Original Article
Incidental Findings on Brain MRI in the General Population
N Engl J Med 2007; 357:1821-1828November 1, 2007
- Abstract
Background
Magnetic resonance imaging (MRI) of the brain is increasingly used both in research and in clinical medicine, and scanner hardware and MRI sequences are continually being improved. These advances are likely to result in the detection of unexpected, asymptomatic brain abnormalities, such as brain tumors, aneurysms, and subclinical vascular pathologic changes. We conducted a study to determine the prevalence of such incidental brain findings in the general population.
Methods
The subjects were 2000 persons (mean age, 63.3 years; range, 45.7 to 96.7) from the population-based Rotterdam Study in whom high-resolution, structural brain MRI (1.5 T) was performed according to a standardized protocol. Two trained reviewers recorded all brain abnormalities, including asymptomatic brain infarcts. The volume of white-matter lesions was quantified in milliliters with the use of automated postprocessing techniques. Two experienced neuroradiologists reviewed all incidental findings. All diagnoses were based on MRI findings, and additional histologic confirmation was not obtained.
Results
Asymptomatic brain infarcts were present in 145 persons (7.2%). Among findings other than infarcts, cerebral aneurysms (1.8%) and benign primary tumors (1.6%), mainly meningiomas, were the most frequent. The prevalence of asymptomatic brain infarcts and meningiomas increased with age, as did the volume of white-matter lesions, whereas aneurysms showed no age-related increase in prevalence.
Conclusions
Incidental brain findings on MRI, including subclinical vascular pathologic changes, are common in the general population. The most frequent are brain infarcts, followed by cerebral aneurysms and benign primary tumors. Information on the natural course of these lesions is needed to inform clinical management.
Media in This Article
Figure 1
Incidental Findings on Brain MRI.Figure 2
Age-Specific Distribution of White-Matter Lesion Volumes.Article Activity
- Article
Magnetic resonance imaging (MRI) of the brain is increasingly used both in research and in clinical medicine, and scanner hardware and MRI sequences are improving. Performing MRI at higher resolution and field strength and with more sensitive sequences may lead to the detection of subtle or small brain abnormalities that would not have been detected previously. In combination with the increasing number of brain MRI scans obtained each year, these advances in MRI technology will probably result in more persons being confronted with incidental brain findings. Incidental findings are previously undetected abnormalities of potential clinical relevance that are unexpectedly discovered and unrelated to the purpose of the examination.1 The detection of incidental findings poses various practical and ethical issues, particularly when the participants in a research study are healthy volunteers.2 The clinical relevance and natural course of these unexpected asymptomatic findings are largely unknown and may differ markedly from those of similar symptomatic abnormalities.
Previous studies investigated incidental findings, such as brain tumors and vascular abnormalities, in healthy research volunteers or in populations of patients who underwent MRI examinations for various reasons.3-8 Katzman et al. reported a prevalence of 1.1% for clinically serious abnormalities, such as brain tumors, in a retrospective study of a heterogeneous population of volunteers, 3 to 83 years old, who were participating in a variety of research studies.9 To date, only one population-based study has reported the occurrence of incidental brain findings; this study showed a prevalence of 1.7%.10,11
Not generally classified as incidental findings are subclinical vascular pathologic changes such as asymptomatic brain infarcts and white-matter lesions, the prevalence of which is known to be high in elderly persons and to increase with age.12-17 These lesions are potentially clinically relevant because of the increased risk of adverse neurologic events associated with them.17-22 We report on the prevalence of incidental brain findings, including subclinical vascular pathologic changes, detected by high-resolution, state-of-the-art brain MRI in 2000 persons who participated in a population-based study.
Methods
Source Population
The subjects of this study were participants in the Rotterdam Study, a prospective, population-based cohort study initiated in 1990 among persons 55 years of age or older who were living in a suburb of Rotterdam, the Netherlands.23 The original cohort of the Rotterdam Study (7983 participants) was expanded in 2000 and again in 2006 to include participants who were 45 years of age or older. Every 2 to 3 years, participants are invited to the research center for interviews and extensive physical examinations. Since August 2005, all participants without contraindications to MRI have been invited to undergo MRI examination as part of the Rotterdam Scan Study, a neuroimaging study embedded in the Rotterdam Study that aims to investigate the causes and consequences of age-related brain changes.
The institutional review board at Erasmus MC University Medical Center approved the study, and all participants gave written informed consent; the consent form included a paragraph on incidental findings and the option to refuse to be informed about any unexpected abnormality. All patients who had incidental findings that required follow-up evaluation or treatment had previously agreed to be informed of such findings and were referred to appropriate specialists.
Between August 1, 2005, and February 1, 2007, 2027 of 2227 eligible subjects (91.0%) agreed to participate in the imaging study. In 27 subjects, imaging could not be performed because of physical constraints (in 21 subjects) or technical problems (in 6 subjects). Brain imaging results were thus available for 2000 participants.
Brain MRI Acquisition
All scans were obtained with a 1.5-T scanner with an eight-channel head coil (GE Healthcare). Two trained technicians performed all examinations in a standardized way. The MRI protocol was identical for all participants and included four high-resolution axial sequences: a three-dimensional, T1-weighted sequence; a two-dimensional, proton-density–weighted sequence; a two-dimensional, fluid-attenuated inversion recovery (FLAIR) sequence; and a three-dimensional, T2*-weighted gradient-recalled echo (GRE) sequence. The slice thickness was 1.6 mm for the T1-weighted, proton-density–weighted, and T2*-weighted GRE sequences (0 padded to 0.8 mm for the T1-weighted and T2*-weighted GRE sequences) and 2.5 mm for the FLAIR sequence; all slices were contiguous. No contrast material was administered.
Assessment of Incidental Findings
All scans were read for incidental findings by one of two trained reviewers. The readings were usually performed within 1 day (over 90% of all scans) and at the latest 1 week after acquisition. One reviewer was a resident in radiology, and the other a resident in neurology, with 4.5 and 2.0 years of experience in reading brain MRIs, respectively. Both reviewers were unaware of any clinical information on the subjects. The readings were performed with a digital picture archiving and communication system (PACS). Incidental findings of potential clinical relevance were defined as those requiring urgent or immediate referral, as previously described by others9,10,24; examples include brain tumors, aneurysms, subdural fluid collections, and arachnoid cysts. The diagnoses were made on the basis of MRI findings characteristic of each lesion and were not confirmed by histologic studies. Case definitions for each incidental MRI finding are detailed in the Supplementary Appendix, available with the full text of this article at www.nejm.org.
In addition, the presence of brain infarcts (both lacunar and cortical) was recorded. The distinction between symptomatic and asymptomatic infarcts was verified as follows. A history of stroke is obtained from each subject on entry into the Rotterdam Study.25 Subsequently, participants are continuously monitored for incident stroke through automated linkage of the study database with files from general practitioners and hospital discharge information. All reported events are validated by an experienced neurologist.26 White-matter lesion volumes (in milliliters) were quantified with a validated automated voxel classification technique, as described elsewhere.27 Brain findings that were not considered clinically relevant and were not recorded as incidental findings included simple sinus disease and variations from the norm, such as pineal cysts, ventricular asymmetry, and enlarged Virchow–Robin spaces.
Two experienced neuroradiologists reviewed and reached a consensus on all initially reported abnormalities. To maximize sensitivity, the threshold for reporting abnormalities on initial review was kept low. To verify the sensitivity of the initial review for detecting incidental findings, an additional 230 scans (11.5% of the total of 2000) were also read by the neuroradiologists. No brain abnormalities were detected in addition to those already recorded by the initial reviewers. This result indicates that the initial review had a very high sensitivity for detection of brain abnormalities.
The management of incidental findings was defined in a protocol that was agreed on before the start of the study. Depending on the detected abnormality and after consultation with clinicians, persons with incidental findings requiring additional clinical workup or medical treatment were referred to a relevant medical specialist (a neurosurgeon, neurologist, or internist).
Statistical Analysis
We calculated the prevalence of each incidental brain finding in the study population. Multiple similar findings within one participant (e.g., more than one aneurysm or multiple asymptomatic brain infarcts) were counted as a single finding. Next, we calculated the age-specific prevalence rates of the most frequent incidental findings. For white-matter lesions, we calculated the age-specific median and interquartile range.
