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Sample records for arachnoiditis

  1. Arachnoiditis

    Science.gov (United States)

    ... of the membranes that surround and protect the nerves of the spinal cord. The arachnoid can become inflamed because of ... direct injury to the spine, chronic compression of spinal nerves, or complications from spinal surgery or other invasive ...

  2. Tuberculous optochiasmatic arachnoiditis

    Directory of Open Access Journals (Sweden)

    Anupriya A

    2010-12-01

    Full Text Available Arachnoiditis involving optic nerve and the optic chiasm can occur as a complication of tuberculous meningitis (TBM. This study evaluates the clinical features, cerebrospinal fluid (CSF and laboratory parameters and imaging findings of optochiasmatic arachnoiditis (OCA and also tried to identify any factors which can predict this complication in patients with TBM. Patients admitted with TBM in the neurology wards of a tertiary care teaching hospital over a period of 6 years formed the material for this study. Student′s "t" test and univariate analysis were done to identify any predictors for this complication and the variables found to be significant were further analyzed by multivariate logistic regression analysis. One hundred sixty-three patients with TBM, admitted over a 6-year period, were studied. Twenty-three (14% patients developed OCA. Eighteen out of 23 (78% developed this complication while on antituberculous treatment (ATT and 5/23 (22% were newly diagnosed cases of TBM. Of those already on treatment, 12/23 (52% were receiving only ATT, the remaining 6/23 (26% had received steroids along with ATT in varying doses and duration. The average period from diagnosis of TBM to visual symptoms was 6.4 months. On the multivariate logistic regression analysis, female sex (P < 0.037, age less than 27 (P < 0.008 years and protein content in the CSF > 260 mg% (P < 0.021 were the factors predisposing toward this complication. At 6 months follow-up, on treatment with steroids and ATT, 17% had improvement and no further deterioration was noted in visual acuity in 52%. OCA can develop even while on treatment with ATT. Young women with a high CSF protein content seem to be more prone for this complication.

  3. Spontaneous hygroma in intracranial arachnoid cyst

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    Agnoli, A.L.

    1984-06-01

    Anamnesis and treatment of two cases of arachnoid cysts extending into the subarachnoid space are described. No traumatic incident was discovered in the previous history of these two patients. The causal genesis of neurological signs of deficiency in patients with arachnoid and acquired cysts is discussed. However, the cause of the development of a subdural hygroma in arachnoid cysts remains unclarified. CT findings of arachnoid cysts with a hypodense zone between brain surface and the vault of the cranium always require an investigation into the possibility of a spontaneous emptying of the cyst or of a congenital and not only localised extension of the cyst itself.

  4. Recurrent spinal adhesive arachnoiditis: a case report

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    James Pitágoras de Mattos

    1988-03-01

    Full Text Available Spinal adhesive arachnoiditis is not an uncommon disease, usually having a monophasic course. We studied an atypical patient with recurrent spinal adhesive arachnoiditis nine years after intrathecal anesthesia and the first attack of the disease. Also noteworthy was the favorable evolution after surgery.

  5. MRI feature of dural sinus arachnoid granulations

    International Nuclear Information System (INIS)

    Objective: To evaluate the MRI feature of dural sinus arachnoid granulations. Methods: All of the brain MRI studies in 2010 were retrospectively analyzed with emphasis on the distribution, size and signal characteristics of dural sinus arachnoid granulations. Results: Superior sagittal sinus was the most location followed by transverse sinus, straight sinus, and sigmoid sinus. The size ranged from 2 mm to 16 mm with the majority smaller than 8 mm in diameter. All of arachnoid granulations were hypointense on T1WI and FLAIR-weighted images slightly higher than cerebrospinal fluid, hyperintense on T2WI slightly lower than cerebrospinal fluid. Most of them did not enhance with contrast with the larger ones showing punctate or linear enhancement. Filling defects were seen on cerebral MRV. Conclusion: MRI characteristics of arachnoid granulations are reliable for distinguishing arachnoid granulations from other lesions of dural sinus. (authors)

  6. Myelographic differential diagnosis of spinal arachnoiditis with an emphasis on Tbc arachnoiditis

    International Nuclear Information System (INIS)

    Spinal arachnoiditis is a rare condition. The arachnoiditis of various causes, leptomeningeal meatasis, leptomeningeal lymphoma, hypertrophic polyneuritis, etc. are known to have a similar radiologic manifestations. The authors reviewed myelographic findings of 20 patients with spinal arachnoiditis retrospectively to discovery any specific findings helpful to make a differential diagnosis. The causes of spinal arachnoiditis were tuberculous origin in 9 cases, pyogenic in 2, postoperative in one, lymphoma in 3 and leptomeningeal metastasis in 5. Myelographic findings of tuberculous spinal arachnoiditis were block of CSF (89%), especially at the conus medullar is level, multiple fine and/or coarse nodular filling defects (78%), nerve root thickening (56%), focal irregular adhesive filling defects (44%) and irregular or indistinct thecal sac margin (44%). Irregular adhesive band like filling defects and/or multiple fine nodular filling defects seem to be characteristics of the arachnoiditis. Myelographic findings showing coarse nodular filling defects without fine ones are suggestive of leptomeningeal metastasis.

  7. Arachnoid granulation affected by subarachnoid hemorrhage

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    R.P. Chopard

    1993-11-01

    Full Text Available The purpose of this study was to investigate using light microscopy the fibro-cellular components of arachnoid granulations affected by mild and severe subarachnoid hemorrage. The erythrocytes were in the channels delimitated by collagenous and elastic bundles and arachnoid cells, showing their tortuous and intercommunicating row from the pedicle to the fibrous capsule. The core portion of the pedicle and the center represented a principal route to the bulk outflow of cerebrospinal fluid and erythrocytes. In the severe hemorrhage, the fibrocellular components are desorganized, increasing the extracellular channels. We could see arachnoid granulations without erythrocytes, which cells showed big round nucleous suggesting their transformation into phagocytic cells.

  8. Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis

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    Srivastava, T. [Department of Neurology, CN Centre, All India Institute of Medical Sciences, New Delhi (India); Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India); Kochar, D.K. [Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India)

    2003-10-01

    Spinal arachnoiditis is one of the common and disabling complication of tuberculous meningitis (TBM). We focused on early diagnosis of spinal arachnoiditis by spinal MRI in asymptomatic patients in whom neurological examination was normal. We studied 16 patients with a diagnosis of probable or highly probable TBM with symptoms for less than 1 month; three had radiological evidence of spinal arachnoiditis. High cerebrospinal fluid protein appeared to be a risk factor for development of spinal arachnoiditis. MRI is sensitive to detect early spinal arachnoiditis. Earlier diagnosis may be helpful in management of spinal arachnoiditis in TBM. (orig.)

  9. Syringomyelia Associated with a Spinal Arachnoid Cyst

    OpenAIRE

    Kim, Min-Su; Kim, Seong-Ho

    2009-01-01

    While syringomyelia is not a rare spinal disorder, syringomyelia associated with a spinal arachnoid cyst is very unusual. Here, we report a 62-year-old man who suffered from gait disturbance and numbness of bilateral lower extremities. Spinal magnetic resonance imaging (MRI) showed the presence of a spinal arachnoid cyst between the 7th cervical and 3rd thoracic vertebral segment and syringomyelia extending between the 6th cervical and 1st thoracic vertebral segment. The cyst had compressed t...

  10. Arachnoid cyst of the middle cranial fossa

    International Nuclear Information System (INIS)

    The middle cranial fossa is the most common site for intracranial arachnoid cysts. Galassi and his associates have provided a useful classification of middle fossa arachnoid cysts based on their computed tomographic appearances. The Type I cyst is a small lenticular lesion. The Type II cyst is quadrangular in shape, reflecting a completely open insula. The Type III cyst appears as a large area of smoothly rounded lucency, with a significant compression of the brain. We report a 2-year-old boy with a middle fossa arachnoid cyst. This cyst differed from the type of Galassi's classification in its extension. Computerized tomograms showed low-density lesions of the bilateral middle cranial fossa and suprasellar area, which was not enhanced with contrast medium. Magnetic Resonance Imaging (MRI) showed a CSF-like pattern (Kjos) and revealed delicate anatomical structures in the surrounding brain. Arachnoid cysts are usually single lesions. However, not infrequently these cystic cavities may be divided by membranous septa into two or more compartments. Bilateral, more or less symmetrical arachnoid cysts in the middle cranial fossa as seen in this patient, however, seem to be very rare. Only a few such cases have been reported previously. MRI was superior to X-ray CT in characterizing intracranial cystic lesions because of its ability to categorize cysts into Kjos's three groups on the basis of the intensity pattern of the cyst contents, thereby improving diagnostic specificity and patient management. (author)

  11. An interesting case of primary spinal arachnoiditis.

    LENUS (Irish Health Repository)

    Vaughan, Denis

    2012-02-27

    Spinal arachnoiditis describes inflammation of the meninges, subarachnoid space and, in most cases, also involve the pial layer. The vast majority of cases described are secondary and are preceded by a known event, for example,. trauma, infections or irritative substances. Here, we present the case of primary spinal arachnoiditis. A 35-year-old lady was referred to the neurosurgical services in Dublin, Ireland with a 15-month history of progressive, right lower limb weakness. Magnetic resonance imaging revealed cystic distortion of the lumbar spinal canal extending up to the conus. Initially, an L2-L4 laminectomy was performed revealing thickened and adherent arachnoid with a large cyst in the spinal canal. Four months after initial operation, the patient represented with bilateral lower limb weakness and loss of detrusor function. Repeat magnetic resonance imaging was performed, which showed the development of a syrinx in the patient\\'s thoracic spine. We then performed a T9-T10 laminectomy, midline myelotomy and insertion of a syringe-arachnoid shunt. Post-operative imaging showed resolution of the syrinx and a vast improvement in lower limb power. The patient also regained bladder control. In conclusion, spinal arachnoiditis is a clearly defined pathological and radiological entity with a highly variable clinical presentation. It is exceedingly difficult to treat as there is no recognised treatment currently, with most interventions aimed at symptomatic relief.

  12. Giant arachnoid granulation in a patient with benign intracranial hypertension

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    Kiroglu, Yilmaz; Yaqci, Baki; Cirak, Bayram; Karabulut, Nevzat [Pamukkale University, Department of Radiology, School of Medicine, Denizli (Turkey)

    2008-10-15

    We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify giant arachnoid granulation and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of giant arachnoid granulations can be used to evaluate the lesion as the cause of the patient's symptoms. (orig.)

  13. Global Characteristics of 'Arachnoids' on Venus

    Science.gov (United States)

    Hamilton, V. E.; Stofan, E. R.

    1996-03-01

    The term "arachnoid" has been used colloquially to describe circular to elliptical structures having a set of radiating lineaments distinctly resembling the legs of a spider. However, little is known about the origin of these features and whether or not they are genetically related to each other or to other circular structures on Venus (e.g., coronae, volcanoes, and calderas). We have conducted a global survey of these features in order to more clearly define their characteristics and determine if they are in fact a separate type of feature. In contrast to previous counts, we find a rather small global population of only 36 features that we feel we can confidently call "arachnoids". A detailed examination of these features reveals that they do not display a common set of volcanic or tectonic characteristics indicative of a single process of formation. We also find that these features do not appear to universally represent a particular stage of corona, volcano, or caldera development. _

  14. Teflon sponge shunt for recurrent arachnoid cyst

    OpenAIRE

    Goel Atul; Shah Abhidha; Pareikh Samir

    2007-01-01

    A 50-year-old female presented with complaints of progressive ataxia. Investigations showed a large intradural arachnoid cyst located anterior to the brainstem. Following marsupialization of the cyst she improved remarkably in her symptoms. The symptoms recurred nine months later and investigations revealed recurrence of the cyst. The cyst was evacuated again and two Teflon sponge sheets were placed such that they traversed the length of the cyst cavity and extended into the cisterna magna. A...

  15. Endoscopic treatment of the suprasellar arachnoid cyst

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    Yadav Y

    2010-01-01

    Full Text Available Surgical options for suprasellar arachnoid cyst are cystoperitoneal shunt, craniotomy fenestration and endoscopic fenestration. Endoscopic management has been found to be safe and effective. We report our experience with endoscopic management in 12 (male five, female seven; age range 8 months to 42 years patients with suprasellar arachnoid cyst. The endoscopic procedure included lateral ventricle puncture by precoronal burr hole and superior and inferior wall of the cyst was communicated with the lateral ventricle and the interpeduncular cistern respectively. All patients had hydrocephalus. Four pediatric patients had macrocephaly. All adult patients had visual disturbances. One adult patient presented with psychomotor disturbance along with features of raised intracranial pressure. All cases improved following endoscopic treatment. There were no complications or death. One patient required VP shunt. Postoperative MRI showed significant reduction in cyst volume in 11 patients. Follow-up ranged from 6 months to 6 and a half years. Our study suggests that endoscopic technique is a safe and effective alternative treatment for suprasellar arachnoid cyst. It prevents complications such as subdural effusion and intracranial hematoma, which are not uncommon with craniotomy fenestration.

  16. Radiologic findings of intraspinal epidural arachnoid cyst

    International Nuclear Information System (INIS)

    To evaluate the radiologic findings of intraspinal epidural arachnoid cyst. Six patients with surgically proven intraspinal epidural arachnoid cyst were included in this study. Four were free of specific past history, but two had a history of trauma. All underwent examination by plain radiogr4aphy, CT-myelography and MRI, and the following aspects were retrospectively analysed:vertebral pressure erosion, interpedicular distance, enlargement of neural foramina, as seen on plain radiograph, contrast-filling and lateral bulging of lesions through neural foramina on CT-myelograph, and signal intensity, size and shape of margin and epidural fat pattern, as seen on MRI. Three of four congenital intraspinal epidural arachnoid cysts were single in the thoracolumbar region, while in the other case, there were multiple cysts in the mid-and lower thoracic regions. Cysts were equivaleut in size to between four and six vertebral bodies. Plain radiographic findings of pedicular pressure erosion, widened interpedicular distance, and bilateral neural foraminal enlargement of several contiguous vertebrae were observed in all four cases. One showed posterior vertebral scalloping. On CT-myelograph, a contrast-filled cystic lesion occupying the posterior epidural space, with lateral bulging through neural foramina and anterior displacement of the contrast-filled thecal sac, was seen. On MRI, longitudinally elongated, well-demarcated cysts were seen to be present in the posterior epidural space;their signal intensity was the same as in CSF. An epidural fat cap pattern enveloping the upper and lower ends of the cysts was apparent in all cases. In two cases, traumatic intraspinal epidural arachnoid cysts were situated in the thoracolumbar and lumbosacral region, respectively, near a previously injured region and were smaller (equivalent to the height of three vertebral bodies). CT-myelograph and MRI showed that their effect on the thecal sac was compressive only. When pressure erosion of

  17. Radiologic findings of intraspinal epidural arachnoid cyst

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    Oh, Jeong Kwon; Eun, Choong Ki; Jeon, Young Seup; Lee, Jong Yuk; Lee, Young Joon; Shim, Jae Hong [Inje Univ. College of Medicine, Pusan (Korea, Republic of); Choi, Soon Seup [Donga Univ. College of Medicine, Pusan (Korea, Republic of)

    1998-10-01

    To evaluate the radiologic findings of intraspinal epidural arachnoid cyst. Six patients with surgically proven intraspinal epidural arachnoid cyst were included in this study. Four were free of specific past history, but two had a history of trauma. All underwent examination by plain radiogr4aphy, CT-myelography and MRI, and the following aspects were retrospectively analysed:vertebral pressure erosion, interpedicular distance, enlargement of neural foramina, as seen on plain radiograph, contrast-filling and lateral bulging of lesions through neural foramina on CT-myelograph, and signal intensity, size and shape of margin and epidural fat pattern, as seen on MRI. Three of four congenital intraspinal epidural arachnoid cysts were single in the thoracolumbar region, while in the other case, there were multiple cysts in the mid-and lower thoracic regions. Cysts were equivaleut in size to between four and six vertebral bodies. Plain radiographic findings of pedicular pressure erosion, widened interpedicular distance, and bilateral neural foraminal enlargement of several contiguous vertebrae were observed in all four cases. One showed posterior vertebral scalloping. On CT-myelograph, a contrast-filled cystic lesion occupying the posterior epidural space, with lateral bulging through neural foramina and anterior displacement of the contrast-filled thecal sac, was seen. On MRI, longitudinally elongated, well-demarcated cysts were seen to be present in the posterior epidural space;their signal intensity was the same as in CSF. An epidural fat cap pattern enveloping the upper and lower ends of the cysts was apparent in all cases. In two cases, traumatic intraspinal epidural arachnoid cysts were situated in the thoracolumbar and lumbosacral region, respectively, near a previously injured region and were smaller (equivalent to the height of three vertebral bodies). CT-myelograph and MRI showed that their effect on the thecal sac was compressive only. When pressure erosion of

  18. Arachnoid cysts as a cause of dementia in the elderly

    International Nuclear Information System (INIS)

    Arachnoid intracranial cysts are benign lesions which until recently have been considered to be quite uncommon. They are benign congenital lesions usually discovered at an early age. We have recently treated two patients with advanced age and arachnoid cysts, unusual due to their location and extent. Both of them presented clinically with an organic dementia syndrome with some similarities to that seen in normal pressure hydrocephalus. Both recovered fully after surgery. We review the literature and try to emphasize the clinical differences between arachnoid and the more rare neuroepithelial cysts. (Author)

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... of this developing later on in life into cancer?” And, you know, my understanding is that there ... the encephalocele. Clearly, the arachnoid cyst is not cancer. This is a cyst, a bubble, a lining ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... that I’m sort of picking this filmy substance, this arachnoid, basically, off the carotid artery. This ... what’s the best way to address it. Our goals were to try to treat the cyst, treat ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... right a very large area of black empty space, which is an arachnoid cyst. And in listening ... again on the slide some arrows indicating the space I’m working on between the eye nerve, ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... an arachnoid cyst. And in listening to Dumanel’s history when we talk with him, it became apparent ... kind of work you see here on the screen, by opening the cyst up, by allowing it ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... on the right a very large area of black empty space, which is an arachnoid cyst. And ... could not be completely removed, what are the statistics that it could refill?” So when you were ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... of a frontal encephalocele and an arachnoid cyst. I’m John Meara from the Department of Plastic ... and David Walton from Partners in Health. Ed, I’m going to let you lead off, and ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... lose the pressure on his brain and hopefully cure the arachnoid cyst. When people are found to ... cysts fenestrated, have a lifetime or long-term cure, and about a quarter to a third end ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... frontal encephalocele and an arachnoid cyst. I’m John Meara from the Department of Plastic Surgery, and ... initially when Dumanel came to our attention. Actually, John Meara, who is here with us on our ...

  7. Fibromyalgia and arachnoiditis presented as an acute spinal disorder

    Directory of Open Access Journals (Sweden)

    Zamzuri Idris

    2014-01-01

    Full Text Available Background: Adhesive arachnoiditis is a chronic, insidious condition that causes debilitating intractable pain and a range of other neurological problems. Its pathophysiology is not well understood. This manuscript discusses its presentations, which can mimic an acute spinal disorder, its hypothetical pathophysiology, treatment, and its relationship with fibromyalgia. Case Description: The authors present a case of a 47-year-old female who presented with clinical features mimicking an acute spinal disorder but later found to have an adhesive arachnoiditis. She was admitted following a trauma with complaints of back pain and paraplegia. On examination, there was marked tenderness over thoracolumbar spine with lower limbs upper motor neuron weakness. An urgent magnetic resonance imaging (MRI of the spine revealed multiple lesions at her thoracic and lumbar spinal canals, which did not compress the spinal cord. Therefore, conservative management was initiated. Despite on regular therapies, her back and body pain worsened and little improvement in her limbs power was noted. Laminectomy was pursued and found to have spinal cord arachnoiditis. Subsequently, she was operated by other team members for multiple pelvic masses, which later proved to be benign. After gathering all the clinical information obtained at surgery and after taking detailed history inclusive of cognitive functions, diagnosis of an adhesive arachnoiditis syndrome was made. Currently, she is managed by neuropsychologist and pain specialist. Conclusion: This case report highlights the importance of knowing an adhesive arachnoiditis syndrome - a rarely discussed pathology by the neurosurgeon, which discloses a significant relationship between immune and nervous systems.

  8. Identification of an intraspinal arachnoidal cyst by CT

    International Nuclear Information System (INIS)

    Clarification of the subjective complaints caused by meningeal malformations represented by an arachnoidal cyst in the sacral region was achieved for the first time by analysing an arachnoidal cyst which had been determined by myelography, computed tomography, biopsy and histological examination. Principles of mechanics and dynamics play an important part. The pattern of complaints is mainly due to the communication between the cyst and the CSF space, as well as a valve mechanism with filling of the cyst. Surgical reduction or removal of the cyst, and elimination of the connection with the CSF, produced freedom from complaints. (orig.)

  9. Two cases of arachnoid cyst complicated by spontaneous intracystic hemorrhage

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    Gunduz Burak

    2010-01-01

    Full Text Available Arachnoid cysts are developmental anomalies which are usually asymptomatic. Intracystic hemorrhage after trauma is a well known complication; however, spontaneous intracystic hemorrhage is rare. This report presents two rare cases of arachnoid cyst complicated by spontaneous intracystic hemorrhage. The first patient was admitted following transient loss of consciousness and speech disturbance, and a subacute subdural hematoma at the left temporal region was diagnosed. The second patient presented with severe headache of four days duration and a subdural hematoma at the left temporoparietal region was diagnosed. In both the patients, both on radiological examination and during surgical intervention, hematomas were found to be intracystic.

  10. Cistos aracnóideos Arachnoidal cysts

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    Nelson Assis

    1970-06-01

    Full Text Available São relatados 3 casos de cistos aracnóideos em crianças, situando-se um deles na fossa posterior e os outros dois acima do tentório. Nos 3 pacientes havia sinais de hipertensão intracraniana de evolução crônica, não sendo observado, contudo, abaulamento diretamente relacionado com a localização do cisto. Em dois casos a etiologia do processo era provavelmente inflamatória e, congênita, em um. O tratamento cirúrgico foi empregado nos 3 casos, havendo resultado satisfatório em dois; o paciente com cisto localizado na fossa posterior faleceu quinze dias após a operação.Three cases of arachnoidal cysts in children are reported; one of them in the posterior fossa and the others located above the tentorium. In all of them chronic intracranial hypertension was present. However, there was no visible bulging of skull related to the cyst localization. In two cases the etiology of the cyst was probably inflammatory and congenital in one. Surgery was the treatment of choice; there was a good result in two cases and one patient deceased.

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... you and I were concerned about whether we should do this sequentially, whether you should deal with the arachnoid cyst and then wait ... be handled at first -- or at once, I should say. And I know that you spent some ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the defect between the nose, which is the hole where the brain came through on the image on the left, but we also found that Dumanel had a little bit of a surprise for us, and you see on the image on the right a very large area of black empty space, which is an arachnoid cyst. And ...

  13. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... Procedure to Treat Encephalocele and an Arachnoid Cyst Children's Hospital Boston, Boston, MA January 28, 2009 Welcome to this “OR-Live” webcast presentation, live from Children’s Hospital Boston, in Boston, Massachusetts. During the program ...

  14. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... an arachnoid cyst. And in listening to Dumanel’s history when we talk with him, it became apparent ... the risk of this developing later on in life into cancer?” And, you know, my understanding is ...

  15. Magnetic resonance cisternography for preoperative evaluation of arachnoid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Awaji, M. [Niigata University, Department of Radiology, Faculty of Medicine, Niigata (Japan); Okamoto, K. [Niigata University, Center for Integrated Human Brain Science, Brain Research Institute, Niigata (Japan); Nishiyama, K. [Niigata University, Department of Neurosurgery, Brain Research Institute, Niigata (Japan)

    2007-09-15

    With a high likelihood of clinical improvement and low rates of complications, minimally invasive neuroendoscopic surgery is becoming the treatment of choice for symptomatic or growing arachnoid cysts. In neuroendoscopic surgery, visualization of anatomical landmarks is essential in achieving successful fenestration without complications. Because of the restricted visual field in neuroendoscopic surgery, preoperative anatomical assessment is very helpful. Magnetic resonance cisternography (MRC) with high spatial resolution and contrast, using for example 3-D Fourier transformation constructive interference in steady state (CISS) or fast imaging employing steady-state acquisition (FIESTA) sequences, is able to detect the arachnoid cyst wall and neighboring anatomical structures as the anatomical landmarks. We retrospectively reviewed T2-weighted (T2-W) fast spin-echo images, and the MRC and intraoperative findings. Axial and coronal T2-W images (6 and 3 mm thickness, respectively) and axial and coronal 0.8 mm thick MRC images with CISS or FIESTA were obtained from four patients with arachnoid cysts treated by neuroendoscopic surgery. Intraoperative findings were reviewed on videotape recorded during the procedures. At the brain surface, the arachnoid cyst wall could be detected clearly in any of the four patients on MRC images, and was only partly seen in the fourth patient T2-W images. Adjacent important anatomical structures including vessels and cranial nerves, and an enough space for cystocisternostomy were identified on MRC images, and the findings were consistent with the findings during neuroendoscopic surgery. Preoperative identification of the arachnoid cyst wall and surrounding anatomical structures by MRC may help avoid complications and allow safer neuroendoscopic surgery. (orig.)

  16. Arachnoid cyst in a patient with psychosis: Case report

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    Guimarães João

    2007-06-01

    Full Text Available Abstract Background The aetiology of a psychotic disturbance can be due to a functional or organic condition. Organic aetiologies are diverse and encompass organ failures, infections, nutritional deficiencies and space-occupying lesions. Arachnoid cysts are rare, benign space-occupying lesions formed by an arachnoid membrane containing cerebrospinal fluid (CSF. In most cases they are diagnosed by accident. Until recently, the coexistence of arachnoid cysts with psychiatric disturbances had not been closely covered in the literature. However, the appearance of some references that focus on a possible link between arachnoid cysts and psychotic symptoms has increased the interest in this subject and raised questions about the etiopathogeny and the therapeutic approach involved. Clinical presentation We present the clinical report of a 21-year-old man, characterised by the insidious development of psychotic symptoms of varying intensity, delusional ideas with hypochondriac content, complex auditory/verbal hallucinations in the second and third persons, and aggressive behaviour. The neuroimaging studies revealed a voluminous arachnoid cyst at the level of the left sylvian fissure, with a marked mass effect on the left temporal and frontal lobes and the left lateral ventricle, as well as evidence of hypoplasia of the left temporal lobe. Despite the symptoms and the size of the cyst, the neurosurgical department opted against surgical intervention. The patient began antipsychotic therapy and was discharged having shown improvement (behavioural component, but without a complete remission of the psychotic symptoms. Conclusion It is difficult to be absolutely certain whether the lesion had influence on the patient's psychiatric symptoms or not. However, given the anatomical and neuropsychological changes, one cannot exclude the possibility that the lesion played a significant role in this psychiatric presentation. This raises substantial problems when it

  17. Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports

    OpenAIRE

    Pillai Promod; Menon Sajesh K; Manjooran Raju P; Kariyattil Rajiv; Pillai Ashok B; Panikar Dilip

    2009-01-01

    Abstract Introduction Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hemat...

  18. Perineural arachnoidal gliomatosis: case report Gliomatose aracnoidal perineural: relato de caso

    OpenAIRE

    Luciano de Sousa Pereira; Timothy James McCulley

    2008-01-01

    Gliomas are the most common infiltrative neoplasms of the optic nerve and can present as two distinct growth patterns: intraneural glial proliferation and perineural arachnoidal gliomatosis (PAG). It has been suggested that perineural arachnoidal gliomatosis is seen almost exclusively in the setting of neurofibromatosis type 1 (NF1). We describe a child with perineural arachnoidal gliomatosis occurring without neurofibromatosis type 1, supported by both radiographic and histological findings....

  19. The Specific Sagittal Magnetic Resonance Imaging of Intradural Extra-Arachnoid Lumbar Disc Herniation

    OpenAIRE

    Tatsuro Sasaji; Kiyoshi Horaguchi; Noboru Yamada; Kazuo Iwai

    2012-01-01

    Intradural extra-arachnoid lumbar disc herniation is a rare disease. Few MRI findings have been reported. We experienced an intradural extra-arachnoid lumbar disc herniation. We reviewed the preoperative MRI findings. Lumbar spine T2-weighted sagittal MRI showed that one line of the ventral dura was divided into two by a disc herniation. We speculated that the two lines comprised the dura and arachnoid and that a disc herniation existed between them. We believe that division of the ventral du...

  20. Spinal arachnoiditis as a consequence of aneurysm-related subarachnoid haemorrhage

    International Nuclear Information System (INIS)

    Only a few case reports currently exist regarding symptomatic spinal arachnoiditis following aneurysm-related subarachnoid haemorrhage. We present three patients who developed symptomatic spinal arachnoiditis following spontaneous aneurysm rupture. Following initial aneurysm and subarachnoid haemorrhage management (including ventriculo-peritoneal shunt placement), all three patients developed gradually worsening neurological abnormalities, and subsequent imaging demonstrated spinal arachnoiditis. Despite spinal decompression, all three patients experienced progressively worsening neurological decline.

  1. Coexistence of Epileptic Nocturnal Wanderings and an Arachnoid Cyst

    OpenAIRE

    Jiménez-Genchi, Alejandro; Díaz-Galviz, John L.; García-Reyna, Juan Carlos; Ávila-Ordoñez, Mario U.

    2007-01-01

    Episodic nocturnal wanderings (ENWs) have rarely been associated with gross abnormalities of brain structures. We describe the case of a patient with ENWs in coexistence with an arachnoid cyst (AC). The patient was a 15-year-old boy who presented with nocturnal attacks characterized by complex motor behaviors. An MRI revealed a left temporal cyst and a SPECT Tc99 scan showed left temporal hypoperfusion and bilateral frontal hyperperfusion, more evident on the right side.

  2. Recent advances in diagnostic approaches for sub-arachnoid hemorrhage

    OpenAIRE

    Kumar, Ashish; Kato, Yoko; Hayakawa, Motoharu; Junpei, ODA; Watabe, Takeya; Imizu, Shuei; Oguri, Daikichi; Hirose, Yuichi

    2011-01-01

    Sub-arachnoid hemorrhage (SAH) has been easily one of the most debilitating neurosurgical entities as far as stroke related case mortality and morbidity rates are concerned. To date, it has case fatality rates ranging from 32-67%. Advances in the diagnostic accuracy of the available imaging methods have contributed significantly in reducing morbidity associated with this deadly disease. We currently have computed tomography angiography (CTA), magnetic resonance angiography (MRA) and the digit...

  3. Computed tomography of a post traumatic spinal arachnoid cyst

    International Nuclear Information System (INIS)

    We decribe the CT findings of a cervical arachnoid cyst with haemorrhagic contents, that was diagnosed after trauma and which clinically presented itself as a high spinal cord compression syndrome. In our case, the diagnosis was only possible by means of CT-myelography, which displayed a haemorrhagic closed pouch in the cervical subarachnoid space, thus changing our initial neuroradiological suggestion of epidural haematoma, made because of its location and shape. (orig.)

  4. Computed tomography of a post traumatic spinal arachnoid cyst

    Energy Technology Data Exchange (ETDEWEB)

    Teruel Agustin, J.J.; Gomez Martinench, E.; Castanyer Corretger, F.; Cando Salcines, L.; Davalos Errando, A.

    1989-09-01

    We decribe the CT findings of a cervical arachnoid cyst with haemorrhagic contents, that was diagnosed after trauma and which clinically presented itself as a high spinal cord compression syndrome. In our case, the diagnosis was only possible by means of CT-myelography, which displayed a haemorrhagic closed pouch in the cervical subarachnoid space, thus changing our initial neuroradiological suggestion of epidural haematoma, made because of its location and shape. (orig.).

  5. Arachnoid nodules in the lungs of high altitude Indians.

    OpenAIRE

    Heath, D.; Williams, D

    1993-01-01

    BACKGROUND--Nodules of cells showing a striking histological similarity to those of arachnoid villi have previously been found closely adjacent to pulmonary venules in several diseases associated with alveolar hypoxia or pulmonary oedema including mitral stenosis, plexogenic pulmonary arteriopathy, pulmonary thromboembolism, and chronic obstructive pulmonary disease. METHODS--Histological sections of the lungs of seven adult native highlanders from La Paz (3600 m) were examined. RESULTS--Arac...

  6. Acute respiratory failure as a manifestation of an arachnoid cyst

    OpenAIRE

    Pillai Lalitha; Achari Gopal; Desai Sanjay; Patil Vinayak

    2008-01-01

    Arachnoid cysts are the most common congenital cystic lesions in the brain occurring in the middle fossa, suprasellar region and occasionally in the posterior fossa. Conventionally all cysts are considered as benign and symptoms are attributed to expansion of cysts causing compression of adjacent neurological structures, bleeds within the cyst or due to the development of acute hydrocephalus. We are reporting this case of a 15-year-old female patient with non-progressive weakness in the limbs...

  7. Spontaneous Arachnoid Cyst Rupture with Subdural Hygroma in a Child.

    Science.gov (United States)

    Khilji, Muhammad Faisal; Jeswani, Niranjan Lal; Hamid, Rana Shoaib; Al Azri, Faisal

    2016-01-01

    Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing's reflex and papilledema of left eye. MRI (magnetic resonance imaging) of the brain showed left temporal extra-axial cystic lesion of 5.40 × 4.10 cm in size, representing arachnoid cyst, with bilateral frontoparietal subdural hygromas. Cyst was partially drained through left temporal craniectomy and subdural hygromas were drained through bilateral frontal burr holes. Postoperatively the child recovered uneventfully and was discharged on the seventh postoperative day. Histopathology proves it to be arachnoid cyst of the brain with subdural CSF (cerebrospinal fluid) collection or hygroma. PMID:26989525

  8. The Specific Sagittal Magnetic Resonance Imaging of Intradural Extra-Arachnoid Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Tatsuro Sasaji

    2012-01-01

    Full Text Available Intradural extra-arachnoid lumbar disc herniation is a rare disease. Few MRI findings have been reported. We experienced an intradural extra-arachnoid lumbar disc herniation. We reviewed the preoperative MRI findings. Lumbar spine T2-weighted sagittal MRI showed that one line of the ventral dura was divided into two by a disc herniation. We speculated that the two lines comprised the dura and arachnoid and that a disc herniation existed between them. We believe that division of the ventral dural line on T2-weighted sagittal images is a characteristic finding of intradural extra-arachnoid lumbar disc herniation. The division of ventral dural line seemed to be a “Y,” and, thus, we called it the “Y sign.” The “Y sign” may be useful for diagnosing intradural extra-arachnoid lumbar disc herniation.

  9. Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusion-weighted MRI useful?

    International Nuclear Information System (INIS)

    Appropriate differentiation between epidermoid-dermoid and arachnoid cysts is important for patient management. MRI has had limitations in differentiating these two types of cysts, especially in the region of the spinal cord. To evaluate the role of diffusion-weighted (DW) MRI for differentiation between spinal arachnoid and epidermoid-dermoid cysts. Four children underwent conventional and DW MRI. Turbo spin-echo imaging was used to obtain DW images. On conventional MRI, low T1-W and high T2-W signal was present in all lesions. DW imaging showed restricted diffusion in two patients with epidermoid-dermoid cysts and no water restriction in two patients with arachnoid cysts. Three of four children had extramedullary lesions and one patient had an intramedullary lesion. Three children had surgery, two with epidermoid-dermoid cysts and one with arachnoid cyst. Diagnosis was confirmed by histopathology. One child with a thoracic arachnoid cyst had stable clinical imaging findings during a follow-up of 21 months. On conventional MRI, epidermoid-dermoid and arachnoid cysts have similar signal characteristics. Initial experience with spine DW imaging shows promise in differentiating epidermoid-dermoid cysts from arachnoid cysts. Preoperative differentiation is important because it changes management and surgical approach. (orig.)

  10. Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusion-weighted MRI useful?

    Energy Technology Data Exchange (ETDEWEB)

    Kukreja, Kamlesh [Miami Children' s Hospital, Department of Radiology, Miami, FL (United States); Manzano, Glen; Ragheb, John [Miami Children' s Hospital and University of Miami, Department of Neurological Surgery, Miami, FL (United States); Santiago Medina, L. [Miami Children' s Hospital, Health Outcomes, Policy and Economics (HOPE) Center, Department of Radiology, Miami, FL (United States)

    2007-06-15

    Appropriate differentiation between epidermoid-dermoid and arachnoid cysts is important for patient management. MRI has had limitations in differentiating these two types of cysts, especially in the region of the spinal cord. To evaluate the role of diffusion-weighted (DW) MRI for differentiation between spinal arachnoid and epidermoid-dermoid cysts. Four children underwent conventional and DW MRI. Turbo spin-echo imaging was used to obtain DW images. On conventional MRI, low T1-W and high T2-W signal was present in all lesions. DW imaging showed restricted diffusion in two patients with epidermoid-dermoid cysts and no water restriction in two patients with arachnoid cysts. Three of four children had extramedullary lesions and one patient had an intramedullary lesion. Three children had surgery, two with epidermoid-dermoid cysts and one with arachnoid cyst. Diagnosis was confirmed by histopathology. One child with a thoracic arachnoid cyst had stable clinical imaging findings during a follow-up of 21 months. On conventional MRI, epidermoid-dermoid and arachnoid cysts have similar signal characteristics. Initial experience with spine DW imaging shows promise in differentiating epidermoid-dermoid cysts from arachnoid cysts. Preoperative differentiation is important because it changes management and surgical approach. (orig.)

  11. [Suprasellar arachnoid cyst--report of a case (author's transl)].

    Science.gov (United States)

    Takahashi, T; Kawai, S; Kaminoh, T; Hiramatsu, K; Maekawa, M; Yuasa, T; Miyamoto, N; Hattori, Y

    1982-04-01

    A 4-year-old boy with suprasellar arachnoid cyst was reported. At the age of 30-month-old his aunt was aware of his squint. During the observation by ophthalmologists from the age of 1y. to 3y., enlargement of the head and impairment of the visual acuity were manifested. Cranial CT scan revealed the enlargement of the ventricular system and a round low density area located superior to the sella. Absorption coefficient of the lesion was similar to that of the cerebrospinal fluid. No abnormal contrast enhancement was seen. Examination revealed the head circumference of 53.3 cm larger than doubled standard deviation, the right external strabismus, impaired vision (R:0.03, L:0.3) and optic atrophy but no other neurological signs. Cerebral angiography showed suprasellar mass lesion. After the ventriculography with water-soluble contrast medium, V-P shunt operation was performed and then the patient was transferred to the CT room. CSF enhanced CT scan showed no communication between the ventricles and the cyst. By frontotemporal approach, microsurgical removal of the cystwall was performed and the histological diagnosis was arachnoid membrane. Several days after the operation, bilateral subdural effusion was seen on CT scan and was treated with bilateral S-P shunt and the removal of V-P shunt. Follow up CT scan disclosed the disappearance of the subdural effusion and the suprasellar cyst. The visual acuity was improved well and the endocrinological study was normal. Analysis of the 45 reported cases of suprasellar arachnoid cyst suggested that direct removal of the cyst wall is better than the V-P shunt operation and the cyst shunting is advisable for repeat recurrence of the cyst. Removal of the ventricular shunting system may be effective for the prevention of the subdural effusion as a complication after direct operation. PMID:7099383

  12. Arachnoid granulations may control heat exchange between intracranial dural sinuses and cerebrospinal fluid

    Directory of Open Access Journals (Sweden)

    Abdullah Kaya

    2013-02-01

    Full Text Available Selective brain cooling is a system in a human that protects the brain from hyperthermia. Cool venous blood from head skin and upper respiratory tract drains into intracranial dural sinuses. In that region, cool blood in the dural sinuses decreases the temperature of the cerebrospinal fluid. Cerebrospinal fluid provides brain cooling. All cortical arteries to the brain pass the cerebrospinal fluid compartment. Also cerebrospinal fluid washes cortical nervous tissue. To provide optimal temperature for the brain cortex, heat exchange between cerebrospinal fluid and venous blood in dural sinuses should be well controlled. Head skin is in direct contact with the outside, and significant heat exchanges may occur within dural sinuses. A barrier made of dura mater and arachnoid mater has been proposed to transmit heat from dural sinuses to the cerebrospinal fluid. However, this barrier is a mechanical barrier and can’t optimize the temperature of cerebrospinal fluid. Also it has two laminas (dura mater and arachnoid mater and dura mater has a high vascularization. Therefore, this barrier may obstruct heat exchange. In this hypothetical paper, I offer arachnoid granulations as a functional barrier for heat exchange between blood in dural sinuses and cerebrospinal fluid. Arachnoid granulations are invaginations of arachnoid mater to the dural sinuses. Cerebrospinal fluid passes to the dural sinuses via arachnoid granulations. An arachnoid granulation provides a very thin wall between two compartments and may transmit heat effectively. Also arachnoid granulations may control cerebrospinal fluid flow to the dural sinuses according to temperature differences between two compartments. It is worth researching whether there are any functional or histological differences of the arachnoid granulations between people living in cold and hot places. There may also be an association between pathologies such as migraine and pseudotumor cerebri and this possible

  13. Spontaneous Arachnoid Cyst Rupture with Subdural Hygroma in a Child

    OpenAIRE

    Muhammad Faisal Khilji; Niranjan Lal Jeswani; Rana Shoaib Hamid; Faisal Al Azri

    2016-01-01

    Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing’s reflex and papilledema of left eye. MRI (ma...

  14. [Suprasellar arachnoid cyst associated with syringomyelia. Case report].

    Science.gov (United States)

    Sleiman, M; Assaker, R; Bourgeois, P; Lejeune, J P; Soto-Ares, G

    2000-02-01

    We present a case of suprasellar arachnoid cyst which was revealed by visual impairement and hypopituitarism. Neuroradiological imaging showed the peculiar association of the suprasellar cyst with cerebellar tonsillar herniation and a large asymptomatic cervical syringomyelic cavity. Surgical treatment of the suprasellar cyst allowed the reduction of both the cyst and the syrinx. A common pathophysiological mechanism of these lesions is discussed. We suggest the possibility that an initial obstruction of the basal cisterns caused the suprasellar cyst formation which led to medullar cavity formation. PMID:10790641

  15. Iatrogenic intradural arachnoid cyst following tethered cord release in a child.

    Science.gov (United States)

    Glenn, Chad A; Bonney, Phillip; Cheema, Ahmed A; Conner, Andrew K; Gross, Naina L; Yaun, Amanda L

    2016-02-01

    Iatrogenic arachnoid cysts represent uncommon complications of intradural spinal procedures. Here we present the case of a 7-year-old girl who was found to have a symptomatic, pathologically proven, intradural arachnoid cyst 3 years following tethered cord release. The patient originally presented with abnormal urodynamics testing and was found to have fatty infiltration in her filum terminale. She underwent sectioning of the filum terminale without complications. The patient presented 3 years later with pain and neurogenic claudication. The patient was successfully treated with subarachnoid cyst fenestration with resolution of her bilateral lower extremity pain. Spinal intradural arachnoid cysts represent an important, though rare, postoperative complication of dural opening. PMID:26602801

  16. [Arachnoid cyst associated with pyloric stenosis in a young boy].

    Science.gov (United States)

    Diaconescu, Smaranda; Păduraru, Gabriela; Bărbuţă, O; Vâscu, B; Lupu, V V; Burlea, M; Aprodu, G

    2010-01-01

    An unusual association between an arachnoid cyst and a decompensated pyloric stenosis in a three years-old boy is presented. The little patient was admitted into hospital with haematemesis, melena, influenced generally condition and acute posthemorrhagic anaemia following aspirin intake for hypertermia. Specific intensive care was successful and the little patient was discharged but without an upper digestive endoscopy(parents refusal, technical reasons). After one week he returned with progressive worsening vomitings and an intracranial hypertension was suspected. CT documented an arachnoid cyst in the right middle cranial fossa and the patient is directed to the Neurosurgical Clinic where a cyst fenestration was done. Subsequent to operation the vomitings reinstaled with severe dehydration and an upper GI series showed a decompensated pyloric stenosis. He was operated on underwenting an antrectomy. Finally the child recovered with good short and long-term evolution. The coincidental presence of an intracranial congenital mass and a complicated aspirin-induced peptic ulcer in this young patient, misleaded us and in the lack of an early endoscopy an intempestive neurosurgical operation was initially done. PMID:21500459

  17. CT and MRI findings of a spinal arachnoid cyst

    International Nuclear Information System (INIS)

    A 39-year-old woman developed progressive difficulty in walking and urination over one year and 9 months. Her past history included a hystero-oophorectomy because of ''infection;'' the operation had been done under lumbar anesthesia. At the time of admission to our hospital, her legs were markedly spastic, with increased knee and ankle jerks as well as bilateral Babinski signs. Sensation to pain was slightly decreased bilaterally at and below Th4. Myelography through a suboccipital tap and CT myelography demonstrated a block of the CSF space at Th6. The spinal cord was displaced and became thin at and below Th1, secondary to an enlarged CSF space. Horizontal MRI demonstrated similar findings; however, sagittal MRI showed that the cord had been displaced and had collapsed; in addition, an abnormally enlarged CSF space indicated a subdural arachnoid cyst. MRI has thus been shown to be a very useful tool in the diagnosis of a spinal arachnoid cyst as well as other spinal-cord diseases. (author)

  18. Anatomic relationship between arachnoid granulations in the transverse sinus and the termination of the vein of Labbe: an angiographic study

    International Nuclear Information System (INIS)

    We studied the anatomic relationship between arachnoid granulations in the transverse sinus and the termination of the vein of Labbe in 57 consecutive angiograms. Patients with pathology in intracranial venous structures or with inadequate image quality of the venous system were excluded. Arachnoid granulations were found in 12 of the 57 patients (21.1 %), always at the junction of the vein of Labbe and the transverse sinus; the vein of Labbe was present in 55 patients (96.5 %), most often without associated arachnoid granulations; the latter, however, were not observed in the absence of a vein of Labbe. This study confirms the close, constant anatomic relationship between arachnoid granulations in the transverse sinus and the termination of the vein of Labbe. This observation may help to differentiate arachnoid granulations from pathologic conditions involving the transverse sinus such as dural sinus thrombosis. The constant character of this relationship suggests a developmental role of afferent veins in the formation of arachnoid granulations. (orig.)

  19. Giant Spiders of Venus - Redefinition, Revised Population, and Implications of Formational Processes of Arachnoids

    Science.gov (United States)

    Kostama, V.-P.; Törmänen, T.

    2007-03-01

    The large population of volcano-tectonic structures is characteristical to the surface of Venus. In addition to the well studied coronae, there are other smaller groups of features, such as the arachnoids.

  20. Large intradural craniospinal arachnoid cyst: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Souvagya Panigrahi

    2012-01-01

    Full Text Available Presence of an arachnoid cyst at craniospinal junction is not very common. This is a very rare anatomic site, with only seven other cases reported in the literature. We report a case of large intradural craniospinal arachnoid cyst presenting with obstructive hydrocephalus and cranial nerve palsy. A 39-year-old male presented with 8-month history of neck pain, headache, vomiting, visual disturbances, diminished taste sensation, and numbness of face. He had bilateral papilledema on ophthalmoscopy. Magnetic resonance imaging (MRI revealed a posterior fossa arachnoid cyst extending down to the lower border of C5 vertebra. Posterior decompression was done through C5 laminectomy. He made a full recovery and was asymptomatic at 6-month follow-up examination. The clinical features, diagnosis, and management of these rare craniospinal arachnoid cysts are discussed.

  1. Large intradural craniospinal arachnoid cyst: A case report and review of literature

    OpenAIRE

    Souvagya Panigrahi; Sudhansu Sekhar Mishra; Srikant Das; Sunil Kumar Patra; Pratap Chandra Satpathy

    2012-01-01

    Presence of an arachnoid cyst at craniospinal junction is not very common. This is a very rare anatomic site, with only seven other cases reported in the literature. We report a case of large intradural craniospinal arachnoid cyst presenting with obstructive hydrocephalus and cranial nerve palsy. A 39-year-old male presented with 8-month history of neck pain, headache, vomiting, visual disturbances, diminished taste sensation, and numbness of face. He had bilateral papilledema on ophthalmosco...

  2. Acute Onset of Psychosis in a Patient with a Left Temporal Lobe Arachnoid Cyst

    OpenAIRE

    Alexander Mironov; Sabu John; Jonathan Auerbach; Ghassan Jamaleddine

    2014-01-01

    Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. A 38-year-old Haitian American female with no past psychiatric history presented with rapid onset of psychosis. Workup for medical etiology proved to be within normal limits, with the exception of a left temporal lobe arachnoid cyst. The purpose of this paper is to add to a number of existing case reports that suggest a relationship between such lesions and psychiatric illness.

  3. Acute Onset of Psychosis in a Patient with a Left Temporal Lobe Arachnoid Cyst

    Directory of Open Access Journals (Sweden)

    Alexander Mironov

    2014-01-01

    Full Text Available Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. A 38-year-old Haitian American female with no past psychiatric history presented with rapid onset of psychosis. Workup for medical etiology proved to be within normal limits, with the exception of a left temporal lobe arachnoid cyst. The purpose of this paper is to add to a number of existing case reports that suggest a relationship between such lesions and psychiatric illness.

  4. A rare case of suprasellar arachnoid cyst with giant perimesencephalic and mesial temporal extension - physiopathological mechanisms

    Directory of Open Access Journals (Sweden)

    Turliuc Dana Mihaela

    2016-03-01

    Full Text Available The arachnoid cyst is a lesion commonly encountered in neurosurgery, especially in pediatric pathology. We are presenting the case of an adult patient with a suprasellar arachnoid cyst with giant perimesencephalic and mesial temporal extension discovered incidentally, where there is a discrepancy between the spectacular neuroimaging and the non-specific symptomatology. Some of the physiopathological mechanisms which led to the evolution of the cyst will also be presented.

  5. Magnetic resonance imaging and computed tomography characteristics of intracranial intra-arachnoid cysts in 6 dogs

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) and computed tomographic imaging (CT) characteristics of intracranial intra-arachnoid cysts in six dogs are described. Of the six dogs, three were less than one year of age and 4 were males. Five of the six dogs weighed less than 11 kg. Five cysts were located in the quadrigeminal cistern. On CT images, the intracranial intra-arachnoid cysts had sharply defined margins, contained fluid isodense to CSF and did not enhance following i.v. administration of contrast. On MRI images, the intracranial intra-arachnoid cysts were extra-axial, contained fluid isointense with CSF and did not enhance following i.v. contrast. While spinal arachnoid cysts of dogs have been reported in the literature, other than the six dogs contained in this report, intracranial intra-arachnoid cysts have not to our knowledge been described in animals. These six dogs have a similar age, sex, history, clinical signs, CT and MRI findings to those reported in people with intracranial intra-arachnoid cysts

  6. [A case of suprasellar arachnoid cyst followed up for a long time].

