David Michael Mirsky

• M.D.
• Pediatric Neuroradiologist at Children's Hospital Colorado

Background Intravoxel incoherent motion (IVIM) MRI uses diffusion-weighted (DW) MRI acquisitions to evaluate the microvascular and cellular environments of tissue. Due to these properties, IVIM has been increasingly utilized to evaluate abnormal placentation. Objective Our primary objective was to compare IVIM parameters in the placenta of patient...

In neuro-oncology, MR imaging is crucial for obtaining detailed brain images to identify neoplasms, plan treatment, guide surgical intervention, and monitor the tumor's response. Recent AI advances in neuroimaging have promising applications in neuro-oncology, including guiding clinical decisions and improving patient management. However, the lack...

OBJECTIVE In a cohort of patients who were treated with resection and adjuvant radiotherapy (RT) for adamantinomatous craniopharyngioma (ACP), the authors aimed to determine whether gross tumor volume (GTV) at the initiation of RT was associated with the risk of progressive disease (PD) following treatment. METHODS Pediatric and adolescent patient...

Background and purpose: Sotos syndrome is a rare autosomal dominant condition caused by pathogenic mutations in the NSD1 gene that presents with craniofacial dysmorphism, overgrowth, seizures, and neurodevelopmental delay. Macrocephaly, ventriculomegaly, and corpus callosal dysmorphism are typical neuroimaging features that have been described in...

OBJECTIVE In a cohort of patients who were treated with resection and adjuvant radiotherapy (RT) for adamantinomatous craniopharyngioma (ACP), we explored whether gross tumor volume (GTV) at the initiation of RT was associated with the risk of progressive disease (PD) following treatment. METHODS Pediatric and adolescent patients who received surg...

BACKGROUND In neuro-oncology, accurately interpreting radiographic images, especially for diagnosing central nervous system (CNS) tumors like Adamantinomatous Craniopharyngioma (ACP), presents formidable challenges. Even with advanced imaging technologies such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT), pinpointing features re...

BACKGROUND Adamantinomatous craniopharyngioma (ACP) is a devastating skull-base tumor believed to derive from epithelial remnants of the primordial craniopharyngeal duct (Rathke’s pouch), which gives rise to the anterior pituitary gland. ACP lacks medical antitumor therapies. Current standard therapy with surgery and radiation is associated with po...

Inherited glycosylphosphatidylinositol deficiency disorders (IGDs) are a group of rare multisystem disorders arising from pathogenic variants in glycosylphosphatidylinositol anchor pathway (GPI-AP) genes. Despite associating 24 of at least 31 GPI-AP genes with human neurogenetic disease, prior reports are limited to single genes without considerati...

Dysraphic malformations of the spine and spinal cord (DMSSC) represent a spectrum of common congenital anomalies typically (though not exclusively) affecting the lower spinal segments. These may be responsible for varying degrees of neurologic, orthopedic, and urologic morbidity. With advances in neuroimaging, it is now possible to better diagnose...

BACKGROUND AND PURPOSE: Although cardinal imaging features for the diagnostic criteria of the Dandy-Walker phenotype have been recently defined, there is a large range of unreported malformations among these patients. The brainstem, in particular, deserves careful attention because malformations in this region have potentially important implication...

Objective: We aimed to determine if T2-weighted hyperintense white matter lesions (WMLs) on brain magnetic resonance imaging (MRI) occur more frequently in pediatric patients with migraine and other primary headache disorders compared to the general pediatric population. Background: Small foci of T2 hyperintensity in the white matter are frequen...

Importance: Physical abuse is a common but preventable cause of long-term childhood morbidity and mortality. Despite the strong association between abuse in an index child and abuse in contact children, there is no guidance outlining how to screen the latter, significantly more vulnerable group, for abusive injuries. Consequently, the radiological...

