Atlas of Neuroradiology: 200 Common Cases
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About this ebook
-Comprises 200 Common and rares Cases with highly organized radiological description of the diseases.
-Classifies all cases in a series of Head and Spine chapters.
-Covers all new imaging modalities.
-Useful for Radiologist, Residents in Radiology preparing their examination (FRCR) and also for Neurologists and Neurosurgeons.
- A different style used to give the opportunity to the readers to use the book directly as an atlas or to cover the diagnosis and comment and use it as a Case-Reviews, this idea is not present in the other books.
Ammar Haouimi
-In life all we are either passenger (passive) or driver (active). I prefer to be a driver through work, helping others especially in my field. When you have more than 20 years experience in several countries you would like to add or offer the medical community a very ditactic book, pleasant to read and profusely illustrated by iconography of good quality. -During my speciality I was an active and brilliant student in class (Bordeaux II University France) and my dream was to write and leave my name in the litterature. -Since five years I am living in my country Algeria after spending more than 18 years between France and gulf countries as consultant radiologist , head of radiology department . Now I am spending my time between my work my family and leisure.
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Atlas of Neuroradiology - Ammar Haouimi
© Copyright 2012 AMMAR HAOUIMI.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the written prior permission of the author.
Printed in the United States of America.
isbn:
978-1-4269-6968-3 (sc)
isbn:
978-1-4269-6971-3 (e)
Library of Congress Control Number: 2011909194
Trafford rev. 01/25/2012
7-Copyright-Trafford_Logo.aiwww.trafford.com
North America & International
toll-free: 1 888 232 4444 (USA & Canada)
phone: 250 383 6864 24336.png fax: 812 355 4082
Contents
Brain
VASCULAR and TRAUMATIC
Infection and
Inflammatory Diseases
Degenerative Diseases
Neoplasms
Malformations, Phacomatosis
and
Granulomatosis
Spine and Spinal Cord
Tumors of Spine
Infection of Spine
Degenerative and Trauma. of spine
Malformations of Spine
Miscellaneous
Atlas of Neuroradiology
200 Cases (COMMON DISEASES)
–––––––––––––––––––-
Ammar HAOUIMI
DIS, DUCT, DURP, EDUS (France)
Consultant Radiologist
Es-Salem Imaging Center
Batna, Algeria
In Colloboration with
Rabah BOUGUELAA
DIS (France)
Consultant Radiologist
Es-Salem Imaging Center
Batna, Algeria
To
My wife and children for understanding and tolering, the countless hours when I was behind the computer working on this book .
Preface
––––––––––––––––––––––
The invention of computed tomography and magnetic resonance imaging has completely changed the morphological and functional exploration of the nervous system and therefore has a very precise approach to diagnosis of the most neurological diseases.
The progress in neuroradiological imaging need intensive further training to enable all radiologists and clinicians, the optimal use of these techniques.
The topics covered in Atlas of Neuroradiology represent the common and important diseases encountered in neuroradiology. The material presented for each case provides a thorough and comprehensive description of the disease entity enabling the radiologist or the clinician to develop a clear concept of the entity through the different imaging modalities that are present. In this book, I attempt, al least to fill a small gap of knowledge in neuroradiology and hope that will be useful for residents in radiology, radiologists, neurologists and neurosurgeons.
Ammar HAOUIMI
Acknowledgements
––––––––––––––––––––––
I would like to acknowledge my teachers, Abdelkrim Berrah Professor and chairman, Department of Medicine at Bab El-oued University Hospital, Algiers, and Professor Moulay Ahmed Meziane, Head Section of Thoracic Imaging, Department of Diagnostic Radiology, Cleveland Clinic Fondation Ohio, USA and Professor Mosleh Al-Raddadi, Head of Radiology Department at King Fahad University Hospital Al Madinah, KSA, for their support and encouragement to continue to grow.
I am grateful for the support and friendship of my colleagues Drs Gamal Hassan, Abdullah Al-Taifi, Ridha Okbi, Abdullah Dardiri, Hussain Shahid, Mohammed Bediaf, Djamel Bourenane, Mohammed Said Gouhiri, Djamel Ouslimane, Saadeddine Yassine, Abdelkader Nashed, Abdelwahab M Gabal, Aftab Ahmed Shaikh, Nacer Kernane, Amrane Mohammedi, Mourad Chirou, Abderrahmane Bennouar, Fouad Athmani, Rabah Gourab, yasmine Bala, Soraya Benali, Souhil Abida, Farid Abed. Kamel Dahmane, Louardi Mohammedi, Toufik Nia and Mahfouth Abdmeziem.
I want to thank my family especially my parents, parents in law and my brothers Nacer, Abdelkader, Ahmed and Abdellatif for their love and support.
To Mr. Ahmed Zergui Head of CIDIS Company.
I would like to thank also all staff working in our Es-Salem Imaging Center, Samia Hocine, A Chinaz, Siham Mekaddem, Rania Lombarkia, Samia Ghenai, Nasereddine Benamor, M’hammed Bouguelaa, Ayachi Nezzar, Zoheir Mellah, Hicham Kadri, Mustapha Benguiba, Mustapha Aoura.
