Diseases of the Brain, Head and Neck, Spine 2024-2027: Diagnostic Imaging (IDKD Springer Series)

This open access book offers an essential overview of brain, head and neck, and spine imaging. Over the last few years, there have been considerable advances in this area, driven by both clinical and technological developments. Written by leading international experts and teachers, the chapters are disease-oriented and cover all relevant imaging modalities, with a focus on magnetic resonance imaging and computed tomography. IDKD books are rewritten (not merely updated) every four years, which means they offer a comprehensive review of the state-of-the-art in imaging. The book is clearly structured and features learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers navigate the text. It will particularly appeal to general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic expertise, as well as clinicians from other specialties who are interested in imaging for their patient care. Contents Part I: Brain/Skull Base/Head 1: Diseases of the Sella Turcica and Parasellar Region 1.1 Introduction 1.2 Imaging Appearance of the Normal Pituitary Gland 1.3 Pituitary Adenomas 1.4 Postoperative Sella Turcica 1.5 Rathke Cleft Cyst 1.6 Craniopharyngioma 1.7 Meningioma 1.8 Chiasmatic and Hypothalamic Gliomas 1.9 Metastases 1.10 Infections 1.11 Noninfectious Inflammatory Lesions 1.12 Vascular Lesions 1.13 Additional Pathology in the Sellar and Parasellar Regions 1.14 Concluding Remarks Further Reading 2: Problem Solving Disorders of CSF 2.1 Spontaneous Intracranial Hypotension (SIH) 2.1.1 Clinical Presentation 2.1.2 Etiology 2.1.3 Diagnostic Work-Up 2.1.3.1 Brain MRI 2.1.3.2 Spine Imaging 2.1.4 Treatment 2.1.5 Concluding Remarks 2.2 Obstructive Hydrocephalus. Communicating Hydrocephalus. Normal Pressure Hydrocephalus 2.2.1 Hydrocephalus 2.2.2 Radiological Findings 2.2.3 Non-communicating (Obstructive) Hydrocephalus 2.2.4 Communicating Hydrocephalus 2.2.5 Concluding Remarks References 3: Stroke and Its Mimics: Diagnosis and Treatment 3.1 Introduction 3.2 Imaging in Acute Ischemic Stroke—Evidence-Based Guidelines 3.3 Imaging Paradigm 3.4 CT: Protocols, Findings, and Pitfalls 3.4.1 Non-contrast CT Head Imaging 3.4.2 CT Angiogram 3.4.3 CT Perfusion 3.5 MRI: Protocols, Findings, Pitfalls, and Example Cases 3.6 Approach to Interpreting “Code Stroke” Imaging 3.7 Optimizing Imaging Workflow in Acute Stroke 3.8 Stroke Mimics 3.8.1 Seizures 3.8.2 Migraines 3.8.3 Posterior Reversible Encephalopathy Syndrome (PRES) 3.8.4 Venous Thrombosis 3.8.5 Tumors 3.9 Concluding Remarks References 4: Cerebral Neoplasms 4.1 Introduction 4.2 Goals of the Revised Classification 4.3 Background 4.4 Infiltrating Gliomas in Adults 4.5 IDH-Mutant Gliomas 4.5.1 Clinical Relevance and Prognosis 4.5.2 Radiological Features 4.6 1p/19q-Codeletion 4.6.1 Clinical Relevance and Prognosis 4.6.2 Radiological Features 4.7 Gliomatosis Cerebri 4.8 CNS Tumor Nomenclature, Integrated Diagnosis, and Layered Reports 4.9 Gliomas in Children 4.10 BRAF Mutation 4.10.1 Radiological Features 4.11 Histone H3K27 Altered Tumors 4.11.1 Radiological Features 4.12 Solitary Fibrous Tumor (SFT) and Hemangiopericytoma (HPC) 4.12.1 Radiological Features 4.13 Multinodular Vacuolating Neuronal Tumor 4.13.1 Radiological Features 4.14 Conclusion References 5: Nontraumatic Intracranial Hemorrhage 5.1 Introduction and Imaging Protocol 5.2 Subarachnoid Hemorrhage 5.2.1 Overview 5.2.1.1 Main Etiologies of a SAH 5.2.1.2 How Can I Determine Which of the Multiple Intracranial Aneurysms Has Bled During a SAH Assessment? 