Results
The mean age of the study population was 63.3 years (range, 45.7 to 96.7), and 1049 of the subjects (52.4%) were women. Table 1Table 1
Incidental Findings on 2000 MRI Scans. shows the prevalence of each incidental finding that was recorded. Asymptomatic brain infarcts were present in 145 persons (7.2%). Among findings other than brain infarcts, aneurysms (1.8%) were the most frequent. All aneurysms except two were located in the anterior circulation, and all except three were less than 7 mm in diameter (the smallest was 2 mm). Four aneurysms had an intracavernous location. Benign tumors were also frequent (1.6%), with meningiomas being recorded most often (0.9%). The meningiomas ranged from 5 to 60 mm in diameter, and their prevalence was 1.1% in women and 0.7% in men. Pituitary macroadenoma was present in six persons (0.3%). Vestibular schwannomas had a prevalence of 0.2%. We found one possibly malignant primary brain tumor (a low-grade glioma that was not histologically confirmed) and one case of multiple cerebral metastases in a person who in retrospect was found to have been treated for lung cancer. The finding that was medically most urgent was a large, chronic subdural hematoma in an otherwise asymptomatic person, who in retrospect was found to have had minor head trauma 4 weeks before the MRI scan. Figure 1Figure 1Incidental Findings on Brain MRI. shows a selection of the abnormalities that were incidentally detected in this study.None of the persons with incidental brain findings reported any symptoms, with the exception of two subjects. One person with vestibular schwannoma reported hearing loss that had been investigated 3 years earlier by computed tomography, which had not revealed any abnormalities. The other person, who had a right-sided intravestibular lipoma, had longstanding ipsilateral hearing loss that had never been evaluated.
None of the incidental findings in Table 1 were histologically or surgically confirmed, except for those in two persons for whom operative treatment was indicated. One had subdural hematoma, and the other had a 12-mm aneurysm of the medial cerebral artery.
Table 2Table 2
Distribution of Incidental Findings According to Age. shows the age-specific distribution of the most frequent incidental findings. The prevalence of asymptomatic brain infarcts increased with age. The prevalence of meningiomas increased from 0.5% in 45- to 59-year-olds to 1.6% in persons 75 years of age or older. Aneurysms showed no change in prevalence with age.The median volume of white-matter lesions increased with increased age (Table 2). The distribution of white-matter lesion volumes according to age category is shown in Figure 2Figure 2
Age-Specific Distribution of White-Matter Lesion Volumes.. The proportion of persons without any white-matter lesions decreased from 5.4% in 45- to 59-year-olds to 2.0% in persons 75 years of age and older. Furthermore, with increasing age, there was a greater spread in the distribution of white-matter lesion volumes (Figure 2).Discussion
In the general population of persons 45 to 97 years old, we found a high prevalence of potentially clinically relevant incidental brain abnormalities, including subclinical vascular pathologic changes. The prevalence of asymptomatic brain infarcts and meningiomas increased with age, as did the volume of white-matter lesions, whereas aneurysms showed no age-related increase in prevalence.
A major strength of our study is the large sample of persons 45 years of age or older. The MRI protocol was uniform for all subjects, and the reviewers were unaware of characteristics of the subjects, making detection bias unlikely. We used high-resolution, state-of-the-art imaging sequences representing the advanced imaging techniques that are increasingly used in brain research.
A potential limitation with respect to the generalizability of our study results is the fairly homogeneous composition of our geographically defined study population, which consisted mainly of white, middle-class persons.29 Our results may not be generalizable to populations that include other ethnic or socioeconomic groups.
Another potential limitation of our study is that not all scans were read by neuroradiologists. However, all scans with abnormalities detected on initial review were reviewed again by two neuroradiologists. In addition, a randomly chosen subgroup of all scans was reviewed by two neuroradiologists, who did not detect any incidental findings missed on initial review. Therefore, our initial review by physicians who were not neuroradiologists had a very high sensitivity for the detection of brain abnormalities, and we do not think the results would have been different if the scans had been read primarily by neuroradiologists. The sensitivity may be lower when scans are read by professionals who are not medically qualified, as is reportedly the case in many research centers in the United States.30
The incidental brain findings in our study were all diagnosed on the basis of imaging. Pathological confirmation of presumed brain tumors was not obtained, since none of these tumors required surgery after referral of the subject. However, the imaging characteristics of all lesions listed in Table 1 were typical and are usually considered diagnostic (see the Supplementary Appendix).
We did not use contrast-enhanced MRI. Because our study population consisted of volunteers without neurologic symptoms who were participating in a research study, the risks associated with the administration of contrast material were not considered warranted. However, the effect of the absence of contrast material, if any, would have been to leave some small lesions undetected, which would have resulted in an underestimate of the prevalence of incidental findings.
The prevalence of subclinical vascular pathologic changes in our population was high and increased with advancing age. This finding was not unexpected, since age-related changes, such as asymptomatic brain infarcts and white-matter lesions, have been reported to be very frequent in the general elderly population.12,13,15-17,31 Although such changes have been shown to be associated with increased risks of stroke and cognitive decline,18,20,32 preventive therapies for patients with these MRI findings have not been evaluated in randomized trials.
The prevalence of incidental brain findings other than subclinical vascular pathologic changes in our population was much higher than that reported in previous studies,8-10,24 even when the subjects were of similar age to the patients in our study.10 We found an especially high prevalence of small aneurysms.4,9,10,24 This difference can partly be explained by differences among study populations, since aneurysms are very infrequent in children and young adults. However, the population-based study by Yue et al. showed aneurysms in only 0.11% of persons 65 years of age or older.10 We feel that a more likely explanation for the difference is that our scanning protocol, especially the high-resolution, proton-density–weighted sequence (Figure 1A), permitted very good visualization of the circle of Willis as compared with conventional T1-weighted and T2-weighted sequences. Of course, the use of even more sensitive sequences, such as magnetic resonance angiography, might have resulted in the detection of even smaller aneurysms. However, in a systematic review of autopsy and angiographic studies, Rinkel et al. concluded that aneurysms can be found in approximately 2% of adults without risk factors for subarachnoid hemorrhage,33 a proportion very close to the 1.8% detected by MRI in our study.
Meningiomas and small aneurysms were highly prevalent in our study population of persons 45 years of age or older. The rate of growth of meningiomas is typically slow,34,35 and most meningiomas remain asymptomatic throughout life, which explains why 50% of all meningiomas are discovered at autopsy.36 The prevalence of meningiomas found at autopsy in persons over 60 years of age is 3%, and the majority of the lesions are less than 1 cm in diameter.37 Nevertheless, it is generally believed that asymptomatic meningiomas require close clinical and radiologic follow-up to rule out rapidly enlarging tumors.34,38 The current practice of many clinicians is to perform MRI yearly for at least 2 to 3 years to ascertain that rapid tumor growth does not occur. If this were done for all persons incidentally found to have meningiomas, many MRI examinations would be performed in otherwise healthy asymptomatic persons. In view of the resulting medical costs, as well as the psychological burden for those undergoing examination, it would be of great interest to review these guidelines on the basis of the natural course of meningiomas incidentally found on brain MRI.
Guidelines for the management of small aneurysms might also be reviewed. More than 90% of unruptured, asymptomatic aneurysms found by means of autopsy or angiography are less than 10 mm in diameter.33,39 In our study, all but three aneurysms were smaller than 7 mm, and all but two were located in the anterior circulation. The reported risk of rupture for aneurysms of this size in the anterior circulation over a period of 4 years is 0%.40 This finding was based on follow-up of a group of patients who had no history of subarachnoid hemorrhage. However, in this group there was an overrepresentation of persons with a family history of aneurysm and of persons with symptoms that had led to the detection of the unruptured aneurysm.40 The risk of rupture associated with asymptomatic aneurysms in the general population would be expected to be even lower than the reported risk in the described patient population.33 Preventive surgery or treatment of risk factors may thus not be indicated in the general population, and the benefit of longer follow-up has not yet been proven.41 Therefore, persons in our study with aneurysms of the anterior circulation that were under 7 mm in diameter were not referred for follow-up or medical treatment.
Several large, population-based MRI studies in the elderly are ongoing,11,16,42-45 and more will be conducted because of the increasing scientific interest in age-related brain diseases such as dementia. Moreover, imaging at higher MRI field strengths and with increased resolution, as well as the use of new MRI sequences that are more sensitive to subtle structural changes, will probably increase the number of small brain abnormalities detected. Incidental findings from brain MRI in middle-aged and elderly persons will therefore become an important issue that should be considered in designing studies. The present study, as well as some previous studies,9,10 provides information on the prevalence of clinically asymptomatic brain abnormalities. This information is especially important in view of the ethical and practical issues involved in the management of incidental findings.1,2
In conclusion, incidental findings on brain MRI in the general population are common. The most frequent findings are brain infarcts, followed by cerebral aneurysms and benign primary tumors. Such findings should be anticipated in the design of research protocols and the use of neuroimaging in clinical practice. Information on the natural course and prognosis of these lesions is needed to inform clinical management.