    Science.gov (United States)

    Kaisho, Y; Miyazaki, S; Shimo-oku, M; Hayashi, T; Tani, E

    1995-01-01

    We followed a case of suprasellar arachnoid cyst for 12 years. The patient was a sixteen-year-old girl without particular problems in her general condition. She showed optic atrophy in both eyes and optic nerve hypoplasia with an inferotemporal quandranopsia in the left eye. A suprasellar arachnoid cyst communicating with the tubarachnoid space was found to extend into the sella turcica as an empty sella. A cyst wall was resected and a cyst-peritoneal shunt performed. After 12 years from the operation, sensitivity was slightly depressed in the visual field where it had already been disturbed. Although there are few reports in the literature on involvement of the optic nerves and chiasma by suprasellar arachnoid cysts, papilledema and optic atrophy are often found in children, and infero-temporal quandranopsia or homonymous hemianopsia have been reported. Visual field defects were most likely caused by compression of the optic nerve by cyst or prolonged papilledema. We also suspect that some kind of disturbance to the optic nerve occurred during extension of the arachnoid cyst as an empty sella, or during formation of arachnoid cyst in the fetus stage. PMID:7887322

  7. Cauda equina syndrome after spinal anaesthesia in a patient with asymptomatic tubercular arachnoiditis

    Directory of Open Access Journals (Sweden)

    Divya Sethi

    2011-01-01

    Full Text Available A 14-year-old boy underwent emergency debridement surgery of right foot under spinal anaesthesia. Four hours after the surgery, the patient developed symptoms of cauda equina syndrome (CES. Postoperative magnetic resonance imaging of the patient′s spine suggested underlying tubercular arachnoiditis. The boy was started on intravenous methylprednisolone and antitubercular therapy. He responded to the therapy and recovered completely in 2 weeks without any residual neurological deficits. We suggest that underlying pathological changes in the subarachnoid space due to tubercular arachnoiditis contributed to maldistribution of the local anaesthetic drug leading to CES.

  8. Acute respiratory failure as a manifestation of an arachnoid cyst

    Directory of Open Access Journals (Sweden)

    Pillai Lalitha

    2008-01-01

    Full Text Available Arachnoid cysts are the most common congenital cystic lesions in the brain occurring in the middle fossa, suprasellar region and occasionally in the posterior fossa. Conventionally all cysts are considered as benign and symptoms are attributed to expansion of cysts causing compression of adjacent neurological structures, bleeds within the cyst or due to the development of acute hydrocephalus. We are reporting this case of a 15-year-old female patient with non-progressive weakness in the limbs since the age of seven years who presented with acute onset syncopal attacks and respiratory failure. She was intubated and ventilated. An magnetic resonance imaging scan showed large posterior fossa cyst extending up to mid second cervical vertebra causing compression of the medulla and pons, with mild hydrocephalus. After a failed attempt to wean her from the ventilator a cysto peritoneal shunt surgery was performed following which she was weaned from the ventilator successfully. Weakness in the upper and lower limbs, which had increased in the preceding month, also improved following the surgery.

  9. Extensive arachnoid ossification with associated syringomyelia presenting as thoracic myelopathy. Case report and review of the literature.

    Science.gov (United States)

    Slavin, K V; Nixon, R R; Nesbit, G M; Burchiel, K J

    1999-10-01

    The authors present the case of progressive thoracic myelopathy caused by the extensive ossification of the arachnoid membrane and associated intramedullary syrinx. Based on their findings and results of the literature search, they describe a pathological basis for this rare condition, discuss its incidence and symptomatology, and suggest a simple classification for various types of the arachnoid ossification. They also discuss the magnetic resonance imaging features of arachnoid ossification and associated spinal cord changes. The particular value of plain computerized tomography, which is highly sensitive in revealing intraspinal calcifications and ossifications, in the diagnostic evaluation of patients with a clinical picture of progressive myelopathy is emphasized. PMID:10505510

  10. Giant arachnoid granulation mimicking dural sinus thrombosis in a boy with headache: MRI

    International Nuclear Information System (INIS)

    We report MRI and angiographic findings of an unusual giant arachnoid granulation in the left sigmoid sinus in a boy with headache. Its signal intensity was lower than that of cerebral cortex on T1-weighted images and higher on T2 weighting, mimicking dural sinus thrombosis. (orig.)

  11. Differential diagnosis of arachnoid cyst from subarachnoid space enlargement by phase-contrast cine MRI

    Institute of Scientific and Technical Information of China (English)

    于群; 孔祥泉; 刘定西

    2003-01-01

    Objectives To reveal the relationship of brain motion and cerebrospinal fluid (CSF) flow by phase-contrast cine MRI, and to evaluate this technique in differentiating between arachnoid cysts and subarachnoid space enlargement. Methods Using a phase-contrast cine MRI pulse sequence, we measured brain motion and CSF flow during the cardiac cycle in 10 healthy volunteers and 10 patients with MRI-suspected arachnoid cyst or subarachnoid space enlargement. CSF stroke volume curve was illustrated according to flow quantification, and time-signal intensity curve was traced. The two curves were compared. Results This study showed that brain motion was due to the volume difference between arterial and venous blood flow during a cardiac cycle, and thus drives CSF pulsation. Arachnoid cysts and subarachnoid space enlargement carried different curve patterns, demonstrating that phase-contrast MRI and flow quantification can be a useful and reliable technique for non-invasive evaluation of brain motion and CSF flow. Conclusion Arachnoid cysts can be successfully differentiated using phase-contrast cine MRI from subarachnoid space enlargement.

  12. [Postoperative lumbar extradural arachnoid cyst. Report of two cases and review of the literature].

    Science.gov (United States)

    Uchibori, M; Kinuta, Y; Koyama, T

    1984-04-01

    Two cases of postoperative extradural arachnoid cyst in the lumbar region were reported. The symptoms such as lumbago, sciatica and paresis of foot which were perfectly cured at discharge relapsed after several months of daily business. The two patients were readmitted and reexamined by myelography and computer assisted tomography. In the two patients a cystic pooling of metrizamide having a connection with the subarachnoid space was noted in the same way. At the second operation a small dural tear and an extradural arachnoid cyst were recognized similarly. Burres and coworkers reported that an extradural arachnoid cyst would easily grow through a small dural defect in the lumbar region, because the hydrostatic pressure is higher than that of the cervical level. Our two cases might well coincident with their theory. In consequence of the experience of the two postoperative extradural arachnoid cyst, we give emphasis that even though the dural tear would be small, especially in the lumbar region, it should not be overlooked and be closed carefully with fine sutures. PMID:6235458

  13. A quantitative method for estimation of volume changes in arachnoid foveae with age.

    Science.gov (United States)

    Duray, Stephen M; Martel, Stacie S

    2006-03-01

    Age-related changes of arachnoid foveae have been described, but objective, quantitative analyses are lacking. A new quantitative method is presented for estimation of change in total volume of arachnoid foveae with age. The pilot sample consisted of nine skulls from the Palmer Anatomy Laboratory. Arachnoid foveae were filled with sand, which was extracted using a vacuum pump. Mass was determined with an analytical balance and converted to volume. A reliability analysis was performed using intraclass correlation coefficients. The method was found to be highly reliable (intraobserver ICC = 0.9935, interobserver ICC = 0.9878). The relationship between total volume and age was then examined in a sample of 63 males of accurately known age from the Hamann-Todd collection. Linear regression analysis revealed no statistically significant relationship between total volume and age, or foveae frequency and age (alpha = 0.05). Development of arachnoid foveae may be influenced by health factors, which could limit its usefulness in aging. PMID:16566755

  14. Recent advances in diagnostic approaches for sub-arachnoid hemorrhage.

    Science.gov (United States)

    Kumar, Ashish; Kato, Yoko; Hayakawa, Motoharu; Junpei, Oda; Watabe, Takeya; Imizu, Shuei; Oguri, Daikichi; Hirose, Yuichi

    2011-07-01

    Sub-arachnoid hemorrhage (SAH) has been easily one of the most debilitating neurosurgical entities as far as stroke related case mortality and morbidity rates are concerned. To date, it has case fatality rates ranging from 32-67%. Advances in the diagnostic accuracy of the available imaging methods have contributed significantly in reducing morbidity associated with this deadly disease. We currently have computed tomography angiography (CTA), magnetic resonance angiography (MRA) and the digital subtraction angiography (DSA) including three dimensional DSA as the mainstay diagnostic techniques. The non-invasive angiography in the form of CTA and MRA has evolved in the last decade as rapid, easily available, and economical means of diagnosing the cause of SAH. The role of three dimensional computed tomography angiography (3D-CTA) in management of aneurysms has been fairly acknowledged in the past. There have been numerous articles in the literature regarding its potential threat to the conventional "gold standard" DSA. The most recent addition has been the introduction of the fourth dimension to the established 3D-CT angiography (4D-CTA). At many centers, DSA is still treated as the first choice of investigation. Although, CT angiography still has some limitations, it can provide an unmatched multi-directional view of the aneurysmal morphology and its surroundings including relations with the skull base and blood vessels. We study the recent advances in the diagnostic approaches to SAH with special emphasis on 3D-CTA and 4D-CTA as the upcoming technologies. PMID:22347331

  15. Population study of Pyxis arachnoides brygooi (Vuillemin & Domergue, 1972 in the area surrounding the Village des Tortues, Ifaty-Mangily, southwest Madagascar

    Directory of Open Access Journals (Sweden)

    Tantelinirina Rakotondriamanga

    2011-06-01

    Full Text Available The Madagascar spider tortoise (Pyxis arachnoides spp. is faced with the threat of habitat destruction as well as the international pet trade. Habitat requirements and population structure of this species are largely unknown. Detailed studies have so far concentrated on the subspecies Pyxis arachnoides arachnoides. The present study surveyed a population of the western subspecies Pyxis arachnoides brygooi during the wet season from February to April 2008. The survey was carried out in the forest of Ifaty - Mangily, 20 km north of Toliara, and supported by a local tortoise centre, the Village des Tortues. Population densities were estimated from transect counts and plot surveys; they range from 0.33 to 1.72 animals per hectare. Both sexes were evenly represented in the field during the research period. Three individuals of the subspecies Pyxis arachnoides arachnoides were detected during this field survey. Their presence might be due to a transitional zone of both subspecies in the area of research.

  16. Development of intracranial hypertension after surgical management of intracranial arachnoid cyst: report of three cases and review of the literature.

    LENUS (Irish Health Repository)

    Kaliaperumal, Chandrasekaran

    2013-11-12

    To describe three cases of delayed development of intracranial hypertension (IH) after surgical treatment of intracranial arachnoid cyst, including the pathogenesis of IH and a review of the literature.

  17. Arachnoid cysts do not contain cerebrospinal fluid: A comparative chemical analysis of arachnoid cyst fluid and cerebrospinal fluid in adults

    Directory of Open Access Journals (Sweden)

    Haaland Øystein A

    2010-06-01

    Full Text Available Abstract Background Arachnoid cyst (AC fluid has not previously been compared with cerebrospinal fluid (CSF from the same patient. ACs are commonly referred to as containing "CSF-like fluid". The objective of this study was to characterize AC fluid by clinical chemistry and to compare AC fluid to CSF drawn from the same patient. Such comparative analysis can shed further light on the mechanisms for filling and sustaining of ACs. Methods Cyst fluid from 15 adult patients with unilateral temporal AC (9 female, 6 male, age 22-77y was compared with CSF from the same patients by clinical chemical analysis. Results AC fluid and CSF had the same osmolarity. There were no significant differences in the concentrations of sodium, potassium, chloride, calcium, magnesium or glucose. We found significant elevated concentration of phosphate in AC fluid (0.39 versus 0.35 mmol/L in CSF; p = 0.02, and significantly reduced concentrations of total protein (0.30 versus 0.41 g/L; p = 0.004, of ferritin (7.8 versus 25.5 ug/L; p = 0.001 and of lactate dehydrogenase (17.9 versus 35.6 U/L; p = 0.002 in AC fluid relative to CSF. Conclusions AC fluid is not identical to CSF. The differential composition of AC fluid relative to CSF supports secretion or active transport as the mechanism underlying cyst filling. Oncotic pressure gradients or slit-valves as mechanisms for generating fluid in temporal ACs are not supported by these results.

  18. Parasellar arachnoid cyst presenting with a nonpupil sparing third nerve palsy mimicking a posterior communicating artery aneurysm in an adult

    OpenAIRE

    Tempel, Zachary J.; Johnson, Stephen A.; Richard, Paul S.; Friedlander, Robert M.; Rothfus, William E.; Hamilton, Ronald L.

    2013-01-01

    Background: Arachnoid cysts are congenital lesions that contain fluid identical to cerebrospinal fluid (CSF). They usually do not communicate with CSF spaces. The vast majority of arachnoid cysts are congenital asymptomatic lesions that are discovered incidentally. Those lesions that do become symptomatic typically present in childhood with signs and symptoms of intracranial hypertension, seizures, and focal neurologic deficits specific to cyst location. Case Description: A rare case of a par...

  19. Thoracic intradural arachnoid cyst: Possible pitfalls with myelo-CT and MR

    International Nuclear Information System (INIS)

    A thoracic intradural arachnoid cyst presenting as an intradural extramedullary mass highly suggestive of psammoma on myelogram and myelo-CT is reported in a 34-year-old female. High densities of the cyst were related to collection of contrast media within the cyst. However MR examination of the thoracic spinal cord including sagittal T1 (without and with contrast) and T2 studies failed to demonstrate the mass. Lack of MR changes were related on one hand to the small size of the cyst and to the absence of mass effect on the spinal cord, and on the other hand to a CSF-like signal of the contents of the cyst. Only combination of myelography, myelo-CT and MR allows precise diagnosis of small intradual arachnoid cysts; however MR is the method of choice for evaluation of large intradural subarachnoid cysts. (orig.)

  20. Goel′s Teflon sponge internal shunt for anterior spinal arachnoid cyst

    OpenAIRE

    Raghvendra Ramdasi; Abhidha Shah

    2014-01-01

    We report a case of a 6-year-old boy who presented with progressive quadriparesis and bowel-bladder incontinence. Magnetic resonance imaging (MRI) of the spine showed anteriorly located arachnoid cyst in the cervicodorsal region. Following marsupialization of the cyst, an internal Teflon sponge shunt (Goel's shunt) was done that extended from the cyst cavity to the subarchnoid space. The patient improved dramatically in his symptoms. The physical nature of the teflon sponge and its usefulness...

  1. Ultrastrucmturaiml munogold labelling of vimentin filaments on postembedding ultrathin sections of arachnoid villi and meningiomas

    OpenAIRE

    Yamashima, Tetsumori; Tachibana, Osamu; Nitta, Hisashi; Yamaguchi, Narihito; Yamashita, Junkoh

    1989-01-01

    An immunoelectron microscopic technique for the labelling of vimentin intermediate filaments on postembedding ultrathin sections is reported. Arachnoid villi obtained at autopsy and meningiomas at surgery were fixed in 1% paraformaldehyde for 30 minutes, embedded without postfixation in Epon-Araldite mixture and polymerized at 37OC for 3 weeks. Ultrathin sections were etched in 2% KOH for 3 minutes and incubated with anti-vimentin monoclonal antibodies whic...

  2. Arachnoiditis following caudal epidural injections for the lumbo-sacral radicular pain.

    Science.gov (United States)

    Nanjayan, Shashi Kumar; Swamy, Girish Nanjunda; Yallappa, Sachin; Bommireddy, Rajendra

    2013-12-01

    Caudal epidural steroid injection is a very common intervention in treatment of low back pain and sciatica symptoms. Although extensively used, it is not devoid of complications. A few reports of chemical and infective arachnoiditis exist following lumbar epidural anaesthesia, but none following a caudal epidural steroid injection.We report a case of arachnoiditis following caudal epidural steroid injections for lumbar radiculopathy. The patient presented with contralateral sciatica, worsening low back pain and urinary retention few days following the injection, followed by worsening motor functions in L4/L5/S1 myotomes with resultant dense foot drop. Gadolinium-enhanced magnetic resonance imaging suggested infective arachnoiditis with diffuse enhancement and clumping of the nerve roots within the lumbar and sacral thecal sac. As the number of injections in the management of back pain and lumbo-sacral radicular pain is increasing annually, it is imperative to have a thorough understanding of this potentially dangerous complication and educate the patients appropriately. PMID:24353855

  3. Study of the clinical features and radiological findings for thoracic communicating arachnoid cysts

    International Nuclear Information System (INIS)

    We analyzed retrospectively, the usefulness of the radiological examinations for 15 cases of communicating arachnoid cysts in thoracic lesions experienced by our department over the last 12 years. Severn men and eight women (age range 32-71 years, mean age 53.8 years) were analyzed. Their symptoms on admission were sensory disturbance of the legs (13 cases), leg weakness (4 cases), back pain (4 cases), and truncal abnormal sensations (2 cases), etc. We performed myelography in 12 patients, and an additional 5 patients were diagnosed by this examination. CT-myelography showed deformity of the spinal cord, deviation of the spinal cord and enlargement of the subarachnoid space in all 12 patients. The axial view in 1.0 T weighted MRI showed the same findings as CT-myelography. However, the cine 1.0 T weighted MRI seemed to be insufficient to detect any spinal arachnoid cysts. As the results of their operations, 13 patients improved, 2 patients remained unchanged, and no cases become worse. The clinical and radiological diagnosis for communicating arachnoid cysts is not easy. Neurological examinations and radiological examinations with detailed readings are essential to obtain a correct diagnosis, when considering the possibility of the disease. (author)

  4. Dominantly inherited cerebral dysplasia: arachnoid cyst associated with mild mental handicap in a mother and her son.

    OpenAIRE

    Tolmie, J L; Day, R.; Fredericks, B; Galea, P; Moffett, A W

    1997-01-01

    We report a mother and son who each presented in infancy with hypotonia and global developmental delay. Subsequently, in both subjects, mild mental handicap was diagnosed in association with temporal lobe arachnoid cysts. Mendelian inheritance of this phenotype seems likely and macroscopic cerebral dysplasia in general may be underdiagnosed in people with familial, mild mental handicap.

  5. Severe adhesive arachnoiditis resulting in progressive paraplegia following obstetric spinal anaesthesia: a case report and review.

    Science.gov (United States)

    Killeen, T; Kamat, A; Walsh, D; Parker, A; Aliashkevich, A

    2012-12-01

    A 27-year-old woman developed severe adhesive arachnoiditis after an obstetric spinal anaesthetic with bupivacaine and fentanyl, complicated by back pain and headache. No other precipitating cause could be identified. She presented one week postpartum with communicating hydrocephalus and syringomyelia and underwent ventriculoperitoneal shunting and foramen magnum decompression. Two months later, she developed rapid, progressive paraplegia and sphincter dysfunction. Attempted treatments included exploratory laminectomy, external drainage of the syrinx and intravenous steroids, but these were unsuccessful and the patient remains significantly disabled 21 months later. We discuss the pathophysiology of adhesive arachnoiditis following central neuraxial anaesthesia and possible causative factors, including contamination of the injectate, intrathecal blood and local anaesthetic neurotoxicity, with reference to other published cases. In the absence of more conclusive data, practitioners of central neuraxial anaesthesia can only continue to ensure meticulous, aseptic, atraumatic technique and avoid all potential sources of contamination. It seems appropriate to discuss with patients the possibility of delayed, permanent neurological deficit while taking informed consent. PMID:23061983

  6. Giant posterior fossa arachnoid cyst causing tonsillar herniation and cervical syringomyelia

    Directory of Open Access Journals (Sweden)

    Vijay P Joshi

    2013-01-01

    Full Text Available Acquired cerebellar tonsillar herniation and syringomyelia associated with posterior fossa mass lesions is an exception rather than the rule. In the present article, we describe the neuroimaging findings in a case of 28-year-old female patient presented with a history of paraesthesia involving right upper limb of 8-month duration. Magnetic resonance imaging showed a giant retrocerebellar arachnoid causing tonsillar herniation with cervical syringomyelia. The findings in the present case supports that the one of the primary mechanism for the development of syringomyelia may be the obstruction to the flow of cerebrospinal fluid causing alterations in the passage of extracellular fluid in the spinal cord and leading to syringomyelia.

  7. Comparative Study on Two Surgical Procedures for Middle Cranial Fossa Arachnoid Cysts

    Institute of Scientific and Technical Information of China (English)

    Liang ZENG; Li FENG; Jun WANG; Jun LI; Yuping WANG; Jincao CHEN; Jian CHEN; Ting LEI; Ling LI

    2008-01-01

    In this study, we explored the operation options for middle cranial fossa arachnoid cysts(MCFAC). One hundred and forty-nine patients who were operated for a symptomatic MCFAC between 1993 and 2006 in our hosptial were analyzed. Follow-up time ranged from 1 y to 14 y(mean=5.4 y). All these patients were divided into three subgroups according to Galassi classification.Long-term outcome and complications were studied respectively. Fenestration (F) resulted in a more favorable long-term outcome and less complication for cysts of types Ⅰ and Ⅱ, whereas a favorable outcome was noted in type Ⅲ patients who underwent cysto-peritoneal shunting (S). We are led to conclude that Fenestration is suitable for cysts of types Ⅰ and Ⅱ (Galassi classification),cysto-peritoneal shunting is better for cysts of type Ⅲ.

  8. A Novel Bilateral Approach for Suprasellar Arachnoid Cysts: A Case Report.

    Science.gov (United States)

    Fujio, Shingo; Bunyamin, Jacob; Hirano, Hirofumi; Oyoshi, Tatsuki; Sadamura, Yuko; Bohara, Manoj; Arita, Kazunori

    2016-01-01

    The endoscopic method is used to treat suprasellar arachnoid cysts (SACs) but it is sometimes difficult to make sufficiently sized fenestrations. Creating a larger fenestration on the cyst wall is preferable to prevent closure of the stoma. In this paper, we report a novel endoscopic approach for SAC treatment in which we use bilateral burr holes to achieve a more extensive cyst fenestration. A 7-year-old girl was referred to our hospital because of incidentally detected hydrocephalus by computed tomography scans. Physical examination did not show any signs of intracranial hypertension, but a digital impression of her skull on X-ray implied chronic intracranial hypertension. Magnetic resonance imaging (MRI) revealed enlargement of both lateral ventricles and a cystic mass occupying the third ventricle. We performed cyst wall fenestration using a bilateral approach in which we created two burr holes to introduce a flexible endoscope and a rigid endoscope. The cyst wall was held by forceps with the flexible endoscope, and resection of the cyst wall was achieved by using a pair of scissors with the rigid endoscope. There were no postoperative complications, and MRI performed 1 year after treatment showed disappearance of the superior part of the cyst wall. PMID:26509420

  9. 松果体区脑池和蛛网膜的显微解剖研究%Microsurgical anatomy of cisterns and arachnoid membranes in pineal region

    Institute of Scientific and Technical Information of China (English)

    樊俊; 漆松涛; 张喜安; 石瑾

    2011-01-01

    目的 系统研究松果体区脑池及其蛛网膜结构的显微解剖学特点,为手术入路及手术操作提供解刮学依据.方法 在手术显微镜下观察20例尸头松果体区各个脑池的形态、边界、内容物及相关蛛网膜结构.结果 松果体区的蛛网膜结构包括蛛网膜袖套、环中脑后膜和小脑前中央膜.其中蛛网膜袖套由枕叶底、内侧面及小脑上表面蛛网膜在幕尖处汇合而成,包裹Galen静脉系统、松果体及松果体七隐窝;环中脑后膜由枕叶底面及小脑上表面蛛网膜在幕切迹处汇合形成,环绕并附着于中脑背侧;小脑前中央膜由小脑上表面蛛网膜和蛛网膜袖套汇合处发出,前下方附着于下丘.四叠体池与小脑上池通过小脑前中央膜分隔,与后胼周池通过蛛网膜袖套分隔.与环池后部通过环中脑后膜的升段分隔,环池后部与小脑中脑裂池通过环中脑后膜的水平段分隔.结论 重新划分了松果体区各个脑池的范围与交通情况,明确了蛛网膜的形态与分布.%Objective To study micro-anatomical features of cisterns and their arachnoid membranes in pineal region. Methods Cisterns in pineal region including their shapes, borders, contents and arachnoidal membranes were observed in 20 cadaveric brains using an operating microscope. Results Arachnoid membranes of the pineal region include the arachnoidal envelope, the posterior perimesencephalic membrane and the cerebellar precentral membrane. At the level of the tentorial apex, arachnoid membranes covering the inferior-medial surface of occipital lobe and the superior surface of cerebellum converge to form the arachnoidal envelope, which encloses the vein of Galen with its tributaries, the pineal gland and the suprapineal recess. The posterior perimesencephalic membrane arises from the outer arachnoid membranes covering the inferior occipital lobe and the superior cerebellum at the tentorial edge. It surrounds and is attached

  10. Experimental determination of the Stern layer thickness at the interface of the human arachnoid membrane and the cerebrospinal fluid

    International Nuclear Information System (INIS)

    The paper is part of an investigation of the electrostatic forces contributing to the interaction between colloidal molecules, suspended in the cerebrospinal fluid, with other molecules of the cerebrospinal fluid and with the surrounding environment. The study is based on experimental observations and theoretical considerations. We are reporting about the microscopic observation of particles suspended in the cerebrospinal fluid which was obtained by lumbar puncture of 27 neurosurgery patients. We found that the mean particle diameter and therefore the mean thickness of the Stern layer at the interface of the arachnoid membrane with the cerebrospinal fluid is a few micrometers. Individual variations of this diameter have been observed. (orig.)

  11. Chronic subdural hematoma associated with sylvian arachnoid cyst in juvenile athletes: report of two cases and literature review

    Institute of Scientific and Technical Information of China (English)

    ZENG Tao; SHI Song-sheng; LIN Yu-feng

    2011-01-01

    The association of chronic subdural hematoma (CSDH) and arachnoid cyst (AC) is uncommon.We reported 2 juvenile athletes with CSDH associated with AC which occurred in their daily sports activities and reviewed the literature. Both of them were treated surgically, with satisfactory outcome. AC is a common predisposing factor in young patients with CSDH. The complication of intracranial bleeding is an indication for surgical management. Though there are still controversies in the treatment of asymptomatic AC, it is the consensus that the patients with AC should avoid violent sports so as to reduce the incidence of intracranial hemorrhage resulted from head injuries.

  12. The Effects of 910-MHz Electromagnetic Field on Rat Cranial Arachnoid and Dura Mater Collagen. The Axial Periodicity of Collagen Fibrils

    OpenAIRE

    Margaret Tzaphlidou; Evangelos Fotiou

    2004-01-01

    The axial periodicity of rat arachnoid and dura mater collagen fibrils exposed to 910 MHz for 2 h/day for 30 consecutive days was measured by means of image analysis of electron-optical data. Such measurements were compared with those from sham-exposed animals. These measurements reveal that on exposure, the intermolecular interactions during collagen fibril assembly are affected.

  13. Predictors and outcomes of shunt-dependent hydrocephalus in patients with aneurysmal sub-arachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Wang Yi-Min

    2012-07-01

    Full Text Available Abstract Background Hydrocephalus following spontaneous aneurysmal sub-arachnoid hemorrhage (SAH is often associated with unfavorable outcome. This study aimed to determine the potential risk factors and outcomes of shunt-dependent hydrocephalus in aneurysmal SAH patients but without hydrocephalus upon arrival at the hospital. Methods One hundred and sixty-eight aneurysmal SAH patients were evaluated. Using functional scores, those without hydrocephalus upon arrival at the hospital were compared to those already with hydrocephalus on admission, those who developed it during hospitalization, and those who did not develop it throughout their hospital stay. The Glasgow Coma Score, modified Fisher SAH grade, and World Federation of Neurosurgical Societies grade were determined at the emergency room. Therapeutic outcomes immediately after discharge and 18 months after were assessed using the Glasgow Outcome Score. Results Hydrocephalus accounted for 61.9% (104/168 of all episodes, including 82 with initial hydrocephalus on admission and 22 with subsequent hydrocephalus. Both the presence of intra-ventricular hemorrhage on admission and post-operative intra-cerebral hemorrhage were independently associated with shunt-dependent hydrocephalus in patients without hydrocephalus on admission. After a minimum 1.5 years of follow-up, the mean Glasgow outcome score was 3.33 ± 1.40 for patients with shunt-dependent hydrocephalus and 4.21 ± 1.19 for those without. Conclusions The presence of intra-ventricular hemorrhage, lower mean Glasgow Coma Scale score, and higher mean scores of the modified Fisher SAH and World Federation of Neurosurgical grading on admission imply risk of shunt-dependent hydrocephalus in patients without initial hydrocephalus. These patients have worse short- and long-term outcomes and longer hospitalization.

  14. Radioisotopic studies of the sub-arachnoid space in cerebral cysticercosis; correlation of scintigraphic with pneumoencephalographic findings

    International Nuclear Information System (INIS)

    Cerabral cysticercosis is a grave public health problem in Ecuador and is caused by a tapeworm, which is parasite of man. The larvae of this tapeworm lodge in various tissues, notably in the brain, causing blockage of the sub-arachnoid space and leading to epileptic seizures and to mental deterioration. The present investigation on 115 patients has compared clinical and radiological findings with those from radionuclide cisternography, performed with a gamma camera after injection of 15-200μCi131I-albumin into the cerebro-spinal fluid. The results from 86 patients have been selected for detailed analysis. Radiological techniques such as pneumoencephalography were in general found to be more precise in determining the site of obstruction than cisternography

  15. Human arachnoid granulations Part I: a technique for quantifying area and distribution on the superior surface of the cerebral cortex

    Directory of Open Access Journals (Sweden)

    Holman David W

    2007-07-01

    Full Text Available Abstract Background The arachnoid granulations (AGs are herniations of the arachnoid membrane into the dural venous sinuses on the surface of the brain. Previous morphological studies of AGs have been limited in scope and only one has mentioned surface area measurements. The purpose of this study was to investigate the topographic distribution of AGs on the superior surface of the cerebral cortex. Methods En face images were taken of the superior surface of 35 formalin-fixed human brains. AGs were manually identified using Adobe Photoshop, with a pixel location containing an AG defined as 'positive'. A set of 25 standard fiducial points was marked on each hemisphere for a total of 50 points on each image. The points were connected on each hemisphere to create a segmented image. A standard template was created for each hemisphere by calculating the average position of the 25 fiducial points from all brains. Each segmented image was mapped to the standard template using a linear transformation. A topographic distribution map was produced by calculating the proportion of AG positive images at each pixel in the standard template. The AG surface area was calculated for each hemisphere and for the total brain superior surface. To adjust for different brain sizes, the proportional involvement of AGs was calculated by dividing the AG area by the total area. Results The total brain average surface area of AGs was 78.53 ± 13.13 mm2 (n = 35 and average AG proportional involvement was 57.71 × 10-4 ± 7.65 × 10-4. Regression analysis confirmed the reproducibility of AG identification between independent researchers with r2 = 0.97. The surface AGs were localized in the parasagittal planes that coincide with the region of the lateral lacunae. Conclusion The data obtained on the spatial distribution and en face surface area of AGs will be used in an in vitro model of CSF outflow. With an increase in the number of samples, this analysis technique can be used

  16. Experience of surgical treatment of intracranial arachnoid cyst%颅内蛛网膜囊肿手术的治疗体会

    Institute of Scientific and Technical Information of China (English)

    孙彬; 王瑞珩

    2014-01-01

    目的:探讨颅内蛛网膜囊肿的手术治疗方式及其疗效。方法回顾性分析35例手术治疗的颅内蛛网膜囊肿患者的临床资料,其中行显微镜下囊壁部分切除+囊肿-脑池造瘘术16例,囊肿-腹腔分流术11例,脑室镜下囊壁部分切除+囊肿-脑室或脑池造瘘术8例。结果随访6个月~2年,30例患者经手术治疗后症状明显改善,33例患者蛛网膜囊肿体积显著减小。结论蛛网膜囊肿患者一旦产生临床症状,均应积极手术治疗,应综合考虑患者的年龄、囊肿位置、大小等因素,进行个体化手术方式。%Objective To explore the surgical approaches of intracranial arachnoid cyst and the effects. Methods The clinical data of 35 patients with intracranial arachnoid cyst treated with surgery were retrospectively analyzed.The mi-croscope cystic wall resection+cyst-cisternal stoma was conducted in 16 cases,cyst-abdominal cavity stoma was con-ducted in 11 cases,ventricle endoscopic partial resection of cyst wall+ventricular or cisternal stoma was conducted in 8 cases. Results Patients were followed-up for 6 months to 2 years.The symptoms of 30 patients got improved after treat-ment. Significant reduction of cyst size was found in 33 cases of arachnoid cysts.Conclusion Patients with symptomatic arachnoid cysts should be treated actively,and such factors as the age,the size and position of cyst should be considered comprehensively to choose individual operation method.

  17. Tubercular Optochiasmatic Arachnoiditis

    Directory of Open Access Journals (Sweden)

    A K Ghosh

    2009-08-01

    Full Text Available What is your diagnosis?"nA 25-year-old woman presented with a low-grade fever, loss of weight and appetite of 4 months duration and intermittent vomiting of two months duration. The diagnosis was tubercular meningitis and the patient was on anti-tubercular therapy from one month. Two weeks ago, a rapidly progressive visual loss emerged in two days. In general observation, she was thin, had mild pallor and no icterus, was conscious and also irritable. In physical examination, she was febrile (100o F, there were bilateral crepitations in the chest and she had mild neck rigidity. On eye examination, there were bilateral dilated sluggishly reacting to light pupils, no projection or rays or perception of light in both eyes, the fundus showed bilateral papilloedema with features of secondary optic atrophy. Extra ocular movements were restricted in all directions suggestive of 3rd, 4th and 6th nerve paresis. Other cranial nerves were normal. There were no focal motor or sensory deficits. Blood investigations were normal except for a raised erythrocyte sedimentation rate (64 mm in the 1st hour. Three consecutive samples of sputum for acid fast bacilli were negative. The brain CT scan showed mild dilation of the third and lateral ventricles and thick basal exudates (Fig. 1.A&B. MRI of the brain showed hypertrophy of the chiasma and the cisternal segment of both optic nerves after contrast enhancement (Figs. 2&3.

  18. Dynamic CT Cisternography in the Diagnosis and Treatment of Intracranial Arachnoid Cysts%CT脑池造影动态扫描在蛛网膜囊肿诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    王翔; 姜曙; 刘艳辉; 毛庆

    2011-01-01

    Objective To investigate the communication between intracranial arachnoid cysts and subarachnoid space using CT cisternography (CTC) and consecutive CT scans. Methods CTC were performed in 38 symptomatic patients with arachnoid cysts before treatment decisions were made. Consecutive CTC images were obtained 2 days after intrathecal omnipaque administrations. The enhancement in cysts was measured quantitatively and compared with neighbouring subarachnoid spaces. Patients with cysts showing early fillings (n=10) were followed up without surgeries. Whereas, patients with cysts showing non-early fillings (n=28) were given surgical treatment through craniotomy. Another 36 patients with arachnoid cysts were given craniotomy without CTC evaluation. Results Arachnoid cysts were classified into complete, incomplete and noncommunicating cysts based on the CTC results. The symptoms of all surgical patients with CTC evaluations were relieved. Only one patient without surgery showed clinical deterioration. In the 36 patients without CTC evaluation, 6 patients did not gain benefit from surgeries. Conclusion The classification of arachnoid cysts based on CTC is useful for the diagnosis and treatment of intracranial arachnoid cysts.%目的 应用CT脑池造影(CTC)动态扫描的方法对蛛网膜囊肿进行分类和治疗.方法 共纳入74例症状性蛛网膜囊肿患者.其中38例患者在治疗前进行CTC检查.腰穿碘海醇注入蛛网膜下腔后的1、3、6、12、24及48 h分别行CT扫描,测量蛛网膜囊肿内及囊外蛛网膜下腔的CT值,评估囊内外脑脊液交通情况.另外36例对照组患者未行CTC,直接行手术治疗.结果 根据CTC及动态扫描的结果,蛛网膜囊肿被分为3种类型:完全交通性,不完全交通性及非交通性囊肿.其中诊断为不完全交通性及非交通性蛛网膜囊肿的28例患者进行手术囊肿切除,其他10例完全交通性蛛网膜囊肿进行观察随访.在CTC组中,所有手术治

  19. Puberdade precoce central como única manifestação de cisto aracnoide supraselar Central precocious puberty as a sole manifestation of suprasellar arachnoid cyst

    Directory of Open Access Journals (Sweden)

    Adriana Mangue E. Aun

    2011-03-01

    Full Text Available OBJETIVO: Os cistos aracnoides são achados raros. Em 10% dos casos, sua localização é supraselar e ocorrem quase exclusivamente em crianças. Em geral, apresentam manifestações neurológicas e visuais, sendo incomum a puberdade precoce central como sinal clínico de sua presença. DESCRIÇÃO DO CASO: Menina avaliada aos dois anos e sete meses por telarca iniciada com um ano e oito meses e pubarca e axilarca com dois anos, com aumento da velocidade de crescimento (13cm/ano e da idade óssea (sete anos e um mês. Ao exame, apresentou peso de 22,6kg (Z+4,0, estatura de 106cm (Z+3,5 e Tanner de M3P2. Exames realizados: teste de estímulo com GnRH (LH basal 8,3 UI/L, pico aos 30 minutos 94,3 UI/L; FSH basal=10,1 UI/L, pico aos 30 minutos 29,5 UI/L, ressonância nuclear magnética de crânio com cisto aracnoide supraselar e demais testes de função hipofisária normais. Foi iniciado tratamento com análogo de GnRH. Atualmente, aos quatro anos e três meses com estadio puberal M3P2, velocidade de crescimento e desenvolvimento neuropsicomotor normais para a idade. COMENTÁRIOS: A puberdade precoce central pode ser manifestação única de um cisto aracnoide, sendo essenciais o diagnóstico e o tratamento precoces, além de seguimento prolongado, uma vez que outras disfunções hipofisárias podem ocorrer tardiamente.OBJECTIVE: Arachnoid cysts (AC are a rare finding; 10% of them are suprasellar and occur almost exclusively in children. They are frequently associated with neurological and visual manifestations. Central precocious puberty as a sole manifestation is uncommon. CASE DESCRIPTION: Girl evaluated at the age of two years and seven months. She started breast development at the age of one year and eight months, pubic and axillary hair at the age of two years, with growth velocity acceleration (13cm/year and increased bone age (seven years and one month. On exam: weight: 22.6kg (Z+4.0, height: 106cm (Z+3.5 and puberal stage of B3P2. The Gn

  20. Posterior communicating artery cistern and associated arachnoid membrane:the microsurgical anatomy and clinal significance%后交通动脉池及相关蛛网膜的显微解剖研究及临床意义

    Institute of Scientific and Technical Information of China (English)

    宋海民; 漆松涛; 樊俊; 黄广龙; 黄理金; 冯文峰; 李伟光; 陆云涛

    2011-01-01

    Objective To investigate the microsurgical anatomic features and clinical significances of the posterior communicating artery cistern (PComA cisterns) and associated arachnoid membranes. Methods 10 cases (20 sides )of formalin-fixed cadaveric head specimens were microdissected to observe structures of PComA cistern and related arachnoid membranes under the operating microscope. Results The frequency rate of PComA cistern was about 60% (12 sides from all of specimens).The anterior wall of the cistern was the posterior communicating membranes. The carotid cistern directly communicated with the PComA cistern in the absence of the posterior communicating membranes. The posterior wall of the cistern was diencephalic and mesencephalic leaves of liliequist membranes. The medial wall was the carotid membranes and the lateral wall of diencephalic and mesencephalic leaves of liliequist membranes. The anterolateral wall was the lateral carotid membranes or the medial temporal lobe, and the posterlaeral wall the arachnoid trabeculaes arising from mesencephalic leaves of liliequist membranes which attached to the oculomotor nerve and posterior communicating artery. The superior lateral wall was incrual membranes, and the bottom wall the arachnoid membranes of base skull and diencephalic leaves of liliequist membranes. The features of different membranes were distinct. Conclusions This study identifies the features of the PComA cistern and associated arachnoid membrane, which is a valuable reference for clinic application.%目的 对后交通动脉池(PComA池)及相关蛛网膜的显微解剖特点进行描述并探讨其临床意义.方法 在手术显微镜下,对10例(20侧)福尔马林固定的尸头标本进行显微解剖,观察PComA池及相关蛛网膜的膜显微特点.结果 PComA池出现率60%(12侧).组成PComA池前壁为后交通膜,若此膜缺失,则与与颈内动脉池(ICA池)相通;后壁为liliequist膜间脑叶和中脑叶;内侧壁为颈内动脉内侧

  1. Correlación de hallazgos radiológicos con los eventos adversos que posiblemente hayan causado aracnoiditis Correlation between radiological findings and adverse events probably causing arachnoiditis

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    J. A. Aldrete

    2005-07-01

    íces en racimo, deformidades del saco dural y tejido cicatricial y fibrótico en el espacio epidural intervenido quirúrgicamente.Clinical diagnosis of arachnoiditis is characterized by a burning, ardent pain with dysesthesia and vesical, rectal and sexual dysfunction that appear after an adverse event during a spinal surgical procedure; it can be confirmed through magnetic resonance or myelogram followed by lumbar spine tomography. In this study, a retrospective review was conducted of image studies from 436 patients referred to a pain clinic with diagnosis of arachnoiditis in order to identify specific patterns on the radiological images that could help to determine the potential etiology of this disease. The apparent cause was correlated to the appearance of neurological changes after spine injections, interventions or surgical procedures. Neurological deficits were observed in 160 patients after myelograms, rachidian or peridural anesthesia, epidural blood patches or injection of steroids or neurolytic drugs for the management of chronic pain. Eleven (6.8% of these patients had inflammation of roots, 135 (84.3% had roots in bunches and 12 cases (7,5% had roots adhered to the dural sac. Two cases of syringomyelia were observed in patients with thoracal or high lumbar peridural anesthesia. Of 276 other patients in which the clinical diagnosis of arachnoiditis was established after spine surgical procedures, 259 patients (93.8% had roots in bunches, 152 (55% had a deformed dural sac and peridural fibrosis was observed in 241 patients (87.3%. Pseudomeningocele and intrathecal calcifications were observed in 21 (7.6% and 4 (0.15% of the surgical cases, respectively. It is concluded that radiological images in cases of arachnoiditis caused by injections and invasive procedures are only characterized by roots in bunches. However, surgical patients have, in addition to roots in bunches, deformation of the dural sac and healing and fibrotic tissue at the epidural space

  2. 听神经瘤安全切除及术中面神经保护解剖学基础%Microanatomy of the relationship between acoustic neuroma and the arachnoid

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    黄广龙; 漆松涛; 张喜安; 石瑾; 潘军; 邱晓瑜

    2013-01-01

    目的 探讨听神经瘤的安全切除、术中面神经保护技术及解剖学基础.方法 121例听神经瘤全部采用枕下乙状窦后入路,在显微外科基础上采用神经电生理监测技术,配合超声吸引(CUSA)和激光刀切除肿瘤,术后采用House-Brackmann (HB)分级方法对面神经功能进行评价. 结果 肿瘤全切除100%(121例).面神经解剖保留93.4%(113例),蜗神经解剖保留90.1%(109例),无死亡病例.术后3个月回访121例,按House-Brackmann分级对面神经功能评估,Ⅰ-Ⅱ级71.9% (87例),Ⅲ-Ⅳ级25.6% (31例),Ⅴ-Ⅵ级3.3%(4例). 结论 掌握听神经瘤与蛛网膜关系的解剖学基础是听神经瘤安全切除及面神经功能保护的关键.%Objective To review microsurgical techniques and facial nerve preservation issues in resection of acoustic neuroma.Methods Clinical data of 121 patients with acoustic neuroma who were surgically treated in our hospital from Jan 2009 to Oct 2012 were retrospectively analyzed.Acoustic neurinomas were removed by microsurgical technique through the suboccipital retrosigrnoid approach accompanied by face nerve EMG monitoring.Results Total separation was achieved in 100% (121 cases).The facial nerve was preserved anatomically in 93.4% (113 cases) and the cochlear nerve in 90.1% (109 cases).There was no surgery-related fatality.In a 3-month follow-up,according to House-Brackmann,the function of facial never was Ⅰ-Ⅱ level in 71.9% (87 cases),Ⅲ-Ⅳ in 25.6% (31cases),Ⅴ-Ⅵ in 3.3% (4 cases).Conclusion Profound understanding of the relationship between the acoustic neuroma and the arachnoid can drastically reduce the incidence of acial nerve damage during resection of acoustic neuromas.

  3. Arachnoiditis ossificans and syringomyelia: A unique presentation

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    Charles F Opalak

    2015-01-01

    Conclusion: This case demonstrates a unique presentation of AO and highlights the need for CT imaging when a noncommunicating syringx is identified. In addition, surgical decompression can achieve good results when AO is associated with concurrent compressive lesions.

  4. Spinal arachnoid cyst; Torbiel pajeczynowki rdzenia

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    Lebkowski, W.J. [Akademia Medyczna, Bialystok (Poland)

    1993-12-31

    Four patients treated operatively have been presented. In 2 cases complete recovery has been achieved, in one case lower extremities plegia has been slightly reduced and in one case only the pain has been eliminated. (author). 15 refs, 3 figs.

  5. Hemorragia de tronco cerebral após remoção cirúrgica de cisto aracnóide da fissura silviana: Relato de caso Brainstem hemorrhage after surgical removal of arachnoid cyst of the sylvian fissure: case report

    Directory of Open Access Journals (Sweden)

    Guilherme Borges

    1995-12-01

    Full Text Available Os autores relatam um caso de hemorragia de tronco cerebral após craniotomia para ressecção de grande cisto aracnóide de fissura silviana esquerda. A sintomatologia inicial pré-operatória incluía sinais de hipertensão intracraniana e a tomografia computadorizada mostrava desvio de linha média. Diversos fatores são discutidos para explicar o sangramento parenquimatoso pós-operatório: edema cerebral, diminuição do retorno venoso e de fluxo sanguíneo no lado comprimido. Entretanto a fisiopatologia da hemorragia parenquimatosa em casos como o relatado permanece obscura. Uma abordagem cirúrgica mais cautelosa é proposta nesses pacientes com de hipertensão intracraniana.The authors report a case of a hemorrhage of the brainstem after craniotomy for resection of a huge arachnoid cyst of the sylvian fissure on the left hemisphere. The previous simptomatology included clinical signs of increased intracranial pressure, and the computerized tomography showed midline shift. Some factors may contribute to brain hemorrhage post-operatively: cerebral edema, ipsilateral changes in the venous reflux and blood perfusion, although the physiopathology remains obscure. A more careful approach is suggested in such cases with intracranial hypertension.

  6. Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média: relato de caso Singular association of Kallmann's syndrome and arachnoid cyst of middle fossa: case report

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    Yvens B. Fernandes

    1995-09-01

    disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = -2,17, pubertal development on stage G II, P II, and 4 cm5 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the refered syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... trained pediatric anesthetists that all they do all day is deal with children. The physiology is different. ... And then there were like one or two days of ICU observations. In terms of what the ...

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    Full Text Available ... actually, in the skull and this resulted in brain protruding out in between the eyes. And I ... What an encephalocele is essentially a bit of brain herniating or pushing out through a whole in ...

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    Full Text Available ... on remediating health inequalities amongst the rural and urban poor, including a program here in Boston. But ... poor. They are farmers that I do subsistence farming, and so -- excuse me -- most of the care ...

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    Full Text Available ... re fortunate enough today to have Dr. Ed Smith from the Department of Neurosurgery, and David Walton ... be essentially a perfect contour. 3 And Dr. Smith is going to remove that bone for me, ...

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    Full Text Available ... the capitol city, which can be difficult to access, shunts can be pretty dicey in term of ... can break, that can clog. If you have access to a health care system nearby where the ...

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    Full Text Available ... medical care. “OR-Live,” the vision of improving health. Well good afternoon. Welcome to Boston. This is ... of Neurosurgery, and David Walton from Partners in Health. Ed, I’m going to let you lead ...

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    Full Text Available ... then spinal fluid can leak out along the track from the catheter. We tend to have a ... the special senses?” And I’ll let you field that. Yeah. So obviously what senses are affected ...

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    Full Text Available ... of encephalocele causes is something called the “long-nose deformity.” And so when you’re reconstructed the frontal orbital band O and the nose, that’s an important thing to address in reducing ...

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    Full Text Available ... in Boston. And Dumanel initially came to our attention about a little over a year ago when ... actually that’s initially when Dumanel came to our attention. Actually, John Meara, who is here with us ...

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    Full Text Available ... and he is going to be able to use that to configure the forehead. And he’ll ... couple of them this rapid sequence. Do you use any adjunctive measures to seal the dura, fibrin ...

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    Full Text Available ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ... what you’re going to see is my team is dissecting around the external portion of the ...

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  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... encephalocele, the part of brain that isn’t healthy and isn’t, you know, functional anymore is ... bipolars,” is to cauterize the tissue between the healthy brain on the left and the unhealthy brain ...

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    Full Text Available ... But essentially what we have is a young child, and if you look at the slide we ... particularly to these patients? So obviously with any child that’s undergoing surgery, one of the things that ...

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    Full Text Available ... addressed from cleft surgical cleft palate to acute appendicitis, to a frontal Encephalocele to, you know, any ... something like this or, say, to someone having appendicitis is really a basic service that one needs, ...

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    Full Text Available ... here was that he had this encephalocele, this mass in between his nose, and there are many ... that he had this large defect -- sorry, large mass in between his eyes. This is what led ...

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    Full Text Available ... did the procedure take, and what does the future hold for the child? And I think in ... of ICU observations. In terms of what the future holds, you know, I think we already know, ...

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    Full Text Available ... the tissue between the healthy brain on the left and the unhealthy brain on the right, represented by the dotted line, as you can ... really see on the video here on the left-hand side you have a nice healthy looking brain, and on the right-hand side you have sort of a grayish ...

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    Full Text Available ... the globe. It was originally founded by Paul Farmer, Ophelia Dahl, Todd McCormick and others in 1983. ... However, there family is extremely poor. They are farmers that I do subsistence farming, and so -- excuse ...

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    Full Text Available ... service that one needs, really, to consider one’s self-having access to care. 7 And so we ... Again, there’s a lot of specific variables that change from case to case, but that’s a rough ...