Tumor Surveillance of Pediatric Adamantinomatous Craniopharyngioma using Unenhanced Magnetic Resonance Imaging

The event‐free survival of pediatric low‐grade gliomas is poor, and patients often require multiple treatment strategies. While MEK and RAF inhibitors are efficacious in early‐phase trials, not all patients respond, and many experience progression following completion of therapy. Evaluating combination therapies that may enhance efficacy or prolong...

Tumors of the central nervous system are the most common solid malignancies in children and the most common cause of pediatric cancer‐related mortality. Imaging plays a central role in diagnosis, staging, treatment planning, and response assessment of pediatric brain tumors. However, the substantial variability in brain tumor imaging protocols acro...

Introduction Prompt detection of traumatic cervical spine injury is important as delayed or missed diagnosis can have disastrous consequences. Given the understood mechanism of non-accidental trauma (NAT), it is reasonable to suspect that cervical spine injury can occur. Current management of young children being evaluated for NAT includes placemen...

Childhood ataxia may be due to multifactorial causes of impairment in the coordination of movement and balance. Acutely presenting ataxia in children may be due to infectious, inflammatory, toxic, ischemic, or traumatic etiology. Intermittent or episodic ataxia in children may be manifestations of migraine, benign positional vertigo, or intermitten...

This paper presents a deep learning framework for image classification aimed at increasing predictive performance for Cytotoxic Edema (CE) diagnosis in infants and children. The proposed framework includes two 3D network architectures optimized to learn from two types of clinical MRI data , a trace Diffusion Weighted Image (DWI) and the calculated...

Introduction Prompt detection of traumatic cervical spine injury is important as delayed or missed diagnosis can have disastrous consequences. Given the understood mechanism of non-accidental trauma (NAT), it is reasonable to suspect that cervical spine injury can occur. Current management of young children being evaluated for NAT includes placemen...

Background and purpose: The traditionally described Dandy-Walker malformation comprises a range of cerebellar and posterior fossa abnormalities with variable clinical severity. We aimed to establish updated imaging criteria for Dandy-Walker malformation on the basis of cerebellar development. Materials and methods: In this multicenter study, ret...

Background and purpose: The 5th edition of the World Health Organization Classification of CNS tumors defines the CNS neuroblastoma FOXR2 in the group of embryonal tumors. Published clinical outcomes tend to suggest a favorable outcome after resection, craniospinal irradiation, and chemotherapy. This multicenter study aimed to describe imaging fea...

Background Craniopharyngioma is a histologically benign tumor of the suprasellar region for which survival is excellent but quality of life is often poor secondary to functional deficits from tumor and treatment. Standard therapy consists of maximal safe resection with or without radiation therapy. Few prospective trials have been performed, and re...

Background Cerebral sinovenous thrombosis (CSVT) has been proposed in legal settings to be an atraumatic mimic of abusive head trauma (AHT). Objective The objective of this study was to determine the prevalence of CSVT and subdural hemorrhage (SDH) in a large AHT population. Materials and methods This retrospective cohort study measured the preva...

Background: Younger stroke patients may suffer worse outcomes than older patients; however, the extent to which age at stroke impacts remote areas of the brain remains unclear. The objective of this study was to determine thalamic volume changes ipsilateral to middle cerebral artery territory strokes based on age at acute ischemic stroke onset. Met...

Macrocephaly is a common diagnosis in the pediatric population, particularly in the infantile time period. There is a wide range of causes of macrocephaly, from benign to malignant, for which imaging plays a key role in the diagnosis and clinical guidance. Our aim is to review the distinct and prevalent neuroimaging findings in the evaluation of th...

Fetal MRI is a safe, noninvasive examination of the fetus and placenta, a complement to ultrasonography. MRI provides detailed CNS evaluation, including depicting parenchymal architecture and posterior fossa morphology, and is key in prenatal assessment of spinal dysraphism, neck masses, and ventriculomegaly. Fetal MRI is typically performed after...

