Seminars in ultrasound, CT, and MR
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Pediatric head trauma is an important cause of morbidity and mortality in children and may be seen in the setting of accidental or abusive injuries. Although many of the patterns of head injury are similar to adults, the imaging manifestations of head injury in children are more complex due to the developing brain and calvarium. Additionally, there are unique considerations for mechanisms of injury in children, to include abusive head trauma and birth-related injuries. The primary role of the radiologist is to identify and characterize the type and severity of head injury to help guide appropriate patient management.
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Semin. Ultrasound CT MR · Oct 2018
ReviewHypoxic, Toxic, and Acquired Metabolic Encephalopathies at the Emergency Room: The Role of Magnetic Resonance Imaging.
Our purpose is to describe typical computed tomography and magnetic resonance imaging findings in encephalopathies in the emergency. The focus of this article are the most frequent toxic and acquired metabolic diseases and their preferential sites of involvement, such as hepatic encephalopathy, hypoglicemia, nonketotic hyperglycemia, osmotic demyelination, posterior reversible encephalopathy syndrome, uremia, illegal drug abuse, carbon monoxide poisoning, and hypoxic-ischemic encephalopathy. The radiologist must be able to identify the most usual patterns of lesion in computed tomography and magnetic resonance imaging in these settings.
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Brain death (BD) is an irreversible cessation of functions of the entire brain, including the brainstem. The diagnosis of BD is made on clinical grounds and neurologic examination. In the United States, clinical criteria set by the American Academy of Neurology (AAN) emphasize 3 specific clinical findings to confirm BD, which include coma, absence of brainstem reflexes and apnea. ⋯ In many cases, the radiologist is often the first person to appreciate the devastating findings of irreversible brain damage. Three most common mimics of BD are hypothermia, locked-in syndrome, and drug intoxication. By judicious usage of the available ancillary tests, cautiously interpreting the findings with awareness of their limitations and pitfalls, a radiologist can provide the support needed to confirm BD.