1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [cf7669a3-e03a-4100-8ca4-975c0330fefc] => Array
        (
            [runtime-id] => cf7669a3-e03a-4100-8ca4-975c0330fefc
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [31481335-c947-423a-a902-42f518dfc04d] => Array
                        (
                            [runtime-id] => 31481335-c947-423a-a902-42f518dfc04d
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;aa072a1d0e816b62bd486b34476039b0718243a4
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [cf7669a3-e03a-4100-8ca4-975c0330fefc] => Array
        (
            [runtime-id] => cf7669a3-e03a-4100-8ca4-975c0330fefc
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [31481335-c947-423a-a902-42f518dfc04d] => Array
                        (
                            [runtime-id] => 31481335-c947-423a-a902-42f518dfc04d
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;aa072a1d0e816b62bd486b34476039b0718243a4
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [d4c2f1cf-1bcc-46e0-8535-136a8de84815] => Array
        (
            [runtime-id] => d4c2f1cf-1bcc-46e0-8535-136a8de84815
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [8d9b755b-bf4c-40a8-8a5c-d9e84f5fb581] => Array
                        (
                            [runtime-id] => 8d9b755b-bf4c-40a8-8a5c-d9e84f5fb581
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;aa072a1d0e816b62bd486b34476039b0718243a4
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [cf7669a3-e03a-4100-8ca4-975c0330fefc] => Array
        (
            [runtime-id] => cf7669a3-e03a-4100-8ca4-975c0330fefc
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [31481335-c947-423a-a902-42f518dfc04d] => Array
                        (
                            [runtime-id] => 31481335-c947-423a-a902-42f518dfc04d
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;aa072a1d0e816b62bd486b34476039b0718243a4
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [cf7669a3-e03a-4100-8ca4-975c0330fefc] => Array
        (
            [runtime-id] => cf7669a3-e03a-4100-8ca4-975c0330fefc
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [31481335-c947-423a-a902-42f518dfc04d] => Array
                        (
                            [runtime-id] => 31481335-c947-423a-a902-42f518dfc04d
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;aa072a1d0e816b62bd486b34476039b0718243a4
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [cf7669a3-e03a-4100-8ca4-975c0330fefc] => Array
        (
            [runtime-id] => cf7669a3-e03a-4100-8ca4-975c0330fefc
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [31481335-c947-423a-a902-42f518dfc04d] => Array
                        (
                            [runtime-id] => 31481335-c947-423a-a902-42f518dfc04d
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;aa072a1d0e816b62bd486b34476039b0718243a4
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [aec5b768-d005-413c-a276-ffb421425e1d] => Array
        (
            [runtime-id] => aec5b768-d005-413c-a276-ffb421425e1d
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [430fae1d-2695-4dfc-b84b-b94ea233fb4c] => Array
                        (
                            [runtime-id] => 430fae1d-2695-4dfc-b84b-b94ea233fb4c
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;aa072a1d0e816b62bd486b34476039b0718243a4
                )

        )

)
<!DOCTYPE html>
<html lang="en" dir="ltr" 
  xmlns="http://www.w3.org/1999/xhtml"
  xmlns:mml="http://www.w3.org/1998/Math/MathML">
  <head prefix="og: http://ogp.me/ns# article: http://ogp.me/ns/article# book: http://ogp.me/ns/book#" >
    <!--[if IE]><![endif]-->
<link rel="dns-prefetch" href="//securepubads.g.doubleclick.net" />
<link rel="dns-prefetch" href="//scholar.google.com" />
<link rel="dns-prefetch" href="//www.google.com" />
<link rel="dns-prefetch" href="//www.googletagmanager.com" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta name="citation_funding_source" content="citation_grant_number=(CM14/00081, CV15/00021) (TA);" />
<meta name="issue_cover_image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/45/6.cover-source.jpg" />
<meta name="type" content="article" />
<meta name="category" content="research-article" />
<meta name="HW.identifier" content="/ajnr/45/6/769.atom" />
<meta name="HW.pisa" content="ajnr;45/6/769" />
<meta name="DC.Format" content="text/html" />
<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8220" />
<meta name="DC.Date" content="2024-06-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2024 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: While classic brain MR imaging features of Alexander disease have been well-documented, lesional patterns can overlap with other leukodystrophies, especially in the early stages of the disease or in milder phenotypes. We aimed to assess the utility of a new neuroimaging sign to help increase the diagnostic specificity of Alexander disease.

MATERIALS AND METHODS: A peculiar bilateral symmetric hyperintense signal on T2-weighted images affecting the medulla oblongata was identified in an index patient with type I Alexander disease. Subsequently, 5 observers performed a systematic MR imaging review for this pattern by examining 55 subjects with Alexander disease and 74 subjects with other leukodystrophies. Interobserver agreement was assessed by the κ index. Sensitivity, specificity, and receiver operating characteristic curves were determined.

RESULTS: The identified pattern was present in 87% of subjects with Alexander disease and 14% of those without Alexander disease leukodystrophy ( P  &lt; .001), 3 with vanishing white matter, 4 with adult polyglucosan body disease, and 3 others. It was found equally in both type I and type II Alexander disease (28/32, 88% versus 18/21, 86%; P  = .851) and in subjects with unusual disease features (2/2). Sensitivity (87.3%; 95% CI, 76.0%–93.7%), specificity (86.5%; 95% CI, 76.9%–92.5%), and interobserver agreement (κ index = 0.82) were high.

CONCLUSIONS: The identified pattern in the medulla oblongata, called the chipmunk sign due to its resemblance to the face of this rodent, is extremely common in subjects with Alexander disease and represents a diagnostic tool that can aid in early diagnosis, especially in subjects with otherwise atypical MR imaging findings and/or clinical features.

APBD
:   adult polyglucosan body disease
ADLD
:   adult-onset autosomal dominant leukodystrophy
AxD
:   Alexander disease
GFAP 
:   glial fibrillary acidic protein
ION
:   inferior olivary nucleus
IQR
:   interquartile range
VWM
:   vanishing white matter" />
<meta name="DC.Contributor" content="Thaís Armangue" />
<meta name="DC.Contributor" content="Matthew T. Whitehead" />
<meta name="DC.Contributor" content="Davide Tonduti" />
<meta name="DC.Contributor" content="Laura Farina" />
<meta name="DC.Contributor" content="Ali Reza Tavasoli" />
<meta name="DC.Contributor" content="Arastoo Vossough" />
<meta name="DC.Contributor" content="Mariko L. Bennett" />
<meta name="DC.Contributor" content="Ylenia Vaia" />
<meta name="DC.Contributor" content="Geneviève Bernard" />
<meta name="DC.Contributor" content="Ettore Salsano" />
<meta name="DC.Contributor" content="Saadet Mercimek-Andrews" />
<meta name="DC.Contributor" content="Amy Waldman" />
<meta name="DC.Contributor" content="Adeline Vanderver" />
<meta name="article:published_time" content="2024-06-01" />
<meta name="article:section" content="Neurodegenerative Disorder Imaging" />
<meta name="citation_title" content="Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;While classic brain MR imaging features of Alexander disease have been well-documented, lesional patterns can overlap with other leukodystrophies, especially in the early stages of the disease or in milder phenotypes. We aimed to assess the utility of a new neuroimaging sign to help increase the diagnostic specificity of Alexander disease.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A peculiar bilateral symmetric hyperintense signal on T2-weighted images affecting the medulla oblongata was identified in an index patient with type I Alexander disease. Subsequently, 5 observers performed a systematic MR imaging review for this pattern by examining 55 subjects with Alexander disease and 74 subjects with other leukodystrophies. Interobserver agreement was assessed by the κ index. Sensitivity, specificity, and receiver operating characteristic curves were determined.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The identified pattern was present in 87% of subjects with Alexander disease and 14% of those without Alexander disease leukodystrophy (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001), 3 with vanishing white matter, 4 with adult polyglucosan body disease, and 3 others. It was found equally in both type I and type II Alexander disease (28/32, 88% versus 18/21, 86%; &lt;i&gt;P&lt;/i&gt; = .851) and in subjects with unusual disease features (2/2). Sensitivity (87.3%; 95% CI, 76.0%–93.7%), specificity (86.5%; 95% CI, 76.9%–92.5%), and interobserver agreement (κ index = 0.82) were high.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The identified pattern in the medulla oblongata, called the chipmunk sign due to its resemblance to the face of this rodent, is extremely common in subjects with Alexander disease and represents a diagnostic tool that can aid in early diagnosis, especially in subjects with otherwise atypical MR imaging findings and/or clinical features.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2024/06/01" />
<meta name="citation_mjid" content="ajnr;45/6/769" />
<meta name="citation_id" content="45/6/769" />
<meta name="citation_public_url" content="http://ajnr-stage2.stage.highwire.org/content/45/6/769" />
<meta name="citation_abstract_html_url" content="http://ajnr-stage2.stage.highwire.org/content/45/6/769.abstract" />
<meta name="citation_full_html_url" content="http://ajnr-stage2.stage.highwire.org/content/45/6/769.full" />
<meta name="citation_pdf_url" content="http://ajnr-stage2.stage.highwire.org/content/ajnr/45/6/769.full.pdf" />
<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A8220" />
<meta name="citation_pmid" content="38697787" />
<meta name="citation_volume" content="45" />
<meta name="citation_issue" content="6" />
<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Neurodegenerative Disorder Imaging" />
<meta name="citation_firstpage" content="769" />
<meta name="citation_lastpage" content="772" />
<meta name="citation_author" content="Thaís Armangue" />
<meta name="citation_author_institution" content="aFrom the Neuroimmunology Program (T.A.), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Hospital Clinic, University of Barcelona, Barcelona, Spain" />
<meta name="citation_author_institution" content="bNeurology Department (T.A.), Neuroimmunology Unit, Sant Joan de Deu Children’s Hospital, University of Barcelona, Barcelona, Spain" />
<meta name="citation_author" content="Matthew T. Whitehead" />
<meta name="citation_author_institution" content="cDepartment of Radiology (M.T.W., A.Vossough), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania" />
<meta name="citation_author_institution" content="dPerelman School of Medicine (M.T.W., A.Vossough, A.W., A.Vanderver), University of Pennsylvania, Philadelphia, Pennsylvania" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-5077-693X" />
<meta name="citation_author" content="Davide Tonduti" />
<meta name="citation_author_institution" content="eUnit of Pediatric Neurology (D.T., Y.V.), Center for Diagnosis and Treatment of Leukodystrophies, V. Buzzi Children’s Hospital, University of Milan, Milan, Italy" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-9371-7454" />
<meta name="citation_author" content="Laura Farina" />
<meta name="citation_author_institution" content="fNeuroimaging Laboratory (L.F.), IRCCS Fondazione Santa Lucia, Rome, Italy" />
<meta name="citation_author" content="Ali Reza Tavasoli" />
<meta name="citation_author_institution" content="gDepartment of Neurology (A.R.T.), Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran" />
<meta name="citation_author_institution" content="hDepartment of Neurology (A.R.T.), Barrow Neurological Institute, Phoenix Children’s Hospital, Phoenix, Arizona" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-0440-5809" />
<meta name="citation_author" content="Arastoo Vossough" />
<meta name="citation_author_institution" content="cDepartment of Radiology (M.T.W., A.Vossough), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania" />
<meta name="citation_author_institution" content="dPerelman School of Medicine (M.T.W., A.Vossough, A.W., A.Vanderver), University of Pennsylvania, Philadelphia, Pennsylvania" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-1346-427X" />
<meta name="citation_author" content="Mariko L. Bennett" />
<meta name="citation_author_institution" content="oDivision of Neurology (M.L.B., Y.V., A.W., A.Vanderver), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="Ylenia Vaia" />
<meta name="citation_author_institution" content="eUnit of Pediatric Neurology (D.T., Y.V.), Center for Diagnosis and Treatment of Leukodystrophies, V. Buzzi Children’s Hospital, University of Milan, Milan, Italy" />
<meta name="citation_author_institution" content="oDivision of Neurology (M.L.B., Y.V., A.W., A.Vanderver), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania." />
<meta name="citation_author_orcid" content="https://orcid.org/0009-0009-7105-7411" />
<meta name="citation_author" content="Geneviève Bernard" />
<meta name="citation_author_institution" content="iDepartments of Neurology and Neurosurgery, Pediatrics, and Human Genetics (G.B.), McGill University, Montreal, Quebec, Canada" />
<meta name="citation_author_institution" content="jDepartment of Specialized Medicine (G.B.), Division of Medical Genetics, McGill University Health Centre, Montreal, Quebec, Canada" />
<meta name="citation_author_institution" content="kChild Health and Human Development Program (G.B.), Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada" />
<meta name="citation_author" content="Ettore Salsano" />
<meta name="citation_author_institution" content="lUnit of Rare Neurological Diseases (E.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy" />
<meta name="citation_author" content="Saadet Mercimek-Andrews" />
<meta name="citation_author_institution" content="mDepartment of Medical Genetics (S.M.-A.), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada" />
<meta name="citation_author_institution" content="nThe Hospital for Sick Children (S.M.-A.), Toronto, Ontario, Canada" />
<meta name="citation_author" content="Amy Waldman" />
<meta name="citation_author_institution" content="dPerelman School of Medicine (M.T.W., A.Vossough, A.W., A.Vanderver), University of Pennsylvania, Philadelphia, Pennsylvania" />
<meta name="citation_author_institution" content="oDivision of Neurology (M.L.B., Y.V., A.W., A.Vanderver), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania." />
<meta name="citation_author" content="Adeline Vanderver" />
<meta name="citation_author_institution" content="dPerelman School of Medicine (M.T.W., A.Vossough, A.W., A.Vanderver), University of Pennsylvania, Philadelphia, Pennsylvania" />
<meta name="citation_author_institution" content="oDivision of Neurology (M.L.B., Y.V., A.W., A.Vanderver), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania." />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-6290-6751" />
<meta name="citation_reference" content="citation_journal_title=Handb Clin Neurol;citation_author=A. Messing;citation_title=Alexander disease;citation_pages=693-700;citation_volume=148;citation_year=2018;citation_pmid=29478608;citation_doi=10.1016/B978-0-444-64076-5.00044-2" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=MS. van der Knaap;citation_author=S. Naidu;citation_author=SN. Breiter;citation_title=Alexander Disease: Diagnosis with MR Imaging;citation_pages=541-552;citation_volume=22;citation_year=2001;citation_issue=3;citation_pmid=11237983" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=LS. Russo;citation_author=A. Aron;citation_author=PJ. Anderson;citation_title=Alexander's disease: A report and reappraisal;citation_pages=607-607;citation_volume=26;citation_year=1976;citation_issue=7;citation_pmid=180453;citation_doi=10.1212/wnl.26.7.607" />
<meta name="citation_reference" content="citation_journal_title=Neuropediatrics;citation_journal_abbrev=Neuropediatrics;citation_author=S. Springer;citation_author=R. Erlewein;citation_author=T. Naegele;citation_title=Alexander disease--classification revisited and isolation of a neonatal form.;citation_pages=86-92;citation_volume=31;citation_year=2000;citation_issue=2;citation_pmid=10832583;citation_doi=10.1055/s-2000-7479" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_author=M. Prust;citation_author=J. Wang;citation_author=H. Morizono;citation_title=GFAP mutations, age at onset, and clinical subtypes in Alexander disease;citation_volume=77;citation_year=2011;citation_pmid=21917775;citation_doi=10.1212/WNL.0b013e3182309f72" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=MS. van der Knaap;citation_author=V. Ramesh;citation_author=R. Schiffmann;citation_title=Alexander disease: Ventricular garlands and abnormalities of the medulla and spinal cord;citation_pages=494-498;citation_volume=66;citation_year=2006;citation_issue=4;citation_pmid=16505300;citation_doi=10.1212/01.wnl.0000198770.80743.37" />
<meta name="citation_reference" content="citation_journal_title=Radiographics;citation_author=LL. Resende;citation_author=AR. de Paiva;citation_author=F. Kok;citation_title=Adult leukodystrophies: a step-by-step diagnostic approach;citation_pages=153-68;citation_volume=39;citation_year=2019;citation_pmid=30620693;citation_doi=10.1148/rg.2019180081" />
<meta name="citation_reference" content="citation_journal_title=Annals of neurology;citation_journal_abbrev=Ann Neurol;citation_author=MS. van der Knaap;citation_author=GS. Salomons;citation_author=R. Li;citation_title=Unusual variants of Alexander's disease.;citation_pages=327-338;citation_volume=57;citation_year=2005;citation_issue=3;citation_pmid=15732098;citation_doi=10.1002/ana.20381" />
<meta name="citation_reference" content="citation_journal_title=J Child Neurol;citation_author=P. Barreau;citation_author=MJ. Prust;citation_author=J. Crane;citation_title=Focal central white matter lesions in Alexander disease;citation_volume=26;citation_year=2011;citation_pmid=21572052;citation_doi=10.1177/0883073811405381" />
<meta name="citation_reference" content="citation_journal_title=Neurol Clin Pract;citation_author=T. Yoshida;citation_author=I. Mizuta;citation_author=K. Saito;citation_title=Characteristic abnormal signals in medulla oblongata-“eye spot” sign: four cases of elderly-onset Alexander disease;citation_volume=5;citation_year=2015;citation_pmid=29443213;citation_doi=10.1212/CPJ.0000000000000124" />
<meta name="citation_reference" content="citation_journal_title=Mol Genet Metab;citation_author=GLIA Consortium;citation_title=Case definition and classification of leukodystrophies and leukoencephalopathies;citation_pages=494-500;citation_volume=114;citation_year=2015;citation_pmid=25649058;citation_doi=10.1016/j.ymgme.2015.01.006" />
<meta name="citation_reference" content="citation_journal_title=Ann Acad Med Singap;citation_author=AP. Tan;citation_author=C. Sahil;citation_author=R. Robinson;citation_title=Neuroimaging in juvenile Alexander disease: tumour-like brainstem lesions;citation_pages=191-93;citation_volume=47;citation_year=2018;citation_pmid=29911736;citation_doi=10.47102/annals-acadmedsg.V47N5p191" />
<meta name="citation_reference" content="citation_journal_title=Pediatric blood &amp; cancer;citation_journal_abbrev=Pediatr Blood Cancer;citation_author=K. Van Poppel;citation_author=D. Ellison;citation_author=A. Broniscer;citation_title=Alexander Disease: An Important Mimicker of Focal Brainstem Glioma-Response.;citation_pages=487-487;citation_volume=54;citation_year=2010;citation_issue=3;citation_pmid=21552504;citation_doi=10.1002/pbc.22335" />
<meta name="citation_reference" content="citation_journal_title=Lancet. Neurology;citation_journal_abbrev=Lancet Neurol;citation_author=MS. van der Knaap;citation_author=JC. Pronk;citation_author=GC. Scheper;citation_title=Vanishing white matter disease.;citation_pages=413-423;citation_volume=5;citation_year=2006;citation_issue=5;citation_pmid=16632312;citation_doi=10.1016/S1474-4422(06)70440-9" />
<meta name="citation_reference" content="citation_journal_title=Archives of Neurology;citation_journal_abbrev=Arch Neurol;citation_author=HD. van der Lei;citation_author=ME. Steenweg;citation_author=M. Bugiani;citation_title=Restricted diffusion in vanishing white matter.;citation_pages=723-727;citation_volume=69;citation_year=2012;citation_issue=6;citation_pmid=22312162;citation_doi=10.1001/archneurol.2011.1658" />
<meta name="citation_reference" content="citation_journal_title=Annals of neurology;citation_journal_abbrev=Ann Neurol;citation_author=F. Mochel;citation_author=R. Schiffmann;citation_author=ME. Steenweg;citation_title=Adult polyglucosan body disease: Natural History and Key Magnetic Resonance Imaging Findings.;citation_pages=433-441;citation_volume=72;citation_year=2012;citation_issue=3;citation_pmid=23034915;citation_doi=10.1002/ana.23598" />
<meta name="twitter:title" content="Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/45/6.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: While classic brain MR imaging features of Alexander disease have been well-documented, lesional patterns can overlap with other leukodystrophies, especially in the early stages of the disease or in milder phenotypes. We aimed to assess the utility of a new neuroimaging sign to help increase the diagnostic specificity of Alexander disease.