Purpose Fetal repair of myelomeningocele (MMC) and myeloschisis leads to improved neurologic outcomes compared to postnatal repair, but the effects of modifications in closure techniques have not been extensively studied. Previous work has suggested that a watertight repair is requisite for improvement in hindbrain herniation (HBH) and to decrease...

Introduction: To determine the feasibility of fetal MRI in identifying the normal anal dimple (AD) and compare it with prenatal ultrasound (US). Methods: Retrospective review of 130 patients with fetal MRI and US. The gestational age (GA) was stratified into four groups: 1) 16 to 21 weeks-6 days; 2) 22 to 27 weeks-6 days; 3) 28 to 33 weeks-6 day...

Response criteria for paediatric intracranial ependymoma vary historically and across different international cooperative groups. The Response Assessment in the Pediatric Neuro-Oncology (RAPNO) working group, consisting of an international panel of paediatric and adult neuro-oncologists, neuro-radiologists, radiation oncologists, and neurosurgeons,...

Perinatal ischemic stroke is a common cause of lifelong disability.

Background Torcular dural sinus malformations (tDSMs) are rare vascular malformations that present in fetuses and infants. Existing data on prognostic imaging features, as well as the associated morbidity and mortality, is limited and variable. We therefore reviewed cases of tDSMs diagnosed on fetal MRI at our referral center to identify pre- and p...

INTRODUCTION: Craniopharyngioma (CP) is a histologically benign tumor of the pituitary stalk that accounts for 4% of pediatric central nervous system (CNS) tumors. Given its location, CP often causes neuro-endocrine, hypothalamic, and vision dysfunction. Standard therapy consists of maximally safe resection +/- radiation therapy (RT). Medical manag...

INTRODUCTION: Ependymomas remain a major cause of cancer-related death in childhood and adolescence, with recurrence occurring in up to 50% of patients. Despite exciting molecular advances in understanding ependymoma tumorigenesis and recurrence, MRI remains the mainstay for assessing objective response to therapy and duration of disease stability....

BACKGROUND: Adamantinomatous craniopharyngioma (ACP) is a devastating skull-base tumor believed to derive from epithelial remnants of the primordial craniopharyngeal duct (Rathke’s pouch), which gives rise to the anterior pituitary gland. ACP lacks medical antitumor therapies. Current standard therapy with surgery and radiation is associated with p...

BACKGROUND: Postoperative paediatric cerebellar mutism syndrome (pCMS) is a common but severe complication which may arise following the resection of posterior fossa tumours in children. Two previous studies have aimed to preoperatively predict pCMS, with varying results. In this work, we examine the generalisation of these models and determine if...

BACKGROUND: The CNS neuroblastoma with forkhead box R2 (CNS NB-FOXR2) activation is one of the new embryonal tumor entities in the WHO CNS tumor classification 2021. The data currently available suggest a comparably favourable outcome after craniospinal irradiation and chemotherapy. The entity is poorly characterized on imaging. We therefore aimed...

Background Palpable masses of the head and neck are a common indication for imaging in the pediatric population. Midline lesions of the infrahyoid neck, particularly lesions isolated to the suprasternal notch, are not well studied. Objective To delineate the histopathological and imaging spectrum of masses that occur within and isolated to the sup...

Purpose The circle of Willis is a circulatory anastomosis that supplies blood to the brain. If any of the bridging segments are hypoplastic or absent, the capacity for collateral flow in the setting of large vessel occlusion may be decreased. Outside of the neonatal period, the prevalence of a complete circle of Willis (CoW) in the pediatric popula...

The event-free survival of pediatric low-grade gliomas is poor, and patients often require multiple treatment strategies. While MEK and RAF inhibitors are efficacious in early-phase trials, not all patients respond and many experience progression following completion of therapy. Evaluating combination therapies that may enhance efficacy or prolong...

Background and purpose: Pediatric vertebral artery dissecting aneurysm is a subtype of vertebral artery dissection that can be challenging to diagnose and may be associated with stroke recurrence. This study examines the presenting features, clinical outcomes, and recurrence risk in a cohort of children with vertebral artery dissection, comparing...

