Digital Commons Network^™

Spectral Characterization Of Colorectal Cancer Using Excitation-Scanning Hyperspectral Imaging, Natalie Hadad

Honors Theses

Colorectal cancer is one of the most common and deadly cancers worldwide, with a lifetime risk of approximately one in twenty-three for men and one in twenty-five for women. Although early detection significantly improves survival, current diagnostic approaches such as tissue biopsy are invasive, reliant on subjective interpretation, have extended turnaround times, and risk missing flat or depressed lesions that are more difficult to detect than raised polyps. These limitations highlight the need for objective, minimally invasive technologies capable of detecting early tissue changes. This study investigates excitation-scanning hyperspectral imaging (Ex-HSI) as a label-free optical approach for identifying colorectal cancer–associated …

Novel Biomarker Discovery In Multiple Sclerosis, Manisha Gangasani

Honors Theses

Multiple Sclerosis (MS) is a chronic neuroinflammatory disorder affecting the brain, spinal cord, and optic nerve. Patients experience cognitive, motor, autonomic, and emotional symptoms that often overlap with other neurological conditions, making early diagnosis challenging. Current diagnostic criteria require evidence of lesions with dissemination in time and space. Racial disparities in MS outcomes are well documented, with Black individuals often exhibiting greater disease severity, higher relapse rates, and increased disability compared to White individuals. These differences likely reflect a combination of genetic, biological, environmental, and healthcare access factors, underscoring the need to improve early diagnosis and reduce inequities in care. …

Characterization Of Circulating Extracellular Proteome In Plasma Samples Of Triple-Negative Breast Cancer Patients, Brionna Wilson

Honors Theses

Extracellular vesicles (EVs) are membrane-bound vesicles secreted by cells in the body that play an important role in intercellular signaling, immune modulation, and transfer of biomolecules between cells. EV s reflect the physiological state of their cells of origin, so they are being explored as potential noninvasive biomarkers for cancer detection and monitoring. Triple-negative breast cancer (TNBC), an aggressive subtype lacking targeted therapies, is difficult to detect early and currently has no reliable prognostic biomarkers. This study aimed to quantify EV concentrations in the blood serum of TNBC patients (n=40) compared with cancer-free healthy controls (n=35) as well as determine …

Developing A Protocol For Non-Cellular Transplantation Of Donor Mitochondria Into Recipient Cells, Andrew Parton

Honors Theses

Tumor innervation has emerged as a critical feature of cancer progression, with increased nerve density correlating with enhanced aggressiveness, metastatic dissemination, and poor clinical outcome. However, the functional contribution of neurons to tumor biology remains incompletely defined. We recently identified the intercellular transfer of mitochondria from neurons to cancer cells as a mechanism that promotes tumor progression. We therefore hypothesized that disruption of this transfer could attenuate tumor aggressivity. To directly investigate this process, we developed an approach to isolate mitochondria from donor cells and transplant them into recipient cancer cells independently of canonical cell-cell interactions. Transferred mitochondria were tracked …

Global Perspectives On Cns Drug Innovation: Achievements, Barriers, And Priorities For The Next Decade, Hiroyuk Uchida, Gabriella Gobbi, Joseph Zohar, Allan Young, Dan Rujescu, Ming-Chyi Huang, Suresh Sundram, Lukoye Atwoli, Jana Vukovic, Kazutaka Ikeda

Internal Medicine, East Africa

Background Over the past decade, neuropsychopharmacology has shifted from stagnation to momentum, with first-in-class mechanisms and biomarker-enabled trials spanning psychiatry and neurology.

Methods We narratively synthesized advances from 2013 to 2026 across central nervous system (CNS) discovery and development, including pivotal trials, regulatory actions, digital/real-world evidence, genetics, artificial intelligence (AI), and implementation/global-access themes that are endorsed by international societies.

