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Neuroradiology: The Requisites E-Book

Neuroradiology: The Requisites E-Book

David M. Yousem | Rohini Nadgir | Rohini Nadgir

(2016)

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Book Details

Abstract

Now in its 4th Edition, this bestselling volume in the popular Requisites series, by Drs. Rohini Nadgir and David M. Yousem, thoroughly covers the extensive field of neuroradiology in an efficient and practical manner. Ideal for both clinical practice and ABR exam study, it presents everything you need to know about diagnostic imaging of the most commonly encountered neurological conditions. The authors address the conceptual, technical, and interpretive core knowledge needed for imaging the brain, spine, and head and neck, and discuss all the latest imaging modalities used, including diffusion weighted imaging, perfusion imaging, MR and CT angiography, and MR spectroscopy.

  • Features 1,200 high-quality images throughout.
  • Makes it easy to locate any topic of interest thanks to a logical organization by diseases and locations.
  • Summarizes differential diagnoses in quick reference tables to reinforce important characteristics of diseases and aid in interpretation.
  • Focuses on essentials to pass the boards and the Certificate of Added Qualification exam.
  • Contains 50% new, updated, or improved illustrations.
  • Covers new techniques such as diffusion tensor imaging tractography to identify white matter tracts.
  • Offers new understandings of demyelination diseases such as neuromyelitis optica (NMO), reversible cerebral vasoconstriction syndrome (RCVS), immune reconstitution inflammatory syndrome (IRIS), and IgG4 related inflammatory disease.
  • Provides updated World Health Organization classification of brain tumors and the recent American Joint Commission on Cancer TNM staging of head and neck cancers.

Table of Contents

Section Title Page Action Price
Front Cover Cover
IFC ES1
THE REQUISITES Neuroradiology i
The Requisites Series ii
NEURORADIOLOGY: THE REQUISITES, iii
Copyright iv
Dedication v
Contributors vi
Foreword vii
Preface viii
Contents ix
1 - CRANIAL ANATOMY 1
TOPOGRAPHIC ANATOMY 1
Cerebral Hemispheres 1
Brain Stem 3
Cerebellum 4
Corpus Callosum 8
Deep Gray Nuclei 8
Ventricular System, Cerebrospinal Fluid, and Cerebrospinal Fluid Spaces 9
Meninges and Associated Potential Spaces 10
Physiologic Calcifications 12
FUNCTIONAL ANATOMY 13
Brodmann Areas 15
Motor System 15
Sensory System 15
Visual Pathway 20
Auditory System 21
Limbic System 21
Taste 22
Speech 22
CRANIAL NERVES 24
Olfactory Nerve 24
Optic Nerve (CN II) 24
Oculomotor Nerve (CN III) 24
Trochlear Nerve (CN IV) 24
Trigeminal Nerve (CN V) 24
Abducens Nerve (CN VI) 26
Facial Nerve (CN VII) 26
Vestibulocochlear (Acoustic) Nerve (CN VIII) 27
Glossopharyngeal Nerve (CN IX) 27
Vagus Nerve (CN X) 27
Spinal Accessory Nerve (CN XI) 27
Hypoglossal Nerve (CN XII) 27
VASCULAR ANATOMY 27
External Carotid Branches 28
Intracranial Circulation 30
Anterior Cerebral Artery System 31
Middle Cerebral Artery System 32
Vertebral Arteries 33
Basilar Artery Branches 33
Venous Anatomy 34
Superficial Drainage 34
Deep Supratentorial Drainage 34
Deep Infratentorial Drainage 36
Blood-Brain Barrier 37
Skull Base Foramina 37
FINAL WORDS 37
2 - Neoplasms of the Brain 40
EXTRAAXIAL VERSUS INTRAAXIAL TUMORS FOR DUMMIES 40
EXTRAAXIAL TUMORS 41
Tumors of the Meninges 41
Meningiomas 41
Atypical Meningiomas 43
Malignant Meningiomas 43
Radiation-Induced Meningioma 44
Mesenchymal Meningeal Tumors 44
Hemangiopericytoma 44
Melanocytic Lesions 44
Tumors of Neurogenic Origin 44
Schwannomas 44
Neurofibromas 46
Neuromas 47
Metastases 47
Dural Metastases 47
Subarachnoid Seeding 47
INTRAVENTRICULAR MASSES (EXCLUDING MENINGIOMA) 49
Choroid Plexus Masses 49
Choroid Plexus Papilloma 49
Choroid Plexus Carcinomas 50
Choroid Plexus Hemangiomas 50
Choroid Plexus Xanthogranuloma 50
Other Intraventricular Masses (Excluding Meningiomas) 50
