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Wintermark M, Yamada K, Lim T, Riascos R, Torres C, Yousry T. Striking a Balance: Global Perspectives on Neuroradiology Workload and Quality of Service. AJNR Am J Neuroradiol 2024; 45:127. [PMID: 38238094 DOI: 10.3174/ajnr.a8125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
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Rodriguez A, Nunez L, Timaran-Montenegro D, Riascos R. Imaging of Common and Infrequent Extradural Tumors. Neuroimaging Clin N Am 2023; 33:443-457. [PMID: 37356861 DOI: 10.1016/j.nic.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Spinal extradural tumors, although uncommon, have high morbidity and mortality rates. Radiographs and computed tomography scans are typically used to assess and determine the characteristics of these tumors. However, MR imaging is the preferred method for the evaluation of complications that can increase morbidity, such as spinal cord and nerve compression. Imaging features, such as type of matrix, cortical involvement, and margins, aid in determining the diagnosis. This article discusses common and infrequent extradural spinal tumors, their imaging characteristics, and how age, location, and clinical presentation help in diagnosing these neoplasms.
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Affiliation(s)
- Andres Rodriguez
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSB 2130B, Houston, TX 77030, USA
| | - Luis Nunez
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSB 2130B, Houston, TX 77030, USA
| | - David Timaran-Montenegro
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSB 2130B, Houston, TX 77030, USA
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSB 2130B, Houston, TX 77030, USA.
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Rodriguez A, Nunez L, Riascos R. Vascular Injuries in Head and Neck Trauma. Radiol Clin North Am 2023; 61:467-477. [PMID: 36931763 DOI: 10.1016/j.rcl.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Blunt and penetrating vascular injuries of the head and neck can represent life-threatening emergencies that require accurate detection to prevent devastating and long-lasting consequences. Implementing appropriate screening criteria to indicate imaging studies is crucial as there is a variable latent time before the onset of clinical manifestations. Computed tomography angiography, MR imaging, and digital subtraction angiography represent the imaging modalities of choice to evaluate vascular injuries. The aim of this review is to provide a description of the different types of vascular injuries, describe the importance of each imaging modality, and recognize the imaging appearance of traumatic vessel injury.
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Affiliation(s)
- Andres Rodriguez
- Department of Diagnostic and Interventional Imaging, Neuroradiology Section, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Luis Nunez
- Department of Diagnostic and Interventional Imaging, Neuroradiology Section, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, Neuroradiology Section, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Nunez L, Jeelani S, Timaran-Montenegro D, Riascos R, McCarty J. Characterization of acute American football spinal injuries in a multi-center healthcare system. Emerg Radiol 2022; 29:1003-1008. [PMID: 36169728 DOI: 10.1007/s10140-022-02089-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/12/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE American football is considered one of the more injury-prone sports given its high-speed and high-impact nature. While much attention has been focused on chronic traumatic encephalopathy, spinal injuries represent the most common catastrophic injury incurred in football. The goal of this investigation is to describe the most common football-associated spinal lesions in a multi-center health system. METHODS This is a retrospective analysis of patients with imaging evidence of spinal injuries related to American football during a 10-year period. Injuries were classified based on the anatomic level, type injury, spinal cord compromise, and therapeutic management. Chi-squared and Fisher's exact test were used for statistical analysis of categorial variables, and simple logistic regression was used to determine individual odds ratios. RESULTS A total of 71 patients were included, with a median age of 17 (IQR, 15-22) years. The cervical spine was the most frequently affected segment (46%), followed by lumbar spine injuries (45%), and thoracic spine injuries (10%). Discogenic injuries were identified in 45 patients (63%). Spinal cord injury was documented in 7 subjects (10%), while cauda equina compression was reported in 1 patient (1%). CONCLUSIONS Acute spinal injuries continue to represent a significant cause of morbidity among American football players. Compared to national statistics, we found a similar distribution of spinal injuries in terms of anatomic location and an alarmingly high proportion of SCI. This investigation represents the largest single-center study addressing spinal injuries among football players.
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Affiliation(s)
- Luis Nunez
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA
| | - Salmaan Jeelani
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA
| | - David Timaran-Montenegro
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA
| | - Jennifer McCarty
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA.
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Mader TH, Gibson CR, Barratt MR, Miller NR, Subramanian PS, Killer HE, Tarver WJ, Sargsyan AE, Garcia K, Hart SF, Kramer LA, Riascos R, Brunstetter TJ, Lipsky W, Wostyn P, Lee AG. Persistent Globe Flattening in Astronauts following Long-Duration Spaceflight. Neuroophthalmology 2020; 45:29-35. [PMID: 33762785 DOI: 10.1080/01658107.2020.1791189] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Posterior globe flattening has been well-documented in astronauts both during and after long-duration space flight (LDSF) and has been observed as early as 10 days into a mission on the International Space Station. Globe flattening (GF) is thought to be caused by the disc centred anterior forces created by elevated volume and/or pressure within the optic nerve sheath (ONS). This might be the result of increased intracranial pressure, increased intraorbital ONS pressure from compartmentalisation or a combination of these mechanisms. We report posterior GF in three astronauts that has persisted for 7 years or more following their return from LDSFs suggesting that permanent scleral remodelling may have occurred.
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Affiliation(s)
| | - C Robert Gibson
- Coastal Eye Associates, Webster, Texas, USA.,KBR, Houston, Texas, USA
| | | | - Neil R Miller
- Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Prem S Subramanian
- Department of Ophthalmology, Sue Anschutz-Rodgers UCHealth Eye Center, University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | | | | | | | - Stephen F Hart
- NASA Johnson Space Center, Space Medicine, Houston, Texas, USA
| | - Larry A Kramer
- Department of Diagnostic Imaging and Intervention, University of Texas Health Science Center, Houston, Texas, USA
| | - Roy Riascos
- Department of Diagnostic Imaging and Intervention, University of Texas Health Science Center, Houston, Texas, USA
| | | | | | - Peter Wostyn
- Department of Psychiatry, PC Sint-Amandus, Beernem, Belgium
| | - Andrew G Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA.,Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.,Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York, USA.,Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, USA.,Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.,Department of Ophthalmology; University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Ophthalmology, Texas A and M College of Medicine, Bryan, Texas, USA
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Sarraj A, Hassan AE, Savitz S, Sitton C, Grotta J, Chen P, Cai C, Cutter G, Imam B, Reddy S, Parsha K, Pujara D, Riascos R, Vora N, Abraham M, Kamal H, Haussen DC, Barreto AD, Lansberg M, Gupta R, Albers GW. Outcomes of Endovascular Thrombectomy vs Medical Management Alone in Patients With Large Ischemic Cores: A Secondary Analysis of the Optimizing Patient's Selection for Endovascular Treatment in Acute Ischemic Stroke (SELECT) Study. JAMA Neurol 2019; 76:1147-1156. [PMID: 31355873 DOI: 10.1001/jamaneurol.2019.2109] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Importance The efficacy and safety of endovascular thrombectomy (EVT) in patients with large ischemic cores remains unknown, to our knowledge. Objective To compare outcomes in patients with large ischemic cores treated with EVT and medical management vs medical management alone. Design, Setting, and Participants This prespecified analysis of the Optimizing Patient's Selection for Endovascular Treatment in Acute Ischemic Stroke (SELECT) trial, a prospective cohort study of imaging selection that was conducted in 9 US comprehensive stroke centers, enrolled patients between January 2016 and February 2018, and followed them up for 90 days. Patients with moderate to severe stroke and anterior circulation large-vessel occlusion presenting up to 24 hours from the time they were last known to be well were eligible for the cohort. Of these, patients with large ischemic cores on computed tomography (CT) (Alberta Stroke Program Early CT Score <6) or CT perfusion scanning (a volume with a relative cerebral blood flow <30% of ≥50 cm3) were included in analyses. Exposures Endovascular thrombectomy with medical management (MM) or MM only. Main Outcomes and Measures Functional outcomes at 90 days per modified Rankin scale; safety outcomes (mortality, symptomatic intracerebral hemorrhage, and neurological worsening). Results A total of 105 patients with large ischemic cores on either CT or CT perfusion images were included: 71 with Alberta Stroke Program Early CT Scores of 5 or less (EVT, 37; MM, 34), 74 with cores of 50 cm3 or greater on CT perfusion images (EVT, 39; MM, 35), and 40 who had large cores on both CT and CT perfusion images (EVT, 14; MM, 26). The median (interquartile range) age was 66 (60-75) years; 45 patients (43%) were female. Nineteen of 62 patients (31%) who were treated with EVT achieved functional independence (modified Rankin Scale scores, 0-2) vs 6 of 43 patients (14%) treated with MM only (odds ratio [OR], 3.27 [95% CI, 1.11-9.62]; P = .03). Also, EVT was associated with better functional outcomes (common OR, 2.12 [95% CI, 1.05-4.31]; P = .04), less infarct growth (44 vs 98 mL; P = .006), and smaller final infarct volume (97 vs 190 mL; P = .001) than MM. In the odds of functional independence, there was a 42% reduction per 10-cm3 increase in core volume (adjusted OR, 0.58 [95% CI, 0.39-0.87]; P = .007) and a 40% reduction per hour of treatment delay (adjusted OR, 0.60 [95% CI, 0.36-0.99]; P = .045). Of 10 patients who had EVT with core volumes greater than 100 cm3, none had a favorable outcome. Conclusions and Relevance Although the odds of good outcomes for patients with large cores who receive EVT markedly decline with increasing core size and time to treatment, these data suggest potential benefits. Randomized clinical trials are needed.
