ExpertDDx: Brain and Spine

Karen L. Salzman, MD, FACR, is Professor of Radiology and Imaging Sciences. She is the Neuroradiology Section Chief and Associate Fellowship Director, and holds the Leslie W. Davis Endowed Chair in Neuroradiology at the University of Utah School of Medicine in Salt Lake City, Utah. Miral D. Jhaveri, MD, MBA is a lead author of the prior editions of this book and lead author of Diagnostic Imaging: Brain. Jhaveri is Professor and Division Head of Neuroradiology as well as Executive Vice-Chair in the Department of Diagnostic Radiology & Nuclear Medicine at Rush University Medical Center in Chicago, IL. Jeffrey S. Ross, MD is a Consultant for the Neuroradiology Division of the Department of Radiology at the Mayo Clinic Arizona, and Professor of Radiology at the Mayo Clinic College of Medicine, in Phoenix, AZ

SECTION 1: SKULL AND BRAIN

SCALP, SKULL

ANATOMICALLY BASED DIFFERENTIALS

4 Skull Normal Variants

Miral D. Jhaveri, MD, MBA

6 Scalp Mass, Child

Luke L. Linscott, MD and Chang Yueh Ho, MD

10 Scalp Mass, Adult

Miral D. Jhaveri, MD, MBA

12 Congenital Anomalies of Skull Base

Luke L. Linscott, MD and Chang Yueh Ho, MD

GENERIC IMAGING PATTERNS

18 "Hair on End"

