Advanced Neuroimaging & Neuroradiology

Neuroimaging is most powerful when interpreted within the context of the patient’s neurological history, examination, laboratory findings, symptoms, injury biomechanics, vascular risk factors, and other objective diagnostics.

Dr. Andrew Funk integrates brain and spinal imaging directly into the neurological diagnostic process to identify structural, traumatic, cerebrovascular, infectious, autoimmune, inflammatory, demyelinating, degenerative, congenital, and other neuropathology.

Dr. Funk reviews radiology reports but, when clinically appropriate, personally reviews the imaging itself. His neuroimaging evaluation incorporates MRI, CT, CT angiography (CTA), MR angiography (MRA), and diagnostic ultrasound, with comprehensive independent neuroradiological interpretation most commonly involving brain MRI and spinal MRI.

Dr. Funk is particularly known for identifying neuropathology on brain and spinal MRI studies that were previously interpreted as normal or nondiagnostic. By the time he reviews the actual imaging, he has often taken an extensive neurological history, performed a comprehensive neurological examination, reviewed laboratory and other diagnostic findings, and developed specific anatomical and pathophysiological hypotheses about where the pathology should be located and what he should be looking for. This provides considerably more clinical context than is typically available during routine radiological interpretation.

When the history, neurological examination, laboratory findings, and other diagnostics converge on the advanced imaging, Dr. Funk is frequently able to identify subtle but clinically significant neuropathology that was missed or not recognized as significant on the original radiology interpretation. His exceptional visual and neurological pattern recognition allows him to rapidly integrate complex clinical and imaging information. Across thousands of complex neurological patients, this ability to detect meaningful pathology and establish diagnoses on previously reported “normal” or nondiagnostic studies has become an important part of his diagnostic work.

Brain MRI interpretation incorporates the available sequences and their complementary signal characteristics, including T1- and T2-weighted imaging, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) mapping, susceptibility-sensitive imaging, and pre- and post-contrast imaging when clinically appropriate. Cross-sequence correlation is particularly important in cerebrovascular diagnosis, where DWI, ADC, FLAIR, susceptibility imaging, lesion distribution, vascular territory, CTA, MRA, and other findings can help characterize ischemic injury, cerebral infarction and stroke, hemorrhage, cerebral small-vessel disease, and other vascular neuropathology.

Contrast-enhanced MRI and sequence-specific analysis can also provide critical information in infectious, autoimmune, neuroinflammatory, demyelinating, neoplastic, vascular, and other neurological diseases. Dr. Funk integrates lesion morphology, distribution, signal characteristics, diffusion restriction, and enhancement patterns with neurological localization, laboratory testing, autoimmune antibodies, infectious studies, and other diagnostics to determine the most coherent diagnosis.

In traumatic brain injury (TBI), Dr. Funk evaluates neuroimaging for cerebral parenchymal contusions, hemorrhagic injury, traumatic vascular abnormalities, and other structural neuropathology. Because TBI can also produce microscopic axonal and microvascular injury that may not be fully demonstrated on conventional CT or MRI, imaging is interpreted within the larger context of injury biomechanics and the complete neurological evaluation.

Dr. Funk also evaluates brain and spinal imaging for cerebrovascular disease, spontaneous intracranial hypotension (SIH), Chiari I malformation (Arnold-Chiari malformation), cerebellar tonsillar ectopia, spinal cord lesions and myelopathy, neural compression, inflammatory and demyelinating lesions, neurodegenerative changes, and other neuropathology capable of producing neurological dysfunction.

A polysubspecialty approach is particularly important in neuroimaging because an imaging abnormality gains diagnostic meaning from the disease process and neurological systems surrounding it. Dr. Funk integrates Neuroimaging and Neuroradiology with Brain Injury Medicine, Vascular Neurology, Neuroimmunology, Neuro-Infectious Disease, Neurodegenerative Neurology, Movement Disorders, Seizures and Epilepsy, Cognitive and Memory Neurology, Vestibular Neurology, Neuro-Ophthalmology, and other relevant neurological subspecialties.

Ultimately, neuroradiology is not simply about finding an abnormality—it is about making the right neurological diagnosis so the patient can receive the right treatment. By integrating advanced neuroimaging with the neurological examination, laboratory testing, and the patient’s complete clinical picture, Dr. Funk uses imaging to clarify the diagnosis, precisely localize the neuropathology, and determine which neurological systems require treatment. That diagnosis then becomes the foundation for a comprehensive, individualized neurology treatment and rehabilitation plan designed to target the underlying disease and neurological dysfunction, improve neurological function, reduce symptoms, and help the patient feel and function better.