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Purpose Subdural hemorrhage (SDH), the accumulation of blood between the dura and arachnoid mater, is one of the most commonly encountered traumatic findings in emergency radiology setting. The purpose of this essay is to review the pitfalls in the diagnosis of SDH including a) mimics on CT imaging and b) etiology other than accidental trauma. We describe several entities that closely mimic SDH on non-contrast CT scans. A knowledge of these mimics is essential in the emergency setting since overdiagnosis of SDH can lead to unnecessary hospital admissions, potentially invasive procedures, or even delay in necessary treatment. The mimics of SDH on non-contrast head CT include: PATHOLOGIC ENTITIES 1. Cerebral venous thrombosis 2. Dural based benign masses 3. Dural based malignant neoplasms 4. Epidural hematoma 5. Hemorrhage in arachnoid cyst 6. Intracranial hypotension 7. Subdural hygroma 8. Subdural empyema IATROGENIC MIMICS 1. Enhancement of chronic subdural collection after contrast administration 2. Temporalis muscle entrapment under craniotomy flap ANATOMIC/PHYSIOLOGIC MIMICS 1. Cortical veins 2. Dural calcification/thickening 3. Dural enhancement 4. Hyperdense dural venous sinuses ARTIFACTUAL MIMICS 1. Cerebral edema 2. Streak and motion artifact We also briefly review non-accidental and non-traumatic causes of SDH. Although, the most common cause of SDH is accidental trauma, other routinely encountered causes of SDH include coagulopathy, non-accidental trauma, cranial surgery, vascular malformations etc. Conclusion Clinicians dealing with SDH in the emergency setting should consider SDH mimics and less common etiologies of SDH in order to facilitate appropriate patient management.

Magnetic resonance (MR) imaging of the spine is increasingly being used in the evaluation of spinal emergencies because it is highly sensitive and specific in the diagnosis of acute conditions of the spine. The prompt and accurate recognition allows for appropriate medical and surgical intervention. This article reviews the MR imaging features of common emergent conditions, such as spinal trauma, acute disc herniation, infection, and tumors. In addition, we describe common MR imaging sequences, discuss challenges encountered in emergency imaging of the spine, and illustrate multiple mimics of acute conditions.

The utility of MR imaging in evaluating abdominal and pelvic pain in the pregnant patient is discussed. Details regarding the indications, technical aspects, and imaging findings of various common abdominal and pelvic abnormalities in pregnancy are reviewed.

Purpose To identify MR imaging features of melanoma brain metastases (MBM) that correlate with genetic profile of melanoma and patient survival. Materials and methods Patients with newly diagnosed melanoma metastases were identified from institutional database A retrospective review of brain MRI was performed focusing on lesion number, size, T1-, T2- and diffusion-weighted signal characteristics, hemorrhage, necrosis, enhancement pattern and edema. Genomic (BRAF status), treatment and survival data was collected. Results 98 patients were included in final analysis. A strong correlation was found between size of the largest lesion and the percent of lesions with T1-weighted hyperintense signal (R = 0.49), percent of lesions with size >1 cm (0.55), and the lesions that are clearly hemorrhagic (0.43). The analyzed imaging parameters were found to be independent of BRAF mutation status. The median survival of subjects with single lesion (9.1 months) was significantly higher than the median survival of subjects with more than 1 lesion (4.9 months) (p = 0.002). Patients with 2–18 lesions had significantly longer survival (5.6 months) than with >18 lesions (2 months) (p < 0.001). Other imaging parameters such as lesion size, T1-weighted hyperintensity, number of lesions with edema and hemorrhage were not found to be significantly related to survival. BRAF inhibitor treatment was found to be the most significant prognostic factor (p = 0.002) among patients with multiple lesions. Conclusion There is a statistically significant correlation between number of brain metastases and survival. In patients with multiple lesions, BRAF inhibitor treatment was the most significant prognostic factor.

This article reviews the computed tomography (CT) findings of miscellaneous regional and diffuse small bowel disorders. CT technique and potential pitfalls are discussed. Several categories of regional and diffuse small bowel conditions are reviewed, with representative CT images. These disorders often have relatively nonspecific CT appearances, and correlation with the history, clinical, and laboratory findings in each specific case is critical. In selected conditions, the CT findings are highly specific. The imaging literature of some of the common as well as some of the less common entities is reviewed, and clues to narrowing the differential diagnosis are provided.