Miral D. Jhaveri, MD, MBA

20 Thick Skull, Generalized

Miral D. Jhaveri, MD, MBA

24 Thick Skull, Localized

Miral D. Jhaveri, MD, MBA

26 Thin Skull, Generalized

Miral D. Jhaveri, MD, MBA

28 Thin Skull, Localized

Miral D. Jhaveri, MD, MBA

30 Lytic Skull Lesion, Solitary

Miral D. Jhaveri, MD, MBA

34 Multiple Lucent Skull Lesions

Miral D. Jhaveri, MD, MBA

38 Sclerotic Skull Lesion, Solitary

Miral D. Jhaveri, MD, MBA

42 Sclerotic Skull Lesions, Multiple

Miral D. Jhaveri, MD, MBA

CLINICALLY BASED DIFFERENTIALS

44 Macrocrania/Macrocephaly

Luke L. Linscott, MD

50 Microcephaly

Luke L. Linscott, MD

MENINGES

ANATOMICALLY BASED DIFFERENTIALS

56 Dural Calcification(s)

Miral D. Jhaveri, MD, MBA

58 Dural-Based Mass, Solitary

Miral D. Jhaveri, MD, MBA

62 Dural-Based Masses, Multiple

Miral D. Jhaveri, MD, MBA

66 Falx Lesions

Miral D. Jhaveri, MD, MBA

GENERIC IMAGING PATTERNS

68 Thick Dura/Arachnoid, Generalized

Miral D. Jhaveri, MD, MBA and Yoshimi Anzai, MD, MPH

70 Pial Enhancement

Miral D. Jhaveri, MD, MBA and Yoshimi Anzai, MD, MPH

74 Dural Tail Sign

Miral D. Jhaveri, MD, MBA

VENTRICLES, PERIVENTRICULAR REGIONS

ANATOMICALLY BASED DIFFERENTIALS

76 Ventricles, Normal Variants

Bernadette L. Koch, MD and Chang Yueh Ho, MD

80 Choroid Plexus Lesions, Child

Chang Yueh Ho, MD and Karen L. Salzman, MD

82 Choroid Plexus Lesions, Adult

Kalen Riley, MD, MBA, Chang Yueh Ho, MD, and Karen L. Salzman, MD

84 Ependymal/Subependymal Lesions

Miral D. Jhaveri, MD, MBA

90 Lateral Ventricle Mass

Karen L. Salzman, MD

94 Thick Septum Pellucidum

Blair A. Winegar, MD and Karen L. Salzman, MD

96 Foramen of Monro Mass

Troy A. Hutchins, MD

100 3rd Ventricle Mass, Anterior

Karen L. Salzman, MD

104 3rd Ventricle Mass, Body/Posterior

Karen L. Salzman, MD

106 Cerebral Aqueduct/Periaqueductal Lesion

Nancy J. Fischbein, MD

112 4th Ventricle Mass, Child

Chang Yueh Ho, MD and Karen L. Salzman, MD

116 4th Ventricle Mass, Adult

Karen L. Salzman, MD

GENERIC IMAGING PATTERNS

118 Bubbly-Appearing Intraventricular Mass

Chang Yueh Ho, MD and Karen L. Salzman, MD

122 Ependymal Enhancement

Blair A. Winegar, MD and Miral D. Jhaveri, MD, MBA

126 Ventriculomegaly

Luke L. Linscott, MD

132 Small Ventricles

Bernadette L. Koch, MD and Chang Yueh Ho, MD

134 Asymmetric Lateral Ventricles

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

138 Irregular Lateral Ventricles

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

142 Periventricular Enhancing Lesions

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

MODALITY-SPECIFIC IMAGING FINDINGS

146 Intraventricular Calcification(s)

Blair A. Winegar, MD and Karen L. Salzman, MD

150 Periventricular Calcification(s)

Luke L. Linscott, MD, Chang Yueh Ho, MD, and Susan I. Blaser, MD, FRCPC

154 Periventricular T2-/FLAIR-Hyperintense Lesions

Troy A. Hutchins, MD and Karen L. Salzman, MD

EXTRAAXIAL SPACES AND SUBARACHNOID CISTERNS

ANATOMICALLY BASED DIFFERENTIALS

158 Subarachnoid Space Normal Variants

Luke L. Linscott, MD and Karen L. Salzman, MD

160 Epidural Mass

Miral D. Jhaveri, MD, MBA and Sheri L. Harder, MD, FRCPC

164 Enlarged Sulci, Generalized

Troy A. Hutchins, MD and Chang Yueh Ho, MD

168 Effaced Sulci, Generalized

Troy A. Hutchins, MD and Anne G. Osborn, MD, FACR

172 Interhemispheric Fissure Cysts

Bernadette L. Koch, MD, Chang Yueh Ho, MD, and Anne G. Osborn, MD, FACR

176 CPA Mass, Adult

Blair A. Winegar, MD and Karen L. Salzman, MD

180 Cystic CPA Mass

Karen L. Salzman, MD and H. Ric Harnsberger, MD

184 Prepontine Cistern Mass

Kalen Riley, MD, MBA, Gregory L. Katzman, MD, MBA, and Miral D. Jhaveri, MD, MBA

190 Ventral Foramen Magnum Mass

Miral D. Jhaveri, MD, MBA and Karen L. Salzman, MD

194 Dorsal Foramen Magnum Mass

Miral D. Jhaveri, MD, MBA and Karen L. Salzman, MD

GENERIC IMAGING PATTERNS

198 Solitary Enhancing Cranial Nerve

Miral D. Jhaveri, MD, MBA and Anne G. Osborn, MD, FACR

200 Multiple Enhancing Cranial Nerves

Miral D. Jhaveri, MD, MBA and Anne G. Osborn, MD, FACR

204 CSF-Like Extraaxial Fluid Collection

Miral D. Jhaveri, MD, MBA and Yoshimi Anzai, MD, MPH

206 Convexal Subarachnoid Hemorrhage

Miral D. Jhaveri, MD, MBA

210 CSF-Like Extraaxial Mass

Miral D. Jhaveri, MD, MBA and Yoshimi Anzai, MD, MPH

212 Sulcal/Cisternal Enhancement

Miral D. Jhaveri, MD, MBA and Sheri L. Harder, MD, FRCPC

216 Fat in Sulci/Cisterns/Ventricles

Miral D. Jhaveri, MD, MBA and Yoshimi Anzai, MD, MPH

218 Pneumocephalus

Miral D. Jhaveri, MD, MBA

MODALITY-SPECIFIC IMAGING FINDINGS

220 Extraaxial Flow Voids

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

222 T1-Hyperintense CSF

Miral D. Jhaveri, MD, MBA and Bronwyn E. Hamilton, MD

224 FLAIR-Hyperintense Sulci

Miral D. Jhaveri, MD, MBA and Bronwyn E. Hamilton, MD

228 T2-Hypointense Extraaxial Lesions

