Low Doses of Ionizing Radiation as a Treatment for Alzheimer's Disease: A Pilot Study.

Background: In 2015, a patient in hospice with Alzheimer's disease (AD) was treated with ionizing radiation to her brain using repeated CT scans. Improvement in cognition, speech, movement, and appetite was observed. These improvements were so momentous that she was discharged from the hospice to a long-term care home.

Incidence of Dural Venous Sinus Thrombosis in Patients with Glioblastoma and Its Implications.

Objective: Glioblastoma (GBM) is associated with increased risk of developing dural venous sinus thrombosis (DVST), which often goes undiagnosed as symptoms are readily attributed to tumor. The purpose of this study was to investigate the incidence of DVST, potential predictive features on imaging, complications, its effect on survival, and time of greatest risk for developing DVST.

Methods: A retrospective search of patients with GBM who had surgery followed by chemotherapy and/or radiation therapy between 2009 and 2015 at our institution was performed.

Temporal evolution of perfusion parameters in brain metastases treated with stereotactic radiosurgery: comparison of intravoxel incoherent motion and dynamic contrast enhanced MRI.

Intravoxel incoherent motion (IVIM) is a magnetic resonance imaging (MRI) technique that is seeing increasing use in neuro-oncology and offers an alternative to contrast-enhanced perfusion techniques for evaluation of tumor blood volume after stereotactic radiosurgery (SRS). To date, IVIM has not been validated against contrast enhanced techniques for brain metastases after SRS. In the present study, we measure blood volume for 20 brain metastases (15 patients) at baseline, 1 week and 1 month after SRS using IVIM and dynamic contrast enhanced (DCE)-MRI.

Radiologic Differences between Human Papillomavirus-Related and Human Papillomavirus-Unrelated Oropharyngeal Carcinoma on Diffusion-Weighted Imaging.

Background And Purpose: Human papilloma virus-related oropharyngeal carcinoma (HPV+ OPC) is a unique entity compared to HPV-unrelated (HPV-) OPC. Previous studies were inconclusive regarding the differences between HPV+ and HPV- OPCs on diffusion-weighted imaging (DWI). This study sought to determine if there is an association between HPV status and apparent diffusion coefficient (ADC) values as an imaging biomarker in OPCs.

Diffusion Tensor Imaging Tractography of the Facial Nerve in Patients With Cerebellopontine Angle Tumors.

Objective: To demonstrate the utility of diffusion tensor imaging (DTI) fiber tractography of the facial nerve in patients with cerebellopontine angle (CPA) tumors.

Study Design: Prospective.

Setting: Tertiary referral center.

Perfusion reduction in the absence of structural differences in cognitively impaired versus unimpaired RRMS patients.

Background: Cognitive impairment affects 40%-68% of relapsing-remitting multiple sclerosis (RRMS) patients. Gray matter (GM) demyelination is complicit in cognitive impairment, yet cortical lesions are challenging to image clinically. We wanted to determine whether cortical cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) differences exist between cognitively impaired (CI) and unimpaired (NI) RRMS.

Validation of the 9-Point and 24-Point Hematoma Expansion Prediction Scores and Derivation of the PREDICT A/B Scores.

Background And Purpose: Nine- and 24-point prediction scores have recently been published to predict hematoma expansion (HE) in acute intracerebral hemorrhage. We sought to validate these scores and perform an independent analysis of HE predictors.

Methods: We retrospectively studied 301 primary or anticoagulation-associated intracerebral hemorrhage patients presenting <6 hours post ictus prospectively enrolled in the Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus Computed Tomography (PREDICT) study.

Neoplastic meningitis presenting with dysphagia and bilateral vocal cord paralysis.

Neoplastic meningitis is the infiltration of the leptomeninges and subarachnoid space by tumor cells occurring in 3% to 5% of patients with systemic malignancies. Most cases present with multifocal neurological symptoms that vary according to the central nervous system territory involved. Here, we describe the first reported case to our knowledge of neoplastic meningitis causing bilateral vocal cord paralysis.

Multicenter accuracy and interobserver agreement of spot sign identification in acute intracerebral hemorrhage.

Background And Purpose: Rapid, accurate, and reliable identification of the computed tomography angiography spot sign is required to identify patients with intracerebral hemorrhage for trials of acute hemostatic therapy. We sought to assess the accuracy and interobserver agreement for spot sign identification.

Methods: A total of 131 neurology, emergency medicine, and neuroradiology staff and fellows underwent imaging certification for spot sign identification before enrolling patients in 3 trials targeting spot-positive intracerebral hemorrhage for hemostatic intervention (STOP-IT, SPOTLIGHT, STOP-AUST).

Face validity study of an artificial temporal bone for simulation surgery.

Hypothesis: Using the rapid prototype (RP) technology, a physical construct of a human temporal bone was developed based on cadaveric tissue to permit simulated surgical training. The objective of the study was to test the face validity of the model.

Background: The cost and access to human cadaveric temporal bones is becoming increasingly challenging, particularly if there are religious and regulatory restrictions.

Hemorrhagic epidermoid cyst in a patient with generalized tonic clonic seizure.

Epidermoid cysts account for approximately 1% of all intracranial tumors. Hemorrhage into an epidermoid cyst is extremely rare, and has only been reported a few times. To our knowledge, there are no reports of a hemorrhagic epidermoid cyst presenting with a first generalized tonic clonic seizure.

NASCET percent stenosis semi-automated versus manual measurement on CTA.

Purpose: To compare North American Symptomatic Carotid Endarterectomy Trial (NASCET) stenosis values and NASCET grade categorization (mild, moderate, severe) of semi-automated vessel analysis software versus manual measurements on computed tomography angiography (CTA).

Methods: There were four observers. Two independently analyzed 81 carotid artery CTAs using semi-automated vessel analysis software according to a blinded protocol.

Rare frontal lobe intraparenchymal epidermoid cyst with atypical imaging.

Epidermoid cysts are slow-growing benign tumors derived from ectodermal tissue that are hypothesized to have been inwardly displaced from the ectodermal surfaces during embryologic development. These cysts represent 1% to 2% of all intracranial tumors, and occur most commonly in the cerebellopontine angle, parasellar region, and subarachnoid spaces of the basal cisterns. Epidermoid cysts that are exclusively intraparenchymal are very rare, and can be difficult to diagnose as they often do not have classic radiologic findings, and share many similar radiologic features to other tumors such as astrocytomas, arachnoid cysts, dermoid cysts, and cavernomas.

Diffuse ischemia in noncontrast computed tomography predicts outcome in patients in intensive care unit.

Purpose: In the intensive care unit (ICU), prognosticating patients who are comatose or defining brain death can be challenging. Currently, the criteria for brain death are clinical supported by paraclinical tests. Noncontrast computed tomography (CT) shows diffuse loss of grey-white differentiation consistent with infarction.

Pictorial essay: early- and late-term effects of radiotherapy in head and neck imaging.

The purpose of this article is to illustrate the cross-sectional imaging appearance of postradiation changes and complications of radiotherapy in the head and neck. Radiotherapy is an important treatment modality for head and neck cancer, and is often used in conjunction with chemotherapy. Recognition of the varied effects of radiotherapy to the head and neck region is essential to correctly interpret posttreatment imaging and may help prevent further complication.