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IDKD Springer Series
Series Editors: Juerg Hodler · Rahel A. Kubik-Huch · Justus E. Roos
Juerg Hodler
Rahel A. Kubik-Huch
Justus E. Roos
Editors
Diseases of the Brain,
Head and Neck, Spine
2024–2027
Diagnostic Imaging
IDKD Springer Series
Series Editors
JuergHodler, Department of Radiology, University Hospital of Zürich,
Zurich,Switzerland
RahelA.Kubik-Huch, Department of Radiology, Kantonsspital Baden,
Baden,Switzerland
JustusE.Roos, Department of Radiology,
Luzerner Kantonsspital, Lucerne,Switzerland
e world-renowned International Diagnostic Course in Davos (IDKD) represents a unique
learning experience for imaging specialists in training as well as for experienced radiologists
and clinicians. IDKD reinforces his role of educator oering to the scientic community tools
of both basic knowledge and clinical practice. Aim of this Series, based on the faculty of the
Davos Course and now launched as open access publication, is to provide a periodically
renewed update on the current state of the art and the latest developments in the eld of organbased imaging (chest, neuro, MSK, and abdominal).
Juerg Hodler • Rahel A. Kubik-Huch
Justus E. Roos
Editors
Diseases of the Brain, Head
and Neck, Spine 2024-2027
Diagnostic Imaging
Editors
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Juerg Hodler
University of Zurich
Zurich, Switzerland
Justus E. Roos
Department of Radiology
Luzerner Kantonsspital
Lucerne, Switzerland
Rahel A. Kubik-Huch
Department of Radiology
Kantonsspital Baden
Baden, Aargau, Switzerland
This book is an open access publication.
ISSN 2523-7829 ISSN 2523-7837 (electronic)
IDKD Springer Series
ISBN 978-3-031-50674-1 ISBN 978-3-031-50675-8 (eBook)
https://doi.org/10.1007/978-3-031-50675-8
Foundation for the Advancement of Education in Medical Radiology
© The Editor(s) (if applicable) and The Author(s) 2024
Open Access This book is licensed under the terms of the Creative Commons Attribution 4.0 International License
(http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction
in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link
to the Creative Commons license and indicate if changes were made.
The images or other third party material in this book are included in the book's Creative Commons license, unless
indicated otherwise in a credit line to the material. If material is not included in the book's Creative Commons license
and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright holder.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed
to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty,
expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been
made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Paper in this product is recyclable
Contents
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Part I Brain/Skull Base/Head
1 Diseases of the Sella Turcica and Parasellar Region . . . . . . . . . . . . . . . . . . . . . . . . 3
W. Kucharczyk and L. A. Loevner
2 Problem Solving Disorders of CSF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Tomas Dobrocky and Àlex Rovira
3 Stroke and Its Mimics: Diagnosis and Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Sarah Power and Achala S. Vagal
4 Cerebral Neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Girish M. Fatterpekar and Pia C. Sundgren
5 Nontraumatic Intracranial Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Pamela W. Schaefer and Myriam Edjlali
6 Intracranial Infection and Inflammation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Tchoyoson Lim and Majda M. Thurnher
7 Neuroimaging Update on Traumatic Brain Injury . . . . . . . . . . . . . . . . . . . . . . . . . 87
Apostolos J. Tsiouris and Yvonne W. Lui
8 Differential Diagnosis of Intracranial Masses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Fabrice Bonneville, H. Rolf Jäger, and James G. Smirniotopoulos
9 Toxic and Metabolic Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Soe Van Cauter and Marco Essig
10 Imaging the Patient with Epilepsy or Seizures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Núria Bargalló and Timo Krings
11 Found Down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Christopher P. Hess and James G. Smirniotopoulos
12 Evaluation of Patients with Cranial Nerve Disorders . . . . . . . . . . . . . . . . . . . . . . . 167
Jan W. Casselman, Alexandre Krainik, and Ian Macdonald
Part II Brain and Spine
13 Demyelinating Diseases of the CNS (Brain and Spine) . . . . . . . . . . . . . . . . . . . . . .189
Frederik Barkhof and Kelly K. Koeller
v
vi
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Part III Pediatric and Fetal
14 Child with Acute Neurological Emergency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Livja Mertiri, Andrea Rossi, Laura M. Huisman,