Background A standardized approach for identifying and treating hypothalamic obesity (HO) in children with hypothalamic tumours is lacking. Objectives To describe children with hypothalamic tumours at risk for obesity, assess outcomes of a novel HO clinical algorithm, and identify factors associated with weight gain. Methods Retrospective analysi...

Background Prenatal surgical closure of Myelomeningocele (MMC) is considered part of the current age armamentarium. Clinical data has demonstrated the need for innovative patches to maximize the benefits and decrease the risks of this approach. Our team has developed a minimally invasive reverse thermal gel (RTG) patch with cellular scaffolding pro...

Background Postoperative paediatric cerebellar mutism syndrome (pCMS) is a common but severe complication which may arise following the resection of posterior fossa tumours in children. Two previous studies have aimed to preoperatively predict pCMS, with varying results. In this work, we examine the generalisation of these models and determine if p...

Aim To identify additional genes associated with infantile spasms using a cohort with defined infantile spasms. Method Whole‐exome sequencing (WES) was performed on 21 consented individuals with infantile spasms and their unaffected parents (a trio‐based study). Clinical history and imaging were reviewed. Potentially deleterious exonic variants we...

Methionine synthase deficiency (cblG complementation group) is a rare inborn error of metabolism affecting the homocysteine re-methylation pathway. It leads to a biochemical phenotype of hyperhomocysteinemia and hypomethioninemia. The clinical presentation of cblG is variable, ranging from seizures, encephalopathy, macrocytic anemia, hypotonia, and...

BACKGROUND Adamantinomatous craniopharyngioma (ACP) is a highly morbid adult and pediatric brain tumor derived from epithelial remnants of the craniopharyngeal canal (Rathke’s pouch), which gives rise to the anterior pituitary gland. Standard therapy includes maximal safe resection with or without radiation therapy. Systemic antitumor therapy remai...

Retinal hemorrhages are an integral part of the evaluation of abusive head trauma (AHT). Timely detection of retinal hemorrhage not only facilitates the diagnosis of AHT, but has the potential to prevent further abuse to the child and the siblings and to identify the abuser. The gold standard for diagnosing retinal hemorrhage is a dilated fundoscop...

In children, seizures represent an extremely heterogeneous group of medical conditions ranging from benign cases, such as a simple febrile seizure, to life-threatening situations, such as status epilepticus. Underlying causes of seizures also represent a wide range of pathologies from idiopathic cases, usually genetic, to a variety of acute and chr...

PurposeThe goal of this study was to determine the feasibility of identifying the anal dimple (AD) on routine prenatal ultrasound. Using the presence, absence, appearance, and location of the anal dimple as an indirect sign for possible underlying anorectal malformations (ARM), we hypothesize that evaluation of the anal dimple as part of the fetal...

Background and purpose: Various etiologies have been theorized for the development of congenital nasal pyriform aperture stenosis (CNPAS). Imaging possibly implicates abnormal fusion of the midline palatal suture and deficient lateral growth of the midface in affected neonates. Materials and methods: A single-center, retrospective study was perf...

Introduction: While cases of acquired Chiari I malformation following ventriculoperitoneal shunting for posthemorrhagic hydrocephalus have been reported, true disproportionate cerebellar growth is rare, with no previous cases requiring posterior fossa decompression reported. Clinical presentation: We present a premature neonate who underwent ven...

METHODS Through the Advancing Treatment for Pediatric Craniopharyngioma (ATPC) consortium we accumulated preoperative MRIs and tumor RNA for 50 unique ACP patients. MRIs were assessed quantitatively for 28 different features and analyzed using Multiple Factor Analysis (MFA) and optimal clustering was determined via maximization of Bayesian Informat...

Accurate antenatal diagnosis is essential for planning appropriate pregnancy management and improving perinatal outcomes. The provision of information vital for prognostication is a crucial component of prenatal imaging, and this can be enhanced by the use of fetal MRI. Image acquisition, interpretation and reporting of a fetal MR study can be daun...

