Sangam Kanekar

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Samuel LÉZÉ

École Normale Supérieure de Lyon

David Luke

University of Greenwich

Alasdair Pickles

University of Leeds

Natalia Szejko

Yale University

Nelson Mauro Maldonato

Università degli Studi di Napoli "Federico II"

María Cecilia Tomasini

Universidad de Buenos Aires

Jeffrey L Saver

University of California, Los Angeles

Gonzalo Bello

Fundação Oswaldo Cruz

Edward Bormashenko

Ariel University

Khalid Tabbara

King Saud University

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Papers by Sangam Kanekar

Imaging of Non-atherosclerotic Vasculopathies

Journal of Clinical Imaging Science

Non-atherosclerotic vasculopathies (NAVs) may present with various neurological symptoms ranging ... more Non-atherosclerotic vasculopathies (NAVs) may present with various neurological symptoms ranging from headache, stroke, visual symptoms, and various types of intracranial hemorrhage. NAVs result from different etiologies which include collagenopathies, immunological, hematological, and infection mechanisms, and other rarer unidentifiable or idiopathic causes. NAV etiologies account for about 10–15% and 20–25% of adult and pediatric stroke cases, respectively, and therefore, diagnosing the underlying cause of NAV becomes clinically very important. Clinical diagnosis of NAV is challenging because the clinical presentation is very non-specific and overlapping with various other central nervous system disorders. Before the advent of non-invasive techniques, making a diagnosis of non-atherosclerotic vasculopathy as a cause of the stroke was very challenging. Today with newer techniques such as high-resolution magnetic resonance (MR), MR and computed tomography perfusion, and angiogram, t...

Magnetic resonance imaging findings in idiopathic sudden sensorineural hearing loss

Acta Radiologica

Imaging of Submandibular and Sublingual Salivary Glands

Neuroimaging clinics of North America, 2018

The submandibular and sublingual salivary glands are major salivary glands with a wide spectrum o... more The submandibular and sublingual salivary glands are major salivary glands with a wide spectrum of pathologic conditions. The corresponding spaces along the floor of mouth have complex anatomy, best evaluated with cross-sectional imaging. The spectrum of diseases in these regions varies from simple infection to advanced malignancy, not just from the gland itself but also from the surrounding structures. The most common abnormalities in these spaces are inflammatory and infectious, and computed tomography is currently the most common imaging modality used. The anatomy of these spaces is much better depicted with MR; however, all the modalities have their unique roles.

Imaging of Neurologic Conditions in Pregnant Patients

RadioGraphics

A number of physiologic, hormonal, immunologic, and hemodynamic changes take place in the materna... more A number of physiologic, hormonal, immunologic, and hemodynamic changes take place in the maternal body during pregnancy. The majority of these changes are essential for maintaining the normal course of pregnancy. However, these changes may also cause acute or chronic conditions that affect various biologic systems in the mother. In addition, conditions of the central and peripheral nervous systems can cause a variety of neurologic symptoms and complications. Neurologic signs and symptoms in pregnant and postpartum women may be due to the exacerbation of a preexisting medical condition, the initial manifestation of a primary central nervous system-related problem, or a neurologic problem unique to pregnancy and the postpartum period. Because the symptoms of these conditions are either nonspecific or overlapping, it can be challenging to pinpoint the diagnosis clinically. These conditions can be classified into more commonly seen conditions such as headache, venous thrombosis, preeclampsia, subarachnoid hemorrhage, posterior reversible encephalopathy syndrome, and certain pituitary disorders; and less commonly seen entities such as aneurysm, arteriovenous malformation, primary or secondary neoplasm, Sheehan syndrome, and Wernicke encephalopathy. Imaging has an important role in the differentiation and exclusion of various neurologic conditions, and most of the time, imaging findings can point the clinician to a specific diagnosis. The imaging appearances of common and uncommon neurologic conditions that can occur during pregnancy and the early postpartum period are highlighted in this article. ©

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A Retrospective Review of Temporal Bone Imaging With Respect to Bone-Anchored Hearing Aid Placement

