Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

2,042 results found
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Tumour pseudoresponse

Tumour pseudoresponse, also known just as pseudoresponse, refers to the phenomenon of tumours appearing to respond to a specific treatment on imaging criteria, when the lesion actually remains stable or has even progressed. The term is largely used in brain tumours imaging follow-up, especially...
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Tumours of the meninges (differential)

Tumours of the meninges are a heterogeneous group of lesions which usually occur as extra-axial masses.  Although a large number of lesions that can involve meninges are scattered throughout the  WHO classification of CNS tumours, the main entities to be considered include:  meningioma and nume...
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Tumour-to-tumour metastasis

A tumour-to-tumour metastasis, also known as a collision tumour, is a rare metastatic process in which a primary malignant tumour ('donor') metastasises to another tumour ('recipient'), most commonly a benign tumour such as a meningioma. Epidemiology Tumour-to-tumour metastasis is considered v...
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Turcot syndrome

Turcot syndrome is one of the variations in polyposis syndromes. Epidemiology Patients typically present in the second decade 3. Pathology Turcot syndrome  is characterised by: intestinal polyposis CNS tumours: most commonly glioblastoma or medulloblastoma Genetics It is thought to carry...
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Tympanic membrane retraction

Tympanic membrane retraction usually occurs when a portion of the tympanic membrane becomes weakened and is pulled inwards by the negative pressure within the middle ear.  Pathology As the tympanic membrane is pulled inwards (medially), it can become draped over the ossicles, resulting in a va...
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Ulegyria

Ulegyria refers to a shrunken and flattened cortex usually due to global hypoxic ischaemic injury in term infants, centering on the deepest portion of gyri, usually in the parasagittal region. It is here that perfusion is most tenuous and, therefore, most susceptible to ischaemic damage. Clinic...
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Uncal herniation

Uncal herniation is a subtype of transtentorial downward brain herniation, usually related to cerebral mass effect increasing the intracranial pressure. Clinical presentation Abnormal posture and poor GCS. There may be pupillary dilation and loss of light reflex due to direct compression of th...
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Unclassified cerebellar dysplasia

Unclassified cerebellar dysplasia is defined as focal or diffuse dysplasia of cerebellar hemispheres or vermis not associated with other known malformations or syndromes. Clinical presentation Can present with hypotonia, microcephaly or speech delay. Radiographic features MRI brain asymmetr...
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Uncus

The uncus is the innermost part of the anterior parahippocampal gyrus, part of mesial temporal lobe.  Gross anatomy The uncus is the most anterior portion of the medial parahippocampal gyrus. It belongs to the limbic system. Housing the primary olfactory cortex, it is part of the olfactory sys...
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Unverricht-Lundborg disease

Unverricht-Lundborg disease (ULD or EPM1) inherited neurodegenerative disorder which often results in myoclonic epilepsy. Epidemiology It is considered the most common single cause of progressive myoclonus epilepsy worldwide.   Pathology Genetics It carries an autosomal recessive inheritanc...
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Upper T sign

The upper T sign is one of the features useful in identifying the central sulcus on cross-sectional imaging. It relies on identifying the superior frontal sulcus which intersects the precentral sulcus in a "T" junction, thus defining the precentral gyrus. The central sulcus is the next posterio...
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Uraemic encephalopathy

Uraemic encephalopathy (UE) is an acquired toxic syndrome characterised by delirium in patients with untreated or inadequately treated end-stage renal disease. UE is often associated with lethargy and confusion in the acute phase, which can progress to seizures, coma, or both in the chronic phas...
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Urbach-Wiethe disease

Urbach-Wiethe disease, also known as lipoid proteinosis or hyalinosis cutis et mucosae, is a rare autosomal recessive genodermatosis that primarily affects the skin, upper respiratory tract, and central nervous system (CNS). Epidemiology Urbach-Wiethe disease is a very rare condition, with few...
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US carotids (summary)

US carotids is a standard test performed in the assessment of cranial arterial blood supply. Reference article This is a summary article; we do not have a more in-depth reference article. Summary indications (acute) assessment of carotid stenosis TIA/stroke important pathology carotid st...
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U sign (central sulcus)

