Table Of ContentIMAGING, PATHOLOGY, AND ANATOMY
Anne G. Osborn
Hedlund | Salzman
ii
iii
IMAGING, PATHOLOGY, AND ANATOMY
SECOND EDITION
Anne G. Osborn, MD, FACR
University Distinguished Professor and Professor of Radiology and Imaging Sciences
William H. and Patricia W. Child Presidential Endowed Chair in Radiology
University of Utah School of Medicine
Salt Lake City, Utah
Gary L. Hedlund, DO
Pediatric Radiologist and Neuroradiologist
Primary Children’s Hospital
Department of Medical Imaging
Intermountain Healthcare
Adjunct Professor of Radiology
University of Utah School of Medicine
Salt Lake City, Utah
Karen L. Salzman, MD
Professor of Radiology and Imaging Sciences
Neuroradiology Section Chief and Fellowship Director
Leslie W. Davis Endowed Chair in Neuroradiology
University of Utah School of Medicine
Salt Lake City, Utah
1600 John F. Kennedy Blvd.
iv
Ste 1800
Philadelphia, PA 19103-2899
OSBORN’S BRAIN, SECOND EDITION ISBN: 978-0-323-47776-5
Copyright © 2018 by Elsevier. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including
photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details
on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations
such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/
permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be
noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our understanding, changes in research methods, professional practices,
or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described
herein. In using such information or methods they should be mindful of their own safety
and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check
the most current information provided (i) on procedures featured or (ii) by the manufacturer
of each product to be administered, to verify the recommended dose or formula, the
method and duration of administration, and contraindications. It is the responsibility of
practitioners, relying on their own experience and knowledge of their patients, to make
diagnoses, to determine dosages and the best treatment for each individual patient, and to
take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or
editors, assume any liability for any injury and/or damage to persons or property as a matter
of products liability, negligence or otherwise, or from any use or operation of any methods,
products, instructions, or ideas contained in the material herein.
Publisher Cataloging-in-Publication Data
Names: Osborn, Anne G., 1943-
Title: Osborn’s brain / [edited by] Anne G. Osborn.
Description: Second edition. | Salt Lake City, UT : Elsevier, Inc., [2017] | Includes
bibliographical references and index.
Identifiers: ISBN 978-0-323-47776-5
Subjects: LCSH: Brain--Pathophysiology--Handbooks, manuals, etc. | Central nervous system--
Diseases--Handbooks, manuals, etc. | Brain--Imaging--Handbooks, manuals, etc. | MESH:
Brain--physiopathology--Atlases. | Central Nervous System--pathology--Atlases. |
Neuroimaging--methods--Atlases.
Classification: LCC RC386.5.O83 2017 | NLM WL 301 | DDC 616.8--dc23
International Standard Book Number: 978-0-323-47776-5
Cover Designer: Tom M. Olson, BA
Cover Art: Lane R. Bennion, MS
Printed in Canada by Friesens, Altona, Manitoba, Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedications
v
FOR RON
Beloved sweetheart, eternal companion, and soulmate, you didn’t live to see the irst
edition completed and then watch it become an international bestseller. The second edition
is even better, and I hope it makes you even more proud. I love you beyond expression and
devote every day of my life in the service of others and in honor of your memory.
AO
FOR DIANA, AARON, AND JAIME
For Diana, my beloved, my best friend.
Your unwavering support nourishes my creative spirit. Thank you, sweetheart.
For Aaron, you honor the integrity of relationship and honest work. This inspires me.
For Jaime, your whole-hearted humanity illuminates the sacredness of our work
in the service of others.
GLH
FOR MY FRIENDS AND COLLEAGUES IN NEURORADIOLOGY
To those of you at the University of Utah and around the world, thank you for the wonderful
collaborations over the years. I am fortunate to practice in a ield with such talented
experts. My work is elevated because of your knowledge and support, for which I am in a
constant state of gratitude.
KLS
vi
Preface
vii
With Osborn’s Brain, irst edition, not only did I break a promise to myself that I would “never, EVER
write another prose-based textbook,” I would have been stunned to know I’d actually write a second
edition of the book! But here we are, ive years later, and I’ve done it. There have been so many
changes in neuroradiology since the publication of the irst edition that I wanted—and needed—to
do a thorough update.
