Showing 3 Abstracts.
Congenital absence of the internal carotid artery (ICA) is a rare vascular anomaly, with a prevalence below 0.01%. This case report presents an unusual instance of idiopathic intracranial hypertension (IIH) and migraine, for which the workup revealed the unexpected absence of the bilateral ICAs. A 13-year-old female, previously healthy, experienced severe, persistent bilateral occipital headaches, neck pain, blurry vision, photophobia, and visual aura. Ophthalmological findings showed optic disc swelling, particularly in the right eye. Pediatric Neurology assessed the patient, finding papilledema (predominantly in the right eye) with no other neurological deficits. Lumbar puncture yielded an elevated opening pressure (34 cm H2O). MRI brain demonstrated imaging characteristics indicating IIH. MRV head/neck excluded dural venous sinus narrowing or thrombosis. MRA head/neck revealed congenital bilateral ICA absence. Both vertebral arteries were patent, and the basilar artery supplied the anterior cerebral circulation. The patient was diagnosed with IIH and migraine. She was discharged with Diamox and Topamax, with ongoing management by pediatric neurology. This case report will review the clinical background and the advanced imaging findings associated with an uncommon intracranial vascular anomaly in pediatric neurology, including arterial spin labeling (ASL). Bilateral ICA absence, though exceptionally rare, can contribute to neurological manifestations, including IIH and migraine. Co-occurring IIH and migraine, alongside congenital bilateral ICA absence, pose a unique diagnostic challenge. A multidisciplinary approach and heightened awareness among healthcare providers are essential for managing such complex presentations. Read More
Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024
Authors: Patel Shital, Aviado Randy, Way Ewa, Bingham Jobeth, Strauss Lauren, Mahdi Eman, Vorona Gregory
Brain hypoxic-ischemic injury (HII) is a devastating injury that results in death or profound long-term neurologic disability in both children and adults. Treatment is mostly supportive, including hypothermia and administration of excitatory amino acid antagonists, with a limited window of effectiveness (as little as 6 hours), making early detection of injury critically important. Neuroimaging with Ultrasound, CT, and MRI has become increasingly valuable in the work-up of patients with HII. In this educational exhibit we will: a) review the pathophysiologic features and factors that influence the pattern of injury, b) discuss the specific imaging patterns in preterm and term neonates, c) review the imaging approach and highlight the role of advanced MRI techniques such as MR spectroscopy, DWI/ADC, and ASL perfusion in the evaluation process. Finally, we will briefly elaborate on the therapeutic hypothermia in HII, and the influence on imaging findings. Read More
Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024
Authors: Aviado Randy, Clark Keaira, Mahdi Eman, Nada Ayman, Mishra Chakradhar, Jones Kathryn, Urbine Jacqueline, Vorona Gregory
The spectrum of imaging findings associated with intracranial germ cell tumors extends well beyond the typical suprasellar and/or pineal region masses. It is imperative that radiologists who interpret pediatric neuroimaging studies be familiar with the range of imaging findings associated with intracranial germ cell tumors, particularly as the appropriate suggestion of germ cell tumor as a diagnosis can have a significant impact on the initial surgical plan. In our case series we will review the typical imaging (CT and MRI) findings of both germinoma and nongerminomatous germ cell tumors, including metastasis and local invasion/extension. We will also review how intracranial germ cell tumors can be multifocal and how they can involve unusual areas such as the basal ganglia, cerebellum, and septal leaflets. MR spectroscopic findings associated with pediatric intracranial germ cell tumors will also be reviewed, including how these findings can be very helpful to differentiate from other similar-appearing pathologies. Finally, we will briefly discuss the treatment and prognosis of intracranial germ cell tumors. Read More
Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023
Authors: Aviado Randy, Vorona Gregory, Tye Gary, Ritter Ann, Wang Zhihong, Mahdi Eman, Mishra Chakradhar, Jones Kathryn, Urbine Jacqueline
Keywords: Germ cell tumor, germinoma, teratoma