Reyna De La Garza Karla,  Salinas Puente Estefany,  Mercado Flores Mariana,  Rodríguez Garza Claudia,  Maya Garcia Haziel,  Montemayor Martinez Alberto

Final Pr. ID: Poster #: CR-030

Encephalitis is a rare neurological disease which a viral infection or an autoinmune disorder can cause. Regardless of the etiology, the presentation is widely varied with symptoms stemming from headaches to hallucinations to cardiac dysrhythmias. A diagnosis is most commonly reached through an elimination process, due to the vague nature of the symptoms.
The purpose of this case is to showcase a patient in which the classical imaging findings of an autoimmune encephailits were absent, in favor of an atypical presentation.
A 19-year-old female began with an episode of auditory hallucinations accompanied by a headache, all resolved without treatment. A week later she developed irrational fear as well as nausea and seizures. Visual hallucinations followed, with an altered state of consciousness, memory loss, and a fever of over 100°F. She was admitted into emergency care, where a head CT scan was performed, which revealed a generalized and diffuse decrease in density of the white matter, corresponding to cerebral edema. Spinal fluid revealed a high protein count, with normal glucose and white blood cell count. An electroencephalogram resulted in the presence of theta brain waves with the absence of an epileptogenic area, which indicates a disfunctional neurological state. The patient developed respiratory distress requiring intubation and was admitted into the intensive care unit with a new treatment of antiviral medicine, with the new diagnostic suspicion of encephalitis. A contrast-enhanced thoracoabdominal CT was performed, which revealed a right adnexal theratoma, guiding the diagnostic suspicion to an anti-NMDA induced encephalitis, for which a brain contrast-enhanced MRI was performed, with no classical findings present such as hippocampal atrophy and temporal lobe hyperintensity; instead the T2-based sequences showed cystic oval lesions in the frontal, temporal and occipital lobe, as well as diffuse hyperintensity of white matter, susceptibility weighted sequences showed focal round hypointesities corresponding to microhemorrhages distributed through the entirety of the white matter, and the gadolinium-enhanced sequence showed avid enhancement of the cystic lesions. A second spinal fluid test revealed antibodies against NMDA receptors and immunoglobulin treatment was administered with a poor response from the patient who presented heart failure shortly after and died. Read More

Authors:  Reyna De La Garza Karla , Salinas Puente Estefany , Mercado Flores Mariana , Rodríguez Garza Claudia , Maya Garcia Haziel , Montemayor Martinez Alberto

Keywords:  encephalitis, autoimmune, neuroradiology

Gokli Ami,  Shekdar Karuna,  Reid Janet

Final Pr. ID: Paper #: 174

Both neuroradiologists and pediatric radiologists require unique skills to confidently manage pediatric neuroradiology cases either in a community setting, or in a specialized pediatric tertiary care hospital. We conducted a needs assessment of pediatric radiologists to define their neuroradiology subspecialty training experience and identify perceived skills and knowledge gaps as well as their attitudes toward a customized pediatric neuroradiology curriculum. Read More

Authors:  Gokli Ami , Shekdar Karuna , Reid Janet

Keywords:  Needs assessment, pediatric neuroradiology, training

Trofimova Anna,  Reddy Kartik,  Bajaj Manish,  Goldman-yassen Adam

Final Pr. ID: Poster #: EDU-046

A broad spectrum of intracranial cysts and cystic-appearing lesions exist with unique imaging and pathologic characteristics. Some cysts have a predilection for certain intracranial locations, which, in combination with specific imaging features, can help point towards a particular pathology and, in some cases, associated syndromes. Herein, we describe a pattern-based approach for evaluation of intracranial cysts and cystic lesions in order to narrow the differential diagnosis and assist in diagnosing an associated syndrome. Cyst pathologies to be discussed include: Arachnoid cysts, dermoid/epidermoid cysts, subependymal cysts, connatal cysts, cystic encephalomalacia, neuroglial cyst, perivascular spaces, choroid plexus cysts, and choroidal fissure cysts. Syndromes and conditions to be discussed include: Aicardi Syndrome (interhemispheric cysts), congenital muscular dystrophy (cerebellar cysts), congenital CMV (anterior temporal cysts), Zellweger syndrome (caudothalamic groove cysts), Glutaric Aciduria type 1 (middle cranial fossa cysts), and trisomy 18 (choroid plexus cysts). By being familiar with the pattern-based approach to characterization of the intracranial cystic lesions, radiologists can hone their differential diagnoses and differentiate benign/incidental lesions from ones that signify a broader pathology. Read More

Authors:  Trofimova Anna , Reddy Kartik , Bajaj Manish , Goldman-yassen Adam

Keywords:  Cyst, Brain, Neuroradiology

Lewis Heidi,  Kucera Jennifer

Final Pr. ID: Poster #: EDU-038

The pediatric orbit presents a wide spectrum of possible abnormalities which differ significantly from those seen in adults. Evaluation of the various pediatric orbital abnormalities depends on radiologic assessment with different imaging techniques to aid in diagnosis. The purpose of this exhibit is to describe and differentiate the more commonly encountered pediatric orbital abnormalities using a multimodality approach. Read More

Authors:  Lewis Heidi , Kucera Jennifer

Keywords:  Orbit, Neuroradiology, Head and Neck

Shah Summit,  Rusin Jerome,  Krishnamurthy Rajesh,  Adler Brent H.

