Back to the list
Congress: ECR25
Poster Number: C-13578
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-13578
Authorblock: O-S. Garbea; Cluj Napoca/RO
Disclosures:
Oana-Stefania Garbea: Nothing to disclose
Keywords: CNS, Emergency, Neuroradiology brain, CT, MR, Diagnostic procedure, Acute, Oedema, Toxicity
Learning objectives -To present the main diagnostic features of CHANTER Syndrome-To highlight the key imaging findings -To illustrate the main differentials 
Read more Background CHANTER (Cerebellar, Hippocampal ANd Basal Nuclei Transient oEdema with Restricted Diffusion) Syndrome was recently described as a constellation of clinical and imaging findings different from from ischemic, anoxic or toxic brain injury, mainly occurring in association with drug abuse, most commonly opioids.POUNCE (Paediatric Opioid Use Associated Neurotoxicity with Cerebellar oEdema) Syndrome presents similarly in paediatric patients treated with opioids. CHANTER Syndrome is characterised by diffusion restriction bilaterally in the hippocampus, cerebellum and basal nuclei due to cytotoxic oedema. In some cases,...
Read more Findings and procedure details In acute setting, non-enhanced computed-tomography (CT) is primarily used for the diagnosis of CHANTER Syndrome. The imaging findings might be in most of the cases only subtle and non-specific, therefore for a complete lesion characterisation, magnetic resonance imaging (MRI) is preferred. Even though generally, on magnetic resonance imaging, diffusion restriction is associated with ischemic stroke or anoxic brain injury, CHANTER Syndrome represents a different entity, with a characteristic imaging pattern and also a different clinical course. Therefore, the cerebellar cortex, hippocampi...
Read more Conclusion -CHANTER Syndrome represents a newly described entity -It is associated with polysubstance use, particularly opioids-Even though its imaging features are subtle, but visible on CT, MRI is used complementarily for a better and complete assessment-Familiarity with this specific diffusion restriction pattern is crucial in emergency neuroradiology as it allows for timely diagnosis and neurosurgical intervention, if required for decompression
Read more References (1) Jasne, A. S., Alsherbini, K. H., Smith, M. S., Pandhi, A., Vagal, A., & Kanter, D. (2019). Cerebellar Hippocampal and Basal Nuclei Transient Edema with Restricted diffusion (CHANTER) Syndrome.Neurocritical Care,31(2), 288–296. https://doi.org/10.1007/s12028-018-00666-4.(2) Osborn, A. G., Linscott, L. L., & Salzman, K. L. (2017). Osborn’s Brain (2nd ed.). Elsevier.(3) Meder, J. (2021). Neuro-Imagerie: Pathologies du Système Nerveux Central (2nd ed.). Sauramps Medical.(4) Mallikarjun, K., Parsons, Nigogosyan, Z., Goyal, & Eldaya, R. (2022). Neuroimaging findings in CHANTER Syndrome: a case series.American Journal...
Read more
GALLERY