Incidental intracranial pathology: a retrospective case review of structural neuroimaging results amongst young adult psychiatric patients

Figures & data

Table 1 Intracranial abnormalities found in various disorders. The abnormalities are classed into how they affect management decisions

Population characteristic	Psychiatric diagnosis (n)	Imaging modality	Normal	Abnormal, benign, non-specific	Abnormal, may modify management and treatment, but unlikely causal link to symptoms	Abnormal, may modify management and treatment, possible causal link to symptoms
inpatients scanned, n=224, mean age =20.97 years, sex ratio M:W =164:60	(21) Adjustment disorder (3) Alcohol use disorder (20) Bipolar I (3) Bipolar II (1) Borderline personality disorder (1) Cannabis induced depressive disorder (7) Cannabis induced psychotic disorder (3) Cannabis use disorder (1) Cluster A traits (2) Delusional disorder (2) Dysthymic disorder (40) Major depressive disorder (2) Malingering (2) OCD (2) Opioid use disorder (4) Polysubstance dependence (12) Schizoaffective disorder (35) Schizophrenia (1) Schizotypal personality disorder (2) Still in hospital (1) Stimulant induced depressive disorder (2) Stimulant induced psychotic disorder (2) Stimulant use disorder (1) Substance/medication-induced depressive disorder (10) Substance/medication-induced psychotic disorder (38) Unspecified schizophrenia spectrum and other psychotic disorder (1) Generalized anxiety disorder (1) Unspecified depressive disorder (1) Post-traumatic stress disorder (1) Intermittent explosive disorder (2) Attention deficit hyperactivity disorder	(224) CT (6) MRI (done off-site as follow-up)	n=194 (86.6%)	(3) benign cysts (1) prominent arachnoid granulation (6) cerebral atrophy (2) mega cisterna magna (3) asymmetric ventricles (3) cavum septum pellucidum (1) prominent extra axial space/dehydration (3) possible artifact (2) small hypodense lesions in perivascular space, n=24 (10.7%)	(2) moderate-to-large arachnoid cysts (1) Rathke cleft cyst (follow-up MRI showed unchanged over several years) (1) localized raduidensity in sella turcica (follow-up MRI showed superior convexity of pituitary with no intraglandular signal/commonly seen as normal variant), n=4 (1.8%)	(1) sulcal effacement with asymmetric prominence cortex of left frontal lobe laterally, ?encephalitis (follow-up MRI revealed normally appearing left frontal lobe) (1) dense calcification in genu of internal capsule ?Fahr’s disease or Cockayne disease, TORCH infection, prior ischemic insult, or metabolic abnormality (follow-up MRI revealed calcification was actually in the globus pallidus and likely physiologic), n=2 (0.9%)

Abbreviations: OCD, Obsessive Compulsive Disorder; CT, Computerized Tomograpghy; MRI, Magnetic Resonance Imaging; TORCH, Toxoplasmosis, Other agents (parvovirus B19, syphilis, varicella), Rubella, Cytomegalovirus.