Miral D. Jhaveri, MD, MBA and Bronwyn E. Hamilton, MD

232 Hyperdense CSF

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

234 Hyperdense Extraaxial Mass(es)

Miral D. Jhaveri, MD, MBA

236 Hypodense Extraaxial Mass(es)

Miral D. Jhaveri, MD, MBA and Bronwyn E. Hamilton, MD

BRAIN PARENCHYMA, GENERAL GENERIC IMAGING PATTERNS

240 Multiple Enhancing Lesions, General

Karen L. Salzman, MD and Miral D. Jhaveri, MD, MBA

244 Ring-Enhancing Lesion, Solitary

Miral D. Jhaveri, MD, MBA and Yoshimi Anzai, MD, MPH

250 Ring-Enhancing Lesion, Multiple

Miral D. Jhaveri, MD, MBA and Yoshimi Anzai, MD, MPH

254 Solitary Cystic Parenchymal Mass, General

Nancy J. Fischbein, MD and Anne G. Osborn, MD, FACR

260 CSF-Like Parenchymal Lesion(s)

Troy A. Hutchins, MD and Anne G. Osborn, MD, FACR

266 Cyst With Nodule

Troy A. Hutchins, MD and Karen L. Salzman, MD

270 Fat and Fat-Like Lesion(s)

Miral D. Jhaveri, MD, MBA and Sheri L. Harder, MD, FRCPC

MODALITY-SPECIFIC IMAGING FINDINGS

272 Solitary Parenchymal Calcification

Miral D. Jhaveri, MD, MBA

276 Multiple Parenchymal Calcifications

Blair A. Winegar, MD, Anne G. Osborn, MD, FACR, and Miral D. Jhaveri, MD, MBA

280 Solitary Hyperdense Parenchymal Lesion

Miral D. Jhaveri, MD, MBA and Anne G. Osborn, MD, FACR

286 Multiple Hyperdense Parenchymal Lesions

Troy A. Hutchins, MD, Anne G. Osborn, MD, FACR, and Miral D. Jhaveri, MD, MBA

292 Solitary Hypodense Parenchymal Lesion

Miral D. Jhaveri, MD, MBA and Anne G. Osborn, MD, FACR

296 Multiple Hypodense Parenchymal Lesions

Troy A. Hutchins, MD and Chang Yueh Ho, MD

300 Multiple Brain Hyperintensities (T2/FLAIR), Common

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

306 Multiple Brain Hyperintensities (T2/FLAIR), Less Common

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

312 Multiple Brain Hyperintensities (T2/FLAIR), Rare but Important

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

318 Multiple Hypointense Foci on T2

Nancy J. Fischbein, MD

320 Multiple Hypointense Foci on GRE/SWI

Nancy J. Fischbein, MD

324 T1-/T2-Hyperintense Parenchymal Lesions

Santhosh Gaddikeri, MD and Anne G. Osborn, MD, FACR

328 T1-Hypointense, T2-Hyperintense Parenchymal Lesions

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

332 T1-/T2-Isointense Parenchymal Lesions

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

336 Restricted Diffusion, General

Miral D. Jhaveri, MD, MBA and Bronwyn E. Hamilton, MD

342 Restricted Diffusion, Cortex

Miral D. Jhaveri, MD, MBA

344 Restricted Diffusion, Basal Ganglia

Miral D. Jhaveri, MD, MBA

348 T1-Hyperintense Parenchymal Lesion(s)

Santhosh Gaddikeri, MD and Anne G. Osborn, MD, FACR

CLINICALLY BASED DIFFERENTIALS

352 Brain Tumor in Newborn/Infant

Chang Yueh Ho, MD

358 Brain Tumor in Child > 1 Year

Chang Yueh Ho, MD

364 Epilepsy, Child

Luke L. Linscott, MD

370 Epilepsy, Adult

Chang Yueh Ho, MD and Bronwyn E. Hamilton, MD

SUPRATENTORIAL BRAIN PARENCHYMA

ANATOMICALLY BASED DIFFERENTIALS

372 Asymmetric Cerebral Hemispheres

Santhosh Gaddikeri, MD and Gregory L. Katzman, MD, MBA

378 Thick Cerebral Cortex

Luke L. Linscott, MD

384 Thin Cortex

Karen L. Salzman, MD, Anne G. Osborn, MD, FACR, and Chang Yueh Ho, MD

390 Focal Cortical Mass

Chang Yueh Ho, MD and James D. Eastwood, MD

396 Cortical Hyperintensity T2/FLAIR

Karen L. Salzman, MD

400 Cortical Enhancement

Karen L. Salzman, MD

402 Solitary White Matter Lesion

Santhosh Gaddikeri, MD and Marinos Kontzialis, MD

406 Confluent White Matter Lesions

Karen L. Salzman, MD

412 Abnormal Shape/Configuration of Corpus Callosum

Luke L. Linscott, MD

418 Corpus Callosum Holes

Troy A. Hutchins, MD and Karen L. Salzman, MD

420 Corpus Callosum Lesion Without Mass Effect

Karen L. Salzman, MD

422 Corpus Callosum Mass

Karen L. Salzman, MD

424 Corpus Callosum Splenium Lesion

Troy A. Hutchins, MD

428 Medial Temporal Lobe Lesion

Chang Yueh Ho, MD

434 Hippocampal Lesion

Chang Yueh Ho, MD

438 Basal Ganglia Calcification

Karen L. Salzman, MD

442 Hyperdense Basal Ganglia

Karen L. Salzman, MD

444 Hypodense Basal Ganglia

Karen L. Salzman, MD

448 T1-Hyperintense Basal Ganglia

Karen L. Salzman, MD

452 T2-Hyperintense Basal Ganglia

Karen L. Salzman, MD

456 Enlarged Perivascular Spaces

Karen L. Salzman, MD

458 Perivascular Space Enhancing Lesions

Karen L. Salzman, MD

462 Bilateral Basal Ganglia Lesions

Nancy J. Fischbein, MD

466 Putamen Lesion(s)

Karen L. Salzman, MD

468 Globus Pallidus Lesion(s)

Karen L. Salzman, MD

472 Unilateral Thalamic Lesion

Karen L. Salzman, MD

474 Bithalamic Lesions

Nancy J. Fischbein, MD and Karen L. Salzman, MD

478 Pulvinar Sign

Karen L. Salzman, MD

480 Tectal (Quadrigeminal Plate) Lesion

Karen L. Salzman, MD

INFRATENTORIAL BRAIN PARENCHYMA

ANATOMICALLY BASED DIFFERENTIALS