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2017

Current bone-anchored hearing aid (BAHA) guidelines recommend placement of the titanium implant 5... more Current bone-anchored hearing aid (BAHA) guidelines recommend placement of the titanium implant 5 to 7 cm posterior to the ear canal. Previous studies show that bone conducted hearing is maximized the closer the transducer is to the cochlea. We aim to investigate the position of the sigmoid sinus with respect to BAHA implants to determine whether they may be safely placed closer to the ear canal in patients with chronic ear disease, enhancing the amplification available to the patient. We performed a retrospective review of high-resolution temporal bone computed tomographies (CTs), comparing multiple measurements between ears with chronic ear disease and normal controls. Images were obtained at a single academic medical center. Eighty patients (160 ears) with temporal bone CTs performed between 2006 and 2009 were measured. Patients with chronic ear disease were identified by international statistical classification of diseases and related health problems, revision 9 code and confirm...

Central Nervous System Complications of Hemorrhagic and Coagulation Disorders

Hematology/Oncology Clinics of North America, 2016

Hematologic disorders affect the central nervous system in a variety of ways, producing a wide ra... more Hematologic disorders affect the central nervous system in a variety of ways, producing a wide range of neurologic disturbances. Early identification of these complications allows for early intervention and better outcome. Cross-sectional imaging plays an important role in identifying brain abnormalities and helps the clinician in deciding appropriate course of action and treatment. This article discuss in short the basics of hemostasis including the coagulation cascade and the application of basic laboratory tests in evaluation of hematologic function. Imaging features of various neurologic disorders associated with these clotting and bleeding diatheses are discussed in detail with illustrations.

Imaging of Neurologic Complications in Hematologic Disorders

Hematology/Oncology Clinics of North America, 2016

Imaging Manifestations of Neurologic Complications in Anemia

Hematology/Oncology Clinics of North America, 2016

The hallmark signs and symptoms of anemia are directly related to a decrease in oxygen delivery t... more The hallmark signs and symptoms of anemia are directly related to a decrease in oxygen delivery to vital tissues and organs and include pallor, fatigue, lightheadedness, and shortness of breath. Neurologic complications are often nonspecific and can include poor concentration, irritability, faintness, tinnitus, and headache. If undiagnosed or untreated, anemia can progress to cognitive dysfunction, psychosis, encephalopathy, myelopathy, peripheral neuropathy, and more focal syndromes, such as stroke, seizures, chorea, and transverse myelitis. Imaging can play an important role in the early diagnosis and treatment of these neurologic and systemic complications associated with anemia, and hence, better outcome.

A Review of Temporal Bone CT Imaging With Respect to Pediatric Bone-anchored Hearing Aid Placement

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, Jan 27, 2016

Bone-anchored hearing aid has been shown to be effective in hearing rehabilitation for conductive... more Bone-anchored hearing aid has been shown to be effective in hearing rehabilitation for conductive loss or single-sided deafness. Current FDA guidelines allow implantation in patients over 5 years old. This guideline is at least partially due to concern for thickness of bone stock at the implant site. We aim to investigate whether temporal bone thickness should be a deterrent to implantation in those younger than five. A retrospective review of high-resolution temporal bone computed tomographies (CTs) comparing measurements between ears with chronic disease and controls. Single institution tertiary care center. One hundred patients between 1 and 5.99 years had temporal bone CTs performed between 2000 and 2009. Patients with chronic ear disease were identified by ICD-9 code, as well as confirmation by review of the imaging. None. Temporal bone thickness was measured on axial CT slices at a point 1 cm posterior to the sigmoid sinus, at the superior margin of the bony canal. Average thi...

Imaging of Multiple Myeloma

Hematology/oncology clinics of North America, Aug 1, 2016

Multiple myeloma is the most common bone malignancy. Imaging plays an important role in identifyi... more Multiple myeloma is the most common bone malignancy. Imaging plays an important role in identifying the extent of the disease, disease process, guiding biopsies, and diagnosing associated spinal and intracranial complications. Multiple myeloma and related plasma cell proliferative disorders have a diverse set of clinicopathologic findings and on neuroimaging present unique and diverse findings from the disease and from complications of the disease and treatment, which are valuable for clinicians and radiologists.

