR imaging. Radiology 1989; 171: 177-187

CNS Infections

Post MJD, Quencer RM, Montalvo BM, et al. Spinal infection: evaluation with MR imaging and intraoperative US. Radiology 1988;169:765-771

Chang KH, Han MH, Roh JK, et al. Gd-DTPA-enhanced MR imaging of the brain in patients with meningitis: comparison with CT. AJNR 11:69-76, 1990


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