DIAGNOSTIC NEURORADIOLOGY PDF ANNE OSBORN S
Anne G. Osborn Divided into six sections, Diagnostic Neuroradiology covers the full range of what is the latest edition? i will order to purchase it please. Ann Osborn is one of the most amazing Neuroradiologists for her knowledge and ability to entertain, as a guest lecturer. Her book is well organized by. osborn s brain: imaging, pathology, and anatomy is the much-pleaded-for successor to anne g. osborn s award winning book diagnostic neuroradiology.
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understand osborns brain second edition by the highly esteemed dr anne g diagnostic neuroradiology and the wealth of online content available through the . Osborn's Brain Imaging, Pathology, And Anatomy () [PDF] [UnitedVRG] - Free ebook Author Anne G. Osborn MD, FACR .. Imaging is absolutely critical to the diagnosis and management of the patient with acute traumatic brain injury. This book is the eagerly anticipated successor to Osborn's previous 'Diagnostic Imaging: Brain', or simply 'the red book', a book that has until.
Additional lesions in the basal ganglia, thalami, brainstem,. DWI may demonstrate a few foci of restricted diffusion consistent with ischemia caused by the vascular injuries. The major differential diagnosis is diffuse axonal injury DAI.
While some lesions in DAI are hemorrhagic, the. It is. Subcortical injuries SCIs are traumatic lesions of deep brain structures such as the brainstem, basal ganglia,. Most represent severe shear-strain injuries that disrupt axons, tear penetrating blood.
Sudden craniocaudal displacement or lateral impaction of the midbrain against the. Manifestations of SCI include deep hemorrhagic contusions, nonhemorrhagic lacerations,. SCIs usually occur with other. As with most traumatic brain injuries, SCIs are most common in males between the ages of 15 and Immediate loss of consciousness with profound neurologic deficits is typical.
Obtundation is the. As with DAI, gross discrepancy between immediate imaging findings often minimal and. Prognosis is poor in these severely injured patients.
Many do not survive; those who do. Controlling intracranial pressure is the most pressing issue. Craniectomy may be an option.
Minimal abnormalities may be present on initial imaging but show dramatic increase on. SCI typically exists with numerous comorbid injuries. Lesions ranging from subtle traumatic SAH to gross. Mass effect with cerebral herniation and gross disturbances in. MR is much more sensitive than CT even though acute hemorrhage is isointense with brain on T1.
DWI may show foci of restricted diffusion. DTI mapping. Miscellaneous Injuries A broad spectrum of miscellaneous primary injuries occurs in head trauma.
Some such as pneumocephalus are. Other lesions are rare. We conclude this chapter with a consideration of these miscellaneous. Pneumocephalus simply means the presence of gas or air within the skull; intracranial air does not exist under. In pneumocephalus, air can be found anywhere within the cranium, including blood vessels, and. While intracranial air is never normal, it can be an expected and therefore routine.
Tension pneumocephalus is a collection of intracranial air that is under pressure. Intracranial air is most often associated with trauma and surgery.
Infection by gas-forming organisms is a rare cause. Any breach in integrity of the calvaria, central skull base, mastoid, or paranasal sinuses that also disrupts the dura.
A ballvalve mechanism may entrap the air, which can be. Intravascular air is usually secondary to intravenous catheterization, most commonly found in the cavernous sinus,. Intraarterial air is seen only with air embolism transient or brain death. Trauma is the most common cause of pneumocephalus.
Virtually all patients who have supratentorial surgery have some degree of pneumocephalus on imaging studies. Tension pneumocephalus is a relatively uncommon complication of. Occasionally, spontaneous pneumocephalus can occur. Rarely, defects in or rupture of an.
The most common presentation is nonspecific headache. Less commonly, neurologic deficit and. Unless it is under tension, most intracranial air resolves. Occasionally, air collections increase and may require. Intracranial air can exist in any compartment and conforms to the shape of that. Epidural air is typically unilateral, solitary, biconvex in configuration, and.
Subdural air is confluent, crescentic, often bilateral, frequently contains air-fluid levels, moves with changes in. Intraventricular air forms air-fluid levels, most often in the frontal horns of the lateral ventricles.
Air is extremely hypodense on CT, measuring approximately -1, HU. The frontal lobes are displaced posteriorly by air under pressure and are typically pointed where they are. Distinguishing air from fat on CT is extremely important. With typical narrow soft tissue windows, both appear.