MATERIALS AND METHODS: A peculiar bilateral symmetric hyperintense signal on T2-weighted images affecting the medulla oblongata was identified in an index patient with type I Alexander disease. Subsequently, 5 observers performed a systematic MR imaging review for this pattern by examining 55 subjects with Alexander disease and 74 subjects with other leukodystrophies. Interobserver agreement was assessed by the κ index. Sensitivity, specificity, and receiver operating characteristic curves were determined.

RESULTS: The identified pattern was present in 87% of subjects with Alexander disease and 14% of those without Alexander disease leukodystrophy ( P  &lt; .001), 3 with vanishing white matter, 4 with adult polyglucosan body disease, and 3 others. It was found equally in both type I and type II Alexander disease (28/32, 88% versus 18/21, 86%; P  = .851) and in subjects with unusual disease features (2/2). Sensitivity (87.3%; 95% CI, 76.0%–93.7%), specificity (86.5%; 95% CI, 76.9%–92.5%), and interobserver agreement (κ index = 0.82) were high.

CONCLUSIONS: The identified pattern in the medulla oblongata, called the chipmunk sign due to its resemblance to the face of this rodent, is extremely common in subjects with Alexander disease and represents a diagnostic tool that can aid in early diagnosis, especially in subjects with otherwise atypical MR imaging findings and/or clinical features.

APBD
:   adult polyglucosan body disease
ADLD
:   adult-onset autosomal dominant leukodystrophy
AxD
:   Alexander disease
GFAP 
:   glial fibrillary acidic protein
ION
:   inferior olivary nucleus
IQR
:   interquartile range
VWM
:   vanishing white matter" />
<meta name="og-title" property="og:title" content="Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/45/6/769" />
<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: While classic brain MR imaging features of Alexander disease have been well-documented, lesional patterns can overlap with other leukodystrophies, especially in the early stages of the disease or in milder phenotypes. We aimed to assess the utility of a new neuroimaging sign to help increase the diagnostic specificity of Alexander disease.

MATERIALS AND METHODS: A peculiar bilateral symmetric hyperintense signal on T2-weighted images affecting the medulla oblongata was identified in an index patient with type I Alexander disease. Subsequently, 5 observers performed a systematic MR imaging review for this pattern by examining 55 subjects with Alexander disease and 74 subjects with other leukodystrophies. Interobserver agreement was assessed by the κ index. Sensitivity, specificity, and receiver operating characteristic curves were determined.

RESULTS: The identified pattern was present in 87% of subjects with Alexander disease and 14% of those without Alexander disease leukodystrophy ( P  &lt; .001), 3 with vanishing white matter, 4 with adult polyglucosan body disease, and 3 others. It was found equally in both type I and type II Alexander disease (28/32, 88% versus 18/21, 86%; P  = .851) and in subjects with unusual disease features (2/2). Sensitivity (87.3%; 95% CI, 76.0%–93.7%), specificity (86.5%; 95% CI, 76.9%–92.5%), and interobserver agreement (κ index = 0.82) were high.

CONCLUSIONS: The identified pattern in the medulla oblongata, called the chipmunk sign due to its resemblance to the face of this rodent, is extremely common in subjects with Alexander disease and represents a diagnostic tool that can aid in early diagnosis, especially in subjects with otherwise atypical MR imaging findings and/or clinical features.

APBD
:   adult polyglucosan body disease
ADLD
:   adult-onset autosomal dominant leukodystrophy
AxD
:   Alexander disease
GFAP 
:   glial fibrillary acidic protein
ION
:   inferior olivary nucleus
IQR
:   interquartile range
VWM
:   vanishing white matter" />
<meta name="og-type" property="og:type" content="article" />
<meta name="og-image" property="og:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/45/6.cover-source.jpg" />
<meta name="Generator" content="Drupal 7 (http://drupal.org)" />
<script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease","hwUrl":"http://ajnr-stage2.stage.highwire.org/content/45/6/769","hwPath":"/content/45/6/769/tab-figures-data","hwType":"journal page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","hwHasFullTextAccess":"yes","hwEntitled":"no"},"content":{"hwIssueDate":"2024-06-01","hwIssueDateTime":"2024-06-01 00:00:00","hwPublicationDate":"2024-06-07","hwPublicationDateTime":"2024-06-07 08:00:52","hwNlmArticleType":"research-article","hwDOI":"10.3174/ajnr.A8220","hwAuthors":"Tha\u00eds Armangue,Matthew T. Whitehead,Davide Tonduti,Laura Farina,Ali Reza Tavasoli,Arastoo Vossough,Mariko L. Bennett,Ylenia Vaia,Genevi\u00e8ve Bernard,Ettore Salsano,Saadet Mercimek-Andrews,Amy Waldman,Adeline Vanderver","hwContributors":"","hwIsEarlyRelease":"no","hwEissn":"1936-959X","hwPissn":"0195-6108","hwVolume":"45","hwIssue":"6","hwArticleType":"Neurodegenerative Disorder Imaging","hwTabView":"main_tab","hwViewType":"full","hwAccessType":"Free","hwOpenAccess":"no","hwFreeAccess":"yes","hwTaxonomy":"","hwCorpusCode":"ajnr","hwType":"article","hwSubtitle":null,"hwOverline":null,"hwPisaId":"ajnr;45/6/769","hwFirstPage":"769","hwLastPage":"772","hwIsLatestVersion":"yes","hwIsCurrentIssue":"no","hwIsOpenIssue":"no","hwHasFullText":"yes","hwHasPDF":"yes","hwParentTitle":"American Journal of Neuroradiology: 45 (6)","hwElectronicPubDate":"2024-06-07","hwElectronicPubDateTime":"2024-06-07 08:00:52"}});
//--><!]]></script>
<link rel="shortcut icon" href="http://ajnr-stage2.stage.highwire.org/sites/default/files/images/favicon.ico" type="image/vnd.microsoft.icon" />
<link rel="alternate" type="application/vnd.ms-powerpoint" title="Powerpoint" href="/content/45/6/769.ppt" />
<meta name="viewport" content="width=device-width, initial-scale=1" />
<link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/45/6/769.full.txt" />
<link rel="alternate" type="application/pdf" title="Full Text (PDF)" href="/content/45/6/769.full.pdf" />
<link rel="canonical" href="http://ajnr-stage2.stage.highwire.org/content/45/6/769" />
<link rel="shortlink" href="/node/108037" />
    <title>Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease | American Journal of Neuroradiology</title>  
    <link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__BJ6Ou6QsBRtnFTmxaakamOIS8n4QswDP2XnnZ1sxtaM__NBuvkP6eInGIkb1aJvUHx5PX79XApuxBDkk_77W5tYk__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__azeXjFYQUa4gTbdEg4sgM2osudOlAYwVv6vNmRXI3ac__zr83wx5lNxUVx-jSIFm8RDKOeMAB7RbaBxriFHS3dt4__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__Ep75tNOnm8H2Mejav16FnGCfM1sLwyporbQrCIgwg3g__vXGjszfa0bvxzymQ8Cfns-o2huFvm80jp3igN8XcYeI__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__TKi6DXKzgLPdEthh1Tnc63zY1QF4rLZHoM06Xy7VN6g__zaEHphFiBcrl8WVy_4n080y02dQ7HKxd_aqZbYgQ5Z0__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/all/modules/highwire/highwire/highwire.style.highwire.css?sycxuq" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__NyJmZzjRqxAejqqh_JlTg7TZvr5VFf-GBu5INSgcstg__euq3WCoqLEk6hPDKiRW0U3ZpoirhhByNPy2IuJuIPsg__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<style type="text/css" media="all">
/* <![CDATA[ */
#sliding-popup.sliding-popup-bottom,#sliding-popup.sliding-popup-bottom .eu-cookie-withdraw-banner,.eu-cookie-withdraw-tab{background:#000000;}#sliding-popup.sliding-popup-bottom.eu-cookie-withdraw-wrapper{background:transparent}#sliding-popup .popup-content #popup-text h1,#sliding-popup .popup-content #popup-text h2,#sliding-popup .popup-content #popup-text h3,#sliding-popup .popup-content #popup-text p,.eu-cookie-compliance-secondary-button,.eu-cookie-withdraw-tab{color:#ffffff !important;}.eu-cookie-withdraw-tab{border-color:#ffffff;}.eu-cookie-compliance-more-button{color:#ffffff !important;}

/* ]]> */
</style>

<!--[if lte IE 7]>
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__ElJr3PIJEvw3qLXc1cnYiLj2G4KgDPSXFOfm6Phf8hw__JdWGm15cDWjsK6KrFlQVXQix9YgNeYysf22XZHj-Y-c__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<![endif]-->
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__Wnlyen9qEpwh_Qaf9okEu4QdVGM0BDothxeqA6Nbvo8__EJmw6SZD9bYoS8jocCpPYS3JFRURpdzmuvJoAUNiI-g__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__nv7Hafs9UucfV8bmT4epWF4zWAFU2G9JLHVgOOHDqbA__k9QUw6MohZGXV0YlzqvUpPTbyzhbizsKOi4x3aA7Tx0__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />

<!--[if (lt IE 9)&(!IEMobile)]>
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__XH6bpcI0f2dImc-p674DLCZtWBGb-QwxJK1YexVGtno__vUceGprdo5nIhV6DH93X7fI3r8RcTJbChbas9TQXeW4__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<![endif]-->

<!--[if gte IE 9]><!-->
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__2WBMox6sOrN42ss5lCnH7WWVRdFdJCxtTKnQJYRwTE4__yqNvNYLvMpjy3ffuJrjjm9uW2i-Me1c23KLYuWHaqio__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
<!--<![endif]-->
<link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__wxg7u6KrkAKrph8zjmzjNAiqxtVP2vhMWX2NZ6DPPZE__ECvRNuvDf2Tm_Pc-j1mEkt48QjmIz2s2CyWDspWAhhI__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.css" media="all" />
    <script type="text/javascript">
<!--//--><![CDATA[//><!--
/*!
 * yepnope1.5.4
 * (c) WTFPL, GPLv2
 */
(function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i<a.length;i++)j=a[i],e(j)?g(j,0,l,0):w(j)?B(j):Object(j)===j&&h(j,l);else Object(a)===a&&h(a,l)},B.addPrefix=function(a,b){z[a]=b},B.addFilter=function(a){x.push(a)},B.errorTimeout=1e4,null==b.readyState&&b.addEventListener&&(b.readyState="loading",b.addEventListener("DOMContentLoaded",A=function(){b.removeEventListener("DOMContentLoaded",A,0),b.readyState="complete"},0)),a.yepnope=k(),a.yepnope.executeStack=h,a.yepnope.injectJs=function(a,c,d,e,i,j){var k=b.createElement("script"),l,o,e=e||B.errorTimeout;k.src=a;for(o in d)k.setAttribute(o,d[o]);c=j?h:c||f,k.onreadystatechange=k.onload=function(){!l&&g(k.readyState)&&(l=1,c(),k.onload=k.onreadystatechange=null)},m(function(){l||(l=1,c(1))},e),i?k.onload():n.parentNode.insertBefore(k,n)},a.yepnope.injectCss=function(a,c,d,e,g,i){var e=b.createElement("link"),j,c=i?h:c||f;e.href=a,e.rel="stylesheet",e.type="text/css";for(j in d)e.setAttribute(j,d[j]);g||(n.parentNode.insertBefore(e,n),m(c,0))}})(this,document);

//--><!]]>
</script>
<script type="text/javascript" src="/sites/all/libraries/modernizr/modernizr.min.js?sycxuq"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
yepnope({
  test: Modernizr.matchmedia,
  nope: '/sites/all/libraries/media-match/media.match.min.js'
});
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__wH8myWXKi4A-QKdUKDXzJAnGs-FRS1A2ZzTTNzjRAdI__4MCtOZK_Ov0QKyRlXNLGQ2LRlYRGWj9ArT-NpFox3QA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
var googletag = googletag || {};
googletag.cmd = googletag.cmd || [];
googletag.slots = googletag.slots || {};
//--><!]]>
</script>
<script type="text/javascript" src="//securepubads.g.doubleclick.net/tag/js/gpt.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__9ici6QMeDS-cROq8R0RhuICsMGMP2wcJZNQQFsqQi44__kScSwG4RXGl1LXnj4qqt0ZxtNX4Gh2TK5W-o8Uup4SA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__fwhbnUWIxW-jFl55E2mBYVtZTjGhJ1JWyZYAJ2cEd3A__jCrCuWCJIPYPe1FzZoUvsJWEjkNMmRIQHYek1h7idBE__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
googletag.slots["rhs"] = googletag.defineSlot("/446583111/RHS_300x250", [300, 250], "dfp-ad-rhs")
  .addService(googletag.pubads());
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__UR8BHznwml64Vq0ijSGFwlm-xe9ttj1aripHInFCOLw__irCalsu-H_fRTOPqjyCv1O8Ax7fqY6DDf-uMOV1dvGY__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
var mapping = googletag.sizeMapping()
  .addSize([768, 0], [728, 90])
  .addSize([0, 0], [300, 50])
  .build();
googletag.slots["bottom_leaderboard"] = googletag.defineSlot("/446583111/Bottom_Banner_728x90", [[728, 90], [300, 50]], "dfp-ad-bottom_leaderboard")
  .addService(googletag.pubads())
  .defineSizeMapping(mapping);
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__bQc6kyz_Gw2afC1F6wguCBh8Z8nev-hxX6F2Tw4bq6k__CO2faEsYCquY82rVj6as9HScSnogGHeR-oh5fSQydG0__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
var mapping = googletag.sizeMapping()
  .addSize([768, 0], [728, 90])
  .addSize([0, 0], [300, 50])
  .build();
googletag.slots["top_leaderboard"] = googletag.defineSlot("/446583111/Top_Leaderboard_728x90", [[728, 90], [300, 50]], "dfp-ad-top_leaderboard")
  .addService(googletag.pubads())
  .defineSizeMapping(mapping);
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__wS6WUeF11NLeJgCqxc-dMvjhALAMQG1jlaeWdG8yVZc__CPiombDS21ooaYdmqHXdcMoJwB2FMn18JzO97LewQxc__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
document.createElement( "picture" );
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__UK1ygaa8bCfT-jsjqYRdRLDZ5N17950T7K5WPC9XtpI__NqLYT1T1SMBsKukLWIe82VgCZYYCMHZX_f609-a1rj8__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
googletag.cmd.push(function() {
  googletag.pubads().enableAsyncRendering();
  googletag.pubads().enableSingleRequest();
  googletag.pubads().collapseEmptyDivs();
  googletag.pubads().addEventListener("slotRenderEnded", function (event) {
    if (event.isEmpty) {
      var id = event.slot.getSlotElementId();
      var x = document.getElementById(id);
      if (x.parentElement.classList.contains("dfp-tag-wrapper")) {
        x.parentElement.style.display = "none";
      }
    }
  });
  googletag.pubads().setTargeting("page:hwTitle", "Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease");
  googletag.pubads().setTargeting("page:hwUrl", "http://ajnr-stage2.stage.highwire.org/content/45/6/769");
  googletag.pubads().setTargeting("page:hwPath", "/content/45/6/769/tab-figures-data");
  googletag.pubads().setTargeting("page:hwType", "journal page");
  googletag.pubads().setTargeting("user:hwAccessUsageTerms", "guest");
  googletag.pubads().setTargeting("user:hwRegisteredUser", "no");
  googletag.pubads().setTargeting("user:hwHasFullTextAccess", "yes");
  googletag.pubads().setTargeting("user:hwEntitled", "no");
  googletag.pubads().setTargeting("content:hwIssueDate", "2024-06-01");
  googletag.pubads().setTargeting("content:hwIssueDateTime", "2024-06-01 00:00:00");
  googletag.pubads().setTargeting("content:hwPublicationDate", "2024-06-07");
  googletag.pubads().setTargeting("content:hwPublicationDateTime", "2024-06-07 08:00:52");
  googletag.pubads().setTargeting("content:hwNlmArticleType", "research-article");
  googletag.pubads().setTargeting("content:hwDOI", "10.3174/ajnr.A8220");
  googletag.pubads().setTargeting("content:hwAuthors", ["Thaís Armangue","Matthew T. Whitehead","Davide Tonduti","Laura Farina","Ali Reza Tavasoli","Arastoo Vossough","Mariko L. Bennett","Ylenia Vaia","Geneviève Bernard","Ettore Salsano","Saadet Mercimek-Andrews","Amy Waldman","Adeline Vanderver"]);
  googletag.pubads().setTargeting("content:hwIsEarlyRelease", "no");
  googletag.pubads().setTargeting("content:hwEissn", "1936-959X");
  googletag.pubads().setTargeting("content:hwPissn", "0195-6108");
  googletag.pubads().setTargeting("content:hwVolume", "45");
  googletag.pubads().setTargeting("content:hwIssue", "6");
  googletag.pubads().setTargeting("content:hwArticleType", "Neurodegenerative Disorder Imaging");
  googletag.pubads().setTargeting("content:hwTabView", "main_tab");
  googletag.pubads().setTargeting("content:hwViewType", "full");
  googletag.pubads().setTargeting("content:hwAccessType", "Free");
  googletag.pubads().setTargeting("content:hwOpenAccess", "no");
  googletag.pubads().setTargeting("content:hwFreeAccess", "yes");
  googletag.pubads().setTargeting("content:hwCorpusCode", "ajnr");
  googletag.pubads().setTargeting("content:hwType", "article");
  googletag.pubads().setTargeting("content:hwPisaId", "ajnr;45/6/769");
  googletag.pubads().setTargeting("content:hwFirstPage", "769");
  googletag.pubads().setTargeting("content:hwLastPage", "772");
  googletag.pubads().setTargeting("content:hwIsLatestVersion", "yes");
  googletag.pubads().setTargeting("content:hwIsCurrentIssue", "no");
  googletag.pubads().setTargeting("content:hwIsOpenIssue", "no");
  googletag.pubads().setTargeting("content:hwHasFullText", "yes");
  googletag.pubads().setTargeting("content:hwHasPDF", "yes");
  googletag.pubads().setTargeting("content:hwParentTitle", "American Journal of Neuroradiology: 45 (6)");
  googletag.pubads().setTargeting("content:hwElectronicPubDate", "2024-06-07");
  googletag.pubads().setTargeting("content:hwElectronicPubDateTime", "2024-06-07 08:00:52");
});

googletag.enableServices();
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__3vwOA0BwlnyBkt9H4CLg6FgNyKAh--OmfOxFOIu_5S4__EXTgktcHbQ7BQfelY6CnrqgPRc4i4eD6XcZ4i3xs5RU__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" async="async" src="https://scholar.google.com/scholar_js/casa.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__11OTRBANYp_FPYy8gxuWv8XYK780LivNl9ef5qg3rfw__TEVdNksA7-zrPiZwnenYHdToBjuVChsDlzQL_vP4NkY__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
if(typeof window.MathJax === "undefined") window.MathJax = { menuSettings: { zoom: "Click" } };
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__rYVa7OrZL2e0r7ly7MDgB_VNGGM66-Hsd3rCYlJfPdk__-npxG4HWfp9kTAuQ3fI2bqs01gaJtXwE1bD4ujFX6oA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="https://www.google.com/recaptcha/api.js?hl=en&amp;render=explicit&amp;onload=drupalRecaptchaOnload"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__4ykqVVdSaGtVGauctG3E3Uojp_237f35KQ7wMtKX9S4__4JHByHSitU6UdWxmWARTSoZyB2PFgzkw__raxGdvbvk__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--