The U sign denotes the characteristic "U" shaped appearance of the subcentral gyrus which surrounds the inferolateral end of the central sulcus and abuts the lateral (Sylvian) fissure. It has been found, at least in one study, to be the most reliable anatomical feature to identify the central su...
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Vagoglossopharyngeal neuralgia

Vagoglossopharyngeal neuralgia is an uncommon presentation of glossopharyngeal neuralgia where the typical symptoms of pain are associated with cardiac symptoms including arrhythmias, asystole, and syncope. It is believed to be due to complex interconnections between the nervus intermedius, the...
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Vagus nerve

The vagus nerve is the tenth cranial nerve and provides the bulk of the parasympathetic input to the gastrointestinal system and to the heart. It is a complex mixed sensory, motor and parasympathetic nerve.  Gross anatomy Central connections The vagus nerve arises as multiple rootlets at the ...
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Vanishing white matter disease

Vanishing white matter disease (VWM), also known as childhood ataxia with central hypomyelination (CACH), is an exceedingly rare entity only fully described in 1997, but due to its name sometimes over-represented in differentials for white matter disease. Epidemiology Most cases are encountere...
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Variably protease sensitive prionopathy

Variably protease sensitive prionopathy (VPSPr) is a very rare type of sporadic human prion disease that was first described in 2008. Clinical presentation Clinical presentation is varied, but most patients demonstrate a combination of: progressive neuropsychiatric features: dementia and psyc...
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Varicella zoster virus encephalitis

Varicella zoster virus (VZV) encephalitis can be due to either an immune reaction to primary infection or reactivation of latent infection in cranial nerve or dorsal root ganglia following childhood chickenpox.  Manifestations following primary infection include:  cerebellar ataxia meningoenc...
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VASARI MRI feature set

The VASARI (Visually AcceSAble Rembrandt Images) MRI feature set is a system designed to enable consistent description of gliomas using a set of defined visual features and controlled vocabulary. It is the result of work by The Cancer Imaging Archive (TCIA) who publish relevant guides to use, an...
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Vascular dementia

Vascular dementia, also known as vascular cognitive impairment, is the second most common cause of dementia after the far more common Alzheimer's disease. It is primarily seen in patients with atherosclerosis and chronic hypertension and results from the accumulation of multiple white matter or ...
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Vasculopathies caused by varicella zoster virus

Vasculopathies caused by varicella zoster virus (VZV) represent a group of illness involving both small and large CNS arteries caused by a inflammatory process involving the media and the vascular endothelium, usually in immunocompromised individuals due the viral reactivation and spread thought...
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Vasogenic cerebral oedema

Vasogenic cerebral oedema refers to a type of cerebral oedema in which the blood brain barrier (BBB) is disrupted (cf. cytotoxic cerebral oedema, where the BBB is intact). It is an extracellular oedema which mainly affects the white matter via leakage of fluid from capillaries. It is most frequ...
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Vein of Galen

The vein of Galen, also known as the great cerebral vein or great vein of Galen, is a short trunk formed by the union of the two internal cerebral veins and basal veins of Rosenthal. It lies in the quadrigeminal cistern. It curves backward and upward around the posterior border of the splenium o...
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Vein of Galen aneurysmal malformation

Vein of Galen aneurysmal malformations (VGAMs), probably better termed as median prosencephalic arteriovenous fistulas, are uncommon intracranial anomalies that tend to present dramatically during early childhood with features of a left-to-right shunt and high-output cardiac failure. Epidemiolo...
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Vein of Labbé

The vein of Labbé, also known as inferior anastomotic vein, is part of the superficial venous system of the brain.  The vein of Labbé is the largest channel that crosses the temporal lobe between the Sylvian fissure and the transverse sinus and connects the superficial middle cerebral vein to t...
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Velum interpositum

The velum interpositum is a small membrane containing a potential space just above and anterior to the pineal gland which can become enlarged to form a cavum velum interpositum.  Gross anatomy The velum interpositum is formed by an invagination of pia mater forming a triangular membrane the ap...
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Venous distension sign

The venous distension sign is a finding that may be identified on sagittal imaging of the dural venous sinuses which is said to have a diagnostic sensitivity and specificity of 94% for intracranial hypotension. The sign is positive when there is a convex inferior margin of the midportion of the ...
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Venous vascular malformation of the facial nerve