This edition is actually more than just an update; it is a major rewrite. Most of the 4,000+ images
have been replaced with new, even better examples, and there are numerous new diagnoses that are
presented. The Cancer Genome Atlas project has revolutionized our understanding of CNS neoplasms,
and the exploding knowledge was relected in the latest World Health Organization’s Classiication of
Tumours of the Central Nervous System, published just a year ago. The “4-plus” WHO forms the basis of
the completely rewritten neoplasms section of this edition.
For those of you who are new to Osborn’s Brain, both the irst and second editions are written as a
curriculum in neuroradiology. The “must know—now!” topics such as brain trauma, stroke, and brain
bleeds are covered in the irst few chapters of the text. The book is meant to be read cover to cover,
progressing through all the major areas of neuroimaging and neuropathology. While the basics are
emphasized, there is a great deal of “advanced” information (read: fellow-and-beyond level stuf) that
practicing neuroradiologists will ind helpful and informative.
As with the irst edition, this book is image-rich with hundreds of color graphics and gross pathology
examples that inform the thousands of new, up-to-date images. I’ve expanded on my trademark
summary “blue boxes” that are scattered throughout the text, allowing for a quick review of the
essential facts.
Lastly, I invited two beloved colleagues, Drs. Gary Hedlund and Karen Salzman, to join me in authoring
parts of the second edition. Gary is a revered pediatric neuroradiologist who is an international expert
on (among other things) abusive head trauma. Karen’s forte is tumor imaging, and her special focus
is sella/parasellar disease. They are both highly respected members of our “Brain Team,” and I have
been privileged to work with them on this edition.
So as you start your journey through Osborn’s Brain, second edition, best wishes and good reading to
all of you! After all, you’re why we write these things in the irst place!
Anne G. Osborn, MD, FACR
University Distinguished Professor and Professor of Radiology and Imaging Sciences
William H. and Patricia W. Child Presidential Endowed Chair in Radiology
University of Utah School of Medicine
Salt Lake City, Utah
Image Contributors
viii
Image Contributors
ix
AFIP Archives B. Hart, MD N. Omar, MD
D. P. Agamanolis, MD E. T. Hedley-White, MD J. Paltan, MD
N. Agarwal, MD G. Hedlund, DO G. Parker, MD
J. Ardyn, MD R. Hewlett, MD T. Poussaint, MD
M. Ayadi, MD P. Hildenbrand, MD R. Ramakantan, MD
S. Aydin, MD C. Y. Ho, MD C. Rambaud, MD
D. Bertholdo, MD B. Horten, MD M. L. Rivera-Zengotita, MD
S. Blaser, MD C. Hsu, MD C. Robson, MBChB
J. Boxerman, MD M. Huckman, MD F. J. Rodriguez, MD
M. Brant-Zawadski, MD P. Hudgins, MD P. Rodriguez, MD
P. Burger, MD A. Illner, MD A. Rosenberg, MD
S. Candy, MD B. Jones, MD E. Ross, MD
M. Castillo, MD J. A. Junker, MD A. Rossi, MD
P. Chapman, MD E. C. Klatt, MD L. Rourke, MD
L. Chimelli, MD D. Kremens, MD Rubinstein Collection, AFIP Archives
S. Chung, MD W. Kucharczyk, MD E. Rushing, MD
M. Colombo, MD P. Lasjaunias, MD M. Sage, MD
J. Comstock, MD S. Lincof, MD B. Scheithauer, MD
J. Curé, MD T. Markel, MD P. Shannon, MD
B. Czerniak, MD M. Martin, MD A. Sillag, MD
A. Datir, MD A. Maydell, MD E. T. Tali, MD
B. N. Delman, MD S. McNally, MD M. Thurnher, MD
B. K. DeMasters, MD T. Mentzel, MD T. Tihan, MD
K. Digre, MD C. Merrow, MD K. Tong, MD
H. D. Dorfman, MD M. Michel, MD J. Townsend, MD
M. Edwards-Brown, MD K. Moore, MD U. of Utah Dept. of Dermatology
D. Ellison, MD S. Nagi, MD S. van der Westhuizen, MD
H. Els, MD T. P. Naidich, MD M. Warmuth-Metz, MD
A. Ersen, MD N. Nakase, MD T. Winters, MD
W. Fang, MD S. Narendra, MD A. T. Yachnis, MD
N. Foster, MD K. Nelson, MD S. Yashar, MD
C. E. Fuller, MD R. Nguyen, MD
S. Galetta, MD G. P. Nielsen, MD
C. Glastonbury, MBBS M. Nielsen, MS
S. Harder, MD K. K. Oguz, MD
H. R. Harnsberger, MD J. P. O’Malley, MD