      $(document).ready(function() {
          $.getJSON("//www.deepdyve.com/rental-link?docId=10.3174/ajnr.A8220&journal=1936-959X&fieldName=journal_doi&affiliateId=asnr&format=jsonp&callback=?", function(data) {
            if (data.status === "ok") {
              // Update the href url so it goes straight to the article page
              $(".js-deepdyve-link a").attr("href", data.url);
              $(".js-deepdyve-link").show();
            } else if (data.status === "not_found") {
              $(".js-deepdyve-link").hide();
            }
          });
        });
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__wHQd6-i_R0h1OYQc4iqxm8AQ5uH0HU8byYTiUp1DkZE__PwZAMcSZnIPDgV7m7rvZ18vKJzqX0hQKV-_iQZGMBFg__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" async="async" src="https://www.googletagmanager.com/gtag/js?id=G-4CRTLTY8KW"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
window.dataLayer = window.dataLayer || [];function gtag(){dataLayer.push(arguments)};gtag("js", new Date());gtag("set", "developer_id.dMDhkMT", true);gtag("config", "G-4CRTLTY8KW", {"groups":"default","anonymize_ip":true});
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__M477akYC_o8wD2J8AZtyUBhNC6AW9zOQ7ghqWa7eiMA__JqJPCq8c51pFbVhLlcmFx4PU7aMruheBCNS31Ss_1Mw__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__156__G_TX0wWbp2x4EuISKOgbs4NaeHZ2KmXq85T6UI__w2izI_4UeJKq2XZJo79kNkQyxp_-2ptYjzA3YJcr-tg__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__az53Pz-SG0wejB-7UDzC-AbKqNFb4dAiZbq9Ymbj0sY__8FyXs8A34T1jX6OUXsgX27-4ASoy8QDncslXiOc2PK4__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
jQuery.extend(Drupal.settings, {"basePath":"\/","pathPrefix":"","ajaxPageState":{"theme":"jcore_1","theme_token":"p-mVGgjrr8wqM35Xx0O61FwrKMlpyz7fjGFI65tjozA","js":{"sites\/all\/libraries\/modernizr\/modernizr.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/jquery\/1.8\/jquery.min.js":1,"misc\/jquery-extend-3.4.0.js":1,"misc\/jquery.once.js":1,"misc\/drupal.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.core.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.widget.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.button.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.mouse.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.draggable.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.position.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.resizable.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.dialog.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.tooltip.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.accordion.min.js":1,"sites\/all\/libraries\/jquery.bgiframe\/jquery.bgiframe.js":1,"sites\/all\/libraries\/jquery.hoverIntent\/jquery.hoverIntent.js":1,"sites\/all\/libraries\/superfish\/superfish.js":1,"sites\/all\/modules\/contrib\/nice_menus\/js\/nice_menus.js":1,"sites\/all\/modules\/contrib\/eu_cookie_compliance\/js\/jquery.cookie-1.4.1.min.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.equal-heights.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.panels-ajax-tab.js":1,"sites\/all\/libraries\/colorbox\/jquery.colorbox-min.js":1,"sites\/all\/modules\/contrib\/colorbox\/js\/colorbox.js":1,"sites\/all\/modules\/contrib\/colorbox\/styles\/default\/colorbox_style.js":1,"https:\/\/scholar.google.com\/scholar_js\/casa.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_log\/highwire_log.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_user\/js\/highwire_user_meta.js":1,"sites\/all\/modules\/contrib\/panels_ajax_tab\/js\/panels_ajax_tab.js":1,"sites\/all\/modules\/contrib\/captcha\/captcha.js":1,"misc\/textarea.js":1,"sites\/all\/modules\/contrib\/recaptcha\/js\/recaptcha.js":1,"https:\/\/www.google.com\/recaptcha\/api.js?hl=en\u0026render=explicit\u0026onload=drupalRecaptchaOnload":1,"sites\/all\/modules\/highwire\/highwire\/highwire_citation\/plugins\/content_types\/js\/highwire_citation_export.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_share_dialog.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/minipanel_dialog_link.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/clipboard.min.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_clipboard.js":1,"sites\/all\/modules\/contrib\/service_links\/js\/twitter_button.js":1,"sites\/all\/modules\/contrib\/service_links\/js\/facebook_like.js":1,"sites\/all\/modules\/contrib\/service_links\/js\/google_plus_one.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_article_nav.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_nav_float.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_citing_links.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_search\/plugins\/content_types\/js\/highwire_search_similar_articles.js":1,"sites\/all\/modules\/contrib\/panels_accordion\/js\/panels_accordion.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_responsive\/plugins\/styles\/highwire_responsive_toggle\/highwire_responsive_toggle.js":1,"sites\/all\/modules\/contrib\/google_analytics\/googleanalytics.js":1,"https:\/\/www.googletagmanager.com\/gtag\/js?id=G-4CRTLTY8KW":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.article-citation-access.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.article-citation-author-tooltip.js":1,"sites\/all\/themes\/highwire\/jcore_1\/js\/theme-scripts.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_responsive\/js\/highwire-mediaqueries.js":1,"sites\/all\/libraries\/enquire.js\/enquire.min.js":1,"sites\/all\/modules\/contrib\/picture\/picturefill2\/picturefill.min.js":1,"sites\/all\/modules\/contrib\/picture\/picture.min.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/js\/highwire_panels_ajax_tab.js":1,"sites\/all\/libraries\/lazysizes\/lazysizes.min.js":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_user\/plugins\/content_types\/js\/highwire_user_salutation.js":1,"sites\/all\/modules\/contrib\/eu_cookie_compliance\/js\/eu_cookie_compliance.js":1,"http:\/\/securepubads.g.doubleclick.net\/tag\/js\/gpt.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.gtranslate.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_datalayer\/js\/highwire_datalayer.js":1,"sites\/all\/themes\/contrib\/omega\/omega\/js\/jquery.formalize.js":1,"sites\/all\/themes\/contrib\/omega\/omega\/js\/omega-mediaqueries.js":1,"sites\/all\/themes\/contrib\/omega\/omega\/js\/omega-equalheights.js":1},"css":{"modules\/system\/system.base.css":1,"modules\/system\/system.menus.css":1,"modules\/system\/system.messages.css":1,"modules\/system\/system.theme.css":1,"misc\/ui\/jquery.ui.core.css":1,"misc\/ui\/jquery.ui.theme.css":1,"misc\/ui\/jquery.ui.button.css":1,"misc\/ui\/jquery.ui.resizable.css":1,"misc\/ui\/jquery.ui.dialog.css":1,"misc\/ui\/jquery.ui.tooltip.css":1,"misc\/ui\/jquery.ui.accordion.css":1,"sites\/all\/modules\/contrib\/date\/date_api\/date.css":1,"sites\/all\/modules\/contrib\/date\/date_popup\/themes\/datepicker.1.7.css":1,"modules\/field\/theme\/field.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_draw\/css\/highwire-draw.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_folders\/highwire_folders.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_responsive\/css\/highwire-responsive.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_saved_searches\/highwire_saved_searches.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_user\/highwire_user.css":1,"modules\/node\/node.css":1,"sites\/all\/modules\/contrib\/picture\/picture_wysiwyg.css":1,"modules\/search\/search.css":1,"modules\/user\/user.css":1,"sites\/all\/modules\/contrib\/views\/css\/views.css":1,"sites\/all\/modules\/contrib\/ckeditor\/css\/ckeditor.css":1,"sites\/all\/modules\/contrib\/colorbox\/styles\/default\/colorbox_style.css":1,"sites\/all\/modules\/contrib\/ctools\/css\/ctools.css":1,"sites\/all\/modules\/contrib\/google_admanager\/google_admanager.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire.style.highwire.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/nlm-elements.css":1,"sites\/all\/modules\/contrib\/panels\/css\/panels.css":1,"public:\/\/ctools\/css\/263bfdb18936424f0ade19d6bd885f37.css":1,"sites\/all\/modules\/contrib\/panels_ajax_tab\/css\/panels_ajax_tab.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/layouts\/highwire_2col_stacked\/highwire-2col-stacked.css":1,"sites\/all\/modules\/contrib\/forward\/forward.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_share_link.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_copy_permalink.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire.style.markup.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_citing_links.css":1,"sites\/all\/modules\/highwire\/highwire\/plugins\/content_types\/css\/highwire_reports_feed.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/highwire-article-citation-list.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_responsive\/plugins\/styles\/highwire_responsive_toggle\/highwire_responsive_toggle.css.less":1,"sites\/all\/modules\/contrib\/nice_menus\/css\/nice_menus.css":1,"sites\/all\/modules\/contrib\/nice_menus\/css\/nice_menus_default.css":1,"sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css":1,"sites\/all\/modules\/contrib\/eu_cookie_compliance\/css\/eu_cookie_compliance.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/highwire.gtranslate.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_theme_tools\/css\/font-hwicons.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_theme_tools\/css\/font-hwicons-glyphs.css":1,"sites\/all\/themes\/highwire\/jcore_1\/eu_cookie_compliance.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/font-awesome-ie7.css":1,"sites\/all\/themes\/contrib\/omega\/alpha\/css\/alpha-reset.css":1,"sites\/all\/themes\/contrib\/omega\/alpha\/css\/alpha-mobile.css":1,"sites\/all\/themes\/contrib\/omega\/alpha\/css\/alpha-alpha.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/formalize.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/omega-text.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/omega-branding.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/omega-menu.css":1,"sites\/all\/themes\/contrib\/omega\/omega\/css\/omega-forms.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/highwire-forms.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/mobile-reset.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/font-awesome.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/forms.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/global.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/jquery-ui-elements.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/text.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/eletters.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/colors.css.less":1,"ie::normal::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default.css":1,"ie::normal::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default-normal.css":1,"ie::normal::sites\/all\/themes\/highwire\/jcore_1\/css\/grid\/jcore_default\/normal\/jcore-default-normal-30.css":1,"narrow::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default.css":1,"narrow::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default-narrow.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/grid\/jcore_default\/narrow\/jcore-default-narrow-30.css":1,"normal::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default.css":1,"normal::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default-normal.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/grid\/jcore_default\/normal\/jcore-default-normal-30.css":1,"wide::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default.css":1,"wide::sites\/all\/themes\/highwire\/jcore_1\/css\/jcore-1-jcore-default-wide.css":1,"sites\/all\/themes\/highwire\/jcore_1\/css\/grid\/jcore_default\/wide\/jcore-default-wide-30.css":1,"sites\/all\/modules\/shared\/jnl_ajnr_styles\/css\/jnl-ajnr-styles.css.less":1,"sites\/all\/modules\/shared\/jnl_ajnr_styles\/css\/jnl-ajnr-breakpoints.css.less":1}},"colorbox":{"opacity":"0.85","current":"{current} of {total}","previous":"\u00ab Prev","next":"Next \u00bb","close":"Close","maxWidth":"98%","maxHeight":"98%","fixed":true,"mobiledetect":true,"mobiledevicewidth":"480px"},"highwire":{"nid":"108037","apath":"\/ajnr\/45\/6\/769.atom","pisa":"ajnr;45\/6\/769","markup":[{"requested":"index","variant":"index","view":"full","pisa":"ajnr;ajnr.A8220\/DC1"},{"requested":"expansion","variant":"expansion","view":"full","pisa":"ajnr;45\/6\/769\/F1"},{"requested":"expansion","variant":"expansion","view":"full","pisa":"ajnr;45\/6\/769\/TU1"},{"requested":"full-text","variant":"full-text","view":"full","pisa":"ajnr;45\/6\/769"},{"requested":"index","variant":"index","view":"full","pisa":"ajnr;ajnr.A8220\/DC1"}],"ac":{"\/ajnr\/45\/6\/769.atom":{"access":{"full":true},"pisa_id":"","apath":"\/ajnr\/45\/6\/769.atom","jcode":"ajnr"},"ajnr;45\/6\/769":{"access":{"full":true},"pisa_id":"ajnr;45\/6\/769","apath":"","jcode":"ajnr"}},"processed":["highwire_math"],"modal_window_width":"560","share_modal_width":"560","share_modal_title":"Share this Article","dataLayer":"{\u0022page\u0022:{\u0022hwTitle\u0022:\u0022Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease\u0022,\u0022hwUrl\u0022:\u0022http:\\\/\\\/ajnr-stage2.stage.highwire.org\\\/content\\\/45\\\/6\\\/769\u0022,\u0022hwPath\u0022:\u0022\\\/content\\\/45\\\/6\\\/769\\\/tab-figures-data\u0022,\u0022hwType\u0022:\u0022journal page\u0022},\u0022user\u0022:{\u0022hwMemberID\u0022:\u0022\u0022,\u0022hwLoggedIntoInstitutionID\u0022:\u0022\u0022,\u0022hwLoggedIntoInstitution\u0022:\u0022\u0022,\u0022hwAccessUsageTerms\u0022:\u0022guest\u0022,\u0022hwRegisteredUser\u0022:\u0022no\u0022,\u0022hwHasFullTextAccess\u0022:\u0022yes\u0022,\u0022hwEntitled\u0022:\u0022no\u0022},\u0022content\u0022:{\u0022hwIssueDate\u0022:\u00222024-06-01\u0022,\u0022hwIssueDateTime\u0022:\u00222024-06-01 00:00:00\u0022,\u0022hwPublicationDate\u0022:\u00222024-06-07\u0022,\u0022hwPublicationDateTime\u0022:\u00222024-06-07 08:00:52\u0022,\u0022hwNlmArticleType\u0022:\u0022research-article\u0022,\u0022hwDOI\u0022:\u002210.3174\\\/ajnr.A8220\u0022,\u0022hwAuthors\u0022:\u0022Tha\\u00eds Armangue,Matthew T. Whitehead,Davide Tonduti,Laura Farina,Ali Reza Tavasoli,Arastoo Vossough,Mariko L. Bennett,Ylenia Vaia,Genevi\\u00e8ve Bernard,Ettore Salsano,Saadet Mercimek-Andrews,Amy Waldman,Adeline Vanderver\u0022,\u0022hwContributors\u0022:\u0022\u0022,\u0022hwIsEarlyRelease\u0022:\u0022no\u0022,\u0022hwEissn\u0022:\u00221936-959X\u0022,\u0022hwPissn\u0022:\u00220195-6108\u0022,\u0022hwVolume\u0022:\u002245\u0022,\u0022hwIssue\u0022:\u00226\u0022,\u0022hwArticleType\u0022:\u0022Neurodegenerative Disorder Imaging\u0022,\u0022hwTabView\u0022:\u0022main_tab\u0022,\u0022hwViewType\u0022:\u0022full\u0022,\u0022hwAccessType\u0022:\u0022Free\u0022,\u0022hwOpenAccess\u0022:\u0022no\u0022,\u0022hwFreeAccess\u0022:\u0022yes\u0022,\u0022hwTaxonomy\u0022:\u0022\u0022,\u0022hwCorpusCode\u0022:\u0022ajnr\u0022,\u0022hwType\u0022:\u0022article\u0022,\u0022hwSubtitle\u0022:null,\u0022hwOverline\u0022:null,\u0022hwPisaId\u0022:\u0022ajnr;45\\\/6\\\/769\u0022,\u0022hwFirstPage\u0022:\u0022769\u0022,\u0022hwLastPage\u0022:\u0022772\u0022,\u0022hwIsLatestVersion\u0022:\u0022yes\u0022,\u0022hwIsCurrentIssue\u0022:\u0022no\u0022,\u0022hwIsOpenIssue\u0022:\u0022no\u0022,\u0022hwHasFullText\u0022:\u0022yes\u0022,\u0022hwHasPDF\u0022:\u0022yes\u0022,\u0022hwParentTitle\u0022:\u0022American Journal of Neuroradiology: 45 (6)\u0022,\u0022hwElectronicPubDate\u0022:\u00222024-06-07\u0022,\u0022hwElectronicPubDateTime\u0022:\u00222024-06-07 08:00:52\u0022}}"},"highwire_panel_tabs":[{"panel_name":"jnl_ajnr_tab_pdf","panel_ajax_tab":"jnl_ajnr_tab_pdf"}],"panel_ajax_tab":{"path":"sites\/all\/modules\/contrib\/panels_ajax_tab"},"urlIsAjaxTrusted":{"\/content\/45\/6\/769\/tab-figures-data":true},"ws_fl":{"width":100,"height":21},"ws_gpo":{"size":"","annotation":"","lang":"","callback":"","width":300},"highwire_search_similar_articles":{"highwire-search-similar-articles-list-1":{"conf":{"context":"requiredcontext_entity:node_1","override_title":1,"override_title_text":"\u003Ci class=\u0022icon-caret-right\u0022\u003E\u003C\/i\u003E Similar Articles","number_per_page":"5","show_pager":0,"more_link_path":"similar\/articles","more_link":1,"empty_message":"No similar articles are available.","citation_style":"jcore_standard","title_type":"prefer_short","title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","display_original_link":0,"display_access_indicator":0,"display_cme_link":0,"display_access_indicator_text":0,"display_highlight_image":"0","display_variants":0,"display_supplements":0,"display_abstract_tooltip":0,"display_author_tooltip":0,"override_title_heading":"h2","citation_settings_source":"citation_manager","citation_manager_wrapper":{"citation_manager_citation":"jcore_list_title_only"},"corpus_config_wrapper":{"corpus_config_citation_context":[]},"cache_enabled":1,"cache_time":"600","short_title_options":{"char_count":"50","add_ellipsis":0},"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"highlight_image_style":"","featured_image_variant":"large","featured_image_click_image":"colorbox","display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":1,"display_orcid_tooltip":0,"display_ads_search_tooltip":0,"display_agricola_tooltip":0,"author_site_search_path":"","display_translations":0,"display_translations_text":"","display_translations_text_icon":"","bundle_overrides_checkboxes":{"highwire_book_fragment":{"selector":0},"highwire_news_story":{"selector":0},"highwire_book_edition":{"selector":0},"highwire_article":{"selector":0},"highwire_issue":{"selector":0},"highwire_comment":{"selector":0},"highwire_fragment":{"selector":0},"highwire_book_section":{"selector":0},"highwire_journal":{"selector":0}},"bundle_overrides":{"highwire_book_fragment":{"selector":0,"citation_style":"jcore_title_and_author","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":"0","access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"thumbnail","display_fragment_caption":1,"display_parent_citation":1,"parent_citation_type":"highwire_book_section","parent_citation_settings":{"citation_style":"folio_book_sections_standard","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_abstract_tooltip":0,"display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":0,"author_site_search_path":"search\/"}},"highwire_news_story":{"selector":0,"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":"0","highlight_image_style":"","featured_image_click_image":"nothing","display_author_tooltip":0,"display_google_scholar_tooltip":0,"display_pubmed_tooltip":0,"display_advanced_search_tooltip":0},"highwire_book_edition":{"selector":0,"citation_style":"folio_books_standard","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":1,"display_orcid_tooltip":1,"author_site_search_path":"search\/"},"highwire_article":{"selector":0,"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":0,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":"0","highlight_image_style":"","featured_image_variant":"large","featured_image_click_image":"nothing","display_cme_link":0,"display_abstract_tooltip":0,"display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":1,"display_orcid_tooltip":1,"display_ads_search_tooltip":0,"display_agricola_tooltip":0,"author_site_search_path":"search\/","display_translations":0,"display_translations_text":"Translations Available","display_translations_text_icon":"icon-globe"},"highwire_issue":{"selector":0,"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","featured_image_click_image":"nothing","display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":0,"display_orcid_tooltip":1,"author_site_search_path":"search\/"},"highwire_comment":{"selector":0,"citation_style":"highwire_comment","show_title":0,"title_as_link":0,"title_as_link_type":"tab_view","author_format_type":"fullname","author_format_custom":"","author_list_separator":", ","date_format":"(j F Y)","display_comment_body":1,"display_attachment":1,"display_conflict_of_interest":1},"highwire_fragment":{"selector":0,"citation_style":"jcore_title_and_author","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":"0","access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_fragment_caption":1,"fragment_image_settings":{"fragment_image_variant":"medium","fragment_click_image":"colorbox","show_download_links":1},"display_parent_citation":1,"parent_citation_type":"highwire_article","parent_citation_settings":{"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":0,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":"0","highlight_image_style":"","featured_image_variant":"large","featured_image_click_image":"nothing","display_cme_link":0,"display_abstract_tooltip":0,"display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":1,"display_orcid_tooltip":1,"display_ads_search_tooltip":0,"display_agricola_tooltip":0,"author_site_search_path":"search\/","display_translations":0,"display_translations_text":"Translations Available","display_translations_text_icon":"icon-globe"}},"highwire_book_section":{"selector":0,"citation_style":"folio_book_sections_standard","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_abstract_tooltip":0,"display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":0,"author_site_search_path":"search\/"},"highwire_journal":{"selector":0,"citation_style":"mla","cache_enabled":1,"cache_time":"600","title_type":"full","short_title_options":{"char_count":"50","add_ellipsis":0},"title_as_link":0,"display_subtitle":0,"choose_pubdate":"ppubdate","display_markup_snippet":"","highlight_image_toggle":0,"display_original_link":0,"display_access_indicator":0,"access_indicator_settings":{"open_access":{"icon":"icon-unlock","title":"Open Access"},"user_access":{"icon":"icon-ok-sign","title":"You have access"},"no_access":{"icon":"icon-lock","title":"Restricted access"}},"display_variants":0,"display_supplements":0,"pdf_download":{"display_pdf_download":0,"pdf_download_icon":"icon-cloud-download","pdf_download_text":"PDF"},"include_on_behalf":1,"cpath_prefix":"\/content","show_mark_citation":0,"display_infotrieve_link":0,"infotrieve_link_settings":{"icon":"icon-usd","link_caption":"Order full text via Infotrieve"},"display_highlight_image":0,"highlight_image_style":"","display_author_tooltip":0,"display_google_scholar_tooltip":1,"display_pubmed_tooltip":1,"display_advanced_search_tooltip":1,"display_author_landing_page_tooltip":0,"display_orcid_tooltip":1,"author_site_search_path":"search\/"}},"cpath_prefix":"\/content","ajax_loading_icon_classes":"icon-spinner icon-spin icon-2x","ajax_loading_text":"","highlight_image_toggle":0,"more_link_label":"See more","url_parameters":{"q":"node\/108037","panels_ajax_tab_tab":"jnl_ajnr_tab_data","panels_ajax_tab_trigger":"tab-figures-data"}},"nid":"108037"}},"panels_accordion":{"highwire_article_accordion_container":{"heightStyle":"content","autoHeight":false,"collapsible":0,"region_accordion_id":"highwire_article_accordion_container","active":0,"animated":"slide"}},"color":{"logo":"http:\/\/ajnr-stage2.stage.highwire.org\/sites\/default\/files\/ajnr-web-logo_0.png"},"nice_menus_options":{"delay":800,"speed":"fast"},"highwireResponsive":{"enquire_enabled":1,"breakpoints_configured":1,"breakpoints":{"zero":"all and (min-width: 0px)","xsmall":"all and (min-width: 380px)","narrow":"all and (min-width: 768px) and (min-device-width: 768px), (max-device-width: 800px) and (min-width: 768px) and (orientation:landscape)","normal":"all and (min-width: 980px) and (min-device-width: 980px), all and (max-device-width: 1024px) and (min-width: 1024px) and (orientation:landscape)","wide":"all and (min-width: 1220px)"}},"eu_cookie_compliance":{"popup_enabled":1,"popup_agreed_enabled":0,"popup_hide_agreed":false,"popup_clicking_confirmation":true,"popup_scrolling_confirmation":false,"popup_html_info":"\u003Cdiv\u003E\n  \u003Cdiv class=\u0022popup-content info\u0022\u003E\n    \u003Cdiv id=\u0022popup-text\u0022\u003E\n      \u003Cp\u003EWe use cookies on this site to enhance your user experience. By clicking any link on this page you are giving your consent for us to set cookies.\u003C\/p\u003E\n    \u003C\/div\u003E\n    \u003Cdiv id=\u0022popup-buttons\u0022\u003E\n      \u003Cbutton type=\u0022button\u0022 role=\u0022dialog\u0022 aria-labelledby=\u0022Continue\u0022\n        class=\u0022agree-button eu-cookie-compliance-default-button\u0022\u003EContinue\u003C\/button\u003E\n                  \u003Cbutton type=\u0022button\u0022 role=\u0022dialog\u0022 aria-labelledby=\u0022Find out more\u0022\n        class=\u0022find-more-button eu-cookie-compliance-more-button\u0022\u003EFind out more\u003C\/button\u003E\n          \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E","use_mobile_message":false,"mobile_popup_html_info":"\u003Cdiv\u003E\n  \u003Cdiv class=\u0022popup-content info\u0022\u003E\n    \u003Cdiv id=\u0022popup-text\u0022\u003E\n          \u003C\/div\u003E\n    \u003Cdiv id=\u0022popup-buttons\u0022\u003E\n      \u003Cbutton type=\u0022button\u0022 role=\u0022dialog\u0022 aria-labelledby=\u0022Continue\u0022\n        class=\u0022agree-button eu-cookie-compliance-default-button\u0022\u003EContinue\u003C\/button\u003E\n                  \u003Cbutton type=\u0022button\u0022 role=\u0022dialog\u0022 aria-labelledby=\u0022Find out more\u0022\n        class=\u0022find-more-button eu-cookie-compliance-more-button\u0022\u003EFind out more\u003C\/button\u003E\n          \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E","mobile_breakpoint":"768","popup_html_agreed":"\u003Cdiv\u003E\n  \u003Cdiv class=\u0022popup-content agreed\u0022\u003E\n    \u003Cdiv id=\u0022popup-text\u0022\u003E\n      \u003Cp\u003EThank you for accepting cookies. You can now hide this message or find out more about cookies.\u003C\/p\u003E\n    \u003C\/div\u003E\n    \u003Cdiv id=\u0022popup-buttons\u0022\u003E\n      \u003Cbutton type=\u0022button\u0022 class=\u0022hide-popup-button eu-cookie-compliance-hide-button\u0022\u003EHide\u003C\/button\u003E\n              \u003Cbutton type=\u0022button\u0022 class=\u0022find-more-button eu-cookie-compliance-more-button-thank-you\u0022 \u003EFind out more\u003C\/button\u003E\n          \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E","popup_use_bare_css":false,"popup_height":"auto","popup_width":"100%","popup_delay":1000,"popup_link":"\/help\/cookie-policy","popup_link_new_window":1,"popup_position":null,"popup_language":"en","store_consent":false,"better_support_for_screen_readers":0,"reload_page":0,"domain":"","popup_eu_only_js":0,"cookie_lifetime":365,"cookie_session":false,"disagree_do_not_show_popup":0,"method":"default","whitelisted_cookies":"","withdraw_markup":"\u003Cbutton type=\u0022button\u0022 class=\u0022eu-cookie-withdraw-tab\u0022\u003EPrivacy settings\u003C\/button\u003E\n\u003Cdiv class=\u0022eu-cookie-withdraw-banner\u0022\u003E\n  \u003Cdiv class=\u0022popup-content info\u0022\u003E\n    \u003Cdiv id=\u0022popup-text\u0022\u003E\n      \u003Cp\u003E\u0026lt;h2\u0026gt;We use cookies on this site to enhance your user experience\u0026lt;\/h2\u0026gt;\u0026lt;p\u0026gt;You have given your consent for us to set cookies.\u0026lt;\/p\u0026gt;\u003C\/p\u003E\n    \u003C\/div\u003E\n    \u003Cdiv id=\u0022popup-buttons\u0022\u003E\n      \u003Cbutton type=\u0022button\u0022 class=\u0022eu-cookie-withdraw-button\u0022\u003EWithdraw consent\u003C\/button\u003E\n    \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n","withdraw_enabled":false},"googleanalytics":{"account":["G-4CRTLTY8KW"],"trackOutbound":1,"trackMailto":1,"trackDownload":1,"trackDownloadExtensions":"7z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip","trackColorbox":1},"omega":{"layouts":{"primary":"normal","order":["narrow","normal","wide"],"queries":{"narrow":"all and (min-width: 768px) and (min-device-width: 768px), (max-device-width: 800px) and (min-width: 768px) and (orientation:landscape)","normal":"all and (min-width: 980px) and (min-device-width: 980px), all and (max-device-width: 1024px) and (min-width: 1024px) and (orientation:landscape)","wide":"all and (min-width: 1220px)"}}}});
//--><!]]>
</script>
    <!--[if lt IE 9]><script src="http://html5shiv.googlecode.com/svn/trunk/html5.js"></script><![endif]-->
  </head>
  <body class="html not-front not-logged-in page-node page-node- page-node-108037 node-type-highwire-article context-content hw-default-jcode-ajnr hw-article-type-research-article hw-article-category-neurodegenerative-disorder-imaging">
<!-- Google Tag Manager -->
<noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-MXP45WNH" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
<script type="text/javascript">(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-MXP45WNH');</script>
<!-- End Google Tag Manager -->
    <div id="skip-link">
      <a href="#main-content" class="element-invisible element-focusable">Skip to main content</a>
    </div>
    <div class="region region-page-top" id="region-page-top">
  <div class="region-inner region-page-top-inner">
      </div>
</div>    <div class="page clearfix footer-borders panels-page panels-layout-jcore_2col" id="page">
      <header id="section-header" class="section section-header">
  <div id="zone-advertising-top-wrapper" class="zone-wrapper zone-advertising-top-wrapper clearfix">  
  <div id="zone-advertising-top" class="zone zone-advertising-top clearfix container-30">
    <div class="grid-28 suffix-1 prefix-1 region region-ad-top" id="region-ad-top">
  <div class="region-inner region-ad-top-inner">
    <div class="block block-panels-mini mobile-hiddens rtecenter block-jnl-ajnr-ad-leaderboard block-panels-mini-jnl-ajnr-ad-leaderboard odd block-without-title" id="block-panels-mini-jnl-ajnr-ad-leaderboard">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_ad_leaderboard">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-dfp-pane text-center" >
  
