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While conventional magnetic resonance, X-ray-based, ultrasound, and nuclear medicine techniques are widely used to facilitate diagnosis, inform therapeutic decision-making, provide information regarding prognosis, and monitor therapeutic response in neurologic diseases, their practical value in acute clinical care is not as yet well-defined and the potential future development is not fully appreciated. This book provides a comprehensive survey of best practice for specialists and trainees in neurology, emergency medicine, neuroradiology, radiology, neurosurgery, and critical care. The symptom-based approach guides the choice of the available imaging tools for efficient, accurate, and cost-effective diagnosis to support immediate management of common and complex neurological disorders in the acute setting. Effective examination algorithms are included that integrate neurological and imaging concepts with the practical demands and constraints of emergency care. Written by leading international authorities, the book is extensively illustrated and contains many helpful case-histories.
In acute multiple sclerosis (MS) lesions, axonal pathology and the number of transected axons correlate with the number of immune cells and therefore with inflammatory activity. In addition to the commonly described white matter locations, demyelination also occurs in the gray matter of MS patients. The concept of MS as an inflammatory demyelinating and neurodegenerative disease provides a framework to help explain disease progression and development of permanent neurological disability in MS patients. Prevention of persistent neurological disability is the main goal when treating neurological diseases. In contrast to most neurodegenerative diseases, patients with MS can be identified early before the occurrence of extensive neurodegeneration by the presentation of symptoms mediated by inflammatory demyelination. Therefore, neuroprotective therapeutics may have a greater probability of clinical efficacy in MS patients since treatment can be initiated before extensive axonal loss. Regardless of the cause of MS, axons and neurons are important therapeutic targets.