Increasing window width or simply looking at bone CT algorithms on which air is clearly. Air is seen as areas of completely absent signal intensity on all sequences. Air is air and shouldn't be mistaken for anything else. If wide windows are not used, a ruptured dermoid cyst with. With the exception of tension pneumocephalus, air itself generally isn't the problem; figure out what's causing it!
Radiologists play a key role in the early diagnosis and imaging of suspected inflicted injury. Imaging must be. Abusive head trauma AHT and acute inflicted head injury are more specific.
NAT brain injuries can be divided into two major groups: Direct injuries are inflicted by blows to the head or direct impact of the cranium on an object such as a wall.
The precise pathoetiology of indirect injuries is unclear, as is the minimum force required to produce them. The head of an infant or young child is relatively. Shaking causes rapid rotation of. The most common result is diffusely. The annual incidence of child abuse is estimated at per , Between three and four. NAT is the most common overall cause of traumatic death in infants, and head trauma is the most.
Most abused children are under two years old. The peak age is between. While the majority of victims are males, in some cultures, female infants are more common. No nationality or demographic group is exempt, and NAT can be found in all socioeconomic groups.
Clinical presentation of an abused child is variable. Discordance between stated history and. Falls from a height less than around four feet e. Irritability, apneic episodes, vomiting, and unarousability are common.
Unusual bruises, patches of torn hair, lip. Finding evidence of repetitive violence indicates that the infant or child is at a high risk for. Post-traumatic brain damage. The medical imperative is to protect the child. Radiologists must clearly communicate any. Notifying Child Protective Services of any. All 50 states in the USA have statutes that. Initial imaging in cases of suspected child abuse should include a complete skeletal survey and brain CT as the.
Many experts emphasize that, while dating of both brain and skeletal injuries is imprecise, the. NECT using both soft tissue and bone algorithm with multiplanar reformatting is the primary tool in. SDHs , is critical Bifrontal, interhemispheric, and peritentorial subdural hematomas of differing ages strongly suggest inflicted.
Traumatic subarachnoid hemorrhage, cortical contusions, and occasionally diffuse axonal injuries are. Ischemic injury may also be present and varies from territorial infarcts to global hypoxic brain injury. Hemispheric or diffuse brain swelling occurs in some infants with acute subdural hematomas. This has been dubbed. Mortality is high in these cases. FLAIR is helpful in detecting small extraaxial collections and white matter injury. Spine and spinal cord injuries are common in infants and children with shaking injuries.
MR is the procedure of. PET in conjunction with high-detail skeletal survey is helpful in the assessment of skeletal trauma. Rarely, an inborn error of metabolism such as glutaric aciduria and Menkes kinky hair syndrome can cause.
Bleeding dyscrasias can cause recurrent subdural. The extent of tissue damage from a projectile depends on the type of bullet, its velocity and mass, and the. Projectile craniocerebral injuries are qualitatively different from. While a detailed discussion of projectiles and their ballistics is beyond the scope of this text, we will briefly.
Readers interested in greater detail are referred to the definitive article by Jandial et al. Neurosurgery 62 2: Much of the information on ballistics and tissue injury. The high-velocity projectile brain injuries seen in noncombatant populations are predominantly gunshot wounds. Stabbing injuries inflicted by sharp objects such as a knife, screwdriver, or ice-pick may also penetrate the calvaria.
The major factors that determine whether a projectile will penetrate the cranium are 1 its energy at impact on. Penetration by a ballistic. The severity of tissue damage is proportional to the kinetic energy deposited in the tissue by the penetrating. Pressure is very high at the tip of an advancing projectile. As a projectile penetrates brain, it leaves a temporary. It also causes outward radial stretching of adjacent tissue, depositing energy at very high strain.
As a bullet penetrates the brain, it yaws not tumbles. This explains why the entry wound is typically small and. Projectiles with high kinetic energy may transfer enough energy to the skull to transform the bone fragments.
In the aggregate, these fragments can be just as lethal as through-. The behavior of a projectile acting on tissue the brain that is anatomically constrained within a closed space the. Bullets passing through the firm brain tissue often take a slightly curved path between the entry point and final. The trajectory is marked by macerated tissue, torn vessels, and disrupted axons While patients at virtually any age can be affected, gunshot would patients tend to be.