      
  
  <div class="pane-content">
    <div id="dfp-ad-top_leaderboard-wrapper" class="dfp-tag-wrapper">
<div class="slug">Advertisement</div>
<div  id="dfp-ad-top_leaderboard" class="dfp-tag-wrapper">
  <script type="text/javascript">
    googletag.cmd.push(function() {
      googletag.display("dfp-ad-top_leaderboard");
    });
  </script>
</div>
</div>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
</div><div id="zone-superheader-wrapper" class="zone-wrapper zone-superheader-wrapper clearfix mobile-only print-hidden">  
  <div id="zone-superheader" class="zone zone-superheader clearfix mobile-only print-hidden container-30">
    <div class="grid-30 region region-superheader" id="region-superheader">
  <div class="region-inner region-superheader-inner">
    <div class="block block-panels-mini block-responsive-menu block-panels-mini-responsive-menu odd block-without-title" id="block-panels-mini-responsive-menu">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-responsive_menu">
  <div class="panel-panel panel-col">
    <div><div id="unique-id3" class="highwire-responsive-toggle-group"><div class="panel-pane pane-panels-mini pane-responsive-menu-main-menu" >
  
        <h2 class="pane-title"><span class="icon-reorder"></span><span class="element-invisible">Main menu</span></h2>
    
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-responsive_menu_main_menu">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-menu-tree pane-main-menu" >
  
      
  
  <div class="pane-content">
    <div class="menu-block-wrapper menu-block-ctools-main-menu-1 menu-name-main-menu parent-mlid-main-menu:0 menu-level-1">
  <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-772" role="menuitem"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Home</a></li>
<li class="expanded active-trail menu-mlid-773" role="menuitem"><a href="/content/current" data-hide-link-title="0" class="active active-trail" data-icon-position="">Content</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first expanded menu-mlid-774" role="menuitem"><a href="/content/current" data-hide-link-title="0" class="" data-icon-position="">Current Issue</a></li>
<li class="leaf menu-mlid-1747" role="menuitem"><a href="/content/early/preprint" data-hide-link-title="0" class="" data-icon-position="">Publication Preview--Preprint</a></li>
<li class="leaf menu-mlid-775" role="menuitem"><a href="/content/early/recent" data-hide-link-title="0" class="" data-icon-position="">Publication Preview--Ahead of Print</a></li>
<li class="leaf menu-mlid-776" role="menuitem"><a href="/content/by/year" data-hide-link-title="0" class="" data-icon-position="">Past Issue Archive</a></li>
<li class="leaf menu-mlid-900" role="menuitem"><a href="/cow/by/year" data-hide-link-title="0" class="" data-icon-position="">Case of the Week Archive</a></li>
<li class="leaf menu-mlid-1006" role="menuitem"><a href="/cc/by/year" data-hide-link-title="0" class="" data-icon-position="">Classic Case Archive</a></li>
<li class="leaf menu-mlid-901" role="menuitem"><a href="/com/by/year" data-hide-link-title="0" class="" data-icon-position="">Case of the Month Archive</a></li>
<li class="last leaf menu-mlid-1334" role="menuitem"><a href="http://www.ajnr.org/content/covid-19-content-and-resources" data-hide-link-title="0" class="" data-icon-position="">COVID-19 Content and Resources</a></li>
</ul></nav></li>
<li class="expanded menu-mlid-784" role="menuitem"><a href="/content/about-us" class="" data-icon-position="" data-hide-link-title="0">About Us</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-785" role="menuitem"><a href="/page/content/About" data-hide-link-title="0" class="" data-icon-position="">About AJNR</a></li>
<li class="leaf menu-mlid-899" role="menuitem"><a href="https://www.ajnr.org/page/content/Ed-Board" data-hide-link-title="0" class="" data-icon-position="">Editorial Board</a></li>
<li class="last leaf menu-mlid-864" role="menuitem"><a href="http://www.asnr.org" data-hide-link-title="0" target="_blank" class="" data-icon-position="">American Society of Neuroradiology</a></li>
</ul></nav></li>
<li class="expanded menu-mlid-1746" role="menuitem"><a href="/" class="" data-icon-position="" data-hide-link-title="0">For Authors</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-1725" role="menuitem"><a href="https://www.ajnr.org/content/author-policies" data-hide-link-title="0" class="" data-icon-position="">Author Policies</a></li>
<li class="leaf menu-mlid-1856" role="menuitem"><a href="https://www.ajnr.org/preprint_publishing" data-hide-link-title="0" class="" data-icon-position="">Preprint Publishing</a></li>
<li class="last leaf menu-mlid-1726" role="menuitem"><a href="https://www.ajnr.org/content/manuscript-submission-guidelines" data-hide-link-title="0" class="" data-icon-position="">Manuscript Submission Guidelines</a></li>
</ul></nav></li>
<li class="leaf menu-mlid-862" role="menuitem"><a href="https://mc.manuscriptcentral.com/ajnr" data-hide-link-title="0" target="_blank" class="" data-icon-position="">Submit a Manuscript</a></li>
<li class="expanded menu-mlid-1184" role="menuitem"><a href="/content/about-us" data-hide-link-title="0" class="" data-icon-position="">Special Collections</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-1733" role="menuitem"><a href="http://www.ajnr.org/cc/CSF-Spinal-Leak" data-hide-link-title="0" class="" data-icon-position="">Spinal CSF Leak Articles (Jan 2020-June 2024)</a></li>
<li class="leaf menu-mlid-1185" role="menuitem"><a href="http://www.ajnr.org/cc/most-impactful-ajnr-articles" data-hide-link-title="0" class="" data-icon-position="">Most Impactful AJNR Articles</a></li>
<li class="last leaf menu-mlid-1896" role="menuitem"><a href="http://www.ajnr.org/cc/2024-Awards" data-hide-link-title="0" class="" data-icon-position="">2024 AJNR Journal Awards</a></li>
</ul></nav></li>
<li class="last expanded menu-mlid-788" role="menuitem"><a href="/content/advertising" class="" data-icon-position="" data-hide-link-title="0">More</a><nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-780" role="menuitem"><a href="/content/subscriber-help-and-services" data-hide-link-title="0" class="" data-icon-position="">Subscribers</a></li>
<li class="leaf menu-mlid-863" role="menuitem"><a href="https://marketplace.copyright.com/rs-ui-web/mp/details/journal/122810747" data-hide-link-title="0" class="" data-icon-position="">Permissions</a></li>
<li class="leaf menu-mlid-782" role="menuitem"><a href="/page/content/Ads" data-hide-link-title="0" class="" data-icon-position="">Advertisers</a></li>
<li class="leaf menu-mlid-790" role="menuitem"><a href="/alerts" data-hide-link-title="0" class="" data-icon-position="">Alerts</a></li>
<li class="last leaf menu-mlid-791" role="menuitem"><a href="/feedback" class="" data-icon-position="" data-hide-link-title="0">Feedback</a></li>
</ul></nav></li>
</ul></nav></div>
  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-pane pane-panels-mini pane-responsive-menu-user-menu" >
  
        <h2 class="pane-title"><span class="icon-gear"></span><span class="element-invisible">User menu</span></h2>
    
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-responsive_menu_user_menu">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-menu-tree pane-user-menu" >
  
      
  
  <div class="pane-content">
    <div class="menu-block-wrapper menu-block-ctools-user-menu-1 menu-name-user-menu parent-mlid-user-menu:0 menu-level-1">
  <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf menu-mlid-801" role="menuitem"><a href="/content/subscriber-help-and-services" data-hide-link-title="0" class="" data-icon-position="">Subscribe</a></li>
<li class="leaf menu-mlid-802" role="menuitem"><a href="/alerts" data-hide-link-title="0" class="" data-icon-position="">Alerts</a></li>
<li class="leaf menu-mlid-803" role="menuitem"><a href="/user/login?destination=/content/45/6/769%3Fpanels_ajax_tab_tab%3Djnl_ajnr_tab_data%26panels_ajax_tab_trigger%3Dtab-figures-data" class="" data-icon-position="" data-hide-link-title="0">Log in</a></li>
<li class="last leaf menu-mlid-17" role="menuitem"><a href="/user/logout?current=node/108037" class="" data-icon-position="" data-hide-link-title="0">Log out</a></li>
</ul></nav></div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-user-identities" >
  
      
  
  <div class="pane-content">
    <div class="highwire-user-message" data-separator="|"><span class="highwire-user-institution" data-id-type="institution" data-identity="a%3A2%3A%7Bs%3A4%3A%22show%22%3Bi%3A1%3Bs%3A7%3A%22message%22%3Bs%3A50%3A%22Institution%3A%20%5Bidentity%3Ainstitutional_display_name%5D%22%3B%7D"></span></div>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-pane pane-panels-mini pane-responsive-menu-search" >
  
        <h2 class="pane-title"><span class="icon-search"></span><span class="element-invisible">Search</span></h2>
    
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-responsive_menu_search">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-seach-qsearch-nocontext" >
  
      
  