Venous vascular malformations of the facial nerve, previously known as facial nerve haemangiomas, are rare benign vascular malformations of the facial nerve usually presenting as a facial nerve palsy, which can be rapid onset mimicking a Bell palsy.  Terminology As they do not appear to have c...
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Ventral cord herniation

Ventral cord herniation, also known by a variety of other terms such as spontaneous thoracic cord herniation or idiopathic spinal cord herniation, is a rare cause of focal myelopathy due to herniation of the thoracic cord through a dural defect.  Post surgical cord herniation can occur at any l...
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Ventral horn

The ventral horn of the spinal cord is one of the grey longitudinal columns found within the spinal cord. It contains the cell bodies of the lower motor neurones which have axons leaving via the ventral spinal roots on their way to innervate muscle fibres. Gross anatomy On transverse section o...
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Ventricular system

The ventricular system in the brain is composed of CSF-filled ventricles and their connecting foraminae. CSF is produced by ependymal cells which line the ventricles. They are continuous with the central spinal canal. Ventricles contain around 1/5 of normal adult CSF volume, which is around 20-2...
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Ventriculitis

Ventriculitis refers to inflammation, usually due to infection, of the ependymal lining of the cerebral ventricles. It is most often due to intraventricular rupture of brain abscess. Epidemiology Its epidemiology is varied and depends on the underlying cause.  meningitis (both pyogenic and vi...
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Ventriculoatrial shunt

Ventriculoatrial shunting is an alternative option for the diversion of CSF and relief of hydrocephalus. In this technique, the distal catheter is placed in the right atrium or even in the superior vena cava 1-2.  It is not the only alternative for the traditional ventriculoperitoneal shunt, an...
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Ventriculogallbladder shunt

Ventriculogallbladder shunts are a rare form of cerebrospinal fluid diversion, used when a ventriculoperitoneal shunt is not possible (e.g. intra-abdominal adhesions, peritonitis). Differential diagnosis a ventriculoperitoneal shunt in a right upper quadrant CSFoma
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Ventriculomegaly

Ventriculomegaly is defined as enlargement of the ventricles. Simply, there are two causes: hydrocephalus communicating non-communicating parenchymal atrophy Refer to the article on hydrocephalus vs. atrophy for more details on how to differentiate both entities. 
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Ventriculoperitoneal shunt

Ventriculoperitoneal (VP) shunts are a device used in the treatment of non-obstructive hydrocephalus. As the name suggests, a catheter is placed in the ventricle, and another catheter travels under the skin to opens into the peritoneal cavity, both the catheters being connected to each other th...
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Ventriculopleural shunt

Ventriculopleural shunting is an alternative option for the diversion of CSF and relief of hydrocephalus. In this technique, the distal catheter is placed in the pleural space. It is an alternative to a ventriculoperitoneal shunt (often considered a next most used alternative). Complications s...
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Ventriculus terminalis

The ventriculus terminalis, also known as the 5th ventricle, is an ependymal-lined, anatomical remnant, positioned at the transition from the tip of the conus medullaris to the origin of the filum terminale.  It represents the canalization and retrogressive differentiation of the caudal end of ...
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Venus necklace

A venus necklace is a term almost never used, but for the sake of completeness is included here. It is used by some authors 1 to describe a series of T2 hyperintense lesions on the inferior surface of the corpus callosum in the midline (callososeptal interface), most frequently seen in multiple ...
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Vermian lobulation

Evaluation of vermian lobulation is essential in assessment of the vermian maturity. MRI is a useful tool in assessment of the fetal posterior fossa. Normal Vermian lobulation by weeks 1: By 21 weeks - Prepyramidal fissure can be seen between the tuber and pyramis. 21 to 22 weeks - Preculmina...
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Vermian maturity assessment (approach)

Radiological evaluation of the posterior fossa is an essential part of the routine fetal assessment, including vermian maturity assessment. Radiographic features Ultrasonography is a readily available diagnostic tool in the assessment of the fetal posterior fossa but is sometimes limited due t...
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Vermis

Gross anatomy The vermis (pl vermes) of the cerebellum is an unpaired medial structure which separates the cerebellar hemispheres. The neocerebellar posterior lobes join in the midline behind the primary fissure to separate the vermis into superior and inferior portions. The vermis can be furth...
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Verocay bodies