5.2.1.3 When Dealing with a Cisternal SAH and a Negative CT Angiogram, Three Possibilities Should Be Considered 5.3 Intraparenchymal Hemorrhage 5.3.1 Overview 5.3.2 Key Imaging Features of Intraparenchymal Hemorrhage 5.3.3 Prognostic Factors 5.3.4 Entities with Underlying Vascular Abnormality on CTA or MRA 5.3.4.1 Arteriovenous Malformation 5.3.4.2 Cerebral Venous Sinus Thrombosis 5.3.4.3 Hemorrhagic Transformation of Ischemic Stroke 5.3.4.4 Aneurysm 5.3.4.5 Moyamoya Syndrome 5.3.4.6 Reversible Cerebral Vasoconstriction Syndrome 5.3.4.7 Miscellaneous Infections Primary CNS Vasculitis Dural AV Fistula Pres 5.3.5 Entities with No Underlying Vascular Abnormality on CTA or MRA 5.3.5.1 Cerebral Amyloid Angiopathy 5.3.5.2 Hypertensive Hemorrhage 5.3.5.3 Cavernous Malformation 5.3.5.4 Tumoral Hemorrhage 5.3.5.5 Coagulopathy 5.3.5.6 Hemorrhagic Encephalitis 5.4 Other Hemorrhage 5.4.1 Microhemorrhage 5.4.2 Subdural and Epidural Hemorrhage 5.5 Blood Mimics 5.5.1 On CT 5.5.2 On MR 5.6 Conclusion References 6: Intracranial Infection and Inflammation 6.1 Approach to CNS Infection 6.2 MRI Technique 6.3 Meningitis 6.3.1 Imaging Features of Meningitis 6.3.2 Differential Diagnosis of Meningitis 6.3.3 Causes and Complications of Meningitis 6.4 Brain Abscess 6.4.1 MRI Features of Diagnosis of Brain Abscess 6.4.2 Differential Diagnosis of Ring Enhancing Lesions 6.5 Parasitic Diseases 6.5.1 Neurocysticercosis 6.6 HIV Infection and Specific Organisms 6.6.1 Toxoplasmosis 6.6.2 Aspergillosis 6.6.3 Tuberculosis 6.7 Viral Infections 6.7.1 Herpes Simplex Virus 6.7.2 Arboviruses and Other Viruses 6.7.3 Progressive Multifocal Leukoencephalopathy 6.8 Inflammatory Diseases of the CNS 6.8.1 Autoimmune and Limbic Encephalitis: LGI1 Antibody Encephalitis 6.8.2 Leptomeningeal Enhancement: Neurosarcoidosis 6.8.3 Pachymeningeal Enhancement: IgG4-Related Diseases 6.8.4 Autoimmune CNS Vasculitis 6.8.4.1 Autoimmune CNS Vasculitis 6.9 Concluding Remarks References 7: Neuroimaging Update on Traumatic Brain Injury 7.1 Introduction 7.2 TBI Clinical Grading 7.3 Imaging Use and Techniques 7.3.1 Computed Tomography (CT) 7.3.2 Magnetic Resonance Imaging (MRI) 7.3.3 CT or MR Angiography (CTA or MRA) 7.3.4 Diffusion Tensor Imaging (DTI) and Diffusion Kurtosis Imaging (DKI) 7.3.5 Outcome Prediction with Imaging Parameters 7.4 Scalp Lesions 7.5 Skull Fractures 7.6 Extra-Axial Lesions 7.6.1 Epidural Hematoma (EDH) 7.6.2 Subdural Hematoma (SHD) 7.6.3 Traumatic Subarachnoid Hemorrhage (SAH) 7.6.4 Traumatic Intraventricular Hemorrhage (IVH) 7.7 Intra-Axial Lesions 7.7.1 Hemorrhagic Cerebral Contusions, Coup Versus Contrecoup 7.7.2 Diffuse Axonal Injury (DAI) 7.8 Vascular Injury 7.8.1 Carotid Artery-Cavernous Sinus Fistula (CCF) 7.8.2 Traumatic Aneurysms 7.8.3 