October Journal Round-Up

Welcome to the October journal round-up!

Emergency – Postoperative appearances can often be confusing and Chughtai et al. have written a useful article covering the normal and pathological findings following craniotomy and craniectomy, from infection and haemorrhage to extracranial tamponade and trephine syndrome.

Susceptibility weighted imaging has become a routine sequence in brain imaging, and is crucial in determining patterns of haemorrhage allowing diagnosis as well as non-haemorrhagic causes. A review by Skalski et al. in Emergency Radiology takes us through the main diagnoses that can be made on SWI.

Neoplastic – Tumour follow-up is a minefield as we are still learning the radiological correlates of treatment and pseudoprogression remains a difficult diagnosis to make confidently. Kessler & Bhatt in Insights into Imaging provide an overview of post-treatment imaging in neuro-oncology, looking at the utility of advanced imaging and the plethora of direct treatment effects, particularly radiation-induced, as well as covering commonly used assessment criteria for treatment response.

As we have touched on many times before in the blog, genetics in neuro-oncology is increasingly becoming an area in which radiologists must have a better understanding, and paediatric brain tumours are no exception. A review in Radiographics by AlRayahi et al. is therefore timely, discussing the key molecular mechanisms to understand for context in paediatric brain tumours and their relationship to imaging and treatment.

Metabolic – Imaging for central diabetes insipidus is relatively common, but knowledge of the underlying physiology and anatomy and the variety of potential causes is essential for interpreting imaging in this context. Adams et al. in Neuroradiology discuss these topics and also address optimal imaging protocols in a helpful pictorial review covering the relevant pathology.

Infection – In Practical Neurology, Delgado-Garcia et al. have published an interesting review of neurocysticercosis and its mimics, summarising their institutional cohort in Mexico and previous case reports. The tables provide a concise breakdown of the different stages of the disease (and the parasite life cycle) and consider imaging mimics for each stage and important discriminating features.

Intervention – A multisociety meeting was held at the World Federation of Interventional and Therapeutic Neuroradiology to discuss the topic of organisation and training for mechanical thrombectomy, and the resulting recommendations published in JNIS provide a framework for thrombectomy practice informed by available evidence and the experience of experts across the globe. These are by necessity rather general at the moment but can form a baseline for informing practice in future.

Spine – Spinal haematoma is uncommon but imperative not to miss, and Pierce et al. provide an excellent review of the relevant anatomy, imaging features of haematoma in different spinal compartments and important differential diagnoses.

Paediatric – The utility of DWI stretches beyond infarct and infection, and this is particularly true in pediatric imaging, as a welcome review by Carney et al. in Clinical Radiology points out. They widen the potential uses of DWI to include metabolic, inflammatory, congenital and neoplastic pathologies as well as to spot abnormalities outside the brain itself, illustrated with characteristic imaging examples.

That’s all for this month – as ever let me know if there is anything you’ve found useful that we’ve missed and see you next month!