Table of Contents
Editorial
Perspectives
Review Articles
Historical Perspectives
Brain
- Long-Term White Matter Changes after Severe Traumatic Brain Injury: A 5-Year Prospective Cohort
The authors used DTI to study posttraumatic white matter changes over a 5-year period. Thirteen patients with severe injuries acutely showed significant fractional anisotropy decreases in the corpus callosum and corona radiata when compared with controls. These abnormalities progressed at 2 years and then remained stable until 5 years. The DTI abnormalities correlated with sequelae such as amnesia, aphasia, and dyspraxia.
- Intracranial Imaging of Uncommon Diseases Is More Frequently Reported in Clinical Publications Than in Radiology Publications
This report explores the idea that articles containing imaging descriptions of uncommon diseases more commonly appear in clinical than in imaging journals. Using PubMed, the authors searched for articles on 5 uncommon entities and found 202 such articles, of which 89% were published in non-radiology journals and only 11% in imaging journals. Because 74% were case reports and most imaging journals do not accept these, this may explain their findings. However, radiologists need to be aware of this and should review non-imaging journals.
- Morphologic, Distributional, Volumetric, and Intensity Characterization of Periventricular Hyperintensities
These authors sought to characterize white matter lesions of elderly adults and determine if some were artifacts. Using FLAIR they imaged 665 subjects without dementia, carefully measured and evaluated periventricular white matter lesions, and correlated these with several aspects of cardiovascular disease. They concluded that periventricular white matter hyperintensity levels, distribution, and association with risk factors and disease suggest that in old age, these are true tissue abnormalities and therefore should not be dismissed as artifacts.
Commentary
- MRI Findings in Autoimmune Voltage-Gated Potassium Channel Complex Encephalitis with Seizures: One Potential Etiology for Mesial Temporal Sclerosis
Voltage-gated potassium channel complex encephalitis is a common form of autoimmune encephalitis presenting with intractable seizures that may respond to immunotherapy. These authors reviewed the imaging findings in 42 such patients and the most common abnormalities noted were enlargement, T2 hyperintensity, contrast enhancement, and restricted diffusion in the mesial temporal lobes with subsequent development of hippocampal atrophy. Because the disease can be confirmed easily by the presence of voltage-gated potassium channel complex antibodies, these imaging findings should prompt serologic testing.
Commentary
- Prevalence of Radiologically Isolated Syndrome and White Matter Signal Abnormalities in Healthy Relatives of Patients with Multiple Sclerosis
Healthy individuals who either had no relatives with multiple sclerosis or had a family history of it were studied and evaluated according the Okuda and Swanton criteria for radiologically isolated syndrome. These investigators found that the frequency of white matter signal abnormalities and radiologically isolated syndrome were higher in the healthy relatives of patients with multiple sclerosis compared with nonfamilial healthy control subjects. In healthy relatives of patients with MS, smoking and obesity also contributed to the presence of white matter lesions.
Interventional
- Comparative Effectiveness of Ruptured Cerebral Aneurysm Therapies: Propensity Score Analysis of Clipping versus Coiling
The authors evaluated a national, multihospital database containing information on over 5200 patients to examine recent trends in ruptured aneurysm therapies and to compare peri-procedural outcomes between clipping and coiling treatments. Clipping therapy frequency decreased from 27% in 2006 to 21% in 2011. Unfavorable outcomes were more common after clipping compared with coiling, including discharge to long-term care, ischemic complications, neurologic complications, and other surgical complications.