Fetal ventriculomegaly is the most common central nervous system abnormality detected by prenatal imaging. It has a high association with other anomalies. Etiologies and prognoses for fetal ventriculomegaly range from normal outcomes to significant neurodevelopmental sequelae. In this paper, we review the development, terminology, pathogenesis, ima...

Genetic defects in mitochondrial DNA encoded tRNA genes impair mitochondrial translation with resultant defects in the mitochondrial respiratory chain and oxidative phosphorylation system. The phenotypic spectrum of disease seen in mitochondrial tRNA defects is variable and proving pathogenicity of new variants is challenging. Only three pathogenic...

Deep learning (DL) is a widely applied mathematical modeling technique. Classically, DL models utilize large volumes of training data, which are not available in many healthcare contexts. For patients with brain tumors, non‐invasive diagnosis would represent a substantial clinical advance, potentially sparing patients from the risks associated with...

Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia with a highly variable clinical presentation affecting people of all ages. Mutations in BRAF V600E are the most identifiable molecular alteration in LCH although its incidence in pediatric patients with isolated pituitary stalk involvement is not well described. Pediatric pati...

Diagnosing complex V deficiencies caused by new variants in mitochondrial DNA is challenging due to the rarity, phenotypic diversity, and limited functional assessments. We describe a child with the m.9032T>C variant in MT-ATP6 encoding p.(Leu169Pro), with primary presentation of microcephaly, ataxia, hearing loss, and lactic acidosis. Functional s...

Relapsing demyelinating syndromes (RDS) in children encompass a diverse spectrum of entities including multiple sclerosis (MS) acute disseminated encephalomyelitis (ADEM), aquaporin-4 antibody associated neuromyelitis optica spectrum disorder (AQP4-NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOG-AD). In addition to these, there...

Head trauma is a frequent indication for cranial imaging in children. The majority of accidental pediatric head trauma is minor and sustained without intracranial injury. Well-validated pediatric-specific clinical decision guidelines should be used to identify very low-risk children who can safely forgo imaging. In those who require acute imaging,...

Stroke is an uncommon but an important and under-recognized cause of morbidity and mortality in children. Strokes may be due to either brain ischemia or intracranial hemorrhage. Common symptoms of pediatric acute stroke include headache, vomiting, focal weakness, numbness, visual disturbance, seizures, and altered consciousness. Most children prese...

The potential for central nervous system (CNS) involvement in coronavirus disease 2019 (COVID-19) is a matter of grave concern and there is a relevant body of evidence in the basic sciences to support this possibility. A neuroradiologist should be aware of the potential mechanisms involved in the neuropathogenesis of this virus, as we begin to see...

Modern Deep Learning (DL) networks routinely achieve classification accuracy superior to human experts, leveraging scenarios with vast amounts of training data. Community focus has now seen a shift towards the design of accurate classifiers for scenarios with limited training data. Such an example is the uncommon pediatric brain tumor, Adamantinoma...

Purpose Pediatric shunt malfunction occurs frequently and is important to recognize due to the high associated morbidity and mortality. Although neuroimaging plays a crucial role in the diagnosis, it remains imperfect. We sought to identify the effect of image fusion software in predicting shunt malfunction. Methods A total of 248 rapid shunt seri...

Purpose: Hydrogen sulfide, a signaling molecule formed mainly from cysteine, is catabolized by sulfide:quinone oxidoreductase (gene SQOR). Toxic hydrogen sulfide exposure inhibits complex IV. We describe children of two families with pathogenic variants in SQOR. Methods: Exome sequencing identified variants; SQOR enzyme activity was measured spe...

Background and purpose: Cervical arterial dissection is one of the frequent causes of pediatric arterial ischemic stroke. Out of concern for missing cervical arterial dissection in patients in whom pediatric stroke is suspected, our tertiary children's hospital added contrast-enhanced 3D neck MR angiography to every pediatric stoke work-up. This r...

