THE REQUISITES Neuroradiology SERIES EDITOR James H. Thrall, MD Radiologist-in-Chief Massachusetts General Hospital Juan M. Taveras Professor of Radiology Harvard Medical School Boston, Massachusetts OTHER VOLUMES IN Breast Imaging THE REQUISITES IN RADIOLOGY SERIES Cardiac Imaging Emergency Radiology Gastrointestinal Imaging Genitourinary Radiology Musculoskeletal Imaging Nuclear Medicine Pediatric Radiology Ultrasound Thoracic Radiology Vascular & Interventional Radiology THE REQUISITES Neuroradiology Third edition David M. Yousem, MD, MBA Professor of Radiology, Director of Neuroradiology Russell H.
Morgan Department of Radiology and Radiological Science Johns Hopkins Medical Institution Baltimore, Maryland Robert I. Grossman, MD Dean and CEO NYU Langone Medical Center Attending Physician Department of Radiology NYU Hospitals Center Attending Physician Department of Radiology Bellevue Hospital Center Professor Department of Radiology Neurosurgery and Physiology & Neuroscience NYU School of Medicine New York, New York 1600 John F. Kennedy Boulevard Suite 1800 Philadelphia, PA 19103-2899 NEURORADIOLOGY: THE REQUISITES ISBN: 978-0-323-04521-6 © 2010 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Neuroradiology : the requisites / David M. Grossman is first named author on previous edition. Includes bibliographical references and index. Nervous system–Radiography.
Series: Requisites in radiology. Central Nervous System Diseases–radiography.8a04757–dc22 2010005631 Acquisitions Editor: Rebecca S. Gaertner Developmental Editor: Stacey Fisher Project Manager: David Saltzberg Design Direction: Steven Stave Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 Dedication To the LOML, my OAO. Thank you for the love and support.
—DMY To Lisse—great mother, perfect wife, spectacular ophthalmologist. You did it all! —RIG Contributors Robert Zimmerman, MD Executive Vice Chairman Professor of Radiology Department of Radiology Weill Cornell Medical College Director of Diagnostic Imaging Department of Radiology New York Presbyterian Hospital-Weill Cornell New York, New York vii Foreword Neuroradiology: The Requisites is now appearing in its third edition Fellows specializing in neuroradiology will also find this to be and has established itself as one of the widely read books on the a very useful book. The organization follows from methods to subject. The third edition again captures the philosophy of the anatomic concepts and disease-oriented applications, presenting series for efficient and economical presentation of material while a logical sequence for their mastering of the subject at the still presenting the important subject matter of neuroradiology at fellowship level.
a level and with a clarity of detail that is sure to be well received. Residents and fellows studying for board exams will also like the Neuroradiology has always been a challenging field to capture in concise nature of the Requisites series, including Neuroradiology: a textbook because of the multiplicity of methods involved and The Requisites. These books can truly be “studied rather than just the inherent complexity of the interplay among neuroanatomy, read superficially,” leading to a much more enduring mastery of physiology, and function that all must be understood in order to the information. master the practice of neuroradiology.
For radiology practitioners, neurologists, and neurosurgeons, In the time since publication of the second edition of Neuroradiology: The Requisites can serve as a textbook for learning Neuroradiology: The Requisites, several important advances and trends the subject and as a useful and efficient reference book to help have continued to transform and reshape the field. Advances in guide their understanding of imaging results and findings in their technology include the fairly widespread adoption of higher field patients. MR imaging at 3.0 Tesla, with associated improvements in image When the Requisites series was first established, there was a quality and increased flexibility in image protocol development. hypothesis and hope that the format would make information read- Multichannel MR imaging has led to improved image quality and ily accessible to the reader by eliminating extraneous material and shortened imaging times.
MR tractography has opened important covering only those topics deemed most important to clinical prac- new avenues of research and is increasingly used for patient care. tice by the respective authors. The success of the series of the past There has been near universal adoption of multislice CT, greatly two decades argues strongly in favor of the approach and format. facilitating the application of functional CT for the diagnosis and I have every confidence that the third edition of Neuroradiology: management of stroke.
These technologic advances are remark- The Requisites will be equally well received as its two predeces- able, and, in retrospect, many of them were beyond our imagination sor editions. I again congratulate Drs. Yousem and Grossman for only a few years ago. their outstanding text.