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    Full Text Available ... that’s appropriate for that venue and collaborated with academic medical centers for care that really can’t ... colleague, Mark Proctor, who has a lot of experience with these cases, yourself, Gary Rogers, a number ...

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    Full Text Available ... the dura, the meninges, and by establishing an edge there, we’ll have a sharp edge, which we can sew to and establish that ... or at the site where you remove the edge of the brain. As an example of that ...

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    Full Text Available ... with Operation Smile and actually focused on finding patients with cleft lip and cleft palates. However, we ... a radio announcement where we were actually seeking patients with any kind of deformity, facial deformity, and ...

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    Full Text Available ... working on between the eye nerve, the optic nerve up above, and the carotid artery, the big blood vessel down below. And as I work in there, you can see that you make a nice hole, and the hope this will allow the spinal fluid to drain away. Well, Ed, thank you. ...

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    Full Text Available ... understanding is that there is no risk. But what’s your understanding of that? Yeah. So I don’t ... neurosurgical colleagues. And what was their feeling and what was your feeling about, you know, the pros and cons ...

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    Full Text Available ... of looks a little bit like a spider web. 5 I think what we’ll see right ... in the procedure at this point. So Dr. Smith in this portion is removing the encephalocele. So ...

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    Full Text Available ... potentially coordinate over e-mail or phone or Internet with the staff here back at Children’s Hospital. ... reconstruction. And I want to touch on one issue here, and that is, one of the deformities ...

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    Full Text Available ... easier to sort of tackle either garden-variety stuff that comes in off the street or complex stuff that comes in from halfway around the world. ... a very important barrier that keeps the good stuff for the brain in and the bad stuff ...

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    Full Text Available ... it’s not supposed to go, it’s no longer functional brain. It will not develop into cancer or ... isn’t healthy and isn’t, you know, functional anymore is off to the right. What we’ ...

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    Full Text Available ... can tell you that from the standpoint of managing shunts in Haiti, it’s actually very difficult. And ... here at Children’s. We also have a big group of neurosurgeons, all of who are pediatric fellowship ...

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    Full Text Available ... really highlighted sort of benefit of having a team approach, which maybe John can talk a little ... and, subsequently, brain pressure, that you have a team that’s dedicated, and we work with a very ...

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    Full Text Available ... but also had another surprise, which made his management a little bit more complex. So one thing ... shunts can be pretty dicey in term of management. Uh-huh. I would comment that, you know, ...

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    Full Text Available ... 28, 2009 Welcome to this “OR-Live” webcast presentation, live from Children’s Hospital Boston, in Boston, Massachusetts. ... thank you. And I think later in the presentation I’d like to talk to you a ...

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    Full Text Available ... inequalities amongst the poor in developing nations and right here in Boston. And Dumanel initially came to ... and you see on the image on the right a very large area of black empty space, ...

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    Full Text Available ... so that nothing scary happens while we’re operating, and then once we had him in position, ... in terms of length of time, the actual operating time, I believe was four to five hours ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have ... for any of the types of brain tumor surgery or other types of craniofacial repairs ... with the plastic surgeons quite a bit. I have another interesting ...

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    Full Text Available ... there just briefly was the head frame that holds him in place so that nothing scary happens ... the procedure take, and what does the future hold for the child? And I think in terms ...

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    Full Text Available ... comment from Aaron here asking, “What is the risk of this developing later on in life into ... know, my understanding is that there is no risk. But what’s your understanding of that? Yeah. So ...

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    Full Text Available ... birth and seemed to get progressively larger over time. As you can see from the graphic, there ... then they get referred up here, and many times the treatment for them is surgery. When Dumanel ...

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    Full Text Available ... many complications that can arise and, again, many emergencies that can arise in children with shunts. You ... so that’s a bit more of a neurosurgical emergency. In Dumanel’s case, he was fortunate to have ...

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    Full Text Available ... nice because then you don’t have a foreign body in there for the rest of the ... can avoid it. The idea being the fewer foreign materials you have the better. But there are ...

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    Full Text Available ... ones that are symptomatic, the ones that do cause problems, what we have to do is somehow ... able to identify the ones that are problem causes and which ones aren’t, and clearly in ...

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    Full Text Available ... him prepared. And, Ed, very briefly, any anesthetic issues particularly to these patients? So obviously with any ... But obviously people have all kinds of surgical issues that need to be addressed from cleft surgical ...

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    Full Text Available ... community health workers.” And they help us; the physicians, nurses, et cetera, be able to treat patients ... getting frequent follow-up appointments both by the physician in the clinic, and we have people going ...

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    Full Text Available ... had a radio announcement where we were actually seeking patients with any kind of deformity, facial deformity, ... that will have the bone graft that provides support for the nose. And you’ll see that ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the central plateau of Haiti with our Haitian staff. We do have Haitian surgeons who, you know, ... taking care of the Haitians, our own medical staff, taking care of people of Haiti. That’s a ...

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    Full Text Available ... The hope here is that we want to preserve all the healthy neural tissue that we can, ... Fortunately with his case, we were able to preserve the olfactory nerves, and as best we can ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... partnering with Operation Smile and actually focused on finding patients with cleft lip and cleft palates. However, ... that something abnormal has gone on, and the diagnosis is usually made with an imaging study like ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... see our most complex patients. It’s a fascinating model and it’s been highly successful. So I guess ... patient and make sure that the post-op management is appropriate and that is very comforting, given ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... rough estimate would be to say about two-thirds of patients to three-quarters of patients who ... term cure, and about a quarter to a third end up needing a shunt. Again, there’s a ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... of the slides just to lay some ground work for us about the frontal encephalocele. Yeah. This ... know, for laying a little bit of ground work. Let’s start looking at the surgery, and I ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... was seen down in Haiti to have this large deformity in between his eyes. This is something ... about how Dumanel not only had this very large encephalocele but also had another surprise, which made ...

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    Full Text Available ... essentially. And so if someone has a chronic disease like HIV or tuberculosis or heart failure ... can directly observe therapy, meaning the patients will never miss a dose ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... again, we’re really doing what we call “horizontal” -- actually much more than just horizontal care. Meaning, you know, I’ll compare and ... of public health. Did you want to comment? Well let me just interject for a minute so ...

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    Full Text Available ... you know, Partners in Health does a wide diversity of procedures down there, and the very special ... who are pediatric fellowship trained -- I mean pediatric board certified pediatric surgeons, and we were able to ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... here in the United States, which is the occipital encephalocele, or here in the back of the ... in other parts of the brain, for example occipital encephaloceles, we can sometimes be able to reduce ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... in terms of length of time, the actual operating time, I believe was four to five hours ... for the audience to understand the accompan’ture system in Haiti and what a wonderful idea that ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the completed reconstruction on the left. That’s a CT scan and the diagram on the right. But I ... the end, and I had shown that final CT scan, which showed that bone graft. And that’s critical ...

  8. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... it would leak under the skin, which could affect wound healing, or if there was any connections ... are involved in the nose, for example, may affect the eye nerves and vision. So in those ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to ... know what a shunt is, it’s a little plastic tube that goes from the cyst down to ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... large deformity in between his eyes. This is something that was noticed since birth and seemed to ... they’re seen, people tend to recognize that something abnormal has gone on, and the diagnosis is ...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... here, or for any of the types of brain tumor surgery or other types of craniofacial repairs where you have to remove part of the tissue surrounding the brain, this is a very important part of the ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... needed to obviously do follow up on a continuous basis pretty closely for the next, you know, ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ...

  13. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... needed to obviously do follow up on a continuous basis pretty closely for the next, you know, ... Again, there’s a lot of specific variables that change from case to case, but that’s a rough ...

  14. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... garden-variety stuff that comes in off the street or complex stuff that comes in from halfway ... as you saw from 15 the pictures. The main nerves that are involved in that region are ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... be elevating a flap that involves skin, subcutaneous tissue, and the periosteum. And one thing I might ... it’s decompressed appropriately and also to disconnect the tissue from the brain. So we have two very ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the drain. So we usually have a pretty good way to assess prior to removal, as we did with Dumanel, to know that he would be a candidate and probably would fly with the drain out. You know, David, I think it’s important for our audience to get a better sense. I know you’ve come to know ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... can see from the graphic, there is a hole, actually, in the skull and this resulted in ... the defect between the nose, which is the hole where the brain came through on the image ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... video where we are actually using plates and screws, but the interesting thing to mention here is ... I would have been using titanium plates and screws, but now we’re using resorbable plates and ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... mass in between his eyes. This is what led to the initial diagnosis and had him brought ... the opposite side of his body, and this led to us talking about a little bit about ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... could comment on, you know, what is the role of surgery in Partners and Health? How important ... Children’s to have a lot of multi-disciplinary teams where it’s not just the surgeons looking at ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... who are pediatric fellowship trained -- I mean pediatric board certified pediatric surgeons, and we were able to ... patient and make sure that the post-op management is appropriate and that is very comforting, given ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the brain. So we have two very different aspects of how we do it, and one of ... now what we’re doing, this is an aspect of the operation called the “craniotomy,” and the ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... do all day is deal with children. The physiology is different. What’s particularly important, though, is that ... called a “coronal incision,” and it goes from ear to ear. And you notice that it’s not ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... that something abnormal has gone on, and the diagnosis is usually made with an imaging study like ... eyes. This is what led to the initial diagnosis and had him brought up here to Children’s. ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... to someone having appendicitis is really a basic service that one needs, really, to consider one’s self- ... of the care in Haiti is fee-for-service. And so whenever -- you know, he spent many, ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... garden-variety stuff that comes in off the street or complex stuff that comes in from halfway ... cavity that can fill up with blood or old tissue. So those are some potential complicated from ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... public charity that’s based in Boston, focused on health care actually, remediating health inequalities amongst the poor in ... really have a good understanding of the Haitian health care delivery system, you know, with a child like ...

  8. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... something, you know, that requires something of monetary value, they then sell these items that can, you ... it’s important to highlight the fact that the value of a cow there is about the average ...

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the risk of this developing later on in life into cancer?” And, you know, my understanding is ... in there for the rest of the child’s life. So that’s the new frontal segment there that ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Science.gov (United States)

    ... on remediating health inequalities amongst the rural and urban poor, including a program here in Boston. But ... a lot easier to sort of tackle either garden-variety stuff that comes in off the street ...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... on remediating health inequalities amongst the rural and urban poor, including a program here in Boston. But ... a lot easier to sort of tackle either garden-variety stuff that comes in off the street ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... from Antonio. He said, “What is the earliest age you would do this procedure?” And that’s a ... anywhere from about one to two years of age. All right. Great. I think it would maybe ...

  13. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... The reason that I feel comfortable and the reason that, you know, Ed and I feel comfortable doing this is that we have an excellent partner in Partners in Health, and they’re able to monitor this patient and make sure that the post-op management is appropriate and that is very comforting, given ...

  14. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... we’re oriented all the way to the right where you see the child’s head, and then what we’re looking is ... outside of one of those clinics. And so right when we identify a child or an adult with a problem such as ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... management a little bit more complex. So one thing I think would be good to talk about now a little bit is ... interestingly, he had this weakness on the opposite side of his body because it’s a very large cyst and seems to be pushing on the brain. The other thing is probably he had a little bit of ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... can tell you that from the standpoint of managing shunts in Haiti, it’s actually very difficult. And ... we can sometimes be able to reduce the risk of spinal fluid leaking after surgery. Now I ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... you know, Partners in Health does a wide diversity of procedures down there, and the very special ... Children’s to have a lot of multi-disciplinary teams where it’s not just the surgeons looking at ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... bit about frontal encephaloceles and our approach to these. Sure. So as was mentioned by David, one ... be brought up here to Children’s, and sometimes these can be very complicated cases to manage. We’ ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... you know, Partners in Health does a wide diversity of procedures down there, and the very special ... in life into cancer?” And, you know, my understanding is that there is no risk. But what’s ...

  20. Optochiasmatic arachnoiditis and neurotuberculosis: Prognostic indicators and therapeutic strategies

    Directory of Open Access Journals (Sweden)

    Gourie-Devi M

    2010-12-01

    Full Text Available Tuberculous meningitis (TBM is a serious meningitic infection commonly found to occur in the developing countries endemic to tuberculosis. Based on the clinical features alone, the diagnosis of TBM can neither be made nor excluded with certainty. Unfortunately there is still no single diagnostic method that is both sufficiently rapid and sensitive. Most factors found to correlate with poor outcome can be directly traced to the stage of the disease at the time of diagnosis. The only way to reduce the mortality and morbidity is by early diagnosis and timely recognition of complications and institution of the appropriate treatment strategies.

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... here at Children’s. We also have a big group of neurosurgeons, all of who are pediatric fellowship ... a whole lot of thinking from many different groups, but we had the infrastructure in place to ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... let me just say we have some interesting e-mails coming in already, and maybe we can ... an additional workup and then potentially coordinate over e-mail or phone or Internet with the staff ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... up here to Children’s. As part of the evaluation, as I mentioned, what is normally done is ... bone, and you can see us using an instrument for this. And the idea is to kind ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... little bit about how we got into the process of planning his surgery and what we went ... when Dumanel presented to us during the screening process, you know, we readily and immediately identified this ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... to Dumanel, I think he’s got an excellent prognosis. David, we have an interesting question here. It ... determine at the time of surgery. The risk factors for trying to figure out if a cyst ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... ago, Ed and I would have been using titanium plates and screws, but now we’re using ... midline because of their displacement. So this is titanium wire, which is very nocuous. The body doesn’ ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have ... know what a shunt is, it’s a little plastic tube that goes from the cyst ... that at the same time during surgery, if we’re able to open this up, ...

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    Full Text Available ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ... patient and make sure that the post-op management is appropriate and that is very comforting, given ...

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... go is there are two sort of important goals with surgery here. One is the very important ... do with his well being. And the second goal of surgery is to control the cyst inside ...

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    Full Text Available ... this is a very important part of the structure -- part of the repair and something which, you know, we work together with the plastic surgeons quite a bit. I have another interesting question here. We’ve touched on a number of issues. But Abu Bacher asks, “What is a common complication ...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... up here to Children’s. As part of the evaluation, as I mentioned, what is normally done is ... something of monetary value, they then sell these items that can, you know, generate some income for ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... see our most complex patients. It’s a fascinating model and it’s been highly successful. So I guess ... made out of. So after 12, 18, 24 months, that plate and screw actually just disappear, which ...

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    Full Text Available ... previously is a 501C3 charity. We, for the purposes of this discussion, I’ll focus on primarily ... them, and they came for a very specific purpose, which was to focus on cleft lip and ...

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    Full Text Available ... manage him surgically and really highlighted sort of benefit of having a team approach, which maybe John ... children aren’t just little adults. And we benefit here at Children’s, obviously, from having trained pediatric ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... any other major risks that we need to be concerned with? Well I think any time you operate on the ... You know, and I guess my comment would be in this case, no, everything went very well and, Ed, you already commented on the potential ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... still -- while the child is still in the nursery. On the other hand, there are other kids ... some basic imaging in terms of X-rays, infectious workup to make that he was a ... has a chronic disease like HIV or tuberculosis or heart failure or ...

  17. [Congenital Minamata disease accompanied by arachnoid cyst (author's transl)].

    Science.gov (United States)

    Hira, K; Harada, M; Takehara, S; Kabashima, K; Tatetsu, S; Fujioka, M; Yasutake, H; Ozaki, M

    1982-03-01

    A male, born on December 8, 1956, during the period when many Minamata diseases broke out in a district. His parents who ate much fish and shell fish taken in Minamata Bay suffered from the light, incomplete Minamata disease showing sensory disturbance, the constriction of the visual field, muscular weakness, etc. He weighed 3,225 gr. upon the normal birth given 10 months after pregnancy. His abnormalities were noted since his head was not stabilized on the neck even six months after the birth. Because of the delay in the development of the motor function, he became barely able to sit, stand up and begin walking at the ages of 3, 5 and 6 respectively. In 1962 (at the age of 6), his congenital Minamata disease was diagnosed in view of his clinical symptoms and epidemiological conditions. The mercury value in the hair and blood upon the birth is not known because a considerable time had elapsed after the birth when his mercury poisoning was discovered. However, the clinical symptoms included intelligence disturbance, character change, dysarthria, primitive reflexes, strabismus, hypersalivation, ataxia and hyperkinesia, indicating a typical congenital Minamata disease. Until he became 13 years old (1969) or so, his mental and motor function developed, both gradually. In the same year, he was admitted to a special class for the handicapped. EEG examination revealed that there was a slow alpha activity in the basic pattern and that 6 Hz positive spike was found in the sleep EEG. The constriction of the visual field was classified through examination.2+ PMID:7093064

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... December, that he’s doing extremely well. And the motor function on his left side is improving. I’ ... What are your thoughts about extensive improvement of motor function. Well, you know, the hope here is ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... do is somehow deflate it to make the water inside of it, the spinal fluid that even ... had a balloon inside your sink, and normally water can flow around the balloon and drain down ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... we treat very shortly after birth while the mother is still -- while the child is still in ... that is very, very low in order of single percentage points or less. In terms of the ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have Dr. Ed Smith from the Department of Neurosurgery, and David Walton from Partners in Health. Ed, I’m going to let you lead ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... that are actually made out of the same material that the suture material is made out of. So after 12, 18, ... avoid it. The idea being the fewer foreign materials you have the better. But there are times ...

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    Full Text Available ... good understanding of the Haitian health care delivery system, you know, with a child like this who ... If you have access to a health care system nearby where the tube can be fixed and ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... get referred up here, and many times the treatment for them is surgery. When Dumanel was diagnosed ... help administer these medications. They can directly observe therapy, meaning the patients will never miss a dose ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... you determine at the time of surgery. The risk factors for trying to figure out if a cyst is going to be recur or become a problem center on a couple different things. ... years are at slightly higher risk; the size of the cyst, the bigger the ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the collaboration that we have with Children’s to send children who have very, very complicated issues here ... they need to buy -- if they need to send their kid to school or if they need ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... live a long life without having subsequent neurosurgical issues. David asks, “Is there any inevitable neurologic damage after the surgery?” You know, and I guess my comment would ...

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    Full Text Available ... webcast screen and open the door to informed medical care. “OR-Live,” the vision of improving health. ... of taking care of the Haitians, our own medical staff, taking care of people of Haiti. That’s ...

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    Full Text Available ... continual medical care in the sense of getting medicines every day, but he is getting frequent follow- ... of our patients sometimes are on blood-thinning medicines or aspirin, you want to make sure that’s ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... determine at the time of surgery. The risk factors for trying to figure out if a cyst is going to be recur or become a problem center on a couple different things. First of all, the age of the child, and as I mentioned, kids under the age of one or two years are at slightly higher risk; the size ...

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    Full Text Available ... essentially. And so if someone has a chronic disease like HIV or tuberculosis or heart failure or ... to that earlier in the sense that the eyes are too far apart because of the protrusion ...

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    Full Text Available ... do all day is deal with children. The physiology is different. What’s particularly important, though, is that ... to get a sense of what the bony anatomy is like, which is relevant not just to ...

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    Full Text Available ... with Children’s and with you, John, looking to increase the capacity to do surgery. Not something, say, ... the other things we can do, and also increase our ability to deliver this kind of care. ...

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    Full Text Available ... a very close team of neuro- anesthetists to help us with this. And what you saw there ... like you and other come down to Haiti, help our Haitian surgeons with different ways of looking ...

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    Full Text Available ... terms of his ability to live a long life without having subsequent neurosurgical issues. David asks, “Is there any inevitable neurologic damage after the surgery?” You know, and I guess my ...

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    Full Text Available ... removing this the brain or in the scull base, whether it’s an encephalocele, whether it’s something called ” ... the smelling nerves, and those run along the base of the skull and head out into the ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... potentially coordinate over e-mail or phone or Internet with the staff here back at Children’s Hospital. ... to learn more. Just click on the “request information” button on your webcast screen and open the ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... do with these little blue, essentially tweezers, called “bipolars,” is to cauterize the tissue between the healthy ... of what we’re dissecting here with the bipolars, the little cautery equipment. The hope here is ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... well, then fluid can leak out through the seams basically and build up pressure underneath the scalp, and that pressure can inhibit healing and make the hole repair at risk. So as you see at the bottom of the video screen here, there’s that white tube, and I mentioned earlier there was an external ...

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    Full Text Available ... something that you determine at the time of surgery. The risk factors for trying to figure out if a ... larger encephaloceles and sphenoidal encephaloceles, sometimes that’s a risk either ... function is like before surgery and have a good sense of what it ...

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    Full Text Available ... care. “OR-Live,” the vision of improving health. Well good afternoon. Welcome to Boston. This is the ... went through and the steps to do that. Well, thank you both, you know, for laying a ...

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    Full Text Available ... open this up, it would allow for better healing for the child, reduce the number of operations ... leak under the skin, which could affect wound healing, or if there was any connections potentially down ...

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    Full Text Available ... there were like one or two days of ICU observations. In terms of what the future holds, ... time. As we mentioned, Dumanel was in the ICU for two days, and then, you know, stayed ...

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    Full Text Available ... could comment on, you know, what is the role of surgery in Partners and Health? How important ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ...

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    Full Text Available ... know, I think there’s a lot of different things about his health-care delivery which is very important in terms of ... And I think one of the most important things is to highlight the fact that, you ... surgical care, for example, that’s appropriate for that venue and ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... I know you’ve come to know the family very well. What are the, you know, so ... terms of monetary significance, you know, to the family, what was done, because I don’t think ...

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    Full Text Available ... then what we’re looking is that red structure right there is a major artery called the “ ... this is a very important part of the structure -- part of the repair and something which, you ...

  8. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... door to informed medical care. “OR-Live,” the vision of improving health. Well good afternoon. Welcome to Boston. This is the Children’s Hospital of Boston Craniofacial webcast. We’re going ...

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... which made his management a little bit more complex. So one thing I think would be good ... of different folks, sometimes otolaryngology. These are sometimes complex lesions, and we have a lot of different ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... door to informed medical care. “OR-Live,” the vision of improving health. Well good afternoon. Welcome to ... in terms of the control his of his vision, his ability for his nose to grow well. ...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... in the community. They do a number of things. They’re called -- essentially they’re called “accompan’tures” or “community health workers.” And they help us; the physicians, nurses, et cetera, be able to treat patients in their homes essentially. And so if someone has a chronic ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ... a permanent drain. Are there any other major risks that we need to be concerned with? Well ...

  13. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... benefit here at Children’s, obviously, from having trained pediatric anesthetists that all they do all day is ... big group of neurosurgeons, all of who are pediatric fellowship trained -- I mean pediatric board certified pediatric ...

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    Full Text Available ... of looks a little bit like a spider web. 5 I think what we’ll see right ... to someone having appendicitis is really a basic service that one needs, really, to consider one’s self- ...

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    Full Text Available ... horizontal” -- actually much more than just horizontal care. Meaning, you know, I’ll compare and contrast what ... Smile came to do for that particular trip. Meaning Operation Smile came, you know, we’re collaborating ...

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    Full Text Available ... we’ll be elevating a flap that involves skin, subcutaneous tissue, and the periosteum. And one thing ... these children with encephaloceles are born without adequate skin coverage, and so that’s a bit more of ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... has inside their brain, get into the normal pathways of spinal fluid. And the analogy I would ... can drain the spinal fluid in the normal pathway, and hopefully by doing that we will allow ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have ... something that you determine at the time of surgery. The risk factors for trying to figure out if a ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have ... plates. They’re clear plates. They look like plastic, but they are actually ... That gives the body adequate time to reform and redeposit bone in ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the eyes there. That is one of our anesthesia folks there who is working on getting him ... very important that 2 as part of undergoing anesthesia and all the shifts that happen with blood ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... relationship with children’s Hospital Boston, and after several months of getting visas and passports, et cetera, Dumanel ... see our most complex patients. It’s a fascinating model and it’s been highly successful. So I guess ...

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    Full Text Available ... I’m curious. What are your thoughts about extensive improvement of motor function. Well, you know, the ... know, his possessions, which in rural Haiti, include livestock or land, et cetera. And actually Recondo, he ...

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    Full Text Available ... these items that can, you know, generate some income for them. But, again, it was really all ... a cow there is about the average annual income in Haiti, so he was willing to give ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... Hospital Boston, in Boston, Massachusetts. During the program it’s easy for you to make referrals, make appointments, ... whole in the skull to some place where it’s not supposed to be. There are many different ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... had this encephalocele, this mass in between his nose, and there are many different kinds of encephalocele. ... The two most common are either in the nose here in the front, which tend to be ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... HIV or tuberculosis or heart failure or 10 diabetes, these community health workers who are actually people in the town or village in which the patients live, can help administer these medications. They can directly observe therapy, meaning the patients will never miss a dose ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... have Dr. Ed Smith from the Department of Neurosurgery, and David Walton from Partners in Health. Ed, ... know that a number of us from the Neurosurgery Department, including my colleague, Mark Proctor, who has ...

  8. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... Haiti, again, we’re really doing what we call “horizontal” -- actually much more than just horizontal care. ... used there. And notice in the what we call the “frontal orbital band O” there’s going to ...

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... skull deformities that maybe you see in your practice here at Children’s. Well I think that’s a ... Thank you for watching this “OR-Live” webcast presentation from Children’s Hospital Boston, in Boston, Massachusetts. OR- ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... that, you know, Partners in Health does a wide diversity of procedures down there, and the very ... sort of help us address that from the word go. I don’t know if you want ...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... to have this large deformity in between his eyes. This is something that was noticed since birth ... resulted in brain protruding out in between the eyes. And I wonder, Dave, if you can talk ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... external drain, before we remove it, we can challenge the child by raising or lowering the drain ... patient and make sure that the post-op management is appropriate and that is very comforting, given ...

  13. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... work for the hospitals who live in the community. They do a number of things. They’re called -- essentially they’re called “accompan’tures” or “community health workers.” And they help us; the physicians, ...

  14. SU-E-I-67: Arachnoid Cysts: The Role of the BLADE Technique

    Energy Technology Data Exchange (ETDEWEB)

    Mavroidis, P [University of North Carolina, Chapel Hill, NC (United States); Vlachopoulou, A; Kostopoulos, S; Ninos, C; Glotsos, D; Bakas, A; Oikonomou, G; Roka, V; Lavdas, E [Technological Education Institute of Athens, Athens, Attika (Greece); Kapsalaki, E; Tsirika, A [University of Thessaly, Larissa, Thessaly (Greece); Papanikolaou, N [University of Texas HSC SA, San Antonio, TX (United States); Stathakis, S [Cancer Therapy and Research Center, San Antonio, TX (United States)

    2015-06-15

    Purpose: The purpose of this study is first to show the extent by which BLADE sequences can reduce all the image artifacts and second to verify that the usefulness of this technique in certain pathological conditions is significant. Methods: In this study, fourteen consecutive patients (5 females, 9 males), who routinely underwent MRI brain examination, between 2010–2014, were selected. The applied routine protocols for brain MR examination included the following sequences: 1) T2-W FLAIR axial; 2) T2-W TSE axial; 3) T2*-W axial, 4) T1-W TSE sagittal; 5) DWI-W axial; 6) T1-W TSE axial; 7) T1-W TSE axial+contrast. In cases of cystic tumors, the T2-W FLAIR BLADE sequence was added to the protocol. All the images were evaluated independently at two separate settings with 3 weeks interval by two radiologists. The radiologists also evaluated the presence of image artifacts (motion, flow, chemical shift, Gibbs ringing). To evaluate the size of the cyst, the two radiologists compared the two techniques (conventional and BLADE) by assessing the extent of the divergence in the measurements of the cysts. Results: Regarding the extent of the cyst size, BLADE measurements were found to be more reliable than the conventional ones with the differences being statistically significant (p<0.01). The qualitative measurements indicated that the T2 FLAIR BLADE sequences were superior to the conventional T2 FLAIR with statistically significant differences (p<0.001) in the following characteristics: 1) overall image quality, 2) CSF nulling; 3) contrast at the pathology and its surrounding; 4) limits of the pathology; 5) motion artifacts; 6) flow artifacts; 7) chemical shift artifacts and 8) Gibbs ringing artifacts. Conclusion: BLADE sequence was found to decrease both flow artifacts in the temporal lobes and motion artifacts from the orbits and it is proposed for clinical use.

  15. SU-E-I-67: Arachnoid Cysts: The Role of the BLADE Technique

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study is first to show the extent by which BLADE sequences can reduce all the image artifacts and second to verify that the usefulness of this technique in certain pathological conditions is significant. Methods: In this study, fourteen consecutive patients (5 females, 9 males), who routinely underwent MRI brain examination, between 2010–2014, were selected. The applied routine protocols for brain MR examination included the following sequences: 1) T2-W FLAIR axial; 2) T2-W TSE axial; 3) T2*-W axial, 4) T1-W TSE sagittal; 5) DWI-W axial; 6) T1-W TSE axial; 7) T1-W TSE axial+contrast. In cases of cystic tumors, the T2-W FLAIR BLADE sequence was added to the protocol. All the images were evaluated independently at two separate settings with 3 weeks interval by two radiologists. The radiologists also evaluated the presence of image artifacts (motion, flow, chemical shift, Gibbs ringing). To evaluate the size of the cyst, the two radiologists compared the two techniques (conventional and BLADE) by assessing the extent of the divergence in the measurements of the cysts. Results: Regarding the extent of the cyst size, BLADE measurements were found to be more reliable than the conventional ones with the differences being statistically significant (p<0.01). The qualitative measurements indicated that the T2 FLAIR BLADE sequences were superior to the conventional T2 FLAIR with statistically significant differences (p<0.001) in the following characteristics: 1) overall image quality, 2) CSF nulling; 3) contrast at the pathology and its surrounding; 4) limits of the pathology; 5) motion artifacts; 6) flow artifacts; 7) chemical shift artifacts and 8) Gibbs ringing artifacts. Conclusion: BLADE sequence was found to decrease both flow artifacts in the temporal lobes and motion artifacts from the orbits and it is proposed for clinical use

  16. Acute hydrocephalus in a child with a third ventricle arachnoid cyst and coincidental enteroviral meningitis

    NARCIS (Netherlands)

    Jeltema, Hanne-Rinck; Kuijlen, Jos M. A.; Hoving, Eelco W.

    2014-01-01

    We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle. Duri

  17. A COMPARATIVE STUDY BETWEEN INTRATHECAL MORPHINE AND INTRATHECAL BUPRENORPHINE FOR POST - OPERATIVE ANALGESIA FOLLOWING CAESARIAN SECTION UNDER SUB ARACHNOID BLOCK

    Directory of Open Access Journals (Sweden)

    Anish M

    2015-05-01

    Full Text Available BACKGROUND: Good pain relief following caesarian section is of great importance and intrathecal opioids provide good quality postoperative analgesia for longer duration. So the following study describes a comparative study between intrathecal morphine and intrathecal buprenorphine for postoperative pain relief following caesarian section (CS under subarachnoid blockade. AIMS: The study was conducted to compare intrathecal morphine and buprenorphine for post of analgesia following CS, to achieve analgesia without seda tion for better maternal child bondage and to popularize intrathecal opioids . MATERIALS AND METHODS: 60 patients posted for CS under SAB were randomly allocated into group A and group B of 30 each, the group A received morphine 0.1 mg and buprenorphine 0 . 0 3 mg was given for group B patients along with the local anaesthetic. Subjective assessment of post - operative analgesia was done by direct questioning of the patient and by a five point pain scores. Duration of analgesia was taken as the time interval betw een the time of injection of intrathecal opiate and the time at which the patient felt pain and requested for additional analgesics. Data’s were analyzed using SPSS 16th version. OBSERVATION AND RESU LTS: The mean duration of post - operative analgesia with i ntrathecal morphine was 24.19+4 . 8 hours and that with buprenorphine was only 11.7+3.28 hours. Over weight patients reported a lower mean duration of analgesia. None of the patients in the study showed any bradycardia, hypotension, desaturation or respirato ry depression. Intrathecal opiates decreased the parenteral opiate requirements. The main side effects noticed were nausea in about 43% of patients in morphine group and 33% of patients in buprenorphine group. CONCLUSIONS: Intrathecal morphine 0 . 1 mg gives good post - operative analgesia of longer duration than buprenorphine 0 . 03mg. The quality of analgesia provided by intrathecal morphine was superior to intrathecal buprenorphine. There was no incidence of respiratory depression or sedation.

  18. Medline Plus

    Full Text Available ... Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst (Children's Hospital Boston, Boston, MA, 1/28/2009) ... Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst (Children's Hospital Boston, Boston, MA, 1/28/2009) ...

  19. Medline Plus

    Full Text Available ... Presbyterian Hospital, New York, NY, 7/15/2008) Neural Tube Defects Craniofacial Procedure to Treat Encephalocele and an Arachnoid ... Presbyterian Hospital, New York, NY, 2/11/2009) Neural Tube Defects Craniofacial Procedure to Treat Encephalocele and an Arachnoid ...

  20. Central nervous system malformations in Mohr's syndrome.

    OpenAIRE

    REARDON, W.; Harbord, M G; Hall-Craggs, M A; Kendall, B; Brett, E. M.; Baraitser, M

    1989-01-01

    A boy with severe developmental delay, bilateral, symmetrical hallucal duplication, and accessory alveolar frenula was found to have radiological evidence of a large arachnoid cyst compressing the cerebellum and brain stem. We review neurological abnormalities in Mohr's syndrome.

  1. [Acute paraplegia and intramedullary cavitation in a patient with pulmonary tuberculosis].

    Science.gov (United States)

    Schapira, M; Presas, J L; Speiser, E; Klimovsky, S; Barro, A; Nogués, M

    1992-01-01

    This 42-year-old male patient voluntarily discontinued treatment for lung TBC and twenty days later developed acute paraplegia. Magnetic resonance imaging (MRI) demonstrated a large intramedullary cavity extending from T2 to the conus medullaris. Having resumed anti-TBC treatment, the patient progressed favourably, despite any change in cavity size. Tuberculous meningitis may be complicated by the appearance of intramedullary cavities by two distinct mechanisms: 1) adhesive arachnoiditis at the skull base with obstruction of Luschka and Magendie foramina, followed by hydrocephalus and hydromyelia; and 2) spinal cord arachnoiditis with the development of arachnoidal and intramedullary cysts. In either case, symptoms are of late presentation. To the best of our knowledge, this is the first report in the literature of lung tuberculosis associated with syringomyelia but without basal arachnoiditis. Acute clinical presentation with paraplegia is exceptional. PMID:1340906

  2. The analysis of the pathophysiology of syringomyelia by means of magnetic resonance imaging

    International Nuclear Information System (INIS)

    The pathophysiology of syringomyelia was examined with magnetic resonance imaging (MRI) in 70 patients. According to complications, syringomyelia was classified as being associated with (1) Chiari malformation, (2) both Chiari malformation and basal arachnoiditis, (3) basal arachnoiditis, (4) an obstruction of the foramen Magendie, and (5) spinal arachnoiditis. MRI features in Type 1 included: wedge-shaped herniated tonsils with the cisterna magna, pencil-shaped rostral end of the intraspinal syrinx, and obliterated caudal part of the fourth ventricle. These findings suggested that the herniated tonsils might result in the disturbance of cerebro-spinal fluid (CSF) circulation. In Type 2, the tip of the herniated tonsils was round; a triangular space was noted between the herniated tonsils and the upper spinal cord; the rostral end of the intraspinal syrinx was round; and the caudal part of the fourth ventricle was well visualized. These findings revealed that the brain stem and spinal cord were less pressed, suggesting that CSF circulatory disturbance resulted from basal arachnoiditis around the foramen magnum. In Type 3, the cisterna magna was narrowed by a thickened arachnoid membrane. In type 4, the intraspinal syrinx was directly connected with the fourth ventricle via the patent central canal associated with hydrocephalus. The position of the cerebellar tonsils and the size of the cisterna magna were both normal. In Type 5, a partial adhesion of the arachnoid membrane around the spinal cord was shown, and the syrinx was found extended toward the rostral as well as the caudal direction of the arachnoid adhesion. The rostral end of the syrinx was sometimes changed in size during MRI examinatin. This phenomenon sustained William's theory of 'suck and slosh mechanism' of intraspinal syrinx extension. (N.K.)

  3. Syringomyelia caused by intrathecal remnants of oil-based contrast medium.

    Science.gov (United States)

    Kubota, Mayumi; Shin, Masahiro; Taniguchi, Makoto; Terao, Toru; Nakauchi, Jun; Takahashi, Hiroshi

    2008-02-01

    Oily contrast medium had been in use since the early 19th century as a radiographic agent for detecting spinal lesions and spinal cord tumors until the late 20th century. At that point computed tomography scanning and magnetic resonance imaging, or other hydrophilic contrast medium substituted for it. Adverse effects of oil-based dye, both acute and chronic, had been reported since the middle of the 20th century. In this paper the authors report the case of syringomyelia that seemed to be caused mainly by remaining oily contrast medium for 44 years. Syringomyelia secondary to adhesive arachnoiditis caused by oily contrast medium after a long period of time is well known. In the present case, however, surgery revealed only mild arachnoiditis at the level of syringomyelia as well as both solid and liquid remnants of contrast medium. Generally, cerebrospinal fluid (CSF) blockage due to an arachnoid adhesion is considered to cause syringomyelia following adhesive arachnoiditis. The authors speculated that in the present case syringomyelia was induced by a mechanism different from that in the previously reported cases; the oily contrast medium itself seems to have induced the functional block of CSF and impaired the buffer system of the intrathecal pressure. No reports on thoracic adhesive arachnoiditis and syringomyelia caused by oil-based dye referred to this mechanism in reviewing the literature. PMID:18248289

  4. Epidural anesthesia as a cause of acquired spinal subarachnoid cysts

    International Nuclear Information System (INIS)

    Six patients with acquired spinal subarachnoid cysts secondary to epidural anesthesia were evaluated with MR imaging (seven patients) and intraoperative US (three patients). The cysts were located in the lower cervical and thoracic spine. Adhesions and irregularity of the cord surface were frequently noted. Associated intramedullary lesions, including intramedullary cysts and myelomalacia, were seen in two of the patients. Arachnoiditis was unsuspected clinically in three patients, and MR imaging proved to be the diagnostic examination that first suggested the cause of the patients symptoms. The underlying mechanism for the formation of these cysts is a chemically induced arachnoiditis

  5. Prenatal diagnosis of Chudley-McCullough syndrome.

    Science.gov (United States)

    Chapman, Teresa; Perez, Francisco A; Ishak, Gisele E; Doherty, Dan

    2016-09-01

    Chudley-McCullough syndrome (CMS) is an autosomal-recessive disorder characterized by a complex brain malformation and profound congenital sensorineural hearing loss. Postnatal brain imaging findings include ventriculomegaly, partial agenesis of corpus callosum, inferior cerebellar dysplasia, arachnoid cysts, and malformations of cortical development including frontal subcortical heterotopia and polymicrogyria. Prenatal diagnosis of CMS is important due to the markedly less severe neurodevelopmental prognosis compared to disorders with similar brain imaging findings. We report prenatal imaging features that help distinguish CMS from other disorders, including slit-like frontal horns, agenesis of the corpus callosum, frontal subcortical heterotopia, arachnoid cysts, and cerebellar dysplasia. © 2016 Wiley Periodicals, Inc. PMID:27312216

  6. Role of diffusion-weighted MR imaging in discrimination between the intracranial cystic masses

    Directory of Open Access Journals (Sweden)

    Ahmed Farid Yousef

    2014-09-01

    Results and conclusions: Patients in this study were categorized into three main groups; first group is brain abscesses (36 cases, 91.6% of them showed restricted diffusion, second group is malignant cystic or necrotic brain tumors, 28 cases of high grade necrotic glioma, 60.7% of them are free diffusion, and third group is benign cystic masses, arachnoid and epidermiod cysts (11 cases; all arachnoid cysts are free diffusion. From these results diffusion-weighted imaging is playing an important role in discrimination of cystic intracranial masses.

  7. Imaging and outcome in severe complications of lumbar epidural anaesthesia: report of 16 cases

    International Nuclear Information System (INIS)

    We reviewed the clinical and neuroradiological features in 16 patients with serious neurological complications of lumbar epidural anaesthesia. We observed acute, transient or permanent and delayed complications. Four patients had symptoms immediately after the procedure. One patient developed a subacute flaccid paraparesis. Two other patients had infectious spondylodiscitis at lumbar puncture level. Eight patients had a delayed progressive spastic paraparesis and were found to have subarachnoid cysts and irregularities of the surface of the spinal cord consistent with arachnoiditis; six of them had an extensive, complex syrinx within the cord. One patient had a severe lumbar polyradiculopathy, and MRI showed adhesive arachnoiditis involving the cauda equina. Although epidural anaesthesia is generally considered safe, rare but severe complications, such as radiculopathy, infectious disease, myelopathy from ischemia and arachnoiditis with a syrinx may occur. The patients with arachnoiditis had a relentless progression of the disease and a poor outcome: five are confined to a wheelchair, one is bedridden. Complications of epidural anaesthesia are easily recognised when they develop immediately; their relationship to the anaesthesia may be ignored or underestimated when they appear after a delay. Awareness of the possibility of delayed complications is important. (orig.)

  8. Imaging and outcome in severe complications of lumbar epidural anaesthesia: report of 16 cases

    Energy Technology Data Exchange (ETDEWEB)

    Chiapparini, L.; Savoiardo, M. [Department of Neuroradiology, Istituto Nazionale Neurologico, Milano (Italy); Sghirlanzoni, A.; Pareyson, D. [Department of Neurology, Istituto Nazionale Neurologico, Milano (Italy)

    2000-08-01

    We reviewed the clinical and neuroradiological features in 16 patients with serious neurological complications of lumbar epidural anaesthesia. We observed acute, transient or permanent and delayed complications. Four patients had symptoms immediately after the procedure. One patient developed a subacute flaccid paraparesis. Two other patients had infectious spondylodiscitis at lumbar puncture level. Eight patients had a delayed progressive spastic paraparesis and were found to have subarachnoid cysts and irregularities of the surface of the spinal cord consistent with arachnoiditis; six of them had an extensive, complex syrinx within the cord. One patient had a severe lumbar polyradiculopathy, and MRI showed adhesive arachnoiditis involving the cauda equina. Although epidural anaesthesia is generally considered safe, rare but severe complications, such as radiculopathy, infectious disease, myelopathy from ischemia and arachnoiditis with a syrinx may occur. The patients with arachnoiditis had a relentless progression of the disease and a poor outcome: five are confined to a wheelchair, one is bedridden. Complications of epidural anaesthesia are easily recognised when they develop immediately; their relationship to the anaesthesia may be ignored or underestimated when they appear after a delay. Awareness of the possibility of delayed complications is important. (orig.)

  9. Cysticercose of the central nervous system: II. Spinal cysticercose

    Directory of Open Access Journals (Sweden)

    Benedicto Oscar Colli

    1994-06-01

    Full Text Available The compromising of the spinal canal by cysticercus is considered infrequent, varying from 16 to 20% in relation to the brain involvement. In the spinal canal the cysticercus predominantly places in the subarachnoid space. Clinical signs in spinal cysticercosis can be caused by direct compression of the spinal cord/roots by cisticerci and by local or at distance inflammatory reactions (arachnoiditis. Another mechanism of lesion is degeneration of the spinal cord due to pachymeningitis or circulatory insufficiency. The most frequent clinical features are signs of spinal cord and/or cauda equina compression. The diagnosis of spinal cysticercosis is based on evidence of cerebral cysticercosis and on neuroradiological examinations (myelography and myelo-CT that show signs of arachnoiditis and images of cysts in the subarachnoid space and sometimes, signs of intramedullary lesions, but the confirmation can only be made through immunological reactions in the CSF or during surgery. The clinical course of 10 patients with diagnosis of spinal cysticercosis observed among 182 patients submitted to surgical treatment due to this diasease are analyzed. The clinical pictures in all cases were signs of spinal cord or roots compression. All but two presented previously signs of brain cysticercosis. Neuroradiological examinations showed signs of arachnoiditis in 4 patients, images of cysts in the subarachnoid space in 5, and signs of arachnoiditis and images of cysts in one. The 6 patients that presented intraspinal cysts were submitted to exeresis of the cysts and 2 patients with total blockage of the spinal canal underwent surgery for diagnosis. The 2 remaining patients with arachnoiditis and blockge of the spinal canal were clinically treated. All of the six patients submitted to cyst exeresis had initial improvement but 4 of them later developed arachnoiditis and recurrence of the clinical signs and only 2 remained well for long-term. The 2 non operated

  10. Outer brain barriers in rat and human development

    DEFF Research Database (Denmark)

    Brøchner, Christian B; Holst, Camilla Bjørnbak; Møllgård, Kjeld

    2015-01-01

    Complex barriers at the brain's surface, particularly in development, are poorly defined. In the adult, arachnoid blood-cerebrospinal fluid (CSF) barrier separates the fenestrated dural vessels from the CSF by means of a cell layer joined by tight junctions. Outer CSF-brain barrier provides...... adults using immunohistochemistry and confocal microscopy. Antibodies against claudin-11, BLBP, collagen 1, SSEA-4, MAP2, YKL-40, and its receptor IL-13Rα2 and EAAT1 were used to describe morphological characteristics and functional aspects of the outer brain barriers. Claudin-11 was a reliable marker of...... the arachnoid blood-CSF barrier. Collagen 1 delineated the subarachnoid space and stained pial surface layer. BLBP defined radial glial end feet layer and SSEA-4 and YKL-40 were present in both leptomeningeal cells and end feet layer, which transformed into glial limitans. IL-13Rα2 and EAAT1 were...

  11. Spinal leptomeningeal cysticercosis

    International Nuclear Information System (INIS)

    The spinal forms of neurocysticercosis are extremely rare, with a frequency under 1% in large series. The types of involvement are a) subarachnoid cysts and b) intramedullary lesions (less frequent). The authors report the case of a 56-year-old female with central nervous system infection by the larval form of Taenia Solium, which conduced to a hydrocephalus, treated by neurosurgical ventricular-peritoneal shunting. After 2 years, the patient consulted due to paraesthesia, spastic paraparesis and incontinence. MRI showed an homogeneous cystic mass compressing the spinal cord at D5-D6 level. Laminectomies were performed and the arachnoid membrane appeared thickened (arachnoiditis); the larval cyst was removed. Anatomo-pathologic exam revealed a leptomeningeal cysticercosis. The patient had a favorable clinical evolution without spinal compression sings or symptoms. (author)

  12. Orthopaedic complications of lumboperitoneal shunts.

    Science.gov (United States)

    McIvor, J; Krajbich, J I; Hoffman, H

    1988-01-01

    Lumboperitoneal (LP) shunts performed for communicating hydrocephalus have been reported to lead to neurologic deficits in the lower limbs and spinal deformities as a result of arachnoiditis. A chart review of 375 children who underwent LP shunts between 1960 and 1981 at The Hospital For Sick Children in Toronto was undertaken. Of the 375 charts reviewed, evidence of shunt-induced neurologic deficits was seen in 63 patients. Thirty-four patients had back pain with or without sciatica, 45 patients had hamstring tightness, and 40 patients had foot deformities. Forty-nine patients had lumbar hyperlordosis, lordoscoliosis, and scoliosis. These deformities are postulated to be the result of arachnoiditis involving the conus medullaris and lower lumbar roots. PMID:3192696

  13. The extracisternal approach in vestibular schwannoma surgery and facial nerve preservation

    Directory of Open Access Journals (Sweden)

    Eduardo A. S. Vellutini

    2014-12-01

    Full Text Available The classical surgical technique for the resection of vestibular schwannomas (VS has emphasized the microsurgical anatomy of cranial nerves. We believe that the focus on preservation of the arachnoid membrane may serve as a safe guide for tumor removal. Method The extracisternal approach is described in detail. We reviewed charts from 120 patients treated with this technique between 2006 and 2012. Surgical results were evaluated based on the extension of resection, tumor relapse, and facial nerve function. Results Overall gross total resection was achieved in 81% of the patients. The overall postoperative facial nerve function House-Brackmann grades I-II at one year was 93%. There was no recurrence in 4.2 years mean follow up. Conclusion The extracisternal technique differs from other surgical descriptions on the treatment of VS by not requiring the identification of the facial nerve, as long as we preserve the arachnoid envelope in the total circumference of the tumor.

  14. Radiographic studies of the ventricles in syringomyelia

    International Nuclear Information System (INIS)

    Radiographic investigations of 171 patients with communicating syringomyelia have been reviewed. Hydrocephalus was found in one third of the cases and has occasionally progressed after operation on the posterior fossa, sometimes with accompanying clinical deterioration. The outlets of the fourth ventricle were usually abnormal; tonsillar descent, arachnoiditis and both together were seen. Arachnoiditis correlated strongly with a history of difficult birth. The foramen of Magendie was sometimes patent and sometimes blocked. There was no consistent level of occulusion corresponding to a persistent roof of the fourth ventricle. The cisterna magna was usually small or obliterated but some examples of large cisterns or subarachnoid pouches were found. Radiological demonstration of a communication from the fourth ventricle to the syrinx occurred in only seven patients by positive contrast material and not by air. It is suggested that a sizable communication is rare at the time when patients seek treatment. (orig.)

  15. Chronic subdural hematoma after eccentric exercise using a vibrating belt machine.

    Science.gov (United States)

    Park, Hey-Ran; Lee, Kyeong-Seok; Bae, Hack-Gun

    2013-09-01

    We report a case of bilateral chronic subdural hematoma (CSDH) in a 75-year-old man after exercise using a vibrating belt machine on the head. He suffered from headache and intermittent left side numbness for ten days. He denied any head injuries except eccentric exercise using a vibrating belt on his own head for 20 days. An MRI revealed bilateral CSDH. The hematoma was isodense on the CT scan. We made burr-holes on the both sides under local anesthesia. We identified the neomembrane and dark red subdural fluid on both sides. In the postoperative CT scan, we found an arachnoid cyst on the left temporal pole. Although the arachnoid cyst itself is asymptomatic, trivial injury such as vibrating the head may cause a CSDH. PMID:24278662

  16. Spinal cysticercosis

    International Nuclear Information System (INIS)

    Spinal cysticercosis is an extremely uncommon condition. We have examined four patients with complaints that resembled nervous root compression by disk herniation. Myelography was shown to be an efficient method to evaluate spinal involvement, that was characterized by findings of multiple filling defect images (cysts) plus signs of adhesive arachnoiditis. One cyst was found to be mobile. Because of the recent development of medical treatment, a quick and precise diagnosis is of high importance to determine the prognosis of this condition. (author)

  17. Usage of innovative precipitating liquid embolics for the endovascular occlusion of broadbased intracranial aneurysms

    OpenAIRE

    Tesmer, Kai

    2011-01-01

    Intracranial aneurysms do not usually become clinically apparent before their rupture. This medical emergency is connected with high morbidity and mortality. An aneurysm rupture is typically accompanied by a subarachnoid haemorrhage (SAH) as bleeding in the external CSF spaces between the arachnoid und pia mater. The primary aim when treating a patient with aneurismal SAH is the speedy elimination of the ruptured aneurysm in order to prevent an often fatal recurrence of the haemorrhaging. In ...

