Publications by authors named "Jeremy Neuman"

22 Publications

  • Page 1 of 1

Transpubic variant of congenital prepubic sinus on magnetic resonance imaging.

Pediatr Radiol 2020 06 24;50(7):1010-1012. Epub 2020 Jan 24.

Department of Radiology, Staten Island University Hospital Northwell Health, 475 Seaview Ave., Staten Island, NY, 10305, USA.

Congenital prepubic sinus is a very rare urogenital anomaly that manifests as a tubular structure of varying histological findings that drains to the skin overlying the pubic symphysis. This tract has been observed to course above, below or, in only a handful of cases, directly through the pubis. We report a case of congenital prepubic sinus with this unusual transpubic course in an 18-year-old man. The patient was initially taken to the operating room for excision of a presumed inclusion cyst. At the time of surgery, the collection was found to track proximally and was excised down to the level of the pubic symphysis. Subsequent magnetic resonance (MR) imaging established the diagnosis of congenital prepubic sinus. We describe the different anatomical courses of congenital prepubic sinus, hypotheses of its pathogenesis, and the use of MR imaging in both diagnosis and surgical planning.
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http://dx.doi.org/10.1007/s00247-020-04619-yDOI Listing
June 2020

Male With Right-Sided Abdominal Pain.

Ann Emerg Med 2019 11;74(5):e83-e84

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY.

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http://dx.doi.org/10.1016/j.annemergmed.2019.05.017DOI Listing
November 2019

Occipital mass in antenatal sonography.

J Neonatal Perinatal Med 2019 ;12(3):321-324

Department of Pediatrics, Staten Island University Hospital Northwell Health, Staten Island, NY, USA.

Biophysical profile (BPP) with ultrasound performed for a 32-year-old G5P3013 admitted at 31 weeks gestation with preterm, premature rupture of membranes (PPROM) noted an extracalvarial mass concerning for an encephalocele. Fetal MRI demonstrated edema over the occiput with no definable lesion visualized. Preterm labor requiring Cesarean delivery resulted in a live male neonate at 33 weeks gestation. An occipital mass was observed on neonatal physical exam. Postnatal ultrasound and MRI were consistent with cephalohematoma. This was surprising given the lack of vaginal delivery. We hypothesize that the occiput was positioned against the maternal ischial tuberosity and developed chronic trauma secondary to normal fetal movement over time, resulting in a cephalohematoma. Postnatal imaging confirmed this diagnosis as the mass gradually decreased and ultimately resolved. Although other etiologies are possible, this case emphasizes the need to consider cephalohematoma in the differential of CNS masses during pregnancy without abdominal trauma and/or vaginal delivery.
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http://dx.doi.org/10.3233/NPM-1872DOI Listing
February 2020

A rare case of laryngeal cleft in association with VACTERL and malrotation.

Radiol Case Rep 2019 Mar 6;14(3):315-319. Epub 2018 Dec 6.

Staten Island University Hospital/Northwell, 475 Seaview Ave. Staten Island, NY 10305, USA.

We report a rare case of a neonatal girl who presented with coughing and dyspnea immediately after feeds. At birth, she was noted to have an imperforate anus with a posterior fourchette fistula from which she was stooling. Initial imaging with radiography showed a normal bowel gas pattern; however, lumbar vertebral anomalies were noted. An upper GI series was performed and revealed a laryngeal cleft and malrotation. Ultrasound confirmed malrotation with an abnormal SMA-SMV relationship. Since laryngeal cleft is a rare condition and may not be known to most radiologists, its incidence is likely underestimated. It is important to note the association of laryngeal clefts with VACTERL and malrotation. In addition, it is essential not to confuse a laryngeal cleft with a tracheoesophageal fistula since the management differs.
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http://dx.doi.org/10.1016/j.radcr.2018.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287062PMC
March 2019

Another Case of Multilevel Cervical Disconnection Syndrome Presenting as Neonatal Encephalopathy.