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Affiliation(s)
- Amrou Sarraj
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | - Ameer E Hassan
- Department of Neurology, University of Texas Rio Grande Valley, Harlingen.,Department of Neurology, University of Texas Health Science Center, Neurology, San Antonio.,Department of Radiology, University of Texas Health Science Center, San Antonio
| | - Sean Savitz
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | - Clark Sitton
- Department of Radiology, University of Texas McGovern Medical School, Houston
| | - James Grotta
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | - Peng Chen
- Department of Neurosurgery, University of Texas McGovern Medical School, Houston
| | - Chunyan Cai
- Clinical and Translational Science, University of Texas McGovern Medical School, Houston
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham
| | - Bita Imam
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | - Sujan Reddy
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | - Kaushik Parsha
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | - Deep Pujara
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | - Roy Riascos
- Department of Radiology, University of Texas McGovern Medical School, Houston
| | - Nirav Vora
- Department of Neurology, OhioHealth-Riverside Methodist Hospital, Columbus
| | - Michael Abraham
- Department of Neurology, University of Kansas Medical Center, Kansas City
| | - Haris Kamal
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | | | - Andrew D Barreto
- Department of Neurology, University of Texas McGovern Medical School, Houston
| | - Maarten Lansberg
- Department of Neurology, Stanford University, Stanford, California
| | - Rishi Gupta
- Department of Neurology, Wellstar Health System, Atlanta, Georgia
| | - Gregory W Albers
- Department of Neurology, Stanford University, Stanford, California
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Khanpara S, Ruiz-Pardo D, Spence SC, West OC, Riascos R. Incidence of cervical spine fractures on CT: a study in a large level I trauma center. Emerg Radiol 2019; 27:1-8. [PMID: 31463806 DOI: 10.1007/s10140-019-01717-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/09/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION/PURPOSE Though spinal fractures constitute a minority of all traumas, the financial burden imposed is immense especially following cervical spine trauma. There have been several papers in the past describing the incidence of cervical spine fractures. In this paper, we report the incidence of cervical spine fractures and correlate with demographic information and cause of injury and review the mechanism of fractures. MATERIALS AND METHODS We performed retrospective analysis of 934 patients who had undergone CT scan for cervical spine trauma at our institute which includes 16 hospitals and one level I trauma center over a period of 2 years. This list was created from a wider database of 13,512 patients imaged for suspected cervical spine injury. All patients who had at least one positive finding on CT were included in this study irrespective of any demographic difference. Each patient was analyzed by reviewing the medical records, and correlation was sought between demographics and cause of injury. RESULTS In our study, the peak incidence of cervical spine trauma was in the age group of 21-30 years followed by 31-40 years with a male:female ratio of 2.1. The major cause of injury in the study population was motor vehicle accidents (66.1%), followed by fall from height of less than 8 ft (12.2%). With regard to the ethnic distribution, Caucasians (46.9%) constituted the major population followed by Hispanic population (23.3%). C1 and C2 were observed to be more frequently fractured as compared with the subaxial spine. Incidence of C2 fractures (188 levels) was higher as compared with C1 (102 levels). Incidence of body and lateral mass fractures was marginally higher as compared with odontoid fractures. C7 (50 levels) was the most fractured vertebral body in the subaxial spine followed by C6 (35 levels) and C5. CONCLUSION Spinal trauma is on the rise and it helps to know the factors which can guide us for better management of these patients. We can utilize these results to prognosticate and streamline clinical management of these patients.
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Affiliation(s)
- Shekhar Khanpara
- Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 2-130B, Houston, TX 77030, United States.
| | | | - Susanna C Spence
- Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 2-130B, Houston, TX 77030, United States
| | - O Clark West
- Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 2-130B, Houston, TX 77030, United States
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 2-130B, Houston, TX 77030, United States
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8
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Nguyen QBD, Amato R, Riascos R, Ballester L, Tandon N, Blanco A, Esquenazi Y. Fluciclovine, Anti-1-Amino-3-[18F]-Fluorocyclobutane-1-Carboxylic Acid: A Novel Radiotracer for Meningioma. World Neurosurg 2018; 119:132-136. [DOI: 10.1016/j.wneu.2018.07.231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
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Giancardo L, Arevalo O, Tenreiro A, Riascos R, Bonfante E. MRI Compatibility: Automatic Brain Shunt Valve Recognition using Feature Engineering and Deep Convolutional Neural Networks. Sci Rep 2018; 8:16052. [PMID: 30375411 PMCID: PMC6207736 DOI: 10.1038/s41598-018-34164-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/05/2018] [Indexed: 11/23/2022] Open
Abstract
The aim of this study is to evaluate whether we could develop a machine learning method to distinguish models of cerebrospinal fluid shunt valves (CSF-SVs) from their appearance in clinical X-rays. This is an essential component of an automatic MRI safety system based on X-ray imaging. To this end, a retrospective observational study using 416 skull X-rays from unique subjects retrieved from a clinical PACS system was performed. Each image included a CSF-SV representing the most common brands of programmable shunt valves currently used in US which were split into five different classes. We compared four machine learning pipelines: two based on engineered image features (Local Binary Patterns and Histogram of Oriented Gradients) and two based on features learned by a deep convolutional neural network architecture. Performance is evaluated using accuracy, precision, recall and f1-score. Confidence intervals are computed with non-parametric bootstrap procedures. Our best performing method identified the valve type correctly 96% [CI 94–98%] of the time (CI: confidence intervals, precision 0.96, recall 0.96, f1-score 0.96), tested using a stratified cross-validation approach to avoid chances of overfitting. The machine learning pipelines based on deep convolutional neural networks showed significantly better performance than the ones based on engineered image features (mean accuracy 95–96% vs. 56–64%). This study shows the feasibility of automatically distinguishing CSF-SVs using clinical X-rays and deep convolutional neural networks. This finding is the first step towards an automatic MRI safety system for implantable devices which could decrease the number of patients that experience denials or delays of their MRI examinations.