Background and Purpose— Subpial hemorrhage of the neonate is a rare stroke subtype reported in few case series. Birth trauma and coagulopathy are commonly proposed etiologies. We evaluated our subpial hemorrhage of the neonate patient cohort to expand current understanding Methods— Cases of subpial hemorrhage of the neonate were identified by keyw...

Objective: Pediatric adamantinomatous craniopharyngiomas (ACPs) are histologically benign brain tumors that confer significant neuroendocrine morbidity. Previous studies have demonstrated that injury to the hypothalamus is associated with worsened quality of life and a shorter lifespan. This insight helps many surgeons define the goals of surgery...

Background and purpose: Various pathologic and nonpathologic states result in brain parenchymal signal intensity changes on unenhanced T1-weighted MR imaging. However, the absence of quantitative data to characterize typical age-related signal intensity values limits evaluation. We sought to establish a range of age-dependent brain parenchymal sig...

Background: Computed tomography (CT) is commonly used for children when there is concern for traumatic brain injury (TBI) and is a significant source of ionizing radiation. Our objective was to determine the feasibility and accuracy of fast MRI (motion-tolerant MRI sequences performed without sedation) in young children. Methods: In this prospec...

Purpose Presacral masses associated with anorectal malformations (ARM) are most frequently dermoid or teratomas. Sacrococcygeal teratoma (SCT), in isolation, is a different condition. There are limited data comparing the two. The aim of this study was to compare presacral masses associated with ARM and isolated SCTs. Methods A retrospective review...

Adamantinomatous craniopharyngioma (ACP) makes up between 6 and 8% of pediatric brain tumors and is the most common pediatric tumor arising in the sellar/suprasellar region of the brain. The 10-year survival for patients diagnosed with craniopharyngioma ranges between 64 and 92%, but complicating factors such as location, common cyst formation, and...

Background: Pediatric cervical spine injuries (CSI) are rare but potentially devastating sequelae of blunt trauma. Existing protocols to evaluate children at risk for CSI frequently incorporate computerized topography (CT) and magnetic resonance imaging (MRI); however, the clinical value of performing both remains unclear. Methods: Single center...

Choosing the appropriate imaging in children with accidental traumatic spine injuries can be challenging because the recommendations based on scientific evidence at this time differ from those applied in adults. This differentiation is due in part to differences in anatomy and physiology of the developing spine. This publication uses scientific evi...

Advances in Artificial Intelligence (AI) have rapidly become well known through the mainstream media, with myriad applications. Most commonly, AI has been leveraged for problems that possess vast amounts of sample data, as this enables AI models to better generalize patterns within the data. We hypothesized that novel computational methods could al...

Adamantinomatous craniopharyngioma (ACP) makes up between 6–8% of pediatric brain tumors and is the most common pediatric tumor arising in the sellar/suprasellar region of the brain. The 10-year survival for patients diagnosed with craniopharyngioma ranges between 64–92%, but given complicating factors such as its location, common cyst formation, a...

Imaging of occult spinal dysraphism (OSD) has evolved significantly over the recent years. The preferred imaging modality of choice for most, if not all, lesions is MRI. In this chapter, we review imaging of five clinically relevant OSDs: low conus medullaris, dermal sinus tract, lipomyelomeningocele, neurenteric cyst, and split cord malformation....

Preoperative diagnosis for tumors arising in the optic chiasm/sellar/suprasellar region in children is helpful to determine surgical necessity and approach, given the high operative risk in this area. We evaluated the ability to differentiate tumor type by preoperative neuroimaging. Thirty‐eight of 53 tumors were correctly diagnosed by neuroimaging...

Purpose Sacral abnormalities range from missing the coccyx, a few sacral vertebrae, or hemi-sacrum, to complete absence with fused iliac bones. The purpose of this study was to review the association between sacral agenesis and fecal incontinence to help inform patient prognosis. Methods A retrospective review was performed of patients who present...