Supported by the Erasmus MC University Medical Center and Erasmus University Rotterdam; the Netherlands Organization for Scientific Research; the Netherlands Organization for Health Research and Development; the Research Institute for Diseases in the Elderly; the Ministry of Education, Culture, and Science; the Ministry of Health, Welfare, and Sports; the European Commission; and the Municipality of Rotterdam; and by grants from the Netherlands Organization for Scientific Research (948-00-010 and 918-46-615).
No potential conflict of interest relevant to this article was reported.
Source Information
From the Departments of Epidemiology and Biostatistics (M.W.V., M.A.I., A.H., M.M.B.B.), Radiology (M.W.V., H.L.T., G.P.K., W.J.N., A.L.), Neurosurgery (A.J.P.E.V.), and Medical Informatics (W.J.N.), Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Address reprint requests to Dr. van der Lugt at the Department of Radiology, Erasmus MC University Medical Center, 's-Gravendijkwal 230, Rotterdam 3015 CE, the Netherlands, or at a.vanderlugt@erasmusmc.nl.
- References
References
1
Illes J ,Kirschen MP ,Edwards E , et al. Ethics: incidental findings in brain imaging research. Science 2006;311:783-784
CrossRef | Web of Science | Medline2
Illes J ,Desmond JE ,Huang LF ,Raffin TA ,Atlas SW . Ethical and practical considerations in managing incidental findings in functional magnetic resonance imaging. Brain Cogn 2002;50:358-365
CrossRef | Web of Science | Medline3
Onizuka M ,Suyama K ,Shibayama A ,Hiura T ,Horie N ,Miyazaki H . Asymptomatic brain tumor detected at brain check-up. Neurol Med Chir (Tokyo) 2001;41:431-434
CrossRef | Web of Science | Medline4
Tsushima Y ,Taketomi-Takahashi A ,Endo K . Prevalence of abnormal findings on brain magnetic resonance (MR) examinations in adult participants of brain docking. BMC Neurol 2005;5:18-18
CrossRef | Web of Science | Medline5
Moser FG ,Panush D ,Rubin JS ,Honigsberg RM ,Sprayregen S ,Eisig SB . Incidental paranasal sinus abnormalities on MRI of the brain. Clin Radiol 1991;43:252-254
CrossRef | Web of Science | Medline6
Takanashi J ,Tada H ,Barkovich AJ ,Saeki N ,Kohno Y . Pituitary cysts in childhood evaluated by MR imaging. AJNR Am J Neuroradiol 2005;26:2144-2147
Web of Science | Medline7
Lubman DI ,Velakoulis D ,McGorry PD , et al. Incidental radiological findings on brain magnetic resonance imaging in first-episode psychosis and chronic schizophrenia. Acta Psychiatr Scand 2002;106:331-336
CrossRef | Web of Science | Medline8
Weber F ,Knopf H . Incidental findings in magnetic resonance imaging of the brains of healthy young men. J Neurol Sci 2006;240:81-84
CrossRef | Web of Science | Medline9
Katzman GL ,Dagher AP ,Patronas NJ . Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA 1999;282:36-39
CrossRef | Web of Science | Medline10
Yue NC ,Longstreth WT Jr ,Elster AD ,Jungreis CA ,O'Leary DH ,Poirier VC . Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the Cardiovascular Health Study. Radiology 1997;202:41-46
Web of Science | Medline11
Jack CR Jr . MR imaging of the brain in epidemiologic research: the Cardiovascular Health Study. Radiology 1997;202:17-19
Web of Science | Medline12
Vermeer SE ,Koudstaal PJ ,Oudkerk M ,Hofman A ,Breteler MM . Prevalence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study. Stroke 2002;33:21-25
CrossRef | Web of Science | Medline13
Howard G ,Wagenknecht LE ,Cai J ,Cooper L ,Kraut MA ,Toole JF . Cigarette smoking and other risk factors for silent cerebral infarction in the general population. Stroke 1998;29:913-917
CrossRef | Web of Science | Medline14
Longstreth WT Jr ,Bernick C ,Manolio TA ,Bryan N ,Jungreis CA ,Price TR . Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study. Arch Neurol 1998;55:1217-1225
CrossRef | Web of Science | Medline15
de Leeuw FE ,de Groot JC ,Achten E , et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. J Neurol Neurosurg Psychiatry 2001;70:9-14
CrossRef | Web of Science | Medline16
Liao D ,Cooper L ,Cai J , et al. Presence and severity of cerebral white matter lesions and hypertension, its treatment, and its control: the Atherosclerosis Risk in Communities Study. Stroke 1996;27:2262-2270
CrossRef | Web of Science | Medline17
Longstreth WT Jr ,Manolio TA ,Arnold A , et al. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people: the Cardiovascular Health Study. Stroke 1996;27:1274-1282
CrossRef | Web of Science | Medline18
Vermeer SE ,Prins ND ,den Heijer T ,Hofman A ,Koudstaal PJ ,Breteler MM . Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med 2003;348:1215-1222
Full Text | Web of Science | Medline19
Longstreth WT Jr ,Dulberg C ,Manolio TA , et al. Incidence, manifestations, and predictors of brain infarcts defined by serial cranial magnetic resonance imaging in the elderly: the Cardiovascular Health Study. Stroke 2002;33:2376-2382
CrossRef | Web of Science | Medline20
Bernick C ,Kuller L ,Dulberg C , et al. Silent MRI infarcts and the risk of future stroke: the Cardiovascular Health Study. Neurology 2001;57:1222-1229
Web of Science | Medline21
Prins ND ,van Dijk EJ ,den Heijer T , et al. Cerebral white matter lesions and the risk of dementia. Arch Neurol 2004;61:1531-1534
CrossRef | Web of Science | Medline22
de Groot JC ,de Leeuw FE ,Oudkerk M ,Hofman A ,Jolles J ,Breteler MM . Cerebral white matter lesions and depressive symptoms in elderly adults. Arch Gen Psychiatry 2000;57:1071-1076
CrossRef | Web of Science | Medline23
Ott A ,Breteler MM ,van Harskamp F ,Stijnen T ,Hofman A . Incidence and risk of dementia: the Rotterdam Study. Am J Epidemiol 1998;147:574-580
Web of Science | Medline24
Kim BS ,Illes J ,Kaplan RT ,Reiss A ,Atlas SW . Incidental findings on pediatric MR images of the brain. AJNR Am J Neuroradiol 2002;23:1674-1677
Web of Science | Medline25
Hollander M ,Bots ML ,Del Sol AI , et al. Carotid plaques increase the risk of stroke and subtypes of cerebral infarction in asymptomatic elderly: the Rotterdam Study. Circulation 2002;105:2872-2877
CrossRef | Web of Science | Medline26
Bos MJ ,Koudstaal PJ ,Hofman A ,Witteman JC ,Breteler MM . Uric acid is a risk factor for myocardial infarction and stroke: the Rotterdam study. Stroke 2006;37:1503-1507
CrossRef | Web of Science | Medline27
Ikram MA, Vrooman HA, Vernooij MW, et al. Brain tissue volumes in the general elderly population: the Rotterdam Scan Study. Neurobiol Aging (in press).
28
Meadows J ,Kraut M ,Guarnieri M ,Haroun RI ,Carson BS . Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging. J Neurosurg 2000;92:920-926
CrossRef | Web of Science | Medline29
van Rossum CT. Socioeconomic inequalities in cardiovascular disease in an ageing population. (Ph.D. thesis. Rotterdam, the Netherlands: Erasmus University Rotterdam, 1999.)