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Affiliation(s)
- Luca Giancardo
- Center for Precision Health, School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA.
| | - Octavio Arevalo
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.,Memorial Hermann Hospital, Houston, TX, USA
| | - Andrea Tenreiro
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.,Memorial Hermann Hospital, Houston, TX, USA
| | - Roy Riascos
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.,Memorial Hermann Hospital, Houston, TX, USA
| | - Eliana Bonfante
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.,Memorial Hermann Hospital, Houston, TX, USA
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Koppelmans V, Scott JM, Downs ME, Cassady KE, Yuan P, Pasternak O, Wood SJ, De Dios YE, Gadd NE, Kofman I, Riascos R, Reuter-Lorenz PA, Bloomberg JJ, Mulavara AP, Ploutz-Snyder LL, Seidler RD. Exercise effects on bed rest-induced brain changes. PLoS One 2018; 13:e0205515. [PMID: 30308004 PMCID: PMC6181401 DOI: 10.1371/journal.pone.0205515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Spaceflight negatively affects sensorimotor behavior; exercise mitigates some of these effects. Head down tilt bed rest (HDBR) induces body unloading and fluid shifts, and is often used to investigate spaceflight effects. Here, we examined whether exercise mitigates effects of 70 days HDBR on the brain and if fitness and brain changes with HDBR are related. METHODS HDBR subjects were randomized to no-exercise (n = 5) or traditional aerobic and resistance exercise (n = 5). Additionally, a flywheel exercise group was included (n = 8). Exercise protocols for exercise groups were similar in intensity, therefore these groups were pooled in statistical analyses. Pre and post-HDBR MRI (structure and structural/functional connectivity) and physical fitness measures (lower body strength, muscle cross sectional area, VO2 max, body composition) were collected. Voxel-wise permutation analyses were used to test group differences in brain changes, and their associations with fitness changes. RESULTS Comparisons of exercisers to controls revealed that exercise led to smaller fitness deterioration with HDBR but did not affect brain volume or connectivity. Group comparisons showed that exercise modulated post-HDBR recovery of brain connectivity in somatosensory regions. Posthoc analysis showed that this was related to functional connectivity decrease with HDBR in non-exercisers but not in exercisers. Correlational analyses between fitness and brain changes showed that fitness decreases were associated with functional connectivity and volumetric increases (all r >.74), potentially reflecting compensation. Modest brain changes or even decreases in connectivity and volume were observed in subjects who maintained or showed small fitness gains. These results did not survive Bonferroni correction, but can be considered meaningful because of the large effect sizes. CONCLUSION Exercise performed during HDBR mitigates declines in fitness and strength. Associations between fitness and brain connectivity and volume changes, although unadjusted for multiple comparisons in this small sample, suggest that supine exercise reduces compensatory HDBR-induced brain changes.
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Affiliation(s)
- Vincent Koppelmans
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, United States of America
| | - Jessica M. Scott
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
- Universities Space Research Association, NASA Johnson Space Center, Houston, Texas, United States of America
| | | | - Kaitlin E. Cassady
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Peng Yuan
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Ofer Pasternak
- Department of Psychiatry and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Scott J. Wood
- NASA Johnson Space Center, Houston, Texas, United States of America
| | | | | | - Igor Kofman
- KBRwyle, Houston, Texas, United States of America
| | - Roy Riascos
- The University of Texas Health Science Center, Houston, Texas, United States of America
| | - Patricia A. Reuter-Lorenz
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, United States of America
- Neuroscience Program, University of Michigan, Ann Arbor, Michigan, United States of America
| | | | | | - Lori L. Ploutz-Snyder
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States of America
- Universities Space Research Association, NASA Johnson Space Center, Houston, Texas, United States of America
| | - Rachael D. Seidler
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, Florida, United States of America
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11
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Jenner ZB, Husein N, Riascos R, Esquenazi Y. Orbital and nasal meningoencephaloceles secondary to chronic hydrocephalus: A rare cause of bilateral proptosis. Neuroradiol J 2018; 31:420-425. [PMID: 29882488 DOI: 10.1177/1971400918778145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Orbital meningoencephalocele formation is primarily a result of congenital defects in the pediatric population and trauma of the anterior cranial fossa in adults. We present a unique case of nontraumatic nasal and orbital meningoencephaloceles presenting as bilateral proptosis with exotropia secondary to chronic hydrocephalus. Clinical presentation A 20-year-old male with a history of tuberous sclerosis, X-linked intellectual disability, and epilepsy presented to the emergency department with two days of nausea, emesis, seizures, and two months of progressive proptosis. Initial radiographs of the skull showed a "copper beaten" appearance, indicating chronically elevated intracranial pressure. Computed tomography imaging of the head demonstrated bilateral defects in the cribriform plate and anterior cranial fossa. Magnetic resonance imaging of the brain revealed triventricular hydrocephalus with meningoencephalocele extension into the nasal cavity and frontal horn herniation into the extraconal space of the orbits. The hydrocephalus was managed with ventriculoperitoneal shunt placement with rapid and complete resolution of the proptosis. Conclusion No reports have described bilateral proptosis as the presenting finding of orbital and nasal meningoencephaloceles in the absence of trauma or congenital defect. This case study demonstrates the management of meningoencephalocele formation secondary to chronic hydrocephalus.
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Affiliation(s)
- Zachary B Jenner
- 1 McGovern Medical School at The University of Texas Health Science Center, USA
| | - Nuruddin Husein
- 2 Vivian L. Smith Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center, USA
| | - Roy Riascos
- 3 Diagnostic and Interventional Imaging, McGovern Medical School at The University of Texas Health Science Center, USA
| | - Yoshua Esquenazi
- 2 Vivian L. Smith Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center, USA
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12
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Yuan P, Koppelmans V, Reuter-Lorenz P, De Dios Y, Gadd N, Wood S, Riascos R, Kofman I, Bloomberg J, Mulavara A, Seidler R. Vestibular brain changes within 70 days of head down bed rest. Hum Brain Mapp 2018. [PMID: 29528169 DOI: 10.1002/hbm.24037] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Head-down-tilt bed rest (HDBR) is frequently utilized as a spaceflight analog research environment to study the effects of axial body unloading and fluid shifts that are associated with spaceflight in the absence of gravitational modifications. HDBR has been shown to result in balance changes, presumably due to sensory reweighting and adaptation processes. Here, we examined whether HDBR results in changes in the neural correlates of vestibular processing. Thirteen men participated in a 70-day HDBR intervention; we measured balance, functional mobility, and functional brain activity in response to vestibular stimulation at 7 time points before, during, and after HDBR. Vestibular stimulation was administered by means of skull taps, resulting in activation of the vestibular cortex and deactivation of the cerebellar, motor, and somatosensory cortices. Activation in the bilateral insular cortex, part of the vestibular network, gradually increased across the course of HDBR, suggesting an upregulation of vestibular inputs in response to the reduced somatosensory inputs experienced during bed rest. Furthermore, greater increase of activation in multiple frontal, parietal, and occipital regions in response to vestibular stimulation during HDBR was associated with greater decrements in balance and mobility from before to after HDBR, suggesting reduced neural efficiency. These findings shed light on neuroplastic changes occurring with conditions of altered sensory inputs, and reveal the potential for central vestibular-somatosensory convergence and reweighting with bed rest.
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Affiliation(s)
- Peng Yuan
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
| | | | | | - Yiri De Dios
- Wyle Science, Technology & Engineering Group, Houston, Texas
| | - Nichole Gadd
- Wyle Science, Technology & Engineering Group, Houston, Texas
| | - Scott Wood
- Department of Psychology, Azusa Pacific University, Azusa, California
| | - Roy Riascos
- The University of Texas Health Science Center, Houston, Texas
| | - Igor Kofman
- Wyle Science, Technology & Engineering Group, Houston, Texas
| | | | - Ajitkumar Mulavara
- NASA Johnson Space Center, Houston, Texas.,Universities Space Research Association, Houston, Texas
| | - Rachael Seidler
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan.,Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, Florida
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Yuan P, Koppelmans V, Reuter-Lorenz P, De Dios Y, Gadd N, Riascos R, Kofman I, Bloomberg J, Mulavara A, Seidler RD. Change of cortical foot activation following 70 days of head-down bed rest. J Neurophysiol 2018; 119:2145-2152. [PMID: 29488843 DOI: 10.1152/jn.00693.2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Head-down tilt bed rest (HDBR) has been used as a spaceflight analog to study some of the effects of microgravity on human physiology, cognition, and sensorimotor functions. Previous studies have reported declines in balance control and functional mobility after spaceflight and HDBR. In this study we investigated how the brain activation for foot movement changed with HDBR. Eighteen healthy men participated in the current HDBR study. They were in a 6° head-down tilt position continuously for 70 days. Functional MRI scans were acquired to estimate brain activation for foot movement before, during, and after HDBR. Another 11 healthy men who did not undergo HDBR participated as control subjects and were scanned at four time points. In the HDBR subjects, the cerebellum, fusiform gyrus, hippocampus, and middle occipital gyrus exhibited HDBR-related increases in activation for foot tapping, whereas no HDBR-associated activation decreases were found. For the control subjects, activation for foot tapping decreased across sessions in a couple of cerebellar regions, whereas no activation increase with session was found. Furthermore, we observed that less HDBR-related decline in functional mobility and balance control was associated with greater pre-to-post HDBR increases in brain activation for foot movement in several cerebral and cerebellar regions. Our results suggest that more neural control is needed for foot movement as a result of HDBR. NEW & NOTEWORTHY Long-duration head-down bed rest serves as a spaceflight analog research environment. We show that brain activity in the cerebellum and visual areas during foot movement increases from pre- to post-bed rest and then shows subsequent recovery. Greater increases were seen for individuals who exhibited less decline in functional mobility and balance control, suggestive of adaptive changes in neural control with long-duration bed rest.
