Moderator: Carlos Torres

Normal Pressure Hydrocephalus
Àlex Rovira

Normal Pressure Hydrocephalus (NPH) is a syndrome characterized by the triad of gait disturbance, mental deterioration, and urinary incontinence, accompanied by ventriculomegaly and normal cerebrospinal fluid (CSF) pressure. Although NPH is a significant cause of reversible and treatable dementia, it is frequently underdiagnosed. This underdiagnosis occurs because the clinical presentation can be atypical or incomplete and may be mimicked by other diseases, necessitating supplementary tests to predict postsurgical outcomes. These tests include various radiological techniques such as CT or MRI. According to international guidelines, CT or MRI are crucial for diagnosing NPH and selecting patients who may benefit from shunting. These imaging techniques provide essential morphological findings, including ventricular enlargement associated with tight high convexity and medial subarachnoid sulci, enlarged Sylvian fissures (disproportionately enlarged subarachnoid space hydrocephalus [DESH]), ballooning of frontal horns, reduction of the callosal angle, thinning of the corpus callosum, and widening of temporal horns not explained by hippocampal atrophy. Other imaging methods, such as radionuclide cisternography or cardiac-gated flow-sensitive phase-contrast cine MRI, are suitable for NPH diagnosis but do not yet offer improved accuracy for identifying shunt-responsive cases. In summary, morphological MRI features remain essential for diagnosing NPH and predicting positive clinical outcomes after shunting.

At the end of this session, participants will be able to:  

• Recognize the clinical features and diagnostic challenges of Normal Pressure Hydrocephalus (NPH) 
• Describe the key imaging features associated with NPH
• Recognize the challenges in predicting shunt responsiveness in NPH Patients 

Target Audience:

• Radiologist
• Resident

CanMEDS:

• Medical Expert

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Spinal Cord Inflammatory Disease: Beyond Multiple Sclerosis
Carlos Torres

This presentation will review the most relevant MRI spinal cord imaging findings in the setting of neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and acute disseminated encephalomyelitis (ADEM).

At the end of this presentation, participants will be able to:

• Review the key imaging findings for diagnosing Neuromyelitis Optica Spectrum Disorder, Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease, and Acute Disseminated Encephalomyelitis.
• Describe the patterns of cord signal abnormalities that may suggest these diagnoses.

Target Audience:

• Radiologist
• Resident
• Medical Student

CanMEDS:

• Medical Expert

COI:

• None Declared

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Neuromyelitis Optica and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: A Clinician Perspective
Giulia Fadda

This presentation will provide an in-depth overview of Neuromyelitis Optica Spectrum Disorder (NMOSD) and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD), focusing on key presenting features, disease course, and prognosis. The session will highlight important differences from other demyelinating conditions and review the latest advancements in management strategies.

At the end of this presentation, participants will be able to:

• Differentiate between the clinical features of Neuromyelitis Optica Spectrum Disorder (NMOSD) and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD), and other demyelinating disorders by identifying key diagnostic criteria and disease patterns.
• Recognize the implications of disease course and prognosis in NMOSD and MOGAD to support the selection of appropriate treatment strategies.
   

Target Audience:

• Radiologist
• Resident
• Medical Student

CanMEDS:

• Medical Expert
• Collaborator
• Health Advocate
• Scholar

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White Matter Disease Differential Diagnosis: Not Always Demyelination
Laurent Létourneau-Guillon

White matter lesions are frequently encountered in neuroimaging. This session will explore the differential diagnosis of white matter diseases beyond classical demyelinating disorders, highlighting key imaging patterns and clinical features that help distinguish between various etiologies, leading to more accurate diagnosis and appropriate patient management.

At the end of this presentation, participants will be able to:

• Differentiate between demyelinating and non-demyelinating white matter diseases using key imaging and clinical characteristics
• Recognize the major categories of white matter disease mimics that can present similarly to Multiple Sclerosis/Neuromyelitis Optica Spectrum Disorder/Myelin Oligodendrocyte Glycoprotein Antibody Disorder
• Apply an organized diagnostic approach to white matter lesions that integrates radiological findings with clinical context to avoid misdiagnosis

Target Audience:

• Radiologist
• Resident
• Medical Student

CanMEDS:

• Medical Expert
• Communicator
• Collaborator
• Health Advocate
• Scholar
• Professional

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