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Listeria monocytogenes brain abscesses presenting as contiguous, tubular rim-enhancing lesions on Magnetic Resonance Imaging: Case series and literature review

Kim, Daniel D; Sadic, Mohammad; Yarabe, Boniface; Loftus, James R; Lieberman, Evan; Young, Matthew G; Jain, Rajan; Dogra, Siddhant
Listeriosis has more than a 50% mortality when the central nervous system is involved, necessitating rapid diagnosis and treatment. We present four patients with brain abscesses in the setting of diagnosed neurolisteriosis, all of which demonstrated an odd presentation of multiple small, contiguous tubular lesions with rim enhancement on magnetic resonance imaging. Our review of published cases of neurolisteriosis suggests that this may be a useful pattern to identify neurolisteriosis abscesses, allowing earlier detection and therapy.
PMID: 38494758
ISSN: 2385-1996
CID: 5639982

Occipital Nocardia Abscess Presenting With Positive Visual Phenomenon and Quadrantanopsia

Fein, Alexander S; Kelly, Sean M; Louie, Eddie; Young, Matthew G; Jain, Rajan; William, Christopher M; Galetta, Steven L; Grossman, Scott N
A 74-year-old man with chronic obstructive pulmonary disease, glaucoma, and Stage IIIB squamous cell lung cancer experienced several minutes of flashing lights in his right visual hemifield, followed by onset of a right visual field defect. On examination, the patient had a right homonymous hemianopsia that was most dense inferiorly by confrontation testing. Emergent CT scan of the head revealed a 2.5 × 3 cm hypodensity in the left occipital lobe, which was interpreted as an acute stroke. Continuous EEG monitoring captured left posterior quadrant seizures that were temporally correlated to the positive visual phenomena. Subsequent MRI of the brain with and without contrast revealed a conglomerate of centrally necrotic and peripherally enhancing mass lesions. On biopsy, a thick purulent material was drained and Gram stain of the sample revealed gram-positive beaded rods, which speciated to Nocardia farcinica. The patient was treated with a six-week course of intravenous meropenem and a one-year course of oral trimethroprim-sulfamethoxazole. On follow-up, the patient experienced resolution of the right visual field deficit.
PMID: 37440372
ISSN: 1536-5166
CID: 5537712

Cerebral venous anatomy: implications for the neurointerventionalist

Shapiro, Maksim; Raz, Eytan; Nossek, Erez; Srivatanakul, Kittipong; Young, Matthew; Narayan, Vinayak; Ali, Aryan; Sharashidze, Vera; Esparza, Rogelio; Nelson, Peter Kim
Meaningful contributions to neurointerventional practice may be possible by considering the dynamic aspects of angiography in addition to fixed morphologic information. The functional approach to venous anatomy requires integration of the traditional static anatomic features of the system-deep, superficial, posterior fossa, medullary veins, venous sinuses, and outflow routes into an overall appreciation of how a classic model of drainage is altered, embryologically, or pathologically, depending on patterns of flow-visualization made possible by angiography. In this review, emphasis is placed on balance between alternative venous networks and their redundancy, and the problems which arise when these systems are lacking. The role of veins in major neurovascular diseases, such as dural arteriovenous fistulae, arteriovenous malformations, pulsatile tinnitus, and intracranial hypertension, is highlighted, and deficiencies in knowledge emphasized.
PMID: 35803732
ISSN: 1759-8486
CID: 5280692

3D Cinematic Volume-Rendering Technique of Traumatic Spine Injuries: A Powerful Tool for Radiology Education

Breen, M. S.; Jawhar, O. M.; Lustrin, E. S.; Young, M. G.
Spine trauma represents a common indication for imaging in the emergency department. Multidetector CT imaging, with its advantage of multiplanar reconstructions and fast image acquisition, is the technique of choice in the initial assessment of a patient with poly-trauma. While many simple spinal fractures are adequately evaluated on 2D multiplanar reconstruction images, more complex, potentially displaced fracture patterns can be more fully highlighted on 3D reconstructions. Compared with conventional volume-rendering techniques, cinematic rendering uses a complex illumination model to create a more pho-torealistic representation of the fracture patterns, images that are certain to excite both trainees and clinicians. This review demonstrates the educational value and clinical utility of 3D cinematic rendering images in understanding complex spinal column injuries. Learning Objective: To demonstrate the methodology, clinical applicability, and educational utility behind 3D photorealistic cinematic rendering images of spine injuries, with emphasis on the "tension bands" biomechanical concept.
SCOPUS:85146287121
ISSN: 2637-8329
CID: 5408712

Video Radiology Reports: A Valuable Tool to Improve Patient-Centered Radiology

Recht, Michael P; Westerhoff, Malte; Doshi, Ankur M; Young, Matthew; Ostrow, Dana; Swahn, Dawn-Marie; Krueger, Sebastian; Thesen, Stefan
PMID: 35441532
ISSN: 1546-3141
CID: 5218302

