February Journal Round-Up

Welcome to the February journal round-up!

Vascular – It’s a bit stroke-heavy this month, so a good place to start is the new American Heart Association stroke guidelines, published in Stroke. Although you may not want to read all 345 pages, the short sections on imaging and thrombectomy are a useful summary of the level of evidence for various factors that will affect us as radiologists, and are worth a read.

As a useful adjunct to this for neurointerventionalists, the Society of Neurointerventional Surgeons have also published updated guidance on mechanical thrombectomy, focusing on the evidence base for specific technical aspects of the procedure, in JNIS.

And for a more detailed discussion of the specific imaging modalities and their strengths and weaknesses in imaging evaluation of stroke, Smith and Rowland Hill have also provided a comprehensive review in the BJR.

Evaluation of carotid disease is clearly a crucial part of stroke imaging, and the relatively new technique of vessel wall imaging is an exciting prospect for this application. The ASNR have published a white paper with their recommendations for the use of vessel wall imaging, which provides an excellent context for where it can be most clinically useful.

Dural arteriovenous fistulae are notoriously difficult to diagnose, and in AJNR this month Copelan et al. describe a case series for a particular characteristic appearance of medullary oedema and enhancement in Cognard type V fistulae, noting the importance of recognising these features to avoid a long work-up for alternative pathologies.

Neoplastic – After the discussion of machine learning techniques in neuroradiology last month, the discussion in AJNR now focuses down on to its use in brain tumours in the new field of ‘radiomics’, noting the particular utility in neuro-oncology because of the potential to align imaging and genetic findings.

Inflammatory – Antibody-mediated encephalitides are increasingly understood to be much more common than we thought – indeed the most common, anti-NMDAR encephalitis, is more common than herpes encephalitis in young people. Yet this can seem like a bewildering array of random letters to the uninitiated! An excellent review in NEJM gives clinical context and highlights useful imaging findings to provide an introduction to these important pathologies.

Erdheim-Chester disease is a rare non-Langerhans cell histiocytosis, and Parks et al. in Neurology Clinical Practice use their relatively large cohort of 53 patients to examine the neuroradiological features of this disease.

Spine – The journal Neurosurgery have a useful (and open access) neuroradiology review series, and I have highlighted two articles from the series in this month’s blog. The first, by Chokshi et al., examines spinal neoplasms (both vertebral and cord) and also provides a very useful post-treatment section, particularly the imaging appearances of radiation-related complications.

Miscellaneous – Epilepsy imaging is an extremely challenging area for neuroradiology trainees, and there is a helpful review in Current Opinion in Neurology by Ruber et al. which focuses on accurate protocolling and the roles of advanced imaging for presurgical planning, as well as looking to potential future applications.

The second Neurosurgery neuroradiology review article, by Hudgins & Baugnon, concerns the skull base and provides an excellent overview and pictorial review of the anatomy and pathology of this complex region.

That’s all for this month. Hope you found it helpful, and do let us know if we’ve missed anything!

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