Ependymal Tumors 50
Anaplastic Ependymomas 51
Subependymoma 51
Central Neurocytoma 52
Nonneoplastic “Tumors” 53
Epidermoids 53
Dermoid 55
Teratoma 55
Lipoma 55
INTRAAXIAL TUMORS 55
Grade I: Circumscribed Astrocytomas 57
Juvenile Pilocytic Astrocytomas 57
Pleomorphic Xanthoastrocytoma 57
Subependymal Giant Cell Astrocytomas 57
Grade II: Diffuse Astrocytoma 58
Brain Stem “Gliomas” 59
Grade III: Anaplastic Astrocytoma 59
Glioblastoma 59
Gliosarcomas 61
Multicentric Astrocytomas 61
Gliomatosis Cerebri 61
Embryonal Tumors 62
Medulloblastomas/Primitive Neuroectodermal Tumors 62
Supratentorial Primitive Neuroectodermal Tumors 63
Ependymoblastoma 64
Atypical Teratoid Rhabdoid Tumors 64
Dysembryoplastic Neuroepithelial Tumor 65
Neuronal, Mixed Neuronal/Glial Tumors 66
Gangliogliomas 66
Desmoplastic Infantile Ganglioglioma 66
Gangliocytoma 66
Oligodendroglial Tumors 69
Oligodendroglioma 69
Mixed Tumors 69
Anaplastic Oligodendroglioma 70
Neuroepithelial Tumors of Uncertain Origin 70
Chordoid Glioma 70
Astroblastoma 70
Hemangioblastomas 70
Metastases 72
Lymphomas 74
Sarcoma 76
PINEAL REGION MASSES 76
Tumors of Germ Cell Origin 77
Germinoma 77
Teratoma 78
Choriocarcinoma and Other Germ Cell Line Tumors 78
Others 78
Tumors of Pineal Cell Origin 78
Pineoblastoma 78
Pineocytoma 79
NONNEOPLASTIC MASSES 80
Cysts 80
Pineal Cyst 80
Colloid Cyst 80
Neuroepithelial Cyst 80
Choristomas 81
Amyloid 81
Other Nonneoplastic Masses 81
Paraneoplastic Syndromes 81
POSTTREATMENT EVALUATION 82
Postoperative 82
Postradiation 83
Pseudoprogression and Pseudoresponse 85
Response Assessment in Neuro-oncology 85
3 - Vascular Diseases of the Brain 87
ISCHEMIC CEREBROVASCULAR DISEASE 87
Clinical Features 87
PATHOLOGY OF ATHEROSCLEROSIS 89
IMAGING TOOLS 91
Brain 91
Vessels 93
Carotid Ultrasound/Transcranial Doppler 93
Magnetic Resonance Angiography 93
Computed Tomographic Angiography 95
Conventional Catheter Angiography 96
Perfusion 97
IMAGING OF INFARCTION 102
Hyperacute Infarction (0 to 6 hours) 102
Hyperacute Stroke Management 108
Acute Infarction (6 to 36 hours)—Cytotoxic and Vasogenic Edema 109
Early Subacute Infarction (36 hours to 5 days): Reperfusion 109
Late Subacute (5 to 14 days): Resolving Edema and Early Healing 111
Chronic Infarction (More Than 2 Weeks): Healing 112
Acute Cerebellar Infarcts 114
ANOXIA, HYPOXIA, AND BRAIN DEATH 115
VASCULOPATHIES 116
Extracranial and Extradural Arteries 118
Fibromuscular Dysplasia 118
Skull Base/Circle of Willis 118
Moyamoya 118
Granulomatous Meningitis (e.g., Tuberculosis) 120
Secondary and Tertiary Carotid and Basilar Branch Vessels 120
Primary Angiitis of the Central Nervous System 122
Wegener Granulomatosis 122
Polyarteritis Nodosa 122
Neurosarcoidosis 122
Infectious Vasculitis 122
Vasculopathies 122
Reversible Cerebral Vasoconstriction Syndrome 122
Lymphomatoid Granulomatosis (Neoplastic Angioendotheliosis) 122
Small Vessel Diseases 123
Collagen Vascular Diseases 123
Sjögren Syndrome 123
Migraine 123
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy 123
INTRACRANIAL HEMORRHAGE 123
Computed Tomography 123
Magnetic Resonance Imaging 126
Temporal Changes in Parenchymal Hemorrhage 127
Hyperacute Hemorrhage (0 to 4 Hours) 128
Acute Hemorrhage (4 to 72 Hours) 128
Early Subacute Hemorrhage (3 to 6 Days) 129
Late Subacute Hemorrhage (6 to 14 Days) 129
Chronic Hemorrhage (Greater Than 2 Weeks) 130
ETIOLOGIES OF INTRACRANIAL HEMORRHAGE 131
Intraparenchymal Hemorrhage 131
Hypertension 132
Cerebral Amyloid Angiopathy 133
Venous Thrombosis 134
Intratumoral Hemorrhage 137
ETIOLOGIES OF EXTRAAXIAL HEMORRHAGE 138
Subarachnoid Hemorrhage 138
Causes of Subarachnoid Hemorrhage 138
Trauma. In most cases of severe head trauma SAH accompanies and is adjacent to parenchymal and/or extraaxial hematomas. Extensiv... 139
Aneurysmal Subarachnoid Hemorrhage. Aneurismal SAH (aSAH) is typically centered around the base of the brain, in particular with... 139
Nonaneurysmal Subarachnoid Hemorrhage. One cause of angiographically negative SAH is benign perimesencephalic SAH (Fig. 3-56). T... 140
