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A 30‐year‐old man presented with minute‐long episodes of vertigo and severe autophony. CVEMP showed a decreased threshold when testing the left side, potentially indicating SSCD. A subsequent MRI demonstrated a multi‐lobulated, cystic mass in the temporal bone and the radiological diagnosis at that time was ELST. Tumor excision was performed, and microscopic examination of the excised material revealed fibrovascular tissue without signs of papillary or cystic projections. The conclusion of the histological assessment rendered a diagnosis of angiofibroma. We were unable to find a previous report of ENA originating around the endolymphatic sac. Laryngoscope, 134:1897–1900, 2024 [ABSTRACT FROM AUTHOR]

Aim: The criteria for diagnosing abusive head trauma (AHT) are not well defined and this condition might be diagnosed on failing premises. Our aim was to review criminal AHT cases in Norwegian courts by scrutinising the underlying medical documentation. Methods: Cases were identified in the data registry for Norwegian courts from 2004 to 2015. Documentation was obtained from relevant health institutions. The medical co‐authors first made independent evaluations of the documentation for each child, followed by a consensus evaluation. Results: A total of 17 children (11 boys) were identified, all diagnosed as AHT by court appointed experts, 15 were infants (mean age 2.6 months). A high proportion (41.2%) was born to immigrant parents and 31.3% were premature. The medical findings could be explained by alternative diagnoses in 16 of the 17 children; 8 boys (7 infants – mean age 2.9 months) had clinical and radiological characteristics compatible with external hydrocephalus complicated by chronic subdural haematoma. Six children (five infants with mean age 2.1 months) had a female preponderance and findings compatible with hypoxic ischaemic insults. Conclusion: The medical condition in most children had not necessarily been caused by shaking or direct impact, as was originally concluded by the court experts. [ABSTRACT FROM AUTHOR]

Two days after admission, a magnetic resonance imaging (MRI) scan confirmed chronic SDH and showed radiological characteristics of BEH (Figure 1C), which, however, were not noticed or described. Abbreviations AHT abusive head trauma BEH benign external hydrocephalus HC head circumference SDH subdural haematoma Benign external hydrocephalus (BEH) is a subtype of hydrocephalus. [Extracted from the article]

IgG4‐related hypophysitis (IgG4‐RH) is increasingly being reported as an isolated entity or, less frequently, as a manifestation of a multiorgan IgG4‐related disease (IgG4‐RD), in which typical histopathology is a cornerstone for the diagnosis. We aimed to describe the histopathological changes in the surgical specimens from patients with clinical signs of pituitary disease that fulfilled the current diagnostic criteria for IgG4‐RH. Histopathological features were correlated with clinical and radiological findings. Of 19 patients with pituitary dysfunction and inflammatory changes in the surgical pituitary specimen operated on during 2011‐2019, we identified five patients with typical IgG4‐related pathology (lymphoplasmacytic infiltration with more than 10 IgG4‐positive plasma cells per one high power microscopic field, representing at least 40% of all plasma cells and at least focal storiform fibrosis). One patient with diabetes insipidus and pachymeningitis with IgG4‐related changes in a biopsy from the dura was also included. Additional histopathological changes that typically are not part of the IgG4‐RH were observed: Rathke's cleft cyst in four and granulomatous changes in two patients. One patient had an elevated serum IgG4 level and systemic manifestations that could be associated with the systemic IgG4‐RD. Our findings indicate that pure IgG4‐RH is uncommon. All patients with pituitary dysfunction, beyond typical IgG4‐related pathology, had other pathological findings that could trigger the secondary IgG4‐response. Both primary pathology and secondary IgG4‐related features should be reported in patients with pituitary dysfunction because their co‐occurrence may cause atypical clinical and imaging features, and unexpected response to surgical and pharmacological treatment. The current criteria for the diagnosis of IgG4‐RH can lead to overdiagnosis of IgG4‐RH if additional pathological changes are not taken into consideration. The classification criteria of IgG4‐RD proposed by the American College of Rheumatology/European League Against Rheumatism could help classify patients more properly as IgG4‐RH if applied to the pituitary gland. [ABSTRACT FROM AUTHOR]