  <div class="pane-content">
    <form class="highwire-quicksearch button-style-mini button-style-mini" action="/content/45/6/769/tab-figures-data" method="post" id="highwire-search-qsearch-nocontext-form" accept-charset="UTF-8"><div><div class="form-item form-item-label-invisible form-type-textfield form-item-keywords">
  <label class="element-invisible" for="quick_search_header_keywords_52553766">Search for this keyword </label>
 <input placeholder="Search..." type="text" id="quick_search_header_keywords_52553766" name="keywords" value="" size="60" maxlength="128" class="form-text" />
</div>
<div class="button-wrapper button-mini"><span class="icon-search"></span><input data-icon-only="1" data-font-icon="icon-search" data-icon-position="after" type="submit" id="quick_search_header_submit_674396159" name="op" value="Search" class="form-submit" /></div><input type="hidden" name="form_build_id" value="form-mrWIsO_a2VkmFKbmlrQaqvX0XYvwyJY3Fa6Zf3QaeME" />
<input type="hidden" name="form_id" value="highwire_search_qsearch_nocontext_form" />
</div></form>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-custom pane-1 highwire-responsive-advanced-search-link pane-menu-tree" >
  
      
  
  <div class="pane-content">
    <ul class="menu">
  <li><a href="/search" title="Advanced search">Advanced search</a></li>
  </ul>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
</div></div>
  </div>
</div>
    </div>
  </div>
</div><div class="block block-panels-mini block-hw-small-logo block-panels-mini-hw-small-logo even block-without-title" id="block-panels-mini-hw-small-logo">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-hw_small_logo">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-small-logo" >
  
      
  
  <div class="pane-content">
    <a href="/" class="" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/default/files/ajnr-logo.png" alt="American Journal of Neuroradiology" title="American Journal of Neuroradiology" /></a>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
</div><div id="zone-user-wrapper" class="zone-wrapper zone-user-wrapper clearfix mobile-hidden print-hidden">  
  <div id="zone-user" class="zone zone-user clearfix equal-height-container mobile-hidden print-hidden container-30">    
  	    <div class="grid-30 region region-user-second equal-height-element" id="region-user-second">
  <div class="region-inner region-user-second-inner">
    <div class="block block-panels-mini text-right no-margin-bottom block-jnl-ajnr-uid-strng block-panels-mini-jnl-ajnr-uid-strng odd block-without-title" id="block-panels-mini-jnl-ajnr-uid-strng">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_uid_strng">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-user-identities" >
  
      
  
  <div class="pane-content">
    <div class="highwire-user-message" data-separator=" | "><span class="highwire-user-institution" data-id-type="institution" data-identity="a%3A2%3A%7Bs%3A4%3A%22show%22%3Bi%3A1%3Bs%3A7%3A%22message%22%3Bs%3A85%3A%22%3Cspan%20class%3D%22narrow-hidden%22%3EInstitution%3A%20%3C%2Fspan%3E%5Bidentity%3Ainstitutional_display_name%5D%22%3B%7D"></span></div>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
</div>  
  <div id="zone-branding" class="zone zone-branding clearfix mobile-hidden print-display-block container-30">
    <div class="grid-19 prefix-1 region region-branding print-display-block" id="region-branding">
  <div class="region-inner region-branding-inner">
        <div class="branding-data clearfix">
            <div class="logo-img">
        <a href="/" rel="home" class="" data-icon-position="" data-hide-link-title="0"><img alt="American Journal of Neuroradiology" src="http://ajnr-stage2.stage.highwire.org/sites/default/files/ajnr-web-logo_0.png" /></a>      </div>
                        <hgroup class="site-name-slogan element-invisible">        
                                <h2 class="site-name element-invisible"><a href="/" title="Home" class="" data-icon-position="" data-hide-link-title="0">American Journal of Neuroradiology</a></h2>
                              </hgroup>
          </div>
          </div>
</div><div class="grid-9 suffix-1 region region-branding-second print-hidden" id="region-branding-second">
  <div class="region-inner region-branding-second-inner">
    <div class="block block-panels-mini text-right no-margin-bottom block-jnl-ajnr-user-menu block-panels-mini-jnl-ajnr-user-menu odd block-without-title" id="block-panels-mini-jnl-ajnr-user-menu">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_user_menu">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-block pane-system-user-menu links inline pane-system" >
  
      
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="/content/subscriber-help-and-services" data-hide-link-title="0" class="" data-icon-position="">Subscribe</a></li>
<li class="leaf" role="menuitem"><a href="/alerts" data-hide-link-title="0" class="" data-icon-position="">Alerts</a></li>
<li class="leaf" role="menuitem"><a href="/user/login?destination=/content/45/6/769%3Fpanels_ajax_tab_tab%3Djnl_ajnr_tab_data%26panels_ajax_tab_trigger%3Dtab-figures-data" class="" data-icon-position="" data-hide-link-title="0">Log in</a></li>
<li class="last leaf" role="menuitem"><a href="/user/logout?current=node/108037" class="" data-icon-position="" data-hide-link-title="0">Log out</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div><div class="block block-panels-mini block-jnl-ajnr-search-box block-panels-mini-jnl-ajnr-search-box even block-without-title" id="block-panels-mini-jnl-ajnr-search-box">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_search_box">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-seach-quicksearch no-margin-bottom" >
  
      
  
  <div class="pane-content">
    <form class="highwire-quicksearch button-style-mini button-style-mini" action="/content/45/6/769/tab-figures-data" method="post" id="highwire-search-quicksearch-form-0" accept-charset="UTF-8"><div><div class="form-item form-item-label-invisible form-type-textfield form-item-keywords">
  <label class="element-invisible" for="search_rightsidebar_keywords_1594627688">Search for this keyword </label>
 <input placeholder="search" type="text" id="search_rightsidebar_keywords_1594627688" name="keywords" value="" size="60" maxlength="128" class="form-text" />
</div>
<div class="button-wrapper button-mini"><span class="icon-search"></span><input data-icon-only="1" data-font-icon="icon-search" data-icon-position="after" type="submit" id="search_rightsidebar_submit_1892942418" name="op" value="Search" class="form-submit" /></div><input type="hidden" name="form_build_id" value="form-YXIdaHEoX4ufwsPb7EK4EPGLJOioST8n3w39OQAhs8w" />
<input type="hidden" name="form_id" value="highwire_search_quicksearch_form_0" />
</div></form>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-custom pane-2" >
  
      
  
  <div class="pane-content">
    <p><a href="/search">Advanced Search</a></p>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
  
  <div id="zone-menu" class="zone zone-menu clearfix mobile-hidden container-30">
    <div class="grid-28 suffix-1 prefix-1 region region-menu region-menu-bg-opaque region-menu-no-border" id="region-menu">
  <div class="region-inner region-menu-inner">
        <div class="block block-nice-menus block-1 block-nice-menus-1 odd block-without-title" id="block-nice-menus-1">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <nav class="menubar-nav"><ul class="nice-menu nice-menu-down nice-menu-main-menu" id="nice-menu-1" role="menu"><li class="menu-772 menu-path-front first odd " role="menuitem"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Home</a></li>
<li class="menu-773 menuparent  menu-path-content-current active-trail  even " role="menuitem"><a href="/content/current" data-hide-link-title="0" class="active" data-icon-position="">Content</a><ul role="menu"><li class="menu-774 menu-path-content-current first odd " role="menuitem"><a href="/content/current" data-hide-link-title="0" class="" data-icon-position="">Current Issue</a></li>
<li class="menu-1747 menu-path-content-early-preprint  even " role="menuitem"><a href="/content/early/preprint" data-hide-link-title="0" class="" data-icon-position="">Publication Preview--Preprint</a></li>
<li class="menu-775 menu-path-content-early-recent  odd " role="menuitem"><a href="/content/early/recent" data-hide-link-title="0" class="" data-icon-position="">Publication Preview--Ahead of Print</a></li>
<li class="menu-776 menu-path-content-by-year  even " role="menuitem"><a href="/content/by/year" data-hide-link-title="0" class="" data-icon-position="">Past Issue Archive</a></li>
<li class="menu-900 menu-path-cow-by-year  odd " role="menuitem"><a href="/cow/by/year" data-hide-link-title="0" class="" data-icon-position="">Case of the Week Archive</a></li>
<li class="menu-1006 menu-path-cc-by-year  even " role="menuitem"><a href="/cc/by/year" data-hide-link-title="0" class="" data-icon-position="">Classic Case Archive</a></li>
<li class="menu-901 menu-path-com-by-year  odd " role="menuitem"><a href="/com/by/year" data-hide-link-title="0" class="" data-icon-position="">Case of the Month Archive</a></li>
<li class="menu-1334 menu-path-ajnrorg-content-covid-19-content-and-resources  even last" role="menuitem"><a href="http://www.ajnr.org/content/covid-19-content-and-resources" data-hide-link-title="0" class="" data-icon-position="">COVID-19 Content and Resources</a></li>
</ul></li>
<li class="menu-784 menuparent  menu-path-node-7  odd " role="menuitem"><a href="/content/about-us" class="" data-icon-position="" data-hide-link-title="0">About Us</a><ul role="menu"><li class="menu-785 menu-path-node-935 first odd " role="menuitem"><a href="/page/content/About" data-hide-link-title="0" class="" data-icon-position="">About AJNR</a></li>
<li class="menu-899 menu-path-sajnrorg-page-content-ed-board  even " role="menuitem"><a href="https://www.ajnr.org/page/content/Ed-Board" data-hide-link-title="0" class="" data-icon-position="">Editorial Board</a></li>
<li class="menu-864 menu-path-asnrorg  odd last" role="menuitem"><a href="http://www.asnr.org" data-hide-link-title="0" target="_blank" class="" data-icon-position="">American Society of Neuroradiology</a></li>
</ul></li>
<li class="menu-1746 menuparent  menu-path-front  even " role="menuitem"><a href="/" class="" data-icon-position="" data-hide-link-title="0">For Authors</a><ul role="menu"><li class="menu-1725 menu-path-sajnrorg-content-author-policies first odd " role="menuitem"><a href="https://www.ajnr.org/content/author-policies" data-hide-link-title="0" class="" data-icon-position="">Author Policies</a></li>
<li class="menu-1856 menu-path-sajnrorg-preprint-publishing  even " role="menuitem"><a href="https://www.ajnr.org/preprint_publishing" data-hide-link-title="0" class="" data-icon-position="">Preprint Publishing</a></li>
<li class="menu-1726 menu-path-sajnrorg-content-manuscript-submission-guidelines  odd last" role="menuitem"><a href="https://www.ajnr.org/content/manuscript-submission-guidelines" data-hide-link-title="0" class="" data-icon-position="">Manuscript Submission Guidelines</a></li>
</ul></li>
<li class="menu-862 menu-path-smcmanuscriptcentralcom-ajnr  odd " role="menuitem"><a href="https://mc.manuscriptcentral.com/ajnr" data-hide-link-title="0" target="_blank" class="" data-icon-position="">Submit a Manuscript</a></li>
<li class="menu-1184 menuparent  menu-path-node-7  even " role="menuitem"><a href="/content/about-us" data-hide-link-title="0" class="" data-icon-position="">Special Collections</a><ul role="menu"><li class="menu-1733 menu-path-ajnrorg-cc-csf-spinal-leak first odd " role="menuitem"><a href="http://www.ajnr.org/cc/CSF-Spinal-Leak" data-hide-link-title="0" class="" data-icon-position="">Spinal CSF Leak Articles (Jan 2020-June 2024)</a></li>
<li class="menu-1185 menu-path-ajnrorg-cc-most-impactful-ajnr-articles  even " role="menuitem"><a href="http://www.ajnr.org/cc/most-impactful-ajnr-articles" data-hide-link-title="0" class="" data-icon-position="">Most Impactful AJNR Articles</a></li>
<li class="menu-1896 menu-path-ajnrorg-cc-2024-awards  odd last" role="menuitem"><a href="http://www.ajnr.org/cc/2024-Awards" data-hide-link-title="0" class="" data-icon-position="">2024 AJNR Journal Awards</a></li>
</ul></li>
<li class="menu-788 menuparent  menu-path-node-9  odd last" role="menuitem"><a href="/content/advertising" class="" data-icon-position="" data-hide-link-title="0">More</a><ul role="menu"><li class="menu-780 menu-path-node-960 first odd " role="menuitem"><a href="/content/subscriber-help-and-services" data-hide-link-title="0" class="" data-icon-position="">Subscribers</a></li>
<li class="menu-863 menu-path-smarketplacecopyrightcom-rs-ui-web-mp-details-journal-122810747  even " role="menuitem"><a href="https://marketplace.copyright.com/rs-ui-web/mp/details/journal/122810747" data-hide-link-title="0" class="" data-icon-position="">Permissions</a></li>
<li class="menu-782 menu-path-node-937  odd " role="menuitem"><a href="/page/content/Ads" data-hide-link-title="0" class="" data-icon-position="">Advertisers</a></li>
<li class="menu-790 menu-path-alerts  even " role="menuitem"><a href="/alerts" data-hide-link-title="0" class="" data-icon-position="">Alerts</a></li>
<li class="menu-791 menu-path-node-10  odd last" role="menuitem"><a href="/feedback" class="" data-icon-position="" data-hide-link-title="0">Feedback</a></li>
</ul></li>
</ul></nav>
    </div>
  </div>
</div><div class="block block-menu text-right block-menu-social-media block-menu-menu-social-media even block-without-title" id="block-menu-menu-social-media">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="http://www.twitter.com/TheAJNR" target="_blank" class="link-icon-only link-icon"><span class="hw-icon-x-twitter"></span> <span class="title element-invisible">Follow AJNR on Twitter</span></a></li>
<li class="leaf" role="menuitem"><a href="http://www.facebook.com/AmJNeuroradiol" target="_blank" class="link-icon-only link-icon"><span class="icon-facebook-sign icon-2x"></span> <span class="title element-invisible">Visit AJNR on Facebook</span></a></li>
<li class="leaf" role="menuitem"><a href="https://www.instagram.com/the_ajnr/?hl=en" class="link-icon-only link-icon"><span class="icon-instagram icon-2x"></span> <span class="title element-invisible">Follow AJNR on Instagram</span></a></li>
<li class="leaf" role="menuitem"><a href="https://www.linkedin.com/company/american-journal-of-neuroradiology" class="link-icon-only link-icon"><span class="icon-linkedin icon-2x"></span> <span class="title element-invisible">Join AJNR on LinkedIn</span></a></li>
<li class="last leaf" role="menuitem"><a href="/rss" class="link-icon-only link-icon"><span class="icon-rss icon-2x"></span> <span class="title element-invisible">RSS Feeds</span></a></li>
</ul></nav>    </div>
  </div>
</div>  </div>
</div>
  </div>
  
  <div id="zone-header" class="zone zone-header clearfix container-30">
  	      <div id="messages" class="grid-28 prefix-1 suffix-1"><div role="alert" class="messages single-msg status highwire">
<div class="msg-col-left"><span class="icon icon-info-sign"></span></div><div class="msg-col-right">Getting new auth cookie, if you see this message a lot, tell someone!</div></div>
</div>
          </div>
</header>    
      <section id="section-content" class="section section-content">
    
  <div id="zone-content" class="zone zone-content clearfix container-30">    
        
    <div class="grid-28 suffix-1 prefix-1 region region-content" id="region-content">
  <div class="region-inner region-content-inner">
    <a id="main-content"></a>
                        <div class="block block-system block-main block-system-main odd block-without-title" id="block-system-main">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panels-960-layout jcore-2col-layout" >
	  <div class="panel-row-wrapper panel-row-first clearfix">
		
		<div class="top-wrapper">
			<div class="panel-panel panel-region-top">
			  <div class="inside"><div class="panel-pane pane-highwire-article-citation" >
  
      
  
  <div class="pane-content">
    <div class="highwire-article-citation highwire-citation-type-highwire-article node108037--5" data-node-nid="108037" id="top-node-108037--6737441164" data-pisa="ajnr;45/6/769" data-pisa-master="ajnr;ajnr.A8220" data-apath="/ajnr/45/6/769.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Neurodegenerative Disorder Imaging</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="ajnr;ajnr.A8220" data-atom-uri="/ajnr/45/6/769.atom" data-request-view="full"></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Thaís Armangue</span>, <span class="highwire-citation-author" data-delta="1">Matthew T. Whitehead</span>, <span class="highwire-citation-author" data-delta="2">Davide Tonduti</span>, <span class="highwire-citation-author" data-delta="3">Laura Farina</span>, <span class="highwire-citation-author" data-delta="4">Ali Reza Tavasoli</span>, <span class="highwire-citation-author" data-delta="5">Arastoo Vossough</span>, <span class="highwire-citation-author" data-delta="6">Mariko L. Bennett</span>, <span class="highwire-citation-author" data-delta="7">Ylenia Vaia</span>, <span class="highwire-citation-author" data-delta="8">Geneviève Bernard</span>, <span class="highwire-citation-author" data-delta="9">Ettore Salsano</span>, <span class="highwire-citation-author" data-delta="10">Saadet Mercimek-Andrews</span>, <span class="highwire-citation-author" data-delta="11">Amy Waldman</span> and <span class="highwire-citation-author" data-delta="12">Adeline Vanderver</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">June 2024,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">769-772; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8220 </span></div>
  
  
  
</div>
<div id="hw-article-author-popups-top-node-108037--6737441164" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Thaís Armangue </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Neuroimmunology Program (T.A.), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Hospital Clinic, University of Barcelona, Barcelona, Spain</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology Department (T.A.), Neuroimmunology Unit, Sant Joan de Deu Children’s Hospital, University of Barcelona, Barcelona, Spain</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=Tha%C3%ADs%2BArmangue%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=Armangue%20T&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 last"><a href="/search/author1%3ATha%25C3%25ADs%2BArmangue%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Matthew T. Whitehead </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (M.T.W., A.Vossough), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Perelman School of Medicine (M.T.W., A.Vossough, A.W., A.Vanderver), University of Pennsylvania, Philadelphia, Pennsylvania</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=Matthew%2BT.%2BWhitehead%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=Whitehead%20MT&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%3AMatthew%2BT.%2BWhitehead%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/0000-0001-5077-693X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Matthew T. Whitehead</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Davide Tonduti </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Unit of Pediatric Neurology (D.T., Y.V.), Center for Diagnosis and Treatment of Leukodystrophies, V. Buzzi Children’s Hospital, University of Milan, Milan, Italy</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=Davide%2BTonduti%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=Tonduti%20D&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%3ADavide%2BTonduti%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/0000-0001-9371-7454" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Davide Tonduti</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Laura Farina </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Neuroimaging Laboratory (L.F.), IRCCS Fondazione Santa Lucia, Rome, Italy </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=Laura%2BFarina%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=Farina%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 last"><a href="/search/author1%3ALaura%2BFarina%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Ali Reza Tavasoli </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Neurology (A.R.T.), Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran</div><div class='author-affiliation'><span class='nlm-sup'>h</span>Department of Neurology (A.R.T.), Barrow Neurological Institute, Phoenix Children’s Hospital, Phoenix, Arizona</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=Ali%2BReza%2BTavasoli%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=Tavasoli%20AR&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%3AAli%2BReza%2BTavasoli%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/0000-0003-0440-5809" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Ali Reza Tavasoli</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Arastoo Vossough </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (M.T.W., A.Vossough), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Perelman School of Medicine (M.T.W., A.Vossough, A.W., A.Vanderver), University of Pennsylvania, Philadelphia, Pennsylvania</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=Arastoo%2BVossough%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=Vossough%20A&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%3AArastoo%2BVossough%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/0000-0003-1346-427X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Arastoo Vossough</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">Mariko L. Bennett </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>o</span>Division of Neurology (M.L.B., Y.V., A.W., A.Vanderver), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.</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=Mariko%2BL.%2BBennett%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=Bennett%20ML&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 last"><a href="/search/author1%3AMariko%2BL.%2BBennett%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">Ylenia Vaia </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Unit of Pediatric Neurology (D.T., Y.V.), Center for Diagnosis and Treatment of Leukodystrophies, V. Buzzi Children’s Hospital, University of Milan, Milan, Italy</div><div class='author-affiliation'><span class='nlm-sup'>o</span>Division of Neurology (M.L.B., Y.V., A.W., A.Vanderver), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.</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=Ylenia%2BVaia%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=Vaia%20Y&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%3AYlenia%2BVaia%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/0009-0009-7105-7411" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Ylenia Vaia</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">Geneviève Bernard </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>i</span>Departments of Neurology and Neurosurgery, Pediatrics, and Human Genetics (G.B.), McGill University, Montreal, Quebec, Canada</div><div class='author-affiliation'><span class='nlm-sup'>j</span>Department of Specialized Medicine (G.B.), Division of Medical Genetics, McGill University Health Centre, Montreal, Quebec, Canada</div><div class='author-affiliation'><span class='nlm-sup'>k</span>Child Health and Human Development Program (G.B.), Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada</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=Genevi%C3%A8ve%2BBernard%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=Bernard%20G&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 last"><a href="/search/author1%3AGenevi%25C3%25A8ve%2BBernard%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">Ettore Salsano </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>l</span>Unit of Rare Neurological Diseases (E.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy</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=Ettore%2BSalsano%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=Salsano%20E&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 last"><a href="/search/author1%3AEttore%2BSalsano%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">Saadet Mercimek-Andrews </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>m</span>Department of Medical Genetics (S.M.-A.), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada</div><div class='author-affiliation'><span class='nlm-sup'>n</span>The Hospital for Sick Children (S.M.-A.), Toronto, Ontario, Canada</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=Saadet%2BMercimek-Andrews%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=Mercimek-Andrews%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 last"><a href="/search/author1%3ASaadet%2BMercimek-Andrews%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">Amy Waldman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Perelman School of Medicine (M.T.W., A.Vossough, A.W., A.Vanderver), University of Pennsylvania, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>o</span>Division of Neurology (M.L.B., Y.V., A.W., A.Vanderver), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.</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=Amy%2BWaldman%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=Waldman%20A&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 last"><a href="/search/author1%3AAmy%2BWaldman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">Adeline Vanderver </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Perelman School of Medicine (M.T.W., A.Vossough, A.W., A.Vanderver), University of Pennsylvania, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>o</span>Division of Neurology (M.L.B., Y.V., A.W., A.Vanderver), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.</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=Adeline%2BVanderver%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=Vanderver%20A&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%3AAdeline%2BVanderver%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/0000-0002-6290-6751" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Adeline Vanderver</a></li></ul></div></div></div>  </div>