  18. Leptomeningeal metastasis from hepatocellular carcinoma with other unusual metastases: a case report

    OpenAIRE

    Pan, Zhenyu; Yang, Guozi; Yuan, Tingting; Pang, Xiaochuan; Wang, Yongxiang; QU, LIMEI; Dong, Lihua

    2014-01-01

    Background Leptomeningeal metastasis, which results from metastasis of tumors to the arachnoid and pia mater, can lead to the dissemination of tumor cells throughout the subarachnoid space via the cerebral spinal fluid, and frequently with a poor prognosis. The primary tumor in adults is most often breast cancer, lung cancer, or melanoma. Although leptomeningeal metastasis due to cholangiocarcinoma has been reported, to the best of our knowledge there is no cytologically confirmed report of l...

  19. Microneurosurgical management of temporal lobe epilepsy by amygdalohippocampectomy (AH) plus standard anterior temporal lobectomy (ATL): a report of our initial five cases in Bangladesh

    OpenAIRE

    Chowdhury, F. H.; Haque, M R; Islam, M S; Sarker, MH; Kawsar, KA; Sarker, AC

    2010-01-01

    Patient presenting as a case of Temporal Lobe Epilepsy (TLE) are usually resistant to antiepileptic drugs and surgery is the treatment of choice. This type of epilepsy may be due to Mesial Temporal Sclerosis (MTS), tumors [i.e. low grade glioma, Arterio-Venous Malformation (AVM) etc], trauma, infection (Tuberculosis) etc. Here we report five cases of surgically treated TLE that were due to a MTS, MTS with arachnoid cyst, low grade ganglioglioma, high grade ganglioglioma and a tuberculoma in t...

  20. Dicty_cDB: Contig-U00009-1 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ration... 34 7.0 AL021960_17( AL021960 |pid:none) Arabidopsis thaliana DNA chromoso... 34 7.0 DQ497350_1( DQ497350 |pid:none) Mano...4 7.0 DQ497352_1( DQ497352 |pid:none) Pyxis arachnoides oocyte maturatio... 34 7.0 DQ497348_1( DQ497348 |pid:none) Mano

  1. Arterial compression of nerve is the primary cause of trigeminal neuralgia

    OpenAIRE

    Chen, Guo-Qiang; Wang, Xiao-Song; Wang, Lin; Zheng, Jia-ping

    2013-01-01

    Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of...

  2. A role for myelography in assessing paraparesis.

    LENUS (Irish Health Repository)

    Merwick, A

    2012-02-03

    Imaging of the spine is a fundamental part of assessment of paraparesis. Since the advent of MRI the indications for myelograms have diminished. However, a myelogram, although an invasive test, should still be considered a useful investigation for localising lesions in the spinal cord and for identifying rare causes of myelopathy. This case illustrates how a CT myelogram identified an arachnoid cyst, which is a potentially treatable cause of paraparesis.

  3. Imaging of brain tumors

    International Nuclear Information System (INIS)

    The contents are diagnostic approaches, general features of tumors -hydrocephalus, edema, attenuation and/or intensity value, hemorrhage, fat, contrast enhancement, intra-axial supratentorial tumors - tumors of glial origin, oligodendrogliomas, ependymomas, subependymomas, subependymal giant cell astrocytomas, choroid plexus papilloma; midline tumors - colloid cysts, craniopharyngiomas; pineal region tumors and miscellaneous tumors i.e. primary intracerebral lymphoma, primitive neuroectodermal tumors, hemangioblastomas; extraaxial tumors - meningiomas; nerve sheath tumors -schwannomas, epidermoids, dermoids, lipomas, arachnoid cysts; metastatic tumors (8 refs.)

  4. Antioxidants: The new frontier for translational research in cerebroprotection

    OpenAIRE

    Anurag Tewari; Vidhi Mahendru; Ashish Sinha; Federico Bilotta

    2014-01-01

    It is important for the anesthesiologist to understand the etiology of free radical damage and how free-radical scavengers attenuate this, so that this knowledge can be applied to diverse neuro-pathological conditions. This review will concentrate on the role of reactive species of oxygen in the pathophysiology of organ dysfunction, specifically sub arachnoid hemorrhage (SAH), traumatic brain injury (TBI) as well as global central nervous system (CNS) hypoxic, ischemic and reperfusion states....

  5. Asuhan Keperawatan pada An. K dengan Prioritas Masalah Defisit Perawatan Diri di RSUD. dr.Pirngadi Medan

    OpenAIRE

    Batubara, Julianti

    2015-01-01

    Meningitis adalah radang dari selaput otak (arachnoid dan piamater). Bakteri dan virus merupakan penyebab utama dari meningitis. Meningitis disebabkan oleh berbagai macam organisme, tetapi kebanyakan pasien dengan meningitis mempunyai faktor predisposisi seperti fraktur tulang tengkorak, infeksi, operasi otak atau sum-sum tulang belakang. Seperti disebutkan di atas bahwa meningitis itu disebabkan oleh virus dan bakteri, maka meningitis dibagi menjadi dua bagian besar yaitu : meningitis purule...

  6. Intracranial Hypotension Syndrome, Diagnosis and Treatment in Radiology Clinics

    OpenAIRE

    Albayram, S

    2005-01-01

    Introduction & Background: Only 12 years ago the first report on pachymeningeal gadolinium enhance-ment in low-pressure headaches appeared in the lit-erature. Intracranial hypotension is a result of low CSF volume caused by either spontaneous or postoperative leakage. The syndrome has been reported to occur after head trauma, a tear in a spinal nerve root sheath, perineural cyst, or spinal arachnoid diverticulum. Iatrogenic causes include lumbar puncture or overdraining ventricular or spi...

  7. A Rare Case of Langerhans Cell Histiocytosis of the Skull in an Adult: a Systematic Review

    OpenAIRE

    Corinna Chiong; Shruti Jayachandra; Eslick, Guy D.; Darweesh Al-Khawaja; Vidyasagar Casikar

    2013-01-01

    We report a 41-year old male who presented to the Emergency Department after falling while water-skiing. He had a previous medical history included chronic headaches, which had persisted for the last 2-3 months prior to presentation. Computed tomography of the head showed a small hypersensitivity with a small extra axial collection with a maximum thickness of 1 mm. Differential diagnoses included an arachnoid cyst, haemangioma, meningioma or a secondary lesion. A diagnosis of Langerhans Cell ...

  8. Postsurgical Pathologies Associated with Intradural Electrical Stimulation in the Central Nervous System: Design Implications for a New Clinical Device

    OpenAIRE

    2014-01-01

    Spinal cord stimulation has been utilized for decades in the treatment of numerous conditions such as failed back surgery and phantom limb syndromes, arachnoiditis, cancer pain, and others. The placement of the stimulating electrode array was originally subdural but, to minimize surgical complexity and reduce the risk of certain postsurgical complications, it became exclusively epidural eventually. Here we review the relevant clinical and experimental pathologic findings, including spinal cor...

  9. Some observations on the pathogenesis of syringomyelia.

    OpenAIRE

    Newman, P K; Terenty, T R; Foster, J B

    1981-01-01

    The pathogenesis of most cases of syringomyelia remains obscure although a modification of the hydrodynamic theory of Gardner allows a logical surgical approach to treatment. Data are presented confirming a high incidence of traumatic birth in patients with syringomyelia who have a Chiari malformation or basal arachnoiditis, but demonstrating no increase in traumatic birth in patients with the Chiari malformation but no syringomyelia. A traumatic birth may be the factor responsible for creati...

  10. A pituitary abscess masquerading as recurrent hypernatremia and aseptic meningitis

    OpenAIRE

    Gonzales, Michael; Marik, Paul Ellis; Khardori, Romesh K.; O'Brian, John T

    2012-01-01

    Pituitary abscess is a rare condition. In the setting of multiple surgical interventions, the risk of its development increases. A 49-year-old man presented with episodes of altered mental status. He had two surgeries for a recurrent suprasellar arachnoid cyst. The second surgery was complicated by a persistent cerebrospinal fluid (CSF) leak that required two repairs following which he developed panhypopituitarism and central diabetes insipidus. Twelve months after his last surgery he was dia...

  11. Adolescent-onset idiopathic hemifacial spasm

    OpenAIRE

    Jianfeng Liang; Zhuangli Guo; Li Zhang; Yanbing Yu

    2014-01-01

    Aims: To study the clinical manifestations, illness-related factors and microsurgical management of adolescent-onset idiopathic hemifacial spasm. Materials and Methods: Of the 1221 microvascular decompression procedures performed for idiopathic hemifacial spasm between March 2001 and July 2007, 16 (1.3%) were in adolescent age (≤18). Results: Clinical manifestations in the adolescent-onset were typical, but milder when compared with late-onset. Gender, thickening and adhesion of the arachnoid...

  12. Non-schwannomatosis lesions of the internal acoustic meatus-a diagnostic challenge and management: a series report of nine cases.

    Science.gov (United States)

    Moura da Silva, Luis Fernando; Buffon, Viviane Aline; Coelho Neto, Maurício; Ramina, Ricardo

    2015-10-01

    Vestibular schwannomas (VS) are the most common lesions of cerebellopontine angle (CPA) corresponding to 76-91 % of the cases. Usually, these lesions present typical CT and MRI findings. Non-schwannomatous tumors restricted to the internal auditory meatus (IAM) are rare and their preoperative radiological diagnosis may be difficult. This article describes nine surgically treated intrameatal non-schwannomatous lesions (NSL) and reviews the literature. In the last 16 years, a total of 471 patients with diagnosis of VS were operated on in our department. Preoperatively, 42 patients had diagnosis of intrameatal schwannomas, but surgery revealed in nine cases NSL (3 meningiomas, 3 arachnoiditis/neuritis, 1 cavernoma, 1 vascular loop, and 1 arachnoid cyst). Most frequent symptoms presented by patients with NSL were hearing loss 89 % (8/9) of patients, tinnitus 78 % (7/9), and vertigo 33 % (3/9). Almost all lesions (8/9) presented MRI findings of isointense signal in T1W with contrast enhancement. The only exception was the arachnoid cyst with intracystic bleeding, which was hyperintense in T1W that is not enhanced with contrast. This series shows an occurrence of 21.4 % of non-schwannomatous tumors in 42 cases of lesions restricted to the IAM. Whenever a solely intrameatal enhanced tumor is detected, it is necessary to think about other diagnostic possibilities rather than VS. Therapeutic management may be changed, specially if radiosurgical treatment is considered. PMID:25957055

  13. Direct communication of the spinal subarachnoid space with the rat dorsal root ganglia.

    Science.gov (United States)

    Joukal, Marek; Klusáková, Ilona; Dubový, Petr

    2016-05-01

    The anatomical position of the subarachnoid space (SAS) in relation to dorsal root ganglia (DRG) and penetration of tracer from the SAS into DRG were investigated. We used intrathecal injection of methylene blue to visualize the anatomical position of the SAS in relation to DRG and immunostaining of dipeptidyl peptidase IV (DPP-IV) for detecting arachnoid limiting the SAS. Intrathecal administration of fluorescent-conjugated dextran (fluoro-emerald; FE) was used to demonstrate direct communication between the SAS and DRG. Intrathecal injection of methylene blue and DPP-IV immunostaining revealed that SAS delimited by the arachnoid was extended up to the capsule of DRG in a fold-like recess that may reach approximately half of the DRG length. The arachnoid was found in direct contact to the neuronal body-rich area in the angle between dorsal root and DRG as well as between spinal nerve roots at DRG. Particles of FE were found in the cells of DRG capsule, satellite glial cells, interstitial space, as well as in small and medium-sized neurons after intrathecal injection. Penetration of FE from the SAS into the DRG induced an immune reaction expressed by colocalization of FE and immunofluorescence indicating antigen-presenting cells (MHC-II+), activated (ED1+) and resident (ED2+) macrophages, and activation of satellite glial cells (GFAP+). Penetration of lumbar-injected FE into the cervical DRG was greater than that into the lumbar DRG after intrathecal injection of FE into the cisterna magna. Our results demonstrate direct communication between DRG and cerebrospinal fluid in the SAS that can create another pathway for possible propagation of inflammatory and signaling molecules from DRG primary affected by peripheral nerve injury into DRG of remote spinal segments. PMID:26844624

  14. Postoperative meningeal enhancement on MRI in children with brain neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Hee; Han, Bokyung Kim; Yoon, Hye Kyung; Shin, Hyung Jin [Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul (Korea, Republic of)

    2000-05-01

    The meninges composed of the dura, the arachnoid and the pia are significant sites of blood-brain barrier. Physical disruption of the integrity of the meninges from a variety of causes including surgery results in various patterns of meningeal enhancement on contrast enhanced MR images. It is important to distinguish normal reactive or benign postoperative enhancement from more serious leptomeningeal metastasis or infection, particularly in children with intracranial neoplasms. We present various patterns of meningeal enhancement on MRI in children following surgery for brain neoplasms. (author)

  15. Post-traumatic leptomeningeal cysts in infancy

    International Nuclear Information System (INIS)

    Post-traumatic leptomeningeal (P.T.L.C.) are capsulated liquor collections in the sub-arachnoidal space consequent to skull fractures. They occur typically in infancy and their deceitful onset needs an accurate X-ray follow-up in children with a history of cranial trauma. The authors present six cases of P.T.L.C. encountered in the last three years, recall the mechanism of formation, and stress the importance of standard radiological examination, and computed tomography for early diagnosis. (orig.)

  16. Pathology of the vestibulocochlear nerve

    Energy Technology Data Exchange (ETDEWEB)

    De Foer, Bert [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: bert.defoer@GZA.be; Kenis, Christoph [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: christophkenis@hotmail.com; Van Melkebeke, Deborah [Department of Neurology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Deborah.vanmelkebeke@Ugent.be; Vercruysse, Jean-Philippe [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: jphver@yahoo.com; Somers, Thomas [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Thomas.somers@GZA.be; Pouillon, Marc [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: marc.pouillon@GZA.be; Offeciers, Erwin [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Erwin.offeciers@GZA.be; Casselman, Jan W. [Department of Radiology, AZ Sint-Jan AV Hospital, Ruddershove 10, Bruges (Belgium); Consultant Radiologist, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium); Academic Consultent, University of Ghent (Belgium)], E-mail: jan.casselman@azbrugge.be

    2010-05-15

    There is a large scala of pathology affecting the vestibulocochlear nerve. Magnetic resonance imaging is the method of choice for the investigation of pathology of the vestibulocochlear nerve. Congenital pathology mainly consists of agenesis or hypoplasia of the vestibulocochlear nerve. Tumoral pathology affecting the vestibulocochlear nerve is most frequently located in the internal auditory canal or cerebellopontine angle. Schwannoma of the vestibulocochlear nerve is the most frequently found tumoral lesion followed by meningeoma, arachnoid cyst and epidermoid cyst. The most frequently encountered pathologies as well as some more rare entities are discussed in this chapter.

  17. Como Lo Hago Yo: Tratamiento Quirurgico Del Mielomeningocele

    Directory of Open Access Journals (Sweden)

    Santiago Portillo

    2014-01-01

    Full Text Available In Argentina there is national program for fortifying flour with folic acid. Prenatal diagnosis is not always accurate. Closure according to standard technique. We close muscle layer. We don × t favor corpectomy for kyphosis. We suture the placode to restore cylinder shape of the cord. We close muscle layer. Hydrocephalus: V-P shunt. Third ventriculostomy is not effective. Chiari II: Cervical laminectomy. Syringomyelia: We shunt the syrinx to the peritoneum. MMCL is the most common neural tube defect. It consists of a neural placode exposed to environment. The placode is surrounded by arachnoid and by thin epithelial tissue.

  18. Obstetrical brachial plexus injuries: a MRI diagnostic approach

    International Nuclear Information System (INIS)

    Purpose: To demonstrate the utility of Magnetic Resonance (MR) imaging in the evaluation of the obstetric injuries of the brachial plexus. Material and methods: 23 patients with semiology of brachial plexus palsy have been evaluated with high field MR. Patients were evaluated with a brain coil in axial, oblique coronal and sagittal planes with T1, T2 and STIR sequences. Results: In four patients (17%) the study was normal. In 19 patients (83%) we got pathological findings (pseudomeningoceles, neuromas, tumour and arachnoid cyst). Conclusion: The MR is a non-invasive method that permits to determinate the site and range of the brachial plexus damage, allowing to plan therapy. (author)

  19. Post-traumatic leptomeningeal cysts in infancy

    Energy Technology Data Exchange (ETDEWEB)

    Gugliantini, P.; Fariello, G.; Caione, P.; Rivosecchi, M.

    1980-01-01

    Post-traumatic leptomeningeal cysts (P.T.L.C.) are capsulated liquor collections in the sub-arachnoidal space consequent to skull fractures. They occur typically in infancy and their deceitful onset needs an accurate X-ray follow-up in children with a history of cranial trauma. The authors present six cases of P.T.L.C. encountered in the last three years, recall the mechanism of formation, and stress the importance of standard radiological examination, and computed tomography for early diagnosis.

  20. Global scale concentrations of volcanic activity on Venus: A summary of three 23rd Lunar and Planetary Science Conference abstracts. 1: Venus volcanism: Global distribution and classification from Magellan data. 2: A major global-scale concentration of volcanic activity in the Beta-Atla-Themis region of Venus. 3: Two global concentrations of volcanism on Venus: Geologic associations and implications for global pattern of upwelling and downwelling

    Science.gov (United States)

    Crumpler, L. S.; Aubele, Jayne C.; Head, James W.; Guest, J.; Saunders, R. S.

    1992-01-01

    As part of the analysis of data from the Magellan Mission, we have compiled a global survey of the location, dimensions, and subsidiary notes of all identified volcanic features on Venus. More than 90 percent of the surface area was examined and the final catalog comprehensively identifies 1548 individual volcanic features larger than approximately 20 km in diameter. Volcanic features included are large volcanoes, intermediate volcanoes, fields of small shield volcanoes, calderas, large lava channels, and lava floods as well as unusual features first noted on Venus such as coronae, arachnoids, and novae.

  1. Bone autografts and allografts in dogs

    International Nuclear Information System (INIS)

    Three patients (1 dog, 2 horses) are described where myelography was complicated, purportedly by injection of contrast medium into the meninges superficial to the subarachnoid space, Contrast medium injected in this location in a cadaver tended to accumulate dorsally within the vertebral canal, deep to the dura mater but superficial to the subarachnoid space, The ventral margin of the pooled contrast medium had a wavy or undulating margin and the dorsal margin was smooth, pooled contrast medium was believed to be sequestered within the structurally weakdural border cell layer between the dura mater and arachnoid membrane, or the so-called subdural space

  2. A rare case of Langerhans cell histiocytosis of the skull in an adult: a systematic review

    Directory of Open Access Journals (Sweden)

    Corinna Chiong

    2013-07-01

    Full Text Available We report a 41-year old male who presented to the Emergency Department after falling while water-skiing. He had a previous medical history included chronic headaches, which had persisted for the last 2-3 months prior to presentation. Computed tomography of the head showed a small hypersensitivity with a small extra axial collection with a maximum thickness of 1 mm. Differential diagnoses included an arachnoid cyst, haemangioma, meningioma or a secondary lesion. A diagnosis of Langerhans Cell Histiocytosis was made based on the histopathology examination and the immunoperoxidase staining.

  3. A Rare Case of Langerhans Cell Histiocytosis of the Skull in an Adult: a Systematic Review

    Science.gov (United States)

    Chiong, Corinna; Jayachandra, Shruti; D. Eslick, Guy; Al-Khawaja, Darweesh; Casikar, Vidyasagar

    2013-01-01

    We report a 41-year old male who presented to the Emergency Department after falling while water-skiing. He had a previous medical history included chronic headaches, which had persisted for the last 2-3 months prior to presentation. Computed tomography of the head showed a small hypersensitivity with a small extra axial collection with a maximum thickness of 1mm. Differential diagnoses included an arachnoid cyst, haemangioma, meningioma or a secondary lesion. A diagnosis of Langerhans Cell Histiocytosis was made based on the histopathology examination and the immunoperoxidase staining. PMID:24179650

  4. Cysts of the central nervous system : a clinicopathologic study of 145 cases.

    Directory of Open Access Journals (Sweden)

    Sundaram C

    2001-07-01

    Full Text Available Non-neoplastic, non-inflammatory cysts of the central nervous system may cause symptoms because of pressure, rupture or secondary inflammation. A total of 145 cases of cysts were reviewed during a study period of 12 years. The clinical details and histological features were noted in all cases. During this period 53 epidermoid cysts, 16 dermoid cysts, 38 colloid cysts, 23 arachnoid cysts, 5 neurenteric cysts, 5 ependymal and glial cysts, 2 Rathke′s cleft cysts and 3 unclassified cysts were encountered. The possible histogenesis is also discussed.

  5. [Studies of the epidermal pattern system of the palms and soles of the howler monkeys (Alouatta) (author's transl)].

    Science.gov (United States)

    Brehme, H; Newell-Morris, L

    1981-01-01

    The epidermal pattern frequencies and pattern intensity values of the palms and soles are described for 110 male and 80 female howler monkeys (genus Alouatta) including the species A. belzebul, A. seniculus, A. caraya and A. villosa. Interspecific comparisons are made and obvious sex and side differences are noted. The plantar surface tends to show greater interspecific variability than does the palmar surface. A. caraya is possibly the most divergent species of the genus. Comparison of the results with those for Ateles and Lagothrix confirms the aberrant position of Ateles arachnoides. PMID:7319428

  6. Acute respiratory failure after endoscopic third ventriculostomy: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Essam A Elgamal

    2012-01-01

    Full Text Available Endoscopic third ventriculostomy (ETV is a relatively safe procedure. However, postoperative acute respiratory failure may be fatal. The authors report an 8-month-old patient with obstructive hydrocephalus secondary to posterior fossa cyst, and Chiari malformation. After ETV he developed difficulty in breathing, and had to be reintubated and ventilated. The infant recovered fully after craniocervical decompression and insertion of cystoperitoneal shunt. We speculate that respiratory failure is related to relative expansion of the posterior fossa arachnoid cyst, causing significant compression on the brain stem. Supportive care with mechanical ventilation and brain stem decompression were the mainstay of treatment.

  7. Diffusion-weighted MR imaging (DWI) in two intradural spinal epidermoid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Thurnher, Majda M. [Medical University of Vienna, Vienna (Austria)

    2012-11-15

    Epidermoid cysts are rare, benign, congenital, slow-growing inclusion cysts. On T1 and T2 weighted NMR images epidermoid cysts show heterogeneity and lack of contrast enhancement. Based on signal intensities on conventional sequences, epidermoid cysts cannot be distinguished from other neoplastic lesions. When located in the spinal cord, differential diagnosis includes ependymoma, astrocytoma, cavernoma and metastasis. Diffusion-weighted imaging (DWI) has been shown to accurately distinguish intracranial epidermoid tumors from arachnoid cysts. DWI findings in two patients with surgically proven epidermoid cysts in the spinal canal are reported.

  8. Foramen Magnum Meningioma: a Case Report and Review of Literature

    Science.gov (United States)

    Jurinovic, Pavao; Bulicic, Ana Repic; Marcic, Marino; Mise, Nikolina Ivica; Titlic, Marina; Suljic, Enra

    2016-01-01

    Introduction: Meningiomas are slow-growing benign tumors that arise at any location where arachnoid cells reside. Although meningiomas account for a sizable proportion of all primary intracranial neoplasms (14.3–19%), only 1.8 to 3.2% arise at the foramen magnum. Their indolent development at the craniocervical junction makes clinical diagnosis complex and often leads to a long interval between onset of symptoms and diagnosis. Case report: We report a case of a 79-year-old male patient, presented with ataxia and sense of threatening fainting during verticalization. Magnetic resonance imaging revealed the presence of meningioma in the right side of craniospinal junction. PMID:27041817

  9. Abnormal origin of the ophthalmic artery from the anterior cerebral artery: Neuroradiological and intraoperative findings

    International Nuclear Information System (INIS)

    A 7-year old male child with an abnormal ophthalmic artery arising from the A1 segment of the anterior cerebral artery is described. The patient suffered growth inhibition which was thought to be caused by a craniobasal cystic lesion affecting the hypothalamus. Preoperative angiograms revealed no vascular abnormalities. The right ophthalmic artery, however, could not be identified. During resection of a large arachnoid cyst the ophthalmic artery was found to arise from the A1 segment of the anterior cerebral artery. To the best of our knowledge, this exact anomaly has not previously been reported. The clinical, neuroradiological and intraoperative findings are presented. (orig.)

  10. Microscopic Posterior Transdural Resection of Cervical Retro-Odontoid Pseudotumors.

    Science.gov (United States)

    Fujiwara, Yasushi; Manabe, Hideki; Sumida, Tadayoshi; Tanaka, Nobuhiro; Hamasaki, Takahiko

    2015-12-01

    Retro-odontoid pseudotumors are noninflammatory masses formed posterior to the odontoid process. Because of their anatomy, the optimal surgical approach for resecting pseudotumors is controversial. Conventionally, 3 approaches are used: the anterior transoral approach, the lateral approach, and the posterior extradural approach; however, each approach has its limitations. The posterior extradural approach is the most common; however, it remains challenging due to severe epidural veins. Although regression of pseudotumors after fusion surgery has been reported, direct decompression and a pathologic diagnosis are ideal when the pseudotumor is large. We therefore developed a new microscopic surgical technique; transdural resection. After C1 laminectomy, the dorsal and ventral dura was incised while preserving the arachnoid. Removal of the pseudotumor was performed and both of the dura were repaired. The patient's clinical symptoms subsequently improved and the pathologic findings showed degenerative fibrocartilaginous tissue. In addition, no neurological deterioration, central spinal fluid leakage, or arachnoiditis was observed. Currently, the usefulness of the transdural approach has been reported for cervical and thoracic disk herniation. According to our results, the transdural approach is recommended for resection of retro-odontoid pseudotumors because it enables direct decompression of the spinal cord and a pathologic diagnosis. PMID:26544168

  11. Microsurgical cerebral aneurysm training porcine model

    Directory of Open Access Journals (Sweden)

    Jon Olabe

    2011-01-01

    Full Text Available The authors developed a simple reproducible technique for aneurysm creation and adapted it to mimic intracranial dissection conditions using glue application as a pseudo-arachnoid type layer. Ten 1-2-month-old healthy domestic swine were employed under general anesthesia. A novel technique for bifurcation aneurysm creation was developed using two arteries and a vein. After aneurysm creation, diluted sulfuric acid was applied on the dome with a micropipette to increase aneurysm fragility in selected zones. The surgical field was then dried and contact glue was applied around the vascular complex in a circular manner so as to emulate arachnoidal connection fibers. Microsurgical dissection of the aneurysm and surrounding vessels was performed by delicately removing the adhesive substance. Diverse aneurysm clipping techniques, emergency rupture situations and vascular reconstruction procedures were trained. Twenty-two aneurysms were created at several vascular sites, one aneurysm dome ruptured during application of sulfuric acid, two aneurysm models were proved to be thrombosed, two aneurysms ruptured during the dissection and no intraoperative deaths occurred. All aneurysms were clipped in an acceptable manner. This bifurcation aneurysm model provides a novel training system to be used not only by neurosurgeons but also by neurovascular interventionists.

  12. MRI of intraspinal cysticercosis

    International Nuclear Information System (INIS)

    To describe the MR features of intraspinal cysticercosis. Medical records and MR images of four cases of intraspinal cysticercosis were retrospectively reviewed. The MR findings were described with regard to the location and signal intensity of the lesions, contrast enhancement, presence or absence of associated intracranial cysticerci, and other findings. There were three cases of subarachnoidal form and one case of intramedullary form. Cysticerci of subarachnoidal form in three cases were located in retromedullary space at C2 level, anterior to cord at C1-C6 levels, and lumbosacral area, respectively. The signal intensities of the lesions were same as those of CSF. Localized arachnoidal enhancement was found in all three cases. In one case there was a large area of high signal intensity within the spinal cord on T2-weighted image suggesting either ischemia secondary to vascular compromise or inflammatory edema. All of these three cases accompanied intracranial cysticercosis. Intramedullary cysticercosis in one case was shown as a single 1 cm cystic lesion at C2 level, which showed hypointense signal on T1-weighted image, hyperintense signal on T2-weighted image, and signet-ring-like enhancement. This lesion did not accompany intracranial cysticerci. Intraspinal cysticercosis manifested as single or multiple cysts within either spinal cord or subarachnoid space, and were frequently associated with arachnoiditis

  13. MRI of intraspinal cysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Cheol; Chang, Kee Hyun; Han, Moon Hee; Han, Gi Seok [Seoul Natioal University College of Medicine, Seoul (Korea, Republic of); Hwang, Hee Young [Chung Ang Gil Hospital, Incheon (Korea, Republic of)

    1995-01-15

    To describe the MR features of intraspinal cysticercosis. Medical records and MR images of four cases of intraspinal cysticercosis were retrospectively reviewed. The MR findings were described with regard to the location and signal intensity of the lesions, contrast enhancement, presence or absence of associated intracranial cysticerci, and other findings. There were three cases of subarachnoidal form and one case of intramedullary form. Cysticerci of subarachnoidal form in three cases were located in retromedullary space at C2 level, anterior to cord at C1-C6 levels, and lumbosacral area, respectively. The signal intensities of the lesions were same as those of CSF. Localized arachnoidal enhancement was found in all three cases. In one case there was a large area of high signal intensity within the spinal cord on T2-weighted image suggesting either ischemia secondary to vascular compromise or inflammatory edema. All of these three cases accompanied intracranial cysticercosis. Intramedullary cysticercosis in one case was shown as a single 1 cm cystic lesion at C2 level, which showed hypointense signal on T1-weighted image, hyperintense signal on T2-weighted image, and signet-ring-like enhancement. This lesion did not accompany intracranial cysticerci. Intraspinal cysticercosis manifested as single or multiple cysts within either spinal cord or subarachnoid space, and were frequently associated with arachnoiditis.

  14. Sudden cardiac arrest in a patient with epilepsy induced by chronic inflammation on the cerebral surface

    Institute of Scientific and Technical Information of China (English)

    Yuxi Liu; Weicheng Hao; Xiaoming Yang; Yimin Wang; Yu Su

    2012-01-01

    The present study analyzed a patient with epilepsy due to chronic inflammation on the cerebral surface underwent sudden cardiac arrest. Paradoxical brain discharge, which occurred prior to epileptic seizures, induced a sudden cardiac arrest. However, when the focal brain pressure was relieved, cardiac arrest disappeared. A 27-year-old male patient underwent pre-surgical video-electroencephalogram monitoring for 160 hours. During monitoring, secondary tonic-clonic seizures occurred five times. A burst of paradoxical brain discharges occurred at 2-19 seconds (mean 8 seconds) prior to epileptic seizures. After 2-3 seconds, sudden cardiac arrest occurred and lasted for 12-22 seconds (average 16 seconds). The heart rate subsequently returned to a normal rate. Results revealed arachnoid pachymenia and adhesions, as well as mucus on the focal cerebral surface, combined with poor circulation and increased pressure. Intracranial electrodes were placed using surgical methods. Following removal of the arachnoid adhesions and mucus on the local cerebral surface, paradoxical brain discharge and epileptic seizures occurred three times, but sudden cardiac arrest was not recorded during 150-hour monitoring. Post-surgical histological examination indicated meningitis. Experimental findings suggested that paradoxical brain discharge led to cardiac arrest instead of epileptic seizures; the insult was associated with chronic inflammation on the cerebral surface, which subsequently led to hypertension and poor blood circulation in focal cerebral areas.

  15. Use of an Android application “clinometer” for measurement of head down tilt given during subarachnoid block

    Science.gov (United States)

    Dixit, RB; Neema, MM

    2016-01-01

    Context: Head down tilt is given to patients after sub arachnoid block for adjustment of height of block. However, the amount of tilt given is subjective and cannot be documented. Aims: We used an android application named “clinometer” to measure exact degree of tilt given by anesthesiologists as their routine practice. Settings and Design: This observational study, at a medical college hospital, was done in 130 patients given sub arachnoid block for lower abdominal surgeries. Materials and Methods: We observed and documented vital data of patients and measured tilt given by application “clinometer.” Results: We observed that the application was easy to use and measured tilt each time. The result obtained can be documented, digitally saved and transferred. In 130 patients studied, we observed incidence of degree of tilt as follows: 6-8° tilt in 38 patients (29.23%), 8-10 in 36 patients (27.69%), 10-12 in 30 patients (23.08%), 12-14 in 12 patients (9.23%) and 14-16° tilt in 14 patients (10.77%). Use of application was received with enthusiasm by practicing anesthesiologists. Various possible uses of this application are discussed. PMID:26955307

  16. The dural tail sign of meningiomas

    International Nuclear Information System (INIS)

    This prospective study was performed to clarify the radiological and pathological features of the dural tail sign in MRIs of meningiomas. We investigated 65 cases of intracranial meningiomas including 23 cases on the cerebral convexity. The dural tail sign was recognized in 47 cases and in 19 cases of convexity lesions, showing continuous enhancement with lengths ranging from 5 to 45 mm. Dura mater marginal to the tumors were resected as widely as possible and analyzed histologically in serial sections. Twenty-two cases was graded as grade I and only one case was as grade II according to World Health Organization (WHO) grading criteria. Subdural proliferation of arachnoidal cells was found in 4 cases and venous dilatation of dura was seen in 7 cases. In contrast, clusters of tumor cells were recognized in 5 cases in the arachnoid, 7 cases along the subdural space, and in 3 cases invading into the dura. These results suggest that infiltration of tumor cells occurs frequently in the dural tail sign of meningiomas. (author)

  17. Comportamiento de reubicación del alimento de Eucranium, escarabajo estercolero endémico de la Argentina y comparación con Scarabaeus (Pachysoma del sudoeste de África (Coleoptera: Scarabaeidae: Scarabaeinae Food relocation and nesting behavior of the Argentinian dung beetle genus Eucranium and comparison with the southwest African Scarabaeus (Pachysoma (Coleoptera: Scarabaeidae: Scarabaeinae

    Directory of Open Access Journals (Sweden)

    Federico C. Ocampo

    2005-07-01

    Full Text Available Se describe el comportamiento de reubicación del alimento del género sudamericano Eucranium Brullé basado en observaciones en su ambiente natural. La preferencia de alimento, el modo de transportarlo, preferencia de hábitat, y período de actividad en la superficie son discutidos para dos especies: E. arachnoides Brullé y E. planicolle Burmeister. La biología y comportamiento de relocación del alimento de Eucranium es comparado con la biología y comportamiento del subgénero del sudoeste de África Scarabaeus (Pachysoma MacLeay, el cual es similar morfológicamente. La convergencia adaptativa a los ambientes áridos de Eucranium y S. (Pachysoma son discutidas.The food relocation and nesting behavior of the South American genus Eucranium Brullé is described based on observations carried out under natural conditions. Food preference, food transportation, period of surface activity, and habitat preference are described for two species, E. arachnoides Brullé and E. planicolle Burmeister. The biology and food relocation behavior of Eucranium is compared with that of the morphologically similar South African subgenus Scarabaeus (Pachysoma MacLeay. The convergent adaptations to psamophilous habitats of Eucranium and S. (Pachysoma are discussed.

  18. [Diagnosis of syringomyelia and its classification on the basis of symptoms, radiological appearance, and causative disorders].

    Science.gov (United States)

    Terae, Satoshi; Hida, Kazutoshi; Sasaki, Hidenao

    2011-09-01

    Although it is easier to accurately diagnose syringomyelia with the advent of magnetic resonance (MR) imaging, syringomyelia still poses challenges to clinicians because of its complex symptomatology, uncertain pathogenesis and multiple treatment options. Here, we propose criteria for classification of syringomyelia not related to those associated with spinal intramedullary tumors. The classification aims to distinguish between the presyrinx state and syringomyelia, between asymptomatic and symptomatic syringomyelia and to clarify the associated disorders such as Chiari malformations, spinal arachnoiditis and spinal cord trauma. Diagnostic criteria for Chiari I and II malformations with MR imaging were also defined. Several hypotheses proposed to explain the pathogenesis of syringomyelia associated with Chiari I malformation were reviewed. A questionnaire survey on syringomyelia based on the proposed criteria conducted between November 2009 and April 2010 in Japan revealed that 160 (22.6%) of the 708 patients were asymptomatic. Chiari I malformation was the most frequent causative disorder (48.3%), followed by spinal arachnoiditis (15.8%). The proposed criteria for classification of syringomyelia will facilitate a nationwide survey of syringomyelia in Japan. Such a survey will inform us of its prevalence and prognosis more precisely, and enable us to build a reliable database that may help determine the optimal treatment for the disease in the future. PMID:21878699

  19. Symptomatic surgically treated non-neoplastic cysts of the central nervous system: a clinicopathological study from pakistan

    International Nuclear Information System (INIS)

    To report clinicopathologic features of symptomatic surgically removed non-neoplastic cysts of the central nervous system (CNS). Study Design: Case series. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from 2003 to 2012. Methodology: All non-neoplastic CNS cysts reported during the study period were retrieved and reviewed. Age, gender, location, histologic type and clinical features were noted. Results: A total of 124 cysts were diagnosed in the study period. These included 44 epidermoid cysts (mean age 30.5 ± 13.8 years), 35 colloid cysts (mean age 31 ± 13.2 years), 32 arachnoid cysts (mean age 24.8 ± 20.2 years), 6 dermoid cysts, 3 enterogenous cysts and Rathke's cleft cysts each and 1 ependymal cyst. All cyst types mainly presented in young adults in both genders with signs and symptoms of a mass lesion. Conclusion: Non-neoplastic cyst mainly presented like a CNS mass lesion in young adults. Epidermoids were the most common type of these cysts in the present series followed by the colloid and the arachnoid cysts. (author)

  20. Histopathological Alterations after Single Epidural Injection of Ropivacaine, Methylprednizolone Acetate, or Contrast Material in Swine

    International Nuclear Information System (INIS)

    Purpose: The consequences from the injection of different types of drugs in the epidural space remains unknown. Increasing evidence suggests that localized inflammation, fibrosis, and arachnoiditis can complicate sequential epidural blockades, or even epidural contrast injection. We investigate the in vivo effect of epidural injections in the epidural space in an animal model. Materials and Methods: A group of ten male adult pigs, five punctures to each at distinct vertebral interspaces under general anesthesia, were examined, testing different drugs, used regularly in the epidural space (iopamidol, methylprednisolone acetate, ropivacaine). Each site was marked with a percutaneous hook wire marker. Histological analysis of the epidural space, the meninges, and the underlying spinal cord of the punctured sites along with staining for caspase-3 followed 20 days later. Results: The epidural space did not manifest adhesions or any other pathology, and the outer surface of the dura was not impaired in any specimen. The group that had the contrast media injection showed a higher inflammation response compared to the other groups (P = 0.001). Positive staining for caspase-3 was limited to <5% of neurons with all substances used. Conclusion: No proof of arachnoiditis and/or fibrosis was noted in the epidural space with the use of the above-described drugs. A higher inflammation rate was noted with the use of contrast media.

  1. Postsurgical pathologies associated with intradural electrical stimulation in the central nervous system: design implications for a new clinical device.

    Science.gov (United States)

    Gibson-Corley, Katherine N; Flouty, Oliver; Oya, Hiroyuki; Gillies, George T; Howard, Matthew A

    2014-01-01

    Spinal cord stimulation has been utilized for decades in the treatment of numerous conditions such as failed back surgery and phantom limb syndromes, arachnoiditis, cancer pain, and others. The placement of the stimulating electrode array was originally subdural but, to minimize surgical complexity and reduce the risk of certain postsurgical complications, it became exclusively epidural eventually. Here we review the relevant clinical and experimental pathologic findings, including spinal cord compression, infection, hematoma formation, cerebrospinal fluid leakage, chronic fibrosis, and stimulation-induced neurotoxicity, associated with the early approaches to subdural electrical stimulation of the central nervous system, and the spinal cord in particular. These findings may help optimize the safety and efficacy of a new approach to subdural spinal cord stimulation now under development. PMID:24800260

  2. Meningitis tuberculosa: Clinical findings and results of cranial computed tomography

    International Nuclear Information System (INIS)

    Guided by 9 own observations between 1977 and 1981, new diagnostic facilities in tuberculous meningitis are discussed. For differentiation from viral meningitis, measurement of CSF lactic acid concentration in addition to that of CSF glucose has proved to be of value in recent years. In accordance with the literature, two cases of this series which were examined for CSF lactic acid concentration showed markedly elevated levels of 8,4 rsp. 10,4 mmol/l. In contrast to this, in viral meningitis usually values of less than 3.5 mmol/l are found. Additionally, the presence of hypochlor- and hyponatremia, which could be demonstrated in 6 of our 9 patients, may raise the suspicion of tuberculous etiology. In the series presented, cranial computed tomography was of greatest diagnostic value, enabling the diagnosis of hydrocephalus internus in 5, and basal arachnoiditis in 2 cases. (orig.)

  3. Spontaneous development of bilateral subdural hematomas in an infant with benign infantile hydrocephalus: color Doppler assessment of vessels traversing extra-axial spaces

    International Nuclear Information System (INIS)

    We present an infant with macrocrania, who initially demonstrated prominent extra-axial fluid collections on sonography of the brain, compatible with benign infantile hydrocephalus (BIH). Because of increasing macrocrania, a follow-up sonogram of the brain was performed; it revealed progressive enlargement of the extra-axial spaces, which now had echogenic debris. Color Doppler US showed bridging veins traversing these extra-axial spaces, so it was initially thought that these spaces were subarachnoid in nature (positive cortical vein sign). However, an arachnoid membrane was identified superior to the cortex, and there was compression of true cortical vessels beneath this dural membrane. An MRI of the brain showed the extra-axial spaces to represent bilateral subdural hematomas. The pathogenesis of spontaneous development of the subdural hematomas, in the setting of BIH, is discussed. We also emphasize that visualizing traversing bridging veins through extra-axial spaces does not necessarily imply that these spaces are subarachnoid in origin. (orig.)

  4. Imaging techniques for diagnosis after surgery for degenerative disc disease

    International Nuclear Information System (INIS)

    The magnetic resonance imaging findings recorded in patients after surgery for degenerative disc disease in the lumbar and cervical spine are discussed in comparison with conventional radiographs and computed tomography findings. In the lumbar spine normal postoperative findings in the immediate postoperative period can be demonstrated by MR imaging. Contrast-enhanced MR imaging can differentiate disc herniation from postoperative scar formation with a greater degree of confidence than other imaging modalities. MR imaging improves differentiation between other causes of failed back syndrome such as postoperative hematoma and infection, lateral spinal stenosis and arachnoiditis. In the cervical spine types of operative approaches, the appearance of bony stenosis and disc herniations by MR imaging are discussed. Computer tomography still has a role in the assessment of osseous complications such as central or foraminal stenosis. (orig.)

  5. A Heidenhain variant of Creutzfeldt-Jakob disease: forensic implication.

    Science.gov (United States)

    Rizzo, M; Bruni, A; Barberio, C; Magro, G; Foncin, J F

    2004-12-01

    To investigate whether typical clinical, diagnostic and neuropathological findings can be identified in a patient with a postmortem diagnosis of a Heidenhain variant of Creutzfeldt-Jakob disease (CJD). We report a new case of CJD in a rare variant. A man admitted to hospital with cefalea and vision disorder. Clinical and neurological examination showed headache, vision reduction, psychomotor anxiety and progressive torpor. The patient died 4 h after admission to hospital. The autopsy findings included marked encephalic vascular congestion. Hystoneurology examination showed no macroscopic anomaly. Microscopy findings included neuronal loss, gliosis in striate area with arachnoid cells and cerebellum microspongiosis. Creutzfeldt-Jakob disease is a rare neurodegenerative human disorder. The prion hypothesis as an explanatory model is currently favoured by majority of researchers. A disease course described by Heidenhain including the leading symptoms of a visual disorder and rapid progression. This report emphasize the multidisciplinary role (forensic, neurogenetic and neurohistologic) for diagnosis and to standardize a protocol to investigate. PMID:15639587

  6. Computed tomography in leptomeningeal and ventricular spread of primary brain tumors

    International Nuclear Information System (INIS)

    Of 8000 consecutive patients studied with computed tomography, 10 patients with primary intracranial tumors (germinoma, medulloblastoma, malignant teratoma and glioblastoma) showed ventricular or leptomeningeal spread of the tumor cells. In patients with leptomeningeal spread, computed tomography showed obliteration of basal cisterns and sulci with isodense or slightly hyperdense mass, which was markedly enhanced following administration of the contrast medium. In cases of ventricular spread, a narrow zone of high density was noted on the ependymal surface, and it was also markedly enhanced with the contrast medium. Similar CT scan appearance of contrast enhancement in the subarachnoid space or the ventricular surface was, however, noted also in the infectious processes such as basal arachnoiditis or ependymitis, and the differentiation of the neoplastic process from the infectious lesions seemed impossible based on the CT scan appearance alone. (author)

  7. Valuation for magnetic resonance of neuro tuberculosis

    International Nuclear Information System (INIS)

    The increased incidence of neuro tuberculosis (NTB), due to the world epidemic of resistant strains and AIDS, has made of magnetic resonance (MR) imaging the study of choice for the early detection of lesions that lead the clinicians to an effective treatment. We present our experience with six cases of NTB, with meningoencephalic (4 cases), spinal, (1 case) and epidural (1 case) involvement. We identified basal arachnoiditis that was also seen on CT. Two cases demonstrated non-classifying tuberculomas, the spinal lesion consisted of casseifying tuberculoma that responded to treatment and disappeared on a follow up MR study. Epidural involvement consisted of Pott's disease with displacement and edema of the spinal cord. The differential diagnosis of these lesions includes mycoses, cysticercosis, sarcoidosis and leptomeningeal metastases

  8. Reduced GABA{sub A} receptor density contralateral to a potentially epileptogenic MRI abnormality in a patient with complex partial seizures

    Energy Technology Data Exchange (ETDEWEB)

    Kuwert, T. [Dept. of Nuclear Medicine, Muenster Univ. (Germany); Stodieck, S.R.G. [Dept. of Neurology, Muenster Univ. (Germany); Puskas, C. [Dept. of Nuclear Medicine, Muenster Univ. (Germany); Diehl, B. [Dept. of Neurology, Muenster Univ. (Germany); Puskas, Z. [Inst. of Clinical Radiology, Muenster Univ. (Germany); Schuierer, G. [Inst. of Clinical Radiology, Muenster Univ. (Germany); Vollet, B. [Dept. of Nuclear Medicine, Muenster Univ. (Germany); Schober, O. [Dept. of Nuclear Medicine, Muenster Univ. (Germany)

    1996-01-01

    Imaging cerebral GABA{sub A} receptor density (GRD) with single-photon emission tomography (SPET) and iodine-123 iomazenil is highly accurate in lateralizing epileptogenic foci in patients with complex partial seizures of temporal origin. Limited knowledge exists on how iomazenil SPET compares with magnetic resonance imaging (MRI) in this regard. We present a patient with complex partial seizures in whom MRI had identified an arachnoid cyst anterior to the tip of the left temporal lobe. Contralaterally to this structural abnormality, interictal electroencephalography (EEG) performed after sleep deprivation disclosed an intermittent frontotemporal dysrhythmic focus with slow and sharp waves. On iomazenil SPET images GRD was significantly reduced in the right temporal lobe and thus contralaterally to the MRI abnormality, but ipsilaterally to the pathological EEG findings. These data suggest that iomazenil SPET may significantly contribute to the presurgical evaluation of epileptic patients even when MRI identifies potentialy epileptogenic structural lesions. (orig.)

  9. Classification, mechanism and surgical treatments for spinal canal cysts

    Institute of Scientific and Technical Information of China (English)

    Jianjun Sun

    2016-01-01

    A variety of cystic lesions may develop in spinal canal. These cysts can be divided into intramedullary, intradural, extradural, cervical, thoracic, lumbar, and sacral cysts according to anatomical presentation, as well as arachnoid, meningeal, perineural, juxtafacet, discal, neurenteric cysts, and cyst-like lesions according to different etiologies. Mechanisms of initiation and growth vary for different cysts, such as congenital, trauma, bleeding, inflammatory, instability, hydrostatic pressure, osmosis of water, secretion of cyst wall, and one-way-valve effect, etc. Up to now, many treatment methods are available for these different spinal canal cysts. One operation method can be applied in cysts with different types. On the other hand, several operation methods may be utilized in one type of cyst according to the difference of location or style. However, same principle should be obeyed in surgical treatment despite of difference among spinal canal cysts, given open surgery is melely for symptomatic cyst. The surgical approach should be tailored to the individual patient.

  10. Interstitial deletion of chromosome 4p associated with mild mental retardation, epilepsy and polymicrogyria of the left temporal lobe

    DEFF Research Database (Denmark)

    Møller, R S; Hansen, C P; Jackson, G D;

    2007-01-01

    In this study, we present a 38-year-old woman with an interstitial deletion of 4p15.1-15.3, mild mental retardation, epilepsy and polymicrogyria adjacent to an arachnoid cyst of the left temporal lobe. The deletion was ascertained through array-comparative genome hybridization screening of patients...... with epilepsy and brain malformations. To date, about 35 patients with cytogenetically visible deletions involving 4p15 and without Wolf-Hirschhorn syndrome have been described, but the extent of the deletions has not been determined in the majority of these cases. The clinical manifestations of the...... patient described in this study were similar but not identical to the previously reported cases with 4p15 interstitial deletions. This finding indicates the presence of one or more genes involved in brain development and epilepsy in this chromosome region....

  11. Meningitis due to Enterobacter aerogenes subsequent to resection of an acoustic neuroma and abdominal fat graft to the mastoid

    Directory of Open Access Journals (Sweden)

    Fida A. Khan

    2004-10-01

    Full Text Available Meningitis is an uncommon complication of neurosurgical procedures, with an incidence of 1.1% to 2.5%. Although unusual, the frequency of nosocomial Gram-negative meningitis appears to be increasing. Gram-negative meningitis has been documented following disruption of the dura-arachnoid barrier secondary to trauma or surgery. The association of Gram-negative bacillary meningitis with neurosurgical procedures was first reported in the 1940's. Wolff et al. described the association between Enterobacter species and post-neurosurgical infection. More recently, risk factors for nosocomial Enterobacter meningitis have been characterized by Parodi et al. Adipose graft, as an independent risk factor has not yet been reported. A patient with acoustic neuroma resection, who developed bacterial meningitis from an abdominal fat pad graft to a mastoidectomy bed is described. A brief overview was made of post-neurosurgical Gram-negative meningitis.