Patients with gunshot wounds to the brain typically present with signs and symptoms of brain. The sudden increase in intracranial pressure caused by. Patients with tangential gunshot wounds commonly present with a relatively good GCS and no loss of consciousness. In these cases, the bullet typically does not breach the skull, although the tangential gunshot wounds may transfer.
Prognosis is highly variable, ranging from death to full recovery. Gunshot wounds that have a. Most fatalities occur. Tangential gunshot wounds with smaller caliber, low-velocity bullets may. The morphology of gunshot wounds is extremely variable. Injuries are most severe with large-caliber missiles. CT with both bone and soft tissue reconstruction is the diagnostic procedure of choice. Possible damage to critical blood vessels should be noted along with. In general, a small-caliber, low-velocity projectile will have a relatively small linear track through the brain The bullet path is hyperdense and tends.
Bullet and bone fragments should be noted. The exit. Pneumocephalus may be present. Head injury depth as an indicator of causes and mechanisms. Facial soft tissue injuries as an aid to ordering a combination head and facial computed. Growing skull fracture stages and treatment strategy. J Neurosurg Pediatr.
Fractures of the clivus and traumatic diastasis of the central skull base in the pediatric. The skull unfolded: Epidural hematoma in children: J Neuroradiol. Neuroimaging of traumatic brain injury.
Mt Sinai J Med. Mixed-density extradural hematomas on computed tomography-prognostic significance. Second-impact syndrome and a small subdural hematoma: J Neurotrauma. Visualization of an actively bleeding cortical vessel into the subdural space by CT angiography. Hyperemia beneath evacuated acute subdural hematoma is frequent and prolonged in.
Acute spontaneous subdural hematoma: J Neurosurg. Clinical features, treatment, and prognosis of patients with acute subdural hematomas. Images in clinical medicine. Bilateral subacute subdural hematomas. N Engl J Med. Diffusion-weighted imaging of traumatic subdural hematoma in the subacute stage.
Neurol Med. Acute-on-chronic subdural hematoma: J Korean Neurosurg Soc. Superficial siderosis associated with a chronic subdural hematoma: T2-weighted MR imaging at.
Cerebrospinal fluid leakage into the subdural space: Traumatic subdural hygromas: J Trauma. Post-traumatic interpeduncular cistern hemorrhage as a marker for brainstem lesions. Evaluation of traumatic subarachnoid hemorrhage using susceptibility-weighted imaging. Intra-arterial calcium channel blocker infusion for treatment of severe vasospasm in traumatic brain. The natural history of brain contusion: Evolution of traumatic intracerebral hemorrhage captured with CT imaging: Focal traumatic brain stem injury is a rare type of head injury resulting from assault: Whole-brain proton MR spectroscopic imaging of mild-to-moderate traumatic brain injury and correlation with neuropsychological deficits.
Prevalence and impact of diffuse axonal injury in patients with moderate and severe head. Diffuse axonal injury: J Clin Neurosci. Diffuse vascular injury: Neuropathological investigation of cerebral white matter lesions caused by closed head injury. Evaluation of delayed neuronal and axonal damage secondary to moderate and severe traumatic.
Spontaneous intraparenchymal otogenic pneumocephalus: A case report and review of literature. Imaging of the post-operative cranium. Clinics in diagnostic imaging Post-traumatic intracerebral pneumatocele.
Nonaccidental trauma child abuse. In Barkovich AJ et al: Pediatric Neuroimaging. How to explore and report children with suspected non-accidental trauma. Pediatr Radiol. Diagnostic imaging of child abuse. Traumatic brain injury in infants: A tangential gunshot wound to the head: J Emerg Med. Ballistics reviews: Forensic Sci Med Pathol.
Ballistics for the neurosurgeon. Gunshot injuries to the head and brain caused by low-velocity handguns and rifles. A review. Graphic shows the skull of a newborn, including the anterior fontanelle, coronal, metopic, sagittal. Cephalohematoma is subperiosteal, limited by sutures. Subgaleal hematoma is under the. Bone CT in newborn with traumatic delivery shows skull. Note that the cephalohematoma does not. Autopsy case from a traumatized infant shows a massive biparietal subgaleal hematoma.
NECT scan through the vertex of an infant with severe head injury shows an. Courtesy E. Hedley-Whyte, MD. Bone CT in a severely. The right lambdoid.