30
Illes J ,Kirschen MP ,Karetsky K , et al. Discovery and disclosure of incidental findings in neuroimaging research. J Magn Reson Imaging 2004;20:743-747
CrossRef | Web of Science | Medline31
Price TR ,Manolio TA ,Kronmal RA , et al. Silent brain infarction on magnetic resonance imaging and neurological abnormalities in community-dwelling older adults: the Cardiovascular Health Study. Stroke 1997;28:1158-1164
CrossRef | Web of Science | Medline32
Vermeer SE ,Hollander M ,van Dijk EJ ,Hofman A ,Koudstaal PJ ,Breteler MM . Silent brain infarcts and white matter lesions increase stroke risk in the general population: the Rotterdam Scan Study. Stroke 2003;34:1126-1129
CrossRef | Web of Science | Medline33
Rinkel GJ ,Djibuti M ,Algra A ,van Gijn J . Prevalence and risk of rupture of intracranial aneurysms: a systematic review. Stroke 1998;29:251-256
CrossRef | Web of Science | Medline34
Olivero WC ,Lister JR ,Elwood PW . The natural history and growth rate of asymptomatic meningiomas: a review of 60 patients. J Neurosurg 1995;83:222-224
CrossRef | Web of Science | Medline35
Nakamura M ,Roser F ,Michel J ,Jacobs C ,Samii M . The natural history of incidental meningiomas. Neurosurgery 2003;53:62-70
CrossRef | Web of Science | Medline36
Staneczek W ,Janisch W . Epidemiologic data on meningiomas in East Germany 1961-1986: incidence, localization, age and sex distribution. Clin Neuropathol 1992;11:135-141
Web of Science | Medline37
Nakasu S ,Hirano A ,Shimura T ,Llena JF . Incidental meningiomas in autopsy study. Surg Neurol 1987;27:319-322
CrossRef | Web of Science | Medline38
Niiro M ,Yatsushiro K ,Nakamura K ,Kawahara Y ,Kuratsu J . Natural history of elderly patients with asymptomatic meningiomas. J Neurol Neurosurg Psychiatry 2000;68:25-28
CrossRef | Web of Science | Medline39
Inagawa T ,Hirano A . Autopsy study of unruptured incidental intracranial aneurysms. Surg Neurol 1990;34:361-365
CrossRef | Web of Science | Medline40
Wiebers DO ,Whisnant JP ,Huston J III , et al. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 2003;362:103-110
CrossRef | Web of Science | Medline41
White PM ,Wardlaw J . Unruptured intracranial aneurysms: prospective data have arrived. Lancet 2003;362:90-91
CrossRef | Web of Science | Medline42
DeCarli C ,Massaro J ,Harvey D , et al. Measures of brain morphology and infarction in the Framingham Heart Study: establishing what is normal. Neurobiol Aging 2005;26:491-510
CrossRef | Web of Science | Medline43
Korf ES ,White LR ,Scheltens P ,Launer LJ . Brain aging in very old men with type 2 diabetes: the Honolulu-Asia Aging Study. Diabetes Care 2006;29:2268-2274
CrossRef | Web of Science | Medline44
Schmidt R ,Fazekas F ,Kapeller P ,Schmidt H ,Hartung HP . MRI white matter hyperintensities: three-year follow-up of the Austrian Stroke Prevention Study. Neurology 1999;53:132-139
Web of Science | Medline45
Leow AD ,Klunder AD ,Jack CR Jr , et al. Longitudinal stability of MRI for mapping brain change using tensor-based morphometry. Neuroimage 2006;31:627-640
CrossRef | Web of Science | Medline
- Citing Articles (143)
Citing Articles
1
Amy-Lee Bredlau, Louis S. Constine, Howard J. Silberstein, Michael T. Milano, David N. Korones. (2012) Incidental brain lesions in children: to treat or not to treat?. Journal of Neuro-Oncology 106:3, 589-594
CrossRef2
Wajd N. Al-Holou, Thomas M. O'Lynnger, Aditya S. Pandey, Joseph J. Gemmete, B. Gregory Thompson, Karin M. Muraszko, Hugh J. L. Garton, Cormac O. Maher. (2012) Natural history and imaging prevalence of cavernous malformations in children and young adults. Journal of Neurosurgery: Pediatrics 9:2, 198-205
CrossRef3
Amy Zarzeczny, Timothy Caulfield. (2012) Legal liability and research ethics boards: The case of neuroimaging and incidental findings. International Journal of Law and Psychiatry
CrossRef4
Israel B. Orija, Robert J. Weil, Amir H. Hamrahian. (2012) Pituitary incidentaloma. Best Practice & Research Clinical Endocrinology & Metabolism 26:1, 47-68
CrossRef5
A. N. Ali, K. Travers, N. Athavale, F. Al-Modoaris. (2012) Malignant meningioma--a rare cause of temporal head lump. QJM
CrossRef6
Simon Jung, Marie Luise Mono, Oliver Findling, Urs Fischer, Aekaterini Galimanis, Anja Weck, Gian Marco Marchis, Pietro Ballinari, Jan Gralla, Caspar Brekenfeld, Gerhard Schroth, Marcel Arnold, Heinrich P. Mattle, Marwan El-Koussy. (2012) White matter lesions and intra-arterial thrombolysis. Journal of Neurology
CrossRef7
Merih I. Baharoglu, Alexandra Lauric, Bu-Lang Gao, Adel M. Malek. (2012) Identification of a dichotomy in morphological predictors of rupture status between sidewall- and bifurcation-type intracranial aneurysms. Journal of Neurosurgery1-11
CrossRef8
Antonio Santacroce, Maja Walier, Jean Régis, Roman Liščák, Enrico Motti, Christer Lindquist, Andras Kemeny, Klaus Kitz, Bodo Lippitz, Roberto Martínez Álvarez, Paal-Henning Pedersen, Shoji Yomo, Francesco Lupidi, Karlheinz Dominikus, Philip Blackburn, Thomas Mindermann, Otto Bundschuh, A.T.C.J. van Eck, Rolf Fimmers, Gerhard A. Horstmann. (2012) Long-term Tumor Control of Benign Intracranial Meningiomas After Radiosurgery in a Series of 4565 Patients. Neurosurgery 70:1, 32-39
CrossRef9
Seung-Hee Kim, Jae-Yong Shim, Hye-Ree Lee, Ha-Young Na, Yong-Jae Lee. (2012) The relationship between pulse pressure and leukoaraiosis in the elderly. Archives of Gerontology and Geriatrics 54:1, 206-209
CrossRef10
Samer Ayoubi, Ian F. Dunn, Ossama Al-Mefty. 2012. Meningiomas. , 600-629.
CrossRef11
T.R. Taylor, N. Evangelou, H. Porter, R. Lenthall. (2012) Primary care direct access MRI for the investigation of chronic headache. Clinical Radiology 67:1, 24-27
CrossRef12
Cristiana Pistol Tanase, Irina Ogrezeanu, Corin Badiu. 2012. Pituitary Tumor Classification. , 1-18.
CrossRef13
Byoung-Jin Park, Jae-Yong Shim, Hye-Ree Lee, Hee-Taik Kang, Jung-Hyun Lee, Yong-Jae Lee. (2012) Association between serum total bilirubin level and leukoaraiosis in Korean adults. Clinical Biochemistry