Looks like a Stroke, Acts like a Stroke, but It's More Than a Stroke: A Case of Cerebral Mucormycosis in a Patient with CLL (P06.182)

Neurology, Feb 12, 2013

ABSTRACT Mucormycosis is a fungus that exhibits angiocentric growth and can cause a thrombotic ar... more ABSTRACT Mucormycosis is a fungus that exhibits angiocentric growth and can cause a thrombotic arteritis. Infection with this organism is uncommon and cerebral involvement is most often secondary to direct invasion through the paranasal sinuses. Here, we present a case of mucormycosis with cerebral involvement without sinus disease, which resulted in ischemic stroke with rapid progression resulting in death.

Malformations of Ventral Induction

Seminars in Ultrasound Ct and Mri, Jun 1, 2011

The Ventricular System of the Brain: Anatomy and Normal Variations

Seminars in ultrasound, CT, and MR, 2016

The cerebral ventricular system is intimately associated with the forebrain and brainstem. The ve... more The cerebral ventricular system is intimately associated with the forebrain and brainstem. The ventricular system functions to produce and circulate cerebrospinal fluid, which plays an important role in mechanical protection and regulation of homeostasis in the central nervous system. This article discusses anatomy and neuroimaging of the ventricular system and highlights normal anatomical variations that may be mistaken for pathology. Applied surgical anatomy is reviewed with emphasis on operative approach and potential risk to adjacent central nervous system structures.

Imaging of Communicating Hydrocephalus

Seminars in ultrasound, CT, and MR, 2016

Hydrocephalus basically means an increase in the volume of cerebrospinal fluid (CSF) and the vent... more Hydrocephalus basically means an increase in the volume of cerebrospinal fluid (CSF) and the ventricles. As simple as it may sound, the definition and classification of hydrocephalus have been a matter of debate over many decades. Many international neurosurgical and radiological workgroups have tried to develop a consensus and over the last 5-10 years have been able to put forth a more well-defined and standardized approach. Though, the debate and controversy surrounding this topic is expected to continue, we have tried to review the most recent and consensually accepted definition and classification. Although conventionally classified as either "obstructive and nonobstructive" or "communicating and noncommunicating," none of the classification schemes were without confusion and errors. A more precise nomenclature is to divide hydrocephalus as either "communicating": with or without obstruction of CSF absorption, or as "noncommunicating": wit...

Intraventricular Tumors

Seminars in ultrasound, CT, and MR, 2016

Intraventricular tumors represent a unique group of intracranial neoplasm separate from the class... more Intraventricular tumors represent a unique group of intracranial neoplasm separate from the classic division as intra- vs extra-axial masses. Intraventricular tumors are unique because of the diverse pathologic spectrum, including the entire gamut of neuroepithelial and nonneuroepithelial tumors. Most of these tumors are clinically benign presenting with headaches or signs and symptoms of hydrocephalus. Computed tomography and magnetic resonance imaging play a pivotal role in diagnosis and neurosurgical guidance. Though, practically any intracranial tumor can have an intraventricular location, we would be discussing the common 8 tumors, which together constitute more than 90% of intraventricular masses. Demographics, clinical and imaging findings, are together very useful in narrowing down the differential.

Metronidazole-induced cerebellar toxicity

Neurology International, 2016

Metronidazole is a very common antibacterial and antiprotozoal with wide usage across the globe, ... more Metronidazole is a very common antibacterial and antiprotozoal with wide usage across the globe, including the least developed countries. It is generally well-tolerated with a low incidence of serious side-effects. Neurological toxicity is fairly common with this drug, however majority of these are peripheral neuropathy with very few cases of central nervous toxicity reported. We report the imaging findings in two patients with cerebellar dysfunction after Metronidazole usage. Signal changes in the dentate and red nucleus were seen on magnetic resonance imaging in these patients. Most of the cases reported in literature reported similar findings, suggesting high predilection for the dentate nucleus in metronidazole induced encephalopathy.