Verocay bodies are a histological feature of schwannomas and represent a particular growth pattern of Antoni type A pattern in which tumour cells form alternating parallel rows of nuclear palisades separated by regions of acellularity 1. 
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Vertebral artery dissection

Vertebral artery dissection, like arterial dissection elsewhere, is a result of blood entering the media through a tear in the intima. It is potentially lethal and can be difficult to diagnose clinically and radiologically. Epidemiology Vertebral artery dissections have an incidence of 1-5 per...
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Vertebral artery thrombosis

Vertebral artery thrombosis results in complete or partial occlusion of the vertebral artery and alteration of blood flow to the posterior cerebral circulation. Ischaemia or infarction to structures supplied by these arteries may result in a range of symptoms. brainstem cerebellum occipital l...
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Vertebral scalloping

Vertebral scalloping is a concavity to the posterior (or less commonly anterior) aspect of the vertebral body when viewed in a lateral projection. A small amount of concavity is normal, as is concavity of the anterior vertebral body (see vertebral body squaring). Posterior scalloping Causes of...
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Vidian nerve

Vidian nerve, also known as the nerve of the pterygoid canal or nerve of the Vidian canal, is so named because of the canal in which is travels: the Vidian canal. It is formed by the confluence of two nerves: greater superfical petrosal nerve (from the geniculate ganglion of the facial nerve) ...
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Viking helmet appearance

The viking helmet appearance refers to the lateral ventricles in coronal projection in patients with dysgenesis of the corpus callosum. The cingulate gyrus is everted into narrowed and elongated frontal horns.  An alternative name is moose head appearance. 
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Viral encephalitides

Viral encephalitides are the result of the brain parenchyma infection by a number of different viruses, many of which have similar presentations and imaging features. Specific diagnosis often requires PCR.  For viral infection of the meninges, please refer to the general article on viral mening...
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Viral meningitis

Viral meningitides correspond to a relatively common and self-limited type of CNS infection clinically diagnosed based on the cerebrospinal fluid analysis and proportionally more frequent in young children than adults. Enteroviruses represent nowadays the most common cause of viral meningitis fo...
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Visual agnosia

Visual agnosia is a special type of agnosia where patients are unable to recognise objects despite having knowledge about them and being able to visually perceive them. It typically occurs when there is damage to the ventral occipito-temporal pathway, such as in posterior cerebral atrophy (Bens...
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Visual hallucinations

Visual hallucinations are relatively uncommon, and can be due to a variety of 'organic' brain diseases, affecting a variety of regions of the brain.  The use of the term organic here is by convention, and should not be taken to imply absence of brain dysfunction in psychiatric illness Clinic...
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Visual pathway deficits

Visual pathway deficits are determined by the location of the lesion or pathology. Understanding of the visual system is paramount and provided the globe is normal, the field defects can be defined from anterior to posterior as: unilateral central scotoma optic nerve bitemporal hemianopsia o...
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Visual system

The visual system transmits visual information from the retina within the eyes to the primary visual cortex of the occipital lobe as well as the pretectal nuclei and superior colliculi of the midbrain. Gross anatomy Below the visual pathway is described from distal to proximal in a single hemi...
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Vitamin B1

Vitamin B1 (thiamine) is a water soluble vitamin that is an important coenzyme for two reactions in the citric acid cycle (Kreb’s cycle). It therefore is vital for cellular ATP production, particularly in the central nervous system. Related pathology Pathological manifestations only occur with...
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Vitamin B3

Vitamin B3 (niacin or nicotinic acid) is a water soluble vitamin that is an important part of the coenzyme nicotinamide adenine dinucleotide (NAD+) which is involved in many reactions of cellular metabolism. Related pathology Pathological manifestation occur in niacin deficiency known as pella...
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Vitamin B9

Vitamin B9 (folate or folic acid) is a water soluble vitamin that is vital for the synthesis of several amino acids, the purines adenosine and guanine and the pyrimidine thymine (three of the four nucleotide bases and hence critical for the synthesis of nucleic acids.) The antimicrobial group s...
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Voltage gated potassium channel (VGKC) antibody encephalitis

Voltage gated potassium channel (VGKC) antibody encephalitis is an autoimmune encephalitis with antibodies against the voltage gated potassium channel. It is one of the most common forms of autoimmune limbic encephalitis in the absence of primary extra-CNS tumours. Autoimmune VGKC encephalitis c...
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Von Hippel-Lindau disease