  
  </div>
</div>
			</div>
		</div>
	
	</div> <!-- /.panel-row-wrapper -->	
	  
  <div class="panel-row-wrapper clearfix">
		
		<div class="main-content-wrapper grid-17 suffix-1 alpha">
			<div class="panel-panel panel-region-content">
			  <div class="inside"><div class="panel-pane pane-highwire-panel-tabs pane-panels-ajax-tab-tabs" >
  
      
  
  <div class="pane-content">
    <div class="item-list"><ul class="tabs inline panels-ajax-tab"><li class="first"><a href="/content/45/6/769" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_art" data-target-id="highwire_article_tabs" data-entity-context="node:108037" data-trigger="" data-url-enabled="1">Article</a><a href="/panels_ajax_tab/jnl_ajnr_tab_art/node:108037/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/45/6/769/tab-figures-data" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_data" data-target-id="highwire_article_tabs" data-entity-context="node:108037" data-trigger="tab-figures-data" data-url-enabled="1">Figures &amp; Data</a><a href="/panels_ajax_tab/jnl_ajnr_tab_data/node:108037/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/45/6/769/tab-supplemental" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_supp" data-target-id="highwire_article_tabs" data-entity-context="node:108037" data-trigger="tab-supplemental" data-url-enabled="1">Supplemental</a><a href="/panels_ajax_tab/jnl_ajnr_tab_supp/node:108037/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/45/6/769/tab-references" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_refs" data-target-id="highwire_article_tabs" data-entity-context="node:108037" data-trigger="tab-references" data-url-enabled="1">References</a><a href="/panels_ajax_tab/jnl_ajnr_tab_refs/node:108037/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li><a href="/content/45/6/769/tab-article-info" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_info" data-target-id="highwire_article_tabs" data-entity-context="node:108037" data-trigger="tab-article-info" data-url-enabled="1">Info &amp; Metrics</a><a href="/panels_ajax_tab/jnl_ajnr_tab_info/node:108037/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li><li class="last"><a href="/content/ajnr/45/6/769.full.pdf" class="panels-ajax-tab-tab" data-panel-name="jnl_ajnr_tab_pdf" data-target-id="highwire_article_tabs" data-entity-context="node:108037" data-trigger="tab-pdf" data-url-enabled="1"><i class="icon-file-alt"></i> PDF</a><a href="/panels_ajax_tab/jnl_ajnr_tab_pdf/node:108037/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li></ul></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container" >
  
      
  
  <div class="pane-content">
    <div data-panels-ajax-tab-preloaded="jnl_ajnr_tab_data" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_ajnr_tab_data"><div class="panel-display panel-1col clearfix" >
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-article-fig-data" >
  
        <h2 class="pane-title">Article Figures &amp; Data</h2>
    
  
  <div class="pane-content">
    <div class="elements-frag-data highwire-markup" id="fig-data"><div id="fig-data-figures" class="group frag-figure"><div class="fig-data-title-jump clearfix"><h3 class="fig-data-group-title">Figures</h3><div class="fig-data-jump-links"><ul class="fig-data-jump-links-list links inline"><li class="table first last"><a href="#fig-data-tables" class="fig-data-jump-link fig-data-jump-link-table link-icon"><span class="icon-caret-down"></span> <span class="title">Tables</span></a></li></ul></div></div><div class="item-list"><ul class="fig-data-list clearfix" id="fragments-fig"><li class="first last"><div class="element-fig-data clearfix figure-caption"><div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="fig-expansion " id="F1"><span class="highwire-journal-article-marker-start"></span><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/45/6/769/F1.large.jpg?width=800&amp;height=600&amp;carousel=1" title="Chipmunk MR imaging sign. T2-weighted axial MRI through the medulla oblongata in subjects with AxD type I (A) and AxD type II (B), an image of a chipmunk face (A, white circle), and a T2WI axial scan of the medulla oblongata in a healthy subject (B, white circle). A typical chipmunk sign in AxD type I (white box in A) and AxD type II (white box in B). The black arrow indicates the inferior olivary nucleus; black arrowhead, medial lemniscus; white arrow, inferior peduncle; white arrowhead, medial longitudinal fasciculus; double white arrows, pyramidal tracts. " class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-646292910" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;Chipmunk MR imaging sign. T2-weighted axial MRI through the medulla oblongata in subjects with AxD type I (&lt;em&gt;A&lt;/em&gt;) and AxD type II &lt;em&gt;(B&lt;/em&gt;), an image of a chipmunk face (&lt;em&gt;A&lt;/em&gt;, &lt;em&gt;white circle&lt;/em&gt;), and a T2WI axial scan of the medulla oblongata in a healthy subject (&lt;em&gt;B&lt;/em&gt;, &lt;em&gt;white circle&lt;/em&gt;). A typical chipmunk sign in AxD type I (&lt;em&gt;white box&lt;/em&gt; in &lt;em&gt;A&lt;/em&gt;) and AxD type II (&lt;em&gt;white box&lt;/em&gt; in &lt;em&gt;B&lt;/em&gt;). The &lt;em&gt;black arrow&lt;/em&gt; indicates the inferior olivary nucleus; &lt;em&gt;black arrowhead&lt;/em&gt;, medial lemniscus; &lt;em&gt;white arrow&lt;/em&gt;, inferior peduncle; &lt;em&gt;white arrowhead&lt;/em&gt;, medial longitudinal fasciculus; &lt;em&gt;double white arrows&lt;/em&gt;, pyramidal tracts. &lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="FIGURE" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/45/6/769/F1.medium.gif" width="399" height="440"/><noscript><img class="highwire-fragment fragment-image" alt="FIGURE" src="http://ajnr-stage2.stage.highwire.org/content/ajnr/45/6/769/F1.medium.gif" width="399" height="440"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/45/6/769/F1.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download FIGURE" data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/45/6/769/F1.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/108055" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption" xmlns:xhtml="http://www.w3.org/1999/xhtml"><span class="fig-label">FIGURE</span> <p id="p-9">Chipmunk MR imaging sign. T2-weighted axial MRI through the medulla oblongata in subjects with AxD type I (<em>A</em>) and AxD type II <em>(B</em>), an image of a chipmunk face (<em>A</em>, <em>white circle</em>), and a T2WI axial scan of the medulla oblongata in a healthy subject (<em>B</em>, <em>white circle</em>). A typical chipmunk sign in AxD type I (<em>white box</em> in <em>A</em>) and AxD type II (<em>white box</em> in <em>B</em>). The <em>black arrow</em> indicates the inferior olivary nucleus; <em>black arrowhead</em>, medial lemniscus; <em>white arrow</em>, inferior peduncle; <em>white arrowhead</em>, medial longitudinal fasciculus; <em>double white arrows</em>, pyramidal tracts. </p><div class="sb-div caption-clear"></div></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div></div></li></ul></div></div><div id="fig-data-tables" class="group frag-table"><div class="fig-data-title-jump clearfix"><h3 class="fig-data-group-title">Tables</h3><div class="fig-data-jump-links"><ul class="fig-data-jump-links-list links inline"><li class="figure first last"><a href="#fig-data-figures" class="fig-data-jump-link fig-data-jump-link-figure link-icon"><span class="icon-caret-up"></span> <span class="title">Figures</span></a></li></ul></div></div><div class="item-list"><ul class="fig-data-list clearfix" id="fragments-table"><li class="first last"><div class="element-fig-data clearfix table-caption"><div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="table-expansion " id="T1"><span class="highwire-journal-article-marker-start"></span><div class="table-caption"><p id="p-18">Involvement of different anatomic structures of the medulla oblongata and additional MR imaging features in subjects with AxD and non-AxD leukodystrophy on T2-weighted images<a id="xref-fn-2-1" class="xref-table-fn" href="#fn-2"><sup>a</sup></a></p><div class="sb-div caption-clear"></div></div><table frame="hsides" id="table-1" alt=""><thead valign="bottom" id="thead-1" class="table-vbottom"><tr id="tr-1"><th align="center" rowspan="1" colspan="1" id="th-1" class="table-center"></th><th align="center" rowspan="1" colspan="1" id="th-2" class="table-center">AxD</th><th align="center" rowspan="1" colspan="1" id="th-3" class="table-center">Non-AxD</th><th align="center" rowspan="1" colspan="1" id="th-4" class="table-center">AxD Type I</th><th align="center" rowspan="1" colspan="1" id="th-5" class="table-center">AxD Type II</th><th align="center" rowspan="1" colspan="1" id="th-6" class="table-center">VWM</th><th align="center" rowspan="1" colspan="1" id="th-7" class="table-center">APBD</th><th align="center" rowspan="1" colspan="1" id="th-8" class="table-center">Other</th></tr></thead><tbody valign="top" id="tbody-1" class="table-vtop"><tr id="tr-2"><td rowspan="1" colspan="1" id="td-1">Total MRIs reviewed</td><td align="char" char="." rowspan="1" colspan="1" id="td-2" class="table-char">55</td><td align="char" char="." rowspan="1" colspan="1" id="td-3" class="table-char">74</td><td align="char" char="." rowspan="1" colspan="1" id="td-4" class="table-char">32</td><td align="char" char="." rowspan="1" colspan="1" id="td-5" class="table-char">21</td><td align="char" char="." rowspan="1" colspan="1" id="td-6" class="table-char">6</td><td align="char" char="." rowspan="1" colspan="1" id="td-7" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-8" class="table-char">67</td></tr><tr id="tr-3"><td rowspan="1" colspan="1" id="td-9">Positive chipmunk sign</td><td align="char" char="." rowspan="1" colspan="1" id="td-10" class="table-char">48</td><td align="char" char="." rowspan="1" colspan="1" id="td-11" class="table-char">10</td><td align="char" char="." rowspan="1" colspan="1" id="td-12" class="table-char">28</td><td align="char" char="." rowspan="1" colspan="1" id="td-13" class="table-char">18</td><td align="char" char="." rowspan="1" colspan="1" id="td-14" class="table-char">3</td><td align="char" char="." rowspan="1" colspan="1" id="td-15" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-16" class="table-char">3</td></tr><tr id="tr-4"><td rowspan="1" colspan="1" id="td-17">T2-hyperintense dorsal medulla</td><td align="char" char="." rowspan="1" colspan="1" id="td-18" class="table-char">52</td><td align="char" char="." rowspan="1" colspan="1" id="td-19" class="table-char">17</td><td align="char" char="." rowspan="1" colspan="1" id="td-20" class="table-char">29</td><td align="char" char="." rowspan="1" colspan="1" id="td-21" class="table-char">21</td><td align="char" char="." rowspan="1" colspan="1" id="td-22" class="table-char">5</td><td align="char" char="." rowspan="1" colspan="1" id="td-23" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-24" class="table-char">8</td></tr><tr id="tr-5"><td rowspan="1" colspan="1" id="td-25">T2-hyperintense pyramids</td><td align="left" rowspan="1" colspan="1" id="td-26" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-27" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-28" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-29" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-30" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-31" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-32" class="table-left"></td></tr><tr id="tr-6"><td rowspan="1" colspan="1" id="td-33"> No</td><td align="char" char="." rowspan="1" colspan="1" id="td-34" class="table-char">8</td><td align="char" char="." rowspan="1" colspan="1" id="td-35" class="table-char">59</td><td align="char" char="." rowspan="1" colspan="1" id="td-36" class="table-char">7</td><td align="char" char="." rowspan="1" colspan="1" id="td-37" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-38" class="table-char">2</td><td align="char" char="." rowspan="1" colspan="1" id="td-39" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-40" class="table-char">57</td></tr><tr id="tr-7"><td rowspan="1" colspan="1" id="td-41"> Yes, asymmetric</td><td align="char" char="." rowspan="1" colspan="1" id="td-42" class="table-char">5</td><td align="char" char="." rowspan="1" colspan="1" id="td-43" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-44" class="table-char">2</td><td align="char" char="." rowspan="1" colspan="1" id="td-45" class="table-char">3</td><td align="char" char="." rowspan="1" colspan="1" id="td-46" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-47" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-48" class="table-char">1</td></tr><tr id="tr-8"><td rowspan="1" colspan="1" id="td-49"> Yes, symmetric</td><td align="char" char="." rowspan="1" colspan="1" id="td-50" class="table-char">42</td><td align="char" char="." rowspan="1" colspan="1" id="td-51" class="table-char">13</td><td align="char" char="." rowspan="1" colspan="1" id="td-52" class="table-char">23</td><td align="char" char="." rowspan="1" colspan="1" id="td-53" class="table-char">17</td><td align="char" char="." rowspan="1" colspan="1" id="td-54" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-55" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-56" class="table-char">5</td></tr><tr id="tr-9"><td rowspan="1" colspan="1" id="td-57">T2-hyperintense central ION</td><td align="left" rowspan="1" colspan="1" id="td-58" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-59" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-60" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-61" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-62" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-63" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-64" class="table-left"></td></tr><tr id="tr-10"><td rowspan="1" colspan="1" id="td-65"> No</td><td align="char" char="." rowspan="1" colspan="1" id="td-66" class="table-char">8</td><td align="char" char="." rowspan="1" colspan="1" id="td-67" class="table-char">58</td><td align="char" char="." rowspan="1" colspan="1" id="td-68" class="table-char">6</td><td align="char" char="." rowspan="1" colspan="1" id="td-69" class="table-char">2</td><td align="char" char="." rowspan="1" colspan="1" id="td-70" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-71" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-72" class="table-char">57</td></tr><tr id="tr-11"><td rowspan="1" colspan="1" id="td-73"> Yes, asymmetric</td><td align="char" char="." rowspan="1" colspan="1" id="td-74" class="table-char">5</td><td align="char" char="." rowspan="1" colspan="1" id="td-75" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-76" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-77" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-78" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-79" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-80" class="table-char">1</td></tr><tr id="tr-12"><td rowspan="1" colspan="1" id="td-81"> Yes, symmetric</td><td align="char" char="." rowspan="1" colspan="1" id="td-82" class="table-char">41</td><td align="char" char="." rowspan="1" colspan="1" id="td-83" class="table-char">13</td><td align="char" char="." rowspan="1" colspan="1" id="td-84" class="table-char">24</td><td align="char" char="." rowspan="1" colspan="1" id="td-85" class="table-char">15</td><td align="char" char="." rowspan="1" colspan="1" id="td-86" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-87" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-88" class="table-char">5</td></tr><tr id="tr-13"><td rowspan="1" colspan="1" id="td-89">T2-hypointense peripheral ION</td><td align="left" rowspan="1" colspan="1" id="td-90" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-91" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-92" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-93" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-94" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-95" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-96" class="table-left"></td></tr><tr id="tr-14"><td rowspan="1" colspan="1" id="td-97"> No</td><td align="char" char="." rowspan="1" colspan="1" id="td-98" class="table-char">6</td><td align="char" char="." rowspan="1" colspan="1" id="td-99" class="table-char">62</td><td align="char" char="." rowspan="1" colspan="1" id="td-100" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-101" class="table-char">2</td><td align="char" char="." rowspan="1" colspan="1" id="td-102" class="table-char">2</td><td align="char" char="." rowspan="1" colspan="1" id="td-103" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-104" class="table-char">60</td></tr><tr id="tr-15"><td rowspan="1" colspan="1" id="td-105"> Yes, asymmetric</td><td align="char" char="." rowspan="1" colspan="1" id="td-106" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-107" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-108" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-109" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-110" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-111" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-112" class="table-char">0</td></tr><tr id="tr-16"><td rowspan="1" colspan="1" id="td-113"> Yes, symmetric</td><td align="char" char="." rowspan="1" colspan="1" id="td-114" class="table-char">47</td><td align="char" char="." rowspan="1" colspan="1" id="td-115" class="table-char">11</td><td align="char" char="." rowspan="1" colspan="1" id="td-116" class="table-char">27</td><td align="char" char="." rowspan="1" colspan="1" id="td-117" class="table-char">18</td><td align="char" char="." rowspan="1" colspan="1" id="td-118" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-119" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-120" class="table-char">3</td></tr><tr id="tr-17"><td rowspan="1" colspan="1" id="td-121">T2-hypointense IP</td><td align="left" rowspan="1" colspan="1" id="td-122" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-123" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-124" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-125" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-126" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-127" class="table-left"></td><td align="left" rowspan="1" colspan="1" id="td-128" class="table-left"></td></tr><tr id="tr-18"><td rowspan="1" colspan="1" id="td-129"> No</td><td align="char" char="." rowspan="1" colspan="1" id="td-130" class="table-char">7</td><td align="char" char="." rowspan="1" colspan="1" id="td-131" class="table-char">58</td><td align="char" char="." rowspan="1" colspan="1" id="td-132" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-133" class="table-char">3</td><td align="char" char="." rowspan="1" colspan="1" id="td-134" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-135" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-136" class="table-char">57</td></tr><tr id="tr-19"><td rowspan="1" colspan="1" id="td-137"> Yes, asymmetric</td><td align="char" char="." rowspan="1" colspan="1" id="td-138" class="table-char">3</td><td align="char" char="." rowspan="1" colspan="1" id="td-139" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-140" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-141" class="table-char">2</td><td align="char" char="." rowspan="1" colspan="1" id="td-142" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-143" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-144" class="table-char">1</td></tr><tr id="tr-20"><td rowspan="1" colspan="1" id="td-145"> Yes, symmetric</td><td align="char" char="." rowspan="1" colspan="1" id="td-146" class="table-char">45</td><td align="char" char="." rowspan="1" colspan="1" id="td-147" class="table-char">14</td><td align="char" char="." rowspan="1" colspan="1" id="td-148" class="table-char">27</td><td align="char" char="." rowspan="1" colspan="1" id="td-149" class="table-char">16</td><td align="char" char="." rowspan="1" colspan="1" id="td-150" class="table-char">5</td><td align="char" char="." rowspan="1" colspan="1" id="td-151" class="table-char">3</td><td align="char" char="." rowspan="1" colspan="1" id="td-152" class="table-char">6</td></tr><tr id="tr-21"><td rowspan="1" colspan="1" id="td-153">T2-hyperintense ML</td><td align="char" char="." rowspan="1" colspan="1" id="td-154" class="table-char">38</td><td align="char" char="." rowspan="1" colspan="1" id="td-155" class="table-char">12</td><td align="char" char="." rowspan="1" colspan="1" id="td-156" class="table-char">19</td><td align="char" char="." rowspan="1" colspan="1" id="td-157" class="table-char">18</td><td align="char" char="." rowspan="1" colspan="1" id="td-158" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-159" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-160" class="table-char">4</td></tr><tr id="tr-22"><td rowspan="1" colspan="1" id="td-161">Atrophy</td><td align="char" char="." rowspan="1" colspan="1" id="td-162" class="table-char">20</td><td align="char" char="." rowspan="1" colspan="1" id="td-163" class="table-char">7</td><td align="char" char="." rowspan="1" colspan="1" id="td-164" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-165" class="table-char">16</td><td align="char" char="." rowspan="1" colspan="1" id="td-166" class="table-char">1</td><td align="char" char="." rowspan="1" colspan="1" id="td-167" class="table-char">4</td><td align="char" char="." rowspan="1" colspan="1" id="td-168" class="table-char">2</td></tr><tr id="tr-23"><td rowspan="1" colspan="1" id="td-169">Mass effect lesions</td><td align="char" char="." rowspan="1" colspan="1" id="td-170" class="table-char">5</td><td align="char" char="." rowspan="1" colspan="1" id="td-171" class="table-char">2</td><td align="char" char="." rowspan="1" colspan="1" id="td-172" class="table-char">3</td><td align="char" char="." rowspan="1" colspan="1" id="td-173" class="table-char">2</td><td align="char" char="." rowspan="1" colspan="1" id="td-174" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-175" class="table-char">0</td><td align="char" char="." rowspan="1" colspan="1" id="td-176" class="table-char">2</td></tr><tr id="tr-24"><td rowspan="1" colspan="1" id="td-177">T2-hypointense MLF</td><td align="char" char="." rowspan="1" colspan="1" id="td-178" class="table-char">35</td><td align="char" char="." rowspan="1" colspan="1" id="td-179" class="table-char">8</td><td align="char" char="." rowspan="1" colspan="1" id="td-180" class="table-char">25</td><td align="char" char="." rowspan="1" colspan="1" id="td-181" class="table-char">8</td><td align="char" char="." rowspan="1" colspan="1" id="td-182" class="table-char">3</td><td align="char" char="." rowspan="1" colspan="1" id="td-183" class="table-char">3</td><td align="char" char="." rowspan="1" colspan="1" id="td-184" class="table-char">2</td></tr></tbody></table><div class="table-foot"><ul class="table-footnotes"><li class="fn" id="fn-1"><p id="p-19"><strong>Note:</strong>—MLF indicates medial longitudinal fasciculus; ML, medial lemniscus; IP, inferior peduncle.</p></li><li class="fn" id="fn-2"><p id="p-20"><a class="rev-xref" href="#xref-fn-2-1">↵</a><span class="fn-label">a</span> See the Online Supplemental Data for details on patients and the comparison group.</p></li></ul></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div></div></li></ul></div></div></div>  </div>