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Affiliation(s)
- Peng Yuan
- School of Kinesiology, University of Michigan , Ann Arbor, Michigan
| | - Vincent Koppelmans
- School of Kinesiology, University of Michigan , Ann Arbor, Michigan.,Department of Psychiatry, University of Utah , Salt Lake City, Utah
| | | | | | | | - Roy Riascos
- The University of Texas Health Science Center , Houston, Texas
| | | | | | | | - Rachael D Seidler
- School of Kinesiology, University of Michigan , Ann Arbor, Michigan.,Department of Applied Physiology & Kinesiology, University of Florida , Gainesville, Florida
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Hasan KM, Mwangi B, Keser Z, Riascos R, Sargsyan AE, Kramer LA. Brain Quantitative MRI Metrics in Astronauts as a Unique Professional Group. J Neuroimaging 2018; 28:256-268. [DOI: 10.1111/jon.12501] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 01/04/2018] [Accepted: 01/16/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Khader M. Hasan
- Medical SchoolDepartment of Diagnostic and Interventional ImagingThe University of Texas Health Science Center Houston TX
| | - Benson Mwangi
- Medical SchoolDepartment of PsychiatryThe University of Texas Health Science Center Houston TX
| | - Zafer Keser
- Medical SchoolDepartment of NeurologyThe University of Texas Health Science Center Houston TX
| | - Roy Riascos
- Medical SchoolDepartment of Diagnostic and Interventional ImagingThe University of Texas Health Science Center Houston TX
| | | | - Larry A. Kramer
- Medical SchoolDepartment of Diagnostic and Interventional ImagingThe University of Texas Health Science Center Houston TX
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15
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Bonfante E, Riascos R. Imaging of Brain Concussion. Neuroimaging Clin N Am 2018. [DOI: 10.1016/s1052-5149(17)30140-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Bonfante E, Riascos R. Imaging of Cerebral Concussion and Chronic Traumatic Encephalopathy. Neuroimaging Clin N Am 2018; 28:xvii-xviii. [DOI: 10.1016/j.nic.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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17
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Abstract
Conventional imaging findings in patients with cerebral concussion and chronic traumatic encephalopathy are absent or subtle in the majority of cases. The most common abnormalities include cerebral volume loss, enlargement of the cavum of the septum pellucidum, cerebral microhemorrhages, and white matter signal abnormalities, all of which have poor sensitivity and specificity. Advanced imaging modalities, such as diffusion tensor imaging (DTI), blood oxygen level dependent functional MR Imaging (BOLD fMRI), MR spectroscopy, perfusion imaging, positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetoencephalography detect physiologic abnormalities in symptomatic patients and, although currently in the investigation phase, may become useful in the clinical arena.
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Affiliation(s)
- Eliana Bonfante
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSB 2130B, Houston, TX 77030, USA.
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSB 2130B, Houston, TX 77030, USA
| | - Octavio Arevalo
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSB 2130B, Houston, TX 77030, USA
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Koppelmans V, Bloomberg JJ, De Dios YE, Wood SJ, Reuter-Lorenz PA, Kofman IS, Riascos R, Mulavara AP, Seidler RD. Brain plasticity and sensorimotor deterioration as a function of 70 days head down tilt bed rest. PLoS One 2017; 12:e0182236. [PMID: 28767698 PMCID: PMC5540603 DOI: 10.1371/journal.pone.0182236] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 07/15/2017] [Indexed: 12/18/2022] Open
Abstract
Background Adverse effects of spaceflight on sensorimotor function have been linked to altered somatosensory and vestibular inputs in the microgravity environment. Whether these spaceflight sequelae have a central nervous system component is unknown. However, experimental studies have shown spaceflight-induced brain structural changes in rodents’ sensorimotor brain regions. Understanding the neural correlates of spaceflight-related motor performance changes is important to ultimately develop tailored countermeasures that ensure mission success and astronauts’ health. Method Head down-tilt bed rest (HDBR) can serve as a microgravity analog because it mimics body unloading and headward fluid shifts of microgravity. We conducted a 70-day 6° HDBR study with 18 right-handed males to investigate how microgravity affects focal gray matter (GM) brain volume. MRI data were collected at 7 time points before, during and post-HDBR. Standing balance and functional mobility were measured pre and post-HDBR. The same metrics were obtained at 4 time points over ~90 days from 12 control subjects, serving as reference data. Results HDBR resulted in widespread increases GM in posterior parietal regions and decreases in frontal areas; recovery was not yet complete by 12 days post-HDBR. Additionally, HDBR led to balance and locomotor performance declines. Increases in a cluster comprising the precuneus, precentral and postcentral gyrus GM correlated with less deterioration or even improvement in standing balance. This association did not survive Bonferroni correction and should therefore be interpreted with caution. No brain or behavior changes were observed in control subjects. Conclusions Our results parallel the sensorimotor deficits that astronauts experience post-flight. The widespread GM changes could reflect fluid redistribution. Additionally, the association between focal GM increase and balance changes suggests that HDBR also may result in neuroplastic adaptation. Future studies are warranted to determine causality and underlying mechanisms.
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Affiliation(s)
- Vincent Koppelmans
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | | | | | - Scott J. Wood
- NASA Johnson Space Center, Houston, TX, United States of America
| | | | | | - Roy Riascos
- The University of Texas Health Science Center, Houston, TX, United States of America
| | | | - Rachael D. Seidler
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, United States of America
- Neuroscience Program, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail:
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Koppelmans V, Pasternak O, Bloomberg JJ, Dios YED, Wood SJ, Riascos R, Reuter-Lorenz PA, Kofman IS, Mulavara AP, Seidler RD. Intracranial Fluid Redistribution But No White Matter Microstructural Changes During a Spaceflight Analog. Sci Rep 2017; 7:3154. [PMID: 28600534 PMCID: PMC5466616 DOI: 10.1038/s41598-017-03311-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/25/2017] [Indexed: 01/01/2023] Open
Abstract
The neural correlates of spaceflight-induced sensorimotor impairments are unknown. Head down-tilt bed rest (HDBR) serves as a microgravity analog because it mimics the headward fluid shift and axial body unloading of spaceflight. We investigated focal brain white matter (WM) changes and fluid shifts during 70 days of 6° HDBR in 16 subjects who were assessed pre (2x), during (3x), and post-HDBR (2x). Changes over time were compared to those in control subjects (n = 12) assessed four times over 90 days. Diffusion MRI was used to assess WM microstructure and fluid shifts. Free-Water Imaging was used to quantify distribution of intracranial extracellular free water (FW). Additionally, we tested whether WM and FW changes correlated with changes in functional mobility and balance measures. HDBR resulted in FW increases in fronto-temporal regions and decreases in posterior-parietal regions that largely recovered by two weeks post-HDBR. WM microstructure was unaffected by HDBR. FW decreases in the post-central gyrus and precuneus correlated negatively with balance changes. We previously reported that gray matter increases in these regions were associated with less HDBR-induced balance impairment, suggesting adaptive structural neuroplasticity. Future studies are warranted to determine causality and underlying mechanisms.
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Affiliation(s)
- Vincent Koppelmans
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | | | | | - Scott J Wood
- NASA Johnson Space Center, Houston, TX, United States
- Azusa Pacific University, Azusa, CA, United States
| | - Roy Riascos
- The University of Texas Health Science Center, Houston, TX, United States
| | | | | | | | - Rachael D Seidler
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States.
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States.
- Neuroscience Program, University of Michigan, Ann Arbor, MI, United States.