Traumatic Vascular Dissection 7.9 Secondary Complications 7.9.1 Definition 7.9.2 Intracranial Hypertension 7.9.2.1 Brain Herniation 7.9.2.2 Secondary Brainstem Hemorrhage (Duret Hemorrhage) 7.9.3 Ischemia and Infarction 7.9.4 Infections 7.10 Post-traumatic Sequelae 7.10.1 Post-traumatic Encephalomalacia 7.10.2 Traumatic CSF Leak 7.10.3 Growing Skull Fracture 7.10.4 Diabetes Insipidus (DI) 7.11 Concluding Remarks References 8: Differential Diagnosis of Intracranial Masses 8.1 Introduction 8.2 Time Course of Disease 8.3 Intra-axial Vs. Extra-axial 8.4 Pattern Analysis 8.5 Neoplastic Vs. Non-neoplastic Disease 8.6 Single Vs. Many Lesions 8.7 Metastatic Disease 8.8 Primary Neoplasms 8.8.1 Extra-axial Neoplasms 8.8.2 Intra-axial Neoplasms 8.9 Concluding Remarks References 9: Toxic and Metabolic Disorders 9.1 Introduction 9.2 Most Common Congenital Metabolic Disorders Presenting or Persisting into Adulthood 9.2.1 X-Linked Adrenoleukodystrophy (ALD) 9.2.2 Globoid Cell Leukodystrophy (Krabbe Disease) 9.2.3 Metachromatic Leukodystrophy (MLD) 9.2.4 Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like Episodes (MELAS) 9.2.5 Fabry Disease (Galactocerebrosidase Deficiency) 9.2.6 Alexander Disease 9.2.7 Primary Familial Brain Calcification (PFBC) 9.3 Acquired Metabolic/Toxic Disorders 9.3.1 Wernicke Encephalopathy (WE) 9.3.2 Subacute Combined Degeneration (SCD) 9.3.3 Osmotic Demyelination Syndrome (ODS) 9.3.4 Hepatic Encephalopathy 9.3.5 Hypoglycemic Encephalopathy 9.3.6 Hyperglycemic Encephalopathy 9.3.7 Hypoxic Ischemic Encephalopathy (HIE) 9.3.8 Drug-Induced Encephalopathy 9.4 Concluding Remarks References 10: Imaging the Patient with Epilepsy or Seizures 10.1 Image Indication and Epilepsy Dedicated MR Protocol 10.2 Mesial Temporal Lobe/Hippocampal Sclerosis 10.3 Malformations of Cortical Development 10.4 Epileptogenic Tumors 10.5 Other Causes of Focal Epilepsy 10.6 Concluding Remarks References 11: Found Down 11.1 Structural and Vascular Abnormalities 11.2 Intracranial Pressure and Herniation Syndromes 11.3 Seizures 11.4 Toxic Exposures and Metabolic Abnormalities 11.5 Concluding Remarks References 12: Evaluation of Patients with Cranial Nerve Disorders 12.1 Introduction 12.2 Anatomy 12.3 Imaging Technique 12.3.1 Imaging Technique: General Considerations 12.3.2 Imaging Technique: New Techniques 12.4 Cranial Nerve Lesions 12.4.1 Intraaxial Cranial Nerve Lesions 12.4.1.1 Ischaemic Stroke 12.4.1.2 Demyelinating Disease 12.4.1.3 Trauma 12.4.1.4 Vascular Malformations 12.4.1.5 Infectious Diseases 12.4.1.6 Tumours 12.4.2 Intracranial Extraaxial Cranial Nerve Lesions 12.4.2.1 Tumours/Cysts/Cyst-Like Lesions Nerve Sheath Tumours Meningiomas Other Tumours, Cysts/Cyst-Like Lesions 12.4.2.2 Vascular Diseases Neurovascular Compression Syndromes Aneurysm and Arterial Dissection 12.4.2.3 Infectious Diseases 12.4.2.4 Non-infectious Inflammatory Diseases 12.4.2.5 Trauma 12.4.3 Skull Base Cranial Nerve Lesions 12.4.3.1 Trauma 12.4.3.2 Neuritis 12.4.3.3 Skull Base Infections and Tumours 12.4.3.4 Cavernous Sinus 12.4.4 Extracranial Cranial Nerve Lesions 12.4.4.1 Vascular Lesions 12.4.4.2 Infectious Diseases 12.4.4.3 Non-infectious Inflammatory