Table of Contents
Perspectives
Editorial
Research Perspectives
Editorial Perspectives
General Contents
- Hyperintense Dentate Nuclei on T1-Weighted MRI: Relation to Repeat Gadolinium Administration
This is a retrospective review of the medical records of 706 consecutive patients who were treated with irradiation for primary brain tumors at The Johns Hopkins Medical Institutions between June 1995–January 2010. The authors found that the appearance of hyperintense dentate nuclei (HDN) is likely permanent, given the long follow-up time of the study, and a significant association between HDN and repeated contrast-enhanced MR studies. A significant increase in the likelihood of HDN occurred after 4 or more enhanced scans, and total dose of 77 ml of gadolinium contrast agent. They found no association between radiation exposure and HDN.
- Differentiation between Cystic Pituitary Adenomas and Rathke Cleft Cysts: A Diagnostic Model Using MRI
This is a retrospective study that included 54 patients with a cystic pituitary adenoma and 28 patients with a Rathke cleft cyst who underwent MR imaging followed by surgery. Regression analysis showed that cystic pituitary adenomas and Rathke cleft cysts could be distinguished on the basis of the presence of a fluid-fluid level, septation, an off-midline location, and the presence of an intracystic nodule.
- Seizure Frequency Can Alter Brain Connectivity: Evidence from Resting-State fMRI
Resting-state fMRI data from 36 patients with hot-water epilepsy (18 with infrequent seizures) and 18 healthy age- and sex-matched controls were analyzed for seed-to-voxel connectivity. Patients in the frequent-seizure group had increased connectivity within the medial temporal structures and widespread areas of poor connectivity, including the default mode network. Seizure frequency can alter functional brain connectivity, which can be visualized by resting-state fMRI.
- Meta-Analysis of CSF Diversion Procedures and Dural Venous Sinus Stenting in the Setting of Medically Refractory Idiopathic Intracranial Hypertension
The authors performed a PubMed search of all peer-reviewed articles from 1988–2014 for patients who underwent a procedure for medically refractory idiopathic intracranial hypertension. The CSF diversion procedure analysis included 435 patients. Postprocedure in this group, there was improvement of vision in 54%, headache in 80%, and papilledema in 70%. The dural venous sinus stenting analysis included 136 patients. In this group, after intervention, there was improvement of vision in 78%, headache in 83%, and papilledema in 97% of patients. The current clinical paradigm of CSF diversion first should be re-examined given the good technical success and low complication rates of stenting.
- Progressive versus Nonprogressive Intracranial Dural Arteriovenous Fistulas: Characteristics and Outcomes
Of 579 patients with intracranial dural arteriovenous fistulas, 545 had 1 fistula and 34 (5.9%) had enlarging, de novo, multiple, or recurrent fistulas. Of those 34 patients, 19 had progressive dural arteriovenous fistulas with de novo fistulas or fistula enlargement. Angioarchitectural correlates to chronically elevated intracranial venous pressures, such as venous sinus dilation and pseudophlebitic cortical venous pattern, were more common in progressive disease. Three young patients died despite endovascular, surgical, and radiosurgical treatments.
- MR Elastography Can Be Used to Measure Brain Stiffness Changes as a Result of Altered Cranial Venous Drainage During Jugular Compression
The authors evaluated the effect of jugular compression on brain tissue stiffness and CSF flow by evaluating 9 volunteers, with and without jugular compression, with MR elastography and phase-contrast CSF flow imaging. The shear moduli of the brain tissue increased with the percentage of blood draining through the internal jugular veins during venous compression. Subjects who maintain venous drainage through the internal jugular veins during jugular compression have stiffer brains than those who divert venous blood through alternative pathways.