Results Therapeutic gains include rapid-acting drugs for treatment-resistant depression (intranasal esketamine); psychedelic-assisted therapy for posttraumatic stress disorder and depression; neuroactive steroid γ-aminobutyric acid-A receptor positive allosteric modulators (brexanolone, zuranolone) for postpartum depression; non-dopaminergic muscarinic agonists (xanomeline–trospium) for schizophrenia; orexin receptor antagonists …

Beyond The Cycle: How Menstruation Influences Gender Identity And Well-Being In Binary And Non-Binary Adults, Rin Nguyen

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Approximately 1.8 billion people worldwide menstruate, including transgender and gender-diverse (TGD) people, yet their experiences remain underrepresented in research. Given that menstruation can affect gender alignment and psychological well-being, understanding its impact on TGD people is critical. Gender congruence, or alignment between one’s gender identity and expression, is a key factor influencing well-being, with research linking it to reduced depression and anxiety. Furthermore, emerging research on gender euphoria, the joy experienced when gender congruence is experienced, suggests it may serve as a protective factor for mental health and well-being. Gender euphoria has been associated with reduced psychological distress and increased …

Transitioning To Adolescent And Young Adult Or Adult Cancer Survivorship Care: A Systematic Review Of Contemporary Guidelines And Trials, Darren Haywood, Hammersley, Ursula Sansom-Daly, Jordana Mcloone, Evan Dauer, Helen Wilding, Nicolas H. Hart, Thomas Walwyn

Research outputs 2022 to 2026

Background: Health service transitions of child, adolescent, and young adult cancer survivors between paediatric and adult cancer care services are pervasively fragmented, resulting in poor coordination, reduced satisfaction, and adverse outcomes for cancer survivors and significant others (e.g., caregivers and family members). Numerous trials and clinical guidelines have been developed to support care transitions, but their convergence, divergence, and methodological quality remain unclear. To advance clinical practice and quality research about care transitions, a synthesis of trials and guidelines on child, adolescent, and young adult care transition across age-appropriate cancer services is required to inform future research, practice, guideline, and …

Diacylglycerol Kinase Eta As A Novel Target In Nras Mutant Melanoma, Haley P. Wilson, Casey D. Stefanski, Signe Caksa, Glenn L. Mersky, Scott D. Varney, Jelan I. Haj, Dan A. Erkes, Timothy J. Purwin, Vivian Chua, Andrew E. Aplin

Research outputs 2022 to 2026

NRAS mutations occur in 10%–30% of cutaneous melanomas and are associated with high tumor mutational burden. Mutant NRAS signaling drives aberrant cell growth and proliferation, in part, through activation of the RAF–MEK-ERK1/2 kinase pathway; however, targeted therapies to this pathway have limited effectiveness in patients with NRAS mutant melanoma. The role of other targetable signaling pathways in NRAS mutant melanoma is poorly characterized. Here, we demonstrated that one isoform of diacylglycerol kinase, diacylglycerol kinase eta (DGKη), a lipid signaling regulator, was highly expressed in NRAS mutant melanoma patient samples. Knockdown of DGKH in NRAS mutant melanoma cell lines resulted in …

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

A Meta-Analysis Of Endometrial Cancer Metabolites As Potential Non-Invasive Biomarkers, Makenna K. Johnson

Honors Theses

Endometrial Cancer (EC) is the most prevalent gynecological cancer in the United States and causes tens of thousands of deaths. Despite its massive negative impact in developed countries, there currently is no reliable screening tool used to diagnose women. Due to this urgent need for minimally invasive and precise techniques to diagnose this malignancy, the metabolomics field has been at the forefront of current research. An untargeted mass-spectrometry approach is used by many researchers to form an initial hypothesis as to which metabolites are key in identifying EC cases. However, there are sometimes inconsistencies between studies. A meta-analysis approach examines …

Measuring School Anxiety In Pediatric Chronic Pain: Initial Investigation Of The Psychometric Properties Of The School Anxiety Inventory For Chronic Pain (Sai-Cp), Caitlyn Maye, Robert C. Gibler, Kristen E. Jastrowski, Dustin Wallace Phd, Cara M. Hoffart, Jenny Scheurich Phd