Diseases Demyelinating Diseases MS Anti-AQP4+ Anti-MOG+ Granulomatous Diseases Graves’ Orbitopathy Orbital Pseudotumor 12.4.4.4 Tumours Primary Nerve Lesions Nerve Sheath Tumours Secondary Nerve Involvement Head and Neck Malignancies and Perineural Tumour Spread Paragangliomas Metastases 12.4.4.5 Trauma 12.4.4.6 Upper Mediastinum 12.4.5 Conclusion References Part II: Brain and Spine 13: Demyelinating Diseases of the CNS (Brain and Spine) 13.1 Introduction 13.2 Inflammatory-Demyelinating Diseases of the CNS 13.3 Multiple Sclerosis (MS) 13.4 Baló Concentric Sclerosis 13.5 Neuromyelitis Optica Spectrum Disorders (NMOSD) 13.6 Acute Disseminated Encephalomyelitis (ADEM) 13.7 Myelin Oligodendrocyte Glycoprotein-Related Antibody Disease (MOGAD) 13.8 Infectious Inflammatory Demyelinating Disorders 13.8.1 Progressive Multifocal Leukoencephalopathy 13.8.2 Human Immunodeficiency Virus Encephalopathy 13.9 White Matter Disease from Toxic Imbalance 13.9.1 Chronic Alcohol Ingestion and Its Consequences 13.9.2 Hepatic Encephalopathy 13.9.3 Marchiafava-Bignami Disease 13.9.4 Wernicke Encephalopathy 13.9.5 Osmotic Demyelination Syndrome 13.10 White Matter Disease Associated with Radiation Therapy and Chemotherapy 13.10.1 Radiation Injury and Necrosis 13.10.2 Chemotherapy-Associated Neurotoxicity 13.11 Vascular Causes of White Matter Disease 13.11.1 Posterior Reversible Encephalopathy Syndrome 13.12 Aging and Ischemic Demyelinating Disorders 13.13 Conclusion References Part III: Pediatric and Fetal 14: Child with Acute Neurological Emergency 14.1 Introduction 14.2 Stroke 14.3 Intracranial Hemorrhages 14.4 Seizures 14.5 Trauma 14.6 Infections 14.7 Metabolic and Toxic Imbalances 14.8 Autoimmune Pathologies 14.9 Acute Facial Nerve Palsy 14.10 Hydrocephalus 14.11 Drowning/Near Drowning 14.12 Spinal Cord Emergencies 14.13 Conclusion References Part IV: Head and Neck 15: Evaluation of Tinnitus and Hearing Loss in the Adult 15.1 Introduction 15.2 Causes of Tinnitus and Hearing Loss 15.2.1 Tinnitus 15.2.1.1 Pulsatile Tinnitus 15.2.1.2 Non-pulsatile Tinnitus 15.2.2 Hearing Loss 15.2.2.1 Conductive Hearing Loss 15.2.2.2 Sensorineural Hearing Loss 15.3 Anatomy 15.3.1 External Auditory Canal 15.3.2 Middle Ear 15.3.3 Inner Ear 15.3.4 Internal Auditory Canal 15.4 Imaging Modalities and Techniques 15.4.1 Computed Tomography 15.4.1.1 Temporal Bone CT Technique 15.4.2 Magnetic Resonance Imaging 15.5 Tinnitus and Hearing Loss Without a Mass 15.5.1 Otospongiosis 15.5.2 Labyrinthitis Ossificans 15.5.3 Superior Semicircular Canal Dehiscence 15.5.4 Enlarged Vestibular Aqueduct Syndrome 15.6 Tinnitus and Hearing Loss with a Mass 15.6.1 Vestibular Schwannoma 15.6.2 Cholesteatoma 15.6.3 Glomus Tumor 15.6.4 Cholesterol Granuloma 15.7 Conclusion References 16: Approach to Masses in Head and Neck Spaces 16.1 Introduction to Head and Neck Spaces 16.2 Suprahyoid Neck: Pharyngeal Mucosal Space (PMS) 16.2.1 Anatomy and Contents 16.2.2 Pathology 16.3 Suprahyoid Neck: Parapharyngeal Space (PPS) 16.3.1 Anatomy and Contents 16.3.2 Pathology 16.4 Suprahyoid Neck: Masticator Space (MS) 16.4.1 Anatomy and Contents 16.4.2 Pathology 16.5 Suprahyoid Neck: Parotid Space (PS) 16.5.1 