VASCULAR ABNORMALITIES 141
Cerebral Aneurysms 141
Work-up of Aneurysmal Subarachnoid Hemorrhage 142
Capillary Telangiectasias 145
Cavernous Angioma (Cavernous Hemangioma, Cavernous Malformation, Cavernoma) 145
Developmental Venous Anomaly (Venous Angioma) 145
Arteriovenous Malformations 146
Dural Arteriovenous Fistula 147
4 - Head Trauma 150
CLASSIFICATION OF INJURY 152
Primary Injury 152
Secondary Complications 153
EPIDURAL HEMATOMA 153
SUBDURAL HEMATOMA 154
SUBDURAL HYGROMA 157
HEMORRHAGIC CONTUSION 159
PENETRATING INJURIES 159
ACUTE VASCULAR INJURY 160
DIFFUSE AXONAL INJURY 162
TRAUMATIC BRAIN INJURY IN THE LONG TERM 162
SECONDARY COMPLICATIONS 164
Herniation Syndromes 164
BRAIN DEATH 165
CHILD ABUSE/NONACCIDENTAL TRAUMA 165
SKULL/SKULL BASE FRACTURE 166
FACIAL AND ORBITAL TRAUMA 167
Naso-Orbital-Ethmoid Complex Fracture and LeFort Injuries 173
Mandible Fractures 173
TRAUMATIC CRANIAL NERVE INJURY 173
5 - Infectious and Noninfectious Inflammatory Diseases of the Brain 174
ANATOMICALLY BOUNDED INFECTIOUS PROCESSES 174
Anatomy of the Spaces around the Brain and Its Coverings 174
Epidural Abscess 174
Subdural Empyema 175
Leptomeningitis 177
Leptomeningitis versus Pachymeningitis 179
Pyogenic Brain Abscess 179
Ventriculitis 182
Choroid Plexitis 183
Septic Embolus 183
SPECIFIC INFECTIOUS PATHOGENS 184
Viral 184
Herpes Simplex 184
Herpes Zoster 185
Postvaricella Encephalitis 187
Epstein-Barr Virus and Infectious Mononucleosis 187
Eastern Equine Encephalitis 187
Japanese Encephalitis 187
Acquired Immunodeficiency Syndrome and Human Immunodeficiency Virus 188
Zika Virus 192
Mycobacterial/Bacterial 193
Tuberculosis 193
Listeria Monocytogenes 195
Rickettsia 195
Spirochetal 195
Fungal 196
Cryptococcosis 196
Coccidioidomycosis 196
Mucormycosis 197
Nocardiosis 197
Aspergillosis 198
Candidiasis 199
Parasitic 199
Toxoplasmosis 199
Cysticercosis 200
Echinococcosis 202
Prion Disease 202
NONINFECTIOUS INFLAMMATORY DISEASES 202
Sarcoidosis 202
Granulomatosis with Polyangiitis 204
Behçet Disease 204
Whipple Disease 204
LAST BUT NOT LEAST 204
Rasmussen Encephalitis 204
FORTUNE COOKIE 205
6 - White Matter Diseases 206
PRIMARY DEMYELINATING DISEASE 206
Multiple Sclerosis 206
Magnetic Resonance Findings 208
New Methods 211
Magnetization Transfer 211
Diffusion 212
Spinal Cord Disease 212
Clinical Differential Diagnosis of Spinal Cord Lesions 212
Multiple Sclerosis Syndromes 212
Optic Neuritis 212
Differential Diagnosis of Multiple Sclerosis Lesions on Magnetic Resonance 213
Lyme Disease 214
Vasculitides 214
Migraine Lesions 214
Virchow-Robin Spaces 214
Trauma 214
Neuromyelitis Optica 215
Final Thoughts 216
SECONDARY DEMYELINATING DISEASES 216
Allergic/Autoimmune 216
Acute Disseminated Encephalomyelitis 216
Viral 217
Progressive Multifocal Leukoencephalopathy 217
Human Immunodeficiency Virus 217
Vascular 218
Age-Associated Leukoaraiosis 218
Binswanger Disease 218
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy 218
Postanoxic Encephalopathy 219
Posterior Reversible Encephalopathy Syndrome 220
Toxic/Metabolic Derangements 222
Osmotic Demyelination or Central Pontine Myelinolysis 222
Alcoholism 222
Wernicke Encephalopathy 223
Toxic Lesions 223
Wallerian Degeneration 223
Hypertrophic Olivary Degeneration 223
Radiation Changes 223
Disseminated Necrotizing Leukoencephalopathy 224
DYSMYELINATING DISEASES 225
Metachromatic Leukodystrophy 225
Adrenoleukodystrophy 225
Alexander Disease 226
Canavan Disease 227
Krabbe Disease 227
Sudanophilic Leukodystrophy/Pelizaeus-Merzbacher Disease 228
Vanishing White Matter Disease/Childhood Ataxia with Central Hypomyelination 228
Vacuolating Megalencephalic Leukoencephalopathy with Subcortical Cysts 229
7 - Neurodegenerative Diseases and Hydrocephalus 230
HYDROCEPHALUS 232
Overproduction of Cerebrospinal Fluid 232
Noncommunicating and Communicating Hydrocephalus 232
Causes of Obstructive Hydrocephalus 232
Colloid Cyst 232
Congenital Aqueductal Stenosis 232