Case Rep Neurol Med 2018 24;2018:7908753. Epub 2018 Oct 24.

Division of Pediatric Hospitalist Medicine, Department of Pediatrics, Staten Island University Hospital-Northwell Health, Staten Island, NY, USA.

Multilevel cervical disconnection syndrome (MCDS) is a rare malformation of the cervical spine previously documented in two toddlers. We present a case of a newborn first thought to have hypoxic-ischemic encephalopathy who was subsequently diagnosed with MCDS. The possibility of in utero presentation of the syndrome in this patient and the categorization of this syndrome in the spectrum of basilar skull/upper cervical malformation syndromes is discussed.
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http://dx.doi.org/10.1155/2018/7908753DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220399PMC
October 2018

Pulmonary Systemic Lupus Erythematosus Mimicking a Pneumonia in a Postpartum Female.

Case Rep Rheumatol 2018 24;2018:5379192. Epub 2018 Jul 24.

Division of Pediatric Hospitalist Medicine, Department of Pediatrics, Staten Island University Hospital-Northwell Health, Staten Island, NY, USA.

The pulmonary manifestations of systemic lupus erythematosus can range in severity from mild to life threatening and can be particularly marked in women who are recently postpartum. We present below a seventeen-year-old female patient, one month postpartum, who had findings consistent with an acute infectious pneumonia whom upon further query and passage of time was diagnosed with severe pneumonitis due to systemic lupus erythematosus.
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http://dx.doi.org/10.1155/2018/5379192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081512PMC
July 2018

Aortitis.

J Emerg Med 2018 09 1;55(3):417-418. Epub 2018 Aug 1.

Department of Emergency Medicine, Staten Island University Hospital, Staten Island, New York.

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http://dx.doi.org/10.1016/j.jemermed.2018.05.035DOI Listing
September 2018

Newborn with a depression to her skull.

Am J Emerg Med 2018 10 22;36(10):1925.e1-1925.e2. Epub 2018 Jun 22.

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America.

A 9 week-old female, born via normal spontaneous vaginal delivery at 40 weeks, presented to the emergency department for a depression to her left skull, first noticed 3 three weeks prior. Ping Pong Fractures should be recognized and appropriately treated by an emergency physician.
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http://dx.doi.org/10.1016/j.ajem.2018.06.053DOI Listing
October 2018

Incidental Findings on Pediatric Abdominal Computed Tomography At A Pediatric Trauma Center.

J Emerg Med 2017 Nov 5;53(5):616-622. Epub 2017 Oct 5.

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

Background: The increasing availability and use of computed tomography (CT) in pediatric abdominal trauma has increased the detection of incidental findings. While some of these findings are benign, others may require further evaluation for possible clinical importance.

Objectives: This study aimed to identify the frequency and type of incidental findings and their need for follow-up on abdominal CT in patients at a pediatric trauma center.

Methods: This was a retrospective, observational study on trauma patients ≤21 years of age who presented to the emergency department between January 1, 2004 and July 31, 2016 and underwent CT scans of the abdomen and pelvis. Findings were classified as benign anatomic variants, benign pathologic lesions, and pathologic lesions requiring additional work-up.

Results: There were 1073 patients included in the study population, with a mean age of 15.5 years; 707 (66%) were males. A total of 418 incidental findings were identified in 345 patients. Of these, 290 (69%) were benign and 60 (14%) were likely benign pathologic that required possible outpatient monitoring. Of those requiring additional evaluation, 5 (1%) patients warranted further evaluation before discharge.

Conclusions: Nearly one-third of patients had at least one radiographic finding unrelated to their injury. Of these, more than two-thirds did not require additional evaluation, but nearly one-third of patients required some form of further work-up.
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http://dx.doi.org/10.1016/j.jemermed.2017.08.003DOI Listing
November 2017

Woman with right upper quadrant pain.

Ann Emerg Med 2017 Aug;70(2):e29-e30

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY.

