The hantavirus pulmonary syndrome (HPS) is an acute, rapidly progressive disease transmitted by rodent excreta, with endothelial damage playing a central role in the pathophysiology. It usually affects rural workers. The lung itself is the target organ and reflects all the patterns of endothelial involvement of this disease. The radiologic findings of HPS are vast and range from a mild interstitial involvement to total obliteration of the airspaces with or without pleural effusion. There are no specific findings on high-resolution computed tomography in HPS; nevertheless, findings of thickening of interlobular septa, ground-glass opacities, and occasionally small ill-defined nodular opacities have been described. The authors report a fulminant case of HPS and discuss its varied high-resolution computed tomography findings. To our knowledge, the "crazy-paving" pattern has not been seen previously in such cases.
Superficial siderosis (SS) of the central nervous system (CNS) is a rare and possibly underdiagnosed disorder resulting from chronic or intermittent bleeding into the subarachnoid space, leading to deposition of blood products in the subpial layers of the meninges. Magnetic resonance imaging (MRI) shows a characteristic curvilinear pattern of hypointensity on its blood-sensitive sequences. Methods Series of cases collected from Brazilian centers. Results We studied 13 cases of patients presenting with progressive histories of neurological dysfunction caused by SS-CNS. The most frequent clinical findings in these patients were progressive gait ataxia, hearing loss, hyperreflexia and cognitive dysfunction. The diagnoses of SS-CNS were made seven months to 30 years after the disease onset. Conclusion SS-CNS is a rare disease that may remain undiagnosed for long periods. Awareness of this condition is essential for the clinician.
Although intramedullary is a rare NCC location, it should be considered in the differential diagnosis in high-risk populations especially when cord compression and myelopathy symptoms are present. Magnetic resonance imaging remains the investigative and follow-up modality of choice, and promptly lesion recognition is fundamental for surgical planning and to improve the patient outcome.
O uso de sinais ou analogias na interpretação de imagens na radiologia médica é prática comum e antiga entre os radiologistas. Comparação entre achados de imagem com animais, alimentos ou objetos se faz de modo natural. Muitos sinais são bastante específicos e em alguns casos patognomônicos. Independentemente do grau de especificidade, sinais auxiliam a prática radiológica. Vários sinais já foram descritos em neurorradiologia. Neste artigo os autores demonstrarão 15 sinais neurorradiológicos. Serão abordados as principais características de cada um, a sua importância na prática clínica e os seus achados de imagem.
The use of signs for interpretation of images in neuroradiology is extremely useful. Some signs are quite specific and, in some cases, pathognomonic. In this second part of their essay, the authors describe 15 additional neuroradiological signs. Main characteristics of imaging findings will be approached and the significance of their role in the clinical practice will be discussed. Keywords: Radiological signs; Neuroradiology; Computed tomography; Magnetic resonance imaging.O uso de sinais na interpretação de imagens na neurorradiologia é extremamente útil. Muitos sinais são bastante específicos e em alguns casos, patognomônicos. Nesta segunda parte os autores descreverão 15 sinais neurorradiológicos adicionais. Serão novamente abordadas as principais características de imagem de cada um e sua importân-cia na prática clínica. Unitermos: Sinais radiológicos; Neurorradiologia; Tomografia computadorizada; Imagem por ressonância magnética. Abstract "High heel foot print sign" in the skull baseThe high heel foot print sign (Figure 1) is useful in the understanding of the intricate anatomy of the skull base and represent two relevant foramina. The anterior aspect of the high heel footprint represents the foramen ovale (FO), and the posterior aspect (the heel itself) the foramen spinosum (FS). The mandibular nerve, one of the three branches of the trigeminal nerve, is the main FO component (1) . Also, the otic Figure 1. Axial CT image demonstrating normal appearance of the skull base. The high heel foot print sign is evidenced. The small arrow indicates the foramen spinosum, and the large arrow, the foramen ovale. Anteriorly to the high heel footprint is the Vesalius foramen (venous foramen) (arrowhead). ganglion, the accessory meningeal artery, the lesser petrosal nerve and the emissary veins are found in this foramen. The middle meningeal artery is in the FS (2) , and the absence of such artery is related to the persistent stapedial artery (3) . "Lemon sign" in spina bifidaThe lemon sign (Figure 2) is an useful sign in the detection of spina bifida and is commonly associated with hydrocephalus and Arnold-Chiari II malformation (4) . Such sign can be found in up to 98% of cases of spina bifida (5) . The lemon sign is not exclusive to spina bifida and can be observed in cases of encephalocele, thanatophoric dys-
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