<b>Background:</b> In pediatric patients presenting with neurological deficit in emergency department, special attention should be given to identify the conditions that can mimic a stroke to avoiding unnecessary interventions. There are various pathologies in pediatric populations that can mimic stroke both clinically and radiologically. Radiologists, by identifying specific imaging patterns of classical stroke and also patterns of those stroke mimics, shall aid clinician in deciding treatment options in a timely manner. <b>Objectives:</b> In this educational poster we aims at, 1) Discussing typical imaging patterns of ischemic stroke. 2) Discussing common pathologies in pediatric age group which can mimic ischimic stroke and pose challenge to the clinicians as well as radiologists. 3) Describing various imaging findings of those stroke mimics that help to differentiate from ischemic stroke. <u><b>We discuss the imaging patterns of following pediatric stroke mimics:</b></u> - Infective pathologies, including HSV encephalitis - Demyelinating lesions. - Vasculitis - Migraine. - Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS). - Hypoxic ischemic encephalopathy. - Moya Moya disease. - Posterior reversible encephalopathy syndrome. - Drug related pathologies. - Miscellaneous conditions. <b>Conclusion:</b> Differentiation of commonly seen stroke mimics from ischemic stroke in a timely manner helps clinician for proper management and unnecessary interventions. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Krishnan Vijay, Kandula Ashrith, Nikam Rahul

Keywords: stroke mimics, magnetic resonance imaging

Vaping is a recreational activity of inhaling heated liquid vapor from electronic cigarettes which has been increasingly used as an alternative to cigarettes. Common substances that may be used in the liquids include nicotine, tetrahydrocannabinol, cannabinoid oils and other additives. There is increasing concern about lung injury associated with vaping, especially in children. While a nascent body of literature is beginning to develop regarding this entity, further investigation from different geographic regions (with access to varying chemical profiles of vaping material) and in differing age populations is necessary to ascertain the imaging patterns of vaping associated lung injury. In this poster, we describe the imaging patterns of pediatric vaping associated lung injury we encountered in our institution. Although this is inherently a diagnosis of exclusion, we consider these imaging patterns strongly suggestive if there is a history of vaping and absence of other risk factors or preexisting disease. We observed the following imaging patterns of lung injury associated with vaping: <b>Chest radiograph findings:</b> 1) Normal. 2) Coarse bilateral interstitial opacities. 3) Pseudo pulmonary edema pattern: bilateral central predominant air space opacities with peripheral sparing. 4) Mixed pattern: combination of air space opacities and reticular opacities. <b>Various patterns of computed tomography findings: </b> 1) Bilateral central ground glass opacities (GGO). 2) Sub pleural sparing , in most of the cases. 3) Interlobular septal thickening in association with GGO - crazy paving pattern. 4) Lower lobe predominant thick subpleural parenchymal bands. 5) Scattered GGO without any lobar predominance - an atypical finding seen in one patient. 6) Mild bronchial wall thickening <b>Take home message: </b> - Bilateral central predominant ground glass opacities with lower lobe predominance and sub pleural sparing are the most consistent findings seen in most of the cases. The GGO show an anteroposterior (dependent) gradient of increasing attenuation. - Posterior dependent parenchymal bands were observed subjacent to subpleural spared lung parenchyma in several cases, a finding which has not been described previously to our knowledge. These parenchymal bands, in association with above mentioned findings, are highly suggestive of vaping associated lung injury in the appropriate clinical setting. - We have observed complete resolution of findings in at least two of the cases on short term followup. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Krishnan Vijay, Schenker Kathleen, Saul David

Keywords: vaping, electronic cigarette

Mitochondrial diseases are a heterogeneous group of disorders caused by defects in intracellular energy production. Due to this heterogeneity, it is not surprising that multiple systematic approaches to diagnosis exist; all of which use a combination of clinical, biochemical and structural criteria. Several distinct syndromes have been recognized with variable clinical and imaging phenotypes, including Leigh's syndrome, Kearns-Sayre syndrome (KSS), mitochondrial encephalopathy with lactic acidosis and strokelike episodes (MELAS). In this exhibit, we discuss imaging morphology of various mitochondrial disease with emphasis on imaging protocol and diagnostic approach. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Nikam Rahul, Kandula Ashrith, Krishnan Vijay, Donuru Achala

Keywords: Mitochondrial diseases, Leigh, MELAS

The inner ear anomalies are a complex group of disorders, the radiologic findings of which may be difficult to interpret. This exhibit details the basic embryology of inner ear with stress on correlation of timing of insult or arrest of development to patho-morphology, the classification schema of inner ear anomalies and various salient features aiding in accurate diagnosis. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Nikam Rahul, Kandula Ashrith, Kumbhar Sachin, Krishnan Vijay, Donuru Achala

Keywords: Inner Ear, CHARGE Syndrome, Waardenburg Syndrome