  12. Evaluation of the Production and Absorption of Cerebrospinal Fluid.

    Science.gov (United States)

    Miyajima, Masakazu; Arai, Hajime

    2015-01-01

    The traditional hypothesis of cerebrospinal fluid (CSF) hydrodynamics presumes that CSF is primarily produced in the choroid plexus (CP), then flows from the ventricles into the subarachnoid spaces, and mainly reabsorbed in the arachnoid granulations. This hypothesis is necessary to reconsider in view of recent research and clinical observations. This literature review presents numerous evidence for a new hypothesis of CSF hydrodynamics-(1) A significantly strong relationship exists between the CSF and interstitial fluid (IF), (2) CSF and IF are mainly produced and absorbed in the parenchymal capillaries of the brain and spinal cord. A considerable amount of CSF and IF are also absorbed by the lymphatic system, and (3) CSF movement is not unidirectional flow. It is only local mixing and diffusion. PMID:26226980

  13. Cranium-brain trauma in computed tomographs - diagnosis and clinical correlation

    International Nuclear Information System (INIS)

    For the successful treatment of intracranial complications in the case of cranium-brain trauma a quick and exact diagnosis is necessary. The goal of this work was to test and evaluate the effectivity of computed tomography for neurotraumatology. Using 565 patients, who were acutely or at one time suffering from a cranium-brain trauma, the high validity of computed tomography for these injuries was proven. The following areas in question were studied with respect to the value of computed tomography in comparison to them: angiography, X-ray diagnostic, echoencephalography, brain scintigraphy, electroencephalography and neurological-psychopathological findings from cranium-brain trauma. Statement possibilities and difficulties of computed tomography are discussed in the cases of the following neurotraumatological diseases: extracranial hematomas; acute cranium-brain traumas; traumatic arachnoidal bleeding; diffuse brain edema; transtentorial herniation and brain contusions. At the end the diagnostic and therapeutic procedures in the case of cranium-brain trauma are presented. (orig.)

  14. The value of magnetic resonance imaging in evaluation of postoperative lumbar spine; Wartosc badania rezonansu magnetycznego w ocenie powiklan pooperacyjnych dyskow ledzwiowych

    Energy Technology Data Exchange (ETDEWEB)

    Lakomiec, B.; Samson, B.; Zabek, M.; Walecki, J.; Krolicki, L. [Wojewodzki Szpital Zespolony, Warsaw (Poland)

    1996-12-31

    Extruded lumbar discs are common reasons of lumbar pain and required appropriate surgical treatment. In 10-40% patients appear postoperative complications (e.g. recurrent lumbar disc on the same or different level, scar tissues involving nerve roots, arachnoiditis, discitis, postoperative pseudomeningocele, wrong level laminectomy) resulting recurrent lumbar pain and neurological symptoms. In our study 20 out of 216 patients have suffered recurrent back pain: 12 patients due to scar tissues, 6 patients due to recurrent discs, 2 patients due to postoperative discitis. Authors try to show the role of magnetic resonance imaging in evaluation of postoperative lumbar spine, result of surgical treatment, analyze the reasons of recurrent back pain. (author) 5 refs, 3 figs

  15. Multiplicity of cerebrospinal fluid functions: New challenges in health and disease

    Directory of Open Access Journals (Sweden)

    Stopa Edward G

    2008-05-01

    and excretory benefits. Finally, CSF reabsorption via multiple pathways (olfactory and spinal arachnoidal bulk flow is likely complemented by fluid clearance across capillary walls (aquaporin 4 and arachnoid villi when CSFP and fluid retention are markedly elevated. A model is presented that links CSF and ISF homeostasis to coordinated fluxes of water and solutes at both the blood-CSF and blood-brain transport interfaces. Outline 1 Overview 2 CSF formation 2.1 Transcription factors 2.2 Ion transporters 2.3 Enzymes that modulate transport 2.4 Aquaporins or water channels 2.5 Receptors for neuropeptides 3 CSF pressure 3.1 Servomechanism regulatory hypothesis 3.2 Ontogeny of CSF pressure generation 3.3 Congenital hydrocephalus and periventricular regions 3.4 Brain response to elevated CSF pressure 3.5 Advances in measuring CSF waveforms 4 CSF flow 4.1 CSF flow and brain metabolism 4.2 Flow effects on fetal germinal matrix 4.3 Decreasing CSF flow in aging CNS 4.4 Refinement of non-invasive flow measurements 5 CSF volume 5.1 Hemodynamic factors 5.2 Hydrodynamic factors 5.3 Neuroendocrine factors 6 CSF turnover rate 6.1 Adverse effect of ventriculomegaly 6.2 Attenuated CSF sink action 7 CSF composition 7.1 Kidney-like action of CP-CSF system 7.2 Altered CSF biochemistry in aging and disease 7.3 Importance of clearance transport 7.4 Therapeutic manipulation of composition 8 CSF recycling in relation to ISF dynamics 8.1 CSF exchange with brain interstitium 8.2 Components of ISF movement in brain 8.3 Compromised ISF/CSF dynamics and amyloid retention 9 CSF reabsorption 9.1 Arachnoidal outflow resistance 9.2 Arachnoid villi vs. olfactory drainage routes 9.3 Fluid reabsorption along spinal nerves 9.4 Reabsorption across capillary aquaporin channels 10 Developing translationally effective models for restoring CSF balance 11 Conclusion

  16. 'Subarachnoid cyst' after evacuation of chronic subdural hematoma: Case report of an unusual postoperative morbidity.

    Science.gov (United States)

    Sharon, Low Y Y; Wai Hoe, N G

    2016-01-01

    Burr-hole drainage of chronic subdural hematomas are routine operative procedures done by neurosurgical residents. Common postoperative complications include acute epidural and/or subdural bleeding, tension pneumocephalus, intracranial hematomas and ischemic cerebral infarction. We report an interesting post-operative complication of a 'subarachnoid cyst' after burr-hole evacuation of a chronic subdural hematoma. The authors hypothesize that the 'cyst' is likely secondary to the splitting of the adjacent neomembrane within its arachnoid-brain interface by iatrogenic irrigation of the subdural space. Over time, this 'cyst' develops into an area of gliosis which eventually causes long-term scar epilepsy in the patient. As far as we are aware, this is the first complication of such a 'subarachnoid cyst' post burr-hole drainage reported in the literature. PMID:27366276

  17. Pleuropulmonary paragonimiasis with migrated lesions cured by multiple therapies.

    Science.gov (United States)

    Hu, Yun; Qian, Jun; Yang, Dongliang; Zheng, Xin

    2016-01-01

    Paragonimiasis is an infectious disease caused by Trematodes of the genus Paragonimus that is endemic in Asia, Africa, and South America. Most patients with paragonimiasis are cured by standard praziquantel treatment. However, several cases have been reported to have unsatisfactory responses to the standard praziquantel treatment. To probe the clinical characteristics, possible cause, and management of the paragonimiasis individuals improved by multiple therapies, we present a 12-year-old Chinese boy, who was infected with Paragonimus accompanied by arachnoid cyst involvement, as not having typical clinical symptoms, but repeatedly presenting with migrated lesions between the lung and pleura. He responded to treatment with 3 cycles of praziquantel and 1 cycle of albendazole. PMID:26960636

  18. Differential diagnosis of dumbbell lesions associated with spinal neural foraminal widening: Imaging features

    International Nuclear Information System (INIS)

    Computed tomography (CT) and magnetic resonance imaging (MRI) reliably demonstrate typical features of schwannomas or neurofibromas in the vast majority of dumbbell lesions responsible for neural foraminal widening. However, a large variety of unusual lesions which are causes of neural foraminal widening can also be encountered in the spinal neural foramen. Radiologic findings can be helpful in differential diagnosis of lesions of spinal neural foramen including neoplastic lesions such as benign/malign peripheral nerve sheath tumors (PNSTs), solitary bone plasmacytoma (SBP), chondroid chordoma, superior sulcus tumor, metastasis and non-neoplastic lesions such as infectious process (tuberculosis, hydatid cyst), aneurysmal bone cyst (ABC), synovial cyst, traumatic pseudomeningocele, arachnoid cyst, vertebral artery tortuosity. In this article, we discuss CT and MRI findings of dumbbell lesions which are causes of neural foraminal widening.

  19. MRI--the investigation of choice in syringomyelia?

    Science.gov (United States)

    Dowling, R J; Tress, B M

    1989-11-01

    During a 12 month period of operation of a 0.3 Tesla MRI iron cored resistive scanner 74 cases of syringomyelia were diagnosed on clinical, radiological and/or surgical grounds. Without knowledge of any clinical or radiological data the syrinxes were classified into five groups--idiopathic, idiopathic associated with Chiari malformation, tumour associated, post-traumatic and arachnoiditis associated--and the lesion characteristics within each group were compared. Although MRI was extremely sensitive in picking up even small syrinxes, there was considerable overlap of MRI characteristics across the sub-groups, so that two post-traumatic syrinxes had lesion characteristics identifiable with those of tumour syrinx and one intramedullary tumour syrinx had the MRI characteristics of a benign, idiopathic syrinx. It is concluded that meticulous attention to technique, including axial as well as sagittal T1 weighted sequences, and the administration of intravenous paramagnetic contrast media are necessary for detection and accurate classification of syrinxes. PMID:2633734

  20. Examinations with computerized cranial axial tomography carried out on patients with epileptic seizures, taking into consideration the EEG and the clinical picture

    International Nuclear Information System (INIS)

    204 patients suffering from epileptic seizures were examined with the help of computerized cranial X-ray tomography; the results were compared with anamnestic, clinical, and EEC-findings. In good agreement with results published in literature, in 54% of the patients pathologic CT's such as tumours, attack scars, changes in ventricles and arachnoid spaces etc. were found. A pathological CT is very likely to appear in male patients who are 30 or even 50 years of age, having partial attacks with elementary symptoms, focal diagnosis in the EEG and a neurological unilateral finding. Especially noteworthy is the tumour detecting rate achieved by CT and the fact that in nearly 5% of the cases CT detected a cerebral lesion which has not been suspected, neither clinically nor in the EEG (4 tumours). This shows clearly that CT represents a heighly valuable diagnostic help, especially for patients with epileptic seizures. (orig./MG)

  1. Intracranial extra-axial hemangioma in a newborn: A case report and literature review

    Science.gov (United States)

    Dalsin, Marcos; Silva, Rafael Sodré; Galdino Chaves, Jennyfer Paula; Oliveira, Francine Hehn; Martins Antunes, Ápio Cláudio; Vedolin, Leonardo Modesti

    2016-01-01

    Background: Congenital hemangiomas are benign vascular tumors, and the intracranial counterpart was described in very few cases. Case Description: A newborn presented with an intracranial tumor associated with an arachnoid cyst, diagnosed by antenatal ultrasound at 37 weeks of gestation. Surgery was indicated due to increased head circumference and bulging fontanelle, and a complete resection of an extra-axial red–brown tumor was performed at the 3rd week of life. Microscopy revealed a hemangioma. Conclusion: Hemangioma is a rare differential diagnosis that must be considered in extra-axial intracranial tumors affecting infants and neonates. The radiological features are not helpful in differentiating from other tumors, and surgery is indicated when the diagnosis is uncertain or whenever there are signs of increased intracranial pressure.

  2. Delleman Oorthuys syndrome

    Directory of Open Access Journals (Sweden)

    Syed Wajahat A Rizvi

    2015-01-01

    Full Text Available Oculocerebrocutaneous or Delleman syndrome is a rare congenital syndrome characterized by microphthalmia/anophthalmia with or without orbital cysts, focal skin defects, intracranial cysts and skin appendages. We here report a case of 1-year-old male child with periocular skin tags, lid colobomas, and dermal hypoplasia. The patient had delayed developmental milestones and history of tonic-clonic seizures. Magnetic resonance imaging of the head revealed a large arachnoid cyst, aplastic cerebellar vermis and polymicrographic pattern of the cerebral cortex. A complex cyst of spleen was also noted on abdominal ultrasonography. Orbital cysts depending on the size can be excised or left alone. Neuroimaging evaluation of patients with congenital orbital cysts and skin appendages is emphasized for early and appropriate management.

  3. Preoperative localization of epileptic foci with SPECT brain perfusion imaging, electrocorticography, surgery and pathology

    International Nuclear Information System (INIS)

    Objective: The value of preoperative localization of epileptic foci with SPECT brain perfusion imaging was investigated. Methods: The study population consisted of 23 patients with intractable partial seizures which was difficult to control with anticonvulsant for long period. In order to preoperatively locate the epileptic foci, double SPECT brain perfusion imaging was performed during interictal and ictal stage. The foci were confirmed with electrocorticography (EcoG), surgery and pathology. Results: The author checked with EcoG the foci shown by SPECT, 23 patients had all typical spike discharge. The regions of radioactivity increase in ictal matched with the abnormal electrical activity areas that EcoG showed. The spike wave originated in the corresponding cerebrum cortex instead of hyperplastic and adherent arachnoid or tumor itself. Conclusions: SPECT brain perfusion imaging contributes to distinguishing location, size, perfusion and functioning of epileptogenic foci, and has some directive function on to making out a treatment programme at preoperation

  4. Case Report: Acute obstructive hydrocephalus associated with infratentorial extra-axial fluid collection following foramen magnum decompression and durotomy for Chiari malformation type I [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sunil Munakomi

    2016-01-01

    Full Text Available Acute obstructive hydrocephalus due to infratentorial extra-axial fluid collection (EAFC is an extremely rare complication of foramen magnum decompression (FMD and durotomy for Chiari malformation type I. Presence of infratentorial  EAFC invariably causes obstruction at the level of the fourth ventricle or aqueduct of Silvius, thereby indicating its definitive role in hydrocephalus. Pathogenesis of EAFC is said to be a local arachnoid tear as a result of durotomy, as this complication is not described in FMD without durotomy. Controversy exists in management. Usually EAFC is said to resolve with conservative management; so hydrocephalus doesn’t require treatment. However, in this case EAFC was progressive and ventriculo-peritoneal shunting (VPS was needed for managing progressive and symptomatic hydrocephalus.

  5. Anatomy and development of the meninges: implications for subdural collections and CSF circulation

    Energy Technology Data Exchange (ETDEWEB)

    Mack, Julie [Penn State Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Squier, Waney [John Radcliffe Hospital, Department of Neuropathology, Oxford (United Kingdom); Eastman, James T. [Lancaster General Hospital, Department of Pathology and Laboratory Medicine, Lancaster, PA (United States)

    2009-03-15

    The dura is traditionally viewed as a supportive fibrous covering of the brain containing the dural venous sinuses but otherwise devoid of vessels and lacking any specific function. However, review of the embryology and anatomy reveals the dura to be a complex, vascularized and innervated structure, not a simple fibrous covering. The dura contains an inner vascular plexus that is larger in the infant than in the adult, and this plexus likely plays a role in CSF absorption. This role could be particularly important in the infant whose arachnoid granulations are not completely developed. Although subdural hemorrhage is frequently traumatic, there are nontraumatic conditions associated with subdural hemorrhage, and the inner dural plexus is a likely source of bleeding in these nontraumatic circumstances. This review outlines the development and age-specific vascularity of the dura and offers an alternative perspective on the role of the dura in homeostasis of the central nervous system. (orig.)

  6. Epidermal nevus syndrome associated with unusual neurological, ocular, and skeletal features

    Directory of Open Access Journals (Sweden)

    Reena Sharma

    2012-01-01

    Full Text Available Epidermal nevus syndrome (ENS is a rare disease, the pathogenesis of which is largely elusive. We, hereby, report an exclusive case of a 20-year-old man with verrucous ENS presented with dark colored papules and plaques along the Blaschko′s lines present over the head and neck area along with fleshy growth in both eyes since birth. Limb length discrepancy and kyphoscoliosis were remarkable. Skin biopsy was compatible with verrucous epidermal nevus while the biopsy of the ocular lesion confirmed complex choristoma. MRI brain revealed calcification in the right temporal lobe. Bilateral arachnoid cyst in the middle cranial fossa, scleral osteoma in the posterior part of the right eyeball, and deformed calvarium were evident on CECT skull and orbit. The present illustration emphasizes the importance of a punctilious work up of the case.

  7. Evaluation of brachial plexus injury by CT myelography

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of CT myelography (CTM) in brachial plexus injury. Methods: Twenty-seven patients with brachial plexus injury were examined by using cervical CTM with spiral scan and bone reconstruction algorithm. CT images were reviewed by the senior radiologists, who determined if the nerve root avulsion was presented. The criteria of diagnosing nerve root avulsion were loss of normal nerve root appearance in the Isovist filled thecal sac in consecutive CTM slices plus companion signs. The sensitivity, specificity, and accuracy of CTM in diagnosing nerve root injuries were calculated with operation findings and follow-up results as gold standard. Results: Direct sign of nerve root avulsion was the loss of normal nerve root defect seen in the Isovist filled thecal sac in consecutive CTM slices. Indirect signs included: (1) Pseudomeningocele bulge: The leak of Isovist into nerve root sheath, and extended into foramina; (2) Arachnoid cyst: displacement of spinal cord; (3) Dissymmetry of subarachnoid cavity: deformity of thecal sac, partially lack of Isovist into arachnoid space; (4) Non-integrity of dural cap sule wall: one side of cap sule cavity was obstructed. Part of the surface of spinal cord was exposed. Brachial plexus injury could be diagnosed by direct sign with one of the indirect signs. Of the 27 patients (128 nerve roots), 91 nerve root avulsions were found on CTM, and 37 was found normal. Compared with operation findings, 84 were true positive, 7 false positive, 34 true negative, and 3 false negative. Based on these results, the sensitivity, specificity, and accuracy were 96.6%, 82.9%, and 92.2%, respectively. Conclusion: CTM is accurate in detecting nerve root avulsion of brachial plexus. (authors)

  8. Diffusion-weighted MRI in cystic or necrotic intracranial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Park, S.H.; Chang, K.H.; Song, I.C.; Kim, Y.J.; Kim, S.H.; Han, M.H. [Dept. of Diagnostic Radiology, Seoul National University Hospital (Korea)

    2000-10-01

    Our purpose was to investigate the signal intensities of cystic or necrotic intracranial lesions on diffusion-weighted MRI (DWI) and measure their apparent diffusion coefficients (ADC). We examined 39 cystic or necrotic intracranial lesions in 33 consecutive patients: five malignant gliomas, seven metastases, two other necrotic tumours, a haemangioblastoma, three epidermoids, an arachnoid cyst, seven pyogenic abscesses, 12 cases of cysticercosis and one of radiation necrosis. DWI was performed on a 1.5 T unit using a single-shot echo-planar spin-echo pulse sequence with b 1000 s/mm{sup 2}. The signal intensity of the cystic or necrotic portion on DWI was classified by visual assessment as markedly low (as low as cerebrospinal fluid), slightly lower than, isointense with, and slightly or markedly higher than normal brain parenchyma. ADC were calculated in 31 lesions using a linear estimation method with measurements from b of 0 and 1000 s/mm{sup 2}. The cystic or necrotic portions of all neoplasms (other than two metastases) gave slightly or markedly low signal, with ADC of more than 2.60 x 10{sup -3} mm{sup 2}/s. Two metastases in two patients showed marked high signal, with ADC of 0.50 x 10{sup -3} mm{sup 2}/s and 1.23 x 10{sup -3} mm{sup 2}/s, respectively. Epidermoids showed slight or marked high signal, with ADC of less than 1.03 x 10{sup -3} mm{sup 2}/s. The arachnoid cyst gave markedly low signal, with ADC of 3.00 x 10{sup -3} mm{sup 2}/s. All abscesses showed marked high signal, with ADC below 0.95 x 10{sup -3} mm{sup 2}/s. The cases of cysticercosis showed variable signal intensity; markedly low in five, slightly low in three and markedly high in four. (orig.)

  9. Diffusion-weighted MRI in cystic or necrotic intracranial lesions

    International Nuclear Information System (INIS)

    Our purpose was to investigate the signal intensities of cystic or necrotic intracranial lesions on diffusion-weighted MRI (DWI) and measure their apparent diffusion coefficients (ADC). We examined 39 cystic or necrotic intracranial lesions in 33 consecutive patients: five malignant gliomas, seven metastases, two other necrotic tumours, a haemangioblastoma, three epidermoids, an arachnoid cyst, seven pyogenic abscesses, 12 cases of cysticercosis and one of radiation necrosis. DWI was performed on a 1.5 T unit using a single-shot echo-planar spin-echo pulse sequence with b 1000 s/mm2. The signal intensity of the cystic or necrotic portion on DWI was classified by visual assessment as markedly low (as low as cerebrospinal fluid), slightly lower than, isointense with, and slightly or markedly higher than normal brain parenchyma. ADC were calculated in 31 lesions using a linear estimation method with measurements from b of 0 and 1000 s/mm2. The cystic or necrotic portions of all neoplasms (other than two metastases) gave slightly or markedly low signal, with ADC of more than 2.60 x 10-3 mm2/s. Two metastases in two patients showed marked high signal, with ADC of 0.50 x 10-3 mm2/s and 1.23 x 10-3 mm2/s, respectively. Epidermoids showed slight or marked high signal, with ADC of less than 1.03 x 10-3 mm2/s. The arachnoid cyst gave markedly low signal, with ADC of 3.00 x 10-3 mm2/s. All abscesses showed marked high signal, with ADC below 0.95 x 10-3 mm2/s. The cases of cysticercosis showed variable signal intensity; markedly low in five, slightly low in three and markedly high in four. (orig.)

  10. Renal and extrarenal manifestations of autosomal dominant polycystic kidney disease

    Directory of Open Access Journals (Sweden)

    E.A. Romão

    2006-04-01

    Full Text Available The objective of the present study was to determine the frequency of the most common clinical features in patients with autosomal dominant polycystic kidney disease in a sample of the Brazilian population. The medical records of 92 patients with autosomal dominant polycystic kidney disease attended during the period from 1985 to 2003 were reviewed. The following data were recorded: age at diagnosis, gender, associated clinical manifestations, occurrence of stroke, age at loss of renal function (beginning of dialysis, and presence of a family history. The involvement of abdominal viscera was investigated by ultrasonography. Intracranial alterations were prospectively investigated by magnetic resonance angiography in 42 asymptomatic patients, and complemented with digital subtraction arteriography when indicated. Mean age at diagnosis was 35.1 ± 14.9 years, and mean serum creatinine at referral was 2.4 ± 2.8 mg/dL. The most frequent clinical manifestations during the disease were arterial hypertension (63.3%, lumbar pain (55.4%, an abdominal mass (47.8%, and urinary infection (35.8%. Loss of renal function occurred in 27 patients (mean age: 45.4 ± 9.5 years. The liver was the second organ most frequently affected (39.1%. Stroke occurred in 7.6% of the patients. Asymptomatic intracranial aneurysm was detected in 3 patients and arachnoid cysts in 3 other patients. In conclusion, the most common clinical features were lumbar pain, arterial hypertension, abdominal mass, and urinary infection, and the most serious complications were chronic renal failure and stroke. Both intracranial aneurysms and arachnoid cysts occurred in asymptomatic patients at a frequency of 7.14%.

  11. Evaluation of usefulness of scintigraphic imaging in diagnosis of intrathecal drug delivery system malfunction – a preliminary report

    International Nuclear Information System (INIS)

    Implantable intrathecal drug delivery systems (IDDS) are basic tool enabling chronic intrathecal pharmacotherapy. Lack of expected clinical results of IDDS therapy necessitates search for the cause with the help of diagnostic imaging methods among other things. Beside radiological techniques, it is also possible to visually assess IDDS systems by nuclear medicine methods. In this study we assess utility of radioisotopic methods in differential diagnosis of failure of therapy with IDDS systems. Scintigraphic studies were performed in selected patients with neurological diseases associated with spasticity, who had IDDS system implanted and were unable to maintain satisfying clinical effect of inrathecally infused baclofen. After emptying the IDDS system of the drug, radiotracer (99mTc-DTPA) solution was injected into the pump reservoir. Subsequently, a series of scintigraphic images was registered, demonstrating passage and distribution of the infused radiotracer. In all investigated cases, scintigraphic study resulted in acquiring relevant additional diagnostic information. Normal or disrupted distribution of radiotracer in spinal canal allowed for a diagnosis drug resistance or demonstrated presence of arachnoid adhesions respectively. Early appearance of radiotracer in blood was considered a proof of leak. Our examinations had decisive influence on further patient treatment, allowing for diagnosis of drug resistance in one patient or complication related to IDDS system in three other cases including breakage of a catheter, pump malfunction and arachnoid adhesions. Scintigraphic methods carry significant amount of information facilitating final diagnosis of the cause of IDDS therapy failure. They should become an important element complementing the diagnostic strategy in patients with suspected failure of intrathecal drug administration systems. Interpretation of radioisotopic studies, since they are purely functional, must be performed in strict relation to

  12. Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine.

    Science.gov (United States)

    Jaeckle, K A; Phuphanich, S; Bent, M J; Aiken, R; Batchelor, T; Campbell, T; Fulton, D; Gilbert, M; Heros, D; Rogers, L; O'Day, S J; Akerley, W; Allen, J; Baidas, S; Gertler, S Z; Greenberg, H S; LaFollette, S; Lesser, G; Mason, W; Recht, L; Wong, E; Chamberlain, M C; Cohn, A; Glantz, M J; Gutheil, J C; Maria, B; Moots, P; New, P; Russell, C; Shapiro, W; Swinnen, L; Howell, S B

    2001-01-01

    DepoCyte is a slow-release formulation of cytarabine designed for intrathecal administration. The goal of this multi-centre cohort study was to determine the safety and efficacy of DepoCyte for the intrathecal treatment of neoplastic meningitis due to breast cancer. DepoCyte 50 mg was injected once every 2 weeks for one month of induction therapy; responding patients were treated with an additional 3 months of consolidation therapy. All patients had metastatic breast cancer and a positive CSF cytology or neurologic findings characteristic of neoplastic meningitis. The median number of DepoCyte doses was 3, and 85% of patients completed the planned 1 month induction. Median follow up is currently 19 months. The primary endpoint was response, defined as conversion of the CSF cytology from positive to negative at all sites known to be positive, and the absence of neurologic progression at the time the cytologic conversion was documented. The response rate among the 43 evaluable patients was 28% (CI 95%: 14-41%); the intent-to-treat response rate was 21% (CI 95%: 12-34%). Median time to neurologic progression was 49 days (range 1-515(+)); median survival was 88 days (range 1-515(+)), and 1 year survival is projected to be 19%. The major adverse events were headache and arachnoiditis. When drug-related, these were largely of low grade, transient and reversible. Headache occurred on 11% of cycles; 90% were grade 1 or 2. Arachnoiditis occurred on 19% of cycles; 88% were grade 1 or 2. DepoCyte demonstrated activity in neoplastic meningitis due to breast cancer that is comparable to results reported with conventional intrathecal agents. However, this activity was achieved with one fourth as many intrathecal injections as typically required in conventional therapy. The every 2 week dose schedule is a major advantage for both patients and physicians. PMID:11161370

  13. Diagnosis, treatment and long-term outcome in fetal hydrocephalus

    International Nuclear Information System (INIS)

    The objective of this study was to evaluate the method of prenatally estimating an appropriate clinical outcome in fetal hydrocephalus. Retrospective study, single institute (Osaka National Hospital). Hundred and seventeen cases with fetal hydrocephalus treated at Osaka National Hospital from 1992 to 2010 were analysed. Of the 117 cases analysed, 38% are diagnosed as isolated ventriculomegaly (IVM), 51% as other types of malformation (30 cases of myelomeningocele, 4 cases of holoprosencephaly, 4 of Dandy Walker syndrome, 10 of arachnoid cyst and 6 of encephalocele etc.) and 11% as secondary hydrocephalus. They are diagnosed between 17 and 40 weeks of gestation (average 27 weeks), 17% diagnosed between 17 and 21 weeks, 30% between 22 and 27 weeks and 53% after 28 weeks. With the exception of 9 aborted cases and 30 unknown cases too young to be evaluated or lost due to lack of follow-up, final outcome was analyzed in 78 cases. Of these 78 cases, 15% died in utero or after birth, 23% showed severe retardation, 17% moderate retardation, 26% mild retardation, and 19% showed good outcome. Long term consequences were mostly influenced by basic disease and accompanied anomalies. Hydrocephalus associated with arachnoid cyst, atresia of Monro, corpus callosum agenesis and hydrocephalus due to fetal intracranial hemorrhage are categorized in the good outcome group. On the other hand, holoprosencephaly, hydrocephalus associated with encephalocele, syndromic hydrocephalus and hydrocephalus due to fetal virus infection are categorized in the poor outcome group. In order to accurate diagnosis and proper counseling, establishment of diagnosis protocol and treatment policy for fetal hydrocephalus including not only fetal sonography, fetal MRI, toxoplasma, rubella, cytomegalovirus, herpes simplex (TORCH) screening test but also chromosomal and gene testing is required. (author)

  14. The usefulness of diffusion weighted imaging in the differential diagnosis of various intracranial cystic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jun, Jeong Su; Hwang, Seong Su; Baik, Jun Hyun; Park, Young Ha [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2004-06-01

    The purpose of this study was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differential diagnosis of various intracranial cystic lesions. This study included 19 patients (13 males, 6 females) with a mean age of 42.5 years. The final histopathological diagnoses for 14 patients were pyogenic brain abscess (n=3), glioblastoma (n=3), ependymoma (n=1), anaplastic astrocytoma (n=1), pilocytic astrocytoma (n=1), hemangioblastoma (n=2), arachnoid cyst (n=1), epidermoid (n=1) and schwannoma (n=1). The other cases of metastasis (n=4) and arachnoid cyst (n=2) were diagnosed on the basis of clinical, laboratory and imaging data. DWI imaging studies were performed with a 1.5 T MR system. A single shot spin echo EPI pulse sequence was applied. B values were set at 0 and 1000 sec/mm{sup 2}. The apparent diffusion coefficient (ADC) were calculated from the ADC map of 10 different cystic brain lesions. Conventional MR imaging included T2WI, T1WI, FLAIR and contrast enhanced T1WI. We analyzed the location, nature, signal intensity on DWI, and the enhancement pattern of the lesions. All of the 3 cases of brain abscess, 1 of 4 cases of metastasis and 1 case of epidermoid showed hyperintensity on DWI. The mean ADC value of brain abscess (2 cases) was less than 1.15 (0.13x10{sup -3} mm{sup 2}/s). The mean ADC values of the other cystic lesions (8 cases) were variable, ranging from 2.840.66 to 3.100.16 (10{sup -3} mm{sup 2}/sec). DWI and ADC values were useful in the differential diagnosis of various intracranial cystic lesions, but some metastatic tumors may mimic a brain abscess on DWI. Therefore, a clinical correlation is mandatory.

  15. The usefulness of diffusion weighted imaging in the differential diagnosis of various intracranial cystic lesions

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differential diagnosis of various intracranial cystic lesions. This study included 19 patients (13 males, 6 females) with a mean age of 42.5 years. The final histopathological diagnoses for 14 patients were pyogenic brain abscess (n=3), glioblastoma (n=3), ependymoma (n=1), anaplastic astrocytoma (n=1), pilocytic astrocytoma (n=1), hemangioblastoma (n=2), arachnoid cyst (n=1), epidermoid (n=1) and schwannoma (n=1). The other cases of metastasis (n=4) and arachnoid cyst (n=2) were diagnosed on the basis of clinical, laboratory and imaging data. DWI imaging studies were performed with a 1.5 T MR system. A single shot spin echo EPI pulse sequence was applied. B values were set at 0 and 1000 sec/mm2. The apparent diffusion coefficient (ADC) were calculated from the ADC map of 10 different cystic brain lesions. Conventional MR imaging included T2WI, T1WI, FLAIR and contrast enhanced T1WI. We analyzed the location, nature, signal intensity on DWI, and the enhancement pattern of the lesions. All of the 3 cases of brain abscess, 1 of 4 cases of metastasis and 1 case of epidermoid showed hyperintensity on DWI. The mean ADC value of brain abscess (2 cases) was less than 1.15 (0.13x10-3 mm2/s). The mean ADC values of the other cystic lesions (8 cases) were variable, ranging from 2.840.66 to 3.100.16 (10-3 mm2/sec). DWI and ADC values were useful in the differential diagnosis of various intracranial cystic lesions, but some metastatic tumors may mimic a brain abscess on DWI. Therefore, a clinical correlation is mandatory

  16. 颅内非感染性囊肿的MRI诊断及鉴别诊断研究%DIAGNOSIC AND DIFFERENTIAL DIAGNOSIC STUDY OF INTRACRANIAL NONINFECTIOUS CYSTS BY MRI

    Institute of Scientific and Technical Information of China (English)

    葛丽红; 牛广明; 韩晓东

    2011-01-01

    Objective :To explore the characteristic MRI findings of intracranial noninfectious cysts and guide clinic diagnosis and differential diagnosis.Methods: 170 intracranial noninfectious cysts having complete clinical data and partly verified by operation and pathology were analyzed.To detect cyst 's location, shape, MRI signal feature.Results :92 arachnoid, 53 located in cysts middle cranial fossa.24 epidermoid cysts, 22 located in cerebellopontine angle cistern, DWI all showed hyperintensity; 14pineal cysts.14 located in pineal gland.12 enlarged perivascular space(PVS), 10 located in basal/midbrain.10 Rathke cleft cysts, 10 located in sellar or suprasella.8 perencephalic cysts, 8 located in cerebral hemispheres.5 neuroglial cysts, 5 located in temporal lobe.4 ependymal cysts, 4 located in lateral ventricle.1 choroid plexus cysts, 1 located in lateral ventricle, arachnoid, PVS, neuroglia, ependyma, porencephalic cysts demonstrated markedly hypointensity on FLAIR, the others showed slightly hypointensity.Conclusion:Arachnoid cysts are common,the cyst' position, DWI and FLAIR are important for differential diagnosis.%目的:探讨颅内非感染性囊肿MRI影像特点,用以指导临床诊断及鉴别诊断.方法:回顾性分析170例颅内非感染性囊肿的MRI资料,其中部分囊肿经手术或病理证实,总结病变发病部位、形态、MRI信号特点.结果:92例蛛网膜囊肿,位于中颅窝颞前部53例;表皮样囊肿24例,22例位于桥前池或桥小脑角区,DWI均表现为高信号;14例松果体囊肿,全部位于松果体区;12例血管周围间隙,10例位于底节区或中脑;10例Rathke裂囊肿,均位于鞍内或鞍上;8例脑穿通畸形,均位于大脑半球;5例脉络膜裂囊肿,均位于颞叶;4例室管膜囊肿,均位于侧脑室三角区;1例脉络丛囊肿位于侧脑室三角区.蛛网膜囊肿、血管周围间隙、脑穿通畸形、脉络膜裂囊肿、室管膜囊肿内液体FLAIR序列上被抑制,表皮样囊肿、松果

  17. The value of multiplanar reconstruction using 64-slice CT myelography in cervical nerve root injury

    International Nuclear Information System (INIS)

    Objective: To study the diagnostic value of multi-direction adjusted multiplanar reconstruction (MPR) by 64-slice CT myelography (CTM) in diagnosing cervical nerve injury, and the possibility of the MPR to replace conventional myelography and CT direct-scanning axial images. Methods: Twenty-six patients with cervical nerve root injury were examined by conventional myelography and 64-slice CT using isotropic parameters. Then multi-direction MPR were performed to display nerve roots on coronal and sagittal planes besides axial images. Twenty-six patients were performed surgical operations and diagnosis were obtained. The coincident diagnosing rate with surgical operations results were compared statistically among multi-direction MPR, direct-scanning axial CT images, conventional myelography. The numbers of images were also compared between axial MPR and direct scanning axial CT images. Results: Direct sign of nerve root avulsion was the loss of normal nerve root defect seen in the Isovist filled thecal sac in 64-slice CT, which was found in 31 nerve roots. Indirect signs included: (1) Traumatic pseudomeningocele: 29 nerve roots showed the leak of Isovist into nerve root sheath, and extended into foramina; (2) Arachnoid cyst: 26 nerve roots clearly displays cystic distension in nerve root, which has low-density fine clew form septation from subarachnoid cavity and no nerve root in the cyst; (3) Deformity of the subarachnoid space: deformity of thecal sac, partially lack of Isovist into arachnoid space, which was found in 17 nerve roots. The coincident diagnosing rate of cervical nerve root injury by multi-direction adjusted coronal MPR imaging was 92.6% (50/54), which was higher than by axial CT (77.8%, 42/54) and conventional myelography (68.5%, 37/54), There was significant difference between the conventional myelography, direct-scanning axial CT, multi-direction MPR images (Kappa=0.686, 0.772, 0.920, respectively, P<0.05), the coronal MPR imaging was significantly

  18. Glossopharyngeal neuralgia: MR findings

    International Nuclear Information System (INIS)

    Objective: To investigate the possibility of MRI on visualizing the relationship between glossopharyngeal nerve and surrounding vessels, and to evaluate the significance of MRI in the diagnosis and treatment of glossopharyngeal neuralgia. Methods: MRI findings were analyzed retrospectively in 12 patients with glossopharyngeal neuralgia, and were compared with surgical findings and effect of pain relief. Results: The artery compression or contact of the glossopharyngeal entry zone, as revealed during operation in 10 patients with glossopharyngeal neuralgia, was visualized on MRI in 9 and not seen in 1. The venous compression of the glossopharyngeal entry zone was not identified on MRI in 1. The conglutinative arachnoids of the glossopharyngeal entry, zone was not visualized on MRI in 1. MRI demonstrated the affected glossopharyngeal nerve root entry zone was compressed or contacted by the posterior inferior cerebellar artery. (PICA) in 8 patients and by the vertebral artery in 1 patient. One patient's offending vessel was confirmed to be the anterior inferior cerebellar artery (AICA) by the operation, and the surgical findings were corresponded with MRI in others. Vascular compression or' contact of the affected glossopharyngeal nerve was not visualized on MRI in 3 patients, and operation confirmed that the glossopharyngeal nerve root entry zone was compressed by unknown artery in 1, by small vein in 1, and by conglutinative arachnoids in 1, respectively. Eight patients presented with symptoms of the ipsilateral trigeminal neuralgia concurrently. The compression of the affected trigeminal nerve root by superior cerebellar artery (SCA) was visualized on MRI in 6 patients, and operation did not reveal the source of artery compression in 1 and corresponded with MRI findings in other 5 cases. Vascular compression of affected trigeminal nerve was not visualized on MRI in 2 patients, and intraoperative inspection revealed that trigeminal nerve root was compressed by

  19. Increased leakage of brain antigens after traumatic brain injury and effect of immune tolerance induced by cells on traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    YAN Hua; ZHANG Hong-wei; WU Qiao-li; ZHANG Guo-bin; LIU Kui; ZHI Da-shi; HU Zhen-bo; ZENG Xian-wei

    2012-01-01

    Background Although traumatic brain injury can lead to opening the blood-brain barrier and leaking of blood substances (including water) into brain tissue,few studies of brain antigens leaking into the blood and the pathways have been reported.Brain antigens result in damage to brain tissues by stimulating the immune system to produce anti-brain antibodies,but no treatment has been reported to reduce the production of anti-brain antibodies and protect the brain tissue.The aim of the study is to confirm the relationship between immune injury and arachnoid granulations following traumatic brain injury,and provide some new methods to inhibit the immune injury.Methods In part one,methylene blue was injected into the rabbits' cisterna magna after traumatic brain injury,and concentrations of methylene blue and tumor necrosis factor (TNF)-α in blood were detected to determine the permeability of arachnoid granulations.In part two,umbilical cord mesenchymal stem cells and immature dendritic cells were injected into veins,and concentrations of interleukin 1 (IL-1),IL-10,interferon (IFN)-y,transforming growth factor (TGF)-β,anti-brain antibodies (ABAb),and IL-12 were measured by ELISA on days 1,3,7,14 and 21 after injury,and the numbers of leukocytes in the blood were counted.Twenty-one days after injury,expression of glutamate in brain tissue was determined by immunohistochemical staining,and neuronal degeneration was detected by H&E staining.Results In part one,blood concentrations of methylene blue and TNF-α in the traumatic brain injury group were higher than in the control group (P <0.05).Concentrations of methylene blue and TNF-α in the trauma cerebrospinal fluid (CSF)injected group were higher than in the control cerebrospinal fluid injected group (P <0.05).In part two,concentrations of IL-1,IFN-y,ABAb,IL-12,expression of glutamate (Glu),neuronal degeneration and number of peripheral blood leukocytes were lower in the group with cell treatment compared to the

  20. Transsylvian selective amygdalohippocampectomy for treatment of medial temporal lobe epilepsy: Surgical technique and operative nuances to avoid complications

    Directory of Open Access Journals (Sweden)

    Timothy J Kovanda

    2014-01-01

    Full Text Available Background: A number of different surgical techniques are effective for treatment of drug-resistant medial temporal lobe epilepsy. Of these, transsylvian selective amygdalohippocampectomy (SA, which was originally developed to maximize temporal lobe preservation, is arguably the most technically demanding to perform. Recent studies have suggested that SA may result in better neuropsychological outcomes with similar postoperative seizure control as standard anterior temporal lobectomy, which involves removal of the lateral temporal neocortex. Methods: In this article, the authors describe technical nuances to improve the safety of SA. Results: Wide sylvian fissure opening and use of neuronavigation allows an adequate exposure of the amygdala and hippocampus through a corticotomy within the inferior insular sulcus. Avoidance of rigid retractors and careful manipulation and mobilization of middle cerebral vessels will minimize ischemic complications. Identification of important landmarks during amygdalohippocampectomy, such as the medial edge of the tentorium and the third nerve within the intact arachnoid membranes covering the brainstem, further avoids operator disorientation. Conclusion: SA is a safe technique for resection of medial temporal lobe epileptogenic foci leading to drug-resistant medial temporal lobe epilepsy.

  1. [Hematopoietic growth factor EPO has neuro-protective and neuro-trophic effects--review].

    Science.gov (United States)

    Zhou, Zhuo-Yan; Yang, Mo; Fok, Tai-Fai

    2005-04-01

    Erythropoietin (EPO) is an acidic glycoprotein that was first detected as a hematopoietic factor and its synthesis is triggered in response to cellular hypoxia-sensing. EPO binds to type I cytokine receptors, which associate with the non-receptor tyrosine kinase Jak2, and thereby activate Stat 5a/5b, Ras/MAPK, and PI3-K/Akt signaling pathways. The recent discovery shows that there is a specific EPO/EPO-receptor system in the central nervous system (CNS), independently of the haematopoietic system. Hypoxia and anemia can up-regulate EPO/EPOR expressions in the CNS. Further studies demonstrate that EPO has substantial neuro-protective effects and acts as a neurotrophic factor on central cholinergic neurons, influencing their differentiation and regeneration. EPO also exerts neuro-protective activities in different models of brain damage in vivo and in vitro, such as hypoxia, cerebral ischaemia and sub-arachnoid haemorrhage. EPO may also be involved in synaptic plasticity via the inhibition or stimulation of various neurotransmitters. Therefore, human recombinant EPO that activate its receptors in the central nervous system might be utilized in the future clinical practice involving neuroprotection and brain repair. PMID:15854305

  2. Dose distribution to spinal structures from intrathecally administered yttrium-90

    Energy Technology Data Exchange (ETDEWEB)

    Mardirossian, George [Oklahoma University Health Sciences Center, 825 N.E. 10th Street, OUPB 1430 Oklahoma City, OK 73104 (United States); Hall, Michael [Oklahoma University Health Sciences Center, 825 N.E. 10th Street, OUPB 1430 Oklahoma City, OK 73104 (United States); Montebello, Joseph [Ohio State University Department of Radiation Oncology, 300 W 10th Avenue, Columbus, OH 43210 (United States); Stevens, Patrick [Oklahoma University Health Sciences Center, 825 N.E. 10th Street, OUPB 1430 Oklahoma City, OK 73104 (United States)

    2006-01-07

    Previous treatment of cerebrospinal fluid (CSF) malignancies by intrathecal administration of {sup 131}I-radiolabelled monoclonal antibodies has led to the assumption that more healthy tissue will be spared when a pure beta-emitter such as {sup 90}Y replaces {sup 131}I. The purpose of this study is to compare and quantitatively evaluate the dose distribution from {sup 90}Y to the CSF space and its surrounding spinal structures to {sup 131}I. A 3D digital phantom of a section of the T-spine was constructed from the visible human project series of images which included the spinal cord, central canal, subarachnoid space, pia mater, arachnoid, dura mater, vertebral bone marrow and intervertebral disc. Monte Carlo N-particle (MCNP4C) was used to model the {sup 90}Y and {sup 131}I radiation distribution. Images of the CSF compartment were convolved with the radiation distribution to determine the dose within the subarachnoid space and surrounding tissues. {sup 90}Y appears to be a suitable radionuclide in the treatment of central nervous system (CNS) malignancies when attached to mAb's and the dose distribution would be confined largely within the vertebral foramen. This choice may offer favourable dose improvement to the subarachnoid and surface of spinal cord over {sup 131}I in such an application.

  3. Recurrent back pain after diskectomy: MRI findings MR of the postoperative lumbar spine

    International Nuclear Information System (INIS)

    Purpose: To show the morphological changes in postoperative lumbar spine. Material and methods: We reviewed 128 Magnetic Resonance Imaging (MRI) studies of lumbar spine. All patients complained of low back pain and had a previous lumbar surgery (1 month to 8 years). All the examinations include axial and sagittal Gadopentate-dimeglumine enhanced T1 weighted imaging. Results: Only 7,8% have the normal appearance of the postoperative lumbar spine. Epidural scar was found in 69% of examinations; of this group, 72% showed radicular involvement, and 28% had no radicular involvement. Recurrent disc herniation was found in 14,8% of exams, using gadopentate-dimeglumine to assist the differentiation from epidural fibrosis; infections like spondylodiscitis and abscess in 12,5%. Other findings included arachnoiditis, pseudomeningoceles and seromas. Conclusions: MRI is a useful method to study the postoperative lumbar spine, specially when enhanced with gadopentate-dimeglumine. Enhanced images can differentiate two of the major complication like epidural fibrosis, and recurrent disc herniation. Spondylodiscitis are important and frequent too. Although the findings of complications in our series in the postoperative lumbar spine represent 92,18 %, these not always explain the symptomatology. Therefore, the interrelation is important with the surgeon to determine which abnormalities are clinically significant. (authors)

  4. Increased anisotropy in neonatal meningitis: an indicator of meningeal inflammation

    International Nuclear Information System (INIS)

    Increased anisotropy in brain abscesses has been shown to be due to adhesion of inflammatory cells and is suggestive of an active inflammatory process. The objective of this study was to determine if similar changes occur in the pia-arachnoid on the surface of the cerebral cortex in patients with pyogenic meningitis, and if these changes regress following antibiotic therapy. Diffusion tensor imaging (DTI) was performed on 14 term neonates (mean age 13 days) with bacterial meningitis and 10 healthy age- and sex-matched controls. Regions of interest (ROIs) were placed on areas including the leptomeninges, the cerebral cortex and adjoining subcortical white matter for quantitation of mean fractional anisotropy (FA) and diffusivity (MD) values. Follow-up MRI was performed in five of the neonates in the patient group after 2 weeks of antibiotic treatment. FA and MD values were compared in patients before and after antibiotic treatment as well as with those in the healthy controls. Significantly higher FA values but no difference in MD values were observed in the patient group as compared to the healthy controls at both time points (before and after antibiotic treatment). Significantly decreased FA values in the frontal, occipital and temporal cortical regions were observed in patients following antibiotic treatment. DTI-derived FA may be of value in the noninvasive assessment of meningeal inflammatory activity and treatment response in neonates. (orig.)

  5. Managing leptomeningeal melanoma metastases in the era of immune and targeted therapy.

    Science.gov (United States)

    Smalley, Keiran S M; Fedorenko, Inna V; Kenchappa, Rajappa S; Sahebjam, Solmaz; Forsyth, Peter A

    2016-09-15

    Melanoma frequently metastasizes to the brain, with CNS involvement being clinically evident in ∼30% of patients (as high as 75% at autopsy). In ∼5% cases melanoma cells also metastasize to the leptomeninges, the sub-arachnoid space and cerebrospinal fluid (CSF). Patients with leptomeningeal melanoma metastases (LMM) have the worst prognosis and are characterized by rapid disease progression (mean survival 8-10 weeks) and a death from neurological causes. The recent years have seen tremendous progress in the development of targeted and immune therapies for melanoma that has translated into an increased survival benefit. Despite these gains, the majority of patients fail therapy and there is a suspicion that the brain and the leptomeninges are a "sanctuary" sites for melanoma cells that escape both targeted therapy and immunologic therapies. Emerging evidence suggests that (1) Cancer cells migrating to the CNS may have unique molecular properties and (2) the CNS/leptomeningeal microenvironment represents a pro-survival niche that influences therapeutic response. In this Mini-Review, we will outline the clinical course of LMM development and will describe how the intracranial immune and cellular microenvironments offer both opportunities and challenges for the successful management of this disease. We will further discuss the latest data demonstrating the potential use of BRAF inhibitors and immune therapy in the management of LMM, and will review future potential therapeutic strategies for the management of this most devastating complication of advanced melanoma. PMID:27084046

  6. MRI of the postoperative lumbar spine: triple-dose gadodiamide and fat suppression

    International Nuclear Information System (INIS)

    In ten patients who had undergone lumbar laminectomy, visual assessment of epidural scar enhancement and diagnostic confidence was performed after 0.1 mmol/kg gadodiamide intravenously, again after a further 0.2 mmol/kg, and once more using a fat-suppression sequence. The single-dose contrast-enhanced T1-weighted images showed clear enhancement of epidural scar in eight cases, and clearly improved diagnostic confidence as regards scar and/or disc herniation in six. Triple-dose contrast-enhanced images showed further increase in epidural enhancement clearly in only two cases and marginally in six, with no significant increase in diagnostic confidence. Fat-suppression, performed in eight cases, showed a further clear increase in epidural enhancement in seven cases, but again no increase in diagnostic confidence. In one patient with arachnoiditis contrast enhancement and diagnostic confidence increased only slightly after each contrast injection, and again with the fat-suppression sequence. Increasing contrast medium dose was thus not useful following laminectomy when epidural scarring obscures a possible recurrent disc herniation. Use of fat suppression may, however, permit reduction of the dose of contrast medium necessary to provide adequate scar enhancement. (orig.). With 2 figs., 4 tabs

  7. A Large Asymptomatic Thoracic Spine Schwannoma Detected Incidentally by {sup 18}F-FDG PET/CT: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee [Seoul Sungae Hospital, Seoul (Korea, Republic of); Yoo, Ie Ryung [Catholic University Medical School Hospital, Seoul (Korea, Republic of)

    2008-10-15

    Schwannoma is not a rare tumor occurring anywhere where sheathed nerve fibers present. However the spinal involvement has been noted to be uncommon. The use of PET in the diagnosis of spinal schwannomas seemed to have only sporadically been reported and standardized uptake values (SUV) measured in peripheral nerves schwannomas varied according to cellularity. Most reported spinal schwannoms were symptomatic and relatively hypometabolic but ours differed in that despite considerable compression of the spinal cord it did not produce clinical symptoms or signs and had a relatively high FDG uptake value. The spine was operated. On opening a 1.0x1.5 cm tumor was found to be encapsulated and located in the right posterolateral aspect of the intradural space at the 4th thoracic spine level. It was completely resected along with the rootlet from which the tumor seemed to have originated not damaging the cord or causing bleeding. The spinal medulla compressed by and adherent to the tumor was decompressed and released following arachnoid adhesiolysis. The hospital stay was uneventful. Patient was discharged and is well and fine without complication eight months after surgery.