  
  </div>
</div>
  </div>
</div>
</div></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-node-pager" >
  
      
  
  <div class="pane-content">
    <div class="pager highwire-pager pager-mini clearfix highwire-node-pager highwire-article-pager"><span class="pager-prev"><a href="/content/45/6/761" title="The Clinical Value of Cranial CT Venography for Predicting Fusobacterium necrophorum as the Causative Agent in Children with Complicated Acute Mastoiditis" rel="prev" class="pager-link-prev link-icon"><span class="icon-circle-arrow-left"></span> <span class="title">Previous</span></a></span><span class="pager-next"><a href="/content/45/6/773" title="DOTATATE PET/MR Imaging Differentiates Secondary-Progressive from de Novo World Health Organization Grade 3 Meningiomas" rel="next" class="pager-link-next link-icon-right link-icon"><span class="title">Next</span> <span class="icon-circle-arrow-right"></span></a></span></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-back-to-top" >
  
      
  
  <div class="pane-content">
    <a href="#page" class="back-to-top" data-icon-position="" data-hide-link-title="0"><span class="icon-chevron-up"></span> Back to top</a>  </div>

  
  </div>
</div>
			</div>
		</div>
		
		<div class="sidebar-right-wrapper grid-10 omega">
			<div class="panel-panel panel-region-sidebar-right">
			  <div class="inside"><div class="panel-pane pane-panels-mini pane-jnl-ajnr-art-issue pane-style-alt-content" >
  
        <h2 class="pane-title">In this issue</h2>
    
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_art_issue">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-article-citation" >
  
      
  
  <div class="pane-content">
    <div class="highwire-article-citation highwire-citation-type-highwire-issue node107924" data-node-nid="107924" id="node-107924--21441880635" data-pisa="ajnr;45/6" data-pisa-master="ajnr;45/6" data-apath="/ajnr/45/6.atom"><div class="highwire-cite highwire-cite-highwire-issue highwire-citation-jcore-issue-widget clearfix">
    
      <div class="highwire-cite-highlight"><a href="/content/45/6"  class="highlight-image-linked"><img class="highlight-image" src="http://ajnr-stage2.stage.highwire.org/sites/default/files/styles/medium/public/highwire/ajnr/45/6.cover-source.jpg?itok=ipNgblcg" alt="American Journal of Neuroradiology: 45 (6)" /></a></div>
  
  <div class="highwire-cite-col">
      
      
          <a href="/content/45/6" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">American Journal of Neuroradiology</span></a>      
      
        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 45</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 6 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jun 2024 </div></div>
      
      
        	<div class="highwire-cite-extras"><div class='highwire-article-citation-variant-list'><ul class="links variants-list"><li class="toc first"><a href="/content/45/6.toc" class="highwire-variant-link variant-toc " title="Table of Contents" rel="alternate" type="text/html" data-icon-position="" data-hide-link-title="0">Table of Contents</a></li><li class="index-by-author"><a href="/content/45/6.index-by-author" class="highwire-variant-link variant-index-by-author " title="Index by author" rel="alternate" data-icon-position="" data-hide-link-title="0">Index by author</a></li><li class="enclosure-complete-issue last"><a href="/content/ajnr/45/6/local/complete-issue.pdf" class="highwire-variant-link variant-enclosure" title="Complete Issue (PDF)" rel="alternative" data-icon-position="" data-hide-link-title="0">Complete Issue (PDF)</a></li></ul></div></div>
      </div>

</div></div>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-ajnr-ad-rhs" >
  
      
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_ad_rhs">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-dfp-pane text-center" >
  
      
  
  <div class="pane-content">
    <div id="dfp-ad-rhs-wrapper" class="dfp-tag-wrapper">
<div class="slug">Advertisement</div>
<div  id="dfp-ad-rhs" class="dfp-tag-wrapper">
  <script type="text/javascript">
    googletag.cmd.push(function() {
      googletag.display("dfp-ad-rhs");
    });
  </script>
</div>
</div>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-ajnr-art-tools" >
  
      
  
  <div class="pane-content">
    <div id="mini-panel-jnl_ajnr_art_tools" class="highwire-2col-stacked panel-display">
	  
  <div class="panel-row-wrapper clearfix">
		<div class="content-left-wrapper content-column">
          <div class="panel-panel panel-region-content-left">
            <div class="inside"><div class="panel-pane pane-highwire-variant-link" >
  
      
  
  <div class="pane-content">
    <a href="/content/ajnr/45/6/769.full-text.print" target="_blank" rel="nofollow" class="link-icon"><span class="icon-print"></span> <span class="title">Print</span></a>  </div>

  
  </div>
<div class="panel-pane pane-highwire-variant-link text-no-wrap" >
  
      
  
  <div class="pane-content">
    <a href="/content/ajnr/45/6/769.full-text.pdf" target="_blank" class="link-icon"><span class="icon-download-alt"></span> <span class="title">Download PDF</span></a>  </div>

  
  </div>
<div class="panel-pane pane-minipanel-dialog-link pane-jnl-ajnr-art-email" >
  
      
  
  <div class="pane-content">
    <div class='minipanel-dialog-wrapper'><div class='minipanel-dialog-link-link'><a href="/" oncontextmenu="javascript: return false;" class="minipanel-dialog-link-trigger link-icon" title="Email this Article"><span class="icon-envelope"></span> <span class="title">Email Article</span></a></div><div class='minipanel-dialog-link-mini' style='display:none'><div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_art_email">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-block pane-forward-form pane-forward" >
  
      
  
  <div class="pane-content">
    <form action="/content/45/6/769/tab-figures-data" method="post" id="forward-form" accept-charset="UTF-8"><div><div id="edit-instructions" class="form-item form-item-label-before form-type-item">
 <p>Thank you for your interest in spreading the word on American Journal of Neuroradiology.</p><p>NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.</p>
</div>
<div class="form-item form-item-label-before form-type-textfield form-item-email">
  <label for="edit-email">Your Email <span class="form-required" title="This field is required.">*</span></label>
 <input type="text" id="edit-email" name="email" value="" size="58" maxlength="256" class="form-text required" />
</div>
<div class="form-item form-item-label-before form-type-textfield form-item-name">
  <label for="edit-name">Your Name <span class="form-required" title="This field is required.">*</span></label>
 <input type="text" id="edit-name" name="name" value="" size="58" maxlength="256" class="form-text required" />
</div>
<div class="form-item form-item-label-before form-type-textarea form-item-recipients">
  <label for="edit-recipients">Send To <span class="form-required" title="This field is required.">*</span></label>
 <div class="form-textarea-wrapper resizable"><textarea id="edit-recipients" name="recipients" cols="50" rows="5" class="form-textarea required"></textarea></div>
<div class="description">Enter multiple addresses on separate lines or separate them with commas.</div>
</div>
<div id="edit-page" class="form-item form-item-label-before form-type-item">
  <label for="edit-page">You are going to email the following </label>
 <a href="/content/45/6/769" class="active" data-icon-position="" data-hide-link-title="0">Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease</a>
</div>
<div id="edit-subject" class="form-item form-item-label-before form-type-item">
  <label for="edit-subject">Message Subject </label>
 (Your Name) has sent you a message from American Journal of Neuroradiology
</div>
<div id="edit-body" class="form-item form-item-label-before form-type-item">
  <label for="edit-body">Message Body </label>
 (Your Name) thought you would like to see the American Journal of Neuroradiology web site.
</div>
<div class="form-item form-item-label-before form-type-textarea form-item-message">
  <label for="edit-message--2">Your Personal Message </label>
 <div class="form-textarea-wrapper resizable"><textarea id="edit-message--2" name="message" cols="50" rows="10" class="form-textarea"></textarea></div>
</div>
<input type="hidden" name="path" value="node/108037" />
<input type="hidden" name="path_cid" value="" />
<input type="hidden" name="forward_footer" value="" />
<input type="hidden" name="form_build_id" value="form-j4lBpxGBAyna0V0BrBUkjEJDgTuLzsAGsfbGWpro0Yc" />
<input type="hidden" name="form_id" value="forward_form" />
<fieldset class="captcha form-wrapper"><legend><span class="fieldset-legend">CAPTCHA</span></legend><div class="fieldset-wrapper"><div class="fieldset-description">This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.</div><input type="hidden" name="captcha_sid" value="108784297" />
<input type="hidden" name="captcha_token" value="34cc64356f676a6de4f40ec8213d090f" />
<input type="hidden" name="captcha_response" value="Google no captcha" />
<div class="g-recaptcha" data-sitekey="6LfnJVIUAAAAAE-bUOMg0MJGki4lqSvDmhJp19fN" data-theme="light" data-type="image"></div></div></fieldset>
<div class="form-actions form-wrapper" id="edit-actions"><input type="submit" id="edit-submit" name="op" value="Send Message" class="form-submit" /></div></div></form>  </div>

  
  </div>
</div>
  </div>
</div>
</div></div>  </div>

  
  </div>
<div class="panel-pane pane-minipanel-dialog-link pane-jnl-ajnr-cite-tool" >
  
      
  
  <div class="pane-content">
    <div class='minipanel-dialog-wrapper'><div class='minipanel-dialog-link-link'><a href="/highwire/citation/108037/download" oncontextmenu="javascript: return false;" class="minipanel-dialog-link-trigger link-icon" title="Citation Tools"><span class="icon-globe"></span> <span class="title">Citation Tools</span></a></div><div class='minipanel-dialog-link-mini' style='display:none'><div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_cite_tool">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-citation-export" >
  
      
  
  <div class="pane-content">
    <div class="highwire-citation-export">  
  <div class="highwire-citation-info">
      <div class="highwire-article-citation highwire-citation-type-highwire-article cite-tool-node108037" data-node-nid="108037" id="citation-node-108037--2475794417" data-pisa="ajnr;45/6/769" data-pisa-master="ajnr;ajnr.A8220" data-apath="/ajnr/45/6/769.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard clearfix">
  
  
  
  
      <div class="highwire-cite-title">Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Thaís</span> <span class="nlm-surname">Armangue</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Matthew T.</span> <span class="nlm-surname">Whitehead</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Davide</span> <span class="nlm-surname">Tonduti</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Laura</span> <span class="nlm-surname">Farina</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Ali Reza</span> <span class="nlm-surname">Tavasoli</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Arastoo</span> <span class="nlm-surname">Vossough</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Mariko L.</span> <span class="nlm-surname">Bennett</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Ylenia</span> <span class="nlm-surname">Vaia</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Geneviève</span> <span class="nlm-surname">Bernard</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Ettore</span> <span class="nlm-surname">Salsano</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Saadet</span> <span class="nlm-surname">Mercimek-Andrews</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Amy</span> <span class="nlm-surname">Waldman</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">Adeline</span> <span class="nlm-surname">Vanderver</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">Jun 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">769-772; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8220 </span></div>
  
  
  
</div>
</div>  </div>
  <div class="highwire-citation-formats">
  	      <h2>Citation Manager Formats</h2>
        <div class="highwire-citation-formats-links">
      <span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.spage=769&amp;rft.epage=772&amp;rft.atitle=Brainstem%20Chipmunk%20Sign%3A%20A%20Diagnostic%20Imaging%20Clue%20across%20All%20Subtypes%20of%20Alexander%20Disease&amp;rft.volume=45&amp;rft.issue=6&amp;rft.date=2024-06-01%2000%3A00%3A00&amp;rft.stitle&amp;rft.jtitle=American%20Journal%20of%20Neuroradiology&amp;rft.au=Armangue%2C+Tha%C3%ADs&amp;rft.au=Whitehead%2C+Matthew+T.&amp;rft.au=Tonduti%2C+Davide&amp;rft.au=Farina%2C+Laura&amp;rft.au=Tavasoli%2C+Ali+Reza&amp;rft.au=Vossough%2C+Arastoo&amp;rft.au=Bennett%2C+Mariko+L.&amp;rft.au=Vaia%2C+Ylenia&amp;rft.au=Bernard%2C+Genevi%C3%A8ve&amp;rft.au=Salsano%2C+Ettore&amp;rft.au=Mercimek-Andrews%2C+Saadet&amp;rft.au=Waldman%2C+Amy&amp;rft.au=Vanderver%2C+Adeline"></span><ul class="hw-citation-links inline button button-alt button-grid clearfix"><li class="bibtext first"><a href="/highwire/citation/108037/bibtext" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">BibTeX</a></li><li class="bookends"><a href="/highwire/citation/108037/bookends" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Bookends</a></li><li class="easybib"><a href="/highwire/citation/108037/easybib" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">EasyBib</a></li><li class="endnote-tagged"><a href="/highwire/citation/108037/endnote-tagged" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">EndNote (tagged)</a></li><li class="endnote-8-xml"><a href="/highwire/citation/108037/endnote-8-xml" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">EndNote 8 (xml)</a></li><li class="medlars"><a href="/highwire/citation/108037/medlars" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Medlars</a></li><li class="mendeley"><a href="/highwire/citation/108037/mendeley" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Mendeley</a></li><li class="papers"><a href="/highwire/citation/108037/papers" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Papers</a></li><li class="refworks-tagged"><a href="/highwire/citation/108037/refworks-tagged" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">RefWorks Tagged</a></li><li class="reference-manager"><a href="/highwire/citation/108037/reference-manager" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Ref Manager</a></li><li class="ris"><a href="/highwire/citation/108037/ris" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">RIS</a></li><li class="zotero last"><a href="/highwire/citation/108037/zotero" class="hw-download-citation-link" data-icon-position="" data-hide-link-title="0">Zotero</a></li></ul>    </div>
  </div>
</div>
  </div>

  
  </div>
</div>
  </div>
</div>
</div></div>  </div>

  
  </div>
</div>
          </div>
        </div>
        
        <div class="content-right-wrapper content-column">
          <div class="panel-panel panel-region-content-right">
            <div class="inside"><div class="panel-pane pane-highwire-share-link highwire_clipboard_link_ajax"  id="shareit">
  
      
  
  <div class="pane-content">
    <a href="/" class="link-icon"><span class="icon-share-alt"></span> <span class="title">Share</span></a>  </div>

  
  </div>
<div class="panel-pane pane-panels-mini pane-jnl-ajnr-share highwire_clipboard_form_ajax_shareit" >
  
      
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_share">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-highwire-article-citation large-margin-bottom" >
  
      
  
  <div class="pane-content">
    <div class="highwire-article-citation highwire-citation-type-highwire-article node108037--3" data-node-nid="108037" id="share-node-108037--41030899562" data-pisa="ajnr;45/6/769" data-pisa-master="ajnr;ajnr.A8220" data-apath="/ajnr/45/6/769.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard clearfix">
  
  
  
  
      <div class="highwire-cite-title">Brainstem Chipmunk Sign: A Diagnostic Imaging Clue across All Subtypes of Alexander Disease</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Thaís</span> <span class="nlm-surname">Armangue</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Matthew T.</span> <span class="nlm-surname">Whitehead</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Davide</span> <span class="nlm-surname">Tonduti</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Laura</span> <span class="nlm-surname">Farina</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Ali Reza</span> <span class="nlm-surname">Tavasoli</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Arastoo</span> <span class="nlm-surname">Vossough</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Mariko L.</span> <span class="nlm-surname">Bennett</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Ylenia</span> <span class="nlm-surname">Vaia</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Geneviève</span> <span class="nlm-surname">Bernard</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Ettore</span> <span class="nlm-surname">Salsano</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Saadet</span> <span class="nlm-surname">Mercimek-Andrews</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Amy</span> <span class="nlm-surname">Waldman</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">Adeline</span> <span class="nlm-surname">Vanderver</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">Jun 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">769-772; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8220 </span></div>
  
  
  
</div>
</div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-article-clipboard-copy large-margin-bottom" >
  
      
  
  <div class="pane-content">
    <div class = "clipboard-copy">
  <span class="label-url">
    <label for="dynamic">Share This Article:</label>
  </span>
  <span class="input-text-url">
    <input type="text" id="dynamic" value="http://ajnr-stage2.stage.highwire.org/content/45/6/769" size="50"/>
  </span>
  <span class="copy-button button">
    <button id="copy-dynamic" class="clipboardjs-button" data-clipboard-target="#dynamic" data-clipboard-alert-style="tooltip" data-clipboard-alert-text="Copied!">Copy</button>
  </span>
</div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-service-links" >
  