CrossRef14
W. Glannon. 2012. Neuroethics/Brain Imaging. , 216-224.
CrossRef15
Paul B. Thaler, Jian Yi Li, Yakov Isakov, Karen S. Black, Michael Schulder, Alexis Demopoulos. (2012) Normal or non-diagnostic neuroimaging studies prior to the detection of malignant primary brain tumors. Journal of Clinical Neuroscience
CrossRef16
M. Akasbi, J. Berenguer, A. Saiz, P. Brito-Zeron, M. Perez-De-Lis, A. Bove, C. Diaz-Lagares, S. Retamozo, Y. Blanco, R. Perez-Alvarez, X. Bosch, A. Siso, F. Graus, M. Ramos-Casals. (2011) White matter abnormalities in primary Sjogren syndrome. QJM
CrossRef17
Hugues Duffau. (2011) Awake surgery for incidental WHO grade II gliomas involving eloquent areas. Acta Neurochirurgica
CrossRef18
Ashish H. Shah, Karthik Madhavan, Deborah Heros, Daniel M. S. Raper, J. Bryan Iorgulescu, Brian E. Lally, Ricardo J. Komotar. (2011) The management of incidental low-grade gliomas using magnetic resonance imaging: systematic review and optimal treatment paradigm. Neurosurgical Focus 31:6, 1-9
CrossRef19
Khaled M. Musallam, Ahmad Beydoun, Roula Hourani, Wassim Nasreddine, Roy Raad, Suzanne Koussa, Ali T. Taher. (2011) Brain magnetic resonance angiography in splenectomized adults with β-thalassemia intermedia. European Journal of Haematology 87:6, 539-546
CrossRef20
Corinne Perret, Eugen Boltshauser, Ianina Scheer, Christian J. Kellenberger, Michael A. Grotzer. (2011) Incidental findings of mass lesions on neuroimages in children. Neurosurgical Focus 31:6, 1-9
CrossRef21
Ronald J.H. Borra, A. Gregory Sorensen. (2011) Incidental Findings in Brain MRI Research: What Do We Owe Our Subjects?. Journal of the American College of Radiology 8:12, 848-852
CrossRef22
Elizabeth B. Claus, Lisa Calvocoressi, Melissa L. Bondy, Joellen M. Schildkraut, Joseph L. Wiemels, Margaret Wrensch. (2011) Family and personal medical history and risk of meningioma. Journal of Neurosurgery 115:6, 1072-1077
CrossRef23
Wajd N. Al-Holou, Adam Khan, Thomas J. Wilson, William R. Stetler, Gaurang V. Shah, Cormac O. Maher. (2011) Incidental findings on cranial imaging in nonagenarians. Neurosurgical Focus 31:6, 1-6
CrossRef24
Walavan Sivakumar, Roukoz Chamoun, Vinh Nguyen, William T. Couldwell, Ph.D.. (2011) Incidental pituitary adenomas. Neurosurgical Focus 31:6, 1-7
CrossRef25
Philipp Taussky, Ricardo A. Hanel, Fredric B. Meyer. (2011) Clinical considerations in the management of asymptomatic carotid artery stenosis. Neurosurgical Focus 31:6, 1-9
CrossRef26
Roukoz Chamoun, Khaled M. Krisht, William T. Couldwell. (2011) Incidental meningiomas. Neurosurgical Focus 31:6, 1-7
CrossRef27
Hussein Alahmadi, Sidney E. Croul. (2011) Pathology and genetics of meningiomas. Seminars in Diagnostic Pathology 28:4, 314-324
CrossRef28
Vincent Koppelmans, Sanne B. Schagen, Mariëlle M.F. Poels, Willem Boogerd, Caroline Seynaeve, Aad van der Lugt, Monique M.B. Breteler. (2011) Incidental findings on brain Magnetic Resonance Imaging in long-term survivors of breast cancer treated with adjuvant chemotherapy. European Journal of Cancer 47:17, 2531-2536
CrossRef29
Gustavo Nader Marta, Sebastião Francisco Miranda Correa, Manoel Jacobsen Teixeira. (2011) Meningioma: review of the literature with emphasis on the approach to radiotherapy. Expert Review of Anticancer Therapy 11:11, 1749-1758
CrossRef30
Seong-Jin Kang, Byoung-Jin Park, Jae-Yong Shim, Hye-Ree Lee, Ji-Man Hong, Yong-Jae Lee. (2011) Mean platelet volume (MPV) is associated with leukoaraiosis in the apparently healthy elderly. Archives of Gerontology and Geriatrics
CrossRef31
Orin Bloch, Gurvinder Kaur, Brian J. Jian, Andrew T. Parsa, Igor J. Barani. (2011) Stereotactic radiosurgery for benign meningiomas. Journal of Neuro-Oncology
CrossRef32
M. Arfan Ikram, Aad Lugt, Wiro J. Niessen, Gabriel P. Krestin, Peter J. Koudstaal, Albert Hofman, Monique M. B. Breteler, Meike W. Vernooij. (2011) The Rotterdam Scan Study: design and update up to 2012. European Journal of Epidemiology 26:10, 811-824
CrossRef33
Kook Jin Ahn, Young Joo Kim, Hang Joo Cho, Hyeon Woo Yim, Bong Joo Kang, Sung Hun Kim, Hyun Suk Kim, Ki Tae Kim, Jae Hee Lee, In Yong Whang. (2011) Correlation between breast arterial calcification detected on mammography and cerebral artery disease. Archives of Gynecology and Obstetrics 284:4, 957-964
CrossRef34
Mei Wang, Chao Chen, Jintao Qu, Tao Xu, Yicheng Lu, Juxiang Chen, Shenhong Wu. (2011) Inverse association between eczema and meningioma: a meta-analysis. Cancer Causes & Control 22:10, 1355-1363
CrossRef35
C. H. Hawkes, S. Chawda, S. Derakshani, N. Muhammed, E. Visentin, D. Boniface. (2011) MRI and visual-evoked potentials in partners of multiple sclerosis patients. Acta Neurologica Scandinavicano-no
CrossRef36
Nithin D. Adappa, John Y.K. Lee, Alexander G. Chiu, James N. Palmer. (2011) Olfactory Groove Meningioma. Otolaryngologic Clinics of North America 44:4, 965-980
CrossRef37
Albert Hofman, Cornelia M. Duijn, Oscar H. Franco, M. Arfan Ikram, Harry L. A. Janssen, Caroline C. W. Klaver, Ernst J. Kuipers, Tamar E. C. Nijsten, Bruno H. Ch. Stricker, Henning Tiemeier, André G. Uitterlinden, Meike W. Vernooij, Jacqueline C. M. Witteman. (2011) The Rotterdam Study: 2012 objectives and design update. European Journal of Epidemiology 26:8, 657-686
CrossRef38
Jennifer Strahle, Karin M. Muraszko, Joseph Kapurch, J. Rajiv Bapuraj, Hugh J. L. Garton, Cormac O. Maher. (2011) Chiari malformation Type I and syrinx in children undergoing magnetic resonance imaging. Journal of Neurosurgery: Pediatrics 8:2, 205-213
CrossRef39
Thomas M. O’Lynnger, Wajd N. Al-Holou, Joseph J. Gemmete, Aditya S. Pandey, B. Gregory Thompson, Hugh J. L. Garton, Cormac O. Maher. (2011) The effect of age on arteriovenous malformations in children and young adults undergoing magnetic resonance imaging. Child's Nervous System 27:8, 1273-1279
CrossRef40
David J. Madden, Ilana J. Bennett, Agnieszka Burzynska, Guy G. Potter, Nan-kuei Chen, Allen W. Song. (2011) Diffusion tensor imaging of cerebral white matter integrity in cognitive aging. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease
CrossRef41
Or Cohen-Inbar, Gil E. Sviri, Jean F. Soustiel, Menashe Zaaroor. (2011) The Geriatric Scoring System (GSS) in meningioma patients—validation. Acta Neurochirurgica 153:7, 1501-1508
CrossRef42
Albert Beckers, Adrian F Daly. (2011) What to do with a pituitary incidentaloma?. Expert Review of Endocrinology & Metabolism 6:4, 505-507
CrossRef43
Tom den Heijer, Henning Tiemeier, Hendrika J. Luijendijk, Fedde van der Lijn, Peter J. Koudstaal, Albert Hofman, Monique M.B. Breteler. (2011) A Study of the Bidirectional Association Between Hippocampal Volume on Magnetic Resonance Imaging and Depression in the Elderly. Biological Psychiatry 70:2, 191-197
CrossRef44
Monique HM Vlak, Ale Algra, Raya Brandenburg, Gabriël JE Rinkel. (2011) Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. The Lancet Neurology 10:7, 626-636
CrossRef45
Wouter I. Schievink, M. Marcel Maya. (2011) Frequency of intracranial aneurysms in patients with spontaneous intracranial hypotension. Journal of Neurosurgery 115:1, 113-115
CrossRef46
Benedetta Ludovica Pettorini, Anna Gao, Desiderio Rodrigues. (2011) Acute deterioration of a Chiari I malformation: an uncommon neurosurgical emergency. Child's Nervous System 27:6, 857-860
CrossRef47
Je Young Yeon, Jong-Soo Kim, Seung-Chyul Hong. (2011) Incidental major artery aneurysms in patients with non-hemorrhagic moyamoya disease. Acta Neurochirurgica 153:6, 1263-1270
CrossRef48
M Kalamarides, A O Stemmer-Rachamimov, M Niwa-Kawakita, F Chareyre, E Taranchon, Z-Y Han, C Martinelli, E A Lusis, B Hegedus, D H Gutmann, M Giovannini. (2011) Identification of a progenitor cell of origin capable of generating diverse meningioma histological subtypes. Oncogene 30:20, 2333-2344
CrossRef49
Aubrey C. Chan, Stavros G. Drakos, Oscar E. Ruiz, Alexandra C.H. Smith, Christopher C. Gibson, Jing Ling, Samuel F. Passi, Amber N. Stratman, Anastasia Sacharidou, M. Patricia Revelo, Allie H. Grossmann, Nikolaos A. Diakos, George E. Davis, Mark M. Metzstein, Kevin J. Whitehead, Dean Y. Li. (2011) Mutations in 2 distinct genetic pathways result in cerebral cavernous malformations in mice. Journal of Clinical Investigation 121:5, 1871-1881
CrossRef50
Anthony S. Kim, Stephen Sidney, Jeffrey G. Klingman, S. Claiborne Johnston. (2011) Practice variation in neuroimaging to evaluate dizziness in the ED. The American Journal of Emergency Medicine
CrossRef51
Barry I. Hudson, Yeseon Park Moon, Anastasia Z. Kalea, Minesh Khatri, Chensy Marquez, Ann Marie Schmidt, Myunghee C. Paik, Mitsuhiro Yoshita, Ralph L. Sacco, Charles DeCarli, Clinton B. Wright, Mitchell S.V. Elkind. (2011) Association of serum soluble Receptor for Advanced Glycation End-products with subclinical cerebrovascular disease: The Northern Manhattan Study (NOMAS). Atherosclerosis 216:1, 192-198
CrossRef52
Isabel Wanke, Zsolt Kulcsar, Stephan G. Wetzel, Daniel A. Rüfenacht. 2011. Intracranial Aneurysm: Current and Future Minimally Invasive Endovascular Treatment Methods. , 420-426.
