Disseminated High-grade Glioma in a Long-term Survivor of Medulloblastoma: Implications and Management of Radiation-induced Malignancies.

We describe a gentleman diagnosed with a posterior fossa medulloblastoma in 1998, successfully treated with craniospinal radiation therapy (RT) and posterior fossa RT boost, followed by 12 months of adjuvant chemotherapy. Nineteen years later, at the age of 28, the patient presented with multiple cranial neuropathies and was found to have disseminated high-grade glioma with leptomeningeal dissemination. In addition to the salient features of this case, we provide a brief review of RT-induced malignancies and the need for further research regarding surveillance and prevention strategies.

Normal Variant Occipital Pneumatization.

Objective: Evaluate prevalence and pattern of occipital pneumatization (OP).

Patients: Individuals with imaging evidence of OP on computed tomography (CT).

Intervention(s): High resolution CT scans of the temporal bone.

Magnetic Resonance Imaging Assessment of Vascular Contact of the Facial Nerve in the Asymptomatic Patient.

 The objective of this study was to determine the prevalence of facial nerve vascular contact on magnetic resonance imaging (MRI) in patients without hemifacial spasm (HFS).  Our radiology database was queried to identify consecutive adult patients without a history of HFS, intracranial tumor, brain radiation therapy, intracranial surgery, traumatic brain injury, or trigeminal nerve vascular compression. One hundred high-resolution MRIs of the posterior fossa were independently reviewed by two neuroradiologists for facial nerve vascular contact (200 sides).

The role of digital subtraction myelography in the diagnosis and localization of spontaneous spinal CSF leaks.

Objective: The objective of our study was to review the clinical utility of digital subtraction myelography for the diagnosis of spinal CSF leaks in patients with spontaneous intracranial hypotension (SIH) and those with superficial siderosis.

Materials And Methods: Procedure logs from 2007 to 2011 were reviewed to identify cases in which digital subtraction myelography was performed to diagnose spinal CSF leaks. Electronic medical records were reviewed to obtain information regarding diagnosis and outcome.

Refractory headaches due to multilevel thoracic cerebrospinal fluid leaks.

Background: Spontaneous cerebrospinal fluid leak is a well-documented cause of postural headache. We report a medically refractory headache due to multilevel thoracic cerebrospinal fluid leaks.

Case Report: A 44-year-old male with an acute onset of postural headache failed to respond to bed rest, hydration, and analgesics.

Metastatic prostate carcinoma mimicking meningioma: case report and review of the literature.

Background: Intracranial dural-based lesions can be due to benign or malignant processes. Imaging characteristics cannot always discern between different pathologic conditions. A thorough clinical evaluation may reveal likely diagnostic possibilities.

Carotid pseudostring sign from vasa vasorum collaterals.

Objective: To describe the spectral and color Doppler imaging findings in 2 cases of internal carotid artery occlusion with vasa vasorum collateral flow, which we term the "pseudostring sign."

Methods: Spectral and color Doppler imaging findings in both cases were reviewed. Magnetic resonance angiography in 2 cases and conventional angiography in 1 case were also reviewed.