Diagnostic Imaging diagnostics in multiple sclerosis [Bildgebende Diagnostik bei multipler Sklerose]

Multiple sclerosis (MS) is an inflammatory autoimmune disease that leads to the development of demyelination foci in the central nervous system and can affect any neurological function. In the developed world, it represents the most common chronic neurological (nontraumatic) disease in young and middle-aged patients. Magnetic resonance imaging (MRI) is the first-line imaging modality for the diagnosis and follow-up of MS. The currently valid McDonald criteria, updated in 2017, define the exact morphological imaging criteria for diagnosing MS. In addition to the detection of typical MS plaques, the determination of spatial and temporal dissemination is essential for the initial diagnosis. A standardized MRI protocol consisting of mandatory and optional sequences is recommended for reliable diagnosis and differentiation from a broad spectrum of differential diagnoses. © 2022, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature

Endovascular Thrombectomy in Acute Ischemic Stroke

Despite several effective strategies of stroke prevention, the stroke epidemic still constitutes the leading cause of permanent disability. The recent series of well-designed, convincingly-positive randomized controlled trials of endovascular thrombectomy in stroke patients with large vessel occlusion launched a paradigm shift and a new era in acute stroke management. The present review provides an overview of the technical aspects of the procedure, discusses patient selection criteria, summarizes the current evidence from randomized trials about its efficacy and safety, and explores its implications in the organization of acute stroke care. © 2018 American Heart Association, Inc

Whiplash injury of the cervical spine

Whiplash injury is a common trauma of the cervical spine which usually occurs during motor vehicle accidents, especially involving rear-end collisions. The trauma typically results from a sudden biphasic movement of the head and cervical spine (reclination followed by inclination), which may cause an injury of bony, muscular and ligamentous elements. The most common symptoms of whiplash injury are pain, stiffness and tenderness of the neck, which occur with a latency of several hours and may become chronic in some patients. The imaging studies rarely demonstrate morphological changes associated with trauma and there are also no specific imaging findings in whiplash injuries. Plain films and computed tomography are used in acute trauma workup to exclude bony injuries. Magnetic resonance imaging (MRI) may demonstrate occult fractures, bone contusions as well as muscular and ligamentous posttraumatic lesions. The whiplash injuries are classified clinically according to Quebec Task Force-Grading, depending on the symptom severity

Spinal cord ischemia [Spinale Ischämie]

Spinal cord ischemia is a rare disease with a poor prognosis. As with cerebral ischemia, spinal infarction typically presents with sudden symptom onset and variable clinical manifestation (depending on the lesion location). The majority of spinal ischemias occur in the supply territory of the anterior spinal artery, involving the anterior and middle third of the myelon. The most common cause of spinal ischemia is an arterial vessel occlusion, although venous ischemia and hypotensive watershed infarcts may also occur. Magnetic resonance imaging (MRI) represents the modality of choice for diagnosis of spinal cord ischemia. © 2021, Springer Medizin Verlag GmbH, ein Teil von Springer Nature

Spinal tumors [Spinale Tumoren]

Spinal tumors are often classified into three anatomical compartments on the basis of their relationship to the dural space and myelon. The most common primary spinal neoplasms are glial tumors (ependymoma, astrocytoma), nerve sheath tumors (schwannoma, neurofibroma) and meningioma. Metastases represent another common tumor entity and can occur in every spinal compartment. Magnetic resonance imaging (MRI) is the most important noninvasive method for spinal tumor imaging. © 2021, Springer Medizin Verlag GmbH, ein Teil von Springer Nature