  8. A Large Asymptomatic Thoracic Spine Schwannoma Detected Incidentally by 18F-FDG PET/CT: A Case Report

    International Nuclear Information System (INIS)

    Schwannoma is not a rare tumor occurring anywhere where sheathed nerve fibers present. However the spinal involvement has been noted to be uncommon. The use of PET in the diagnosis of spinal schwannomas seemed to have only sporadically been reported and standardized uptake values (SUV) measured in peripheral nerves schwannomas varied according to cellularity. Most reported spinal schwannoms were symptomatic and relatively hypometabolic but ours differed in that despite considerable compression of the spinal cord it did not produce clinical symptoms or signs and had a relatively high FDG uptake value. The spine was operated. On opening a 1.0x1.5 cm tumor was found to be encapsulated and located in the right posterolateral aspect of the intradural space at the 4th thoracic spine level. It was completely resected along with the rootlet from which the tumor seemed to have originated not damaging the cord or causing bleeding. The spinal medulla compressed by and adherent to the tumor was decompressed and released following arachnoid adhesiolysis. The hospital stay was uneventful. Patient was discharged and is well and fine without complication eight months after surgery

  9. Analysis of intracranial cystic disease on 1H MR spectroscopy

    International Nuclear Information System (INIS)

    Objective: To analyze the features of intracrayze the features of intracranial cystic diseases on 1H MRS, and to evaluate the applicable value of 1H MRS. Methods: Fifty-two patients were examinated by single voxel 1H MRS, included I-II graded astrocytomas (n=8), glioblastomas (n=9), metastasis (n=13), brain abscesses (n=10), epidermoids (n=4), anachnoid cysts (n=5), brain Cysticerciasis (n=3). Results: (1) There was only Lac in I-II graded astrocytomas. But in glioblastomas, as were as all showed Lac, 4 cases showed low Cho and NAA and 2 cases Lip. (2) In 13 metastasis patients, 7 cases only presented Lac, 6 cases showed Cho, 3 cases showed low NAA and 6 ones Lip. (3) In brain abscesses, all showed Lac, 9 cases displayed AA, 6 cases showed Ace, 5 cases appeared Suc and Ala, 2 eases had Lip. (4) Four eases of epidermoid showed Lac, one showed Lip. In 4 arachnoid cysts, 2 cases had low Lac, one showed Lip. Three cases of cysticercosis showed Lac, Ace, Suc, Ala and no AA, Cho, NAA. Conclusion: Lac is the most common resonance peak on 1H MRS in intracranial cystic diseases and for no diagnostic specificity. AA combined Ace, Suc, and Ala are highly specificity for brain abscess. Ace, Suc and Ala appearance cues the the possible existence of cysticercosis. 1H MRS is helpful for the qualitative diagnosis of intracranial disease. (authors)

  10. The superiority of 3D-CISS sequence in displaying the cisternal segment of facial, vestibulocochlear nerves and their abnormal changes

    Energy Technology Data Exchange (ETDEWEB)

    Liang Changhu, E-mail: tigerlch@163.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Zhang Bin, E-mail: liangchangbo.student@sina.co [Liao Cheng City People' s Hospital, Dongchang Road, Liaocheng, Shandong (China); Wu Lebin, E-mail: Lebinwu518@163.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Du Yinglin, E-mail: duyinglinzhuo@sohu.co [Shandong Provincial Center for Disease Control and Prevention, Public Health Institute, 72, Jingshi Road, Jinan, Shandong (China); Wang Ximing, E-mail: wxminmg369@163.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Liu Cheng, E-mail: cacab2a@126.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Yu Fuhua, E-mail: changhu1970@163.co [Weifang Medical College, 7166, West Road Baotong Weifang, Shandong (China)

    2010-06-15

    Objective: To select the best imaging method for clinical otologic patients through evaluating 3D constructive interference of steady state (CISS) image quality in visualizing the facial, vestibulocochlear nerves (CN:VII-VIII) and their abnormal changes. Methods: The CN:VII-VIII as well as inner ear structures in 48 volunteers were examined using 3D-CISS and 3D turbo spin echo (TSE) sequences respectively, and displayed to the full at the reformatted and maximum intensity projection (MIP) images. The nerve identification and image quality were graded for the CN:VII-VIII as well as inner ear structures. Statistical analysis was performed using the Wilcoxin test, p < 0.05 was considered significant. In addition, 8 patients with abnormality in facial or vestibulocochlear nerves were also examined using 3D-CISS sequence. Results: The identification rates for the cisternal segment of facial, vestibulocochlear nerves and corresponding membranous labyrinth were 100%. Abnormal changes of the facial or vestibulocochlear nerves were clearly shown in 8 patients, among them 1 was caused by bilateral acoustic neurinoma, 1 by cholesteatoma at cerebellopontine angle, 1 by arachnoid cyst, 1 by neurovascular adhesion, 4 by neurovascular compression. Conclusion: With 3D-CISS sequence the fine structure of the CN:VII-VIII and corresponding membranous labyrinth can be clearly demonstrated; lesions at the site of cerebellopontine angle can also be found easily.

  11. Possibilities of magnetic resonance tomography in identification and diagnostics of neurosyphilis forms

    Directory of Open Access Journals (Sweden)

    Kolokolov O.V.

    2011-09-01

    Full Text Available Aim: To evaluate the possibilities of the magnetic resonance tomography (MRT in diagnostics and identification of neurosyphilis. Materials and methods: A total of 1387 patients with different forms of documented neurosyphilis were examined to study the deficiency of neurological function. The diagnosis of neurosyphilis was confirmed by CSF-study. MRT was performed in 57 cases. Results: Magnetic resonance tomography (MRT in 6 patients showed no pathology, 16 patients had arachnoid cystic changes and in 16 cases hydrocephaly occurred. Cerebral cortical atrophy was presented in 13 patients, in 12 cases — multifocal changes were visualized, 12 patients had white matter structural changes. Two cases required diagnostics. A 59-year-old man was hospitalized with epileptic seizure, progressive dementia and multifocal neurologic symptoms. A 40-year-old man was examined with recurring episodes of acute cere-brospinal accident and progressing cognitive disorders. Conclusion: MRT could be used in differential diagnostics of neurosyphilis imitating space-occupying lesions of cerebrum and spinal cord, tumors of central nervous system and could help to define the form of neurosyphilis

  12. A STUDY OF POSTERIOR FOSSA MALFORMATIONS: MR IMAGING

    Directory of Open Access Journals (Sweden)

    Ravi

    2015-02-01

    Full Text Available AIMS AND OBJECTIVES: The aim of our study is to describe the imaging findings of various posterior fossa malformations and to evaluate the supratentorial abnormalities associated with posterior fossa malformations. MATERIALS AND METHODS: MR images of 30 patients wi th posterior fossa malformations detected in the department of Radiodiagnosis, BMCRI over a period of two years, from December 2012 to December 2014 were evaluated retrospectively. The various posterior fossa malformations were evaluated. Associated suprat entorial abnormalities were noted. RESULTS: 30 patients with posterior fossa malformations were included in the study. The age group of patients ranged from 1year to 53years. There were 18 males and 12 females. The various posterior fossa malformations det ected were Dandy Walker malformation (1 case, Dandy Walker variant (2 cases, mega cisterna magna (8 cases, arachnoid cysts (5 cases, Chiari 1 malformation (5 cases, Chairi 2 malformation (2 cases, Joubert malformation (1 case, lipoma (2 cases, verm ian and/or cerebellar hypoplasia without posterior fossa CSF collection or cyst (4 cases. Associated supratentorial abnormalities were seen in 8 cases . CONCLUSION: MRI is the imaging modality of choice in the evaluation of posterior fossa malformations. I t is very important to know the imaging findings of these malformations and to have knowledge about the various supratentorial and spinal abnormalities associated with them so as to provide an accurate diagnosis which is very essential for predicting the p rognosis and planning further management.

  13. Leptomeningeal angiomatosis of the left occipital surface detected by CT scan

    International Nuclear Information System (INIS)

    A case of left occipital leptomeningeal angiomatosis was reported. The patient was a 12-year-old boy who had episodes of severe vascular type headache accompanied by transient right homonymous hemianopsia. CT scan showed localized superficial high density area in the left occipital pole. Remarkable enhancement of the lower and inner surface of the left occipital lobe was demonstrated. Angiography showed poor filling of the distal portion of the left posterior cerebral artery. Skull tomograms showed linear calcifications in the left occipital region. Brain scan showed increased RI uptake in the left occipital region. During operation, the surface of the left occipital lobe was covered by excessive, fine, vascular networks which extended over the arachnoid membrane. The abnormal vessels were cauterized by a CO2 laser as throughly as possible. The occipital pole, felt gritty. Histologically, the abnormal vessels had spread into the subarachnoid space and were predominantly veins with thin and enlarged walls. The abnormal vessels followed the leptomeninges in the sulci of the cerebral cortex. Underneath the abnormal vessels, in the external layers of the cerebral cortex, calcium deposits were scattered and gliosis and degeneration of the ganglion cells were observed. The lesion was comparable with leptomeningeal angiomatosis. Though the pathological findings of the specimen, CT findings, and brain scan findings were extremely similar to those of Sturge-Weber disease, in this case, the typical clinical and roentgenographic findings of Sturge-Weber disease were all absent. (author)

  14. Cauda Equina Syndrome Secondary to Leptomeningeal Carcinomatosis of Gastroesophageal Junction Cancer

    Science.gov (United States)

    Alkhotani, Amal; Alrishi, Nouf; Alhalabi, M. Salem; Hamid, Tahira

    2016-01-01

    Leptomeningeal carcinomatosis (LMC) is a diffuse or multifocal malignant infiltration of the pia matter and arachnoid membrane. The most commonly reported cancers associated with LMC are breast, lung, and hematological malignancies. Patients with LMC commonly present with multifocal neurological symptoms. We report a case of LMC secondary to gastroesopha-geal junction cancer present initially with cauda equina syndrome. A 51-year-old male patient with treated adenocarcinoma of the gastroesophageal junction presented with left leg pain, mild weakness, and saddle area numbness. Initial radiological examinations were unremarkable. Subsequently, he had worsening of his leg weakness, fecal incontinence, and urine retention. Two days later, he developed rapidly progressive cranial neuropathies including facial diplegia, sensorineural hearing loss, dysarthria, and dysphagia. MRI with and without contrast showed diffuse enhancement of leptomeninges surrounding the brain, spinal cord, and cauda equina extending to the nerve roots. Cerebrospinal fluid cytology was positive for malignant cells. The patient died within 10 days from the second presentation. In cancer patients with cauda equina syndrome and absence of structural lesion on imaging, LMC should be considered. To our knowledge, this is the first case of LMC secondary to gastroesophageal cancer presenting with cauda equina syndrome. PMID:27239185

  15. Fetal central nervous system anomalies: fast MRI vs ultrasonography

    International Nuclear Information System (INIS)

    Objective: To evaluate the ability of fast MRI to detect fetal central nervous system (CNS) anomalies and to compare its performance with that of prenatal ultrasonography (US). Methods Forty-eight pregnant women were detected by conventional prenatal US and MRI. Twenty-two fetuses with CNS anomalies were conformed by autopsy and follow-up. The MR and US appearances of fetal CNS structure were compared to each other and to that of autopsy. Results: A total of 26 CNS anomalies were identified by autopsy (n=17) and follow-up (n=9) including anencephaly (n=6), rachischisis (n=2), encephalocele (n=3), congenital hydrocephalus (n=7), alobar holoprosencephaly (n=1), porencephalia (n=3), arachnoid cyst (n=2) and choroids plexus cyst (n=2). US diagnosed 24 CNS anomalies, the correct diagnostic rate was 92.3%, the false-positive rate was 3.8%, the missed-diagnostic rate was 3.8%. MRI diagnosed 23 CNS anomalies, the correct-diagnostic rate was 88.5%, the false-positive rate was 3.8% ,the missed-diagnostic rate was 7.7%. There was no difference between US and MRI (P>0.05), but MRI have larger FOV, higher tissues resolution, and can demonstrate gray-white matter in detail. Conclusions: MR imaging has a similar sensitivity to that of US in the detection of fetal CNS anomalies. (authors)

  16. Spaceflight-Induced Intracranial Hypertension: An Overview

    Science.gov (United States)

    Traver, William J.

    2011-01-01

    This slide presentation is an overview of the some of the known results of spaceflight induced intracranial hypertension. Historical information from Gemini 5, Apollo, and the space shuttle programs indicated that some vision impairment was reported and a comparison between these historical missions and present missions is included. Optic Disc Edema, Globe Flattening, Choroidal Folds, Hyperopic Shifts and Raised Intracranial Pressure has occurred in Astronauts During and After Long Duration Space Flight. Views illustrate the occurrence of Optic Disc Edema, Globe Flattening, and Choroidal Folds. There are views of the Arachnoid Granulations and Venous return, and the question of spinal or venous compliance issues is discussed. The question of increased blood flow and its relation to increased Cerebrospinal fluid (CSF) is raised. Most observed on-orbit papilledema does not progress, and this might be a function of plateau homeostasis for the higher level of intracranial pressure. There are seven cases of astronauts experiencing in flight and post flight symptoms, which are summarized and follow-up is reviewed along with a comparison of the treatment options. The question is "is there other involvement besides vision," and other Clinical implications are raised,

  17. An enlarged parietal foramen in the late archaic Xujiayao 11 neurocranium from Northern China, and rare anomalies among Pleistocene Homo.

    Directory of Open Access Journals (Sweden)

    Xiu-Jie Wu

    Full Text Available We report here a neurocranial abnormality previously undescribed in Pleistocene human fossils, an enlarged parietal foramen (EPF in the early Late Pleistocene Xujiayao 11 parietal bones from the Xujiayao (Houjiayao site, northern China. Xujiayao 11 is a pair of partial posteromedial parietal bones from an adult. It exhibits thick cranial vault bones, arachnoid granulations, a deviated posterior sagittal suture, and a unilateral (right parietal lacuna with a posteriorly-directed and enlarged endocranial vascular sulcus. Differential diagnosis indicates that the perforation is a congenital defect, an enlarged parietal foramen, commonly associated with cerebral venous and cranial vault anomalies. It was not lethal given the individual's age-at-death, but it may have been associated with secondary neurological deficiencies. The fossil constitutes the oldest evidence in human evolution of this very rare condition (a single enlarged parietal foramen. In combination with developmental and degenerative abnormalities in other Pleistocene human remains, it suggests demographic and survival patterns among Pleistocene Homo that led to an elevated frequency of conditions unknown or rare among recent humans.

  18. Neurologic screening by magnetic resonance imaging in asymptomatic subjects in Self Defence Force Maizuru guard area

    International Nuclear Information System (INIS)

    To clarify usefulness of cranial magnetic resonance imaging (MRI) for group health care. We performed 1136 cranial MRI and MRA examinations between March 1992 and February 1997 in members of the Self Defense Force (SDF) stationed in the Maizuru area. We selected subjects when they reached the age of 40 years, when they retired, or when they were found to have risk factors for cerebrovascular disease. Furthermore, we investigated occurrence of symptomatic cerebral disease of our subjects and non-subjects in SDF Maizuru area during MRI screening. We found 77 asymptomatic cerebral infarctions, 8 unruptured cerebral aneurysms, 2 pituitary adenomas, 4 venous angiomas and 4 arachnoid cysts. Among asymptomatic cerebral disease, the number of cerebral infarctions was significantly greater in the risk factor and retired group compared to the 40-year-old group. In 24 patients with asymptomatic cerebral infarction whom we were able to follow, we prescribed antiplatelet drugs and none became symptomatic. Unruptured cerebral aneurysms and pituitary tumors we treated operatively, resulting in good functional outcomes in all patients. There were less symptomatic cerebral diseases in the subject group (0.08%) vs. in the non-subject group (0.3%). However, the difference was not statistically significant (p=.20). Screening cranial MRI and MRA examinations indicated considerable overall utility. However, further human study is warranted to identify usefulness of MRI screening system. (author)

  19. Suboccipital bony decompression combined with removal of the dural band as treatment for Chiari I malformation

    Institute of Scientific and Technical Information of China (English)

    周大彪; 赵继宗; 张东; 赵元立

    2004-01-01

    @@ Chiari I malformation (CMI) is a disorder involving hindbrain maldevelopments characterized by herniation of the cerebellar tonsils through the foramen magnum. The clinical presentations of CMI are related to the direct compression of the brainstem and cerebellum and to disturbances to cerebral spinal fluid (CSF) circulation. Surgical intervention is indicated in symptomatic patients with neuroradiological abnormalities. Though many different surgical options are available, suboccipital decompression has been widely accepted as a preferred procedure with or without additional manipulations.1-11 Nevertheless, any intradural procedures will risk related complications, including meningitis or arachnoiditis, CSF leakage, pseudomeningoceles, vascular injuries, brainstem dysfunction, as well as delayed neurological deterioration. Since the main benefit of surgery for CMI is to arrest the progression of the disease and stabilize the patient's neurological state,2,12 additional procedures seem to be unnecessary. To achieve acceptable therapeutic results for CMI, it is beneficial to perform a simple and effective procedure involving a minimal extent of surgery. The purpose of this article is to present an extradural technique for the modification of suboccipital decompression and to evaluate its efficacy based on clinical and neuroradiological results.

  20. Fetal magnetic resonance imaging in prenatal diagnosis of central nervous system abnormalities

    International Nuclear Information System (INIS)

    The diagnostic value of fetal magnetic resonance imaging (MRI), performed in 42 pregnant women whose fetuses had structural abnormalities of the central nervous system identified with transabdominal ultrasonography from 1995 through 2002, was analyzed retrospectively. Half-Fourier acquisition single-shot turbo spin-echo (HASTE) T2-weighted imaging clearly delineated the cerebrospinal fluid (CSF) space and the malformed brain and spinal cord and provided valuable information for the diagnosis of structural abnormalities related to the CSF space, such as spina bifida with Chiari type II malformation (7 cases), colpocephaly with agenesis of the corpus callosum (7 cases), holoprosencephaly (6 cases), porencephaly (2 cases), lissencephaly with hydrocephalus (2 cases), and middle fossa arachnoid cyst (1 case). However, some difficulty was encountered in the diagnosis of rare pathologic conditions that were not related to the CSF space, such as epignathus, multiple arteriovenous fistulae, trapped suboccipital meningocele, and Turner syndrome. We conclude that HASTE T2-weighted imaging, which provides useful diagnostic images in a reasonable time, is a useful adjunct to ultrasonography to confirm or exclude certain abnormalities related to the CSF space. (author)

  1. Study on the causes of "false-negative" in indocyanine green angiography during intracranial aneurysm surgery

    Directory of Open Access Journals (Sweden)

    XUE Zhe

    2012-02-01

    Full Text Available Objective To explore the causes and treatment principles of the "false-negative" phenomenon of intraoperative near-infrared indocyanine green angiography (ICGA during intracranial aneurysm surgery. Methods The causes of "false-negative" and limitations of ICGA during aneurysm surgery were analysed and the related treatment principles were studied. Results Seven patients with intracranial aneurysm presented ICGA "false-negative" during surgical clipping. When the aneurysm body was incised or stabbed errhysis may emerged. After immediately cleaned away the oozing of blood at the neck of aneurysm and regulated the clipping position of aneurysm, errhysis was eliminated. Conclusion Although ICGA is useful in determining the obliteration of aneurysm by surgical clipping, there are some limitations. Wide-necked aneurysm, thrombosis on the neck of aneurysm or atheromatous plaque at the vessel wall and arachnoid incomplete seperated may induce ICGA "false-negative". Therefore, when ICGA "false negative" occurs in surgical clipping of aneurysm other monitoring methods should be used to confirm the obliteration of aneurysm.

  2. A study of brain MRI findings in children with epilepsy

    International Nuclear Information System (INIS)

    Magnetic resonance imaging in the brain was performed in 293 patients with childhood-onset (<15 y.o.) epilepsy who had been classified into 4 groups, idiopathic localization-related epilepsy (ILRE), 78 patients; idiopathic generalized epilepsy (IGE), 116 patients; symptomatic localization-related epilepsy (SLRE), 68 patients and symptomatic generalized epilepsy (SGE), 31 patients, with the Classification of Epilepsies and Epileptic Syndrome (1989 International League Against Epilepsy). The examination was performed with a 1.5 T magnet. One hundred twenty-five patients (42.7%) showed abnormal findings, and the incidence in each group was as follows: Idiopathic epilepsy: The rate of abnormal findings in the ILRE and IGE groups was 21.8% and 20.7%, respectively. Most of the abnormal findings were secondary changes, such as diffuse or localized brain atrophy. Of the congenital abnormalities, the main finding was arachnoid cyst. Symptomatic epilepsy: The rate of abnormality in the SLRE patients was 88.2%, and 85% of the findings were secondary changes, i.e., brain atrophy, or degeneration of the white matter. In the SGE group, the rate was 77.4%, with an almost equal percentage of congenital and secondary changes. Of 255 patients who were examined by electroencephalography (EEG) on the same day as MRI, about 50% showed a correlation between the EEG records and the MRI abnormalities. However, only 8 patients showed a correlation in localization between the EEG and MRI abnormalities. (author)

  3. Imaging diagnosis of various small lesions in the cerebellopontine angle by Suboccipital air CT cisternography

    Energy Technology Data Exchange (ETDEWEB)

    Tsukahara, Kaoru (Toho Univ., Tokyo (Japan). School of Medicine)

    1989-11-01

    A modified air CT cisternography technique, characterized by suboccipital air infusion was carried out in a total of 180 patients over the past 5 years. The patients were divided into two groups according to their suspected lesions. The first group consisted of 151 patients who were diagnosed as having retrolabyrinthine lesions by neurootological examinations; 29 patients with facial twitching or trigeminal neuralgia were classified in the second group. In the first group, air CT cisternography revealed 21 cases of small acoustic tumors including intracanalicular tumors. Additionally, several unexpected small lesions were detected in the cerebellopontine angle. These included small meningiomas, osteoma, osteogenic tumor, nodulated acoustic nerve in neurofibromatosis, primary acoustic nerve atrophy, adhesive arachnoiditis, elongated basilar artery and patulous acoustic meatus. In the second group, the causative artery of neurovascular compression at the nerve exit zone failed to be confirmed in many cases, but satisfactory preoperative information concerning nerves and vessels in the cerebellopontine angle were provided by air CT cisternography. The advantages and disadvantages of air CT cisternography and MRI-CT for the diagnosis of small lesions in the cerebellopontine angle are also discussed. (author).

  4. A case of apical ballooning syndrome in a male with status asthmaticus; highlighting the role of B2 agonists in the pathophysiology of a reversible cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Farah F. Salahuddin

    2013-07-01

    Full Text Available Apical ballooning syndrome (ABS, also known as Takotsubo cardiomyopathy, was first reported by Dote and colleagues in Japanese literature in 1991 in a review of five cases. Case series have highlighted the association of severe psychological stressors as the major precipitating factors of this syndrome. Status Epilepticus and Sub-Arachnoid hemorrhage are also now established independent etiologies for this phenomenon in patients without coronary artery disease. We report a case of reversible apical ventricular dysfunction in a 50-year-old male presenting with status asthmaticus who quickly underwent intubation. Following this, he had ST elevations in precordial leads with mild cardiac enzyme leak. Subsequent cardiac catheterization revealed a left ventricular ejection fraction of 25–30% with apical aneurismal segment. No obstructive disease was observed. Three days later there was marked clinical improvement; the patient was extubated and repeat echocardiography revealed a remarkable return to normal ventricular size and systolic function. Our case demonstrates that excess use of beta-agonists may be a potential risk factor for ABS and raises the possibility of cathecholamine cardiotoxicity being mediated via beta-receptors. Furthermore, it also negates the propensity of apical ballooning so far reported only in women with respiratory distress without confounding emotional stressors.

  5. The analysis of MR findings of the postoperative diskitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Min; Lee, Sang Woo; Huh, Suh Ku; Lee, Kyeong Hee; Kim, Chang Soo [Maryknoll Hospital, Pusan (Korea, Republic of)

    1997-05-01

    To evaluate MR findings of postoperative diskitis following operation for intervertebral disk herniation. Twelve cases with postoperative diskitis following operation for intervertebral disk herniation were included in this study. MR findings of postoperative diskitis were analysed to determine 1)the extent and pattern of alteration of the involved disks, 2)the pattern of destruction of endplates and vertebral bodies, and 3)the pattern of inflammatory extension into the surrounding soft tissue. 1)Disk alteration developed mainly at the middle and posterior portions of the disk, and was characterized by loss of intranuclear cleft at the involved portion of the disk and intranuclear abscess formation 2)Vertebral bodies involved ware symmetrically adjacent to involved disks and in three cases, bone abscesses within the endplates were detected. 3)The extension of inflammation yielded prevertebral or pre-/paravertebral masses(7 cases), epidural abscesses(5 cases), arachnoiditis(6 cases), and inflammatory masses(2 cases) beneath the posterior longitudinal ligament. Disk involvement was mainly at the middle and posterior portions of the disks, and there was accompanying intranuclear cleft loss. Symmetric involvement of the vertebral bodies adjacent to the involved disks was noted.

  6. Prevalence of Perinatal Central Nervous System Anomalies in East Azarbaijan-Iran

    Directory of Open Access Journals (Sweden)

    M. Ghavami

    2011-06-01

    Full Text Available Background/Objective: Central nervous system (CNS anomalies are the most serious congenital abnormalities. Ultrasound examination is an effective and noninvasive modality for prenatal diagnosis of these anomalies. The purpose of the current study was to determine thefrequency of CNS and associated abnormalities.Patients and Methods: A total of 22500 pregnant women who were referred by obstetricians/ gynecologists for routine work up of pregnancy were scanned over a period of 3 years by two expert sonologists in a referral center using high resolution ultrasound unit.Results: After transabdominal sonographic examination of 22500 pregnant women, 112 (0.5%fetuses were detected with CNS anomalies, some of whom had more than one anomaly. Forty-one (37% Chiari malformations, 26 (23% monro and aqueductal stenosis cases, 18 (16% anencephaly cases, nine (8% encephaloceles, seven (6% microcephalies, five (4% Dandywalker syndromes,two (2% arachnoid cysts, two (2% agenesis of corpus callosum cases, one (1% holoprosencephaly and one (1% schizencephaly were reported in our study.Conclusion: According to our results, Chiari malformation and ydrocephalus were the most prevalent anomalies of CNS congenital abnormalities in East Azarbaijan, Iran. An accurate diagnosis depends upon fetal age, amniotic fluid volume, fetal position, operator experience and careful evaluation of the associated malformations, which are often present.

  7. Host-pathogen interactions in bacterial meningitis.

    Science.gov (United States)

    Doran, Kelly S; Fulde, Marcus; Gratz, Nina; Kim, Brandon J; Nau, Roland; Prasadarao, Nemani; Schubert-Unkmeir, Alexandra; Tuomanen, Elaine I; Valentin-Weigand, Peter

    2016-02-01

    Bacterial meningitis is a devastating disease occurring worldwide with up to half of the survivors left with permanent neurological sequelae. Due to intrinsic properties of the meningeal pathogens and the host responses they induce, infection can cause relatively specific lesions and clinical syndromes that result from interference with the function of the affected nervous system tissue. Pathogenesis is based on complex host-pathogen interactions, some of which are specific for certain bacteria, whereas others are shared among different pathogens. In this review, we summarize the recent progress made in understanding the molecular and cellular events involved in these interactions. We focus on selected major pathogens, Streptococcus pneumonia, S. agalactiae (Group B Streptococcus), Neisseria meningitidis, and Escherichia coli K1, and also include a neglected zoonotic pathogen, Streptococcus suis. These neuroinvasive pathogens represent common themes of host-pathogen interactions, such as colonization and invasion of mucosal barriers, survival in the blood stream, entry into the central nervous system by translocation of the blood-brain and blood-cerebrospinal fluid barrier, and induction of meningeal inflammation, affecting pia mater, the arachnoid and subarachnoid spaces. PMID:26744349

  8. Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance

    International Nuclear Information System (INIS)

    To determine frequency, imaging features and clinical significance of herniations of brain parenchyma into dural venous sinuses (DVS) and/or calvarium found on MRI. A total of 6160 brain MRI examinations containing at least one high-resolution T1- or T2-weighted sequence were retrospectively evaluated to determine the presence of incidental brain herniations into the DVS or calvarium. MRI sequences available for review were evaluated according to their capability to demonstrate these herniations. Patients' symptoms and clinical findings were recorded. Twenty-one (0.32 %) brain parenchyma herniations into the DVS (n = 18) or calvarium (n = 3) in 20 patients were detected. The most common locations of the herniations were the transverse sinuses (n = 13) and those involving inferior gyrus of the temporal lobe (n = 9). High-resolution T1- and T2-weighted sequences were equally useful in the detection of these brain herniations. According to clinical symptoms, brain herniations were considered to be incidental but headaches were present in nine patients. Brain herniations with surrounding cerebrospinal fluid (CSF) into the DVS and/or calvarium are incidental findings and not proven to be associated with any symptoms. Although rare, these herniations are more common than previously recognized and should not be confused with arachnoid granulations, clots or tumours. (orig.)

  9. Nondural-based lumbar clear cell meningioma. Case report.

    Science.gov (United States)

    Holtzman, R N; Jormark, S C

    1996-02-01

    This 32-year-old man had noticed right leg pain for 4 years and developed classic right sciatica after heavy lifting, followed by episodes of buckling of both legs 1 month prior to admission. His medical history included congenital left abducens palsy. Examination revealed a right Lasègue's sign and Fajersztajn's sign with mild weakness of the right extensor hallucis longus. Magnetic resonance imaging revealed a 1.5 x 2.0-cm enhancing intradural lesion at the L3-4 level. Following laminectomy of L-3 and L-4 and intradural exposure, the tumor was found to be draped loosely by the roots of the cauda equina and attached to a single root without any adherence to dura. Transection of the adherent fascicles and typical microdissection of arachnoidal filaments permitted its complete removal without violation of the capsule, allowing the preservation of a large fascicle. The patient's recovery was uneventful. Postoperatively, a mild right lateral foot hypalgesia and diminution of the right ankle jerk implicated the S-1 root. Histological and immunohistochemical analyses diagnosed the specimen as a clear cell meningioma. PMID:8592230

  10. The Usefulness of Lumbar Spine MRI for Cauda Equina Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Tae Yong; Baik, Seong Kug [Dept. of Radiology, Pusan National University Yangsan Hospital, Yangsan(Korea, Republic of); Lee, In Sook [Dept. of Radiology and Medical Research Institite, Pusan National University Hosptal, Pusan (Korea, Republic of)

    2011-05-15

    To understand the usefulness of the lumbar MRI studies to establish therapeutic plans for cauda equina syndrome (CES) including the management of rectal and bladder dysfunction symptoms. We retrospectively reviewed the lumbar MRI studies of 10 patients with CES. Their diagnoses included four adhesive arachnoiditis of cauda equina (CE), three conus medullaris atrophies, three spinal canal stenoses, one tuberculous leptomeningitis, one metastatic tumor on the sacral canal, and one dural arteriovenous fistula with venous congestion of the conus medullaris. In 6 of the 10 total cases the symptoms of rectal and bladder dysfunction were resolved by decompression laminectomies (n=2), irradiation (n=1), glue embolization (n=1), anticholine and steroid infusion (n=1), and anti-tuberculous medication (n=1) within at least 5 days. The 4 other cases were settled by lumboperitoneal shunting and neural stem cell implants. The study results indicate that lumbar MRI is the modality of choice in search for the causative lesion and to subsequently set up the best therapeutic plans for patients with CES.

  11. Epilepsy and ring chromosome 20: case report

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    Gomes Marleide da Mota

    2002-01-01

    Full Text Available We present the clinical, electroencephalographic, neuroimaging (brain magnetic resonance image - MRI and spectroscopy by MRI and cytogenetic findings of a young male patient with a rare cytogenetic anomaly characterised by a de novo 46,XY,r(20(p13q13.3 karyotype. He presents with mental retardation, emotional liability, and strabismus, without any other significant dysmorphies. There are brain anomalies characterised by corpus callosum, uvula, nodule and cerebellum pyramid hypoplasias, besides arachnoid cysts in the occipital region. He had seizures refractory to pharmacotherapy and long period of confusional status with or without a motor component. The authors recognised that the EEG pattern was not fixed but changed over time, specially for bursts of slow waves with great amplitude accompanied or not by sharp components, and bursts of theta waves sharply contoured. Previously, epilepsy solely has been assigned to region 20q13. However, the important structural cerebral alterations present in our case has not been reported associated to such chromosomal abnormality and may indicate possible new chromosomal sites where such atypical neurological characteristics could be mapped.

  12. Measurement of fluorescent probes concentration ratio in the cerebrospinal fluid for early detection of Alzheimer's disease

    Science.gov (United States)

    Harbater, Osnat; Gannot, Israel

    2014-03-01

    The pathogenic process of Alzheimer's Disease (AD), characterized by amyloid plaques and neurofibrillary tangles in the brain, begins years before the clinical diagnosis. Here, we suggest a novel method which may detect AD up to nine years earlier than current exams, minimally invasive, with minimal risk, pain and side effects. The method is based on previous reports which relate the concentrations of biomarkers in the Cerebrospinal Fluid (CSF) (Aβ and Tau proteins) to the future development of AD in mild cognitive impairment patients. Our method, which uses fluorescence measurements of the relative concentrations of the CSF biomarkers, replaces the lumbar puncture process required for CSF drawing. The process uses a miniature needle coupled trough an optical fiber to a laser source and a detector. The laser radiation excites fluorescent probes which were prior injected and bond to the CSF biomarkers. Using the ratio between the fluorescence intensities emitted from the two biomarkers, which is correlated to their concentration ratio, the patient's risk of developing AD is estimated. A theoretical model was developed and validated using Monte Carlo simulations, demonstrating the relation between fluorescence emission and biomarker concentration. The method was tested using multi-layered tissue phantoms simulating the epidural fat, the CSF in the sub-arachnoid space and the bone. These phantoms were prepared with different scattering and absorption coefficients, thicknesses and fluorescence concentrations in order to simulate variations in human anatomy and in the needle location. The theoretical and in-vitro results are compared and the method's accuracy is discussed.

  13. Germline and somatic mutations in meningiomas.

    Science.gov (United States)

    Smith, Miriam J

    2015-04-01

    Meningiomas arise from the arachnoid layer of the meninges that surround the brain and spine. They account for over one third of all primary central nervous system tumors in adults and confer a significant risk of location-dependent morbidity due to compression or displacement. A significant increase in risk of meningiomas is associated with neurofibromatosis type 2 (NF2) disease through mutation of the NF2 gene. In addition, approximately 5% of individuals with schwannomatosis disease develop meningiomas, through mutation of the SWI/SNF chromatin remodeling complex subunit, SMARCB1. Recently, a second SWI/SNF complex subunit, SMARCE1, was identified as a cause of clear cell meningiomas, indicating a wider role for this complex in meningioma disease. The sonic hedgehog (SHH)-GLI1 signaling pathway gene, SUFU, has also been identified as the cause of hereditary multiple meningiomas in a large Finnish family. The recent identification of somatic mutations in components of the SHH-GLI1 and AKT1-MTOR signaling pathways indicates the potential for cross talk of these pathways in the development of meningiomas. This review describes the known meningioma predisposition genes and their links to the recently identified somatic mutations. PMID:25857641

  14. Therapeutic approaches to cerebral vasospasm complicating ruptured aneurysm

    Directory of Open Access Journals (Sweden)

    Mohamed Barbarawi

    2009-10-01

    Full Text Available Cerebral vasospasm is a serious complication of ruptured aneurysm. In order to avoid short- and long-term effects of cerebral vasospasm, and as there is no single or optimal treatment modality employed, we have instituted a protocol for the prevention and treatment of vasospasm in patients suffering aneurysmal sub-arachnoid hemorrhage (SAH. We then reviewed the effectiveness of this protocol in reducing the mortality and morbidity rate in our institution. In this study we present a retrospective analysis of 52 cases. Between March 2004 and December 2008 52 patients were admitted to our service with aneurysmal SAH. All patients commenced nimodipine, magnesium sulphate (MgSO4 and triple H therapy. Patients with significant reduction in conscious level were intubated, ventilated and sedated. Intracranial pressure (ICP monitoring was used for intubated patients. Sodium thiopental coma was induced for patients with refractory high ICP; angiography was performed for diagnosis and treatment. Balloon angioplasty was performed if considered necessary. Using this protocol, only 13 patients (25% developed clinical vaso-spasm. Ten of them were given barbiturates to induce coma. Three patients underwent transluminal balloon angioplasty. Four out of 52 patients (7.7% died from severe vasospasm, 3 patients (5.8% became severely disabled, and 39 patients (75% were discharged in a condition considered as either normal or near to their pre-hemorrhage status. Our results confirm that the aforementioned protocol for treatment of cerebral vasospasm is effective and can be used safely.

  15. Critical ventriculo-peritoneal shunt failure due to peritoneal tuberculosis: Case report and diagnostic suggestions for abdominal pseudocyst

    Directory of Open Access Journals (Sweden)

    Hajime Takase

    2014-01-01

    Full Text Available Background: Tuberculous peritonitis (TBP is a well-known complication of ventriculo-peritoneal (VP shunt treatment for hydrocephalus resulting from tuberculous meningitis (TBM. However, a case of hydrocephalus unrelated to TBM resulting from VP shunt malfunction due to TBP has not been reported. Case Description: A 21-year-old male presented with nausea, abdominal pain, and headache. VP and cysto-peritoneal (CP shunts had been inserted to treat hydrocephalus due to a suprasellar arachnoid cyst, replaced the VP and removed the CP in his childhood. Computed tomography demonstrated acute hydrocephalus and an abdominal pseudocyst surrounding the distal end of the peritoneal tube. Initial laboratory data showed elevated white blood cell count and C-reactive protein level, but no causative pathogen was identified. External drainage of cerebrospinal fluid (CSF and of the fluid in the peritoneal cyst was established, and empirical antibiotic therapy was initiated. Bacterial cultures eventually revealed Mycobacterium tuberculosis infection, and TBP was diagnosed. The patient responded well to antituberculosis (anti-TB agents and insertion of a ventriculo-pleural shunt. Conclusion: This case highlights the possibility of CSF shunt failure and concomitant neurological sequelae from TB infection even when the pathogen has not invaded the central nervous system, as in TBM. Moreover, TBP is rare in developed countries and therefore may be misdiagnosed because of nonspecific clinical features and low sensitivity of common TB screening methods.

  16. Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament

    Directory of Open Access Journals (Sweden)

    Dachuan Wang

    2014-01-01

    Full Text Available Intradural herniation of a cervical disc is rare; less than 35 cases have been reported to date. A 52-year-old man with preexisting ossification of posterior longitudinal ligament developed severe neck pain with Lt hemiparesis while asleep. Neurological exam was consistent with Brown-Séquard syndrome. Magnetic resonance images showed a C5-6 herniated disc that was adjacent to the ossified ligament and indenting the cord. The mass was surrounded by cerebrospinal fluid signal intensity margin, and caudally the ventral dura line appears divided into two, consistent with the “Y-sign” described by Sasaji et al. Cord edema were noted. Because of preexisting canal stenosis and spinal cord at risk, a laminoplasty was performed, followed by an anterior C6 corpectomy. Spot-weld type adhesions of the posterior longitudinal ligament to the dura was noted, along with a longitudinal tear in the dura. An intradural extra-arachnoid fragment of herniated disc was removed. Clinical exam at 6 months after surgery revealed normal muscle strength but persistent mild paresthesias. It is difficult to make a definite diagnosis of intradural herniation preoperatively; however, the clinical findings and radiographic signs mentioned above are suggestive and should alert the surgeon to look for an intradural fragment.

  17. Central nervous system tuberculosis: MRI

    International Nuclear Information System (INIS)

    The MRI findings of 18 proven cases of central nervous system (CNS) tuberculosis were reviewed; 10 patients were seropositive for HIV. All had medical, laboratory, or surgical proof of CNS tuberculosis. Eleven patients had meningitis, of whom two also had arachnoiditis. Five patients had focal intra-axial tuberculomas: four brain masses and one an intramedullary spinal lesion. Two patients had focal extra-axial tuberculomas: one in the pontine cistern, and one in the spine. In all 11 patients with meningitis MRI showed diffuse, thick, meningeal enhancement. All intraparenchymal tuberculomas showed low signal intensity on T2-weighted images and ring or nodular enhancement. The extra-axial tuberculomas had areas isointense or hypointense relative to normal brain and spinal cord on T2-weighted images. Although tuberculous meningitis cannot be differentiated from other meningitides on the basis of MR findings, intraparenchymal tuberculomas show characteristic T2 shortening, not found in most other space-occupying lesions. In the appropriate clinical setting, tuberculoma should be considered. (orig.)

  18. Immunodeficiency, Centromeric instability, Facial anomalies (ICF) syndrome, due to ZBTB24 mutations, presenting with large cerebral cyst

    Science.gov (United States)

    Cerbone, Manuela; Wang, Jun; Van der Maarel, Silvère M.; d’Amico, Alessandra; d’Agostino, Antonio; Romano, Alfonso; Brunetti-Pierri, Nicola

    2012-01-01

    The Immunodeficiency, Centromeric instability, Facial anomalies (ICF) syndrome is an autosomal recessive disease presenting with immunodeficiency secondary to hypo- or agammaglobulinemia, developmental delay, and facial anomalies. Centromeric instability is the cytogenetic hallmark of the disorder which results from targeted chromosomal rearrangements related to a genomic methylation defect. We describe a patient carrying a homozygous mutation of the ZBTB24 gene, which has been recently shown to be responsible for ICF syndrome type 2. Our patient presented with intellectual disability, multiple café-au-lait spots, and a large cerebral arachnoidal cyst. Although laboratory signs of impaired immune function, such as reduced serum IgM were detected, our patient did not present clinical manifestations of immunodeficiency. Brain malformations have not been reported so far in ICF syndrome and it can be speculated that ZBTB24 mutations may alter cerebral development. Nevertheless, we cannot rule out that the presence of the cerebral cyst in the patient is coincidental. In summary, our patient illustrates that clinical evidence of immunodeficiency is not a universal feature of ICF2 syndrome type 2 and suggests that brain malformations may be present in other ICF cases. PMID:22786748

  19. Cranial x-ray CT and MRI in congenital muscular dystrophy

    International Nuclear Information System (INIS)

    The involvements of central nervous system in those cases of congenital muscular dystrophy (CMD), especially in Fukuyama type CMD, have been observed both radiologically and pathologically. The recent development of MRI made it easier to detect fine structural changes in brain matter than the X-ray CT. Then, we tried to evaluate the central nervous system abnormalities of six cases of CMD by both X-ray CT and MRI. In one case, X-ray CT revealed diffuse hypodensity of cerebral white matter, and MRI showed high intensity on long spin-echo image and low intensity on inversion-recovery image. In another case, X-ray CT showed no abnormal findings, but long spin-echo image revealed two high intensity spots in cerebral white matter. In other four cases, brain atrophy was demonstrated by X-ray CT and/or MRI, one case of these patients had bilateral congenital arachnoid cysts in the middle cranial fossa and hypogenesis of temporal lobes. Although we could not demonstrate polymicrogyria and agyria in all cases by MRI, white matter changes and structural changes were revealed more clearly than X-ray CT. The combination of X-ray CT and MRI seems to make a noteworthy contribution to estimate the central nervous system abnormalities in CMD. (author)

  20. Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Battal, Bilal; Hamcan, Salih; Akgun, Veysel; Sari, Sebahattin; Tasar, Mustafa [Gulhane Military Medical School, Department of Radiology, Ankara (Turkey); Oz, Oguzhan [Gulhane Military Medical School, Department of Neurology, Ankara (Turkey); Castillo, Mauricio [University of North Carolina School of Medicine, Division of Neuroradiology, Department of Radiology, Chapel Hill, NC (United States)

    2016-06-15

    To determine frequency, imaging features and clinical significance of herniations of brain parenchyma into dural venous sinuses (DVS) and/or calvarium found on MRI. A total of 6160 brain MRI examinations containing at least one high-resolution T1- or T2-weighted sequence were retrospectively evaluated to determine the presence of incidental brain herniations into the DVS or calvarium. MRI sequences available for review were evaluated according to their capability to demonstrate these herniations. Patients' symptoms and clinical findings were recorded. Twenty-one (0.32 %) brain parenchyma herniations into the DVS (n = 18) or calvarium (n = 3) in 20 patients were detected. The most common locations of the herniations were the transverse sinuses (n = 13) and those involving inferior gyrus of the temporal lobe (n = 9). High-resolution T1- and T2-weighted sequences were equally useful in the detection of these brain herniations. According to clinical symptoms, brain herniations were considered to be incidental but headaches were present in nine patients. Brain herniations with surrounding cerebrospinal fluid (CSF) into the DVS and/or calvarium are incidental findings and not proven to be associated with any symptoms. Although rare, these herniations are more common than previously recognized and should not be confused with arachnoid granulations, clots or tumours. (orig.)

  1. Neurologic complications after intrathecal liposomal cytarabine in combination with systemic polychemotherapy in primary CNS lymphoma.

    Science.gov (United States)

    Ostermann, Kathrin; Pels, Hendrik; Kowoll, Annika; Kuhnhenn, Jan; Schlegel, Uwe

    2011-07-01

    Intrathecal application of liposomal cytarabine (Ara-C) (DepoCyte(®)) has been associated with neurotoxicity when applied as part of a polychemotherapy regimen. Patients with primary central nervous system lymphoma treated with high-dose systemic methotrexate (MTX)- and Ara-C-based polychemotherapy including six cycles of liposomal Ara-C (50 mg intrathecally every 3 weeks) were prospectively monitored for neurotoxic side-effects. Between November 2005 and February 2009, 149 intrathecal applications of liposomal cytarabine (DepoCyte(®)) were carried out in 33 patients, 7 (21%) of whom developed an incomplete conus medullaris/cauda equina syndrome with incontinence for bladder (6) and bowel function (3) or lumbosacral polyradicular paresis (1), resolving only incompletely over a follow-up period of 9-30 months. In six of these seven patients, lumbosacral magnetic resonance imaging (MRI) was negative for leptomeningeal infiltration or arachnoiditis. Cerebrospinal fluid (CSF) analysis performed in six of these seven patients showed normal cell count in all and increased total protein in four of them. One patient among these seven suffered a seizure without other identifiable causes. Conus/cauda syndrome has to be considered as a serious potential neurotoxic side-effect in patients receiving liposomal Ara-C as part of a multimodal regimen including high-dose systemic MTX and Ara-C. PMID:20953896

  2. Surgical Outcome of Intradural Spinal Tumors.

    Science.gov (United States)

    Ahsan, M K; Sakeb, N; Ali, M Y; Awwal, M A; Khan, S I; Goni, M M; Mia, M B; Alam, M B; Zaman, N; Jannat, S N

    2016-07-01

    Results of 63 surgically treated intradural spinal tumors between the period of October 2003 and December 2014 at Bangabandhu Sheikh Mujib Medical University (BSMMU) and in our private settings, Dhaka, were analyzed retrospectively. There were 33 males, 30 females with an average age of 52.4 years (13-70 years) and followed up for at least a year. The preoperative symptom with duration, tumors location and intradural space occupancy and the histopathological diagnosis were analyzed. Pain was evaluated by the visual analogue scale (VAS) and the neurologic function was assessed by Nurick's grade. The tumors were located as, thoracic (n=32, 50.79%), lumbar (n=16, 25.39%), cervical (n=05, 07.93%), and junctional (n=10, 15.87%, CervicoThoracic-01, Thoracolumbar-09). The histopathological diagnosis included schwannoma (n=30, 47.7%), meningiomas (n=14, 22.3%), neurofibroma, arachnoid cyst and myxopapillary ependymoma (n=03, 04.76%) each and paraganglioma (n=01, 01.59%). Among the intramedullary tumors, ependymoma (n=03, 04.76%), astrocytoma and epidermoid cyst (n=02, 03.17%), haemangioblastoma, paraganglioma and cavernous haemangioma (n=01, 01.59%) each. The VAS score was reduced in all cases from 8.0±1.2 to 1.2±0.8 (pbedsore and recurrence (Ependymoma) (n=01, 01.59%). Aggressive surgical excision potentially minimizes neurologic morbidity and improved outcome except intramedullary tumors where initial treatment consists of maximum safe surgical resection or biopsy. PMID:27612900

  3. Dynamic oxygen-enhanced MRI of cerebrospinal fluid.

    Directory of Open Access Journals (Sweden)

    Taha M Mehemed

    Full Text Available Oxygen causes an increase in the longitudinal relaxation rate of tissues through its T1-shortening effect owing to its paramagnetic properties. Due to such effects, MRI has been used to study oxygen-related signal intensity changes in various body parts including cerebrospinal fluid (CSF space. Oxygen enhancement of CSF has been mainly studied using MRI sequences with relatively longer time resolution such as FLAIR, and T1 value calculation. In this study, fifteen healthy volunteers were scanned using fast advanced spin echo MRI sequence with and without inversion recovery pulse in order to dynamically track oxygen enhancement of CSF. We also focused on the differences of oxygen enhancement at sulcal and ventricular CSF. Our results revealed that CSF signal after administration of oxygen shows rapid signal increase in both sulcal CSF and ventricular CSF on both sequences, with statistically significant predominant increase in sulcal CSF compared with ventricular CSF. CSF is traditionally thought to mainly form from the choroid plexus in the ventricles and is absorbed at the arachnoid villi, however, it is also believed that cerebral arterioles contribute to the production and absorption of CSF, and controversy remains in terms of the precise mechanism. Our results demonstrated rapid oxygen enhancement in sulcal CSF, which may suggest inhaled oxygen may diffuse into sulcal CSF space rapidly probably due to the abundance of pial arterioles on the brain sulci.