Von Hippel-Lindau (vHL) disease is characterised by the development of numerous benign and malignant tumours in different organs (at least 40 types 1) due to mutations in the VHL tumour suppressor gene on chromosome 3. Epidemiology The disease is rare with an estimated prevalence of 1:35,000-5...
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Walker-Warburg syndrome

Walker-Warburg syndrome (WWS), sometimes known as HARDE syndrome, is an extremely rare lethal form of congenital muscular dystrophy. It is primarily characterised by: fetal hydrocephalus: almost always present neuronal migrational anomalies: agyria (cobblestone lissencephaly / lissencephaly ty...
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Wallerian degeneration

Wallerian degeneration (WaD) is the process of antegrade degeneration of the axons and their accompanying myelin sheaths following proximal axonal or neuronal cell body lesions. It may result following neuronal loss due to cerebral infarction, trauma, necrosis, focal demyelination or haemorrhage...
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Wasp-waist sign (spine)

The wasp-waist sign is a radiographic appearance seen in patients with Klippel Feil syndrome. It results from fusion of the vertebral bodies such that the anteroposterior diameter at the level of the affected discovertebral joint is smaller than the diameter at the superior and inferior limits o...
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Watershed cerebral infarction

Watershed cerebral infarctions, also known as border zone infarcts, occur at the border between cerebral vascular territories where the tissue is furthest from arterial supply and thus most vulnerable to reductions in perfusion.  Epidemiology Watershed cerebral infarction account for 5-10% of ...
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Weber syndrome

Weber syndrome is a midbrain stroke syndrome that involves the fascicles of the oculomotor nerve resulting in an ipsilateral CN III palsy and contralateral hemiplegia or hemiparesis 1-3. Using imaging alone, it is difficult to distinguish Weber from Benedikt syndrome, unless clear involvement o...
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Wernicke-Korsakoff syndrome

Wernicke encephalopathy, also referred as Wernicke-Korsakoff syndrome, is due to thiamine (vitamin B1) deficiency, and is typically seen in alcoholics. On imaging, it is commonly seen on MRI as areas of symmetrical increased T2/FLAIR signal involving the mamillary bodies, dorsomedial thalami, t...
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Wernicke's area

Wernicke's area (Brodmann area 22) is an area of the posterior temporal lobe in the dominant hemisphere concerned with the receptive components of speech. Gross anatomy Wernicke's area is located in the superior temporal gyrus, posterior to the posterior commissure line. Relations It is boun...
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WFNS grading system

The WFNS (World Federation of Neurosurgical Societies) grading system uses the Glasgow Coma Scale and presence of focal neurological deficits to grade the severity of subarachnoid haemorrhage. This grading system was proposed in 1988, and this is one of the accepted systems (although not conside...
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Whipple disease (neurological manifestations)

Neurological manifestations of Whipple disease are rare. Whipple's disease can also appear as a primary neurological disorder in rare cases. It is rarely incidentally found as a differential diagnosis in patients with a progressive neurological deficit. It has been suggested that neurological i...
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White cerebellum sign

White cerebellum sign, also called reversal sign or dense cerebellum sign, is encountered when there is a diffuse decrease in density of the supratentorial brain parenchyma, with relatively increased attenuation of the thalami, brainstem and cerebellum. This sign indicates irreversible brain dam...
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White epidermoid cyst

White epidermoids are a rare type of epidermoid cyst that do not follow the usual near-CSF density and signal intensity on CT and MR respectively. To make matters worse the literature uses the term inconsistently, although generally the 'white' refers to the T1 weighted imaging appearance.  Rad...
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White matter buckling sign

The white matter buckling sign is helpful in distinguishing an extra-axial mass from an intra-axial one, and represents the white matter projecting into gyri being compressed and displaced by the mass, even in the presence of oedema (which would usually expand gyri, if the mass were intra-axial)...
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White matter changes in HIV

White matter changes in HIV have overlapping appearances and varied in aetiology. These can be divided into: primary effects of HIV opportunistic infection neoplasms vascular disease metabolic and nutritional disorders Primary effects of HIV HIV encephalitis Opportunistic infection cyto...
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White matter disorders

