By Renato Hoffmann Nunes, Ana Lorena Abello, Mauricio Castillo
This ebook offers transparent tips as to which neuroradiological findings in ailing or injured sufferers may be instantly communicated through radiologists and trainees to the emergency room and referring physicians in an effort to facilitate key judgements and get rid of preventable error. It bargains a realistic and illustrative strategy that identifies what to appear for and the way to document it and describes the mandatory follow-up and the commonest differential diagnoses of the most severe findings in neuroradiology. The ebook is distinct in being written from a “critical findings perspective”, which makes its content material more effective and remarkable than that of a regular Emergency Neuroradiology textbook. It additionally illustrates the worth of constructing algorithmic methods to document and converse severe findings in response to lists. whereas the publication will attract a wide and variable viewers, it truly is specifically addressed to radiology education courses and may be a “must learn” for citizens and fellows in training.
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Additional resources for Critical Findings in Neuroradiology
Emergent image-guided treatment of a large CSF leak to reverse “in-extremis” signs of intracranial hypotension. AJNR Am J Neuroradiol. 2008;29(9):1627–9. Binder DK, Dillon WP, Fishman RA, Schmidt MH. Intrathecal saline infusion in the treatment of obtundation associated with spontaneous intracranial hypotension: technical case report. Neurosurgery. 2002;51(3):830–6; discussion 6–7. Binder DK, Sarkissian V, Dillon WP, Weinstein PR. Spontaneous intracranial hypotension associated with transdural thoracic osteophyte reversed by primary.
Do not confuse IHS with a Chiari type I malformation as performing decompressive surgery in IHS may aggravate the symptoms and even results in cerebellar infarcts and death. • The most prevalent sign of IHS is dural thickening and contrast enhancement. The dural abnormalities should be diffuse and smooth and not nodular. • Always look for other signs of IHS and remember that they are nonspecific; thus, their number increases the possibility of an accurate diagnosis. • Lack of findings does not exclude the diagnosis, and it is important to keep IHS in the differential diagnosis in the correct clinical setting.
In patients with suspected cortical laminar necrosis, SWI may help differentiate it from hemorrhagic transformation as the former shows no signal drop while blood at any stage is hypointense [51, 52]. An important complication of ischemic stroke that may be identified by imaging follow-up is hemorrhagic transformation. The European Cooperative Acute Stroke Study (ECASS)  classified hemorrhagic infarction 1 (HI1) as small petechiae along the periphery of the infarct, hemorrhagic infarction 2 (HI2) as confluent petechiae within the infarct without space-occupying effect, parenchymal hemorrhage 1 (PH1) as bleeding ≤30 % of the infarcted area with mild spaceoccupying effect, and parenchymal hemorrhage 2 (PH2) as bleeding >30 % of the infarcted area with space-occupying effect (Fig.