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Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
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Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Pre-Course Activities
1 topic, 3 min.
Lesson
Introduction to Stroke Imaging
4 topics, 17 min.
Lesson
Noncontrast CT
5 topics, 14 min.
Lesson
CTA Neck
10 topics, 33 min.
Vascular Imaging in Stroke - CTA vs MRA
2 m.Carotid and Vertebral Vasculopathies Overview & Examples of Atherosclerotic Disease
3 m.Case - Atheromatous Disease with Severe ICA Stenosis
4 m.Carotid & Vertebral Artery Dissection Overview & Examples
3 m.Case - Embolic Stroke with ICA Dissection
5 m.Collagen Vascular Diseases Overview - Examples of FMD, Carotid Web
2 m.Case - Fibromuscular Dysplasia (FMD)
5 m.Case - Ehlers Danlos
7 m.Inflammatory Conditions with Stroke Symptoms - Examples of Takayasu's, TIPIC
4 m.Case - Takayasu’s Arteritis
4 m.Lesson
CTA Head
9 topics, 37 min.
CTA Head in Acute Stroke - Source Images, MIPS, Collaterals
4 m.Case - MCA Stem Embolus with Good Collaterals
5 m.Case - MCA Stem Embolus with Poor Collaterals
4 m.Case - Basilar Tip Thrombus
6 m.Circle of Willis Stenoses: Differential Diagnoses
2 m.Case - Moya Moya disease
6 m.Case - Reversible Cerebral Vasoconstrictive Syndrome (RCVS)
5 m.Case - Primary Angiitis of the CNS (PACNS)
7 m.Infectious Causes of Multifocal Circle of Willis Stenosis
2 m.Lesson
CT Perfusion
3 topics, 15 min.
Lesson
MRI (DWI, FLAIR, SWI) of Acute Stroke
3 topics, 14 min.
Lesson
MRA of Head and Neck
6 topics, 18 min.
Lesson
Multifocal Strokes With No Visualized Vascular Abnormality
6 topics, 26 min.
Lesson
Brain Ischemia, Hypoxia, & Death
6 topics, 16 min.
Lesson
Stroke Mimics & Other Causes of Restricted Diffusion
7 topics, 18 min.
Stroke Mimics - Other Causes of Restricted Diffusion
2 m.Case - Seizure (Stroke Mimic)
4 m.Case - MELAS (Stroke Mimic)
3 m.Case - Hypoglycemia (Stroke Mimic)
3 m.Case - Herpes Virus Encephalitis (Stroke Mimic)
4 m.Case - Osmotic Demyelination Syndrome (Stroke Mimic)
3 m.Case - Brain Metastases (Stroke Mimic)
4 m.Lesson
MR Perfusion
8 topics, 17 min.
MR Perfusion - Data, Maps and Uses
4 m.Case - MR Perfusion Target Mismatch (Good Collaterals)
2 m.Case - MR Perfusion Target Mismatch (Poor Collaterals)
3 m.Case - Ischemia Detected Only on MR Perfusion (Case 1)
2 m.Case - Ischemia Detected Only on MR Perfusion (Case 2)
3 m.Arterial Spin Labelling Perfusion - Usage Examples
3 m.Case - ASL Matched Defect
2 m.Case - ASL Showing Tissue at Risk
2 m.Lesson
Subacute Stroke & Differentials
5 topics, 13 min.
0:00
Hypoglycemia is another stroke mimic.
0:04
Patients with severe hypoglycemia
0:06
get cytotoxic edema,
0:09
and they'll get restricted diffusion,
0:10
especially in the occipital
0:12
lobes and splenium of the corpus callosum.
0:15
But other sites are also seen, hippocampi, basal ganglia,
0:19
deep white matter and occasionally posterior
0:22
fossa structures.
0:23
These are two patients who had profound hypoglycemia
0:26
and had visual disturbance.
0:27
This patient has restricted diffusion in
0:30
the bilateral occipital lobes, as you can see on the DWI
0:33
and ADC maps, and has some mild swelling
0:36
and FLARE hyperintensity.