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http://dx.doi.org/10.1016/j.annemergmed.2017.03.017DOI Listing
August 2017

Viral Appendiceal Lymphoid Hyperplasia.

J Emerg Med 2017 04 16;52(4):571-572. Epub 2017 Jan 16.

Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York.

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http://dx.doi.org/10.1016/j.jemermed.2016.12.007DOI Listing
April 2017

Newborn With Vomiting.

Ann Emerg Med 2016 Sep;68(3):e63-4

Department of Emergency Medicine, Staten Island University Hospital, Staten Island, NY.

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http://dx.doi.org/10.1016/j.annemergmed.2016.01.040DOI Listing
September 2016

Rare association of progressive congenital extrahepatic portosystemic shunt with development of multifocal hepatocellular carcinoma.

BJR Case Rep 2017 22;3(1):20150077. Epub 2016 Jul 22.

Radiology, Staten Island University Hospital, Staten Island, NY, USA.

The association between the Abernethy malformation, a rare vascular anomaly in which the portal blood is diverted into the systemic circulation, and development of hepatic tumours is well established. We present a case of multifocal hepatocellular carcinoma (HCC) in the presence of extrahepatic portosystemic shunt with a diminutive portal vein (Type 2 Abernethy malformation). Abdominal ultrasound performed on a 72-year-old female presenting with elevated liver function tests found a 5.6 cm right hepatic lobe mass. Subsequent CT and MRI examinations demonstrated multifocal lesions. A diminutive portal vein was present (transverse diameter of 7 mm) with a large tortuous complex shunt (maximum transverse diameter 2.0 cm) arising at the portal vein bifurcation with branches connecting to the left renal vein and inferior vena cava. Review of a CT examination performed 10 years ago demonstrated a normal-sized portal vein (transverse diameter of 1.5 cm) with a smaller calibre portosystemic shunt (maximum transverse diameter 9 mm). To our knowledge, this is one of the first reports to demonstrate the evolution of progressive portosystemic shunting and the development of HCC.
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http://dx.doi.org/10.1259/bjrcr.20150077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159295PMC
July 2016

Periorbital Edema in a 7-year-old Girl.

Pediatr Rev 2016 03;37(3):e7-9

Department of Pediatrics, Staten Island University Hospital, The Children's Cancer Center, Staten Island, NY.

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http://dx.doi.org/10.1542/pir.2015-0064DOI Listing
March 2016

Childhood asymmetrical labium majus enlargement sonographic and MR imaging appearances.

Pediatr Radiol 2016 May 11;46(5):674-9. Epub 2016 Feb 11.

Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Background: Childhood asymmetrical labium majus enlargement (CALME) has been described sparsely in recent surgery, pathology, pediatric and gynecology literature; however, no comprehensive description from a radiology perspective has been developed.

Objective: The purpose of this case series is to describe the imaging findings of CALME and to review the current understanding of this recently described clinical entity with regard to clinical presentation, pathophysiology, differential diagnosis and treatment options.

Materials And Methods: This is a retrospective analysis of 3 girls, ages 5-7 years, who presented for imaging evaluation with subsequent pathologically proven CALME. Each child's clinical history, length of symptoms, imaging appearance and pathological findings were reviewed.

Results: All three girls presented with unilateral enlargement of the labium majus (two right-side, one left-side) with no history of trauma or other inciting cause. Two girls had painless labial enlargement that was recognized for weeks, and one had similar symptoms for 1 year prior to presentation. One girl was evaluated initially with sonography, and all three children underwent MR imaging. Sonographic evaluation showed asymmetrical labial enlargement without a definable mass. In each girl, the MR imaging findings were characterized by relatively ill-defined T1-weighted hypointense signal, T2-weighted hypo- to isointense signal with interspersed hyperintense septae, and heterogeneous patchy and feathery strands of enhancement on post-contrast imaging. Biopsy from each child showed benign fibrous tissue with intervening mature fibroadipose tissue, vessels and nerves without findings of inflammation or neoplasia.