  4. Postoperative cerebrospinal-fluid fistula associated with erosion of the dura. Findings after anterior resection of ossification of the posterior longitudinal ligament in the cervical spine.

    Science.gov (United States)

    Smith, M D; Bolesta, M J; Leventhal, M; Bohlman, H H

    1992-02-01

    Of twenty-two patients who had had anterior decompression of the spinal canal for ossification of the posterior longitudinal ligament and cervical myelopathy, seven had absence of the dura adjacent to the ossified part of the ligament. The spinal cord and nerve-roots were visible through this defect. Although the arachnoid membrane appeared to be intact and watertight in most patients, a cerebrospinal-fluid fistula developed postoperatively in five, and three had a second operation to repair the defect in the dura. On the basis of this experience, we recommend use of autogenous muscle or fascial dural patches, immediate lumbar subarachnoid shunting, and modification of the usual postoperative regimen, such as limitation of mechanical pulmonary ventilation to the shortest time that is safely possible and use of anti-emetic and antitussive medications to protect the remaining coverings of the spinal cord when the dura is found to be absent adjacent to an ossified portion of the posterior longitudinal ligament in the cervical spine. PMID:1541620

  5. Optic Tract Edema: A Highly Specific Magnetic Resonance Imaging Finding for the Diagnosis of Craniopharyngiomas

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    Hirunpat, S.; Tanomkiat, W.; Sriprung, H.; Chetpaophan, J. [Prince of Songkla Univ., Hat Yai (Thailand). Dept. of Radiology and Epidemiology Unit

    2005-07-01

    Purpose: To clarify the accuracy, sensitivity, and specificity of optic tract edema in the diagnosis of craniopharyngiomas. Material and Methods: Preoperative magnetic resonance images (MRIs) of 49 patients (between May 1996 and March 2003) who had a diagnosis of parasellar masses were blindly reviewed by two radiologists. The spread of edema surrounding the tumor on the coronal TSE T2-weighted images was analyzed. Sensitivity and specificity were calculated based on the numbers in this series and also pooled numbers from previous known reported series. Results: Edema along the optic tracts was detected in 7 of 1 craniopharyngiomas, giving a sensitivity of 63.6% (95% CI{approx_equal}30.8-89.1) for our series and 66.7% (95% CI{approx_equal}47.2-82.7) for the pooled numbers. The specificity was 00% (95% CI{approx_equal}90.7-100.0) for our series and 93.9% (95% CI{approx_equal}87.1-97.7) for the pooled numbers. None of the 28 pituitary macroadenomas, 4 meningiomas, 2 hypothalamic astrocytomas, 2 germinomas, mixed-germ cell tumor and arachnoid cyst in our study showed edema of the optic pathways. Conclusion: Optic tract edema, commonly seen in craniopharyngiomas, is a useful MR finding for distinguishing craniopharyngiomas from other parasellar tumors with considerable sensitivity and high specificity.

  6. Synteny of human chromosomes 14 and 15 in the platyrrhines (Primates, Platyrrhini

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    Cristiani Gifalli-Iughetti

    2009-01-01

    Full Text Available In order to study the intra- and interspecific variability of the 14/15 association in Platyrrhini, we analyzed 15 species from 13 genera, including species that had not been described yet. The DNA libraries of human chromosomes 14 and 15 were hybridized to metaphases of Alouatta guariba clamitans, A. caraya, A. sara, Ateles paniscus chamek, Lagothrix lagothricha, Brachyteles arachnoides, Saguinus midas midas, Leontopithecus chrysomelas, Callimico goeldii, Callithrix sp., Cebus apella, Aotus nigriceps, Cacajao melanocephalus, Chiropotes satanas and Callicebus caligatus. The 14/15 hybridization pattern was present in 13 species, but not in Alouatta sara that showed a 14/15/14 pattern and Aotus nigriceps that showed a 15/14/15/14 pattern. In the majority of the species, the HSA 14 homologue retained synteny for the entire chromosome, whereas the HSA 15 homologue displayed fragmented segments. Within primates, the New World monkeys represent the taxon with the highest variability in chromosome number (2n = 16 to 62. The presence of the HSA 14/15 association in all species and subspecies studied herein confirms that this association is the ancestral condition for platyrrhines and that this association has been retained in most platyrrhines, despite the occurrence of extensive inter- and intrachromosomal rearrangements in this infraorder of Primates.

  7. Increased anisotropy in neonatal meningitis: an indicator of meningeal inflammation

    Energy Technology Data Exchange (ETDEWEB)

    Trivedi, Richa; Gupta, Rakesh K.; Nath, Kavindra [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow, UP (India); Malik, Gyanendra K.; Gupta, Amit [King George' s Medical University, Department of Pediatrics, Lucknow (India); Prasad, Kashi N. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Microbiology, Lucknow (India); Purwar, Ankur; Rathore, Divya; Rathore, Ram K.S. [Indian Institute of Technology, Department of Mathematics, Kanpur (India); Narayana, Ponnada A. [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Houston, TX (United States)

    2007-09-15

    Increased anisotropy in brain abscesses has been shown to be due to adhesion of inflammatory cells and is suggestive of an active inflammatory process. The objective of this study was to determine if similar changes occur in the pia-arachnoid on the surface of the cerebral cortex in patients with pyogenic meningitis, and if these changes regress following antibiotic therapy. Diffusion tensor imaging (DTI) was performed on 14 term neonates (mean age 13 days) with bacterial meningitis and 10 healthy age- and sex-matched controls. Regions of interest (ROIs) were placed on areas including the leptomeninges, the cerebral cortex and adjoining subcortical white matter for quantitation of mean fractional anisotropy (FA) and diffusivity (MD) values. Follow-up MRI was performed in five of the neonates in the patient group after 2 weeks of antibiotic treatment. FA and MD values were compared in patients before and after antibiotic treatment as well as with those in the healthy controls. Significantly higher FA values but no difference in MD values were observed in the patient group as compared to the healthy controls at both time points (before and after antibiotic treatment). Significantly decreased FA values in the frontal, occipital and temporal cortical regions were observed in patients following antibiotic treatment. DTI-derived FA may be of value in the noninvasive assessment of meningeal inflammatory activity and treatment response in neonates. (orig.)

  8. The Usefulness of Lumbar Spine MRI for Cauda Equina Syndrome

    International Nuclear Information System (INIS)

    To understand the usefulness of the lumbar MRI studies to establish therapeutic plans for cauda equina syndrome (CES) including the management of rectal and bladder dysfunction symptoms. We retrospectively reviewed the lumbar MRI studies of 10 patients with CES. Their diagnoses included four adhesive arachnoiditis of cauda equina (CE), three conus medullaris atrophies, three spinal canal stenoses, one tuberculous leptomeningitis, one metastatic tumor on the sacral canal, and one dural arteriovenous fistula with venous congestion of the conus medullaris. In 6 of the 10 total cases the symptoms of rectal and bladder dysfunction were resolved by decompression laminectomies (n=2), irradiation (n=1), glue embolization (n=1), anticholine and steroid infusion (n=1), and anti-tuberculous medication (n=1) within at least 5 days. The 4 other cases were settled by lumboperitoneal shunting and neural stem cell implants. The study results indicate that lumbar MRI is the modality of choice in search for the causative lesion and to subsequently set up the best therapeutic plans for patients with CES.

  9. Optic Tract Edema: A Highly Specific Magnetic Resonance Imaging Finding for the Diagnosis of Craniopharyngiomas

    International Nuclear Information System (INIS)

    Purpose: To clarify the accuracy, sensitivity, and specificity of optic tract edema in the diagnosis of craniopharyngiomas. Material and Methods: Preoperative magnetic resonance images (MRIs) of 49 patients (between May 1996 and March 2003) who had a diagnosis of parasellar masses were blindly reviewed by two radiologists. The spread of edema surrounding the tumor on the coronal TSE T2-weighted images was analyzed. Sensitivity and specificity were calculated based on the numbers in this series and also pooled numbers from previous known reported series. Results: Edema along the optic tracts was detected in 7 of 1 craniopharyngiomas, giving a sensitivity of 63.6% (95% CI≅30.8-89.1) for our series and 66.7% (95% CI≅47.2-82.7) for the pooled numbers. The specificity was 00% (95% CI≅90.7-100.0) for our series and 93.9% (95% CI≅87.1-97.7) for the pooled numbers. None of the 28 pituitary macroadenomas, 4 meningiomas, 2 hypothalamic astrocytomas, 2 germinomas, mixed-germ cell tumor and arachnoid cyst in our study showed edema of the optic pathways. Conclusion: Optic tract edema, commonly seen in craniopharyngiomas, is a useful MR finding for distinguishing craniopharyngiomas from other parasellar tumors with considerable sensitivity and high specificity

  10. MRI - the investigation of choice in syringomyelia?

    International Nuclear Information System (INIS)

    During a 12 month period of operation of a 0.3 Tesla Magnetic Resonance Imaging (MRI) iron cored resistive scanner 74 cases of syringomyelia were diagnosed on clinical, radiological and/or surgical grounds. Without knowledge of any clinical or radiological data the syrinxes were classified into five groups - idiopathic, idiopathic associated with Chiari malformation, tumour associated, post-traumatic and arachnoiditis associated - and the lesion characteristics within each group were compared. Although MRI was extremely sensitive in picking up even small syrinxes, there was considerable overlap of MRI characteristics across the sub-groups, so that two post-traumatic syrinxes had lesion characteristics identifiable with those of tumour syrinx and one intramedullary tumour syrinx had the MRI characteristics of a benign, idiopathic syrinx. It is concluded that meticulous attention to technique, including axial as well as sagittal T1 weighted sequences, and the administration of intravenous paramagnetic contrast media are necessary for detection and accurate classification of syrinxes. 26 refs., 15 figs., 1 tab

  11. A case of neurosarcoidosis monitored by computerized tomography

    International Nuclear Information System (INIS)

    A 21-year-old man complaining of impaired visual acuity was admitted to the hospital. Physical examinations showed asymptomatic bilateral hilar lymphadenopathy and cardiomyopathy. Neurological findings disclosed left blindness and right temporal hemianopsia. Computerized tomography, pneumoencephalography and carotid angiography revealed a suprasellar mass. After the admission, the following symptoms deteriorated rapidly: diabetes insipidus, anterior pituitary dysfunction, visual loss of the right eye and hepatomegaly, subsequently consciousness disorder developed during a month though he was given steroids. The more deteriorated the clinical course, the larger the suprasellar mass with expanding hydrocephalus in repeated computerized tomographies. After the ventriculo-peritoneal shunt operation, consciousness improved. Diabetes insipidus also improved after Diabenese administration. On the operation, adhesive arachnoiditis over all the frontotemporal cortex and swollen purplishly red optic chiasm were exposed. Microscopically the specimen from the optic chiasm evidenced a sarcoid granuloma which composed of epitheroid cells, lymphocytes and multi-nucleated giant cells with numerous hemosiderin droplets. The specimen from the surface of the left frontal lobe showed thick fibrosis in the subarachnoid space. By steroids therapy, diabetes insipidus and hepatomegaly disappeared five months after the admission, whereas blindness never recovered. He died of developed status epilepticus eleven months after the admission. The authors reviewed neuroradiological findings of neurocarcoidosis based on pathological findings in the literature, and emphasized that computerized tomography was the most useful for diagnosis and treatment of neurosarcoidosis. (author)

  12. Oxidative Stress in the Developing Rat Brain due to Production of Reactive Oxygen and Nitrogen Species

    Science.gov (United States)

    Wilhelm, Jiří; Vytášek, Richard; Uhlík, Jiří; Vajner, Luděk

    2016-01-01

    Oxidative stress after birth led us to localize reactive oxygen and nitrogen species (RONS) production in the developing rat brain. Brains were assessed a day prenatally and on postnatal days 1, 2, 4, 8, 14, 30, and 60. Oxidation of dihydroethidium detected superoxide; 6-carboxy-2′,7′-dichlorodihydrofluorescein diacetate revealed hydrogen peroxide; immunohistochemical proof of nitrotyrosine and carboxyethyllysine detected peroxynitrite formation and lipid peroxidation, respectively. Blue autofluorescence detected protein oxidation. The foetuses showed moderate RONS production, which changed cyclically during further development. The periods and sites of peak production of individual RONS differed, suggesting independent generation. On day 1, neuronal/glial RONS production decreased indicating that increased oxygen concentration after birth did not cause oxidative stress. Dramatic changes in the amount and the sites of RONS production occurred on day 4. Nitrotyrosine detection reached its maximum. Day 14 represented other vast alterations in RONS generation. Superoxide production in arachnoidal membrane reached its peak. From this day on, the internal elastic laminae of blood vessels revealed the blue autofluorescence. The adult animals produced moderate levels of superoxide; all other markers reached their minimum. There was a strong correlation between detection of nitrotyrosine and carboxyethyllysine probably caused by lipid peroxidation initiated with RONS.

  13. Blood-brain barrier and blood-cerebrospinal fluid barrier in normal and pathological conditions.

    Science.gov (United States)

    Ueno, Masaki; Chiba, Yoichi; Murakami, Ryuta; Matsumoto, Koichi; Kawauchi, Machi; Fujihara, Ryuji

    2016-04-01

    Blood-borne substances can invade into the extracellular spaces of the brain via endothelial cells in sites without the blood-brain barrier (BBB), and can travel through the interstitial fluid (ISF) of the brain parenchyma adjacent to non-BBB sites. It has been shown that cerebrospinal fluid (CSF) drains directly into the blood via the arachnoid villi and also into lymph nodes via the subarachnoid spaces of the brain, while ISF drains into the cervical lymph nodes through perivascular drainage pathways. In addition, the glymphatic pathway of fluids, characterized by para-arterial pathways, aquaporin4-dependent passage through astroglial cytoplasm, interstitial spaces, and paravenous routes, has been established. Meningeal lymphatic vessels along the superior sagittal sinus were very recently discovered. It is known that, in mice, blood-borne substances can be transferred to areas with intact BBB function, such as the medial regions of the hippocampus, presumably through leaky vessels in non-BBB sites. In the present paper, we review the clearance mechanisms of interstitial substances, such as amyloid-β peptides, as well as summarize models of BBB deterioration in response to different types of insults, including acute ischemia followed by reperfusion, hypertension, and chronic hypoperfusion. Lastly, we discuss the relationship between perivascular clearance and brain disorders. PMID:26920424

  14. Neurofibromatosis: Evaluation of Clinical Features of 11 Cases

    Directory of Open Access Journals (Sweden)

    Gülşen Akoğlu

    2013-12-01

    Full Text Available Objective: Neurofibromatosis (NF is one of the most commonly seen autosomal dominantly inherited neurocutaneous syndromes. The most common subtypes are NF1 and NF2. The clinical course of NF may be heterogeneous.In this study, clinical features of patients with NF and its rare manifestations were described. Methods: Records of 11 patients with NF diagnosed between May 2008 and August 2011 were retrospectively reviewed. Demographic and clinical features of patients were detailed. Results: Six female and 5 male patients were enrolled. Patients' ages ranged between 1.5 and 58 years. Seven of them had positive family history for NF. A 1.5-year-old baby presented early appearance of Lisch nodules. One female patient had unilateral segmentally distributed pigmentary macules with bilateral Lisch nodules. Severe scoliosis and multiple painful neurofibromas were observed in a male patient. An asymptomatic arachnoid cyst was detected incidentally in a female patient. A male patient with NF1 had diffuse large B cell lymphoma and glioblastoma multiforme. Conclusion: Patients with NF may present with diverse clinical manifestations. Since patients may first apply to a dermatology outpatient clinic with only cutaneous complaints, early diagnosis of NF both in the patients and in their first degree relatives by careful dermatological and ophthalmological examinations and radiological evaluations can be possible.

  15. Postoperative epidural hematoma contributes to delayed upper cord tethering after decompression of Chiari malformation type I

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    Antonio Lopez-Gonzalez

    2014-01-01

    Full Text Available Background: Symptomatic arachnoiditis after posterior fossa surgical procedures such as decompression of Chiari malformation is a possible complication. Clinical presentation is generally insidious and delayed by months or years. It causes disturbances in the normal flow of cerebrospinal fluid and enlargement of a syrinx cavity in the upper spinal cord. Surgical de-tethering has favorable results with progressive collapse of the syrinx and relief of the associated symptoms. Case Description: A 30-year-old male with Chiari malformation type I was treated by performing posterior fossa bone decompression, dura opening and closure with a suturable bovine pericardium dural graft. Postoperative period was uneventful until the fifth day in which the patient suffered intense headache and progressive loose of consciousness caused by an acute posterior fossa epidural hematoma. It was quickly removed with complete clinical recovering. One year later, the patient experienced progressive worsened of his symptoms. Upper spinal cord tethering was diagnosed and a new surgery for debridement was required. Conclusions: The epidural hematoma compressing the dural graft against the neural structures contributes to the upper spinal cord tethering and represents a nondescribed cause of postoperative fibrosis, adhesion formation, and subsequent recurrent hindbrain compression.

  16. The significance of morphological changes in the brain-tumor interface for the pathogenesis of brain edema in meningioma: Magnetic resonance tomography and intraoperative findings

    International Nuclear Information System (INIS)

    Purpose: The aim of the study was to verify a possible correlation between macroscopic changes of the brain-tumor interface (BTI) and the development of a peritumoral brain edema in meningiomas. Methods: 27 meningiomas were investigated in this prospective study using an optimized inversion-recovery (IR) sequence. After i.v. administration of 0.2 mmol Gd-DTPA/kg axial and coronary images were acquired (slice thickness=2 mm). The distances of signal altered cortex and obliterations of the subarachnoid space (SAS) were measured at the BTI and related to the pial tumor circumference (cortical-index and SAS-index). Intraoperatively the BTI was divided into the following categories: 0: SAS not obliterated, 1: SAS partially obliterated, 2: Direct contact between tumor and white matter, 3: Tumor infiltration into brain. Results: Edema-associated meningiomas showed a significantly (p=0.0001) increased SAS-index (0.47 vs. 0.07) and cortical index (0.45 vs. 0.0) compared to cases without edema. Intraoperatively 95% of meningiomas with brain edema showed SAS-obliterations, compared to 50% of cases without an edema. Conclusions: Arachnoid adhesions at the BTI with obliteration of the SAS seem to play an essential role in the induction of brain edema in meningiomas. (orig.)

  17. Leptomeningeal metastasis from hepatocellular carcinoma with other unusual metastases: a case report

    International Nuclear Information System (INIS)

    Leptomeningeal metastasis, which results from metastasis of tumors to the arachnoid and pia mater, can lead to the dissemination of tumor cells throughout the subarachnoid space via the cerebral spinal fluid, and frequently with a poor prognosis. The primary tumor in adults is most often breast cancer, lung cancer, or melanoma. Although leptomeningeal metastasis due to cholangiocarcinoma has been reported, to the best of our knowledge there is no cytologically confirmed report of leptomeningeal metastasis from hepatocellular carcinoma. We herein report a case of leptomeningeal metastasis from hepatocellular carcinoma in a 53-year-old woman with concomitant systemic metastases to the lung, bone, brain, kidney, adrenal gland, subcutaneous tissues, and abdominal pelvis. The neurological symptoms of the patient were relieved after treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy. To our knowledge this is the first report of leptomeningeal metastasis from hepatocellular carcinoma confirmed by cytology. Treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy was effective

  18. Medical-surgical treatment of progressive tuberculous (Pott's) paraplegia in Gabon.

    Science.gov (United States)

    Loembe, P M

    1995-10-01

    The present study deals with the results of the medical-surgical treatment of 22 patients with Pott's tetraplegia or paraplegia. Seventeen had progressive tetraplegia-paraplegia which failed to respond solely to medical treatment. On admission, four patients exhibited an acute onset tetraplegia-paraplegia, and one had a 'spinal tumour syndrome'. In addition to antituberculous therapy, seven patients had anterior spinal surgery, consisting of four corporectomies, two anterior debridments and grafting, and one debridment alone. Moreover, one patient had a posterior interbody fusion, four had laminotomies, and 10 had laminectomies. The causes of the spinal cord or cauda equina compression, as was determined at operation, were extradural abscess in eight patients, bony compressions in 11, arachnoiditis in two, and posterior neural arch tuberculosis in one patient. Neurological recovery began between 10 and 21 days postoperatively. The mean length of follow-up was 42.36 months (range 8-144 months). Fourteen patients were found to be functionally and neurologically normal at follow-up examinations (63%). Eighty-two percent recovered sufficiently to walk unaided. Two patients were left paralysed and unable to walk. Two patients were able to get about on crutches. The onset of objective improvement soon after surgical decompression suggests a causal effect. It was concluded that early neural decompression and spinal stabilisation provided the maximum potential for neurological recovery. PMID:8848312

  19. Retrospective study on structural neuroimaging in first-episode psychosis.

    Science.gov (United States)

    Coentre, Ricardo; Silva-Dos-Santos, Amilcar; Talina, Miguel Cotrim

    2016-01-01

    Background. No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT) and magnetic resonance imaging (MRI)) in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18-48 years (mean age: 29.6 years), consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI) were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI) and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification). No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age. PMID:27257547

  20. Síndrome do nevus organóide: relato de caso Organoid nevus syndrome: case report

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    Priscilla Luppi Ballalai

    2001-08-01

    Full Text Available Os autores apresentam um caso de uma criança com síndrome do nevus organóide, que se caracteriza pela presença de uma lesão epibulbar em olho direito, associada a nevus sebáceo de Jadassohn em couro cabeludo e cisto de aracnóide na fossa temporal. O exame anatomopatológico da lesão ocular revelou a presença de tecidos de origem ectodérmica e mesodérmica, levando ao raro diagnóstico de coristoma epibulbar complexo. A síndrome é raramente descrita na literatura oftalmológica. São feitas considerações a respeito das alterações oftalmológicas e sistêmicas associadas a esta síndrome.The authors present a case of a child with organoid nevus syndrome, characterized by epibulbar choristoma in the right eye, Jadassohn's nevus sebaceous in the scalp and arachnoid cist. The pathology of the ocular lesion revealed a mixture of ectodermal and mesodermal elements, leding to the rare diagnosis of epibulbar complex choristoma.The syndrome is rarely described in the ophthalmologic literature. Some considerations are made regarding ophthalmologic and systemic associations.

  1. Imaging of cerebellopontine angle lesions: an update. Part 2: intra-axial lesions, skull base lesions that may invade the CPA region, and non-enhancing extra-axial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Bonneville, Fabrice; Chiras, Jacques [Pitie-Salpetriere Hospital, Department of Neuroradiology, Paris (France); Savatovsky, Julien [Adolphe de Rothschild Foundation, Department of Radiology, Paris (France)

    2007-11-15

    Computed tomography (CT) and magnetic resonance (MR) imaging reliably demonstrate typical features of vestibular schwannomas or meningiomas in the vast majority of mass lesions responsible for cerebellopontine angle (CPA) syndrome. However, a large variety of unusual lesions can also be encountered in the CPA. Covering the entire spectrum of lesions potentially found in the CPA, these articles explain the pertinent neuroimaging features that radiologists need to know to make clinically relevant diagnoses in these cases, including data from diffusion- and perfusion-weighted imaging or MR spectroscopy, when available. A diagnostic algorithm based on the lesion's site of origin, shape and margins, density, signal intensity and contrast material uptake is also proposed. Non-enhancing extra-axial CPA masses are cystic (epidermoid cyst, arachnoid cyst, neurenteric cyst) or contain fat (dermoid cyst, lipoma). Tumours can also extend into the CPA by extension from the skull base (paraganglioma, chondromatous tumours, chordoma, cholesterol granuloma, endolymphatic sac tumour). Finally, brain stem or ventricular tumours can present with a significant exophytic component in the CPA that may be difficult to differentiate from an extra-axial lesion (lymphoma, hemangioblastoma, choroid plexus papilloma, ependymoma, glioma, medulloblastoma, dysembryoplastic neuroepithelial tumour). (orig.)

  2. [Subdural hemorrhage of aneurysmal origin].

    Science.gov (United States)

    Sánchez, R; Alfaro, A; Perla, C; Blasco, R; Cortés, F; Solís, P

    1994-02-01

    Although most subdural hematomas are considered to be venous in origin, they may also be of arterial origin. When subdural bleeding is due to the rupture of an intracranial aneurysm, most commonly at the middle cerebral or internal carotid arteries, the amount of subdural blood is usually small and of no clinical importance. We describe two patients with subdural hematomas secondary to rupture of an intracranial aneurysm, who needed prompt surgical treatment. The first patient had a left internal carotid artery aneurysm at the origin of the ophthalmic artery. In the second patient the aneurysm was at the anterior communicating artery and rebled into the subdural space directly through a right intraparenchymatous frontobasal hematoma. The most probable mechanism of subdural bleeding in our two patients was the existence of adhesions between the aneurysm and the arachnoid due to previous minor hemorrhages. The indication of cerebral angiography in a patient with subdural hematoma is based mainly upon the existence of meningeal signs, the presence of blood in more than one intracranial compartment or the rapid progression of bleeding. PMID:8204251

  3. A retrospective study of the outcome of cesarean section for women with severe pre-eclampsia in a third world setting

    Directory of Open Access Journals (Sweden)

    Obinna V Ajuzieogu

    2011-01-01

    Full Text Available Objective: To compare the outcome of subarachnoid block (spinal anesthesia and general anesthesia in Cesarean delivery for women with severe pre-eclampsia. Methods: A retrospective study of women with severe pre-eclampsia requiring Cesarean section from January 2005 to June 2009 was carried out. Maternal age, parity, gestational age at delivery, booking status, Apgar scores, maternal and perinatal mortality of the sub-arachnoid block group were compared with those of general anesthesia group using c2 , Student t-test and Fischer exact test. Results: There were no significant difference between the two groups in overall maternal mortality (5.4% vs. 11.9%, P=0.5 and perinatal mortality (2.7% vs. 11.9%, P=0.15. The general anesthesia group had significantly more birth asphyxia than the spinal group (55.9% vs. 27.0%, P=0.0006. Conclusion: There was no significant difference in the maternal and perinatal mortality outcome of cesarean delivery between women with severe pre-eclampsia who had regional anesthesia and those that had general anesthesia. There was significantly higher proportion of birth asphyxia in babies of women who received general anesthesia.

  4. The endothelin system as a therapeutic target in cardiovascular disease: great expectations or bleak house?

    Science.gov (United States)

    Kirkby, N S; Hadoke, P W F; Bagnall, A J; Webb, D J

    2008-03-01

    There is considerable evidence that the potent vasoconstrictor endothelin-1 (ET-1) contributes to the pathogenesis of a variety of cardiovascular diseases. As such, pharmacological manipulation of the ET system might represent a promising therapeutic goal. Many clinical trials have assessed the potential of ET receptor antagonists in cardiovascular disease, the most positive of which have resulted in the licensing of the mixed ET receptor antagonist bosentan, and the selective ET(A) receptor antagonists, sitaxsentan and ambrisentan, for the treatment of pulmonary arterial hypertension (PAH). In contrast, despite encouraging data from in vitro and animal studies, outcomes in human heart failure have been disappointing, perhaps illustrating the risk of extrapolating preclinical work to man. Many further potential applications of these compounds, including resistant hypertension, chronic kidney disease, connective tissue disease and sub-arachnoid haemorrhage are currently being investigated in the clinic. Furthermore, experience from previous studies should enable improved trial design and scope remains for development of improved compounds and alternative therapeutic strategies. Although ET-converting enzyme inhibitors may represent one such alternative, there have been relatively few suitable compounds developed, and consequently, clinical experience with these agents remains extremely limited. Recent advances, together with an increased understanding of the biology of the ET system provided by improved experimental tools (including cell-specific transgenic deletion of ET receptors), should allow further targeting of clinical trials to diseases in which ET is involved and allow the therapeutic potential for targeting the ET system in cardiovascular disease to be fully realized. PMID:17965745

  5. Computed tomograms of the newborn

    International Nuclear Information System (INIS)

    Computed tomograms (CT) from 204 cases of premature and full term infants were studied. 1) In 70 infants of hyaline membrane disease, primary apnea and asymptomatic transient hypoglycemia and hypocalcemia, without any abnormal CT findings such as intracranial hemorrhage, periventricular lucency was found in 65 cases (93%) and a wide extracerebral space of the temporal lobes was found in 60 cases (86%) before 44 weeks of gestation. A wide interhemispheric fissure was found in 11 cases of extremely premature infants before term. Periventricular lucency and a wide extracerebral space of temporal lobes may not be the result of the intracranial pathological changes, but they may represent a stage of brain development. 2) In 204 cases, intracranial hemorrhage was found in 39 cases; intra ventricular 14 cases, subependymal 2 cases, intracerebral 4 cases, subarachnoid 19 cases. CT was useful in evaluating the site and extent of hemorrhage. Among 14 cases of intraventricular hemorrhage, 9 cases with massive hemorrhage died and 2 cases had developmental retardation. Other intracranial pathologic changes included hydrocephalus (17 cases), arachnoid cyst (3 cases), and agenesis of corpus callosum (1 case). Diffuse low density of the cerebral cortex was found in 8 cases. Two cases died and 5 cases had developmental retardation. Early ventricular dilatation was found in 19 cases, 2 with intravfouricularhemorrhage and 5 with diffuse low density of the cerebral cortex. Among them 11 cases had developmental retardation. Neurological prognosis was poor in infants with massive intraventricular hemorrhage, diffuse low density of the cerebral cortex and early ventricular dilatation. (author)

  6. Mythology and Neurosurgery.

    Science.gov (United States)

    Ökten, Ali İhsan

    2016-06-01

    Myths are the keystone of mythology. They are interpretations of events that have been told as stories and legends for thousands of years, inherited from generation to generation, and have reached the present day. Although most myths are considered figments of the imagination or fictitious legends, all of them contain references to facts from the time they occurred. Mythology, which is a collection of figments of imagination concerning nature and human beings, is a product of human effort to perceive, explain, and interpret the universe and the world, much like science. The interaction between mythology and science dates back to the early days of civilization. Mythology, a reflection of human creativity, is extensively used in modern science, particularly in a terminological context. This article aims to reveal the texture of mythology in neurosurgery, by analyzing the birth of medicine in mythology; heroes such as Apollo and Asklepios, the gods of healing and medicine, as well as Hygieia, the goddess of health and hygiene; and mythological terms and phrases such as Achilles tendon, atlas vertebra, gigantism, priapism syndrome, hippocampus, lethargy, syrinx, and arachnoid. Through the use of symbols, mythology has attempted to explain several subjects, such as human nature, disease, birth, and death. In this respect, mythology and medicine dance arm in arm, and this dance has been going on for centuries. As a result, mythology has manifested itself in many fields within medicine, either anatomically or by giving names to various diseases. PMID:26970479

  7. Segmentation of brain parenchyma and cerebrospinal fluid in multispectral magnetic resonance images.

    Science.gov (United States)

    Lundervold, A; Storvik, G

    1995-01-01

    Presents a new method to segment brain parenchyma and cerebrospinal fluid spaces automatically in routine axial spin echo multispectral MR images. The algorithm simultaneously incorporates information about anatomical boundaries (shape) and tissue signature (grey scale) using a priori knowledge. The head and brain are divided into four regions and seven different tissue types. Each tissue type c is modeled by a multivariate Gaussian distribution N(mu(c),Sigma(c)). Each region is associated with a finite mixture density corresponding to its constituent tissue types. Initial estimates of tissue parameters {mu(c),Sigma(c )}(c=1,...,7) are obtained from k-means clustering of a single slice used for training. The first algorithmic step uses the EM-algorithm for adjusting the initial tissue parameter estimates to the MR data of new patients. The second step uses a recently developed model of dynamic contours to detect three simply closed nonintersecting curves in the plane, constituting the arachnoid/dura mater boundary of the brain, the border between the subarachnoid space and brain parenchyma, and the inner border of the parenchyma toward the lateral ventricles. The model, which is formulated by energy functions in a Bayesian framework, incorporates a priori knowledge, smoothness constraints, and updated tissue type parameters. Satisfactory maximum a posteriori probability estimates of the closed contour curves defined by the model were found using simulated annealing. PMID:18215837

  8. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

    Directory of Open Access Journals (Sweden)

    Nurgul Ceran

    2011-02-01

    Full Text Available Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83% and fever (44%. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

  9. Uptake of amino acids in brain tumours using positron emission tomography as an indicator for assessing metabolic activity and malignancy

    International Nuclear Information System (INIS)

    Diagnosis and post-therapeutic follow-up of tumour patients necessitates morphological and particularly functional imaging methods. For the latter approach positron emission tomography has proven a valid tool for the measurement of perfusion, of energy consumption parameters such as oxygen extraction, glucose metabolism and amino acid uptake. However, neither perfusion nor energy consumption parameters have yielded unambiguous information on the clinical status of various tumours in respect of their malignancy and their growth status. It is shown in this paper that amino acid uptake seems to be a valid measure for the functional activity of tumour tissue for a broad range of neoplasms. The uptake of 11C-L-Methionine was measured in 33 patients having various brain tumours, and was compared with 6 patients who had an infarction, and with 8 patients suffering from arachnoidal cysts. The amino acid uptake correlated well with the histological grading of the tumours and the clinical status of the patient. The uptake was well differentiated against metabolically inactive lesions. Parallel investigations on the uptake mechanisms of amino acids in an animal model have shown that transport phenomena regulate the uptake rather than protein synthesis rates. However, protein synthesis may nevertheless exercise a control function on the transport process. (orig.)

  10. Neurologic screening by magnetic resonance imaging in asymptomatic subjects in Self Defence Force Maizuru guard area

    Energy Technology Data Exchange (ETDEWEB)

    Yanagawa, Youichi; Saitoh, Daizoh; Terai, Chikanori; Okada, Yoshiaki [National Defence Medical Coll., Tokorozawa, Saitama (Japan). Hospital; Nawashiro, Hiroshi; Shima, Katsuji

    1998-12-01

    To clarify usefulness of cranial magnetic resonance imaging (MRI) for group health care. We performed 1136 cranial MRI and MRA examinations between March 1992 and February 1997 in members of the Self Defense Force (SDF) stationed in the Maizuru area. We selected subjects when they reached the age of 40 years, when they retired, or when they were found to have risk factors for cerebrovascular disease. Furthermore, we investigated occurrence of symptomatic cerebral disease of our subjects and non-subjects in SDF Maizuru area during MRI screening. We found 77 asymptomatic cerebral infarctions, 8 unruptured cerebral aneurysms, 2 pituitary adenomas, 4 venous angiomas and 4 arachnoid cysts. Among asymptomatic cerebral disease, the number of cerebral infarctions was significantly greater in the risk factor and retired group compared to the 40-year-old group. In 24 patients with asymptomatic cerebral infarction whom we were able to follow, we prescribed antiplatelet drugs and none became symptomatic. Unruptured cerebral aneurysms and pituitary tumors we treated operatively, resulting in good functional outcomes in all patients. There were less symptomatic cerebral diseases in the subject group (0.08%) vs. in the non-subject group (0.3%). However, the difference was not statistically significant (p=.20). Screening cranial MRI and MRA examinations indicated considerable overall utility. However, further human study is warranted to identify usefulness of MRI screening system. (author)

  11. MRI of the hypothalamic-pituitary axis in children

    Energy Technology Data Exchange (ETDEWEB)

    Argyropoulou, Maria I. [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece); Kiortsis, Dimitrios Nikiforos [University of Ioannina, Department of Physiology, Medical School, Ioannina (Greece)

    2005-11-01

    In childhood, the MR characteristics of the normal pituitary gland are well established. During the first 2 months of life the adenohypophysis demonstrates high signal. Pituitary gland height (PGH) decreases during the 1st year of life and then increases, reaching a plateau after puberty. The magnetization transfer ratio (MTR) increases in both sexes up to the age of 20 years. On dynamic contrast-enhanced studies, the posterior pituitary lobe enhances simultaneously with the straight sinus, and the adenohypophysis later, but within 30 s. In genetically determined dysfunctional states, the adenohypophysis may be normal, hypoplastic, or enlarged. Pituitary enlargement, observed in Prop 1 gene mutations, is characterized by a mass interposed between the anterior and posterior lobes. An ectopic posterior lobe (EPP), associated with a hypoplastic or absent pituitary stalk, may be observed in patients with hypopituitarism. Tumors of the hypothalamic-pituitary (HP) axis may be the origin of adenohypophyseal deficiencies. A small hypointense adenohypophysis is found in iron overload states and is often associated with hypogonadotrophic hypogonadism. Absence of the posterior lobe bright signal, with or without a thick pituitary stalk or a mass at any site from the median eminence to the posterior pituitary lobe, may be found in diabetes insipidus. Hydrocephalus, suprasellar arachnoid cysts, hypothalamic hamartomas and craniopharyngiomas may result in central precocious puberty (CPP). Increased PGH in girls with idiopathic CPP is useful for its differential diagnosis from premature thelarche (PT). Pituitary adenomas, observed mainly in adolescents, present the same MR characteristics as those in adults. (orig.)

  12. Adolescent-onset idiopathic hemifacial spasm

    Directory of Open Access Journals (Sweden)

    Jianfeng Liang

    2014-01-01

    Full Text Available Aims: To study the clinical manifestations, illness-related factors and microsurgical management of adolescent-onset idiopathic hemifacial spasm. Materials and Methods: Of the 1221 microvascular decompression procedures performed for idiopathic hemifacial spasm between March 2001 and July 2007, 16 (1.3% were in adolescent age (≤18. Results: Clinical manifestations in the adolescent-onset were typical, but milder when compared with late-onset. Gender, thickening and adhesion of the arachnoid membrane at the cerebellopontine angle and a small volume of posterior cranial fossa might be important illness-related factors for adolescent-onset idiopathic hemifacial spasm. Arterial compression was the main cause. Typical compression of offending arteries was observed in 14 patients. Compression of petrous bone crest was found in one patient. Immediate effective rate was 100%, and curative rate was 75%. The curative rate, effective rate and delayed resolution rate during the follow-up period (mean: 22.9 months were 87.5%, 100% and 12.5%, respectively. There was no recurrence. The postoperative complications (2; 12.5% included: One patient had transient moderate facial palsy and decreased hearing and one patient had transient decreased hearing and tinnitus. Conclusions: This suggests that microvascular decompression is effective in adolescent-onset idiopathic hemifacial spasm.

  13. Basilar impression, Chiari malformation and syringomyelia: a retrospective study of 53 surgically treated patients Impressão basilar, malformação de Chiari e siringomielia: estudo retrospecivo de 53 casos operados

    Directory of Open Access Journals (Sweden)

    José Alberto Gonçalves da Silva

    2003-06-01

    Full Text Available The present study shows the results of 53 patients who have been treated surgically for basilar impression (BI, Chiari malformation (CM, and syringomyelia (SM. The patients were divided into two groups. Group I (24 patients underwent osteodural decompression with large inferior occipital craniectomy, laminectomy from C 1 to C 3, dural opening in Y format, dissection of arachnoid adhesion between the cerebellar tonsils, medulla oblongata and spinal cord, large opening of the fourth ventricle and dural grafting with the use of bovine pericardium. Group II patients (29 patients underwent osteodural-neural decompression with the same procedures described above plus dissection of the arachnoid adherences of the vessels of the region of the cerebellar tonsils, and tonsillectomy (amputation in 10 cases, and as for the remainning 19 cases, intrapial aspiration of the cerebellar tonsils was performed. The residual pial sac was sutured to the dura in craniolateral position. After completion of the suture of the dural grafting, a thread was run through the graft at the level of the created cisterna magna and fixed to the cervical aponeurosis so as to move the dural graft on a posterior- caudal direction, avoiding, in this way, its adherence to the cerebellum.São analisados os resultados obtidos com o tratamento cirúrgico de 53 casos de impressão basilar (IB, malformação de Chiari (MC e siringomielia (SM. Os pacientes foram divididos em dois grupos: no grupo I (24 casos foi realizada a descompressão osteodural, caracterizada por craniectomia ampla occipital inferior, laminectomia variável de C 1 a C 3, abertura da dura-máter em forma de Y, dissecção das aderências aracnóideas das tonsilas cerebelares com o bulbo e medula cervical, abertura ampla do quarto ventrículo e enxerto dural; no grupo II (29 casos foi utilizada a descompressão osteodural-neural, caracterizada pelos mesmos detalhes técnicos empregados no grupo I, acrescidos da

  14. 核素脑池显像对脑脊液循环障碍的评估%Evaluation of circulatory disturbance of cerebrospinal fluid with radionuclide cisternography

    Institute of Scientific and Technical Information of China (English)

    童冠圣; 文哲; 樊军; 胡志强; 关峰; 李征

    2011-01-01

    目的 探讨核素脑池显像的影像特征及其对脑积水脑脊液循环障碍的评估价值.方法 回顾性分析72例经CT或MRJ证实为脑积水病人的临床资料,根据年龄分为儿童组(37例)和成人组(35例).均行核素脑池显像检查.结果 经核素脑池显像诊断交通性脑积水38例,其中儿童21例,成人17例;大脑凸面显像剂分布减少或无分布30例(79%),分布接近正常8例(21%);儿童组伴颅内蛛网膜囊肿10例(48%),成人组伴颅内蛛网膜囊肿2例(12%),交通性脑积水病人未发现囊肿与蛛网膜下腔相交通.非交通性脑积水34例,其中儿童组16例,成人组18例;大脑凸面显像剂分布减少或无分布17例(50%),分布接近正常17例(50%);儿童组伴颅内蛛网膜囊肿5例(31%),其中囊肿与蛛网膜下腔相交通3例,成人组伴颅内蛛网膜囊肿2例(11%),未见囊肿与蛛网膜下腔交通.结论 核素脑室显像有助于鉴别脑积水的类型和脑脊液吸收情况,并可判断蛛网膜囊肿是否与蛛网膜下腔相通,对选择合适的治疗方案有重要参考价值.%Objective To investigate the imaging characteristics of radionuclide cisternography (RC) and its evaluation value for circulatory disturbance of cerebrospinal fluid (CSF) in patients with hydrocephalus. Methods Clinical data of 72 patients with hydrocephalus confirmed by CT or MRI were analyzed retrospectively. The patients were divided into child group (n=37) and adult group (n=35) according to the age, and RC were performed in all the patients. Results Communicating hydrocephalus was diagnosed by RC in 38 cases, including 21 in child group and 17 in adult group. RC showed decrease or absence of radiotracer distributing in cerebral convexities in 30 cases (79%), and closed to normal in 8 (2 1 %). Communicating hydrocephalus accompanied by intracrauial arachnoid cysts were found in 10 cases (48%) in child group and 2 (12%) in adult group, and there was no communication between

  15. Clinical classification and pathological findings of vestibular schwannoma requiring surgical therapy after stereotactic radiosurgery

    International Nuclear Information System (INIS)

    The present study investigated imaging, intraoperative and pathological findings, and surgical indications and timing in 10 patients [5 men, 5 women; mean age, 52.3 years (range, 17-70 years)] with vestibular schwannoma who underwent surgical therapy due to poor radiotherapy-mediated tumor control; these included Gamma Knife (n=8), X-Knife (n=1) and proton beam (n=1) therapies. The mean period from radiotherapy endpoint until surgery was 63.3 months (range, 30-96 months) and patients were classified according to the time elapsed between radiotherapy and surgical therapy [≥2 to <5 years (n=4); ≥5 to <8 years (n=4); or ≥8 years (n=2)]. Surgical indications were classified into two groups: exacerbated or additional neurological symptoms caused by solid tumor component enlargement (n=2); and exacerbated or additional neurological symptoms with extraparenchymal extension of the tumor cyst (n=8). Imaging findings were classified as large cystic (LC; n=8), multi-micro cystic (MC; n=2), or solid component enlargement (SC; n=0) types. Pathological findings revealed no malignant changes in any patient, and primary pathological conditions comprised radiotherapy-induced exacerbation of vascular occlusion and permeability. MC patients presented marked hemosiderosis and recurrent small hemorrhage was predicted. Intraoperative findings included marked adhesions with peripheral neurons and the cerebellum, as well as arachnoid thickening, rendering complete resection difficult. Decompression surgery was relatively straightforward for LC, which presents little bleeding, but it was challenging for MC due to its hemorrhagic nature. SC cases have been previously reported, but were not found in the present study, which had an inclusion criterion of ≥2 years follow-up after radiotherapy. Other than a single case that became malignant, all of the previously reported cases were within 2 years of radiotherapy and transient swelling may have been present. (author)

  16. Early neurosurgical intervention of spinal cord contusion: an analysis of 30 cases

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background The incidence of spinal injury with spinal cord contusion is high in developed countries and is now growing in China. Furthermore, spinal cord injury happens mostly in young people who have a long life expectance. A large number of patients thus are wheelchair bound for the rest of their lives. Therefore, spinal cord injury has aroused great concern worldwide. Despite great efforts, recovery from spinal cord injury remains unsatisfactory. Based on the pathology of spinal cord contusion, an idea of early neurosurgical intervention has been formulated in this study. Methods A total of 30 patients with "complete" spinal cord injury or classified as American Spinal Injury Association (ASIA)-A were studied. Orthopedic treatment of the injured vertebra(e), internal fixation of the vertebral column, and bilateral laminectomy for epidural decompression were followed directly by neurosurgical management, including separation of the arachnoid adhesion to restore cerebrospinal fluid flow and debridement of the spinal cord necrotic tissue with concomitant intramedullary decompression. Rehabilitation started 17 days after the operation. The final outcome was evaluated after 3 months of rehabilitation. Pearson chi-square analysis was used for statistical analysis. Results All the patients recovered some ability to walk. The least recovered patients were able to walk with a wheeled weight support and help in stabilizing the weight bearing knee joint (12 cases, 40%). Thirteen patients (43%) were able to walk with a pair of crutches, a stick or without any support. The timing of the operation after injury was important. An optimal operation time window was identified at 4-14 days after injury. Conclusions Early neurosurgical intervention of spinal cord contusion followed by rehabilitation can significantly improve the locomotion of the patients. It is a new idea of a therapeutic approach for spinal cord contusion and has been proven to be very successful.

  17. Functional redundancy and complementarities of seed dispersal by the last neotropical megafrugivores.

    Directory of Open Access Journals (Sweden)

    Rafael S Bueno

    Full Text Available BACKGROUND: Functional redundancy has been debated largely in ecology and conservation, yet we lack detailed empirical studies on the roles of functionally similar species in ecosystem function. Large bodied frugivores may disperse similar plant species and have strong impact on plant recruitment in tropical forests. The two largest frugivores in the neotropics, tapirs (Tapirus terrestris and muriquis (Brachyteles arachnoides are potential candidates for functional redundancy on seed dispersal effectiveness. Here we provide a comparison of the quantitative, qualitative and spatial effects on seed dispersal by these megafrugivores in a continuous Brazilian Atlantic forest. METHODOLOGY/PRINCIPAL FINDINGS: We found a low overlap of plant species dispersed by both muriquis and tapirs. A group of 35 muriquis occupied an area of 850 ha and dispersed 5 times more plant species, and 13 times more seeds than 22 tapirs living in the same area. Muriquis dispersed 2.4 times more seeds in any random position than tapirs. This can be explained mainly because seed deposition by muriquis leaves less empty space than tapirs. However, tapirs are able to disperse larger seeds than muriquis and move them into sites not reached by primates, such as large forest gaps, open areas and fragments nearby. Based on published information we found 302 plant species that are dispersed by at least one of these megafrugivores in the Brazilian Atlantic forest. CONCLUSIONS/SIGNIFICANCE: Our study showed that both megafrugivores play complementary rather than redundant roles as seed dispersers. Although tapirs disperse fewer seeds and species than muriquis, they disperse larger-seeded species and in places not used by primates. The selective extinction of these megafrugivores will change the spatial seed rain they generate and may have negative effects on the recruitment of several plant species, particularly those with large seeds that have muriquis and tapirs as the last living

  18. [Pregnancy and childbirth in a patient with a spinal cord lesion].