Case 299: Sellar Spine [Case Report]

Radmanesh, Alireza; Young, Matthew G
History Part one of this case appeared 4 months previously and may contain larger images. A 32-year-old woman presented to an ophthalmologist for bilateral blurry vision. She underwent MRI of the brain and orbits, which showed a focal abnormality within the pituitary gland. The patient was referred to an endocrinologist for further evaluation. Review of systems and physical examination by the endocrinologist revealed no symptoms or signs of endocrine dysfunction. Anterior pituitary hormone levels, including growth hormone, prolactin, thyroid stimulating hormone, follicular-stimulating hormone, luteinizing hormone, and adrenocorticotropic hormone, were normal. Dynamic contrast-enhanced MRI of the sella and pituitary gland and subsequent CT of the anterior skull base were performed.
PMID: 35196175
ISSN: 1527-1315
CID: 5173982

Central Retinal Artery Visualization with Cone-Beam CT Angiography

Raz, Eytan; Shapiro, Maksim; Shepherd, Timothy M; Nossek, Erez; Yaghi, Shadi; Gold, Doria M; Ishida, Koto; Rucker, Janet C; Belinsky, Irina; Kim, Eleanore; Grory, Brian Mac; Mir, Osman; Hagiwara, Mari; Agarwal, Shashank; Young, Matthew G; Galetta, Steven L; Nelson, Peter Kim
Background There are multiple tools available to visualize the retinal and choroidal vasculature of the posterior globe. However, there are currently no reliable in vivo imaging techniques that can visualize the entire retrobulbar course of the retinal and ciliary vessels. Purpose To identify and characterize the central retinal artery (CRA) using cone-beam CT (CBCT) images obtained as part of diagnostic cerebral angiography. Materials and Methods In this retrospective study, patients with catheter DSA performed between October 2019 and October 2020 were included if CBCT angiography included the orbit in the field of view. The CBCT angiography data sets were postprocessed with a small field-of-view volume centered in the posterior globe to a maximum resolution of 0.2 mm. The following were evaluated: CRA origin, CRA course, CRA point of penetration into the optic nerve sheath, bifurcation of the CRA at the papilla, visualization of anatomic variants, and visualization of the central retinal vein. Descriptive statistical analysis was performed. Results Twenty-one patients with 24 visualized orbits were included in the analysis (mean age, 55 years ± 15; 14 women). Indications for angiography were as follows: diagnostic angiography (n = 8), aneurysm treatment (n = 6), or other (n = 7). The CRA was identified in all orbits; the origin, course, point of penetration of the CRA into the optic nerve sheath, and termination in the papilla were visualized in all orbits. The average length of the intraneural segment was 10.6 mm (range, 7-18 mm). The central retinal vein was identified in six of 24 orbits. Conclusion Cone-beam CT, performed during diagnostic angiography, consistently demonstrated the in vivo central retinal artery, demonstrating excellent potential for multiple diagnostic and therapeutic applications. © RSNA, 2021 Online supplemental material is available for this article.
PMID: 34783593
ISSN: 1527-1315
CID: 5049072

Correction to: Tumor volume improves preoperative differentiation of prolactinomas and nonfunctioning pituitary adenomas

Wright, Kyla; Lee, Matthew; Escobar, Natalie; Pacione, Donato; Young, Matthew; Fatterpekar, Girish; Agrawal, Nidhi
PMID: 34097197
ISSN: 1559-0100
CID: 4906032

Correction: Tumor volume improves preoperative differentiation of prolactinomas and nonfunctioning pituitary adenomas

Wright, Kyla; Lee, Matthew; Escobar, Natalie; Pacione, Donato; Young, Matthew; Fatterpekar, Girish; Agrawal, Nidhi
PMID: 34227041
ISSN: 1559-0100
CID: 5025042

Case 299

Radmanesh, Alireza; Young, Matthew G
History A 32-year-old woman presented to an ophthalmologist for bilateral blurry vision. She underwent MRI of the brain and orbits, which showed a focal abnormality within the pituitary gland. The patient was referred to an endocrinologist for further evaluation. Review of systems and physical examination by the endocrinologist revealed no symptoms or signs of endocrine dysfunction. Anterior pituitary hormone levels, including growth hormone, prolactin, thyroid stimulating hormone, follicular stimulating hormone, luteinizing hormone, and adrenocorticotropic hormone, were normal. Dynamic contrast-enhanced MRI of the sella and pituitary gland (Figs 1-3) and subsequent CT of the anterior skull base (Figs 4, 5) were performed.
PMID: 34694934
ISSN: 1527-1315
CID: 5042242