Clots or Synechiae 232
Masses or Tumors 233
Hematomas and Infarcts 234
Trapped Ventricles 234
Causes of Communicating Hydrocephalus 234
Infection, Hemorrhage, Tumors 234
Adult Hydrocephalus 234
External Hydrocephalus 236
The Almighty Failed Shunt 237
Slit Ventricle Syndrome 238
Pseudotumor Cerebri 238
ATROPHY 239
Neurodegenerative Disorders 239
Alzheimer Disease 239
Pittsburgh Compound B Imaging 240
Frontotemporal Dementia 241
Creutzfeldt-Jakob Disease 243
Mad Cow Disease 243
Parkinson Disease 243
Atypical Parkinson Disease 244
Dementia with Lewy Bodies 244
Multiple System Atrophy 245
Progressive Supranuclear Palsy 245
Corticobasal Ganglionic Degeneration 245
Acquired Immunodeficiency Syndrome Dementia Complex 246
Vascular Dementias 247
Amyotrophic Lateral Sclerosis 247
Dyke-Davidoff-Masson Syndrome 247
Porencephaly 248
Miscellaneous 248
Deep Gray Nuclei Disorders 248
Huntington Chorea 248
Pantothenate Kinase-Associated Neurodegeneration 249
Wilson Disease 250
Fahr Disease 251
Metabolic and Toxic Disorders 251
Hepatic Failure 251
Other Metabolic Derangements 251
Drugs and Toxins 252
Basal Ganglionic Calcification 252
Cerebellar Atrophy 254
Alcohol Abuse 254
Long-Term Drug Use 255
Olivopontocerebellar Degeneration 255
Friedreich Ataxia 256
Ataxia Telangiectasia 256
Ischemia 257
Hypertrophic Olivary Degeneration 257
Paraneoplastic Syndromes 257
METABOLIC DISORDERS 257
Mucopolysaccharidoses 257
Lipidoses and Other Storage Diseases 257
Mitochondrial Defects 258
Leigh Disease 258
Mitochondrial Encephalomyopathy, Lactic Acidosis, and Strokelike Episodes Syndrome 259
Aminoacidopathies and Other Enzyme Deficiencies 261
Lysosomal Disorders 262
8 - Congenital Anomalies of the Central Nervous System 263
TIMING OF FORMATION OF CONGENITAL LESIONS 263
Primary Neurulation 263
Promesencephalic Development 263
Neuronal Proliferation 263
Neuronal Migration 263
Neuronal Organization 264
Myelination 264
SUPRATENTORIAL CONGENITAL LESIONS 264
Disorders of Forebrain Development 265
Holoprosencephaly 265
Commissural Anomalies 265
Septooptic Dysplasia 271
Pituitary Anomalies 271
Cortical Malformations 271
Proliferation Disorders 271
Migrational Disorders 274
Focal Cortical Dysplasia 276
Organizational Disorders 277
Anencephaly 279
INFRATENTORIAL ABNORMALITIES 280
Anomalies Limited to the Cerebellum 280
Dandy-Walker Malformation 280
Blake Pouch Cyst 281
Mega Cisterna Magna 281
Rhombencephalosynapsis 281
Other 282
Isolated Vermian Hypoplasia. This is a distinct entity not to be confused with Dandy-Walker malformation. Vermian hypoplasia ref... 282
Arachnoid Cyst in the Posterior Fossa. About 10% of the arachnoid cysts occur in the posterior fossa. The duplication of the ara... 282
Anomalies Involving the Cerebellum and Brain Stem 282
Joubert Syndrome 282
Pontocerebellar Dysplasia 283
Cerebellar Disruptions 283
Chiari Malformations 283
Chiari I Malformation 283
Chiari II Malformation 285
Chiari III Malformation 285
CONGENITAL HYDROCEPHALUS AND ARACHNOID CYSTS 285
Aqueductal Stenosis 286
Arachnoid Cyst 287
CONGENITAL INFECTIONS 288
PHAKOMATOSES 291
Neurofibromatosis 291
Neurofibromatosis Type 1 291
Neurofibromatosis Type 2 293
Tuberous Sclerosis 294
Sturge-Weber Syndrome 296
von Hippel-Lindau Disease 297
Hereditary Hemorrhagic Telangiectasia 298
Neurocutaneous Melanosis 298
PHACES Syndrome 298
CONGENITAL SPINAL ANOMALIES 298
Disorders of Primary Neurulation 298
Open Spinal Dysraphism 299
Closed Spinal Dysraphism 299
Dorsal Dermal Sinus 300
Disorders of Secondary Neurulation 300
Fibrolipoma of the Filum Terminale 300
Caudal Regression Syndrome 301
Sacrococcygeal Teratoma 301
Anomalies of Notocord Development 302
Diastematomyelia 302
Neuroenteric Cysts 303
Formation and Segmentation Anomalies of the Spinal Column 304
Dural Ectasia 304
Miscellaneous 305
Syringohydromyelia 305
Ventriculus Terminalis 305
Lateral Thoracic Meningoceles 305
SKULL ANOMALIES 305
Craniostenosis 305
Osteopetrosis 306
Achondroplasia 306
Wormian Bones 307
Basilar Invagination and Platybasia 307