White matter diseases are a group of conditions that predominantly or significantly affect the white matter of the brain. They comprise a vast heterogeneous group and have a variety of appearances and presentations. They cause disease by altering the process of normal myelination.  Useful group...
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White matter tracts

White matter tracts, also known as white matter fibres, are classified into three categories: Projection tracts tracts connecting the cortex with other area in the CNS, e.g. deep nuclei, brainstem, cerebellum or spine may be efferent (motor) or afferent tracts (sensory) white matter tracts t...
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White matter tracts of the spinal cord

The spinal cord has numeorus white matter tracts that ascend and descend in the peripheral substance of the cord. They can be divided by their location and function: anterolateral columns anterior corticospinal tract medial longitudinal fasiculus spinothalamic tracts lateral spinothalamic t...
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WHO classification of CNS tumours

The WHO classification of CNS tumours is the most widely accepted system for classifying CNS tumours and was based on the histological characteristics of the tumour. Although the most recent version of the 'blue book' is the 4th edition from 2007, an update has been released in 2016 3, which sho...
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WHO grading of CNS tumours

WHO (World Health Organisation) grading of CNS tumours is based on histological characteristics such as cellularity, mitotic activity, pleomorphism, necrosis, and endothelial proliferation (neoangiogenesis). It is used in the WHO classification of CNS tumours.  It should be noted that at the ti...
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WHO grading system for diffuse astrocytomas

 The WHO grading system is the most widely used system for grading diffuse astrocytomas (at the time of writing i.e. mid 2016), and is an adaptation of the now superseded  St Anne-Mayo grading system (also known as the Daumas-Duport grading system).  Grade I is reserved for localised astrocytom...
Article

Wildervanck syndrome

Wildervanck syndrome, also known as cervico-ocular-acoustic dysplasia, consists of the triad of: Klippel-Feil syndrome congenital ossicular anomalies: usually diffuse ossicular ankylosis and sensorineural deafness. Duane syndrome: an ocular motility disturbance due to fibrosis of the extraocu...
Article

Wilson disease

Wilson disease, also known as hepatolenticular degeneration, is a rare autosomal recessive disorder of copper metabolism affecting multiple systems.  Epidemiology Wilson disease is commonly found in Japan. It affects 1 in 30,000-40,000 individuals 12. Clinical presentation Clinical presentat...
Article

Wilson disease (CNS manifestations)

Wilson disease, also known as hepatolenticular degeneration, is a multisystem disease due to abnormal accumulation of copper. It is characterised by early onset liver cirrhosis with CNS findings most frequently affecting the basal ganglia and midbrain. This article aims to discuss the central n...
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Xanthomatous meningioma

Xanthomatous meningiomas are rare histological variants of meningiomas grouped into the subtype of metaplastic meningiomas, being WHO grade I tumours. They are characterised by cells with a lipid-filled vacuolated cytoplasm. Although reported numbers are too small to confirm that this is defini...
Article

Yasargil classification of vein of Galen aneurysmal malformations

The Yasargil classification is one of the two common systems for classifying vein of Galen malformations that is currently in use at the time of writing (mid 2016).  Classification type I: small pure cisternal fistula between the vein of Galen (voG) and either the pericallosal arteries (anteri...
Article

Y sign (epidural lipomatosis)

The Y sign refers to a common appearance in lumbar epidural lipomatosis where excess fat in the extradural space compresses the dural sac into the shape of the letter "Y". 
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Zabramski classification of cerebral cavernous malformations

The Zabramski classification of cerebral cavernomas has been proposed as a way of classifying cerebral cavernous malformations, and although not used in clinical practice it is useful in scientific publications that seek to study cavernous malformations. The classification was proposed in 1994 ...
Article

Zebra sign (cerebellum)

The zebra sign has been termed to describe the finding of layering of blood in amongst the folia of the cerebellum, particularly in the setting of remote cerebellar haemorrhage.1 This type of haemorrhage is characterised by a streaky pattern, like a zebra's stripes, due to blood spreading in th...
Article

Zellweger syndrome

Zellweger syndrome (ZS), also known as the cerebrohepatorenal syndrome, is a multisystem metabolic abnormality. As the name implies it primarily affects the central nervous system (CNS), liver and kidneys.  Epidemiology The condition typically presents in neonates with poor feeding and/or seiz...

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