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20
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Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C. Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. Radiographics 2016; 35:2121-34. [PMID: 26562241 DOI: 10.1148/rg.2015150035] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Approximately one-third of all cervical spine injuries involve the craniocervical junction (CCJ). Composed of the occiput and the first two cervical vertebrae, this important anatomic landmark, in conjunction with an intricate ligamentous complex, is essential to maintaining the stability of the cervical spine. The atlantoaxial joint is the most mobile portion of the spine, predominantly relying on the ligamentous framework for stability at that level. As acute onsite management of trauma patients continues to improve, CCJ injuries, which often lead to death onsite where the injury occurred, are increasingly being encountered in the emergency department. Understanding the anatomy of the CCJ is crucial in properly evaluating the cervical spine, allowing the radiologist to assess its stability in the trauma setting. The imaging findings of important CCJ injuries, such as atlanto-occipital dissociation, occipital condyle fractures, atlas fractures with transverse ligament rupture, atlantoaxial distraction, and traumatic rotatory subluxation, are important to recognize in the acute setting, often dictating patient management. Thin-section multidetector computed tomography with sagittal and coronal reformats is the study of choice in evaluating the extent of injury, allowing the radiologist to thoroughly evaluate the stability of the cervical spine. Furthermore, magnetic resonance (MR) imaging is increasingly being used to evaluate the spinal soft tissues and ligaments, and to identify associated spinal cord injury, if present. MR imaging is also indicated in patients whose neurologic status cannot be evaluated within 48 hours of injury. .
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Affiliation(s)
- Roy Riascos
- From the Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.130B, Houston, TX 77030 (R.R., E.B., M.G., C.W.); and Department of Radiology, University of Texas Medical Branch, Galveston, Tex (C.C., R.H.)
| | - Eliana Bonfante
- From the Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.130B, Houston, TX 77030 (R.R., E.B., M.G., C.W.); and Department of Radiology, University of Texas Medical Branch, Galveston, Tex (C.C., R.H.)
| | - Claudia Cotes
- From the Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.130B, Houston, TX 77030 (R.R., E.B., M.G., C.W.); and Department of Radiology, University of Texas Medical Branch, Galveston, Tex (C.C., R.H.)
| | - Mary Guirguis
- From the Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.130B, Houston, TX 77030 (R.R., E.B., M.G., C.W.); and Department of Radiology, University of Texas Medical Branch, Galveston, Tex (C.C., R.H.)
| | - Reza Hakimelahi
- From the Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.130B, Houston, TX 77030 (R.R., E.B., M.G., C.W.); and Department of Radiology, University of Texas Medical Branch, Galveston, Tex (C.C., R.H.)
| | - Clark West
- From the Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.130B, Houston, TX 77030 (R.R., E.B., M.G., C.W.); and Department of Radiology, University of Texas Medical Branch, Galveston, Tex (C.C., R.H.)
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21
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Yuan P, Koppelmans V, Reuter-Lorenz PA, De Dios YE, Gadd NE, Wood SJ, Riascos R, Kofman IS, Bloomberg JJ, Mulavara AP, Seidler RD. Increased Brain Activation for Dual Tasking with 70-Days Head-Down Bed Rest. Front Syst Neurosci 2016; 10:71. [PMID: 27601982 PMCID: PMC4993791 DOI: 10.3389/fnsys.2016.00071] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/05/2016] [Indexed: 01/24/2023] Open
Abstract
Head-down tilt bed rest (HDBR) has been used as a spaceflight analog to simulate the effects of microgravity exposure on human physiology, sensorimotor function, and cognition on Earth. Previous studies have reported that concurrent performance of motor and cognitive tasks can be impaired during space missions. Understanding the consequences of HDBR for neural control of dual tasking may possibly provide insight into neural efficiency during spaceflight. In the current study, we evaluated how dual task performance and the underlying brain activation changed as a function of HDBR. Eighteen healthy men participated in this study. They remained continuously in the 6° head-down tilt position for 70 days. Functional MRI for bimanual finger tapping was acquired during both single task and dual task conditions, and repeated at 7 time points pre-, during- and post-HDBR. Another 12 healthy males participated as controls who did not undergo HDBR. A widely distributed network involving the frontal, parietal, cingulate, temporal, and occipital cortices exhibited increased activation for dual tasking and increased activation differences between dual and single task conditions during HDBR relative to pre- or post-HDBR. This HDBR-related brain activation increase for dual tasking implies that more neurocognitive control is needed for dual task execution during HDBR compared to pre- and post-HDBR. We observed a positive correlation between pre-to-post HDBR changes in dual-task cost of reaction time and pre-to-post HDBR change in dual-task cost of brain activation in several cerebral and cerebellar regions. These findings could be predictive of changes in dual task processing during spaceflight.
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Affiliation(s)
- Peng Yuan
- School of Kinesiology, University of Michigan Ann Arbor, MI, USA
| | | | | | - Yiri E De Dios
- Wyle Science, Technology and Engineering Group Houston, TX, USA
| | - Nichole E Gadd
- Wyle Science, Technology and Engineering Group Houston, TX, USA
| | - Scott J Wood
- Department of Psychology, Azusa Pacific University Azusa, CA, USA
| | - Roy Riascos
- The University of Texas Health Science Center Houston, TX, USA
| | - Igor S Kofman
- Wyle Science, Technology and Engineering Group Houston, TX, USA
| | | | - Ajitkumar P Mulavara
- NASA Johnson Space CenterHouston, TX, USA; Universities Space Research AssociationHouston, TX, USA
| | - Rachael D Seidler
- School of Kinesiology, University of MichiganAnn Arbor, MI, USA; Department of Psychology, University of MichiganAnn Arbor, MI, USA; Neuroscience Program, Medical School, University of MichiganAnn Arbor, MI, USA
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22
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Abstract
Paragangliomas are uncommon tumors that arise from the parasympathetic neuroectodermal ganglionic cells and have been described in numerous anatomic locations, most commonly in the abdomen. Head and neck paragangliomas are classified into carotid body (most common), vagal, and jugulotympanic types. Computed tomography is the initial imaging modality of choice for the preoperative assessment of the extent of paragangliomas. Magnetic resonance imaging and selective angiography provide more detail of the surrounding tissues and vasculature. Surgical resection is the treatment of choice.
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Affiliation(s)
- Alejandro Zuluaga
- Department of Radiology, The University of Texas Medical Branch, Galveston, TX, USA
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Datta S, Zhu JJ, Riascos R, Narayana P. NIMG-22MORPHOLOGICAL RECONSTRUCTION BASED AUTOMATED SEGMENTATION OF GLIOBLASTOMA TUMOR VOLUME ON MULTI-MODAL MRI IMAGES. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov225.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
The classification of posterior fossa congenital anomalies has been a controversial topic. Advances in genetics and imaging have allowed a better understanding of the embryologic development of these abnormalities. A new classification schema correlates the embryologic, morphologic, and genetic bases of these anomalies in order to better distinguish and describe them. Although they provide a better understanding of the clinical aspects and genetics of these disorders, it is crucial for the radiologist to be able to diagnose the congenital posterior fossa anomalies based on their morphology, since neuroimaging is usually the initial step when these disorders are suspected. We divide the most common posterior fossa congenital anomalies into two groups: 1) hindbrain malformations, including diseases with cerebellar or vermian agenesis, aplasia or hypoplasia and cystic posterior fossa anomalies; and 2) cranial vault malformations. In addition, we will review the embryologic development of the posterior fossa and, from the perspective of embryonic development, will describe the imaging appearance of congenital posterior fossa anomalies. Knowledge of the developmental bases of these malformations facilitates detection of the morphological changes identified on imaging, allowing accurate differentiation and diagnosis of congenital posterior fossa anomalies.
