A Rare Presentation of Intracerebellar Schwannoma: A Case Report.

Background: Intracerebellar schwannoma is an extremely rare disease entity with only 21 case reports described in the literature. Case Description: A 68-year-old male presented with chronic headaches, dizziness, gait imbalance, and incoordination. Previous MRI had revealed a cystic lesion in the right cerebellum; however, patient was lost to follow-up. Updated MRI revealed dramatic enlargement of the lesion in addition to worsening clinical status. The patient underwent successful surgical resection. Conclusion: Intracerebellar schwannoma can be challenging to diagnose preoperatively due to its rare occurrence; however, it should be included in the differential diagnosis of cystic lesions in the cerebellum, and most cases can be successfully treated with complete surgical resection. Pathological examination revealed a spindle cell neoplasm with other typical histopathological features of schwannoma.

Generating New Musical Preferences From Multilevel Mapping of Predictions to Reward.

Much of what we know and love about music hinges on our ability to make successful predictions, which appears to be an intrinsically rewarding process. Yet the exact process by which learned predictions become pleasurable is unclear. Here we created novel melodies in an alternative scale different from any established musical culture to show how musical preference is generated de novo. Across nine studies (n = 1,185), adult participants learned to like more frequently presented items that adhered to this rapidly learned structure, suggesting that exposure and prediction errors both affected self-report liking ratings. Learning trajectories varied by music-reward sensitivity but were similar for U.S. and Chinese participants. Furthermore, functional MRI activity in auditory areas reflected prediction errors, whereas functional connectivity between auditory and medial prefrontal regions reflected both exposure and prediction errors. Collectively, results support predictive coding as a cognitive mechanism by which new musical sounds become rewarding.

Non-Hodgkins lymphoma of the nasal cavity: A case report.

We present a rare case of an 81-year-old woman presenting with acute left nasal blockage caused by a large nasal mass of unknown origin. The mass was subsequently diagnosed as diffuse large B-cell non-Hodgkin lymphoma (NHL). Nasal/paranasal space involvement in NHL is uncommon, representing only 0.2%-2% of cases. In this case, the nasal NHL mass exhibited a favorable prognosis, in contrast to previously reported sinonasal lymphomas with poor outcomes. The patient underwent excisional biopsy and was treated with 3 cycles of R-CHOP chemotherapy, resulting in complete resolution of the mass confirmed by a follow-up CT scan and no signs of disease after 1 year. Differentiating sinonasal lymphomas from other neoplasms can be challenging due to their variable morphology and location. Diffuse presentations of sinonasal lymphoma can aid in distinguishing them from discrete lesions associated with other sinonasal neoplasms. However, differentiation from acute invasive sinonasal infection remains difficult. MRI can help identify lymphomas through the characteristic hypointense T2 signal and diffusion restriction, with the combined use of CT to aid in differentiating masses of unknown morphology. Nonetheless, squamous cell carcinoma, which mimics lymphoma features on MRI, poses additional challenges to accurate identification. This case highlights the rarity of nasal NHLs, their potential for excellent prognosis, and the importance of diverse imaging techniques in their diagnosis and differentiation from other sinonasal pathologies.

Craniocerebral gunshot injury bullet migration to the cardiac right ventricle.

BACKGROUND: Missile embolism is the process of slow velocity projectiles penetrating into vascular spaces followed by arterial, venous, or paradoxical embolism of the fragments. This is a rare complication in craniocerebral gunshot injuries (CGI), with only five other cases previously published demonstrating pulmonary or arterial emboli from these injuries. There is a high rate of mortality from these injuries. CASE DESCRIPTION: A patient presented with a CGI from an occipital trajectory, causing penetrating fragments into the venous sinus system. The weapon was a Glock Model 17M 9 mm with a hollow-point bullet, fired close range. Initial chest X-ray demonstrated only atelectasis. After stabilization, 18 min from the initial chest X-ray, subsequent computed tomography (CT) imaging demonstrated extensive intracranial injuries and fragmentation of the bullet with the expected devastating intracranial injuries. Unexpectedly, chest CT revealed metallic fragments in the right cardiac ventricle which was redemonstrated on follow-up chest X-ray. Unfortunately, his extensive intracranial injuries and poor clinical status were nonsurvivable, and thus the family elected to discontinue supportive measures. CONCLUSION: This case demonstrates radiographic imaging of a metallic intravascular fragment from CGI through presumed transvenous mechanisms. The imaging provides a consistent timeline demonstrating migration can occur in the acute phase. This study additionally supports the presumed mechanism for pulmonary of migration through the right heart. Fragment embolization should be considered in cases of acute deterioration in this patient population.

Artificial Intelligence and Deep Learning in Neuroradiology: Exploring the New Frontier.

There have been many recently published studies exploring machine learning (ML) and deep learning applications within neuroradiology. The improvement in performance of these techniques has resulted in an ever-increasing number of commercially available tools for the neuroradiologist. In this narrative review, recent publications exploring ML in neuroradiology are assessed with a focus on several key clinical domains. In particular, major advances are reviewed in the context of: (1) intracranial hemorrhage detection, (2) stroke imaging, (3) intracranial aneurysm screening, (4) multiple sclerosis imaging, (5) neuro-oncology, (6) head and tumor imaging, and (7) spine imaging.