and Thierry A. G. M. Huisman
Part IV Head and Neck
15 Evaluation of Tinnitus and Hearing Loss in the Adult . . . . . . . . . . . . . . . . . . . . . . 227
Graham C. Keir, Jenny K. Hoang, and C. Douglas Phillips
16 Approach to Masses in Head and Neck Spaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Brianna E. Damadian, Patricia A. Rhyner, and Deborah R. Shatzkes
17 Head and Neck Squamous Cell Cancer: Approach to Staging
and Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Heejun (Tony) Kang, Tabassum A. Kennedy, and Eugene Yu
Part V Spine, Spinal Cord, Plexus and Nerves
18 Evaluation of Myelopathy and Radiculopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Lubdha M. Shah and Jeffrey S. Ross
Contents
19 Spinal Trauma and Spinal Cord Injury (SCI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Luc van den Hauwe and Adam E. Flanders
20 Masses in and Around the Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295
Jan E. Vandevenne and Adrian Kastler
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Part I
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Brain/Skull Base/Head
Diseases oftheSella Turcica
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andParasellar Region
W.Kucharczyk andL.A.Loevner
1
Abstract
Knowledge of the anatomy in the regions of the sella turcica, suprasellar cistern, and cavernous sinus paired with
clinical history and presentation is important for accurate
image interpretation. Focused diagnosis of lesions in
these regions requires identifying the anatomic location in
which a lesion arises, evaluation of specic imaging ndings inherent to the lesion as well as in the surrounding
structures, and correlation with clinical presentation
(symptoms and signs).
It is important to determine whether a mass arises in
the sella turcica versus the suprasellar cistern, and whether
it involves both the sella turcica and suprasellar cistern.
Imaging features of a sellar mass that should be
assessed include:
• Arising from or separate from the pituitary gland
• Cystic degeneration
• Size of the sella
• Infundibulum involved
• Stalk deviation
• Relationship to chiasm
• Edema optic pathways, hypothalamus
• Cavernous sinus—internal carotid artery
• Osseous remodeling, destruction
Keywords
Pituitary gland · Pituitary stalk · Sella turcica ·
Suprasellar cistern · Magnetic resonance imaging · CT
imaging · Pituitary adenomas
W. Kucharczyk (*)
Department of Radiology, University of Toronto,
Toronto, ON, Canada
e-mail: w.kucharczyk@utoronto.ca
L. A. Loevner
Neuroradiology Division, Department of Radiology, University of
Pennsylvania, Philadelphia, PA, USA
Learning Objectives
• Review anatomy of the sella turcica and parasellar
regions.
• Illustrate distinguishing imaging ndings of the
most common lesions arising from the sellar and
parasellar regions.
• Use imaging ndings in conjunction with clinical
signs and symptoms to develop a concise differential diagnosis and the “single best” diagnosis.
Key Points
• Knowledge of the anatomy of the pituitary gland,
pituitary stalk, cavernous sinus, suprasellar cistern,
optic chiasm, and arteries of the central skull base is
essential for accurate diagnosis.
1.1 Introduction
A spectrum of pathology affects the pituitary gland/sella
turcica and the surrounding regions. The most common
abnormality is a pituitary adenoma, followed by Rathke
cleft cyst and meningioma. Magnetic resonance imaging
(MRI) is the imaging modality of choice in the evaluation
of sellar and parasellar pathology. Patients are referred for
MRI most often on the basis of clinical and laboratory
ndings; however, it is also common to discover lesions in
these regions as incidental ndings on imaging of the
brain performed for other indications. Computed tomography (CT) may be used to supplement MRI ndings such
as to evaluate for intra- lesional calcications or changes
in adjacent bones (remodeling, destruction, or
hyperostosis).
© The Author(s) 2024
J. Hodler et al. (eds.), Diseases of the Brain, Head and Neck, Spine 2024-2027, IDKD Springer Series,
https://doi.org/10.1007/978-3-031-50675-8_1
3
4
ab
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W. Kucharczyk and L. A. Loevner
1.2 Imaging Appearance oftheNormal
Pituitary Gland
The anterior lobe of the pituitary gland is isointense to brain
on T1W and T2W imaging and demonstrates homogeneous
Fig. 1.1 Normal pituitary
gland unenhanced
T1-weighted MR (a).
Contrast-enhanced
T1-weighted MR (b)
enhancement following contrast administration (Fig. 1.1a,
b). The posterior lobe of the pituitary gland is often hyperin-
tense on T1-weighted imaging and positioned slightly behind
the adenohypophysis, often within a cup-shaped depression
of the dorsum sellae (Fig.1.1a).
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