0:37
But the MRA was normal.
0:40
So with normal vessels profound hypoglycemia,
0:42
this is consistent with profound hypoglycemia.
0:45
Here's another patient
0:46
who also had profound hypoglycemia.
0:49
Posterior temporal and occipital distribution and
0:52
that patient also presented with visual changes.
0:56
These are images of a 45 year old female
1:00
who had type 1 diabetes and was found
1:03
by her husband on the couch unresponsive.
1:07
She had a glucose of less than 40,
1:10
and on further review,
1:13
they thought that the glucose may have been that low
1:15
for approximately six hours.
1:18
These are diffusion and ADC maps
1:21
and you can see there's restricted diffusion in the
1:25
occipital and posterior temporal lobes,
1:29
and it extends up into the parietal lobes,
1:32
and there's also involvement of the bilateral frontal lobes.
1:37
Note there's some sparing of the perirolandic region,
1:41
which would be a little
1:43
unusual for acute hypoxia
1:46
and the patient
1:49
had refractory hypoglycemia.
1:51
They eventually changed it,
1:54
but she had these persistent changes over multiple MRs.
1:59
We can also look at the FLARE images.
2:02
And in those regions of restricted diffusion,
2:05
you can see some mild FLARE hyperintensity, as well.
2:10
Note there's just involvement of cortex,
2:12
a lot of involvement in cortex,
2:15
not much involvement of subcortical white matter
2:17
to be a little unusual for stroke.
Case - Hypoglycemia (Stroke Mimic)
HIDEInteractive Transcript
0:00
Hypoglycemia is another stroke mimic.
0:04
Patients with severe hypoglycemia
0:06
get cytotoxic edema,
0:09
and they'll get restricted diffusion,
0:10
especially in the occipital
0:12
lobes and splenium of the corpus callosum.
0:15
But other sites are also seen, hippocampi, basal ganglia,
0:19
deep white matter and occasionally posterior
0:22
fossa structures.
0:23
These are two patients who had profound hypoglycemia
0:26
and had visual disturbance.
0:27
This patient has restricted diffusion in
0:30
the bilateral occipital lobes, as you can see on the DWI
0:33
and ADC maps, and has some mild swelling
0:36
and FLARE hyperintensity.
0:37
But the MRA was normal.
0:40
So with normal vessels profound hypoglycemia,
0:42
this is consistent with profound hypoglycemia.
0:45
Here's another patient
0:46
who also had profound hypoglycemia.
0:49
Posterior temporal and occipital distribution and
0:52
that patient also presented with visual changes.
0:56
These are images of a 45 year old female
1:00
who had type 1 diabetes and was found
1:03
by her husband on the couch unresponsive.
1:07
She had a glucose of less than 40,
1:10
and on further review,
1:13
they thought that the glucose may have been that low
1:15
for approximately six hours.
1:18
These are diffusion and ADC maps
1:21
and you can see there's restricted diffusion in the
1:25
occipital and posterior temporal lobes,
1:29
and it extends up into the parietal lobes,
1:32
and there's also involvement of the bilateral frontal lobes.
1:37
Note there's some sparing of the perirolandic region,
1:41
which would be a little
1:43
unusual for acute hypoxia
1:46
and the patient
1:49
had refractory hypoglycemia.
1:51
They eventually changed it,
1:54
but she had these persistent changes over multiple MRs.
1:59
We can also look at the FLARE images.
2:02
And in those regions of restricted diffusion,
2:05
you can see some mild FLARE hyperintensity, as well.
2:10
Note there's just involvement of cortex,
2:12
a lot of involvement in cortex,
2:15
not much involvement of subcortical white matter
2:17
to be a little unusual for stroke.
Report
Faculty
Pamela W Schaefer, MD, FACR
Professor of Radiology, Vice Chair of Education
Massachusetts General Hospital
Tags
Vascular Imaging
Neuroradiology
Neuro
Metabolic
MRI
Head and Neck
Brain
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