Posters

Introduction: School anxiety is common among adolescents with chronic pain and often impacts academic and social functioning. Existing anxiety measures lack specificity for capturing the unique sources and symptoms of school-related anxiety in this population. To address this gap, a bank of new potential measure items (the School Anxiety Inventory for Chronic Pain [SAI-CP]), was developed based on the original School Anxiety Inventory (SAI), qualitative interviews with adolescents with chronic pain, and expert clinician input. The objective of this study was to evaluate the construct validity and internal consistency of the SAI-CP and identify avenues for future measure refinement. Method: …

Recognizing What Matters Most: Using Safety-Critical Tasks To Strengthen Central Line-Associated Bloodstream Infection (Clabsi) Prevention Rounds, Lacey Bergerhofer, Christian Anthony Schneider, Emily Evans

Posters

Background: Our CLABSI improvement team developed high-risk rounding processes on the Hematology/Oncology unit. Expanding this model to additional Med/Surg units was challenging due to limited staffing and time-intensive tasks required during rounds. Concurrently, CLABSI rates across other Med/Surg units increased, necessitating a scalable approach. Objectives: Apparent Cause Analysis (ACA) review in Med/Surg units identified an opportunity to strengthen surveillance by engaging Vascular Access subject-matter experts. Our proactive high-risk rounds pilot led to CLABSI rate reduction. The objective was to expand service coverage without compromising established high-risk rounding quality standards. Our goal is to assess > 90% of central lines in Med/Surg …

A Rare Convergence: Malignant Thymoma With Pericardial Invasion In A Brca2 Mutation Carrier With A Synchronous Breast Mass, Mahmoud Yacout, Mohammad Chisti

Conference Presentation Abstracts

Introduction Thymomas are rare epithelial tumors of the anterior mediastinum, accounting for < 1% of adult malignancies, with an estimated annual incidence of approximately 0.15 cases per 100,000 persons. Although often indolent, thymomas are malignant by definition and may invade locally, recur, and, less commonly, disseminate. They are classically associated with autoimmune conditions, most notably myasthenia gravis, yet their relationship with hereditary cancer syndromes remains poorly defined. Germline BRCA2 mutations are well established in the pathogenesis of breast, ovarian, pancreatic, prostate, and other malignancies through impaired homologous recombination DNA repair. However, an association between BRCA2 mutations and thymic epithelial tumors has rarely been reported. We describe an unusual case of invasive malignant thymoma with pericardial invasion in a BRCA2 mutation carrier, discovered concurrently with a synchronous FDG-avid breast mass suspicious for malignancy. Case Presentation An 85-year-old man with a history of CAD, hypertension, GERD, and prior radical prostatectomy presented with several months of unintentional weight loss and chronic diarrhea. During evaluation for recurrent appendicitis, imaging incidentally revealed a large anterior mediastinal mass measuring up to 7.9 cm with irregular margins. FDG-PET demonstrated moderate metabolic activity within the mass (SUVmax 3.8). CT-guided biopsy revealed a thymic epithelial neoplasm consistent with thymoma. There was no clinical evidence of myasthenia gravis. He subsequently underwent partial sternotomy with thymectomy. Pathology demonstrated a 6-cm type B2 thymoma with direct pericardial invasion, positive surgical margins (R1), and no regional lymph node involvement (pN0), consistent with pT2 stage III disease by the Masaoka–Koga system. Given high-risk features, adjuvant radiation therapy was initiated, with planned surveillance using PET imaging and circulating tumor DNA monitoring. Concurrent PET imaging identified a palpable FDG-avid right breast mass. Genetic testing revealed a pathogenic germline BRCA2 mutation. The breast lesion is currently undergoing diagnostic biopsy and surgical evaluation. Discussion Thymomas are malignant neoplasms with a predilection for local invasion. Type B2 thymomas carry a higher risk of recurrence, particularly in the presence of pericardial invasion or incomplete resection. Complete surgical excision remains the cornerstone of management, while postoperative radiotherapy is recommended in invasive or R1 disease to reduce locoregional recurrence. The coexistence of invasive thymoma and a germline BRCA2 mutation is exceedingly rare and raises questions regarding shared oncogenic mechanisms. While thymic epithelial tumors are not classically associated with BRCA mutations, DNA repair defects may contribute to tumorigenesis in rare malignancies. The presence of a synchronous FDG-avid breast mass in a male BRCA2 carrier further underscores the importance of comprehensive oncologic and genetic evaluation and highlights the need for multidisciplinary management in complex hereditary cancer presentations. Conclusion We report a rare case of malignant type B2 thymoma with pericardial invasion in a BRCA2 mutation carrier, identified alongside a synchronous breast mass suspicious for malignancy. This case highlights the potential intersection between thymic epithelial tumors and hereditary cancer syndromes, reinforces the importance of genetic evaluation in patients with multiple malignancies, and underscores the need for long‑term multidisciplinary surveillance. Further investigation is warranted to elucidate any causal relationship between BRCA‑mediated DNA repair dysfunction and thymoma development.

