Intracranial incidental findings on brain MR images in a pediatric neurology practice: A retrospective study

Gupta, Smriti; Belay, Brook

doi:10.1016/j.jns.2007.06.055

Cited by 60 publications

(53 citation statements)

References 18 publications

(21 reference statements)

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“…Since HUNT MRI was a quite healthy cohort [8] and all findings were checked against patient records and patient medical history, it seems unlikely that the prevalence of incidental findings was overestimated in the study. Nevertheless, the number of incidental findings on brain MRI was higher in this study than in most published studies, particularly the earlier studies [1][2][3][4][5][9][10][11][12][13][14][15][16].…”

Section: Reviewcontrasting

confidence: 70%

Incidental Findings on Brain MRI: Insight from HUNT MRI - A General Population Study

Ak¹

2016

J Headache Pain Manag

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The aim of the study was to assess the prevalence of incidental findings on brain Magnetic Resonance Imaging (MRI) in a general population of middle aged adults. In addition, the clinical impact, follow up and postoperative outcome resulting from uncovering an incidental finding during a research study were examined.Brain MRI was performed in a general population as part of the Nord-Trøndelag Health Study (HUNT), which is a multiphase, multipurpose health study on the inhabitant's ≥13 years in the county of Nord-Trøndelag, Norway. Only standard MRI exclusion criteria were applied to participant selection. In total, 1006 HUNT participants (530 women) between 50 and 66 years were included.The cohort was representative for the population, but participant versus nonparticipant assessment demonstrated a somewhat better health profile of those included in HUNT MRI. Scanning was performed on one 1.5T scanner with a comprehensive scan protocol, all scans were read by two senior neuroradiologists and presence of intracranial findings were evaluated based on patient hospital records and medical history obtained by phone interview.The prevalence of incidental findings on brain MRI was 29% and 15% of the relatively healthy, middle aged adults participating in HUNT MRI were referred to some type of follow-up. Acquired and developmental cerebrovascular pathologies (silent infarctions, excessive white matter hyperintensities relative to age, aneurysms, occlusion/stenosis of arteries, arteriovenous malformation, and cavernous hemangioma) were most common, followed by extra-and intra-axial brain tumors (meningioma, pituitary tumors, glioma or vestibular schwannoma). Intracranial intervention was performed 1.4% of the cohort with one postoperative deficit, giving a prevalence of 0.1% for a postoperative neurological deficit as a result of brain MRI in a research setting.Based on the HUNT MRI cohort, about 1 in 7 middle aged participants from the general population will require clinical follow up if undergoing brain MRI scanning in a research setting. Unrecognized excessive white matter hyperintensities and silent strokes were frequent findings, and demonstrate a significant potential for different types of measures aimed at preventing and/or ameliorating unidentified arteriosclerotic disease to maintain brain health in even quite healthy middle aged adults.

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Section: Reviewcontrasting

confidence: 70%

Incidental Findings on Brain MRI: Insight from HUNT MRI - A General Population Study

Ak¹

2016

J Headache Pain Manag

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“…A minority consist of vascular malformations (for example, cavernoma or developmental venous anomaly), tissue changes, or tumoral lesions, accounting for less than 1% of all the incidental brain findings. 6,8,11,14,18 The nature and the spontaneous evolution of these neoplastic lesions, as well as their appropriate management, remain under debate in view of limited literature reports and personal experience. The aims of this study are to describe incidental CNS mass lesions and their evolution, to discuss management options, and to determine the prevalence of incidental CNS mass lesions in our pediatric clinic.…”

mentioning

confidence: 99%

Incidental findings of mass lesions on neuroimages in children

Perret¹,

Boltshauser

Scheer

et al. 2011

FOC

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Increasing use of neuroimaging in children has led to more incidental findings of CNS mass lesions, the management of which is uncertain. The authors' aims in this study are to describe these mass lesions and their evolution, as well as to discuss the management options and determine the prevalence of incidental CNS mass lesions at their pediatric clinic. A retrospective study was undertaken in children with primary CNS tumors who were younger than 18 years old and were admitted to the University Children's Hospital of Zurich, Switzerland, between January 1995 and December 2010. In 19 (5.7%) of 335 patients with newly diagnosed CNS tumors, the diagnosis of a CNS mass lesion was an incidental finding. Reasons for obtaining neuroimages in these 19 patients were head trauma (in 6 patients); research protocols (in 3); nasal/orbital malformations (in 2); endocrinological and psychiatric evaluations (in 2); and vertebral bone anomaly without neurological signs, absence seizures, congenital ataxia, recurrent vomiting, developmental delay, and “check-up” at the explicit request of the parents (in 1 patient each). Seven patients underwent immediate surgery for low-grade glioma (4 patients) and craniopharyngioma, ependymoma, and choroid plexus papilloma (1 patient each); and 12 were treated conservatively or were observed. Ten of 12 conservatively treated patients remained stable (median follow-up time 1.8 years) and the other 2 underwent delayed surgery because of tumor progression (medulloblastoma in one patient and fibrillary astrocytoma in the other). Clinicians are increasingly challenged by the discovery of incidental CNS mass lesions. A subgroup of such lesions (with typical imaging patterns such as tectal glioma and dysembryoplastic neuroepithelial tumor) can be monitored conservatively, clinically, and radiographically. Future prospective studies are needed to define optimal management strategies based on larger collections of natural histories, as well as to assess the true prevalence of incidental CNS mass lesions.

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“…La protrusión de las amígdalas cerebelosas de > 5 mm por debajo del agujero magno se define como ectopia amigdalina cerebelosa. 20 Los pacientes con malformación de Chiari tipo 1 pueden tener cefalea, parálisis de pares craneales bajos, debilidad y escoliosis. 21 En nuestro estudio, el patrón de la cefalea en los pacientes con malformación de Chiari tipo 1 y ectopia amigdalina cerebelosa no fue atribuible a la malformación de Chiari tipo 1.…”

Section: Figura 2 Rmn De Cerebro De Los Pacientes; Las Flechas De Counclassified

“…10,12,22 La prevalencia de la malformación de Chiari tipo 1 (1,7%) y de ectopia amigdalina cerebelosa (0,8%) fue también del 2,5% en los pacientes pediátricos atendidos en los consultorios externos de neurología. 20 Los quistes aracnoideos son bolsas llenas de líquido cefalorraquídeo dentro de la membrana aracnoidea. La mayoría de los quistes aracnoideos son congénitos pero podrían desarrollarse de manera secundaria a un traumatismo, tumor o infección.…”

Section: Figura 2 Rmn De Cerebro De Los Pacientes; Las Flechas De Counclassified

“…25 Asimismo, en el estudio de Gupta y col., la incidencia de espacios perivasculares agrandados fue del 3,8%. 20 Las anomalías inespecíficas de la sustancia blanca son focos de desmielinización isquémica y gliosis. 26 Estas anomalías se detectan mejor como hiperintensidades en las secuencias ponderadas en T2.…”

Section: Figura 2 Rmn De Cerebro De Los Pacientes; Las Flechas De Counclassified

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Resultados de la resonancia magnética nuclear de cerebro en niños con cefalea

2017

Arch Argent Pediat

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Intracranial incidental findings on brain MR images in a pediatric neurology practice: A retrospective study

Cited by 60 publications

References 18 publications

Incidental Findings on Brain MRI: Insight from HUNT MRI - A General Population Study

Incidental Findings on Brain MRI: Insight from HUNT MRI - A General Population Study

Incidental findings of mass lesions on neuroimages in children

Resultados de la resonancia magnética nuclear de cerebro en niños con cefalea

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