CrossRef53
Steven C. Cramer, Jennifer Wu, Joseph A. Hanson, Sarvenaz Nouri, Diraj Karnani, Tony M. Chuang, Vu Le. (2011) A system for addressing incidental findings in neuroimaging research. NeuroImage 55:3, 1020-1023
CrossRef54
L. Abeloos, F. Lefranc. (2011) Que faire en cas de découverte fortuite d’un méningiome ?. Neurochirurgie 57:2, 78-81
CrossRef55
Anouk G.W. van Norden, Karlijn F. de Laat, Ewoud J. van Dijk, Inge W.M. van Uden, Lucas J.B. van Oudheusden, Rob A.R. Gons, David G. Norris, Marcel P. Zwiers, Frank-Erik de Leeuw. (2011) Diffusion tensor imaging and cognition in cerebral small vessel disease. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease
CrossRef56
Randolph W. Evans, James C. Johnston. (2011) Migraine and Medical Malpractice. Headache: The Journal of Head and Face Pain 51:3, 434-440
CrossRef57
Hugues Duffau, Johan Pallud, Emmanuel Mandonnet. (2011) Evidence for the genesis of WHO grade II glioma in an asymptomatic young adult using repeated MRIs. Acta Neurochirurgica 153:3, 473-477
CrossRef58
Sunil V Furtado, Sumit Thakar, Alangar S Hegde. (2011) Correlation of Functional Outcome and Natural History With Clinicoradiological Factors in Surgically Managed Pediatric Chiari I Malformation. Neurosurgery 68:2, 319-328
CrossRef59
L. Augsburger, P. Reymond, D. A. Rufenacht, N. Stergiopulos. (2011) Intracranial Stents Being Modeled as a Porous Medium: Flow Simulation in Stented Cerebral Aneurysms. Annals of Biomedical Engineering 39:2, 850-863
CrossRef60
Mohamad Chmayssani, Jean G Rebeiz, Tania J Rebeiz, H Hunt Batjer, Bernard R Bendok. (2011) Relationship of growth to aneurysm rupture in asymptomatic aneurysms ≤7mm: A Systematic Analysis of the Literature. Neurosurgery1
CrossRef61
A.D. Elster. (2011) Incidental Findings Are Frequent in Young Healthy Individuals Undergoing Magnetic Resonance Imaging in Brain Research Imaging Studies: A Prospective Single-Center Study. Yearbook of Diagnostic Radiology 2011, 189-190
CrossRef62
Magnus Berle, Ann C Kroksveen, Øystein A Haaland, Thin T Aye, Jill A Opsahl, Eystein Oveland, Knut Wester, Rune J Ulvik, Christian A Helland, Frode S Berven. (2011) Protein profiling reveals inter-individual protein homogeneity of arachnoid cyst fluid and high qualitative similarity to cerebrospinal fluid. Fluids and Barriers of the CNS 8:1, 19
CrossRef63
Kwang-Wook Jo, Chang-Hyun Kim, Doo-Sik Kong, Ho-Jun Seol, Do-Hyun Nam, Kwan Park, Jong-Hyun Kim, Jung-Il Lee. (2011) Treatment modalities and outcomes for asymptomatic meningiomas. Acta Neurochirurgica 153:1, 62-67
CrossRef64
Tae Yeon Jeon, Pyoung Jeon, Keon Ha Kim. (2011) Prevalence of Unruptured Intracranial Aneurysm on MR Angiography. Korean Journal of Radiology 12:5, 547
CrossRef65
Anouk G.W. van Norden, Karlijn F. de Laat, Ilma Fick, Inge W.M. van Uden, Lucas J.B. van Oudheusden, Rob A.R. Gons, David G. Norris, Marcel P. Zwiers, Roy P.C. Kessels, Frank-Erik de Leeuw. (2011) Diffusion tensor imaging of the hippocampus and verbal memory performance: The RUN DMC Study. Human Brain Mappingn/a-n/a
CrossRef66
Michael E. Sughrue, Martin J. Rutkowski, Derick Aranda, Igor J. Barani, Michael W. McDermott, Andrew T. Parsa. (2010) Treatment decision making based on the published natural history and growth rate of small meningiomas. Journal of Neurosurgery 113:5, 1036-1042
CrossRef67
Johan Torgersen, Christian Helland, Hans Flaatten, Knut Wester. (2010) Reversible dyscognition in patients with a unilateral, middle fossa arachnoid cyst revealed by using a laptop based neuropsychological test battery (CANTAB). Journal of Neurology 257:11, 1909-1916
CrossRef68
Christian A. Helland, Morten Lund-Johansen, Knut Wester. (2010) Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample. Journal of Neurosurgery 113:5, 934-939
CrossRef69
Lars Norberg, Robert Johansson, Torgny Rasmuson. (2010) Intracranial tumours after external fractionated radiotherapy for pituitary adenomas in northern Sweden. Acta Oncologica 49:8, 1276-1282
CrossRef70
Yuichi Ishikawa, Takehisa Hirayama, Yoshikazu Nakamura, Ken Ikeda. (2010) Incidental cerebral aneurysms in acute stroke patients: Comparison of asymptomatic healthy controls. Journal of the Neurological Sciences 298:1-2, 42-45
CrossRef71
Johan Pallud, Denys Fontaine, Hugues Duffau, Emmanuel Mandonnet, Nader Sanai, Luc Taillandier, Philippe Peruzzi, Rémy Guillevin, Luc Bauchet, Valérie Bernier, Marie-Hélène Baron, Jacques Guyotat, Laurent Capelle. (2010) Natural history of incidental world health organization grade II gliomas. Annals of Neurology 68:5, 727-733
CrossRef72
Mads Aarhus, Ove Bruland, Hege Aase Sætran, Sverre J Mork, Morten Lund-Johansen, Per M Knappskog. (2010) Global Gene Expression Profiling and Tissue Microarray Reveal Novel Candidate Genes and Down-Regulation of the Tumor Suppressor Gene CAV1 in Sporadic Vestibular Schwannomas. Neurosurgery 67:4, 998-1019
CrossRef73
Jason L. Sperry, Margaret S. Massaro, Richard D. Collage, Dederia H. Nicholas, Raquel M. Forsythe, Gregory A. Watson, Gary T. Marshall, Louis H. Alarcon, Timothy R. Billiar, Andrew B. Peitzman. (2010) Incidental radiographic findings after injury: Dedicated attention results in improved capture, documentation, and management. Surgery 148:4, 618-624
CrossRef74
Mohsen Sadatsafavi, Carlo Marra, David Li, Judy Illes. (2010) An Ounce of Prevention Is Worth a Pound of Cure: A Cost-Effectiveness Analysis of Incidentally Detected Aneurysms in Functional MRI Research. Value in Health 13:6, 761-769
CrossRef75
Joseph Wiemels, Margaret Wrensch, Elizabeth B. Claus. (2010) Epidemiology and etiology of meningioma. Journal of Neuro-Oncology 99:3, 307-314
CrossRef76
Alexander Claus Langheinrich, Mesut Yeniguen, Anne Ostendorf, Simone Marhoffer, Christian Dierkes, Susanne Gerlach, Max Nedelmann, Marian Kampschulte, Georg Bachmann, Erwin Stolz, Tibo Gerriets. (2010) In vitro evaluation of the sinus sagittalis superior thrombosis model in the rat using 3D micro- and nanocomputed tomography. Neuroradiology 52:9, 815-821
CrossRef77
Christian Mawrin, Arie Perry. (2010) Pathological classification and molecular genetics of meningiomas. Journal of Neuro-Oncology 99:3, 379-391
CrossRef78
L. T. Westlye, K. B. Walhovd, A. M. Dale, A. Bjornerud, P. Due-Tonnessen, A. Engvig, H. Grydeland, C. K. Tamnes, Y. Ostby, A. M. Fjell. (2010) Life-Span Changes of the Human Brain White Matter: Diffusion Tensor Imaging (DTI) and Volumetry. Cerebral Cortex 20:9, 2055-2068
CrossRef79
Andrew Chow, Katharine J. Drummond. (2010) Ethical considerations for normal control subjects in MRI research. Journal of Clinical Neuroscience 17:9, 1111-1113
CrossRef80
Christian A. Helland, Mads Aarhus, Per Knappskog, Lisa K. Olsson, Morten Lund-Johansen, Mahmood Amiry-Moghaddam, Knut Wester. (2010) Increased NKCC1 expression in arachnoid cysts supports secretory basis for cyst formation. Experimental Neurology 224:2, 424-428