Finally, I would like to express my gratitude to Mr Oliver Mitchell, Supervisor Publishing Team and Mr. Dennis Taylor Publishing Services Associates at Trafford Publishing (Bloomington, USA).
––––––––––––––––––––––
Brain
VASCULAR and TRAUMATIC
Case 1
Clinical Presentation
A 49 year-old female patient with new onset of nausea, vomiting, mild left weakness, right facial numbness, vertigo, and ataxia.
Radiological Findings
A Image24603.JPG B Image24609.JPG C Image24615.JPG
MR Scan of brain axial FLAIR (A), and T2 (B) and sagittal T2 (C) of spine show a focal high signal intensity area of the left medulla. No other abnormality of the cerebellar hemispheres or the spinal cord. This is consistent with an acute infarct in the PICA distribution.
Diagnosis: Wallenberg Syndrome
Case 2
Clinical Presentation
An 86 year-old female patient presenting an acute dizziness, vertigo, dysarthria, the 2nd nonenhanced CT Scan (C, D) was performed 48 hours later after sudden loss of consiousness, weakness of limbs and blindness.
Radiological Findings
A Image24621.JPG Image24627.JPG B
C Image24633.JPG Image24639.JPG D
Nonenhanced brain CT Scan: The first brain CT Scan(A, B) done few hours after the acute onset shows normal size and density of the brainstem and both cerebellar hemispheres. The second CT Scan(C, D) done 48 hours later shows an enlarged brainstem with large central low-density area consisting with brainstem infarction.
Diagnosis: Brainstem Infarction
Case 3
Clinical Presentation
A 65 year-old female patient presented with left hemiplegia.
Radiological Findings
A Image24645.JPG Image24651.JPG B
C Image24657.JPG Image24663.JPG D
Brain MR, non-enhanced sagittal T1 (A), axial FLAIR (B), coronal T2 (C) and MRA-3D-TOF (D) showing a low-T1 and high-FLAIR and T2 lesion involving the right anterolateral aspect of the pons. The MRA shows complete thrombosis of the right vertebral artery.
Diagnosis: Brainstem Infarction
Case 4
Clinical Presentation
An 86 year-old male patient with acute diminution of the vision.
Radiological Findings
A Image24669.JPG Image24675.JPG B
C Image24681.JPG Image24687.JPG D
Plain brain CT Scan reveals a large low-density area in the right temporo-occipital region in the distribution of the posterior cerebral artery (PCA) territory with mass effect on the adjacent temporal horn. No other abnormality.
Diagnosis: PCA Territory Infarction
Case 5
Clinical Presentation
A 64 year-old female diabetic and hypertensive patient with one week history of temporo-spatial disorientation, headaches and drowsiness.
Radiological Findings
A Image24693.JPG Image24699.JPG B
C Image24705.JPG Image24711.JPG D
Plain brain CT Scan showing large low-attenuation areas involving both gray and white matter of the cerebellar hemispheres and occipital regions with obliteration of the cerebellar and occipital sulci and mass effect on the 4th ventricle. Note calcification of the right vertebral artery (image A).
Diagnosis: Vertebro-basilar Territory Infarction
Case 6
Clinical Presentation
A 63 year-old male patient, presented with right hemiparesis.
Radiological Findings
A Image24717.JPG Image24723.JPG B
Nonenhanced brain CT Scan (A, B) demonstrates a large low-density area within the distribution of the superficial territory of the left middle cerebral artery (MCA) with loss of the gray-white matter differentiation and adjacent sulcal effacement. No significant ventricular compression or midline shift.
Diagnosis: Left MCA Infarction
Case 7
Clinical Presentation
A 57 year-old male patient fell while sking 2 days ago and developed acute visual deterioration with left hemiplegia.
Radiological Findings
A Image24729.JPG Image24735.JPG B
C Image24741.JPG Image24747.JPG D
Plain CT Scan reveals a large low-attenuation area involving the right middle cerebral artery (MCA) territory with dense MCA, containing hyperdense areas (hemorrhagic transformation) with sulcal effacement and mild mass effect on the adjacent lateral ventricle.
Diagnosis: Hemorrhagic Transformation in Acute MCA Infarct
Case 8
Clinical Presentation
A 47 male patient with no particular past-history, presenting a sudden left hemiplegia.
Radiological Findings
A Image24753.JPG Image24759.JPG B
C Image24765.JPG Image24771.JPG D
The first CT (A) shows a hyperattenuated linear vascular structure in the right temporal region (hyperdense MCA sign), representing thrombus formation within the vessel (early CT sign of ischemia). The second CT (B, C, D) done three days later shows a large low density area in the distribution of the MCA territory, containing hyperdense areas (hemorrhagic transformation of an ischemic infarct).
D Image24777.JPG Image24783.JPG E
F Image24789.JPG Image24795.JPG G
…continued, MR Scan (done four days later) sagittal T1 (D), axial FLAIR (E), coronal T2 (F) and MRA 3D-TOF (I) images show the extension of the infarct in the right MCA territory as a large area of low-T1 and high-T2 and FLAIR signal intensity, containing