Anatomy and Contents 16.5.2 Pathology 16.6 Suprahyoid Neck: Sublingual (SLS) and Submandibular Space (SMS) 16.6.1 Anatomy and Contents 16.6.2 Pathology 16.7 Infrahyoid Neck: Visceral Space (VS) 16.7.1 Anatomy and Contents 16.7.2 Thyroid and Parathyroid Pathology 16.7.3 Larynx, Hypopharynx, Trachea, and Esophagus Pathology 16.8 Entire Neck: Carotid Space (CS) 16.8.1 Anatomy and Contents 16.8.2 Pathology 16.9 Entire Neck: Retropharyngeal, Danger, and Prevertebral Spaces (RPS) 16.9.1 Anatomy and Contents 16.9.2 Pathology 16.10 Entire Neck: Perivertebral Space (PVS) 16.10.1 Anatomy and Contents 16.10.2 Pathology 16.11 Concluding Remarks References 17: Head and Neck Squamous Cell Cancer: Approach to Staging and Surveillance 17.1 Imaging Methods 17.1.1 Computed Tomography (CT) 17.1.2 Magnetic Resonance Imaging (MRI) 17.1.3 Positron Emission Tomography/Computed Tomography (PET/CT) 17.1.4 Ultrasound (US) 17.1.5 Up and Coming: Magnetic Resonance/Positron Emission Tomography (MR/ PET) 17.2 TNM Staging 17.2.1 Key Changes in the AJCC/UICC Eighth Edition 17.3 Nasopharyngeal Carcinoma (NPC) 17.3.1 Anatomic Boundaries 17.3.2 Key Upstaging Features 17.4 Oral Cavity SCC (OCSCC) 17.4.1 Anatomic Boundaries 17.4.2 Key Upstaging Features 17.5 Oropharyngeal SCC (OPSCC) 17.5.1 Anatomic Boundaries 17.5.2 Key Upstaging Features 17.6 Hypopharynx/Larynx SCC 17.6.1 Anatomic Boundaries 17.6.2 Key Upstaging Features 17.7 Cervical Lymphadenopathy 17.8 Perineural Spread (PNS) 17.9 Surveillance 17.10 Neck Cancer of Unknown Primary (NCUP) 17.11 Concluding Remarks References Part V: Spine, Spinal Cord, Plexus and Nerves 18: Evaluation of Myelopathy and Radiculopathy 18.1 Clinical Presentation 18.2 Myelopathy 18.2.1 Extrinsic 18.2.2 Intrinsic 18.3 Radiculopathy 18.4 Concluding Remarks References 19: Spinal Trauma and Spinal Cord Injury (SCI) 19.1 Imaging Modalities for Spinal Trauma 19.1.1 Plain Film Radiography 19.1.2 Computed Tomography (CT) 19.1.3 Magnetic Resonance Imaging (MRI) 19.2 Different Grading Systems to Evaluate Spinal Injuries 19.2.1 Injuries to the Vertebral Column 19.3 Soft Tissue Injuries 19.3.1 Traumatic Disc Herniation and Ligamentous Injury 19.3.2 Whiplash-Associated Disorders 19.4 Injuries to the Spinal Cord 19.4.1 Spinal Cord Hemorrhage 19.4.2 Spinal Cord Edema 19.5 Blunt Cerebrovascular Injury 19.6 Injuries to the Pediatric Spine and Spinal Cord 19.7 Neurologic Recovery After Spinal Cord Injury 19.8 Concluding Remarks References 20: Masses in and Around the Spine 20.1 Detection of Masses in and Around the Spine 20.2 Anatomical Compartments in and Around the Spine: Paraspinal, Vertebral, and Epidural 20.3 Grading of Masses in and Around the Spine 20.3.1 Weinstein-Boriani-Biagini Classification 20.3.2 Spinal Instability Neoplastic Score (SINS) 20.3.3 Epidural Spinal Cord Compression (ESCC) Scale, Bilsky Score 20.4 Characterization of Masses in and Around the Spine 20.4.1 Mass in the Paraspinal Space 20.4.2 Mass Within the Vertebra 20.4.2.1 Vertebral Metastasis 20.4.2.2 Primary Malignant Tumors of the Vertebrae 20.4.2.3 Primary Benign Tumors of the Vertebrae 20.4.3 Mass in the Epidural Space 20.5 Concluding Remarks References Index