Conclusion: The MR imaging appearance of CALME is consistent. Recognition and appreciation of this unique pediatric entity by the radiologist may be essential for appropriate diagnosis and can help to guide therapy. Current preferred treatment approach is conservative.
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http://dx.doi.org/10.1007/s00247-016-3543-9DOI Listing
May 2016

Wilson-Cowan Equations for Neocortical Dynamics.

J Math Neurosci 2016 Dec 4;6(1). Epub 2016 Jan 4.

Department of Pediatrics, University of Chicago, KCBD 900 East 57th Street, Chicago, IL, 60637, USA.

In 1972-1973 Wilson and Cowan introduced a mathematical model of the population dynamics of synaptically coupled excitatory and inhibitory neurons in the neocortex. The model dealt only with the mean numbers of activated and quiescent excitatory and inhibitory neurons, and said nothing about fluctuations and correlations of such activity. However, in 1997 Ohira and Cowan, and then in 2007-2009 Buice and Cowan introduced Markov models of such activity that included fluctuation and correlation effects. Here we show how both models can be used to provide a quantitative account of the population dynamics of neocortical activity.We first describe how the Markov models account for many recent measurements of the resting or spontaneous activity of the neocortex. In particular we show that the power spectrum of large-scale neocortical activity has a Brownian motion baseline, and that the statistical structure of the random bursts of spiking activity found near the resting state indicates that such a state can be represented as a percolation process on a random graph, called directed percolation.Other data indicate that resting cortex exhibits pair correlations between neighboring populations of cells, the amplitudes of which decay slowly with distance, whereas stimulated cortex exhibits pair correlations which decay rapidly with distance. Here we show how the Markov model can account for the behavior of the pair correlations.Finally we show how the 1972-1973 Wilson-Cowan equations can account for recent data which indicates that there are at least two distinct modes of cortical responses to stimuli. In mode 1 a low intensity stimulus triggers a wave that propagates at a velocity of about 0.3 m/s, with an amplitude that decays exponentially. In mode 2 a high intensity stimulus triggers a larger response that remains local and does not propagate to neighboring regions.
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http://dx.doi.org/10.1186/s13408-015-0034-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733815PMC
December 2016

Modeling focal epileptic activity in the Wilson-cowan model with depolarization block.

J Math Neurosci 2015 27;5. Epub 2015 Mar 27.

Department of Pediatrics, University of Chicago, KCBD 900 East 57th Street, Chicago, IL 60637 USA.

Unlabelled: Measurements of neuronal signals during human seizure activity and evoked epileptic activity in experimental models suggest that, in these pathological states, the individual nerve cells experience an activity driven depolarization block, i.e. they saturate. We examined the effect of such a saturation in the Wilson-Cowan formalism by adapting the nonlinear activation function; we substituted the commonly applied sigmoid for a Gaussian function. We discuss experimental recordings during a seizure that support this substitution. Next we perform a bifurcation analysis on the Wilson-Cowan model with a Gaussian activation function. The main effect is an additional stable equilibrium with high excitatory and low inhibitory activity. Analysis of coupled local networks then shows that such high activity can stay localized or spread. Specifically, in a spatial continuum we show a wavefront with inhibition leading followed by excitatory activity. We relate our model simulations to observations of spreading activity during seizures.

Electronic Supplementary Material: The online version of this article (doi:10.1186/s13408-015-0019-4) contains supplementary material 1.
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http://dx.doi.org/10.1186/s13408-015-0019-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385301PMC
April 2015

More than just Langerhans cell histiocytosis: a radiologic review of histiocytic disorders.

Radiographics 2014 Nov-Dec;34(7):2008-24

From the Department of Radiology, Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305.