Eptinezumab In Treatment-Resistant Chronic Migraine: Four-Year Real-World Effectiveness And Treatment Persistence, Wan-Jen Hsieh, Kelly Nicol, Chai Ching Ng, Tsung-Wei Hou, Phillip Phan, Scott W. Keith, Brittany Heckel, Michael J. Marmura, Hsiangkuo Yuan

Department of Neurology Faculty Papers

AimTo evaluate 48-month real-world outcomes of eptinezumab users in chronic migraine (CM), including longitudinal effectiveness, treatment persistence, reasons for discontinuation, and post-discontinuation anti-calcitonin gene-related peptide (CGRP) treatment patterns.MethodsWe conducted a retrospective cohort study of 112 CM subjects initiating eptinezumab at a tertiary headache center between 2019 and 2021. Monthly headache days (MHD), migraine disability assessment (MIDAS), and average pain intensity (API) were extracted at baseline and every 6 months for up to 48 months using a predefined outcome form at each visit. Longitudinal changes were analyzed using generalized estimating equations (GEE) with an unstructured correlation matrix, adjusting for age, sex, …

Agnikarma Therapy In Management Of Plantar Fasciitis (Vatakantaka): A Systematic Review Of Ayurvedic Case Reports, Karishma Sebastian, Nidhin John, Amanda Killeen

School of Podiatric Medicine - Student Research

Plantar fasciitis is a leading cause of heel pain, commonly affecting adults aged 40–60, characterized by microtears and inflammation of the plantar fascia.

Conventional treatments (NSAIDs, corticosteroids, orthotics, surgery) often provide incomplete relief or cause adverse effects.

In Ayurveda, plantar fasciitis corresponds to Vatakantaka, a Vata-dominant condition of the heel region (Khudukapradesha).

Agnikarma, a para-surgical Ayurvedic technique involving therapeutic thermal cauterization using heated metallic rods (Shalaka), is described for disorders involving ligaments, bones, and joints with chronic pain and stiffness.

This review synthesizes clinical case reports evaluating Agnikarma as a treatment for plantar fasciitis to determine its efficacy, safety, and …

Two Glands, One Problem: Navigating Fertility Treatment In Concurrent Nonclassic Congenital Adrenal Hyperplasia And Polycystic Ovary Syndrome, Paul Meram, Mary Show, Elliott Gappy, Ajaz Banka

Conference Presentation Abstracts

Background: Nonclassic congenital adrenal hyperplasia (NCCAH) caused by 21-hydroxylase deficiency is generally a milder variant of congenital adrenal hyperplasia characterized by partial enzyme activity and variable increases in adrenal androgen levels. Patients presenting with such a condition may present in adolescence or adulthood with symptoms such as acne, hirsutism, irregular menses, and infertility. These symptoms often overlap with those of Polycystic Ovary Syndrome (PCOS), creating challenges in differentiation and management. It is critical to differentiate between PCOS and NCCAH in females of reproductive age, as hyperandrogenism treatment depends on the underlying cause, such as adrenal, ovarian, or a combination of …