They have truly brought to bear their Given the continued changes in the practice of medicine authoritative knowledge and experience in neuroradiology for and neuroradiology, anyone who deals with the nervous system the benefit of the reader, whether beginning resident or sea- will find the third edition of Neuroradiology: The Requisites to be soned warrior. an invaluable resource on the subject. The concise nature of the book will make it particularly appealing to residents dur- James H. Thrall, MD ing their neuroradiology rotations, where they face the unique Radiologist-in-Chief problem of going from a minimal knowledge base of neuroradiol- Massachusetts General Hospital ogy to a working knowledge in a very short period of time.
The Professor of Radiology Requisties series was designed to address this issue by balancing text and illustrations appropriately and reinforcing concepts with Harvard Medical School summary tables and boxes. Boston, Massachusetts ix Preface Somewhere between the first and the second edition of 20 years, Rena Geckle; and my great buddy, Norm Beauchamp. Neuroradiology: The Requisites, Bob Grossman and I lost our tight At Elsevier, Martha, Linnea, and Rebecca have shepherded me focus or, some will say, got full of ourselves and the book bal- through the process with minimal pain and maximal assistance looned to more than 900 pages (with index). There was a lot more and support.
On the home front, close friends Scott and Coos, great stuff in the second edition, but there was also a lot of “non- and loving family members, especially my ever-delighting Ilyssa requisite” stuff as we covered more subtle and obscure entities. and Mitch and Liz support me. Hard to believe that Mitch was The third edition marks a return to the essentials of neuroradi- “in utero” for the first edition of the book and is on the way ology, with the elimination of many of the less common entities to driver’s ed at the time of this third edition. I cannot express most people will not see outside the quaternary care academic enough love and gratitude to my ever spiritual wife, Kelly, who medical institutions.
We still guarantee passing grades for ABR has recharged my batteries in many, many ways as I pass from candidates and feel confident that we cover the subject thor- my 40s to my 50s…. She is my muse, and I love her oughly, but our goal was to recapture about 200 pages and get the more and more with each passing day. Many days of writing in book back to “the requisites.” We hoped that we could recreate a our home on Sarkar Cove, Alaska, were punctuated by her offers book that residents everywhere could read on a 1- month rotation of more coffee, more salmon, more halibut, more granola, more comfortably, undaunted by the size, and one that still served the brownies. She has kept me happy and happily writing.
Thank practice of most radiologists needing a firm base in neuroradiol- you, my love. ogy from all venues of practice. Live, love, learn, and leave a legacy. As I participated in feedback sessions on Aunt Minnie about —DMY what the third edition should sound like, there was a strong pref- erence expressed for rolling back much of the humor that dotted the first and second editions.
While I had mixed feelings about Tempus fugit—so true! I still have the image of a young David that, I recognized that it would be helpful to reduce the size of the Yousem and me in 1994 choosing photographs for the first edition of book if Bob and my attempts to have a piece of humor on every our book. It was an ice-cold winter, and we were exhausted trying to page were reduced. Thus, hopefully, the humor that remains finish the manuscript in a timely fashion. I had the highest respect for will be less intrusive, in good taste, and used to make teaching his work ethic then, and nothing has changed in the past 15 years.
points, not just to demonstrate wit. if there was any there to Well, not quite. David left Penn and became head of neurora- begin with. Because this is more “my edition,” people will no doubt think that it was Bob who had the good sense of humor diology at Johns Hopkins, where he has built a superb academic and Yousem was the serious dull one, but so be it.
The books will section and has embellished his legacy as a leader in the field. have a different tone, no doubt, but it still is a joint product. My career had a few twists and turns. After not being afforded an Bob left the third edition to me to revise.
I have used his strong interview for the Radiology Chair position at Penn, I was incred- basis from the previous editions and have updated, trimmed, and ibly fortunate to have been given a better opportunity at NYU. enhanced, and eliminated material from his original chapters. Starting in 2001 and working with a team of energetic and talented Nonetheless, because the vast majority of the text is his original individuals, we transformed the department into an academic material Bob Grossman remains a co-author. He also remained a powerhouse in a few short years.
sounding board for me to bounce ideas about the book and to lis- In 2004, the second edition of this book was published. The ten to me complain and gripe about various aspects of the author- combined sales of our book was more than 50,000 copies!