CrossRef81
Cabot, Richard C.Harris, Nancy Lee, Shepard, Jo-Anne O., Rosenberg, Eric S., Cort, Alice M., Ebeling, Sally H.Peters, Christine C., Greenberg, Steven M., Rapalino, Otto, Frosch, Matthew P., . (2010) Case 22-2010. New England Journal of Medicine 363:4, 373-381
Full Text82
N. Cheung, T. Mosley, A. Islam, R. Kawasaki, A. R. Sharrett, R. Klein, L. H. Coker, D. S. Knopman, D. K. Shibata, D. Catellier, T. Y. Wong. (2010) Retinal microvascular abnormalities and subclinical magnetic resonance imaging brain infarct: a prospective study. Brain 133:7, 1987-1993
CrossRef83
Gesa Hartwigsen, Hartwig R. Siebner, Günther Deuschl, Olav Jansen, Stephan Ulmer. (2010) Incidental Findings Are Frequent in Young Healthy Individuals Undergoing Magnetic Resonance Imaging in Brain Research Imaging Studies. Journal of Computer Assisted Tomography 34:4, 596-600
CrossRef84
K. Menzler, J. Iwinska-Zelder, K. Shiratori, R.K. Jaeger, W.H. Oertel, H.M. Hamer, F. Rosenow, S. Knake. (2010) Evaluation of MRI criteria (1.5T) for the diagnosis of hippocampal sclerosis in healthy subjects. Epilepsy Research 89:2-3, 349-354
CrossRef85
A Stijntje E Bor, Marieke JH Wermer, Gabriel JE Rinkel. (2010) Unruptured intracranial aneurysms: initial and follow-up screening. Future Neurology 5:3, 421-431
CrossRef86
Mirjam I. Geerlings, Auke P.A. Appelman, Koen L. Vincken, Ale Algra, Theo D. Witkamp, Willem P.T.M. Mali, Yolanda van der Graaf. (2010) Brain volumes and cerebrovascular lesions on MRI in patients with atherosclerotic disease. The SMART-MR study. Atherosclerosis 210:1, 130-136
CrossRef87
Benjamin E Schreiber, Charlotte Agrup, Dorian O Haskard, Linda M Luxon. (2010) Sudden sensorineural hearing loss. The Lancet 375:9721, 1203-1211
CrossRef88
Aspasia Soultati, Alexandra Alexopoulou, Spyridon P. Dourakis, Helen Dimopoulou, Panayiotis Katsaounis, Demosthenes Cokkinos, Athanasios J. Archimandritis. (2010) The burden of incidental findings in clinical practice in a tertiary care center. European Journal of Internal Medicine 21:2, 123-126
CrossRef89
JAMES L. BERNAT. (2010) In Neuroimaging Trials, How Do You Handle Controls Who Are Found to Have Incidentally Discovered Abnormalities?. Neurology Today 10:7, 26-27
CrossRef90
George A. Alexiou, Pinelopi Gogou, Sofia Markoula, Athanasios P. Kyritsis. (2010) Management of meningiomas. Clinical Neurology and Neurosurgery 112:3, 177-182
CrossRef91
Albert Beckers. (2010) Higher prevalence of clinically relevant pituitary adenomas confirmed. Clinical Endocrinology 72:3, 290-291
CrossRef92
Dima Abdelmannan, David C Aron. (2010) Incidentally discovered pituitary masses: pituitary incidentalomas. Expert Review of Endocrinology & Metabolism 5:2, 253-264
CrossRef93
Erica K. Rangel. (2010) The Management of Incidental Findings in Neuro-Imaging Research: Framework and Recommendations. The Journal of Law, Medicine & Ethics 38:1, 117-126
CrossRef94
Shoji Yomo, Manabu Tamura, Romain Carron, Denis Porcheron, Jean Régis. (2010) A quantitative comparison of radiosurgical treatment parameters in vestibular schwannomas: the Leksell Gamma Knife Perfexion versus Model 4C. Acta Neurochirurgica 152:1, 47-55
CrossRef95
M. Necmettin Pamir, Peter M. Black, Rudolf Fahlbusch. 2010. Decision Making in Meningiomas. , 275-289.
CrossRef96
Ayumi Seki, Hitoshi Uchiyama, Tamami Fukushi, Osamu Sakura, Koeda Tatsuya, Japan Children's Study Group. (2010) Incidental Findings of Brain Magnetic Resonance Imaging Study in a Pediatric Cohort in Japan and Recommendation for a Model Management Protocol. Journal of Epidemiology 20:Supplement_II, S498-S504
CrossRef97
Michael E. Sughrue, Isaac Yang, Derick Aranda, Khadja Lobo, Lawrence H. Pitts, Steven W. Cheung, Andrew T. Parsa. (2010) The natural history of untreated sporadic vestibular schwannomas: a comprehensive review of hearing outcomes. Journal of Neurosurgery 112:1, 163-167
CrossRef98
V.P. Collins. 2010. Molecular Biology and Genetics of Meningiomas. , 127-134.
CrossRef99
Thomas Westermaier, Giles Hamilton Vince, Matthias Meinhardt, Camelia Monoranu, Klaus Roosen, Cordula Matthies. (2010) Arachnoid cysts of the fourth ventricle - short illustrated review. Acta Neurochirurgica 152:1, 119-124
CrossRef100
Duk-Hee Chun, Na-Young Kim, Yang-Sik Shin. (2010) Subarachnoid and Intraventricular Hemorrhage due to Ruptured Aneurysm after Combined Spinal-Epidural Anesthesia. Yonsei Medical Journal 51:3, 475
CrossRef101
A. T. TAHER, K. M. MUSALLAM, W. NASREDDINE, R. HOURANI, A. INATI, A. BEYDOUN. (2010) Asymptomatic brain magnetic resonance imaging abnormalities in splenectomized adults with thalassemia intermedia. Journal of Thrombosis and Haemostasis 8:1, 54-59
CrossRef102
Mark O. McCarron, Carrie Sands, Peter McCarron. (2010) Neuroimaging reports in a general hospital: Results from a quality-improvement program. Clinical Neurology and Neurosurgery 112:1, 54-58
CrossRef103
Robert Sigstr
m, Ingmar Skoog, Simona Sacuiu, Bj
CrossRef104
Mads Aarhus, Christian A. Helland, Knut Wester. (2009) Differences in anatomical distribution, gender, and sidedness between ruptured and unruptured intracranial aneurysms in a defined patient population. Acta Neurochirurgica 151:12, 1569-1574
CrossRef105
JOSEPH PRANDOTA. (2009) THE IMPORTANCE OF TOXOPLASMA GONDII INFECTION IN DISEASES PRESENTING WITH HEADACHES. HEADACHES AND ASEPTIC MENINGITIS MAY BE MANIFESTATIONS OF THE JARISCH-HERXHEIMER REACTION. International Journal of Neuroscience 119:12, 2144-2182
CrossRef106
Micaela Santos, Enikö Kövari, Patrick R. Hof, Gabriel Gold, Constantin Bouras, Panteleimon Giannakopoulos. (2009) The impact of vascular burden on late-life depression. Brain Research Reviews 62:1, 19-32
CrossRef107
Judy Illes, Emily Borgelt. (2009) Brain imaging: Incidental findings: in practice and in person. Nature Reviews Neurology 5:12, 643-644
CrossRef108
Darin T. Okuda. (2009) Unanticipated demyelinating pathology of the CNS. Nature Reviews Neurology 5:11, 591-597
CrossRef109
Sulene L Chi, M Tariq Bhatti. (2009) The diagnostic dilemma of neuro-imaging in acute isolated sixth nerve palsy. Current Opinion in Ophthalmology 20:6, 423-429
CrossRef110
Adrian F. Daly, Maria A. Tichomirowa, Albert Beckers. (2009) The epidemiology and genetics of pituitary adenomas. Best Practice & Research Clinical Endocrinology & Metabolism 23:5, 543-554
CrossRef111
Mark E. Molitch. (2009) Pituitary incidentalomas. Best Practice & Research Clinical Endocrinology & Metabolism 23:5, 667-675
CrossRef112
Yuki Sato, Yo Chin, Tomomasa Kato, Yuichi Tanaka, Yusuke Tozuka, Mitsuhito Mase, Naohide Ageyama, Fumiko Ono, Keiji Terao, Yasuhiro Yoshikawa, Tatsuhiro Hisatsune. (2009) White matter activated glial cells produce BDNF in a stroke model of monkeys. Neuroscience Research 65:1, 71-78