Although Langerhans cell histiocytosis (LCH) is a familiar entity to most radiologists and to pediatric radiologists in particular, it is but one of a group of disorders caused by the overproduction of histiocytes, a subtype of white blood cells. Other less familiar diseases in this category are Erdheim-Chester disease (ECD), juvenile xanthogranuloma (JXG), Rosai-Dorfman disease (RDD), and hemophagocytic lymphohistiocytosis (HLH). This review describes the classification system, clinical manifestations, and pathophysiology of each disease, with particular attention to differential radiographic findings, including typical locations of involvement and varying appearances at radiography, computed tomography, magnetic resonance imaging, ultrasonography, and nuclear medicine imaging. Although LCH has a wide variety of manifestations and appearances, classic imaging findings include vertebra plana, skull lesions with a beveled edge, the "floating tooth" sign, bizarre lung cysts, and an absent posterior pituitary bright spot with infundibular thickening. The classic imaging findings of ECD are a perirenal rind of soft tissue and patchy long bone osteosclerosis. RDD has more nonspecific imaging findings, including lymphadenopathy (most commonly cervical) and intracranial lesions. Imaging findings in HLH are broad, with the most common abnormalities being hepatosplenomegaly, cerebral volume loss, and periventricular white matter abnormalities. JXG can manifest at imaging, but radiology does not play a major role in diagnosis. Familiarity with these disorders and their associated imaging findings facilitates correct and timely diagnosis. Imaging also features prominently in the assessment of treatment response.
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http://dx.doi.org/10.1148/rg.347130132DOI Listing
November 2015

Intranasal foreign body mimicking a fat-containing lesion.

Pediatr Radiol 2014 May 1;44(5):618-20. Epub 2013 Nov 1.

Department of Radiology, Staten Island University Hospital, Staten Island, NY, 10305, USA,

We present a 21-month-old child with a foreign body (an intranasal almond) measuring fat attenuation on CT. To the best of our knowledge, this appearance has not been previously described and can be confused with other diagnoses resulting in inappropriate or delayed treatment.
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http://dx.doi.org/10.1007/s00247-013-2821-zDOI Listing
May 2014

Prenatal imaging of amniotic band sequence: utility and role of fetal MRI as an adjunct to prenatal US.

Pediatr Radiol 2012 May 2;42(5):544-51. Epub 2011 Dec 2.

Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Background: Amniotic band sequence and its US manifestations have been well-described. There is little information, however, regarding the accuracy and utility of fetal MRI.

Objective: To describe the MRI findings in amniotic band sequence and to compare the diagnostic accuracy of MRI and US.

Materials And Methods: Prenatal MRI and US studies were retrospectively reviewed in 14 consecutive pregnancies with confirmed amniotic band sequence. Both studies were evaluated for amniotic band visualization, body part affected, type of deformity, umbilical cord involvement and vascular abnormality.

Results: Amniotic bands were confidently identified with MRI in 8 fetuses (57%), suggested with MRI in 3 fetuses (21%) and confidently seen by US in 13 fetuses (93%). Neither modality detected surgically proven bands on one fetus. Both techniques were equally able to define the body part affected and the type of deformity. At least one limb abnormality was visualized in all cases and truncal involvement was present in two cases. Cord involvement was identified in seven cases, with one case detected only by MRI.

Conclusion: Fetal MRI is able to visualize amniotic bands and their secondary manifestations and could be complementary to prenatal US when fetal surgery is contemplated.
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http://dx.doi.org/10.1007/s00247-011-2296-8DOI Listing
May 2012

Radiology-pathology conference: sclerosing hemangioma of the lung.

Clin Imaging 2006 Nov-Dec;30(6):409-12

Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA.

Sclerosing hemangioma (SH) is a relatively rare, benign neoplasm of the lung. Although there are relatively characteristic imaging findings, biopsy remains the definitive diagnostic test. We report the radiology and pathology of a patient with a SH, with emphasis on the computed tomographic and (18)F-fluorodeoxyglucose positron emission tomography findings, and review the literature on this unusual tumor.
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http://dx.doi.org/10.1016/j.clinimag.2006.05.030DOI Listing
January 2007