Table Of ContentEmergency Neuroradiology
A Case-Based Approach
Emergency Neuroradiology
A Case-Based Approach
YangTangMDPhD
AssistantProfessorandAttendingRadiologistinNeuroradiologyandEmergencyRadiology,
VirginiaCommonwealthUniversityMedicalCenter,Richmond,VA,USA
SugotoMukherjeeMD
AssistantProfessor,DepartmentofRadiologyandMedicalImaging,UniversityofVirginiaHealthSystem,
Charlottesville,VA,USA
MaxWintermarkMDMASMBA
ProfessorofRadiologyandChiefofNeuroradiology,StanfordUniversity,Stanford,CA,USA
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Informationonthistitle:www.cambridge.org/9781107676138
(cid:2)C YangTang,SugotoMukherjee,andMaxWintermark2015
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Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateand
up-to-dateinformationwhichisinaccordwithacceptedstandardsandpractice
atthetimeofpublication.Althoughcasehistoriesaredrawnfromactualcases,
everyefforthasbeenmadetodisguisetheidentitiesoftheindividualsinvolved.
Nevertheless,theauthors,editors,andpublisherscanmakenowarrantiesthatthe
informationcontainedhereinistotallyfreefromerror,notleastbecauseclinical
standardsareconstantlychangingthroughresearchandregulation.Theauthors,
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Toourfamilies,fortheloveandunwaveringsupport!
Contents
Listofcontributors pagex
ForewordbyMauricioCastillo xi
Preface xiii
Listofabbreviations xiv
Section1–Brain Case2.3: Diffuseaxonalinjury 71
Case2.4: Traumaticcarotid–cavernousfistulaand
Sectioneditor:YangTang carotidarteryinjury 73
1. Cerebrovasculardiseases 1 3. Cerebraldemyelinatingandinflammatory
YangTang,XinliDu,SugotoMukherjee,and diseases 75
MaxWintermark YangTang,XinliDu,MaxWintermark,and
SugotoMukherjee
Case1.1: Anteriorcirculationstroke 1
Case1.2: Distalbasilarthrombosis 6 Case3.1: Tumefactivemultiplesclerosis 75
Case1.3: Spontaneouscarotiddissection 8 Case3.2: Acutedisseminatedencephalomyelitis 77
Case1.4: Adulthypoxic–ischemicinjury 11 Case3.3: Neurosarcoidosis 79
Case1.5: Neonatalhypoxic–ischemicinjury 14 Case3.4: Neuromyelitisoptica–brain 82
Case1.6: Reperfusionhemorrhageaftercarotid Case3.5: Lupuscerebritis 85
stenting 17 Case3.6: Neuro-Behc¸et’ssyndrome 87
Case1.7: Thromboticmicroangiopathy 20
4. Intracranialinfections 89
Case1.8: Reversiblecerebralvasoconstriction
YangTang,XinliDu,SugotoMukherjee,and
syndrome 23
MaxWintermark
Case1.9: ArteryofPercheroninfarction 25
Case1.10: Primaryangiitisofcentralnervous Case4.1: Bacterialmeningitis 89
system 27 Case4.2: Pyogenicabscess 92
Case1.11: Cerebralvenousthrombosis 30 Case4.3: CNStuberculosis 95
Case1.12: Lobarhemorrhageduetoduralsinus Case4.4: Cerebralfungalinfection 98
thrombosis 34 Case4.5: Herpesencephalitis 102
Case1.13: Cerebralamyloidangiopathy 37 Case4.6: Nonherpeticviralencephalitis 104
Case1.14: Cavernousmalformation 39 Case4.7: Lymeneuroborreliosis 107
Case1.15: Cerebralaneurysms 42 Case4.8: Cerebellitis 109
Case1.16: Vasospasmanddelayedcerebral Case4.9: Parenchymalneurocysticercosis 112
ischemiaaftersubarachnoid Case4.10: Ventricularneurocysticercosis 114
hemorrhage 47 Case4.11: Creutzfeldt–Jakobdisease 116
Case1.17: Cerebralarteriovenousmalformation 50 Case4.12: Neurosyphilis 118
Case1.18: Duralarteriovenousfistula 53 Case4.13: Cerebraltoxoplasmosis 120
Case1.19: Cerebralarteriovenousfistula 56 Case4.14: CNScryptococcosis 122
Case1.20: Moyamoyadisease 57 Case4.15: Progressivemultifocal
Case1.21: Spontaneouscarotid–cavernousfistula 60 leukoencephalopathy 125
Case1.22: Carotidblow-outsyndrome 62 Case4.16: Cytomegalovirusinfection 127
Case1.23: Sinuspericranii 64