CrossRef113
Albert Hofman, Monique M. B. Breteler, Cornelia M. Duijn, Harry L. A. Janssen, Gabriel P. Krestin, Ernst J. Kuipers, Bruno H. Ch. Stricker, Henning Tiemeier, André G. Uitterlinden, Johannes R. Vingerling, Jacqueline C. M. Witteman. (2009) The Rotterdam Study: 2010 objectives and design update. European Journal of Epidemiology 24:9, 553-572
CrossRef114
Robert Elliott, Stephen Kalhorn, Donato Pacione, Howard Weiner, Jeffrey Wisoff, David Harter. (2009) Shunt malfunction causing acute neurological deterioration in 2 patients with previously asymptomatic Chiari malformation Type I. Journal of Neurosurgery: Pediatrics 4:2, 170-175
CrossRef115
A. Storstein, L. Gjerstad, L. J. Stovner, N. E. Gilhus. (2009) Norwegian neurology: present status and future trends. Acta Neurologica Scandinavica 120, 5-7
CrossRef116
G. A. Kuchel, N. Moscufo, C. R. Guttmann, N. Zeevi, D. Wakefield, J. Schmidt, C. E. DuBeau, L. Wolfson. (2009) Localization of Brain White Matter Hyperintensities and Urinary Incontinence in Community-Dwelling Older Adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 64A:8, 902-909
CrossRef117
Susanne C. Ladd. (2009) Whole-body MRI as a screening tool?. European Journal of Radiology 70:3, 452-462
CrossRef118
Leslie A. Aitken, Camilla E. Lindan, Stephen Sidney, Nalin Gupta, A. James Barkovich, Michael Sorel, Yvonne W. Wu. (2009) Chiari Type I Malformation in a Pediatric Population. Pediatric Neurology 40:6, 449-454
CrossRef119
Chengxuan Qiu, Mary Frances Cotch, Sigurdur Sigurdsson, Ronald Klein, Fridbert Jonasson, Barbara E. K. Klein, Melissa Garcia, Palmi V. Jonsson, Tamara B. Harris, Gudny Eiriksdottir, Olafur Kjartansson, Mark A. van Buchem, Vilmundur Gudnason, Lenore J. Launer. (2009) Microvascular lesions in the brain and retina: The age, gene/environment susceptibility-Reykjavik study. Annals of Neurology 65:5, 569-576
CrossRef120
Annet M. Aukes, Jan C. de Groot, Jan G. Aarnoudse, Gerda G. Zeeman. (2009) Brain lesions several years after eclampsia. American Journal of Obstetrics and Gynecology 200:5, 504.e1-504.e5
CrossRef121
Samuel R. Pierce, Richard T. Lauer, Laura A. Prosser, Feroze B. Mohamed, Jaimie B. Dougherty, Scott H. Faro, Randall R. Betz. (2009) Incidental Findings During Functional Magnetic Resonance Imaging. American Journal of Physical Medicine & Rehabilitation 88:4, 275-277
CrossRef122
Taro Shimono, Makoto Hosono, Ryuichiro Ashikaga, Seishi Kumano, Izumi Imaoka, Yukinobu Yagyu, Masahiro Okada, Masatomo Kuwabara, Takamichi Murakami. (2009) Ring-shaped lateral ventricular nodules: an incidental finding on brain magnetic resonance imaging. Neuroradiology 51:3, 145-150
CrossRef123
Lawrence D. Recht, Griffith Harsh, Harvey J. Cohen. (2009) The rationale for early detection and treatment of brain tumors in survivors of childhood cancer. Oncology Reviews 3:1, 51-57
CrossRef124
John C. Mazziotta, Roger Woods, Marco Iacoboni, Nancy Sicotte, Kami Yaden, Mary Tran, Courtney Bean, Jonas Kaplan, Arthur W. Toga. (2009) The myth of the normal, average human brain—The ICBM experience: (1) Subject screening and eligibility. NeuroImage 44:3, 914-922
CrossRef125
Loic Boussel, Vitaliy Rayz, Alastair Martin, Gabriel Acevedo-Bolton, Michael T. Lawton, Randall Higashida, Wade S. Smith, William L. Young, David Saloner. (2009) Phase-contrast magnetic resonance imaging measurements in intracranial aneurysms in vivo of flow patterns, velocity fields, and wall shear stress: Comparison with computational fluid dynamics. Magnetic Resonance in Medicine 61:2, 409-417
CrossRef126
Belinda A. Campbell, Ashu Jhamb, John A. Maguire, Brian Toyota, Roy Ma. (2009) Meningiomas in 2009. American Journal of Clinical Oncology 32:1, 73-85
CrossRef127
Jean Raymond. (2009) Incidental intracranial aneurysms: rationale for treatment. Current Opinion in Neurology 22:1, 96-102
CrossRef128
S. Ulmer, U.R. Jensen, O. Jansen, H.M. Mehdorn, J. Schaub, G. Deuschl, H.R. Siebner. (2009) Impact of Incidental Findings on Neuroimaging Research Using Functional MR Imaging. American Journal of Neuroradiology 30:4, e55-e55
CrossRef129
D Kernick, S Stapley, PJ Goadsby, W Hamilton. (2008) What happens to new-onset headache presented to primary care? A case-cohort study using electronic primary care records. Cephalalgia 28:11, 1188-1195
CrossRef130
G. Richter, M. Köhrmann, S. Schwab, A. Dörfler. (2008) Intrakranielle Aneurysmen, arteriovenöse Malformationen und Karotisstenosen. Der Nervenarzt 79:10, 1144-1155
CrossRef131
M. Grau-Olivares, A. Arboix, D. Bartrés-Faz, C. Junqué. (2008) Higher severity of frontal periventricular white matter and basal ganglia hyperintensities in first-ever lacunar stroke with multiple silent lacunes. European Journal of Neurology 15:9, 1002-1005
CrossRef132
Kai Kallenberg, Christoph Dehnert, Arnd Dörfler, Peter D Schellinger, Damian M Bailey, Michael Knauth, Peter D Bärtsch. (2008) Microhemorrhages in nonfatal high-altitude cerebral edema. Journal of Cerebral Blood Flow & Metabolism 28:9, 1635-1642
CrossRef133
D.A. Brown, A.N. Hasso. (2008) Toward a Uniform Policy for Handling Incidental Findings in Neuroimaging Research. American Journal of Neuroradiology 29:8, 1425-1427
CrossRef134
K. Wester. (2008) Intracranial arachnoid cysts – do they impair mental functions?. Journal of Neurology 255:8, 1113-1120
CrossRef135
S Larjavaara, H Haapasalo, R Sankila, P Helén, A Auvinen. (2008) Is the incidence of meningiomas underestimated? A regional survey. British Journal of Cancer 99:1, 182-184
CrossRef136
Susan M. Wolf, Jordan Paradise, Charlisse Caga-anan. (2008) The Law of Incidental Findings in Human Subjects Research: Establishing Researchers' Duties. The Journal of Law, Medicine & Ethics 36:2, 361-383
CrossRef137
Susan M. Wolf. (2008) Introduction: The Challenge of Incidental Findings. The Journal of Law, Medicine & Ethics 36:2, 216-218
CrossRef138
D. Ganesan, A. F. Dean, N. Antoun, R. W. Kirollos. (2008) A second biopsy? – Tandem lesion. Acta Neurochirurgica 150:5, 501-503
CrossRef139
Ricardo J. Komotar, Robert M. Starke, E. Sander Connolly. (2008) Brain Magnetic Resonance Imaging Scans for Asymptomatic Patients: Role in Medical Screening. Mayo Clinic Proceedings 83:5, 563-565
CrossRef140
Kiarash Shahlaie, Jonathan Hartman, Garth H. Utter, Rudolph J. Schrot. (2008) Acute deterioration in occult Chiari malformation following missile spinal trauma. Journal of Neurosurgery: Spine 8:4, 385-389
CrossRef141
(2008) Incidental Findings on Brain MRI. New England Journal of Medicine 358:8, 853-855
Full Text142
Judy Illes. (2008) Brain screening and incidental findings: flocking to folly?. The Lancet Neurology 7:1, 23-24
CrossRef143
Alice Goodman. (2008) Incidental Pathological Findings More Common Than Thought ??? But What to Do?. Neurology Today 8:24, 4-5
CrossRef
- Letters