MISCELLANEOUS 307
Germinal Matrix-Intraventricular Hemorrhage 307
Periventricular Leukomalacia 307
Hypoxic-Ischemic Encephalopathy 308
Temporal Lobe Seizures and Mesial Temporal Sclerosis 308
9 - Orbit 311
ANATOMY 311
Globe 311
Foramina 311
Extraocular Muscles 312
Optic Nerve 313
Vascular Structures 313
Lacrimal System 315
Visual Pathway 316
IMAGING CONSIDERATIONS: INDICATIONS FOR MAGNETIC RESONANCE, COMPUTED TOMOGRAPHY, AND ORBITAL ULTRASOUND 316
A Few Technical Points 316
OCULAR LESIONS 316
Ocular Calcifications 317
Pediatric Ocular Diseases 318
Retinoblastoma 318
Persistent Hyperplastic Primary Vitreous 318
Coats Disease 319
Toxocara Canis Infection 320
Retinopathy of Prematurity 320
Hamartomas 320
Adult Ocular Diseases 320
Melanoma 321
Choroidal Hemangioma 321
Medulloepithelioma 322
Metastases 322
Choroidal Osteoma 322
Ocular Infections 322
Intraocular Hemorrhage Following Subarachnoid Hemorrhage 323
Abnormalities of Globe Morphology 323
Ocular Hypotony and Choroidal Detachments. Ocular hypotony is defined as low tension in the globe secondary to surgery, trauma, ... 323
Globe Tenting. Globe tenting occurs when the posterior globe configuration changes so that it appears as a conical or tented str... 323
Coloboma. A coloboma of the eye is a congenital defect in any ocular structure. It is classified as typical or atypical dependin... 324
Staphyloma. Posterior staphyloma and coloboma may be detected by CT or MR and are superficially similar (Fig. 9-18). Staphylomas... 324
The Big or Small Globe. Occasionally, one is confronted with an image of an enlarged globe (Box 9-4). The most common cause of t... 324
Small globes (microophthalmia) have been reported as an isolated event or may be associated with conditions such as craniofacial... 324
RETROBULBAR LESIONS 324
Intraconal Lesions 324
Enlarged Cerebrospinal Fluid Space 324
Optic Nerve Atrophy 326
Optic Neuritis 326
Optic Nerve and Visual Pathway Glioma 327
Optic Nerve Sheath Meningioma 327
Slow-Flow Vascular Malformations 329
Venous Malformations. Congenital hemangiomas are tumors that are visible at birth, whereas infantile hemangiomas are seen after ... 329
Orbital Varix. The orbital varix is a venous malformation in which there is dilatation of an otherwise normal venous system (pri... 332
High-Flow Vascular Malformations: Carotid Cavernous Fistula and Dural Vascular Malformation 332
Metastases and Lymphoma 334
Neurogenic Tumors 334
Conal Lesions 334
Thyroid Ophthalmopathy 334
Orbital Inflammatory Pseudotumor 335
Tolosa-Hunt 336
Sarcoidosis 336
Granulomatosis with Polyangiitis 336
Orbital Lymphoma 337
Extraconal Lesions 337
Orbital Infection 337
Lacrimal Sac Lesions 338
Lacrimal Gland Lesions 339
Mucoceles 339
Dermoids 340
Orbital Rhabdomyosarcoma 340
Fibrous Histiocytoma 340
Metastases 340
Sphenoid Wing Meningioma 342
Primary Bone Lesions 342
10 - Sella and Central Skull Base 344
ANATOMY 344
IMAGING OF THE NORMAL PITUITARY GLAND AND THE PARASELLAR REGION 349
INTRASELLAR LESIONS 350
Congenital Lesions of the Pituitary 350
Pituitary Adenoma 352
Pituitary Apoplexy 353
Metastatic Disease 353
Abscess 353
Granulomatous Disease 354
Lymphocytic Hypophysitis 355
Posterior Pituitary Tumors 355
Intrasellar Meningioma 356
Aneurysm 356
Empty Sella Syndrome 356
Postoperative Pituitary 358
SUPRASELLAR LESIONS 358
Infundibular Lesions 358
Rathke Cleft Cyst 358
Arachnoid Cyst 358
Other Developmental Lesions 360
Craniopharyngioma 361
Meningioma 364
Chiasmatic and Hypothalamic Astrocytoma 365
Hamartoma of the Tuber Cinereum 365
Aneurysm 366
Germinoma 367
PARASELLAR LESIONS 367
Aneurysm 368
Carotid-Cavernous Fistula or Dural Malformation 368
Thrombosis of the Cavernous Sinus 368
Cavernous Sinus Meningioma 370
Trigeminal Nerve Lesions 370
Perineural Spread of Tumor 370
Tolosa-Hunt Syndrome 371
Chondrosarcoma 372
INFRASELLAR AND BASE OF SKULL LESIONS 374
Developmental Lesions 374
Juvenile Angiofibroma 374
Chordoma 374
Metastatic Lesions 376
Other Infrasellar Lesions 377
11 - Temporal Bone 378
