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<meta name="DC.Title" content="Detection and Characteristics of Temporal Encephaloceles in Patients with Refractory Epilepsy" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5704" />
<meta name="DC.Date" content="2018-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Temporal encephaloceles are increasingly visualized during neuroimaging assessment of individuals with refractory temporal lobe epilepsy, and their identification could indicate an intracranial abnormality that may be related to a potential seizure focus. Careful review by an experienced neuroradiologist may yield improved detection of TEs, and other clinical, neurophysiologic, and radiologic findings may predict their presence.

MATERIALS AND METHODS: Data were reviewed retrospectively in patients at our institution who were presented at a multidisciplinary conference for refractory epilepsy between January 1, 2010, and December 31, 2016. Clinical, neurophysiologic, and imaging data were collected. An expert neuroradiologist reviewed the latest MR imaging of the brain in patients for whom one was available, noting the presence or absence of temporal encephaloceles as well as other associated imaging characteristics.

RESULTS: A total of 434 patients were reviewed, 16 of whom were excluded due to unavailable or poor-quality MR imaging. Seven patients had temporal encephaloceles reported on initial imaging, while 52 patients had temporal encephaloceles identified on expert review. MR imaging findings were more often initially normal in patients with temporal encephaloceles ( P &lt; .001), and detection of temporal encephaloceles was increased in patients in whom 3T MR imaging was performed ( P &lt; .001), the T2 sampling perfection with application-optimized contrasts by using different flip angle evolutions sequence was used ( P &lt; .001), or the presence of radiologic findings suggestive of idiopathic intracranial hypertension was noted. Seizure onset by scalp electroencephalogram among patients with temporal encephaloceles was significantly more likely to be temporal compared with patients without temporal encephaloceles ( P &lt; .001). A significant correlation between intracranial electroencephalogram seizure onset and patients with temporal encephaloceles compared with patients without temporal encephaloceles was not observed, though there was a trend toward temporal-onset seizures in patients with temporal encephaloceles ( P = .06).

CONCLUSIONS: Careful review of MR imaging in patients with refractory temporal lobe epilepsy by a board-certified neuroradiologist with special attention paid to a high-resolution T2 sequence can increase the detection of subtle temporal encephaloceles, and certain clinical and neurophysiologic findings should raise the suspicion for their presence.

EEG
:   electroencephalogram
RTLE
:   refractory temporal lobe epilepsy
SPACE
:   sampling perfection with application-optimized contrasts by using different flip angle evolutions
TE
:   temporal encephalocele" />
<meta name="DC.Contributor" content="Z.M. Campbell" />
<meta name="DC.Contributor" content="J.M. Hyer" />
<meta name="DC.Contributor" content="S. Lauzon" />
<meta name="DC.Contributor" content="L. Bonilha" />
<meta name="DC.Contributor" content="M.V. Spampinato" />
<meta name="DC.Contributor" content="M. Yazdani" />
<meta name="article:published_time" content="2018-08-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Detection and Characteristics of Temporal Encephaloceles in Patients with Refractory Epilepsy" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Temporal encephaloceles are increasingly visualized during neuroimaging assessment of individuals with refractory temporal lobe epilepsy, and their identification could indicate an intracranial abnormality that may be related to a potential seizure focus. Careful review by an experienced neuroradiologist may yield improved detection of TEs, and other clinical, neurophysiologic, and radiologic findings may predict their presence.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Data were reviewed retrospectively in patients at our institution who were presented at a multidisciplinary conference for refractory epilepsy between January 1, 2010, and December 31, 2016. Clinical, neurophysiologic, and imaging data were collected. An expert neuroradiologist reviewed the latest MR imaging of the brain in patients for whom one was available, noting the presence or absence of temporal encephaloceles as well as other associated imaging characteristics.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;A total of 434 patients were reviewed, 16 of whom were excluded due to unavailable or poor-quality MR imaging. Seven patients had temporal encephaloceles reported on initial imaging, while 52 patients had temporal encephaloceles identified on expert review. MR imaging findings were more often initially normal in patients with temporal encephaloceles (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001), and detection of temporal encephaloceles was increased in patients in whom 3T MR imaging was performed (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001), the T2 sampling perfection with application-optimized contrasts by using different flip angle evolutions sequence was used (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001), or the presence of radiologic findings suggestive of idiopathic intracranial hypertension was noted. Seizure onset by scalp electroencephalogram among patients with temporal encephaloceles was significantly more likely to be temporal compared with patients without temporal encephaloceles (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001). A significant correlation between intracranial electroencephalogram seizure onset and patients with temporal encephaloceles compared with patients without temporal encephaloceles was not observed, though there was a trend toward temporal-onset seizures in patients with temporal encephaloceles (&lt;i&gt;P&lt;/i&gt; = .06).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Careful review of MR imaging in patients with refractory temporal lobe epilepsy by a board-certified neuroradiologist with special attention paid to a high-resolution T2 sequence can increase the detection of subtle temporal encephaloceles, and certain clinical and neurophysiologic findings should raise the suspicion for their presence.&lt;/p&gt;" />
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<meta name="twitter:title" content="Detection and Characteristics of Temporal Encephaloceles in Patients with Refractory Epilepsy" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Temporal encephaloceles are increasingly visualized during neuroimaging assessment of individuals with refractory temporal lobe epilepsy, and their identification could indicate an intracranial abnormality that may be related to a potential seizure focus. Careful review by an experienced neuroradiologist may yield improved detection of TEs, and other clinical, neurophysiologic, and radiologic findings may predict their presence.