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Affiliation(s)
- Claudia Cotes
- Department of Radiology, and Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX, USA
| | - Eliana Bonfante
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | | | - Leonard Swischuk
- Department of Radiology, and Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX, USA
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, USA
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25
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Bonfante E, Koenig MK, Adejumo R, Perinjelil V, Contreras N, Riascos R. Early imaging findings in Kearns Sayre Syndrome. A case presentation. Mitochondrion 2015. [DOI: 10.1016/j.mito.2015.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Cotes C, Riascos R, Swischuk LE. Facial vein thrombophlebitis: an uncommon complication of sinusitis. Pediatr Radiol 2015; 45:1244-8. [PMID: 25636529 DOI: 10.1007/s00247-014-3272-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 11/11/2014] [Accepted: 12/26/2014] [Indexed: 11/26/2022]
Abstract
Facial vein thrombophlebitis is an uncommon complication of sinusitis. In cases where periorbital swelling complicating sinusitis is diagnosed, clinical findings of swelling and erythema extending beyond the orbital region into the cheek should alert the physician about this unusual complication and the need for further contrast-enhanced imaging and venography. The radiologist must be particularly careful in the evaluation of vascular structures of the face and neck in these children. CT and MRI with contrast material and MR venography are studies that clearly demonstrate the vascular anatomy and possible complications. However, MR venography confirms flow abnormalities within the venous system with the advantage of avoiding radiation exposure to the pediatric patient.
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Affiliation(s)
- Claudia Cotes
- Department of Radiology, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555-0709, USA,
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27
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Riascos R, Heymann JC, Hakimelahi R, Hasan K, Sargsyan A, Barr YR, Tom J, Alperin N, Kramer LA. Novel finding of optic nerve central T2 hypointensity utilizing 3 Tesla MR imaging. Neuroradiol J 2015; 28:133-6. [PMID: 25923682 DOI: 10.1177/1971400915576668] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We sought to report a central T2 hypointensity within the optic nerve on 3 T MRI studies obtained as part of the NASA Flight Medicine Visual Impairment Intracranial Pressure Protocol that had not been described previously. Twenty-one astronauts, who had undergone MRI of both orbits with direct coronal T2 sequences between 2010 and 2012, were retrospectively included. Two of the astronauts did not have previous exposure to microgravity at the time of their scans. A central T2 hypointensity was observed in 100% of both right and left eyes. It was completely visualized throughout the nerve course in 15 right eyes (71.4%) and in 19 left eyes (90.5%).We describe a new finding seen in all study participants: a central T2 hypointensity in the epicenter of the optic nerve. We speculate that this T2 hypointensity may represent flow voids caused by the central retinal vessels.
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Affiliation(s)
- Roy Riascos
- Department of Diagnostic and Interventional Imaging, The University of Texas in Houston
| | - John C Heymann
- Department of Radiology, University of Texas Medical Branch, Houston, TX, USA
| | - Reza Hakimelahi
- Department of Radiology, University of Texas Medical Branch, Houston, TX, USA
| | - Khader Hasan
- Department of Diagnostic and Interventional Imaging, The University of Texas in Houston
| | | | - Yael R Barr
- University of Texas Medical Branch / NASA Johnson Space Center Bioastronautics Contract, Houston, TX, USA
| | - James Tom
- Department of Radiology, University of Texas Medical Branch, Houston, TX, USA
| | - Noam Alperin
- Department of Radiology, The University of Miami, Coral Gables, FL, USA
| | - Larry A Kramer
- Department of Diagnostic and Interventional Imaging, The University of Texas in Houston
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28
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Riascos R, Dodds J, Patel N. Retropharyngeal masses in neurofibromatosis type 1: Imaging findings in 2 cases. Ear Nose Throat J 2014; 93:E35-E37. [PMID: 25531853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Neurofibromatosis type 1 (NF-1) affects mesenchymal development via multisystemic manifestations. We present 2 cases of NF-1 that manifested as a retropharyngeal mass-1 as a lateral cervical meningocele in a 60-year-old man and the other as a focal neurofibroma in a 37-year-old man. Contrast-enhanced magnetic resonance imaging (MRI) was invaluable in identifying the exact nature of the 2 lesions; no contrast enhancement was seen in the case of the meningocele, and enhancement was seen in the case of the neurofibroma. These 2 cases illustrate the importance of the history and contrast-enhanced MRI in managing NF-1 patients with a retropharyngeal mass.
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Affiliation(s)
- Roy Riascos
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, MSB 2.130B, Houston, TX 77030, USA.
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Bauer JD, Riascos R, Qiu S, Chao C. Suspected liposarcoma of the hip by magnetic resonance imaging 3 years after large-volume fat grafting for buttock augmentation. Aesthet Surg J 2014; 34:NP66-9. [PMID: 24891408 DOI: 10.1177/1090820x14536389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- John D Bauer
- Drs Bauer and Chao are Associate Professors, Department of Surgery, University of Texas Medical Branch, Galveston, TexasDr Riascos is an Associate Professor, Department of Radiology, University of Texas Medical Branch, Galveston, TexasDr Qiu is an Associate Professor, Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Roy Riascos
- Drs Bauer and Chao are Associate Professors, Department of Surgery, University of Texas Medical Branch, Galveston, TexasDr Riascos is an Associate Professor, Department of Radiology, University of Texas Medical Branch, Galveston, TexasDr Qiu is an Associate Professor, Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Suimin Qiu
- Drs Bauer and Chao are Associate Professors, Department of Surgery, University of Texas Medical Branch, Galveston, TexasDr Riascos is an Associate Professor, Department of Radiology, University of Texas Medical Branch, Galveston, TexasDr Qiu is an Associate Professor, Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Celia Chao
- Drs Bauer and Chao are Associate Professors, Department of Surgery, University of Texas Medical Branch, Galveston, TexasDr Riascos is an Associate Professor, Department of Radiology, University of Texas Medical Branch, Galveston, TexasDr Qiu is an Associate Professor, Department of Pathology, University of Texas Medical Branch, Galveston, Texas
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Patro SN, Torres C, Riascos R. An unusual case of isolated hypoglossal nerve palsy secondary to osteophytic projection from the atlanto-occipital joint. Neuroradiol J 2014; 27:361-4. [PMID: 24976205 DOI: 10.15274/nrj-2014-10039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 04/05/2014] [Indexed: 11/12/2022] Open
Abstract
We describe an unusual and rare case of isolated left hypoglossal nerve palsy secondary to compression from a prominent degenerative osteophyte from the left atlanto-occipital joint. The hypoglossal nerve is a purely motor cranial nerve innervating the tongue musculature. Palsy of the hypoglossal nerve is frequently associated with other cranial nerve palsies and can be related to vascular, neoplastic, infectious or traumatic conditions. Isolated hypoglossal nerve palsy is quite rare and very few cases have been reported in the literature to date.
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Affiliation(s)
- Satya Narayana Patro
- Department of Radiology, University of Ottawa, The Ottawa Hospital; Ottawa, ON, Canada -
| | - Carlos Torres
- Department of Radiology, University of Ottawa, The Ottawa Hospital; Ottawa, ON, Canada
| | - Roy Riascos
- Department of Radiology, The University of Texas Medical Branch; Galveston, TX, USA
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Abstract
Tuberculosis (TB) has shown a resurgence in nonendemic populations in recent years and accounts for 8 million deaths annually in the world. Central nervous system involvement is one of the most serious forms of this infection, acting as a prominent cause of morbidity and mortality in developing countries. The rising number of cases in developed countries is mostly attributed to factors such as the pandemic of acquired immunodeficiency syndrome and increased migration in a globalized world. Mycobacterium TB is responsible for almost all cases of tubercular infection in the central nervous system. It can manifest in a variety of forms as tuberculous meningitis, tuberculoma, and tubercular abscess. Spinal infection may result in spondylitis, arachnoiditis, and/or focal intramedullary tuberculomas. Timely diagnosis of central nervous system TB is paramount for the early institution of appropriate therapy, because delayed treatment is associated with severe morbidity and mortality. It is therefore important that physicians and radiologists understand the characteristic patterns, distribution, and imaging manifestations of TB in the central nervous system. Magnetic resonance imaging is considered the imaging modality of choice for the study of patients with suspected TB. Advanced imaging techniques including magnetic resonance perfusion and diffusion tensor imaging may be of value in the objective assessment of therapy and to guide the physician in the modulation of therapy in these patients.