5. Braintumorsandtumor-likeconditions 129
2. Headtrauma 66 RajkamalS.Khangura,MaxWintermark,
YangTang,MaxWintermark,andSugotoMukherjee SugotoMukherjee,andYangTang
Case2.1: Epiduralhematoma 66 Case5.1: Glioblastomamultiforme 129
Case2.2: Cerebralherniationsyndrome 68 Case5.2: Gliomatosiscerebri 132
vii
Contents
Case5.3: Oligodendroglioma 135 Case7.7: Temporalbonefractures 228
Case5.4: PrimaryCNSlymphoma 137 Case7.8: Eaglesyndrome 230
Case5.5: Brainstemglioma 141 Case7.9: Laryngealinjury 232
Case5.6: Pediatricposteriorfossatumors 144
8. Headandneckinfections 234
Case5.7: Centralneurocytoma 148
JasonDeBerry,MaxWintermark,SugotoMukherjee,and
Case5.8: Dysembryoplasticneuroepithelialtumor 150
YangTang
Case5.9: Metastaticneuroblastoma 152
Case5.10: Tumefactiveperivascularspace 154 Case8.1: Acutetonsillitisandperitonsillarabscess 234
Case5.11: Hamartomaoftubercineureum 156 Case8.2: Lemierre’ssyndrome 236
Case5.12: Epidermoid 158 Case8.3: Odontogenicabscess 238
Case5.13: Colloidcyst 161 Case8.4: Ludwig’sangina 240
Case5.14: Rupturedarachnoidcyst 163 Case8.5: Adultsupraglottitis 242
Case5.15: Rupturedintracranialdermoidcyst 165 Case8.6: Acuteretropharyngealcalcifictendinitis 244
Case5.16: Choroidplexuspapilloma 167 Case8.7: Retropharyngealabscessand
Case5.17: Craniopharyngioma 169 descendingnecrotizingmediastinitis 246
Case5.18: Intracranialmetastasis 171 Case8.8: Orbitalcellulitis 248
Case8.9: Invasivefungalsinusitis 250
6. Miscellaneouscerebralemergencies 174
Case8.10: Petrousapicitis 253
YangTang,MatthewR.Parry,SugotoMukherjee,and
Case8.11: Skullbaseosteomyelitis 256
MaxWintermark
Case8.12: Mastoiditiswithcomplications 258
Case6.1: Posteriorreversibleencephalopathy
9. Orbits 260
syndrome 174
ThomasJ.E.Muttikal,YangTang,MaxWintermark,and
Case6.2: Acutehepatic(hyperammonemic)
SugotoMukherjee
encephalopathy 177
Case6.3: Wernicke’sencephalopathy 179 Case9.1: Opticneuritis 260
Case6.4: Delayedpost-hypoxic Case9.2: Ophthalmicarteryaneurysm 262
leukoencephalopathy 181 Case9.3: Orbitalvarix 264
Case6.5: Centralpontinemyelinolysis 183 Case9.4: Orbitalcavernoushemangioma 266
Case6.6: Metronidazoletoxicity 185 Case9.5: Orbitalpseudotumor 268
Case6.7: Radiationnecrosis 187 Case9.6: Orbitallymphoma 270
Case6.8: Leighsyndrome 193 Case9.7: Thyroidophthalmopathy 272
Case6.9: Maple-syrupurinedisease 196 Case9.8: Pituitaryapoplexy 274
Case6.10: Limbicencephalitis 198 Case9.9: Cavernoussinuslymphoma 276
Case6.11: Idiopathicintracranialhypertension 200
10. Paranasalsinuses 279
Case6.12: IntracranialhypotensionduetoCSF
leak 202 JasonDeBerry,MaxWintermark,SugotoMukherjee,and
Case6.13: Peri-ictalsignalchanges 206 YangTang
Case6.14: Mesialtemporalsclerosis 209 Case10.1: Allergicfungalsinusitis 279
Case6.15: Walleriandegeneration 210 Case10.2: Squamouscellcarcinomaofmaxillary
Case6.16: Amyotrophiclateralsclerosis 212 sinus 281
Case10.3: Esthesioneuroblastoma 282
Section2–Headandneck Case10.4: Invertedpapilloma 284
Case10.5: Frontoethmoidal
Sectioneditor:SugotoMukherjee meningoencephalocele 286
7. Facialtrauma 214 11. Temporalbone 288
DavidChiao,YangTang,MaxWintermark,and MichaelReardon,YangTang,MaxWintermark,and
SugotoMukherjee SugotoMukherjee
Case7.1: Orbitalblow-outfractures 214 Case11.1: Externalauditorycanalcholesteatoma 288
Case7.2: Globeinjury 216 Case11.2: Middleearcholesteatoma 290
Case7.3: Naso-orbital-ethmoidalfractures 218 Case11.3: Glomusjugulotympanicum
Case7.4: Zygomaticomaxillarycomplexfractures 221 paraganglioma 292
Case7.5: LeFortfractures 223 Case11.4: Petrousapexcholesterolgranuloma 294
Case7.6: Mandibularfractures 226 Case11.5: Labyrinthitis 296
viii