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Imaging of Ventricular Shunts

Seminars in Ultrasound, CT and MRI, 2016

A cerebrospinal fluid (CSF) shunt is an internalized system used for the treatment of hydrocephal... more A cerebrospinal fluid (CSF) shunt is an internalized system used for the treatment of hydrocephalus and connects the ventricular system to the peritoneal space, right atrium, or the pleural space. The CSF shunt malfunction can occur due to obstruction, migration, overdrainage, infection, or CSF accumulation at the distal end. Although conventional radiography and radionuclide studies are used for evaluation of integrity of the shunts, computed tomography, ultrasound, and magnetic resonance imaging are used for the evaluation of shunt obstruction, migration, CSF accumulations, infections, overdrainage, and other complications. We discuss the different types and components of the CSF shunt, as this is important for the evaluation of the shunt integrity. Imaging of various causes of CSF shunt malfunction and the complications related to CSF shunts would be illustrated.

Imaging of Petrous Apex

ABSTRACT

Distinguishing grade I meningioma from higher grade meningiomas without biopsy

Oncotarget, Jan 9, 2015

Many meningiomas are identified by imaging and followed, with an assumption that they are WHO Gra... more Many meningiomas are identified by imaging and followed, with an assumption that they are WHO Grade I tumors. The purpose of our investigation is to find clinical or imaging predictors of WHO Grade II/III tumors to distinguish them from Grade I meningiomas. Patients with a pathologic diagnosis of meningioma from 2002-2009 were included if they had pre-operative MRI studies and pathology for review. A Neuro-Pathologist reviewed and classified all tumors by WHO 2007. All Brain MRI imaging was reviewed by a Neuro-radiologist. Pathology and Radiology reviews were blinded from each other and clinical course. Recursive partitioning was used to create predictive models for identifying meningioma grades. Factors significantly correlating with a diagnosis of WHO Grade II-III tumors in univariate analysis: prior CVA (p = 0.005), CABG (p = 0.010), paresis (p = 0.008), vascularity index = 4/4: (p = 0.009), convexity vs other (p = 0.014), metabolic syndrome (p = 0.025), non-skull base (p = 0.041...

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Hippocampal Changes in Febrile Infection-Related Epilepsy Syndrome (FIRES)

Polish Journal of Radiology, 2015

Background: Febrile seizures are the most common seizure disorder in childhood, associated with a... more Background: Febrile seizures are the most common seizure disorder in childhood, associated with a significant rise in body temperature. However, post-infectious refractory afebrile form of seizures in previously healthy children is being increasingly recognized in around the world, which evolves into a chronic refractory form of epilepsy. The term 'Febrile infection-related epilepsy syndrome' (FIRES) has been proposed for these conditions and represents a refractory severe post-infectious epileptic condition in previously normal children.

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Imaging of Non-atherosclerotic Vasculopathies

Journal of Clinical Imaging Science

Magnetic resonance imaging findings in idiopathic sudden sensorineural hearing loss

Acta Radiologica

Imaging of Submandibular and Sublingual Salivary Glands

Neuroimaging clinics of North America, 2018

Imaging of Neurologic Conditions in Pregnant Patients

RadioGraphics

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A Retrospective Review of Temporal Bone Imaging With Respect to Bone-Anchored Hearing Aid Placement

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2017

Central Nervous System Complications of Hemorrhagic and Coagulation Disorders

Hematology/Oncology Clinics of North America, 2016

Imaging of Neurologic Complications in Hematologic Disorders

Hematology/Oncology Clinics of North America, 2016

Imaging Manifestations of Neurologic Complications in Anemia

Hematology/Oncology Clinics of North America, 2016

A Review of Temporal Bone CT Imaging With Respect to Pediatric Bone-anchored Hearing Aid Placement

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, Jan 27, 2016