Introduction: Our aim was to investigate the accuracy of postmortem fetal magnetic resonance imaging (MRI) compared with fetal autopsy in second trimester pregnancies terminated due to fetal anomalies. A secondary aim was to compare the MRI evaluations of two senior radiologists.Material and Methods: This was a prospective study including 34 fetuses from pregnancies terminated in the second trimester due to fetal anomalies. All women accepted a postmortem MRI and an autopsy of the fetus. Two senior radiologists performed independent evaluations of the MRI images. A senior pathologist performed the fetal autopsies. The degree of concordance between the MRI evaluations and the autopsy reports was estimated as well as the consensus between the radiologists.Results: Thirty-four fetuses were evaluated. Sixteen cases were associated with the central nervous system (CNS), five were musculoskeletal, one cardiovascular, one was associated with the urinary tract, and 11 cases had miscellaneous anomalies such as chromosomal aberrations, infections and syndromes. In the 16 cases related to the CNS, both radiologists reported all or some, including the most clinically significant anomalies in 15 (94%; CI 70%-100%) cases. In the 18 non-CNS cases, both radiologists reported all or some, including the most clinically significant anomalies in six (33%; CI 5%-85%) cases. In 21 cases (62%; CI 44%-78%), both radiologists held opinions that were consistent with the autopsy reports. The degree of agreement between the radiologists was high, with a Cohen's Kappa of 0.87.Conclusions: Postmortem fetal MRI can replace autopsy for second trimester fetuses with CNS anomalies. For non-CNS anomalies, the concordance is lower but postmortem MRI can still be of value when autopsy is not an option. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral complications are the main reasons for morbidity and mortality in preeclampsia and eclampsia. As yet, we do not know whether the pathophysiology entails hypo- or hyperperfusion of the brain, or how and when edema emerges, due to the difficulty of examining the cerebral circulation.Material and Methods: We have used a non-invasive diffusion weighted-magnetic resonance imaging technique, intravoxel incoherent motion, to study cerebral perfusion on the capillary level and cerebral edema in women with preeclampsia (n = 30), normal pregnancy (n = 32), and non-pregnant women (n = 16). Estimates of cerebral blood volume, blood flow, and edema were measured in 5 different regions. These points were chosen to represent blood supply areas of both the carotid and vertebrobasilar arteries, and to include both white and gray matter.Results: Except for the caudate nucleus, we did not detect any differences in cerebral perfusion measures on a group level. In the caudate nucleus, we found lower cerebral blood volume and lower blood flow in preeclampsia than in either normal pregnancy (P = .01 and P = .03, respectively) or non-pregnant women (both P = .02). No differences in edema were detected between study groups.Conclusion: The cerebral perfusion measures were comparable between the study groups, except for a portion of the basal ganglia where hypoperfusion was detected in preeclampsia but not in normal pregnancy or non-pregnant women. [ABSTRACT FROM AUTHOR]

Re-evaluation of medical findings in alleged shaken baby syndrome and abusive head trauma in Norwegian courts fails to support abuse diagnoses. In case number 6, we described clavicle and rib fractures, but unfortunately, we did not report that there was also a scapula fracture. Corrigendum to the paper 'Re-evaluation of medical findings in alleged shaken baby syndrome and abusive head trauma in Norwegian courts fails to support abuse diagnoses'. [Extracted from the article]