EXTERNAL AUDITORY CANAL 378
Normal Anatomy 378
Congenital Anomalies 378
Atresia and Hypoplasia 378
First Branchial Cleft Cyst 378
Calcifications of the External Ear Organs 379
Inflammatory Lesions 379
Malignant Otitis Externa 379
Keratosis Obturans 380
Swimmer’s Ear and Surfer’s Ear 380
Neoplasms 380
Benign Neoplasms 380
Malignant Neoplasms 381
Squamous Cell Carcinomas. Squamous cell carcinomas of the EAC are the most common neoplastic processes in this location. This is... 381
Other Primary Malignant Tumors. Other skin tumors such as basal cell carcinomas or melanomas may also affect the external ear in... 381
Metastases. Metastases rarely affect the EAC portion of the temporal bone 381
THE MIDDLE EAR AND FACIAL NERVE 381
Normal Anatomy 381
Congenital Anomalies 385
Hypoplasia and Fusion 385
Epidermoids 385
Inflammatory Lesions 386
Otitis Media 386
Mastoiditis 387
Acquired Cholesteatomas 387
Other Inflammatory Conditions of the Middle Ear 389
Surgery for Otomastoiditis 389
Benign Neoplasms 391
Glomus Tympanicum 391
Hemangiomas 393
Variations in Vascular Anatomy 393
Dural Vascular Malformations 394
Facial Schwannomas 394
Facial Hemangiomas 395
Facial Nerve Enhancement 395
Malignant Neoplasms 396
INNER EAR AND PETROUS APEX 397
Normal Anatomy 397
Congenital Anomalies 397
Cochlear Abnormalities 397
Vestibular Aqueduct Abnormalities 399
Semicircular Canal Abnormalities 399
Congenital Internal Auditory Canal Abnormalities 400
Congenital Syndromes 400
Labyrinthine Disease 400
Perilymphatic Fistula 400
Labyrinthine Ossification 400
Otospongiosis 400
Ménière Disease 402
Paget Disease 403
Fibrous Dysplasia 403
Labyrinthitis 403
Petrous Apex Lesions 403
Petrous Apicitis 403
Cholesterol Granulomas 404
Other Causes of Hearing Loss 405
Benign Neoplasms of the Inner Ear 405
Malignant Neoplasms of the Inner Ear 405
Endolymphatic Sac Tumors 405
JUGULAR FORAMEN LESIONS 405
TRAUMA 407
Introduction to Head\rand Neck Chapters 411
12 - Sinonasal Disease 412
PARANASAL SINUS DEVELOPMENT 413
IMAGING MODALITIES 414
CONGENITAL DISORDERS 415
Choanal Atresia 415
Congenital Sinonasal Masses 415
Hypoplastic Maxillary Antrum 417
INFLAMMATORY LESIONS 417
Sinusitis 417
Anatomic Considerations 417
Appearance on Imaging 419
Post-Functional Endoscopic Sinus Surgery Scanning 423
Less Common Inflammatory Conditions of the Sinuses 424
Granulomatous Diseases 424
Complications of Sinusitis 425
Thrombophlebitis 425
Fungal Sinusitis 425
Cystic Fibrosis 427
Mucocele 427
Postoperative Encephaloceles and Cerebrospinal Fluid Leaks 427
Polyposis 428
Retention Cysts 428
BENIGN NEOPLASMS 430
Osteomas 430
Papillomas 430
Enchondromas 431
Meningiomas 431
Fibrous Dysplasia 432
MALIGNANT NEOPLASMS 432
Squamous Cell Carcinoma 434
Sinonasal Undifferentiated Carcinoma 435
Minor Salivary Gland Cancers 435
Melanoma 435
Adenocarcinoma 436
Olfactory Neuroblastoma 436
Sarcomas 436
Lymphoma 436
Neuroendocrine Tumors 437
Metastases 437
LYMPH NODE DRAINAGE OF NEOPLASMS 438
OPERABILITY OF SINONASAL TUMORS 438
13 - MUCOSAL AND NODAL DISEASE OF THE HEAD AND NECK 439
ANATOMY 439
Nasopharynx 439
Oropharynx 439
Oral Cavity 439
Hypopharynx 440
Larynx 441
CONGENITAL LESIONS 441
Tornwaldt Cyst 441
Bony Congenital Lesions 443
Branchial Apparatus Fistulas 443
Developmental Cysts 444
Lingual Thyroid Gland 444
Venous Vascular Malformations 444
Airway Lesions 444
LESIONS OF THE AERODIGESTIVE SYSTEM AND LYMPH NODES 445
Inflammatory Pharyngeal Disease 445
Adenitis 446
Tuberculous Adenitis 446
Castleman Disease 446
Mononucleosis 447
Cat Scratch Fever 447
Sinus Histiocytosis 448
Kikuchi Fujimoto Disease 448
Kimura Disease 448
Posttransplant Lymphoproliferative Disorder 448
Cysts 448
Laryngotracheal Papillomatosis 448
Macroglossia 449
Odontogenic Lesions 449
Inflammatory Laryngeal Disease 449
Supraglottitis 449
Croup 452
Pharyngoceles and Laryngoceles 452
Ranula 453
Trauma 453
Vocal Cord Paralysis 454
Zenker Diverticulae 455
BENIGN NEOPLASMS OF THE AERODIGESTIVE TRACT 455
Juvenile Nasopharyngeal Angiofibroma 455