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Affiliation(s)
- Carlos Torres
- From the *Department of Radiology, The Ottawa Hospital Civic and General Campus, University of Ottawa, Ottawa, Ontario, Canada; †Department of Radiology, The University of Texas Medical Branch, Galveston, TX; ‡Medical College of Georgia, Georgia Regents University, Martinez, GA; and §Department of Radiology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
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Riascos R, Lazor J, Vu L, Von Rischtl R, Zamudio R. Calcific tendinitis of the prevertebral space: a case report. Ear Nose Throat J 2013; 92:E25-E28. [PMID: 24057912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Calcific prevertebral tendinitis is a self-limiting inflammatory condition of the prevertebral space that involves the insertion of the longus colli tendon. Understanding this condition and its characteristic imaging findings is essential for early diagnosis and differentiation of the disorder from other acute conditions. We describe a case of a 40-year-old patient who presented to the emergency department with severe odynophagia and exhibited the computed tomography findings necessary to confirm this disease.
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Affiliation(s)
- Roy Riascos
- Department of Radiology, University of Texas Medical Branch, Galveston, 2.820 E. John Sealy Annex, 301 University Blvd., Galveston, TX 77555-0709, USA.
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Riascos R, Vu L, Cuellar H, Haberman A, Nishino T, Layer L. CT evaluation of caudal versus lumbar access to the intradural space. Neurol Res 2013; 33:1094-8. [DOI: 10.1179/1743132811y.0000000008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Layer L, Riascos R, Firouzbakht F, Amole A, Von Ritschl R, Dipatre P, Cuellar H. Subarachnoid and basal cistern navigation through the sacral hiatus with guide wire assistance. Neurol Res 2012; 33:633-7. [PMID: 21708073 DOI: 10.1179/1743132810y.0000000025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Intraspinal navigation with catheters and fiberscopes has shown feasible results for diagnosis and treatment of intraspinal and intracranial lesions. The most common approach, lumbar puncture, has allowed access to the spinal cord, however, coming with the difficulties of fiberscope damage and decreased torque for guidance. Our objective in this study is to allow an alternate access, the sacral hiatus, with guide wire assistance into the subarachnoid and intracranial structures, while easing the angle of entry and increasing torque. METHODS We advanced catheters with guide wire and fluoroscopy assistance into the sacral hiatus of three cadavers. After entry, the thecal sac was punctured and the catheter with guide wire was advanced rostrally until positioned in the basal cisterns of the brain. We confirmed catheter placement with contrast injection, autopsy, and dissection. RESULTS In our study, the sacral hiatus was easily accessed, but resistance was found when attempting to puncture the thecal sac. The advancement of the catheter with guide wire assistance glided easily rostrally until some mild resistance was discovered at entry into the foramen magnum. With redirection, all catheters passed with ease into the basal cisterns. Positioning was confirmed with contrast injection with fluoroscopy evidence, autopsy, and dissection. There was no macroscopic or microscopic evidence of damage to the spinal roots, spinal cord, or cranial nerves. CONCLUSION The sacral hiatus with guide wire assistance is an accessible conduit for uncomplicated entry into the subarachnoid and basal cistern space without damaging surrounding structures.
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Affiliation(s)
- Lauren Layer
- Department of Radiology, New York University, USA
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Pernas FG, Coughlin AM, Hughes SE, Riascos R, Maeso PA. A novel use of a landmark to avoid injury of the anterior ethmoidal artery during endoscopic sinus surgery. Am J Rhinol Allergy 2011; 25:54-7. [PMID: 21711980 DOI: 10.2500/ajra.2011.25.3541] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of this study was to describe and correlate radiographically the anterior ethmoidal artery (AEA) to useful endoscopic surgical landmarks, such as the nasal beak (NB), nasal crest (NC), and axilla of the middle turbinate, because these are commonly encountered during endoscopic sinus surgery and skull base surgery. METHODS A retrospective review and software analysis was performed by three independent observers. Measurements of distance and angulation from the AEA to the NC, NB, and axilla of the middle turbinate were performed. A total of 138 unique computed tomography (CT) scans performed at a university tertiary care center were evaluated. RESULTS The average age of the patients whose scans were analyzed was 50.5 (range, 17-90 years) years of age. The gender distribution was 61 male and 89 female patients. After comparing the measurements to the three landmarks noted, it was determined that the NB had the most interpatient concordance and the least interobserver variability. The average distance between the NB and the AEA as it penetrates the lamina papyracea is 2.34 cm (variance, 0.07) at an angle of 45.21° from the Frankfurt horizontal line. CONCLUSION The real advantage of this novel use of the NB as a landmark to identify the AEA is that it is easy to use, unobtrusive, and is not time-consuming. This relationship between the NB and the AEA is consistent across genders and ethnicities and is more valuable than others presented previously, which may be more variable.
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Affiliation(s)
- Francisco G Pernas
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, Texas, USA.
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Cuellar H, Gómez-Ramos P, Riascos R, De Alba L. Neuroimaging Studies in Alzheimer's Disease. Neuroradiol J 2009; 22:525-33. [DOI: 10.1177/197140090902200503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 10/07/2009] [Indexed: 11/16/2022] Open
Abstract
Alzheimer's Disease (AD) is a progressive neurodegenerative disease associated with memory loss and gradual behavioral, functional and cognitive impairment. Conventional imaging studies, such as magnetic resonance or computed tomography have played a secondary role in AD diagnosis: While other causes of memory loss and cognitive deficit can be evaluated by these imaging methods, AD structural changes are not detected until very late in the course of the disease. Recent and more precise techniques have been developed to detect subtle changes not visualized with those imaging methods. This article presents a review of the neuroimaging techniques used as a diagnostic aid for AD.
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Affiliation(s)
- H. Cuellar
- Department of Radiology, “José E. González” University Hospital, Universidad Autónoma de Nuevo León; Monterrey, México
| | - P. Gómez-Ramos
- Department of Anatomy, Histology and Neurosciences, Faculty of Medicine, Universidad Autónoma de Madrid; Madrid, Spain
| | - R. Riascos
- Department of Radiology, The University of Texas Medical Branch; Galveston, TX, USA
| | - L. De Alba
- Department of Radiology, “José E. González” University Hospital, Universidad Autónoma de Nuevo León; Monterrey, México
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Restrepo CS, Rojas CA, Martinez S, Riascos R, Marmol-Velez A, Carrillo J, Vargas D. Cardiovascular complications of cocaine: imaging findings. Emerg Radiol 2008; 16:11-9. [PMID: 18773229 DOI: 10.1007/s10140-008-0762-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Accepted: 08/20/2008] [Indexed: 10/21/2022]
Abstract
Cocaine is the second most commonly abused illicit drug in the US and the most common one involved in emergency department visits, the majority of which are related to the cardiovascular system. Cardiovascular complications related with cocaine abuse include myocardial ischemia and infarction, myocarditis, hypertrophic cardiomyopathy, dilated cardiomyopathy, aortic dissection, thrombosis, stroke and cerebral hemorrhage, and different forms of visceral ischemia, among others. In an era where cocaine use has reached epidemic proportions, it is necessary for the radiologist to understand the pathophysiology, clinical presentation, and imaging characteristics of its cardiovascular complications.
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Affiliation(s)
- Carlos S Restrepo
- Thoracic Radiology, The University of Texas HSC at San Antonio, San Antonio, TX 78229-3900, USA.
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Cuellar H, Riascos R, Palacios E, Rojas R, Molina P. Imaging of isolated cerebral mucormycosis. A report of three cases. Neuroradiol J 2007; 20:525-30. [PMID: 24299941 DOI: 10.1177/197140090702000509] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Accepted: 07/29/2007] [Indexed: 11/16/2022] Open
Abstract
Mucormycosis is a rare infection in immunosupressed patients caused by fungi from the family Mucoraceae. Three types of disease spread have been described: rhinocerebral, systemic and isolated. Isolated spread is the most uncommon form, usually resulting in death. It has been described in diabetics, immunosupressed patients and intravenous drug abusers. Neuroimaging can aid the diagnosis of this entity, but biopsy remains the only reliable method. Imaging findings of Mucormycosis include abscesses and hemorrhagic or ischemic infarcts, usually in the basal ganglia and frontal lobes. Single or multiple lesions have been described as well as meningoencephalitis. Understanding these findings can help to detect the infection in an early stage. We describe three cases of isolated cerebral mucormycosis; all of them were intravenous drug abusers with one patient also being HIV positive.
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Affiliation(s)
- H Cuellar
- Department of Endovascular Therapy , Interventional Neuroradiology Fellow, Clinica Nuestra Señora del Rosario; Madrid, España -
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Abstract
Methadone is an opiate used as part of the treatment for heroin abuse; it can be ingested orally. We present the lethal outcome of a 22-month-old child intoxicated after methadone ingestion.