Left NECT scan with soft tissue windows shows a depressed skull fracture. Right Bone algorithm shows the severely comminuted, deeply.
Axial NECT scan shows severe scalp laceration with a combination of elevated and depressed. NECT scan shows a large subgaleal hematoma crossing the sagittal suture. Hyperdense vertex. Bone CT in. The superior sagittal sinus has been.
Axial NECT scan in a patient with progressive right hemiparesis following prior head trauma shows. The overlying skull appears focally deformed and thinned. Bone CT in the same patient shows a wide lucent skull lesion with rounded, scalloped margins.
Axial graphic depicts different basilar skull fractures crossing the petrous apex and clivus , as. Autopsy case shows multiple. Axial bone CT shows skull base fractures that involve the clivus , left sigmoid sinus , and.
Note hemotympanum. AP view of MR venogram in the same patient. EDH with depressed skull fracture lacerating the middle meningeal artery.
Inset shows. Endocranial view shows temporal bone fracture crossing the middle meningeal artery groove. Dorsal view of the dura-covered brain shows the biconvex EDH on top of the dura. NECT scan shows classic hyperdense biconvex appearance of acute epidural hematoma over the. Axial NECT scan in a child with acute head trauma shows that the gray-.
Biconvex acute EDH is heterogeneously hyperdense. Thin subdural blood collection is present. Subtle extraaxial blood is seen over the left hemisphere. Right Coronal reconstruction from facial bone CT demonstrates a comminuted fracture overlying the.
Series of imaging studies demonstrates temporal evolution of a small EDH. Initial NECT scan shows a. Bone CT in the same patient shows a slightly depressed right. Small bifrontal hypodense subdural hygromas are now seen. Repeat study 6 weeks after trauma. Axial bone CT shows extensive subgaleal hematoma and linear skull fractures crossing the.
Coronal scan shows that vertex epidural hematomas cross the midline, displacing the superior. Top Bone CT in a year-old man who fell 25 feet onto his head shows a diastatic fracture of. Bottom The fracture continues superiorly, following the lambdoid suture above. More cephalad scan in the same patient shows that the EDH extends above the tentorium behind. Left Coronal, right sagittal reformatted images nicely show that the EDH.
Autopsy shows acute SDH spreading over the brain between dura , thin veil-like arachnoid. Acute SDH spreads over left hemisphere , along tentorium , into interhemispheric fissure. SDH over the left hemisphere is. The patient's. Mixed-density aSDH with rapid bleeding and hypodense unretracted clots.
The gray-white matter interface is. The entire right hemisphere is hypodense, indicating diffuse holohemispheric brain. This lifethreatening complication of an aSDH may require emergent decompressive craniectomy. Autopsy case shows sSDH with organized hematoma , thick outer membrane , deformed brain.
SDHs decrease approximately 1. By days, blood in hematoma is isodense with cortex.
The right GM-WM. NECT scan in.
Note that both GMWM interfaces. Axial T1WI. Note gyral compression with almost completely obliterated sulci. T1WI in a year-old man with seizures shows bilateral subdural collections that are slightly. Findings are consistent. Complicated cSDHs contain loculated pockets of old and new blood, seen as fluid-fluid levels. Autopsy case shows loculated collections with old and new blood, characteristic of mixed chronic SDH.
Gallery of different cases shows the broad spectrum of imaging findings in cSDH. Here, NECT scan in a. Mixed-age SDHs are common. The chronic. A small residual loculated fluid collection.
DWI in a patient with chronic right. Graphic depicts traumatic subarachnoid hemorrhage. Low-power photomicrograph shows an autopsied brain of a boxer who collapsed and expired after. Typical tSAH covers the gyri and extends into the sulci. Courtesy J. Paltan, MD. Subtle tSAH in a patient with closed head injury is present in the interpeduncular fossa , left. FLAIR scan with artifactual sulcal hyperintensity caused by incomplete water suppression. NECT in severe cerebral edema shows pseudosubarachnoid hemorrhage caused by lowdensity brain.
Cortical contusions are located primarily along gyral crests , around a sylvian fissure. Autopsy shows petechial and larger confluent cortical contusions , tSAH in adjacent sulci. Autopsy shows large frontal contusion with focal traumatic SAH enlarging the adjacent sulcus. Graphics depict the most common sites of cerebral contusions in red.
