Fungal sinusitis was once considered a rare disorder but is now reported with increasing frequency throughout the world. The classification of fungal sinusitis has evolved in the past two decades, and this entity is now thought to comprise five subtypes. Acute invasive fungal sinusitis, chronic invasive fungal sinusitis, and chronic granulomatous invasive fungal sinusitis make up the invasive group, whereas noninvasive fungal sinusitis is composed of allergic fungal sinusitis and fungus ball (fungal mycetoma). These five subtypes are distinct entities with different clinical and radiologic features. The treatment strategies for the subtypes are also different, as are their prognoses. An understanding of the different types of fungal sinusitis and knowledge of their particular radiologic features allow the radiologist to play a crucial role in alerting the clinician to use appropriate diagnostic techniques for confirmation. Prompt diagnosis and initiation of appropriate therapy are essential to avoid a protracted or fatal outcome.

Our computer analysis showed that the size of the composite thermal injury created by overlapping multiple thermal ablation spheres is surprisingly small relative to the number of ablations performed. These results emphasize the need for a methodic tumor ablation strategy.

We present a rare case of intracerebral epidermoid cyst with partial calcification on CT and a characteristic hyperintense signal on diffusion-weighted MR imaging (DWI). MR imaging with DWI may help to accurately distinguish the lesion from other cystic tumours of the brain.

This report describes MRI findings of a rare case of biopsy-proven fatal cerebral infection with Chaetomium strumarium in a 28-year-old man with a history of i.v. drug abuse. Magnetic resonance imaging revealed rapidly progressing lesions with irregular peripheral enhancement, possible central haemorrhage and significant mass effect. Only six cases of cerebral infection with Chaetomium have been reported in the English literature. This is the first report in the radiology literature describing the imaging findings. The previously reported cases of cerebral infection by the Chaetomium species are also reviewed.

Abstract-The ketogenic diet is often effective for intractable epilepsy, but many patients have trouble complying with the strict regimen. The authors tested an alternative diet regimen, a low-glycemic-index treatment, with more liberal total carbohydrate intake but restricted to foods that produce relatively little increase in blood glucose (glycemic index Ͻ 50). Ten of 20 patients treated with this regimen experienced a greater than 90% reduction in seizure frequency. NEUROLOGY 2005;65:1810-1812 Heidi H. Pfeifer, RD, LDN; and Elizabeth A. Thiele, MD, PhDThe ketogenic diet (KD) has been considered an effective treatment for epilepsy since the early 1920s and remains valuable for treatment of pharmacoresistant epilepsy. Historically, one-third of patients initiated on the KD have had greater than 90% reduction in seizure frequency. 1 However, it is difficult for patients and families to adhere to the rigid constraints of the KD. The KD includes approximately 80% to 90% fat, much higher than the typical American diet, which makes it unpalatable for some patients. These dietary restrictions are accompanied by psychosocial issues: patients feel isolated from peers because they eat completely distinct foods. Although attempts have been made to make the diet more palatable, the classic KD remains the best dietary therapy available for epilepsy.Because acute carbohydrate intake can rapidly terminate the protective effect of the KD, 2 we have tried a liberalized dietary regimen guided by the principle of minimizing the increase of blood glucose. The glycemic index (GI) describes the tendency of foods to increase blood glucose, compared with an equivalent amount of reference carbohydrate, usually glucose.3 It is calculated from the incremental area under the (blood glucose) curve after feeding, indexed to glucose ϭ 100. Our low-glycemic-index treatment (LGIT) uses a liberalized but still low carbohydrate intake, with carbohydrates supplied only in the form of low-GI foods (GI Ͻ 50 relative to glucose). Some examples of low-GI foods are lentils, grapefruit, and whole grain high-fiber bread. Our review of this treatment in 20 patients suggests that this diet is efficacious and more palatable than the classic KD.Methods. We reviewed the charts of patients who were initiated on the LGIT for intractable epilepsy from 2002 to 2004 (see table E-1 on the Neurology Web site at www.neurology.org). Seizure frequency was assessed on a monthly basis by contemporaneous parental report. Some patients were placed on a LGIT while waiting to initiate the traditional ketogenic diet (LGIT-alone group), either because of scheduling constraints for admitting children to start the diet or because families were not sure their child could comply with the complexity of the full ketogenic diet. Others had demonstrated improved seizure control on the KD but were unable to tolerate the constraints of the KD and were therefore transitioned to the LGIT (after-KD group). Reduction in seizure frequency was calculated relative to the prediet baseline. ...