Premenstrual dysphoric disorder (PMDD) is the prototypical sex-specific disorder in which symptom onset and offset require a particular hormonal milieu and for which there is moderate heritability. The present study investigated brain emotion processing in PMDD and healthy controls, as well as functional polymorphisms in two candidate genes for PMDD, the serotonin transporter ( 5-HTT) and brain derived neurotrophic factor ( BDNF). The 5-HTT linked polymorphic region (5-HTTLPR) and BDNF Val66Met polymorphisms were genotyped in 31 patients with PMDD and 31 healthy controls. A subset of 16 patients and 15 controls participated in two functional magnetic resonance imaging-sessions performing an emotion processing task; once in the mid-follicular, and once in the late luteal phase which corresponds with maximum severity of mood symptoms. Genotypes were not directly associated with PMDD. A main effect of group was found in the whole brain analysis, with patients having lower activation of the pre-genual anterior cingulate and ventro-medial prefrontal cortex, independent of menstrual cycle phase. Post-hoc functional ROI analyses in the fronto-cingulate cluster showed no effect of 5-HTTLPR genotype but a genotype-by-group-by-phase interaction effect of BDNF Val66Met. Women with PMDD who were carriers of the Met-allele had lower fronto-cingulate cortex activation in the luteal phase compared to Met-allele carrying controls. The results provide suggestive evidence of impaired emotion-induced fronto-cingulate cortex activation in PMDD patients. Although limited by a small sample, the potential influence of BDNF Val66Met in PMDD is in line with preclinical findings. Hum Brain Mapp 35:4450-4458, 2014. © 2014 The Authors. Human Brain Mapping Published by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the additional information of second trimester magnetic resonance imaging (MRI) compared with ultrasound in fetuses with identified or suspected non-CNS anomalies and to study the clinical impact of the MRI information on pregnancy management. Design. Prospective study during 2003-2007. The fetal MRI examination was planned to be performed within 3 days after the ultrasound. Setting. Uppsala University hospital. Sample. Sixty-three women in whom the second trimester ultrasound identified or raised suspicion of fetal anomalies were included. Methods. Ultrasound was compared to MRI in relation to the final diagnosis, which was based on the assessment of all available data, including postpartum clinical follow-up and autopsy results. Main Outcome Measures. Evaluation of the additional information gained from MRI and the consequences it had on pregnancy management. Results. The mean interval between ultrasound and MRI was 2.6 days (range 0-15 days). In 42 (67%) women MRI was performed within 3 days. All MRI examinations were assessable. In 43 (68%) fetuses MRI provided no additional information, in 17 (27%) MRI added information without changing the management and in three (5%) MRI provided additional information which changed the management. All these three cases had oligohydramnios. In all six cases of diaphragmatic hernia MRI provided additional information. Conclusions. Fetal MRI of non-CNS anomalies in the second trimester seems to be a valuable adjunct to ultrasound diagnosis of non-CNS anomalies, especially in cases of oligohydramnios and diaphragmatic hernia. [ABSTRACT FROM AUTHOR]

Objectives. To evaluate the additional information of second trimester magnetic resonance imaging (MRI) compared to ultrasound in fetuses with identified or suspected central nervous system (CNS) anomalies and to study the clinical impact of the information on pregnancy management. Design. Prospective study during 2004-2007. The fetal MRI examination was planned to be performed within 3 days after the ultrasound. Setting. Uppsala University hospital. Material. Twenty-nine pregnant women in whom second trimester ultrasound identified or suspected fetal CNS anomalies. Main outcome measures. Evaluation of the additional information gained from MRI and the consequence it had on pregnancy management. Results. The mean interval between ultrasound and MRI was 1.6 days (range 0-7). In 16 fetuses (55%), MRI verified the ultrasound diagnosis but provided no additional information, while in 10 (35%) MRI gave additional information without changing the management. In 3 (10%), MRI provided additional information that changed the management of the pregnancy. Two of these women were obese. Conclusions. Fetal MRI in the second trimester might be a clinically valuable adjunct to ultrasound for the evaluation of CNS anomalies, especially when ultrasound is inconclusive due to maternal obesity. [ABSTRACT FROM AUTHOR]

Purpose: To process single voxel spectra of low- and high-grade gliomas. To propose correlation analysis of the scatter plots of normalized spectral amplitudes as a pattern recognition tool for the classification (grading) of brain tumors. To propose a spectrum processing approach that improves the differentiation of proton spectra with dominating macromolecule and lipid peaks. Materials and Methods: LCModel was used to process spectra. Mean metabolite concentrations and mean normalized spectra were obtained for normal white matter and for gliomas. The mean spectra of macromolecules and lipids (ML) in the range 1.4-0.9 ppm, and mean difference spectra (DS) without ML and lactate were computed. Correlation analysis of the scatter plot of the patient and mean normalized spectral amplitudes and dispersion of the scatter plot points were used for classification and grading of tumors. Results: It was found advantageous to perform the classifications using DS spectra. The shape of ML spectrum and concentration of tCr seem to be a good markers for glioma grade. Conclusion: Combining a qualitative comparison of the patient and mean DS spectra of the tumors using correlation analysis of normalized spectra amplitudes with a quantitative comparison of metabolite concentrations is a powerful tool in studying brain lesions. J. Magn. Reson. Imaging 2010;31:39-45. © 2009 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]