MATERIALS AND METHODS: Data were reviewed retrospectively in patients at our institution who were presented at a multidisciplinary conference for refractory epilepsy between January 1, 2010, and December 31, 2016. Clinical, neurophysiologic, and imaging data were collected. An expert neuroradiologist reviewed the latest MR imaging of the brain in patients for whom one was available, noting the presence or absence of temporal encephaloceles as well as other associated imaging characteristics.

RESULTS: A total of 434 patients were reviewed, 16 of whom were excluded due to unavailable or poor-quality MR imaging. Seven patients had temporal encephaloceles reported on initial imaging, while 52 patients had temporal encephaloceles identified on expert review. MR imaging findings were more often initially normal in patients with temporal encephaloceles ( P &lt; .001), and detection of temporal encephaloceles was increased in patients in whom 3T MR imaging was performed ( P &lt; .001), the T2 sampling perfection with application-optimized contrasts by using different flip angle evolutions sequence was used ( P &lt; .001), or the presence of radiologic findings suggestive of idiopathic intracranial hypertension was noted. Seizure onset by scalp electroencephalogram among patients with temporal encephaloceles was significantly more likely to be temporal compared with patients without temporal encephaloceles ( P &lt; .001). A significant correlation between intracranial electroencephalogram seizure onset and patients with temporal encephaloceles compared with patients without temporal encephaloceles was not observed, though there was a trend toward temporal-onset seizures in patients with temporal encephaloceles ( P = .06).

CONCLUSIONS: Careful review of MR imaging in patients with refractory temporal lobe epilepsy by a board-certified neuroradiologist with special attention paid to a high-resolution T2 sequence can increase the detection of subtle temporal encephaloceles, and certain clinical and neurophysiologic findings should raise the suspicion for their presence.

EEG
:   electroencephalogram
RTLE
:   refractory temporal lobe epilepsy
SPACE
:   sampling perfection with application-optimized contrasts by using different flip angle evolutions
TE
:   temporal encephalocele" />
<meta name="og-title" property="og:title" content="Detection and Characteristics of Temporal Encephaloceles in Patients with Refractory Epilepsy" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/8/1468" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Temporal encephaloceles are increasingly visualized during neuroimaging assessment of individuals with refractory temporal lobe epilepsy, and their identification could indicate an intracranial abnormality that may be related to a potential seizure focus. Careful review by an experienced neuroradiologist may yield improved detection of TEs, and other clinical, neurophysiologic, and radiologic findings may predict their presence.

MATERIALS AND METHODS: Data were reviewed retrospectively in patients at our institution who were presented at a multidisciplinary conference for refractory epilepsy between January 1, 2010, and December 31, 2016. Clinical, neurophysiologic, and imaging data were collected. An expert neuroradiologist reviewed the latest MR imaging of the brain in patients for whom one was available, noting the presence or absence of temporal encephaloceles as well as other associated imaging characteristics.

RESULTS: A total of 434 patients were reviewed, 16 of whom were excluded due to unavailable or poor-quality MR imaging. Seven patients had temporal encephaloceles reported on initial imaging, while 52 patients had temporal encephaloceles identified on expert review. MR imaging findings were more often initially normal in patients with temporal encephaloceles ( P &lt; .001), and detection of temporal encephaloceles was increased in patients in whom 3T MR imaging was performed ( P &lt; .001), the T2 sampling perfection with application-optimized contrasts by using different flip angle evolutions sequence was used ( P &lt; .001), or the presence of radiologic findings suggestive of idiopathic intracranial hypertension was noted. Seizure onset by scalp electroencephalogram among patients with temporal encephaloceles was significantly more likely to be temporal compared with patients without temporal encephaloceles ( P &lt; .001). A significant correlation between intracranial electroencephalogram seizure onset and patients with temporal encephaloceles compared with patients without temporal encephaloceles was not observed, though there was a trend toward temporal-onset seizures in patients with temporal encephaloceles ( P = .06).

CONCLUSIONS: Careful review of MR imaging in patients with refractory temporal lobe epilepsy by a board-certified neuroradiologist with special attention paid to a high-resolution T2 sequence can increase the detection of subtle temporal encephaloceles, and certain clinical and neurophysiologic findings should raise the suspicion for their presence.