Neurogenic Tumors 457
Benign Odontogenic Tumors 457
Ameloblastoma 457
Osseous Tumors 457
Papilloma 457
Pleomorphic Adenoma 457
Other Rare Birds 458
MALIGNANT NEOPLASMS: SQUAMOUS CELL CARCINOMA 458
TNM Staging 458
Nasopharyngeal Carcinoma 458
Oropharyngeal Squamous Cell Carcinoma 461
Preepiglottic Fat Invasion 461
Mandibular Invasion 462
Prevertebral Muscle Invasion 462
Pterygopalatine Fossa Invasion 462
Pterygomandibular Raphe Invasion 463
Bilateral or Deep Invasion of the Tongue Base 463
Lymphadenopathy 463
Prognosis 463
Oral Cavity Squamous Cell Carcinoma 464
Hypopharyngeal Squamous Cell Carcinoma 465
Squamous Cell Carcinoma of the Larynx 466
Supraglottic Squamous Cell Carcinoma 466
Glottic Squamous Cell Carcinoma 468
Subglottic Squamous Cell Carcinoma 471
Chondroradionecrosis 472
Carcinosarcoma 472
Other Mucosal Based Malignancies 473
Lymphoma 473
Minor Salivary Gland Malignancies 473
Plasmacytomas 473
Sarcomas 473
MALIGNANT ADENOPATHY 474
Malignant Adenopathy: Other Considerations 477
Nodal Metastases from Thyroid Carcinoma 478
Lymphoma 478
POSTTREATMENT IMAGING 479
FUTURE CANCER RISK 480
14 - Extramucosal Diseases of the Head and Neck 481
SALIVARY GLANDS 481
Anatomy 481
Congenital Disorders 482
Branchial Cleft Cyst 482
Venous Vascular Malformations 483
Inflammatory Lesions 484
Calculous Disease 484
Sialosis 485
Sialadenitis 485
Sialodochitis 486
Lymphoepithelial Lesions 486
Sialocele 486
Ranula 487
Retention Cysts 487
Miscellaneous Inflammatory Disorders 488
Benign Neoplasms 488
Pleomorphic Adenoma 488
Warthin Tumor 490
Oncocytoma 490
Hemangioma 490
Other Benign Tumors 490
Malignant Neoplasms 490
Mucoepidermoid Carcinoma 491
Adenoid Cystic Carcinoma 492
Squamous Cell Carcinoma 492
Adenocarcinoma 492
Acinic Cell Carcinoma 493
Undifferentiated Carcinoma 493
Metastatic Adenopathy 493
MASTICATOR SPACE 493
Anatomy 493
Inflammatory Lesions 494
Bruxism and Atrophy 494
Fibrous Dysplasia 496
Temporomandibular Joint Syndrome 496
Benign Neoplasms 499
Hemangiomas and Vascular Malformations 499
Ameloblastoma 500
Neurogenic Tumors 500
Malignant Neoplasms 500
Osteosarcoma and Ewing Sarcoma 500
Squamous Cell Carcinoma 501
Metastasis 501
Soft-Tissue Sarcoma 501
Lymphoma 501
PARAPHARYNGEAL SPACE 502
Anatomy 502
Congenital Disorders 502
Inflammatory Lesions 502
Benign Neoplasms 502
Malignant Neoplasms 503
CAROTID SPACE 503
Anatomy 503
Congenital Disorders 504
Branchial Cleft Cyst and Lymphangioma 504
Inflammatory Lesions 505
Cervical Adenitis 505
Vascular Inflammatory Lesions 505
Benign Neoplasms 505
Schwannoma 505
Glomus Tumor 506
Malignant Disease 508
Lymphadenopathy 508
Mucosal Disease Spread 509
RETROPHARYNGEAL SPACE 509
Anatomy 509
Congenital Disorders 509
Retropharyngeal Carotid Artery 509
Inflammatory Lesions 510
Benign Neoplasms 510
Malignant Neoplasms 510
Lymphadenopathy 510
Contiguous Spread from Mucosal Disease 511
Rhabdomyosarcoma 511
Leukemia/Lymphoma 511
PERIVERTEBRAL SPACE 511
Anatomy 511
Congenital Disorders 511
Inflammatory Lesions 512
Benign Neoplasms 512
Chordoma 513
Malignant Neoplasms 513
Metastasis 513
Lymphadenopathy 514
BRACHIAL PLEXUS 514
Congenital Lesions 514
Inflammatory Lesions 515
Benign Neoplasms 515
Malignant Neoplasms 515
THYROID GLAND 516
Anatomy 516
Congenital Disorders 516
Agenesis and Ectopic Thyroid Tissue 516
Thyroglossal Duct Cyst 516
Autoimmune and Inflammatory Lesions 517
Goiter 517
Suppurative Thyroiditis 518
Subacute Thyroiditis 518
Hashimoto Thyroiditis 518
Riedel Thyroiditis and Radiation-Induced Thyroiditis 519
Graves Disease 519
Benign Neoplasms 519
Adenoma 519
Colloid Cyst 519
Malignant Neoplasms 519
Papillary Carcinoma 520
Follicular Carcinoma 520
Medullary Carcinoma 520
Anaplastic Carcinoma 520
Non-Hodgkin Lymphoma 520
Metastasis 521
Incidental Thyroid Nodule 521
PARATHYROID GLANDS 521
Anatomy 521
Congenital Disorders 522
Benign Neoplasms 522
Malignant Neoplasms 523
CYSTIC MASSES IN THE NECK 523
15 - ANATOMY AND DEGENERATIVE DISEASES OF THE SPINE 527
SPINAL PARLANCE 527
ANATOMY 527