      
  
  <div class="pane-content">
    <div class="service-links"><a href="http://del.icio.us/post?url=http%3A//ajnr-stage2.stage.highwire.org/content/45/6/769&amp;title=Brainstem%20Chipmunk%20Sign%3A%20A%20Diagnostic%20Imaging%20Clue%20across%20All%20Subtypes%20of%20Alexander%20Disease" id="delicious" title="Bookmark this post on del.icio.us" class="service-links-delicious" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/images/delicious-32.png" alt="del.icio.us logo" /></a> <a href="http://twitter.com/share?url=http%3A//ajnr-stage2.stage.highwire.org/content/45/6/769&amp;text=Brainstem%20Chipmunk%20Sign%3A%20A%20Diagnostic%20Imaging%20Clue%20across%20All%20Subtypes%20of%20Alexander%20Disease" id="twitter" title="Share this on Twitter" class="service-links-twitter" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/images/twitter.png" alt="Twitter logo" /></a> <a href="http://www.facebook.com/sharer.php?u=http%3A//ajnr-stage2.stage.highwire.org/content/45/6/769&amp;t=Brainstem%20Chipmunk%20Sign%3A%20A%20Diagnostic%20Imaging%20Clue%20across%20All%20Subtypes%20of%20Alexander%20Disease" id="facebook" title="Share on Facebook" class="service-links-facebook" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/images/fb-blue.png" alt="Facebook logo" /></a> <a href="http://www.mendeley.com/import/?url=http%3A//ajnr-stage2.stage.highwire.org/content/45/6/769&amp;title=Brainstem%20Chipmunk%20Sign%3A%20A%20Diagnostic%20Imaging%20Clue%20across%20All%20Subtypes%20of%20Alexander%20Disease" id="mendeley" title="Share on Mendeley" class="service-links-mendeley" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><img src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/images/mendeley.png" alt="Mendeley logo" /></a></div>  </div>

  
  </div>
</div>
  </div>
</div>
  </div>

  
  </div>
<div class="panel-pane pane-service-links" >
  
      
  
  <div class="pane-content">
    <div class="service-links"><div class="item-list"><ul><li class="first"><a href="http://twitter.com/share?url=http%3A//ajnr-stage2.stage.highwire.org/content/45/6/769&amp;count=horizontal&amp;via=&amp;text=Brainstem%20Chipmunk%20Sign%3A%20A%20Diagnostic%20Imaging%20Clue%20across%20All%20Subtypes%20of%20Alexander%20Disease&amp;counturl=http%3A//ajnr-stage2.stage.highwire.org/content/45/6/769" class="twitter-share-button service-links-twitter-widget" id="twitter_widget" title="Tweet This" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><span class="element-invisible">Tweet Widget</span></a></li><li><a href="http://www.facebook.com/plugins/like.php?href=http%3A//ajnr-stage2.stage.highwire.org/content/45/6/769&amp;layout=button_count&amp;show_faces=false&amp;action=like&amp;colorscheme=light&amp;width=100&amp;height=21&amp;font=&amp;locale=" id="facebook_like" title="I Like it" class="service-links-facebook-like" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><span class="element-invisible">Facebook Like</span></a></li><li class="last"><a href="http://ajnr-stage2.stage.highwire.org/content/45/6/769" id="google_plus_one" title="Plus it" class="service-links-google-plus-one" rel="nofollow" target="_blank" data-icon-position="" data-hide-link-title="0"><span class="element-invisible">Google Plus One</span></a></li></ul></div></div>  </div>

  
  </div>
</div>
          </div>
        </div>
	</div> <!-- /.panel-row-wrapper -->	
	
	</div>

  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-jnl-ajnr-rental" >
  
      
  
  <div class="pane-content">
    <span class="js-deepdyve-link">
            <a class="button btn btn-primary btn-sm" role="button"  href="https://www.deepdyve.com/doc-view?docId=10.3174/ajnr.A8220&fieldName=journal_doi&affiliateId=asnr"><i class="icon-usd"> </i> Purchase</a>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-article-nav mobile-hidden pane-style-alt-content" >
  
        <h2 class="pane-title">Jump to section</h2>
    
  
  <div class="pane-content">
    <div class="highwire-list-wrapper highwire-article-nav highwire-nav-float"><div class="highwire-list"><ul data-highwire-float="1" data-highwire-float-class="grid-10 alpha omega"><li class="parent first odd"><a href="/content/45/6/769" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">Article</a><div class="highwire-list"><ul><li class="first odd"><a href="#abstract-2" class="highwire-article-nav-jumplink first" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">Abstract</a></li><li class="even"><a href="#glossary-1" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">ABBREVIATIONS:</a></li><li class="odd"><a href="#sec-5" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">MATERIALS AND METHODS</a></li><li class="even"><a href="#sec-9" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">RESULTS</a></li><li class="odd"><a href="#sec-10" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">DISCUSSION</a></li><li class="even"><a href="#sec-11" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">CONCLUSIONS</a></li><li class="odd"><a href="#fn-group-1" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">Footnotes</a></li><li class="last even"><a href="#ref-list-1" class="highwire-article-nav-jumplink last" data-panel-ajax-tab="jnl_ajnr_tab_art" data-icon-position="" data-hide-link-title="0">References</a></li></ul></div></li><li class="even"><a href="/content/45/6/769/tab-figures-data" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_data" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">Figures &amp; Data</a></li><li class="odd"><a href="/content/45/6/769/tab-supplemental" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_supp" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">Supplemental</a></li><li class="even"><a href="/content/45/6/769/tab-references" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_refs" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">References</a></li><li class="odd"><a href="/content/45/6/769/tab-article-info" class="highwire-article-nav-jumplink" data-panel-ajax-tab="jnl_ajnr_tab_info" data-is-tab-link="true" data-icon-position="" data-hide-link-title="0">Info &amp; Metrics</a></li><li class="last even"><a href="/content/45/6/769.full.pdf" class="highwire-article-nav-jumplink" data-icon-position="" data-hide-link-title="0"><i class="icon-file-alt"></i> PDF</a></li></ul></div></div>  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-ajnr-accordion" >
  
      
  
  <div class="pane-content">
    <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_accordion">
  <div class="panel-panel panel-col">
    <div><div id="highwire_article_accordion_container"><h3 ><i class="icon-caret-right"></i> Related Articles</h3><div><div class='highwire-list-footer'><div class="highwire-related-articles-footer"><ul class="links inline"><li class="related-pubmed first"><a href="/lookup/external-ref?link_type=MED_NBRS&amp;access_num=38697787" target="_blank" class="" data-icon-position="" data-hide-link-title="0">PubMed</a></li><li class="related-google-scholar last"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=related&amp;author%5B0%5D=Tha%C3%ADs%2BArmangue&amp;author%5B1%5D=Matthew%2BT.%2BWhitehead&amp;author%5B2%5D=Davide%2BTonduti&amp;author%5B3%5D=Laura%2BFarina&amp;author%5B4%5D=Ali%2BReza%2BTavasoli&amp;author%5B5%5D=Arastoo%2BVossough&amp;author%5B6%5D=Mariko%2BL.%2BBennett&amp;author%5B7%5D=Ylenia%2BVaia&amp;author%5B8%5D=Genevi%C3%A8ve%2BBernard&amp;author%5B9%5D=Ettore%2BSalsano&amp;author%5B10%5D=Saadet%2BMercimek-Andrews&amp;author%5B11%5D=Amy%2BWaldman&amp;author%5B12%5D=Adeline%2BVanderver&amp;title=Brainstem%2BChipmunk%2BSign%3A%2BA%2BDiagnostic%2BImaging%2BClue%2Bacross%2BAll%2BSubtypes%2Bof%2BAlexander%2BDisease&amp;publication_year=2024&amp;path=content/45/6/769" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Google Scholar</a></li></ul></div></div></div><h3 ><i class="icon-caret-right"></i> Cited By...</h3><div><div class="highwire-list highwire-cited-by"><ul><li class="first last odd"><a href="http://pn.bmj.com/cgi/content/full/pn-2024-004490v1" class="" data-icon-position="" data-hide-link-title="0"><div class="highwire-cite-title">Diagnosing Alexander disease in adults</div></a><div class="variant-links"></div></li></ul></div><div class='highwire-list-footer'><ul class="links inline"><li class="citing-cross-ref first"><a href="/crossref-forward-links/ajnr/45/6/769#crossref" class="hw-crossref hw-crossref-link-ajax" data-list-wrapper="hw-crossref-list-wrapper" target="_blank" data-icon-position="" data-hide-link-title="0">Crossref</a></li><li class="citing-google-scholar last"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=citedby&amp;path=content/45/6/769" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Google Scholar</a></li></ul></div><div title="Crossref Cited-by Linking Search Results" style="display:none;" class="hw-crossref-list-wrapper"><p class = "hw-crossref-message">This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.</p></div></div><h3 ><i class="icon-caret-right"></i> More in this TOC Section</h3><div><div class="highwire-list highwire-article-citation-list"><ul><li class="first odd"><div class="highwire-article-citation highwire-citation-type-highwire-article node112571" data-node-nid="112571" id="node-112571--2810499805" data-pisa="ajnr;ajnr.A8451v1" data-pisa-master="ajnr;ajnr.A8451" data-apath="/ajnr/early/2025/01/02/ajnr.A8451.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard-title-only clearfix">
  
  
  
  
      <a href="/content/early/2025/01/02/ajnr.A8451" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">Automated Detection of Normal Pressure Hydrocephalus Using CT Imaging for Calculating the Ventricle-to-Subarachnoid Volume Ratio</span></a>  
  
  
  
  
</div>
</div></li><li class="even"><div class="highwire-article-citation highwire-citation-type-highwire-article node112513" data-node-nid="112513" id="node-112513--21229456709" data-pisa="ajnr;ajnr.A8448v2" data-pisa-master="ajnr;ajnr.A8448" data-apath="/ajnr/early/2024/12/26/ajnr.A8448.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard-title-only clearfix">
  
  
  
  
      <a href="/content/early/2024/12/26/ajnr.A8448" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">Predicting Post-Operative Side Effects in VIM MRgFUS Based on THalamus Optimized Multi Atlas Segmentation (THOMAS) on White-Matter-Nulled MRI: A Retrospective Study</span></a>  
  
  
  
  
</div>
</div></li><li class="last odd"><div class="highwire-article-citation highwire-citation-type-highwire-article node112303" data-node-nid="112303" id="node-112303--2162533924" data-pisa="ajnr;ajnr.A8446v2" data-pisa-master="ajnr;ajnr.A8446" data-apath="/ajnr/early/2024/12/12/ajnr.A8446.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard-title-only clearfix">
  
  
  
  
      <a href="/content/early/2024/12/12/ajnr.A8446" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">Inter- and Intrarater Agreement of CT Brain Calcification Scoring in Primary Familial Brain Calcification</span></a>  
  
  
  
  
</div>
</div></li></ul></div><div class='highwire-list-footer'><a href="/content/by/section/Neurodegenerative%20Disorder%20Imaging" class="" data-icon-position="" data-hide-link-title="0">Show more <span class="wrapper">NEURODEGENERATIVE DISORDER IMAGING</span></a></div></div><h3 ><i class="icon-caret-right"></i> Similar Articles</h3><div><div class="highwire-search-similar-ajax-wrapper" id="highwire-search-similar-articles-list-1"><div class="highwire-ajax-loading"><span class="icon-spinner icon-spin icon-2x"></span></div></div></div></div></div>
  </div>
</div>
  </div>

  
  </div>
</div>
			</div>
		</div>
	
	</div> <!-- /.panel-row-wrapper -->	
	
	</div>

    </div>
  </div>
</div><div class="block block-panels-mini more-padding-top mobile-hiddens block-jnl-ajnr-ad-bot-leaderboard block-panels-mini-jnl-ajnr-ad-bot-leaderboard even block-without-title" id="block-panels-mini-jnl-ajnr-ad-bot-leaderboard">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_ad_bot_leaderboard">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-dfp-pane text-center" >
  
      
  
  <div class="pane-content">
    <div id="dfp-ad-bottom_leaderboard-wrapper" class="dfp-tag-wrapper">
<div class="slug">Advertisement</div>
<div  id="dfp-ad-bottom_leaderboard" class="dfp-tag-wrapper">
  <script type="text/javascript">
    googletag.cmd.push(function() {
      googletag.display("dfp-ad-bottom_leaderboard");
    });
  </script>
</div>
</div>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>      </div>
</div>  </div>
</section>    
  
      <footer id="section-footer" class="section section-footer">
    
  <div id="zone-postscript" class="zone zone-postscript clearfix container-30">
    <div class="grid-28 suffix-1 prefix-1 region region-postscript-fourth" id="region-postscript-fourth">
  <div class="region-inner region-postscript-fourth-inner">
    <div class="block block-panels-mini block-jnl-ajnr-footer block-panels-mini-jnl-ajnr-footer odd block-without-title" id="block-panels-mini-jnl-ajnr-footer">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panels-960-row jcore-row-4col clearfix" id="mini-panel-jnl_ajnr_footer">
  <div class="panel-panel panel-region-col-1 grid-7 alpha">
    <div class="inside"><div class="panel-pane pane-block pane-menu-navigate pane-menu" >
  
        <h2 class="pane-title">News and Updates</h2>
    
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="https://www.ajnr.org/cc/2024-Awards" data-hide-link-title="0" class="" data-icon-position="">2024 Journal Award Winners</a></li>
<li class="last leaf" role="menuitem"><a href="/page/content/Reviewer-Recognition" data-hide-link-title="0" class="" data-icon-position="">Thanks to our 2023 Distinguished Reviewers</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
  <div class="panel-panel panel-region-col-2 grid-7">
    <div class="inside"><div class="panel-pane pane-block pane-menu-more-information pane-menu" >
  
        <h2 class="pane-title">Resources</h2>
    
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="/page/content/EBM" data-hide-link-title="0" class="" data-icon-position="">Evidence-Based Medicine Level Guide</a></li>
<li class="leaf" role="menuitem"><a href="/content/browse-podcast-archives" data-hide-link-title="0" class="" data-icon-position="">AJNR Podcast Archive</a></li>
<li class="leaf" role="menuitem"><a href="/content/institutional-subscriptions" data-hide-link-title="0" class="" data-icon-position="">Librarian Resources</a></li>
<li class="last leaf" role="menuitem"><a href="http://www.ajnr.org/page/content/Terms-and-Conditions" data-hide-link-title="0" class="" data-icon-position="">Terms and Conditions</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
  <div class="panel-panel panel-region-col-3 grid-7">
    <div class="inside"><div class="panel-pane pane-block pane-menu-add-journals pane-menu" >
  
        <h2 class="pane-title">Opportunities</h2>
    
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first last leaf" role="menuitem"><a href="/page/content/Publons" data-hide-link-title="0" class="" data-icon-position="">Get Peer Review Credit from Publons</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
  <div class="panel-panel panel-region-col-4 grid-7 omega">
    <div class="inside"><div class="panel-pane pane-block pane-menu-other-services pane-menu" >
  
        <h2 class="pane-title">American Society of Neuroradiology</h2>
    
  
  <div class="pane-content">
    <nav class="menubar-nav"><ul class="menu" role="menu"><li class="first leaf" role="menuitem"><a href="http://www.neurographics.org/" data-hide-link-title="0" class="" data-icon-position="">Neurographics</a></li>
<li class="leaf" role="menuitem"><a href="http://www.asnr.org/index.php/education/fellowship-portal/" data-hide-link-title="0" class="" data-icon-position="">Fellowship Portal</a></li>
<li class="last leaf" role="menuitem"><a href="https://www.asnr.org/membership-types/" data-hide-link-title="0" class="" data-icon-position="">Not an ASNR Member? Join Now</a></li>
</ul></nav>  </div>

  
  </div>
</div>
  </div>
</div>    </div>
  </div>
</div>  </div>
</div>  </div>
  
  <div id="zone-footer" class="zone zone-footer clearfix container-30">
    <div class="grid-28 suffix-1 prefix-1 region region-footer-first" id="region-footer-first">
  <div class="region-inner region-footer-first-inner">
    <div class="block block-panels-mini block-jnl-ajnr-foot-info block-panels-mini-jnl-ajnr-foot-info odd block-without-title" id="block-panels-mini-jnl-ajnr-foot-info">
  <div class="block-inner clearfix">
                
    <div class="content clearfix">
      <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_ajnr_foot_info">
  <div class="panel-panel panel-col">
    <div><div class="panel-pane pane-page-logo-footer" >
  
      
  
  <div class="pane-content">
    <img class="footer-logo" src="http://ajnr-stage2.stage.highwire.org/sites/default/files/ajnr-logo.png" alt="" />  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-snippet pane-footer-copyright-text" >
  
      
  
  <div class="pane-content">
    <div class="snippet footer-copyright-text" id="footer-copyright-text">
  
      
  <div class="snippet-content">
    <p>&copy; 2025 by the <a href="http://www.asnr.org">American Society of Neuroradiology</a> All rights, including for text and data mining, AI training, and similar technologies, are reserved.<br />
Print ISSN: 0195-6108 Online ISSN: 1936-959X</p>
  </div>

</div>
  </div>

  
  </div>
<div class="panel-separator"></div><div class="panel-pane pane-highwire-branding" >
  
      
  
  <div class="pane-content">
    <a href="http://home.highwire.org" target="_blank" class="highwire-branding-link" data-icon-position="" data-hide-link-title="0"><img class="logo-highwire" src="http://ajnr-stage2.stage.highwire.org/sites/all/modules/highwire/highwire/plugins/content_types/images/logo_small_hw_white.png" width="190" height="31" alt="Powered by HighWire" /></a>  </div>

  
  </div>
</div>
  </div>
</div>
    </div>
  </div>
</div>  </div>
</div>  </div>
</footer>  </div>    <div class="region region-page-bottom" id="region-page-bottom">
  <div class="region-inner region-page-bottom-inner">
      </div>
</div><script type="text/javascript" src="/sites/default/files/advagg_js/js__bnwyEQSuZLC-kZnFqCi5iE02nOCzM7DjY7zYxcN9nsQ__VBiBT_qq_eHMMO2Q1rXK1u-hHff31XLUkmi9dgjuPeY__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__GM3GJPR36rRIz0TRkjC5OQwrioSyN9aoYRivDhCO_AM__qAl84FcCv2jyN22yFGS5Oc85cjd9zKX6p_cFNLGhe-M__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js" async="async"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__uW7NyUocxI-7E_sL-GP7L5FYvHrfi0D8UkwaFa_jFUQ__ITpTmydBN18ujP4Nq9igNKs2_uPvSa_MMIGZilNH7xo__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__2WRbxlwOW0MEUc_hSWU5MBepQg6Lch6O5SZwefpJ6IE__HCL0YQJqLkOhrLPZZYGqosGvtFsEHMGghHIkSx4y9vA__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js" defer="defer"></script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__7JcO4FSl5jd0Ka8T_VnshezxUM7PtQSO7sKX4gvf-g8__00CRL0zf_Zia_vqj6R6JALHj3oqIsE4FfJDoLxQwyto__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
function euCookieComplianceLoadScripts() {}
//--><!]]>
</script>
<script type="text/javascript">
<!--//--><![CDATA[//><!--
var eu_cookie_compliance_cookie_name = "";
//--><!]]>
</script>
<script type="text/javascript" src="/sites/default/files/advagg_js/js__WcTpt-w0y1FyXrxZNriX8Ts1KjsFTDpdvZaw9yhRn24__aFJpdvsZPb1v9rWrq-WXbz_WQ9IThQN-mFTCdm1cfXc__Op4k-kV4DoWc7bsUP7umKmZ0WXfmoYdRDoZFPNSd-oM.js"></script>
  </body>
</html>