Less common sites are shown in. Autopsied brain shows typical locations of contusions, i. NECT scan 24 hours after trauma shows frontotemporal contusions , left inferior frontal subdural.
T2WI obtained immediately after the CT scan above shows contusions with perilesional edema. A left temporal contusion is. Sagittal graphic depicts common sites of axonal injury in the corpus callosum and midbrain. Graphics depict the most common sites of axonal injury in red. Frequent but relatively less common. Autopsy case shows typical findings of diffuse axonal injury with linear hemorrhages in the.
NECT in a patient with severe nonimpact head injury shows diffuse brain swelling with small. DAI is present, seen as several punctate and linear hemorrhagic foci in. More cephalad scan in the same patient shows. NECT scan in a patient with closed head injury from high-speed motor vehicle collision shows no. Because of the discrepancy between imaging findings and the patient's.
Hyperdense foci in the deep gray nuclei and fornix suggest axonal injury. Autopsy case shows findings of diffuse vascular injury with multiple petechial and linear. Note subcortical injury to thalamus , corpus callosum splenium.
Courtesy R. Hewlett, MD.
Osborn’s Brain: Imaging, Pathology, and Anatomy
GCS was 8 at the scene; by the time he reached the emergency department, the. MR was obtained because of the gross discrepancy between clinical and imaging findings. T2WI shows. Torn arachnoid is probably. SWI in the same patient shows innumerable linear. Autopsy specimen from a patient who died in a high-speed MVC shows a large hemorrhage in the.
NECT scan in a patient with post-traumatic subcortical injury shows a large expanding basal ganglia. Some air is also present in the frontal horn. NECT shows bifrontal subdural air. Bone CT in a child with multiple fractures shows air in the arteries. Other injuries e. Note diffuse edema involving almost the entire left hemisphere. T2WI in the same patient shows. Autopsy specimen from a patient with a gunshot wound from a 9 mm bullet shows the typical findings.
NECT scan shows a low-velocity injury with a bullet fragment , linear hemorrhage along a. Series of NECT scans depicts findings from a patient with a large-caliber, highvelocity gunshot. The entrance wound is through the squamous portion of the right temporal bone.
A mass of blood,. More cephalad. Scan through the frontal horns shows continuation of the pathway through the lateral. Image through the upper lateral ventricles shows intraventricular hemorrhage. Blood is. Enough kinetic energy was present to punch the. TBI is a ongoing series of pathophysiological. While perhaps most useful for trainees and consultants in neuroradiology, its accessible layout, pertinent images and illustrations make it an excellent resource for general radiologists, neurosurgeons, neurologists and neuropathologists also.
As a senior radiology trainee specializing in neuroradiology, this book is an essential companion in my everyday reporting.
At over pages it may seem a little long to be used as a reference book, but it is so accessible that I use it as such often. Furthermore, as a radiologist herself, Osborn includes advice regarding scan acquisition and optimum viewing conditions, which really helps to give context to the text — a particular strength of this book.
With its rich presentation and Osborn's friendly and authoritative tone throughout, this book is enjoyable to read and a pleasure to use. I would recommend it highly and feel it is well worth its price.
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Preview — Diagnostic Neuroradiology by Anne G. Diagnostic Neuroradiology: Charts, tables and lists pull important information into the open for easy review and reference. Divided into six sections, Diagnostic Neuroradiology covers the full range of neurologic disease imaging: Get A Copy. Hardcover , pages. More Details Original Title. Other Editions 2.
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Community Reviews. Showing Rating details. Sort order. Dec 07, Henry Ford Hospital marked it as checked-out Shelves: Patel Stolen! Khalid July 09 3.Even relatively minor head trauma, especially in elderly patients who are often anticoagulated,. Nevertheless, your. Commissural and Cortical Maldevelopment We begin our discussion with a consideration of scalp and skull lesions as we work our way from the outside to the.
Brain laceration occurs when severe trauma disrupts the pia and literally tears the underlying. I would recommend it highly and feel it is well worth its price. I hope you enjoy the journey! Subtle tSAH may be the only clue on initial imaging studies that more serious injuries lurk beneath the surface…. Other lesions are rare. NECT scan in a patient with post-traumatic subcortical injury shows a large expanding basal ganglia.
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