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Affiliation(s)
- Roy Riascos
- Radiology Department, The University of Texas Medical Branch, 301 University Blvd-Route 0709, Galveston, TX 77555-0709, USA.
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Affiliation(s)
- Carlos S Restrepo
- Radiology Department, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
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Abstract
Multiple neurological complications of cocaine abuse have been described including both ischemic and hemorrhagic cerebrovascular events, atrophy in the case of chronic abuse, and an increase in incidence of congenital malformations in the setting of maternal use. The abuse of cannabis may cause a number of neurovascular changes that, in turn, may result in ischemic events, however, a direct connection between these has not been fully established. The use of MDMA (ecstasy), a popular recreational drug, has been related to ischemic and hemorrhagic cerebrovascular events, as well as atrophy. Neuroimaging studies are vital in the assessment of the extent of neurologic damage in these patients.
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Affiliation(s)
- Rafael Rojas
- Neuroradiology Section, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
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Abstract
The central nervous system is one of the primary targets for the detrimental effects of drugs of abuse. Diagnostic imaging, especially MRI, plays an important role in the detection of complications associated with drug abuse. We present the imaging findings associated with the abuse of opioids and other morphine derivatives, as well, as solvents. Of the morphine derivatives, heroin is the most commonly abused. Several CNS pathologic effects have been described in association with its abuse. These include neurovascular complications such as microvascular ischemic changes or ischemic stroke. A rare form of leukoencephalopathy has been described in those abusers who inhale heroin vapors. Other neurologic complications include atrophy and various infectious processes. Solvent inhalation is a common practice among adolescents and young adults secondary to its ease of access and low cost. The most important component of industrial solvents is toluene. Complications of toluene abuse may be either acute, showing no neuroradiological changes, or chronic, characterized by cerebral and cerebellar demyelination as well as atrophy.
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Affiliation(s)
- Jessica Borne
- Neuroradiology Section, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
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Abstract
The use of imaging in the evaluation of the brain under the influence of drugs has evolved into a functional assessment of its processes. It has been shown that SPECT and PET imaging studies demonstrate selected areas that are affected by multiple drugs among substance abusers. This paper illustrates examples of different drugs and how their effect on the brain may be portrayed by imaging applications. The developing "road maps" that we have obtained possess multidimensional applications. They can be useful to confirm specific diseases, clarify diagnosis wherein the clinical picture is not observed, aid in the development of new treatment evaluations and also provide researchers a better insight in the detection and functionality of dementia and specific mental illnesses processes.
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Affiliation(s)
- J Carlos Mena
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
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Abstract
Imaging plays a key role in the evaluation of patients with known or suspected musculoskeletal infection. Although conventional radiograph still remains as the initial imaging approach, it has low sensitivity and specificity in the setting of acute infection. Magnetic resonance is highly sensitive for the detection of acute osteomyelitis and septic arthritis. Computed tomography is usually reserved for guided interventional procedures (eg, aspiration or drainage) and for evaluation of sinus tracts in chronic infections. Ultrasound is useful for fluid detection in joints and soft tissues but limited in bone assessment. Nuclear medicine, with the different radiotracers currently available, is highly sensitive for the diagnosis of acute osteomyelitis. Newer radiotracers are being developed that promise high sensitivity and specificity for the detection of these pathologies.
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Affiliation(s)
- Santiago Restrepo
- Department of Radiology, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, Room 212, New Orleans, LA 70112, USA.
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Martínez S, Riascos R, Molano E, Madero G. Tiroiditis de hashimoto: Entre el "infierno" y lo normal. Repert Med Cir 2004. [DOI: 10.31260/repertmedcir.v13.n2.2004.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Riascos R, Martínez S, Molano E, Fuentes J. Anomalías vasculares de tejidos blandos: Dilema en terminología y enfoque diagnóstico. Revisión de la literatura y presentación de un caso. Repert Med Cir 2004. [DOI: 10.31260/repertmedcir.v13.n2.2004.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Las anomalías vasculares de los tejidos blandos se han denominado de tantas maneras que dificultan la precisión diagnóstica. El sistema de clasificación actual las divide en hemangiomas infantiles y malformaciones vasculares. Estas últimas a su vez se dividen en lesiones de alto y bajo flujo. El diagnóstico se basa en los hallazgos clínicos apoyados en las imágenes diagnósticas que permiten aclarar la morfología, extensión y características del flujo de la lesión. La ecografía doppler de color espectral, así como la resonancia magnética con angiorresonancia 3D son las imágenes no invasivas utilizadas en la actualidad. Se presenta un caso de malformación arteriovenosa estudiado en nuestra institución mediante doppler de color espectral y angiorresonancia con gadolinio.
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Riascos R, Martínez F, Martínez S, Borrero L. Nasofibroma Juvenil. Repert Med Cir 2003. [DOI: 10.31260/repertmedcir.v12.n3.2003.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cuesta Vélez JP, Hernández JJ, Barrero L, Riascos R, Martínez N. Dolor lumbar crónico: Bloqueos facetarios y radiculares guiados por tomografía axial computarizada Experiencia en el hospital de San José. Repert Med Cir 2003. [DOI: 10.31260/repertmedcir.v12.n2.2003.317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Los bloqueos facetarios y radiculares, diagnósticos y terapéuticos, utilizando como guía sólo los reparos anatómicos externos, han sido una gran herramienta en el manejo del dolor lumbar crónico desde hace mucho tiempo. En la actualidad, estos procedimientos se realizan guiados por imágenes como la tomografía axial computarizada (TAC) y la fluoroscopia. La TAC ha ganado terreno en los últimos años, ya que permite una óptima visualización de las estructuras anatómicas óseas y de los tejidos blandos involucrados, mejorando la exactitud de la punción y disminuyendo la posibilidad de complicaciones. Se presenta la experiencia de esta técnica en la institución con un grupo de 29 pacientes atendidos en la clínica de dolor, con diagnóstico de dolor crónico lumbar refractario al tratamiento médico y la rehabilitación, de los cuales se descartaron nueve por evidencia de ganancia secundaria (económica, social o física) en la evaluación psicológica. Se realizaron 23 bloqueos en la región lumbosacra, 18 de raíces nerviosas y seis facetarios. Veintidós procedimientos se hicieron guiados por TAC y uno por fluoroscopia, sin complicaciones técnicas. El 95% de los pacientes refirió mejoría inmediata después del procedimiento, con resultados variables a largo plazo. No se presentaron complicaciones técnicas, ni posteriores a la inyección. Se concluye que el bloqueo facetario o radicular guiado por TAC es un método preciso y seguro, y que el neurorradiólogo puede aportar su experiencia en la interpretación de imágenes diagnósticas, para formar parte del grupo interdisciplinario de dolor.
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Suárez JJ, Riascos R, González JM. Osteogénesis imperfecta: Reporte de un caso. Repert Med Cir 2001. [DOI: 10.31260/repertmedcir.v10.n3.2001.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La osteogénesis imperfecta o enfermedad de Lobstein, es una alteración deformante ósea en la cual se afectan los genes que forman el colágeno. Se caracteriza clínicamente por la presencia de huesos deformes con múltiples fracturas patológicas, escleras azules e hipoacusia. Se divide en dos grupos principales, la forma letal o congénita y la tardía. Se presenta un caso interesante de este último que fue diagnosticado por ecografía intrauterina.
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Riascos R, Martínez S, González R. ¿Cómo diagnosticar la obstrucción intestinal? Repert Med Cir 2001. [DOI: 10.31260/repertmedcir.v10.n2.2001.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
El íleo intestinal es una manifestación frecuente que se presenta asociada con la mayor parte de las afecciones abdominales y, en algunas ocasiones, torácicas y pélvicas. Como tal, no es una entidad nosológica sino más bien un signo dentro del espectro particular presente. Es imprescindible, por tanto, tener un conocimiento amplio acerca de esta entidad y su reconocimiento. La radiología simple de abdomen es una de las principales armas en la confirmación de los diferentes tipos de íleo intestinal; de hecho, como estudio inicial, constituye el procedimiento de primera elección y es mandatorio.
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