The First Cut Is The Deepest: Understanding Learner Trauma In The Emergency Medicine Clerkship, Dimitrios Papanagnou, Leela Raj, Karen E. Watkins, Xiao C. Zhang, Andres Fernandez, Md, Victoria J. Marsick

Department of Emergency Medicine Faculty Papers

BACKGROUND: As third-year medical students transition into high-stakes, high-stress clinical environments like the emergency department (ED), they may experience significant personal trauma. However, little is known about how this trauma is experienced early in their training - specifically during the transition from preclinical to clinical learning environments. This study addresses that gap by exploring third-year medical students' experiences of trauma during the emergency medicine (EM) clerkship through the lens of Trauma-Informed Care (TIC) and identifies workplace factors and intersectional demographics influencing these experiences.

METHODS: This qualitative study used the critical incident technique to explore emotionally-significant events encountered by third-year medical …

Preclinical Animal Modeling To Investigate Redox-Mediated Molecular Dysfunction In Traumatic Brain Injury, Brandon Z. Mcdonald

Department of Agricultural and Biological Systems Engineering: Dissertations, Theses, and Student Research

Impacts associated with traumatic brain injury (TBI) induce a multitude of neurological morbidities mediated by a spread of biochemical dysfunction. Redox stress is a significant contributor to TBI pathophysiology and several redox stress markers have substantial evidence to support their role in diagnosing preclinical and clinical TBI. However, there is a critical need to verify their translational utility through correlations with behavioral, imaging, and molecular modalities. In chapter two, we examined the therapeutic efficacy of an antioxidant treatment (NPC3) using a controlled cortical impact (CCI) mouse model of TBI. NPC3 alleviated glial expression and reactivity while influencing the expression of …

Novel Applications Of Coronary Cta In Patients With Intermediate Risk Of Cad, Ashley Armstrong, Luai Madanat, Robert D. Safian

Conference Presentation Abstracts

Background: ACC/AHA guidelines provide class 1 and 2A recommendations respectively for coronary CTA and FFRCT in patients with chest pain and intermediate risk of CAD. We present a case in which novel applications of CTA excluded obstructive CAD, identified the correct diagnosis, and allowed optimization of medical therapy. Case: In a 72-year-old male with stable angina and HEART score 6, stress ECG was positive for angina and frequent PVCs (Fig 1A). Coronary CTA (Fig 1B) and FFRCCT (Fig 1C) showed non-obstructive CAD and intramyocardial bridging/severe systolic compression in the mid-LAD (Fig 1D). AI plaque analysis demonstrated a mixed plaque burden …

Leveraging State Of The Art Simulation-Based Education To Enhance Medical Student Interest In Internal Medicine And Cardiology, Mohamed Abdalaziz, Nicholas Mitchell, Ryan Madder

Conference Presentation Abstracts

Abstract Background: Early clinical exposure plays a critical role in shaping medical student interest, and therefore choice in medical specialty. Traditional curricula offer limited opportunities for hands-on engagement with cardiovascular decision-making and procedures. Simulation-based education may address this gap by providing immersive, low-risk learning experiences. Methods: An internal medicine resident and Cardiology fellow led, faculty-supported simulation curriculum was developed for third- and fourth-year medical students using a state-of-the-art simulation laboratory. Two 75-minute sessions were conducted over a two-month period, with a total of 27 students participating. The first session included a focused electrocardiography didactic emphasizing ST-elevation myocardial infarction (STEMI) recognition, …

Right Atrial Thrombosis In Behcet's Disease Presenting With Tricuspid Inflow Obstruction, Famta Basher Bisher, Thekrayat M. Asad, Sireen Shehadah

