Shriram Varadharajan

• DM Neuroimaging and Interventional Neuroradiology
• Senior Consultant & Clinical Lead at Kauvery Hospital

Introduction: Magnetic resonance imaging (MRI) has emerged as the primary modality for diagnosing and evaluating central nervous system (CNS) tumors, transitioning from structural to functional assessment. Advanced MRI techniques, including MR spectroscopy and perfusion imaging, offer insights into functional, metabolic, and hemodynamic changes in...

Cardiac CT studies to detect embolic sources can be a useful supplement to the imaging armamentarium of acute stroke patients and we explore its possibilities in 2 distinct populations in this technical note. Prior literature has looked at the yield of covering the heart during CT angiography (CTA) in addition to echocardiography and found that it...

Purpose: The purpose is to determine the inter-rater reliability in grading ASPECTS score, between emergency medicine physician at first contact and radiologist among patients with acute ischemic stroke. Materials and methods: We conducted a prospective analysis of 765 acute ischemic stroke cases referred to the Department of Radiodiagnosis in a...

Recent studies have shown that diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) MRI (DWI-FLAIR) mismatch is useful for thrombolytic treatment decisions in acute ischemic stroke. However, the role of partial mismatch in strategic locations among patients with evolving stroke has not been described before. Partial imag...

Neonatal strokes constitute a major cause of pediatric mortality and morbidity. Neuroimaging helps in its diagnosis as well as prognostication. However, advanced imaging, including magnetic resonance imaging (MRI), carries multiple challenges. Limited data exists in the literature on imaging-based predictors of neurological outcomes in neonatal str...

A brief overview of our epilepsy protocol and review its sequences The spectrum of imaging findings in our acute seizure patients Differentiation of seizure-induced changes on imaging from underlying causes Diagnostic algorithm for seizure imaging using case-based examples

Neck pain is a common presentation to the emergency department (ED) and a prominent source of disability in the adult population, accounting for about 10–20% of the population. Neck pain can be challenging for ED clinicians to accurately diagnose and manage. The vital role of ED remains in diagnosing the musculoskeletal red flag conditions such as...

Headache during pregnancy is a common complaint in the emergency room. In pregnancy, pituitary disorders include both hormone active and hormone inactive tumors. Apoplexy may be the first clinical presentation of an underlying pituitary tumor. Red flag signs of presenting symptoms, to be assessed for identifying life-threatening etiology. Various p...

Background: Imaging of acute stroke patients in emergency settings is critical for treatment decisions. Most commonly, CT with CTA is used worldwide for acute stroke. However, MRI may be advantageous in certain settings. With advancements in endovascular clot retrieval techniques, there is a need to identify and use the best possible imaging for th...

Background Postoperative neurological deficits following spinal decompression are often caused due to an expanding hematoma or other iatrogenic injuries. When a definitive etiology could not be identified, it may rarely be related to a reperfusion injury. Such unexplained neurological deficits are often associated with the presence of cord signal c...

Purpose: Our study aimed to compare the sensitivity of T2 relaxometry and positron emission tomography - computed tomography (PET/CT) in patients with a history suggestive of mesial temporal lobe epilepsy using video electroencephalography (EEG) as the reference standard. Material and methods: In our study, 35 patients with a history suggestive...

Background Arterial spin labelling (ASL) is a noncontrast, magnetic resonance perfusion technique which can provide information about the parenchymal perfusion status and collaterals in acute stroke. Its role in the setting of large vessel occlusion (LVO) is underutilized due to the limited availability of magnetic resonance imaging (MRI) in the em...

Introduction Invasive CNS aspergillosis is extremely rare and happens more frequently in the setting of immunosuppression. Although it’s occurrence is rare in immunocompetent host, the number of case reports about this infection has been increasing in the recent years and is associated with significant morbidity and mortality. Case presentation:We...

The COVID-19 pandemic had brought unique and difficulties challenges to emergency health care services worldwide. Indian scenario was no different and public fear of the pandemic combined with strict travel restrictions enforced during the initial lockdown phases drastically affected number of patients seeking emergency medical attention. Stroke i...

The COVID-19 pandemic had brought unique difficulties and challenges to emergency health care services worldwide. Indian scenario was no different and public fear of the pandemic combined with strict travel restrictions enforced during the initial lockdown phases drastically affected number of patients seeking emergency medical attention. Stroke i...

Acute Stroke is managed by a multidisciplinary team and treatment decisions are based on imaging studies. The goals of imaging for various treatments in acute stroke are outlined and incorporated into an imaging-based flow chart.We have developed simplified and structured reporting formats to avoid confusion and treatment delays as well as for medi...

Background We review our initial experience of India’s and Asia’s first mobile stroke unit (MSU) following the completion of its first year of operation. We outline the clinical care pathway integrating the MSU services using a case example taking readers along our clinical care workflow while highlighting the challenges faced in organizing and opt...

Background Cardiac myxomas are sporadic in nature and can often recur with a frequency of 3%, especially in middle-aged women, and 22% of the cases account to a part of Carney complex. Complete surgical removal of the myxoma is usually curative. Recurrence has been related with partial surgical excision, multicentricity, and embolism of tumor fragm...

Conventional techniques of vascular imaging (CTA, MRA and DSA) reveal abnormalities of the lumen of the vessel. However, most vascular pathologies show similar lumenographic findings. Intracranial high resolution vessel wall imaging (vWI) has emerged as a promising tool which can directly visualize and characterize the disease of the vessel wall. W...

Precipitating hydrophobic injectable liquid (PHIL) is a newly available liquid embolic agent for endovascular therapy. It is nonadhesive and composed of a biocompatible polymer dissolved in dimethyl sulfoxide solvent and bonded covalently with iodine. In this report, the authors present their preliminary experience using PHIL in the treatment of in...

Objective: To determine the diagnostic characteristics of poor visualisation of nigrosome-1 as a neuroimaging biomarker in Parkinson's disease (PD) and to explore the relationship of poor visualisation of nigrosome-1 and clinical asymmetry. Methods: High-resolution gradient-echo sequences of 67 patients with PD and 63 healthy controls were revie...

Background and purpose Headache constitutes the most common symptom of cerebral venous sinus thrombosis (CVST), but its pathophysiology is unclear. We sought to investigate the potential mechanism for headache genesis in patients with CVST based on its imaging correlates. Methods A subgroup of CVST patients having headache as the predominant sympt...

Imaging in acute stroke has traditionally focussed on the 4Ps-parenchyma, pipes, perfusion, and penumbra-and has increasingly relied upon advanced techniques including magnetic resonance imaging to evaluate such patients. However, as per European Magnetic Resonance Forum estimates, the availability of magnetic resonance imaging scanners for the gen...