Purpose Recent evidence suggests that recovery from secondary neurodegeneration following arterial ischemic stroke (AIS) may be related to age at injury and site of occlusion. We conducted a study of hippocampal volume (HCV) in a cohort of pediatric patients with middle cerebral artery (MCA) territory AIS to determine whether HCV would be preserved...

Introduction: Arterial ischemic stroke (AIS) occurs in 1-2 children/100,000/year. Most children have neurologic deficits post-AIS, but the influence of infarct volume on neurologic outcome is understudied. While acute infarct volume {best measured as a percentage of total brain volume infarcted (%aTBVi) in the growing brain} likely predicts outcome...

Aim: The aim of this study was to use dual energy CT technology to maintain or improve image quality in pediatric head CT while simultaneously reducing radiation dose. Materials and methods: In this retrospective study, helical head CTs performed using a standard head CT protocol were compared to studies performed with a dual energy (DE) protoco...

Sinusitis is common in children that usually resolves spontaneously. Imaging is not part of the standard of care for initial diagnosis, however may be necessary in cases with persistent or chronic sinusitis to guide surgical intervention, or to rule out intracranial and vascular complications of sinusitis. Computed tomography (CT) and magnetic reso...

Purpose Approximately 25% of patients with anorectal malformation have tethered cord. The traditional way of determining conus medullaris level on magnetic resonance imaging (MRI) relies on counting vertebrae, which may be challenging due to vertebral numeric variation, segmentation anomalies, as well as transitional vertebral body anatomy. The pur...

Background: Studies evaluating small patient cohorts have found a high, but variable, rate of occult head injury in children <2 years old with concern for physical abuse. The American College of Radiology (ACR) recommends clinicians have a low threshold to obtain neuroimaging in these patients. Objectives: Our aim was to determine the prevalence...

Two 2-year-old males presented post-operatively following adenoidectomy with persistent fever and neck stiffness. After multiple office visits, both patients were admitted and found to have a widened spheno-occipital synchondrosis and other imaging findings indicative of skull base osteomyelitis. Treatment with antibiotics allowed for recovery with...

Introduction: Little is known about the etiology of olfactory dysfunction in the pediatric population. The aim of this study is to characterize the etiology and clinical features of anosmia and to explore evaluation options in a pediatric population. Methods: Olfactory dysfunction was identified at a tertiary pediatric hospital between January 2...

Sporadic meningiomas within the pediatric population manifest neuroimaging features that are poorly defined in the literature. We sought to establish a set of imaging features which may help lead to early diagnosis, as well as determine whether the imaging attributes, neuropathology, and clinical outcomes of sporadic meningiomas differ from those t...

INTRODUCTION Pediatric craniopharyngioma confers significant morbidity, with injury to the hypothalamus representing a particular challenge. This insight led to reconsideration of goals of surgery for certain patients. Puget et al (2007), proposed a pre- and post-operative grading system based on the degree of hypothalamic invasion on MRI. Their sy...

INTRODUCTION Various tumors arising in the optic pathway/sellar/suprasellar region in children necessitate different therapeutic approaches. Although surgical biopsy is the gold standard for diagnosis, not all tumors in this area require surgical intervention, and surgery here is associated with a high risk of morbidity. If an accurate diagnosis ca...

INTRODUCTION Genomic assessment of BRAF V600E has become routine in specific pediatric glioma subtypes in recent years given availability of targeted therapies. Comparison of imaging characteristics of pediatric gliomas with or without the V600E mutation has not been previously reported. METHODS Pathology reports of pediatric brain tumors diagnose...

Background: Interictal 18F-fluorodeoxyglucose-positron emission topography (FDG-PET) hypometabolism is routinely used in the presurgical workup of children with medically intractable epilepsy (MIE). FDG-PET hypermetabolism, however, is rarely seen, and the significance of this finding in the epilepsy workup is not well established. Methods: We p...