Conference Presentation Abstracts

Introduction Behçet’s disease (BD) is a chronic multisystem vasculitis characterized by recurrent mucocutaneous, ocular, vascular, and neurologic manifestations. Cardiac involvement is rare but can be severe, with intracardiac thrombosis representing an uncommon and potentially life-threatening complication. Management is challenging, as first-line medical therapy may be limited by bleeding risk or hemodynamic compromise. Case Presentation A 26-year-old woman with a 9-year history of Behçet’s disease presented with two weeks of progressive dyspnea, palpitations, fever, fatigue, and cough. She denied chest pain, or syncope, or lower extremity swelling. One year prior, she had been hospitalized for pulmonary embolism and was found to …

Igg4-Related Aortitis Presenting As Intramural Hematoma Of The Descending Thoracic Aorta, Sarah Ibrahim, Tejasvini Khanna, Lark Steafo, Ioannis Karageorgiou, Judith Bateman

Conference Presentation Abstracts

IgG4-related aortitis is a rare manifestation of IgG4-related disease and can closely mimic acute aortic syndromes, including intramural hematoma (IMH), on imaging. Isolated involvement of the descending thoracic aorta is particularly uncommon, and misdiagnosis may lead to unnecessary surgical or endovascular intervention. A 68-year-old man with extensive cardiovascular disease, including prior coronary artery bypass grafting, recent percutaneous coronary intervention with drug-eluting stent placement, permanent pacemaker implantation for complete heart block, and recent pulmonary embolism, presented with three days of chest pain, shortness of breath, and left lower quadrant abdominal pain. At presentation, he was receiving apixaban, aspirin, and clopidogrel. Computed …

Diagnostic Ability Of Rate Of Torque Development For Patellofemoral Pain, Arun Loganathan, Neal R. Glaviano Phd, Sungwan Kim Phd

Honors Scholar Theses

Context: Patellofemoral pain (PFP) is a highly prevalent condition (22.7% in general population) that significantly impacts the quality of life of those who suffer from it. However, there is no gold standard test to diagnose it yet, leading to inconsistencies with treatment as well as delayed intervention. Rate of torque development (RTD) is a neuromuscular measure that has shown strong connections to PFP.

Objective: The purpose of this study is to determine the diagnostic ability of RTD for PFP.

Design: Cross-sectional.

Setting: Laboratory.

Participants: Thirty-five individuals with PFP (24 males and 11 females, 22.7 ± 3.7 years, 1.67 ± 0.1 …

Validation Of A Real-Time Pcr Laboratory Developed Test For The Detection Of Pneumocystis Jirovecii In Bronchoalveolar Lavage Samples, Caitlyn Moon

Honors Scholar Theses

Pneumocystis jirovecii is an opportunistic, host-obligate fungal pathogen responsible for causing P. jirovecii pneumonia (PJP) in humans. PJP is treated with trimethoprim-sulfamethoxazole (TMP-SMX), a strong broad-spectrum antibiotic that carries risk of renal and hepatotoxicity. Therefore, rapid diagnosis or exclusion of PJP is crucial to ensure PJP-positive patients receive effective treatment and PJP-negative patients avoid unnecessary antibiotics. Unlike most microorganisms, P. jirovecii cannot be cultured, presenting complications for the typical methods of diagnosing fungal pathogens. Historically, the gold standard for diagnosis was direct microscopic examination with stains such as methenamine silver and calcofluor white, but this diagnostic technique requires highly skilled …

Play To Win: A Randomized Controlled Trial To Assess The Effects Of Play-Based Training On Upper Extremity Function In Children With Hemiplegia, Vivian London

Honors Scholar Theses

Hemiplegia, or paralysis of one side of the body, is the primary symptom of unilateral cerebral palsy, a subtype of cerebral palsy, the most common movement disorder in children. Standard of care is regular physical and occupational therapy to improve performance in bimanual activities, but conventional therapy can be expensive and draining for caregivers and children, so a need exists for a novel intervention that can take place at home and that is economical for families while being engaging for children. This thesis reports data from a subset of ten children seen as part of a randomized controlled clinical trial …