EEG
:   electroencephalogram
RTLE
:   refractory temporal lobe epilepsy
SPACE
:   sampling perfection with application-optimized contrasts by using different flip angle evolutions
TE
:   temporal encephalocele" />
<meta name="og-type" property="og:type" content="article" />
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      <h1 class="highwire-cite-title" id="page-title">Detection and Characteristics of Temporal Encephaloceles in Patients with Refractory Epilepsy</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Z.M. Campbell</span>, <span class="highwire-citation-author" data-delta="1">J.M. Hyer</span>, <span class="highwire-citation-author" data-delta="2">S. Lauzon</span>, <span class="highwire-citation-author" data-delta="3">L. Bonilha</span>, <span class="highwire-citation-author" data-delta="4">M.V. Spampinato</span> and <span class="highwire-citation-author" data-delta="5">M. Yazdani</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1468-1472; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5704 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-62131--61190951965" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Z.M. Campbell </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neurology (Z.M.C., L.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.M.%2BCampbell%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Campbell%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AZ.M.%2BCampbell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8622-2565" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Z.M. Campbell</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.M. Hyer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Public Health Sciences (J.M.H., S.L.), Medical University of South Carolina, Charleston, South Carolina.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.M.%2BHyer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hyer%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.M.%2BHyer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0825-3462" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.M. Hyer</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">S. Lauzon </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Public Health Sciences (J.M.H., S.L.), Medical University of South Carolina, Charleston, South Carolina.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BLauzon%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lauzon%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BLauzon%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4911-0636" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Lauzon</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">L. Bonilha </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neurology (Z.M.C., L.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BBonilha%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bonilha%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BBonilha%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6153-8942" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Bonilha</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M.V. Spampinato </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology and Radiologic Science (M.Y., M.V.S.), Neuroradiology</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.V.%2BSpampinato%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Spampinato%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.V.%2BSpampinato%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2040-1894" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.V. Spampinato</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">M. Yazdani </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology and Radiologic Science (M.Y., M.V.S.), Neuroradiology</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BYazdani%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yazdani%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BYazdani%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5072-665X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Temporal encephaloceles are increasingly visualized during neuroimaging assessment of individuals with refractory temporal lobe epilepsy, and their identification could indicate an intracranial abnormality that may be related to a potential seizure focus. Careful review by an experienced neuroradiologist may yield improved detection of TEs, and other clinical, neurophysiologic, and radiologic findings may predict their presence.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> Data were reviewed retrospectively in patients at our institution who were presented at a multidisciplinary conference for refractory epilepsy between January 1, 2010, and December 31, 2016. Clinical, neurophysiologic, and imaging data were collected. An expert neuroradiologist reviewed the latest MR imaging of the brain in patients for whom one was available, noting the presence or absence of temporal encephaloceles as well as other associated imaging characteristics.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> A total of 434 patients were reviewed, 16 of whom were excluded due to unavailable or poor-quality MR imaging. Seven patients had temporal encephaloceles reported on initial imaging, while 52 patients had temporal encephaloceles identified on expert review. MR imaging findings were more often initially normal in patients with temporal encephaloceles (<em>P</em> &lt; .001), and detection of temporal encephaloceles was increased in patients in whom 3T MR imaging was performed (<em>P</em> &lt; .001), the T2 sampling perfection with application-optimized contrasts by using different flip angle evolutions sequence was used (<em>P</em> &lt; .001), or the presence of radiologic findings suggestive of idiopathic intracranial hypertension was noted. Seizure onset by scalp electroencephalogram among patients with temporal encephaloceles was significantly more likely to be temporal compared with patients without temporal encephaloceles (<em>P</em> &lt; .001). A significant correlation between intracranial electroencephalogram seizure onset and patients with temporal encephaloceles compared with patients without temporal encephaloceles was not observed, though there was a trend toward temporal-onset seizures in patients with temporal encephaloceles (<em>P</em> = .06).</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> Careful review of MR imaging in patients with refractory temporal lobe epilepsy by a board-certified neuroradiologist with special attention paid to a high-resolution T2 sequence can increase the detection of subtle temporal encephaloceles, and certain clinical and neurophysiologic findings should raise the suspicion for their presence.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">EEG<span class="def-item-dt-sep"></span></dt><dd>electroencephalogram<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">RTLE<span class="def-item-dt-sep"></span></dt><dd>refractory temporal lobe epilepsy<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">SPACE<span class="def-item-dt-sep"></span></dt><dd>sampling perfection with application-optimized contrasts by using different flip angle evolutions<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">TE<span class="def-item-dt-sep"></span></dt><dd>temporal encephalocele</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2018 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/39/8/1468.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 39</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 8 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Aug 2018 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Z.M.</span> <span class="nlm-surname">Campbell</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.M.</span> <span class="nlm-surname">Hyer</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Lauzon</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Bonilha</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.V.</span> <span class="nlm-surname">Spampinato</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Yazdani</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1468-1472; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5704 </span></div>
  
  
  
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