Extracerebral anatomic blind spots in computed tomography (CT) head: a pictorial review of non-traumatic findings.

CT head has been increasingly performed in the Emergency Department for patients presented with trauma, acute neurological or psychological symptoms. Most of the emergency physicians and radiologists have undergone dedicated training and are capable of identifying and interpreting life-threatening cerebral pathologies. However, as most attention is directed to the brain, the extracerebral non-traumatic pathologies on CT head can easily be overlooked, and some of them harbour clinically significant pathologies. We categorise the extracerebral anatomic landmarks, illustrate and describe the representative pathologies from each category. The purpose of this article is to increase awareness and familiarity on the non-traumatic extracerebral pathologies, with the aim of achieving comprehensive interpretation of CT head.

Correction to: Extracerebral anatomic blind spots in computed tomography (CT) head: a pictorial review of non-traumatic findings.

The original version of this article contains an error. The author name Raphael Shih Zhu Yiin was incorrectly listed as Raphael Shih Zhu Yin. The correct spelling is presented above. The original article has been corrected.

Diffusion-weighted MRI abnormalities in an outbreak of Streptococcus agalactiae Serotype III, multilocus sequence type 283 meningitis.

PURPOSE: In 2015, an outbreak of group B streptococcal (GBS) infection caused by Streptococcus agalactiae Serotype III, multilocus sequence type 283, related to consuming infected raw freshwater fish, affected more than 200 patients in Singapore. We describe the clinical, laboratory, and neuroimaging features of a subgroup of adults with central nervous system (CNS) infections caused by GBS. MATERIALS AND METHODS: The database of the Singapore Neurologic Infections Program (SNIP), a national multicenter study for surveillance of infectious neurologic disease, was reviewed to select patients with GBS CNS infection during the outbreak. Cases were diagnosed on the basis of clinical features, cerebrospinal fluid (CSF) findings and identification or isolation of Streptococcus agalactiae in the blood or CSF. Demographic, clinical and neuroradiological information was obtained prospectively and retrospectively abstracted. RESULTS: Fourteen patients (6 male, 8 female; median age, 58 years) presented with fever, meningism, headache, encephalopathy, focal neurological deficits, and/or seizures. All except two were previously healthy. Diffusion-weighted imaging (DWI) on admission was abnormal in 13 patients, showing tiny hyperintensities in the subarachnoid space (7 patients), ventricles (6 patients) and brain parenchyma (8 patients); 5 patients had cerebellar abnormalities. CONCLUSION: Among healthy non-pregnant adults infected with Serotype III, multilocus sequence type 283 GBS meningitis linked to eating infected raw freshwater fish, DWI detected small pus collections and unusual cerebellar involvement. A collaborative national surveillance system that includes MRI can be helpful during unusual food-borne zoonotic infectious disease outbreaks. LEVEL OF EVIDENCE: 4 J. Magn. Reson. Imaging 2017;45:507-514.

Metronidazole induced encephalopathy: case report and discussion on the differential diagnoses, in particular, Wernicke's encephalopathy.

Metronidazole induced encephalopathy is a rare central nervous system toxicity, which may be completely reversible with prompt cessation of metronidazole usage. We present a case of metronidazole induced encephalopathy in a 59-year-old man with a history of Whipple's procedure for pancreatic neuroendocrine tumour. The characteristic magnetic resonance imaging features of metronidazole induced encephalopathy and its main differential diagnosis, Wernicke's encephalopathy, are discussed.