The Development Of A Crispr-Based Calibrated Functional Assay For Classifying Pathogenicity Of Msh2 And Msh6 Variants In Lynch Syndrome, Olivia N. Amodeo

Honors Scholar Theses

Lynch syndrome is a hereditary disease caused by the inheritance of a mismatch repair gene variant. Individuals with this condition are predisposed to cancer development, most commonly colorectal cancer. Current guidelines for variant classification are based on numerous evidence categories, including functional evidence. However, many novel clinical variants are not well characterized, and evidence is difficult to obtain if functional assays are not calibrated.

To address this, our lab created a calibrated functional assay that calculates an odds of pathogenicity score for MSH2 and MSH6 gene variants that can be used as evidence for classifying variants of uncertain significance. This …

When The Eagle Strikes The Vein: A Case Of Styloid-Induced Venous Sinus Thrombosis, Neud Kiros, Ahmad Chehab, Abeer Abukamil, Ali Luqman, Kamil Abu-Shaban, Mehdy Haidar, Ay-Ming Wang

Conference Presentation Abstracts

Clinical History 41-year-old male with no prior relevant medical history presented to the emergency department with severe neck pain and occipital headaches radiating bilaterally to the temporal regions. He also reported diplopia and “tunnel vision.” He had presented two weeks earlier with similar symptoms and was advised outpatient follow-up. Initial CT head and cervical spine were unremarkable. Imaging Findings Brain MRI/MRV demonstrated heterogeneous signal and enhancement in the left transverse and sigmoid sinuses and jugular bulb, initially thought to reflect possible motion artifact. However, CT venography was recommended for further assessment. The MRI also showed subtle left posterior occipital subdural …

Diffuse Marrow And Orbital Fat Signal Abnormality Mimicking Infiltrative Disease: A Case Of "Flip-Flop" On Mri, Mehdy Haidar, Alexander Pietroski, Kamil Abu-Shaban, Anant Krishnan

Conference Presentation Abstracts

Clinical History A 68-year-old male with a history of left tonsillar squamous cell carcinoma treated 5 months ago and reportedly negative recent PET and CT scans of the neck and body with eye pain with possible but uncertain remote history of trauma was sent in for imaging of the orbits. The patient has a feeding tube and was recently hospitalized and discharged for tube obstruction. Imaging Findings Orbital imaging revealed diffuse signal alterations involving the orbital and scalp fat, and marrow, characterized by low signal intensity on T1WI and high signal intensity on T2WI. In particular on the STIR sequence, …

Persistent Wheezing In An Adolescent Patient, Matilda Dervisevic, Stephen Cliff

Posters

No abstract provided.

Combined Middle Meningeal Artery Embolisation And Subdural Evacuation Port System Drainage For Chronic Subdural Haematoma: A Systematic Review, Single-Arm Meta-Analysis, Meta-Regression, And Cost-Benefit Analysis, Shiva A. Nischal, Santosh Guru, Shaan Patel, Ashviniy Thamilmaran, Mary Murphy

Department of Neurosurgery Faculty Papers

BACKGROUND: Chronic subdural haematoma (cSDH) is an increasingly prevalent condition in older, anticoagulated, and medically frail patients, in whom recurrence and perioperative risk remain substantial despite standard surgical evacuation. Growing recognition of cSDH as an angiogenic, inflammatory disorder has prompted interest in minimally invasive strategies that combine mechanical decompression with targeted modulation of the underlying vascular pathology. This study aimed to evaluate the safety, effectiveness, and health-economic profile of combined middle meningeal artery embolisation and subdural evacuation port system (MMAE-SEPS) drainage for cSDH, compared with conventional burr-hole evacuation.

METHODS: MEDLINE, Embase, and CENTRAL were searched from inception to 24th August …