Nontraumatic Neuroemergencies - II

  • John R. Hesselink


Several clinical presentations require emergent neuroimaging to determine the cause of the neurological deficit and to institute appropriate therapy. Time is critical because neurons that are lost cannot be replaced. Generally, the clinical symptoms are due to ischemia, compression, or destruction of neural elements. The two primary imaging modalities for the central nervous system (CNS) are computed tomography (CT) and magnetic resonance imaging (MRI). CT is fast and can readily visualize fractures, hemorrhage, and foreign bodies. Otherwise, in patients who can cooperate for the longer imaging study, MRI provides better contrast resolution and has higher specificity for most CNS diseases. The five major categories of nontraumatic neuroemergencies are discussed below.


Herpes Simplex Encephalitis Obstructive Hydrocephalus Epidural Abscess Homonymous Hemianopsia Clinical Magnetic Resonance Imaging 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Levy C, Laissy JP, Raveau V et al (1994) Carotid and vertebral artery dissections: three-dimensional time-of-flight MR angiography and MR imaging versus conventional angiography. Radiology 190:97PubMedGoogle Scholar
  2. 2.
    Lee SK, ter Brugge KG (2003) Cerebral venous thrombosis in adults: the role of imaging evaluation and management. Neuroimag Clin N Am 13:139–152CrossRefGoogle Scholar
  3. 3.
    Chepuri NB, Perl II J, Masaryk TJ, Turski PA (2006) Aneurysms and central nervous system vascular malformations. In: Edelman, Hesselink, Zlatkin, Crues (eds), Clinical magnetic resonance imaging. 3rd edn. Saunders-Elsevier, Philadelphia, pp 1414–1453Google Scholar
  4. 4.
    Noguchi K, Ogawa T, Inugami A et al (1995) Acute subarachnoid hemorrhage: MR imaging with fluid-attenuated inversion recovery pulse sequences. Radiology 196:773–777PubMedGoogle Scholar
  5. 5.
    Kanamalla US, Ibarra RA, Jinkins JR (2000) Imaging of cranial meningitis and ventriculitis, Neuroimaging Clin N Am 10:309–332Google Scholar
  6. 6.
    Karampekios S, Hesselink JR (2006) Infectious and inflammatory diseases. In: Edelman, Hesselink, Zlatkin, Crues (eds) Clinical magnetic resonance imaging. 3rd edn. Saunders-Elsevier, Philadelphia, pp 1248–1286Google Scholar
  7. 7.
    Sämann PG, Schlege J, Müller G et al (2003) Serial proton MR spectroscopy and diffusion imaging findings in HIV-related herpes simplex encephalitis. AJNR Am J Neuroradiol 24:2015–2019PubMedGoogle Scholar
  8. 8.
    Khan SH, Hussain MS, Grieber RW, Hettingh S (2003) Comparison of primary and secondary spinal epidural abscesses: a retrospective analysis of 29 cases. Surg Neurol 59:28–33PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • John R. Hesselink
    • 1
  1. 1.Department of RadiologyUniversity of California, San Diego Medical CenterSan DiegoUSA

Personalised recommendations