Spinal Nerves 527
Vertebrae 528
Intervertebral Disks and Spinal Ligaments 529
Spinal Cord 530
Blood Supply to the Spinal Cord 531
RADIOLOGIC WORK-UP 533
Imaging Fundamentals and Techniques 533
Magnetic Resonance Technique 533
Myelography 535
Computed Tomography 535
Discography 536
Low Tech: Plain Spine Films 536
NORMAL MAGNETIC RESONANCE APPEARANCE OF THE VERTEBRAL BODY MARROW 537
DEGENERATIVE DISEASES (AND OTHER COMMON SPINE MALADIES) 538
Disk Herniation 539
Time Course 543
Schmorl Node 543
Scheuermann Disease 543
Thoracic Disk Herniation 543
Osteophyte Formation 543
Endplate Changes 546
Vacuum Phenomenon 546
Synovial Cysts 546
Ossification of the Posterior Longitudinal Ligament 548
Diffuse Idiopathic Skeletal Hyperostosis 549
Spondylolysis and Spondylolisthesis 549
Congenital Posterior Element Variations 550
Ankylosing Spondylitis 550
Spinal Stenosis 550
Postoperative Diskitis 553
Dural Ectasia 554
Myelopathy from Degenerative Disease 554
Immediate Scanning 554
Failed Back Surgery Syndrome (The Surgeon’s Worst Nightmare) 555
Arachnoiditis 556
16 - Nondegenerative Diseases of the Spine 559
INFECTIOUS AND INFLAMMATORY DISEASES 559
Diskitis and Osteomyelitis 559
Granulomatous Infections 559
Intraspinal Infection 561
Renal Spondyloarthropathy 562
Sarcoidosis 562
Intramedullary Lesions in Acquired Immunodeficiency Syndrome 562
Transverse Myelitis and Multiple Sclerosis 562
Lupus Myelitis 563
Subacute Combined Degeneration 563
Radiation-Induced Changes 564
Tethered Cord 564
CYSTIC LESIONS 567
Arachnoid Cyst 567
Tarlov Cyst 568
Epidermoid Cyst 568
Syringomyelia (Syringohydromyelia) and Cysts within the Cord 569
Cysts Associated with Neoplasia 570
INTRASPINAL LESIONS BY LOCATION 571
Intramedullary Lesions 571
Astrocytoma 571
Ependymoma 572
Hemangioblastoma 573
Ganglioglioma/Gangliocytoma 574
Paragangliomas 574
Intradural Metastatic Disease 575
Extramedullary Intradural Lesions 575
Meningioma 575
Nerve Sheath Tumors: Schwannoma and Neurofibroma 575
Hereditary Motor and Sensory Neuropathies 577
Inflammatory Neuropathies 578
Lipoma 578
Extradural Lesions 578
Osteoporotic Compression Fractures 579
Neural Crest Tumors 581
Hemangioma 582
Chordoma 583
Chondrosarcoma 583
Aneurysmal Bone Cyst, Giant Cell Tumor, Osteoblastoma, and Osteoid Osteoma 584
Eosinophilic Granuloma 584
Osteochondroma 584
Paget Disease 584
Multiple Myeloma 584
Vertebroplasty 586
Epidural Lipomatosis 587
VASCULAR LESIONS 588
Infarction 588
Vascular Malformations 588
Spinal Dural Arteriovenous Fistula 589
Spinal Cord Arteriovenous Malformation 591
Spinal Cord Arteriovenous Fistula 591
Cavernous Angioma 591
Siderosis 592
SPINAL TRAUMA/INJURY 593
Cervical Nerve Root Avulsions 595
Spine Fractures and Dislocations 596
Atlantooccipital Dislocation 597
Atlantoaxial Distraction 597
Atlantoaxial Rotation 598
Atlantoaxial Instability 598
Basilar Invagination/Basilar Impression 599
Odontoid Fracture 601
Os Odontoideum 601
Jefferson Fracture 601
Hangman Fracture 601
Thoracolumbar Spine Fractures 603
Insufficiency Fractures of the Sacrum 604
Spinal Cord Injury without Radiologic Abnormality 604
17 - Approach and Pitfalls in Neuroimaging 605
SEARCH STRATEGY 605
Reading a Brain Computed Tomography Scan 605
Reading a Brain Magnetic Resonance Scan 606
Reading Spine Studies 608
Reading Neck Studies 608
HOW TO INTERPRET AN IMAGE 608
REVIEW OF BRAIN NEOPLASMS 610
Extraaxial Brain Neoplasms 610
Benign Extraaxial Brain Neoplasms 610
Malignant Extraaxial Brain Neoplasms 611
Intraventricular Neoplasms 611
Pineal Region Neoplasms 611
Suprasellar Neoplasms 611
Intraaxial Brain Neoplasms 612
Adult Intraaxial Neoplasms 612
Pediatric Intraaxial Neoplasms 612
NONNEOPLASTIC BRAIN LESIONS 613
Infarcts 613
Infections 613
Metabolic Disorders 613
Demyelinating Disorders 613
Hematomas 614
SPINAL LESIONS 614
GRAND FINALE 615
Important Diagnostic Gamuts e1
Index 617
A 617
B 618
C 618
D 620
E 620
F 621
G 621
H 621
I 622
J 623
K 623
L 623
M 624
N 624
O 625
P 626
R 626
S 627
T 628
U 629
V 629
W 630
X 630
Z 630
IBC ES2