Final Pr. ID: Poster #: SCI-052

RADPEER has been criticized for lack of clinical implications, yet few studies have compared RADPEER to alternative peer-review systems or correlated peer review scores with changes in patient management. We aimed to implement a pediatric subspecialty over-read program and compare RADPEER to a Clinical Outcomes Scale, which graded impact on patient outcomes. Read More

Authors:  Shah Summit , Rusin Jerome , Krishnamurthy Rajesh , Adler Brent H.

Keywords:  Quality, Safety, Neuroradiology

Park Seungweon,  Sarma Asha,  Dewan Michael,  Leschied Jessica,  Greene Elton,  Pruthi Sumit,  Martin Dann,  Foust Alexandra

Final Pr. ID: Poster #: EDU-081

Spinal cord lipomas are rare benign tumors of adipose tissue that have a range of presentations and management based on size, location, and embryogenesis. Importantly, the intradural lipomatous tissue can act as a tethering lesion placing the cord at risk of vascular compromise, particularly during periods of growth. Since spinal lipomas cause progressive disease and symptoms, early recognition and treatment in the pediatric population is beneficial. Neurosurgical literature supports further classification of spinal lipomas as dorsal, transitional, terminal, and chaotic based on location and imaging features for risk stratification, surgical planning, and prognostication. Although categorization for the purpose of guiding surgical management is based on imaging features, there currently is lack of representation of this classification system for spinal cord lipomas in the radiology literature.

The aim of this exhibit is to educate pediatric radiologists about this classification system for spinal cord lipomas. Relevant anatomy and embryogenesis will be reviewed, and case-based examples will be used to illustrate relevant imaging features of each type of spinal lipoma. Findings impacting surgical planning and prognosis will be specifically highlighted. Read More

Authors:  Park Seungweon , Sarma Asha , Dewan Michael , Leschied Jessica , Greene Elton , Pruthi Sumit , Martin Dann , Foust Alexandra

Keywords:  spinal lipoma, embryogenesis, neuroradiology

Mceniery Jane,  Corness Jonathan

Final Pr. ID: Poster #: CR-015

To report an unusual case of synchoronous primary brain tumours of two different histological subtypes in the posterior fossa of a 13 year old girl. Read More

Authors:  Mceniery Jane , Corness Jonathan

Keywords:  Neuroradiology, Oncology, MRI

Creeden Sean,  Dahmoush Hisham,  Guimaraes Carolina

Final Pr. ID: Poster #: EDU-079

Brainstem anomalies pose a diagnostic challenge for trainees to even the most advanced in their practice. Our exhibit aims to provide a comprehensive review of these rare disorders which are being diagnosed earlier and more frequently utilizing advanced imaging and genetic sequencing techniques. Representative images of these disorders with key distinguishing features will be presented. Familiarity with these conditions will benefit practicing radiologists, radiologists in training, and our clinical colleagues. Read More

Authors:  Creeden Sean , Dahmoush Hisham , Guimaraes Carolina

Keywords:  fetal imaging, neuroradiology, MRI

Soker Tom,  Wien Michael

Final Pr. ID: Poster #: EDU-062

Objectives:
To review normal neonatal brain anatomy as seen on ultrasound.
To review the pathophysiology of common brain injuries in premature neonates.
To detail the utility of ultrasound and MRI in evaluation of common neonatal brain injuries.

Table of contents:
US evaluation of the neonatal brain
–Review standard views
–Review normal neonatal brain anatomy
Pathophysiology of Germinal Matrix Hemorrhage (GMH)
Review of ultrasound and MRI findings in GMH
–Initial injuries, and how they evolve over time
–Sample cases and mimics
Pathophysiology of Periventricular Leukomalacia (PVL)
Review ultrasound and MRI findings in PVL
–Initial injuries, and how they evolve over time
–Sample cases
Summary and key facts Read More

Authors:  Soker Tom , Wien Michael

Keywords:  Germinal Matrix Hemorrhage, Brain Ultrasound, Pediatric Neuroradiology