    Science.gov (United States)

    Vanderbeke, I; Boll, D; Verguts, J K

    2008-05-17

    A 37-year-old woman with a spinal cord lesion at the level of TvIII due to a car-accident, became pregnant. She had posttraumatic syringomyely at Cv-TvIII, for which she underwent syringo-arachnoidal drainage. At approximately six weeks of amenorrhoea she presented at the emergency room with vaginal bleeding. She was treated with dalteparine 5000 IU once daily given by intramuscular injection until 6 weeks post partum. Weekly urine checks were advised. At 36 6/7 weeks of pregnancy, the patient was admitted to hospital for daily cardiotocography and 4-hourly contraction monitoring. After spontaneous rupture of the membranes she went into labour and had a vaginal delivery of a son weighing 3320 g. His Apgar score was 6 after 1 min and 9 after 5 min; arterial pH was 7.31. For three months after giving birth she received specialist care at home as well as help and counselling from a rehabilitation centre. In pregnant women with a spinal cord lesion, special attention should be paid to urinary tract infections, pressure areas, anaemia and thrombo-embolic symptoms. During partus, cardiotocographic monitoring should be carried out, also in patients with TvI-Tx lesions regularly from 36 weeks. In pregnant women with lesions from TvI, medical attendants should be aware of the possibility of autonomous dysreflection. Epidural anaesthesia should be administered and episiotomy or rupture avoided. Post partum, the bladder should always be completely emptied and pressure areas and signs ofthrombo-embolic complications monitored. A urological bladder function consultation should be requested, and, ifepisiotomy or rupture does occur, extra care should be taken to avoid infection. The ergonomic situation at home should be evaluated to ensure that any ergonomic changes necessary for the care of the patient and her newborn, take place in time. PMID:18549144

  19. Magnetic resonance imaging of racemous cysticercosis of the cauda equina

    International Nuclear Information System (INIS)

    37-year-old man presented with low back pain for the last 6 months followed by sensation of numbness in the lower limbs that evolved with paraparesis, urinary retention and impotence. Subsequently, he lost control over the bowel function. Neurological examination revealed increased muscle tone along with grade zero power in both lower limbs. Knee and ankle jerks were exaggerated. Nine months prior to admission, a type II diabetes mellitus was diagnosed and he has been taking insulin ever since. MRI revealed multiple cystic lesions in the cauda equina opposite the L1-S1 vertebral bodies with no involvement of the spinal cord (Figure A: sagittal section T1-weighted image after contrast with cystic lesions on the left side - yellow arrow -, and T2-weighted image on the right - red arrows pointing cystic lesions). The cysts were hypointense on T1-weighted images (Figure B: horizontal section - yellow arrows) and hyperintense in T2-weighted images (Figure A - red arrows). Computerized tomography of the brain showed moderate ventricle dilatation (Figure C) with no intra or extra axial lesions. He was submitted to laminectomy and the cysts were surgically removed. An intense inflammatory process (arachnoiditis) involving the nerve roots of the cauda equina was reported. Histology of the surgical specimen confirmed the diagnosis of racemous cysticercosis. He improved quickly after surgery. Three months later, at the outpatient clinic, he walked with support, resumed sphincter control of the bladder and bowel and had no more pain. Ten months later he returned to hospital walking with crutches, with hypoesthesia and paraesthesia on the left leg and urinary incontinence. He refused treatment with albendazole and steroids. (author)

  20. Petrous apex cephalocele and empty sella: Is there any relation?

    International Nuclear Information System (INIS)

    Objective: To document the presence of incidental petrous apex cephalocele (PAC) in association with empty sella in a group of patients and propose an etiologic/pathologic relation between the two lesions. Materials and methods: Retrospective review of our imaging archive for the period from October 2001 to October 2006 revealed five patients with PAC (four females and one male; age range, 25-60 years; mean, 47 years). All patients underwent enhanced MR examination of the skull base and four of them underwent CT examination. Lesions were evaluated for size, content, signal intensity, enhancement, and relation to Meckel's cave and petrous apex. Images were also evaluated for the presence of empty sella. Results: The presenting symptoms in all patients were not attributable to PAC. None of the patients had symptoms related to the trigeminal nerve or history of CSF leak. Four patients had bilateral PAC and one had left PAC (total nine lesions). The lesions ranged from 6 mm to 15 mm (mean 9 mm) in the maximum diameter. All lesions were centered posterolateral to Meckel's cave and had low attenuation on CT with sharply demarcated margins. No lesion reached the inner ear structures, internal auditory canal, or mastoid air cells. On MR imaging, all lesions demonstrated CSF signal intensity that is continuous with that of the Meckel's cave. Only the periphery of the lesions demonstrated mild enhancement. All patients had empty sella. One patient had small arachnoid cysts in the middle cranial fossa, bilaterally. Conclusion: PAC and empty sella are similar mechanically in terms of CSF extension and erosion into petrous apex and sella, respectively. Both conditions are seen predominantly in females and have been reported in association with CSF leak, which raises a possibility of etiologic/pathologic relation between the two

  1. Direct-trauma model of posttraumatic syringomyelia with a computer-controlled motorized spinal cord impactor.

    Science.gov (United States)

    Wong, Johnny H Y; Song, Xin; Hemley, Sarah J; Bilston, Lynne E; Cheng, Shaokoon; Stoodley, Marcus A

    2016-05-01

    OBJECTIVE The pathogenesis of posttraumatic syringomyelia remains enigmatic and is not adequately explained by current theories. Experimental investigations require a reproducible animal model that replicates the human condition. Current animal models are imperfect because of their low reliability, severe neurological deficits, or dissimilar mechanism of injury. The objective of this study was to develop a reproducible rodent model of posttraumatic syringomyelia using a spinal cord impactor that produces an injury that more closely mimics the human condition and does not produce severe neurological deficits. METHODS The study consisted of 2 parts. Seventy animals were studied overall: 20 in Experiment 1 and 48 in Experiment 2 after two rats with severe deficits were killed early. Experiment 1 aimed to determine the optimal force setting for inducing a cystic cavity without neurological deficits using a computer-controlled motorized spinal cord impactor. Twenty animals received an impact that ranged from 50 to 150 kDyn. Using the optimal force for producing an initial cyst determined from Experiment 1, Experiment 2 aimed to compare the progression of cavities in animals with and those without arachnoiditis induced by kaolin. Forty-eight animals were killed at 1, 3, 6, or 12 weeks after syrinx induction. Measurements of cavity size and maximum anteroposterior and lateral diameters were evaluated using light microscopy. RESULTS In Experiment 1, cavities were present in 95% of the animals. The duration of limb weakness and spinal cord cavity size correlated with the delivered force. The optimal force chosen for Experiment 2 was 75 kDyn. In Experiment 2, cavities occurred in 92% of the animals. Animals in the kaolin groups developed larger cavities and more vacuolations and enlarged perivascular spaces than those in the nonkaolin groups. CONCLUSIONS This impact model reliably produces cavities that resemble human posttraumatic syringomyelia and is suitable for further

  2. Hindlimb Suspension (HLS) in Rodents for the Study of Intracranial Pressure, Molecular and Histologic Changes in the Eye, and CSF Production Regulation and Resorption: A Status Report of Two Studies

    Science.gov (United States)

    Theriot, C. A.; Taibbi, G.; Vizzeri, G.; Parsons-Wingerter, P.; Chevez-Barrios, P.; Rivera, A.; Zanello, S. B.

    2016-01-01

    This status report corresponds to two studies tied to an animal experiment being executed at the University of California Davis (Charles Fuller's laboratory). The animal protocol uses the well-documented rat hindlimb suspension (HLS) model, to examine the relationship between cephalic fluid shifts and the regulation of intracranial (ICP) and intraocular (IOP) pressures as well as visual system structure and function. Long Evans rats are subjected to HLS durations of 7, 14, 28 and 90 days. Subgroups of the 90-day animals are studied for recovery periods of 7, 14, 28 or 90 days. All HLS subjects have age-matched cage controls. Various animal cohorts are planned for this study: young males, young females and old males. In addition to the live measures (ICP by telemetry, IOP and retinal parameters by optical coherence tomography) which are shared with the Fuller study, the specific outcomes for this study include: -Gene expression analysis of the retina -Histologic analysis - Analysis of the microvasculature of retina flat mounts by NASA's VESsel GENeration Analysis (VESGEN) Software. To date, the young male and female cohorts are being completed. Due to the need to keep technical variation to a minimum, the histologic and genomic analyses have been delayed until all samples from each cohort are available and can be processed in a single batch per cohort. The samples received so far correspond to young males sacrificed at 7,14, 28 and 90 days of HLS and at 90 days of recovery; and from young females sacrificed at 7, 14 and 28 of HLS. A complementary study titled: "A gene expression and histologic approach to the study of cerebrospinal fluid (CSF) production and outflow in hindlimb suspended rats" seeks to study the molecular components of CSF production and outflow modulation as a result of HLS, bringing a molecular and histologic approach to investigate genome wide expression changes in the arachnoid villi and choroid plexus of HLS rats compared to rats in normal

  3. TIPIT: A randomised controlled trial of thyroxine in preterm infants under 28 weeks' gestation

    Directory of Open Access Journals (Sweden)

    Victor Suresh

    2008-03-01

    Full Text Available Abstract Background Infants born at extreme prematurity (below 28 weeks' gestation are at high risk of developmental disability. A major risk factor for disability is having a low level of thyroid hormone which is recognised to be a frequent phenomenon in these infants. At present it is unclear whether low levels of thyroid hormone are a cause of disability, or a consequence of concurrent adversity. Methods We propose an explanatory multi-centre double blind randomised controlled trial of thyroid hormone supplementation in babies born below 28 weeks' gestation. All infants will receive either levothyroxine or placebo until 32 weeks' corrected gestational age. The primary outcome will be brain growth. This will be assessed by the width of the sub-arachnoid space measured using cranial ultrasound and head circumference at 36 weeks' corrected gestational. The secondary outcomes will be (a thyroid hormone concentrations measured at increasing postnatal age, (b status of the hypothalamic pituitary axis, (c auxological data between birth and 36 weeks' corrected gestational age, (d thyroid gland volume, (e volumes of brain structures (measured by magnetic resonance imaging, (f determination of the extent of myelination and white matter integrity (measured by diffusion weighted MRI and brain vessel morphology (measured by magnetic resonance angiography at expected date of delivery and (g markers of morbidity including duration of mechanical ventilation and chronic lung disease. We will also examine how activity of the hypothalamic-pituitary-adrenal axis modulates the effects of thyroid supplementation. This will contribute to decisions about which confounding variables to assess in large-scale studies. Trial registration Current Controlled Trials ISRCTN89493983

  4. TIPIT: A randomised controlled trial of thyroxine in preterm infants under 28 weeks gestation: Magnetic Resonance Imaging and Magnetic Resonance Angiography protocol

    Directory of Open Access Journals (Sweden)

    Tietze Anna

    2008-06-01

    Full Text Available Abstract Background Infants born at extreme prematurity are at high risk of developmental disability. A major risk factor for disability is having a low level of thyroid hormone described as hypothyroxinaemia, which is recognised to be a frequent phenomenon in these infants. Derangements of critical thyroid function during the sensitive window in prematurity when early development occurs, may have a range of long term effects for brain development. Further research in preterm infants using neuroimaging techniques will increase our understanding of the specificity of the effects of hypothyroxinaemia on the developing foetal brain. This is an explanatory double blinded randomised controlled trial which is aimed to assess the effect of thyroid hormone supplementation on brain size, key brain structures, extent of myelination, white matter integrity and vessel morphology, somatic growth and the hypothalamic-pituitary-adrenal axis. Methods The study is a multi-centred double blinded randomised controlled trial of thyroid hormone supplementation in babies born below 28 weeks' gestation. All infants will receive either levothyroxine or placebo until 32 weeks corrected gestational age. The primary outcomes will be width of the sub-arachnoid space measured using cranial ultrasound and head circumference at 36 weeks corrected gestational age. The secondary outcomes will be thyroid hormone concentrations, the hypothalamic pituitary axis status and auxological data between birth and expected date of delivery; thyroid gland volume, brain size, volumes of key brain structures, extent of myelination and brain vessel morphology at expected date of delivery and markers of morbidity which include duration of mechanical ventilation and/or oxygen requirement and chronic lung disease. Trial registration Current Controlled Trials ISRCTN89493983

  5. Magnetic resonance imaging of racemous cysticercosis of the cauda equina; Ressonancia magnetica de paciente com cisticercose racemosa da cauda equina

    Energy Technology Data Exchange (ETDEWEB)

    Costa Junior, Leodante Batista da; Lemos, Sandro Pedroso [Hospital da Baleia, Belo Horizonte, MG (Brazil). Servico de Neurocirurgia; Lambertucci, Jose Roberto [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Faculdade de Medicina. Servico de Doencas Infecciosas e Parasitarias

    2003-12-01

    37-year-old man presented with low back pain for the last 6 months followed by sensation of numbness in the lower limbs that evolved with paraparesis, urinary retention and impotence. Subsequently, he lost control over the bowel function. Neurological examination revealed increased muscle tone along with grade zero power in both lower limbs. Knee and ankle jerks were exaggerated. Nine months prior to admission, a type II diabetes mellitus was diagnosed and he has been taking insulin ever since. MRI revealed multiple cystic lesions in the cauda equina opposite the L1-S1 vertebral bodies with no involvement of the spinal cord (Figure A: sagittal section T1-weighted image after contrast with cystic lesions on the left side - yellow arrow -, and T2-weighted image on the right - red arrows pointing cystic lesions). The cysts were hypointense on T1-weighted images (Figure B: horizontal section - yellow arrows) and hyperintense in T2-weighted images (Figure A - red arrows). Computerized tomography of the brain showed moderate ventricle dilatation (Figure C) with no intra or extra axial lesions. He was submitted to laminectomy and the cysts were surgically removed. An intense inflammatory process (arachnoiditis) involving the nerve roots of the cauda equina was reported. Histology of the surgical specimen confirmed the diagnosis of racemous cysticercosis. He improved quickly after surgery. Three months later, at the outpatient clinic, he walked with support, resumed sphincter control of the bladder and bowel and had no more pain. Ten months later he returned to hospital walking with crutches, with hypoesthesia and paraesthesia on the left leg and urinary incontinence. He refused treatment with albendazole and steroids. (author)

  6. The efficacy of intraoperative ultrasonography-assisted microinvasive cisterna magna reconstruction for Chiari malformation typeⅠwith syringomyelia

    Directory of Open Access Journals (Sweden)

    LI Peng-chao

    2012-08-01

    Full Text Available Objective To report the method and effect of intraoperative ultrasonography-assisted microinvasive cisterna magna reconstruction for Chiari malformation type Ⅰ with syringomyelia. Methods Ninty-three patients suffered from Chiari malformation typeⅠwith syringomyelia were treated by microinvasive cisterna magna reconstruction. The skin incision was 1.50-3.00 cm. The bone removal of foramen magnum was 1.50 cm × 2.00 cm with C1 reserved. Dura and arachnoid were incised and sutured linearly. All of the patients underwent cerebellar tonsillar resection and exploration of median aperture of fourth ventricle. Intraoperative ultrasonography was performed both before and after cerebellar tonsillar resection to judge the effect of cisterna magna reconstruction. According to Tator method, the curative effect was divided into 3 groups, improved, stable and worsen. MRI were reviewed at the same time, and the result was divided into syrinx disappeared, reduced, no change and expanded. Results The operation was successful in all patients. Postoperative complications included cerebellum hemorrhage (n = 1, cerebral infarction (n = 1, hydrocephalus (n = 1, subcutaneous dropsy (n = 2 and were recovered after specific treatment. All patients were followed up for 6 months to 12 months after operation. Thirty-six cases were improved, 55 cases were stable, and 2 cases got worse. The MRI showed that the syringomyelia shrinked or disappeared in 90 cases, no change in 3 cases and no expansion. Eighty cases were followed up for 30 months to 36 months after operation, 12 stable cases improved, 1 stable case got worse, while the others remained unchanged. The MRI showed no change was compared with previous follow-up imaging. Conclusion Microinvasive cisterna magna reconstruction is a surgical procedure with mininal injury, quick recovery, stable effect, fewer complications, and high security. Intraoperative ultrasonography provides reliable data and is easy to perform.

  7. Antigen-specific immune reactions to ischemic stroke

    Directory of Open Access Journals (Sweden)

    Xabier eUrra

    2014-09-01

    Full Text Available Brain proteins are detected in the CSF and blood of stroke patients and their concentration is related to the extent of brain damage. Antibodies against brain antigens develop after stroke, suggesting a humoral immune response to the brain injury. Furthermore, induced immune tolerance is beneficial in animal models of cerebral ischemia. The presence of circulating T cells sensitized against brain antigens, and antigen presenting cells (APCs carrying brain antigens in draining lymphoid tissue of stroke patients support the notion that stroke might induce antigen-specific immune responses. After stroke, brain proteins that are normally hidden from the periphery, inflammatory mediators, and danger signals can exit the brain through several efflux routes. They can reach the blood after leaking out of the damaged blood-brain barrier or following the drainage of interstitial fluid to the dural venous sinus, or reach the cervical lymph nodes through the nasal lymphatics following CSF drainage along the arachnoid sheaths of nerves across the nasal submucosa. The route and mode of access of brain antigens to lymphoid tissue could influence the type of response. Central and peripheral tolerance prevents autoimmunity, but the actual mechanisms of tolerance to brain antigens released into the periphery in the presence of inflammation, danger signals, and APCs, are not fully characterized. Stroke does not systematically trigger autoimmunity, but under certain circumstances, such as pronounced systemic inflammation or infection, autoreactive T cells could escape the tolerance controls. Further investigation is needed to elucidate whether antigen-specific immune events could underlie neurological complications impairing stroke outcome.

  8. Role and limitation of fetal and neonatal MRIs for delineation of neural tube defects

    International Nuclear Information System (INIS)

    Development of MRI has contributed to the perioperative diagnosis of neural tube defect (NTD). We assessed the usefulness of fetal MRI in NTD in comparison with neonatal MRI. Fourteen consecutive cases suspected of NTDs (11 spina bifida, 2 cranium bif ida, 1 other) were evaluated with fetal and/or neonatal MRIs (Philips, 1.5T). Some initial abnormalities were suspected 27w6d (mean) of gestation from ultrasonography (US) and fetal MRIs were performed at 31w3d of gestation in 10 cases (4 other cases were transferred to us after birth). The infants were delivered 37w6d of gestation on average and neonatal MRIs were performed 2.4d (mean, 0-23d) after birth in 13 cases, except one patient with myeloschisis who underwent emergency operation just after the birth. Mean diameter of the lesions was 48.6 mm. Skin defect and deviation of the distal end of the cord were observed in fetal MRI. Deviated cords in the myelomeningoceles were confirmed in 2 cases by fetal MRI and in 4 cases by neonatal MRI. Neonatal MRIs showed the lesions to be covered with skin in 9 out of 10 cases (including 2 encephalomeningoceles) without postnatal cerebrospinal fluid (CSF) leakage, while fetal MRIs showed this possibility in only 3 cases. Concerning complications, hydrocephalus was demonstrated with fetal MRIs in 4 cases, for which ventriculo-peritoneal shunt operations were necessary after birth, while Chiari malformations were barely detected, even in 3 cases in which they were suspected through neonatal MRIs. One case suspected of NTD with sacral cystic lesion through US was diagnosed as having teratoma, which was depicted as a presacral mass by fetal MRI. Fetal MRI was useful in differentiating myeloschisis, myelomeningocele and other lumbosacral mass lesions and in delineating coexisting hydrocephalus. Limitations of fetal MRIs in comparison with neonatal MRIs have become evident, however, in depicting skin coverings on lesions, arachnoids (CSF leakage) and Chiari malformations. (author)

  9. Clinical and Morphological Aspects of Gray Matter Heterotopia Type Developmental Malformations

    International Nuclear Information System (INIS)

    Gray matter heterotopia (GMH) is a malformation of the central nervous system characterized by interruption of normal neuroblasts migration between the 7th and 16th week of fetal development. The aim of the study was the analysis of clinical symptoms, prevalence rate and the most common concurrent central nervous system (CNS) developmental disorders as well as assessment of characteristic morphological changes of gray matter heterotopia in children hospitalized in our institution between the year 2001 and 2012. We performed a retrospective analysis of patients’ data who were hospitalized in our institution between the year 2001 and 2012. We assessed clinical data and imaging exams in children diagnosed with gray matter heterotopia confirmed in MRI (magnetic resonance imaging). GMH occurred in 26 children hospitalized in our institution between the year 2001 and 2012. Among children with gray matter heterotopia most common clinical symptoms were: epilepsy, intellectual disability and hemiparesis. The commonest location of heterotopic gray matter were fronto-parietal areas of brain parenchyma, mostly subependymal region. Gray matter heterotopia occurred with other developmental disorders of the central nervous system rather than solely and in most cases it was bilateral. Schizencephaly and abnormalities of the corpus callosum were the most often developmental disorders accompanying GMH. 1. Subependymal gray matter heterotopia was more common than subcortical GMH. Subependymal GMH showed tendency to localize in the region of the bodies of the lateral ventricles. The least common was laminar GMH. 2. Gray matter heterotopia occurred more often with other developmental disorders of the central nervous system rather than solely. The most frequent concurrent disorders of the central nervous system were: schizencephaly, developmental abnormalities of the corpus callosum, arachnoid cyst, abnormalities of the septum pellucidum and the fornix. 3. GMH foci were more often

  10. MRI findings of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    MRI findings were analyzed retrospectively in 46 patients with temporal lobe epilepsy in which the side of epileptogenic focus had been confirmed by EEG studies. T1- and T2-weighted images were obtained by the use of a 1.0 or 1.5 T superconducting-type MRI machine with a coronal scan perpendicular to the axis of the temporal horn of the lateral ventricle. Additional axial and sagittal scans were performed in some cases. The area of the hippocampal body was measured quantitatively using a computerized image-analysis system in 26 cases in which the hippocampus had been visualized with enough contrast on T1-weighted coronal images. Abnormal findings were observed in 31/46 (67%) cases. Hippocampal (HC) and temporal lobe (TL) atrophy were observed in 18/46 (39%) and 23/46 (50%) cases respectively, and the side of the atrophy corresponded with the side of the epileptogenic focus, as confirmed by EEG studies, with specificities of 89% and 74% respectively. A quantitative measurement of the area of the hippocampal body showed unilateral hippocampal atrophy more than 10% in 18/25 (69%) cases (10-25%: 10 cases, 25-50%: 7 cases, 50%2 abnormality was observed in only 4 cases. Structural lesions were observed in 4 cases including an arachnoid cyst, an astrocytoma in amygdala, the Dandy-Walker syndrome, and tuberous sclerosis, using the more efficient imaging qualities than the CT scan. From these observations, it is apparant that superconducting MRI is extremely useful in the diagnosis of the epileptogenic topography of temporal lobe epilepsy. Particularly, hippocampal atrophy was found to correspond with the side of the epileptogenic focus on EEG with a high specificity; its quantitative evaluation could be one of the most important standards in detecting the operative indications for temporal lobe epilepsy. (author)

  11. Petrous apex cephalocele and empty sella: Is there any relation?

    Energy Technology Data Exchange (ETDEWEB)

    Alorainy, Ibrahim A. [Department of Radiology and Diagnostic Imaging, College of Medicine and King Khalid University Hospital, King Saud University, PO Box: 9047, Riyadh 11413 (Saudi Arabia)]. E-mail: alorainy@ksu.edu.sa

    2007-06-15

    Objective: To document the presence of incidental petrous apex cephalocele (PAC) in association with empty sella in a group of patients and propose an etiologic/pathologic relation between the two lesions. Materials and methods: Retrospective review of our imaging archive for the period from October 2001 to October 2006 revealed five patients with PAC (four females and one male; age range, 25-60 years; mean, 47 years). All patients underwent enhanced MR examination of the skull base and four of them underwent CT examination. Lesions were evaluated for size, content, signal intensity, enhancement, and relation to Meckel's cave and petrous apex. Images were also evaluated for the presence of empty sella. Results: The presenting symptoms in all patients were not attributable to PAC. None of the patients had symptoms related to the trigeminal nerve or history of CSF leak. Four patients had bilateral PAC and one had left PAC (total nine lesions). The lesions ranged from 6 mm to 15 mm (mean 9 mm) in the maximum diameter. All lesions were centered posterolateral to Meckel's cave and had low attenuation on CT with sharply demarcated margins. No lesion reached the inner ear structures, internal auditory canal, or mastoid air cells. On MR imaging, all lesions demonstrated CSF signal intensity that is continuous with that of the Meckel's cave. Only the periphery of the lesions demonstrated mild enhancement. All patients had empty sella. One patient had small arachnoid cysts in the middle cranial fossa, bilaterally. Conclusion: PAC and empty sella are similar mechanically in terms of CSF extension and erosion into petrous apex and sella, respectively. Both conditions are seen predominantly in females and have been reported in association with CSF leak, which raises a possibility of etiologic/pathologic relation between the two.

  12. The dural venous sinuses: normal intraluminal architecture defined on contrast-enhanced MR venography

    International Nuclear Information System (INIS)

    Our objective was to define the appearance and distribution of normally occurring intraluminal structures within the dural venous sinuses on contrast-enhanced MR venography (CE-MRV). Informed consent was obtained from all subjects participating in the study, and the study protocol was approved by the institutional review board of the University Health Network. A group of 56 patients underwent CE-MRV. Intraluminal structures were categorized as an arachnoid granulation (AG) or trabeculation (Willis cord). Willis cords within the transverse and sigmoid sinuses as well as AGs 4 mm or more in size were recorded. In 20 of the 56 patients (36%), 29 AGs measuring 4 mm or more were identified within the dural sinuses. All AGs were spherical or ovoid and occurred at sites where a cortical vein joined a dural sinus. Nearly all AGs (28 of 29, 97%) displayed an eccentric internal vein. Willis cords were seen within the superior sagittal sinus in all patients. Willis cords were less prevalent in the remaining dural sinuses. A minimum of one Willis cord was seen in 58 of the 112 transverse sinuses (52%). These cords were 1-2 mm in maximal thickness, uniformly smooth, and commonly partitioned the sinus. Willis cords and AGs (of any size) were not encountered within the sigmoid sinuses or jugular veins. CE-MRV elucidates structures normally found within the dural sinuses. These consist of AGs and Willis cords. This report confirms and establishes new criteria for identification of these normally occurring intraluminal structures providing a basis for their differentiation from pathologic entities. (orig.)

  13. Imaging studies for failed back surgery syndrome; Imagerie du rachis lombaire opere

    Energy Technology Data Exchange (ETDEWEB)

    Cosnard, G.; Cordoliani, Y.S.; Sarrazin, J.L.; Soulie, D. [Hopital des Armees du Val-de-Grace, 75 - Paris (France)

    1995-09-01

    In patients with failed back surgery syndrome, magnetic resonance imaging (MRI) can be the best first-line imaging study because it simplifies the diagnosis. This update is based on over 600 cases. MRI shows the scar tissue at the surgical site, persistent evidence of disk herniation for several weeks after surgery, and evidence of local and regional edema in one-fourth of cases. The edema is most marked between two months and two years after the operation and can misleadingly suggest discitis. MRI is the best investigation for detecting recurrent herniation at the same vertebral level or another level. Herniated disk material is seen as a mass that does not enhance after gadolinium, in contrast to the vascularized scar tissue. Free fragments are often clearly visible within the scar tissue. Fragments that migrate to the epidural space can give rise to granulomatous reactions. Scar tissue can be seen in the epidural space and within the disk; it can show enhancement after gadolinium for several years. The scar can be atrophic or hypertrophic and can encase or impinge on the dural sac and nerve roots. Pathological fibrosis cannot be differentiated from ordinary scar tissue. Arachnoiditis causing adherence of the nerve roots to the dura mater or to each other occurs in 5 % to 10 % of cases. Nerve root enhancement after gadolinium is seen in three-fourths of cases. Bone lesions are common, especially some time after surgery; they are usually accompanied with other lesions. Hematomas are seen in less than 10 % of cases. Infections are similarly rare (0.25 % each for discitis and epiduritis). The diagnosis of discitis is difficult and requires percutaneous biopsy of the disk, especially when MRI shows fluid within the disk, with decreased signal intensity on T2 images, and non enhancement after intravenous gadolinium. (authors). 19 refs., 7 figs.

  14. Clinical Value of MR in Diagnosis of Tumors in the Angle of the Bridge%桥小脑角区肿瘤MR诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘付广

    2015-01-01

    目的探讨桥小脑角区(CPA)肿瘤MR诊断价值。方法搜集经手术和病理证实的单侧桥小脑角区肿瘤56例,回顾性分析其MR表现。结果听神经瘤29例,三叉神经瘤10例,脑膜瘤6例,胆脂瘤(表皮样囊肿)6例,蛛网膜囊肿4例,转移瘤1例。结论听神经瘤是桥小脑角区最常见的肿瘤,MR因其具有无颅骨伪影和多维成像的特点成为CPA区肿瘤诊断的重要方法。%Objective To investigate the cerebel opontine angle (CPA) value of MR in diagnosis of tumor. Methods Col ected by 56 cases of unilateral cerebel opontine angle operation and pathology of tumors, retrospective analysis of the MR performance. Results 29 cases of acoustic neuroma, 10 cases of trigeminal neuroma, 6 cases of meningioma, cholesteatoma (epidermoid cyst) in 6 cases, 4 cases of arachnoid cyst, 1 cases of metastatic tumor. Conclusion Acoustic neuroma is the most common cerebel opontine angle tumors, MR because of its characteristic of skul artifacts and multi-dimensional imaging has become an important method for tumor diagnosis CPA.

  15. Expression of ZIC family genes in meningiomas and other brain tumors

    International Nuclear Information System (INIS)

    Zic zinc finger proteins are present in the developing rodent meninges and are required for cell proliferation and differentiation of meningeal progenitors. Although human ZIC genes are known to be molecular markers for medulloblastomas, their expression in meningioma has not been addressed to date. We examined the mRNA and protein expression of human ZIC1, ZIC2, ZIC3, ZIC4 and ZIC5 genes in meningiomas in comparison to other brain tumors, using RT-PCR, analysis of published microarray data, and immunostaining. ZIC1, ZIC2 and ZIC5 transcript levels in meningiomas were higher than those in whole brain or normal dura mater, whereas all five ZIC genes were abundantly expressed in medulloblastomas. The expression level of ZIC1 in public microarray data was greater in meningiomas classified as World Health Organization Grade II (atypical) than those classified as Grade I (benign). Immunoscreening using anti-ZIC antibodies revealed that 23 out of 23 meningioma cases were ZIC1/2/3/5-immunopositive. By comparison, nuclear staining by the anti-ZIC4 antibody was not observed in any meningioma case, but was strongly detected in all four medulloblastomas. ZIC-positive meningiomas included meningothelial, fibrous, transitional, and psammomatous histological subtypes. In normal meninges, ZIC-like immunoreactivities were detected in vimentin-expressing arachnoid cells both in human and mouse. ZIC1, ZIC2, and ZIC5 are novel molecular markers for meningiomas whereas ZIC4 expression is highly selective for medulloblastomas. The pattern of ZIC expression in both of these tumor types may reflect the properties of the tissues from which the tumors are derived

  16. Afferent and efferent immunological pathways of the brain. Anatomy, function and failure.

    Science.gov (United States)

    Carare, R O; Hawkes, C A; Weller, R O

    2014-02-01

    Immunological privilege appears to be a product of unique lymphatic drainage systems for the brain and receptor-mediated entry of inflammatory cells through the blood-brain barrier. Most organs of the body have well-defined lymphatic vessels that carry extracellular fluid, antigen presenting cells, lymphocytes, neoplastic cells and even bacteria to regional lymph nodes. The brain has no such conventional lymphatics, but has perivascular pathways that drain interstitial fluid (ISF) from brain parenchyma and cerebrospinal fluid (CSF) from the subarachnoid space to cervical lymph nodes. ISF and solutes drain along narrow, ∼100 nm-thick basement membranes within the walls of cerebral capillaries and arteries to cervical lymph nodes; this pathway does not allow traffic of lymphocytes or antigen presenting cells from brain to lymph nodes. Although CSF drains into blood through arachnoid villi, CSF also drains from the subarachnoid space through channels in the cribriform plate of the ethmoid bone into nasal lymphatics and thence to cervical lymph nodes. This pathway does allow the traffic of lymphocytes and antigen presenting cells from CSF to cervical lymph nodes. Efferent pathways by which lymphocytes enter the brain are regulated by selected integrins on lymphocytes and selective receptors on vascular endothelial cells. Here we review: (1) the structure and function of afferent lymphatic drainage of ISF and CSF, (2) mechanisms involved in the efferent pathways by which lymphocytes enter the brain and (3) the failure of lymphatic drainage of the brain parenchyma with age and the role of such failure in the pathogenesis of Alzheimer's disease. PMID:24145049

  17. A balanced view of the cerebrospinal fluid composition and functions: Focus on adult humans.

    Science.gov (United States)

    Spector, Reynold; Robert Snodgrass, S; Johanson, Conrad E

    2015-11-01

    In this review, a companion piece to our recent examination of choroid plexus (CP), the organ that secretes the cerebrospinal fluid (CSF), we focus on recent information in the context of reliable older data concerning the composition and functions of adult human CSF. To accomplish this, we define CSF, examine the methodology employed in studying the CSF focusing on ideal or near ideal experiments and discuss the pros and cons of several widely used analogical descriptions of the CSF including: the CSF as the "third circulation," the CSF as a "nourishing liquor," the similarities of the CSF/choroid plexus to the glomerular filtrate/kidney and finally the CSF circulation as part of the "glymphatic system." We also consider the close interrelationship between the CSF and extracellular space of brain through gap junctions and the paucity of data suggesting that the cerebral capillaries secrete a CSF-like fluid. Recently human CSF has been shown to be in dynamic flux with heart-beat, posture and especially respiration. Functionally, the CSF provides buoyancy, nourishment (e.g., vitamins) and endogenous waste product removal for the brain by bulk flow into the venous (arachnoid villi and nerve roots) and lymphatic (nasal) systems, and by carrier-mediated reabsorptive transport systems in CP. The CSF also presents many exogenous compounds to CP for metabolism or removal, indirectly cleansing the extracellular space of brain (e.g., of xenobiotics like penicillin). The CSF also carries hormones (e.g., leptin) from blood via CP or synthesized in CP (e.g., IGF-2) to the brain. In summary the CP/CSF, the third circulation, performs many functions comparable to the kidney including nourishing the brain and contributing to a stable internal milieu for the brain. These tasks are essential to normal adult brain functioning. PMID:26247808

  18. Evaluating the sensitivity and specificity of 201Tl SPECT in intracranial tumoral pathology

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the sensitivity of SPECT with 201Tl in detecting the cerebral tumors. A hundred and forty nine explorations were carried out (107 SPECT in patients clinically suspected and/or cerebral tumor radiography, 42 SPECT in patients treated for cerebral tumor to evaluate the persistence of the tumoral tissue immediately post-operation, or the presence of a tumoral recurrence). The SPECTs were achieved 15 minutes after the IV injection of 185 MBq of 201Tl with a double head Elscint Helix HR camera with fan collimators. The reconstructions were obtained by retro-projection with a Metz 3.13 filter. As the brain normally do not capture 201Tl, any fixation of 201Tl was considered an positive examination. The final diagnosis was based either on the histology (n = 41) or on clinical evolution (n = 149). The pathologies recorded were: 33 glial tumors, 32 metastases (51 lesions), 14 meningiomas, 1 hypophyseal adenoma, 1 cranio-pharyngogioma, 1 malign lymphoma, 1 gr.4 neurinomas, 1 arachnoid cyst, 34 AVCs, 24 normal, 2 complete surgical extirpations, and 5 necroses after treatment. In our population the sensitivity of SPECT with 201Tl for the diagnosis of intracranial tumors was calculated to be 91.5% and the specificity, 98.5%. We have met a false positive (recent hemorrhagic AVC) and 7 false negatives (4 metastases of which 3 were under 1 cm and another largely necrotic, 3 patients presenting residual tumoral tissue immediately post-operation, presently in recurrence). These excellent results prove the utility of SPECT with 201Tl both for positive diagnosis of cerebral tumors and for evaluation of these tumors after treatment

  19. Localization of Epileptic Foci in Temporal Lobe Epilepsy by MR and EEG%颞叶癫 的EEG和MR术前定位研究

    Institute of Scientific and Technical Information of China (English)

    高翔; 江澄川; 洪震; 俞丽云

    2000-01-01

    Aim:To discuss pre-operative localization of epileptic foci in intractable temporal epilepsy by EEG and MR. Meth-ods: MR and EEG were used to localize the epileptic foci in 20 patients with intractable temporal lobe epilepsy (TLE)pre-oper-atively,all the patients had intra-operative cortical EEG examination and post-operative follow-up. Restults: 17 patients' seizurefoci were localized by MR and EEG examination ,among them l 0 patients have hippocampus sclerosis, 3 cases tephromalacia, 2cases arachnoid cyst, 1 case glioma. Another 3 cases were localized hy repetitive EEG examinaticm while MR examinationswere normal. All patients were followed up after operation,the result was satisfactory. Conclusion:EEG is the most importantlocalizing method for temporal lobe epilepsy,MR is useful for the secondary TLE.Examination of hippocampus for HS will behelpful while the ordinary MR examination is normal.%目的:探讨EEG、MR对颞叶癫 (TLE)术前定位。方法:用MR、EEG对20例TLE病例进行术前定位与术中EEG和术后随访结果比较。结果:20例病例中17例依据MR及EEG获得定位,主要在海马区域病变12例,前颞叶5例,另3例MR检查正常,依据多次EEG检查获得定位,随访疗效满意。结论:EEG是诊断TLE的重要手段,MR可对继发性TLE作出正确诊断,MR对海马硬化检查可协助EEG对TLE定位诊断。

  20. The role of MRI and CT of the brain in first episodes of psychosis

    International Nuclear Information System (INIS)

    Aim: To investigate whether imaging is associated with early detection of the organic causes of the first episode of psychosis (FEP). Materials and methods: Individuals with FEP but no neurological signs referred to a tertiary centre for cerebral magnetic resonance imaging (MRI) or computed tomography (CT) were reviewed retrospectively. Two groups were evaluated with either CT or MRI; the two groups were independent and no individual underwent both CT and MRI. Results: One hundred and twelve consecutive cerebral MRI and 204 consecutive CT examinations were identified. Three (2.7%) individuals had brain lesions [brain tumour and human immunodeficiency virus (HIV) encephalopathy] potentially accountable for the psychosis at MRI. Seventy patients (62.5%) had incidental brain lesions, such as cerebral atrophy, small vessel ischaemic changes, unruptured Circle of Willis aneurysm, cavernoma, and arachnoid cysts at MRI. Three patients (1.5%) had focal brain lesions (primary or secondary tumours) potentially accountable for the psychosis at CT. One hundred and thirty-three patients (65.2%) had incidental brain lesions unrelated to the psychosis on CT scan. There was no significant difference between MRI and CT imaging in detecting organic disease potentially responsible for FEP (p < 0.001). Conclusion: Routine MRI or CT imaging of the brain is unlikely to reveal disease leading to a significant change in management. MRI was comparable with CT in terms of diagnosis of both pathological and incidental cerebral lesions. Therefore, routine brain structural imaging of FEP in patients without focal neurology may not be routinely required and if imaging is requested then CT may function equally as well as MRI as the first-line investigation

  1. Safety and toxicity of intrathecal liposomal cytarabine (Depocyte) in children and adolescents with recurrent or refractory brain tumors: a multi-institutional retrospective study.

    Science.gov (United States)

    Benesch, Martin; Siegler, Nele; Hoff, Katja von; Lassay, Lisa; Kropshofer, Gabriele; Müller, Hermann; Sommer, Constanze; Rutkowski, Stefan; Fleischhack, Gudrun; Urban, Christian

    2009-10-01

    This retrospective study aimed to evaluate the safety and toxicity of intrathecal liposomal cytarabine (Depocyte) in children and adolescents with refractory or recurrent brain tumors. Nineteen heavily pretreated patients (males, n = 14; females, n = 5; median age at diagnosis 8.5 years; range, 1.4-22 years) were given intrathecal liposomal cytarabine on a compassionate use basis for recurrent refractory medulloblastoma (n = 12), mixed germ cell tumor (n = 2), central nervous system primitive neuroectodermal tumors of the pons (n = 1), anaplastic ependymoma (n = 1), anaplastic oligodendroglioma (n = 1), atypical teratoid rhabdoid tumor (n = 1), or rhabdoid papillary meningioma (n = 1). Eighteen patients received concomitant systemic radiochemotherapy. A total of 88 intrathecal injections of liposomal cytarabine (dose range, 20-50 mg) were administered with concomitant dexamethasone prophylaxis. The median number of doses per patient was four (range, 1-10). Duration of treatment ranged from (1/2) to 10 months. Eleven patients (57.9%) did not show any side effects, whereas eight patients (42.1%) developed side effects related to either chemical arachnoiditis (n = 4) or neurological progression (n = 2). Less typical treatment-related symptoms (e.g. lethargy, ataxia, and slurred speech) were observed in two patients. Treatment with intrathecal liposomal cytarabine was discontinued twice because of side effects. In conclusion, although intrathecal liposomal cytarabine was generally well tolerated, it should be used cautiously and only with dexamethasone prophylaxis in extensively pretreated patients with recurrent brain tumors. Proof of efficacy requires a prospective single-agent phase II study. PMID:19617818

  2. Longitudinal measurements of syrinx size in a rat model of posttraumatic syringomyelia.

    Science.gov (United States)

    Najafi, Elmira; Bilston, Lynne E; Song, Xin; Bongers, Andre; Stoodley, Marcus A; Cheng, Shaokoon; Hemley, Sarah J

    2016-06-01

    OBJECTIVE Syringomyelia pathophysiology is commonly studied using rodent models. However, in vivo studies of posttraumatic syringomyelia have been limited by the size of animals and lack of reliable noninvasive evaluation techniques. Imaging the rat spinal cord is particularly challenging because the spinal cord diameter is approximately 1-3 mm, and pathological lesions within the spinal cord parenchyma are even smaller. The standard technique has been histological evaluation, but this has its limitations. The aim of the present study was to determine whether syrinx size could be reliably measured using a preclinical high-field MRI animal system in a rat model of posttraumatic syringomyelia. METHODS The authors used an existing rat model of posttraumatic syringomyelia, which was created using a controlled pneumatic compression device to produce the initial spinal cord injury, followed by a subarachnoid injection of kaolin to produce arachnoiditis. T2-weighted MRI was performed on each animal using a 9.4-T scanner at 7, 10, and 13 weeks after injury. Animals were killed and syrinx sizes were calculated from in vivo MRI and histological studies. RESULTS MRI measurements of syrinx volume and length were closely correlated to histological measurements across all time points (Pearson product moment correlation coefficient r = ± 0.93 and 0.79, respectively). CONCLUSIONS This study demonstrates that high-field T2-weighted MRI can be used to measure syrinx size, and data correlate well with syrinx size measured using histological methods. Preclinical MRI may be a valuable noninvasive technique for tracking syrinx formation and enlargement in animal models of syringomyelia. PMID:26918577

  3. Intraparenchymal epidermoid cysts in the brain: diagnostic value of MR diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hu, X.-Y. [Medical Imaging Center, The First Affiliated Hospital of Suzhou, Jiangsu Province (China); Hu, C.-H. [Imaging Center, Soochow University (China)], E-mail: wpdrhxy@hotmail.com; Fang, X.-M.; Cui, L.; Zhang, Q.-H. [Medical Imaging Center, The First Affiliated Hospital of Suzhou, Jiangsu Province (China)

    2008-07-15

    Aim: To evaluate the value of magnetic resonance (MR) diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADC) maps in the diagnosis of intraparenchymal epidermoid cysts (ECs). Materials and methods: Six cases of histopathologically proven intraparenchymal ECs were studied. All patients were examined with conventional MR (T1WI, T2WI, contrast-enhanced T1WI) and DWI sequences. Along with the mean ADC values (mADC) of the ECs, the cerebrospinal fluid (CSF) and grey matter (GM) were measured. Qualitative and quantitative assessments, as well as MRI findings, were retrospectively analysed using a double blind method by three radiologists in consensus. Results: Four lesions were located in the cerebellum, among them, one was accompanied by an arachnoid cyst; one huge lesion crossed the parenchyma of the frontal and temporal lobes; the other was located in the left temporal lobe. Two lesions had a homogeneous CSF-like intensity on both T1WI and T2WI. The other four were of mixed-intensity on both T1WI and T2WI. All lesions were strikingly hyperintense on DWI, and iso- or slightly hypointense on ADC (relative to the brain). The mADCs of the ECs were significantly higher than that of GM, but significantly lower than that of CSF. Three cases (3/6) were accurately diagnosed using conventional MR sequences without DWI, but in the remaining three cases, correct diagnosis could only be made with help of DWI. Conclusion: DWI sequences can facilitate the diagnosis of intraparenchymal ECs, thus alerting surgeons of the risk of chemical meningitis at surgery. The MR findings of intraparenchymal ECs are basically as the same as those of extracerebral ECs, but the former is likely to have a mixed signal. The hyperintense signal of ECs on DWI is probably caused by the T2 shine-through effect in tumour tissue.

  4. CT SCAN FINDINGS IN PATIENTS WITH SEIZURES IN NOTHERN CHHATTISGARH : A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Archana

    2015-09-01

    Full Text Available A five years study of CT scan findings in seizure patients is carried out to know the different etiology. Seizure is a finite event of altered cerebral function because of excessive and abnormal electrical discharges of the brain cells. Epilepsy is a chronic condition predisposing a person to recurrent seizures. This study is designed to establish usefulness of CT in defining the etiology of seizures in various age groups in people of Northern Chhattisgarh. This is a retrospective hospital - based study conducted in Radio - diagnosis Department of Chhattisgarh Institute of Medical Sciences, Bilaspur, Chhattisgarh. The study was carried out over a 5 year period. Hospital admissions with history of seizures are very common. Almost 3 - 9% p er 1000 population of total hospital emergencies is seizure cases. Epilepsy is an important health problem in developing countries, where its prevalence can be up to 57 per 1000 population. This study has high prevalence of seizures in First, second, third and fourth decades with decreasing pattern with increasing age. Prevalence in first decade is low as compare to second and third decades. Tuberculoma (9.39% and Neurocysticercosis (3.60% has highest prevalence in partial seizures followed by Focal Cereb ral Edema (6.22% whereas Diffuse Cerebral edema (4.91% seen with Generalised Seizures Cerebral infarct has equally seen in both types of seizures. Brain tumour presented mostly with Generalised seizure (2.07% than in partial seizures (0.98% . Other abno rmal findings like Cerebral calcifications, Diffuse cortical atrophy, Focal cortical atrophy, Sub Arachnoid hemorrhage, Intracerebral Hemorrhage, Hypoxic Ischemic Encephalopathy, Hydrocephalus and few rare diseases like Fahr disease and Tuberous sclerosis have also seen in CT scan in seizure patients. CT scan is valuable in making a diagnosis particularly in Indian subcontinent, where infective causes in form of space occupying lesions and infections are most

  5. Pattern of spinal compression (retrospective and prospective clinical study)

    International Nuclear Information System (INIS)

    Seventy two patients with spinal cord compressions were admitted to the national centre for neurological sciences in the period between january 1995 and december 1996. Male female ratio was 2.5:1 and the mean age was 40.5 years, myelogram was found to be the most helpful investigation in (90.3%) of patients and plain x-ray was abnormal in (43%) of patients. Tumors were found as the cause of compression in (26.4%), disc prolapse in (26.4%) of patients, spinal injuries in 13.8%, arachnoid cysts in (8.3%) of patients and tuberculosis in (8.3%). Other causes like spinal osteopathy, syringomyelia, spinal hematomas, spinal canal stenosis and spinal haemangiomas were also encountered. Thick ligamentum flavum was found in (25%) of cases, mostly in association with other pathologies, and as the sole compressing pathology in only two patients. The patients were followed up for a period from one month to two years, 41.6% of them were cured completely, while 37.5% were partially improved, 5.6% showed no improvement, 5.6% were died, 9.7% lost their follow up. The factors affecting the outcome were found to be, the duration of the condition before presentation for treatment, presence of blocks in myelograms, and the type of the pathology, disc and benign tumors gave the best outcome. Urinary complications like urine incontinence, urinary tract infection, and urine retention, were observed in (26.4%, 30.6%, 11.1%) of patients respectively, D.V.T. occurred in (15.3%) of patients and the mortality rate was (5.6%) and the major cause of death was pulmonary embolism. (Author)

  6. Spinal perineurial and meningeal cysts.

    Science.gov (United States)

    Tarlov, I M

    1970-12-01

    Perineurial cysts may be responsible for clinical symptoms and a cure effected by their removal. They do not fill on initial myelography but may fill with Pantopaque some time, days or weeks, after Pantopaque has been instilled into the subarachnoid space. Perineurial cysts arise at the site of the posterior root ganglion. The cyst wall is composed of neural tissue. When initial myelography fails to reveal an adequate cause for the patient's symptoms and signs referable to the caudal nerve roots, then about a millilitre of Pantopaque should be left in the canal for delayed myelography which may later reveal a sacral perineurial cyst or, occasionally, a meningeal cyst. Meningeal diverticula occur proximal to the posterior root ganglia and usually fill on initial myelography. They are in free communication with the subarachnoid space and are rarely in my experience responsible for clinical symptoms. Meningeal diverticula and meningeal cysts appear to represent a continuum. Pantopaque left in the subarachnoid space may convert a meningeal diverticulum into an expanding symptomatic meningeal cyst, as in the case described. Many cases described as perineurial cysts represent abnormally long arachnoidal prolongations over nerve roots or meningeal diverticula. In general, neither of the latter is of pathological significance. Perineurial, like meningeal cysts and diverticula, may be asymptomatic. They should be operated upon only if they produce progressive or disabling symptoms or signs clearly attributable to them. When myelography must be done, and this should be done only as a preliminary to a probable necessary operation, then patient effort should be made to remove the Pantopaque. PMID:5531903

  7. [Epidemiology of syringomyelia in Japan--the nationwide survey].

    Science.gov (United States)

    Moriwaka, F; Tashiro, K; Tachibana, S; Yada, K

    1995-12-01

    The nationwide epidemiological survey of syringomyelia was carried out in Japan by sending inquiries to neurologists, child neurologists, neurosurgeons and orthopedic surgeons for the period of 1991 and 1992. A total of 1,243 cases of syringomyelia were ascertained. Among them, 622 were men and 619 women, and the average age of onset was 28 years old. The classification by Barnett et al was used, presenting syringomyelia with Chiari malformation in 684 cases (51.2%), dysraphism in 47 (3.7%), post traumatic syringomyelia in 139 (11%), post-spinal arachnoiditis in 76 (6%), spinal cord tumor in 132 (10.5%) and others in 204. Its predominant clinical course was slowly progressive, but 202 cases (17.9%) showed rather stable course including spontaneous resolution in 29 cases. The main initial symptoms were numbness in 522 cases (42%), motor disturbance in 504 (40.5%), and pain in 296 (23.8%). Neurologic signs noted in the abnormality of deep tendon reflexes in 836 cases (67.3%), motor disturbance in 763 (60.4%) and positive pathological reflexes in 383 (30.1%). Sensory disturbance was found in 942 cases (75.8%) and the dissociated type were 559 out of them (59.3%). It is noteworthy that 982 out of 1,243 were documented by MRI and surgical operations such as foramen magnum decompression, syringo-subarachnoid shunt and others were performed in 829 cases. Syringobulbia was confirmed on MRI in 101 cases of syringomyelia in which spinal cord tumors were most frequently associated. PMID:8752408

  8. Experimental bacterial meningitis in rabbit; evaluation with CT and MRI

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the usefulness of computed tomography(CT) and magnetic resonance imaging(MRI) in experimental bacterial meningitis. CT and MR images of experimental bacterial meningitis were obtained after inoculation of 1ml suspension of 10-6/ml Staphylococcus aureus directly into the supratentorial arachnoid space of 18 New Zealand white rabbits. Each animal was studied with both pre-enhanced and post-enhanced CT and MRI at 12, 24, 48 hours and 1 week. Cerebrospinal fluid of all of 18 rabbits were sampled and cultured for bacterial growth. All of 18 rabbits had the clinical symptoms such as neck stiffness and anorexia within 24 hours after the inoculation. Cerebrospinal fluid cultures were positive for Staphylococcus aureus growth. Gd-enhanced MRI exhibited diffuse enhancement along the thickened supratentorial meninges earlier than CT. In Gd-enhanced MRI, the mean contrast enhancement along the thickened supratentorial meninges earlier than CT. In Gd-enhanced MRI, the mean contrast enhancement ratio(CER) at supratentorial meninges increased to 1.93 at 12 hours and 2.99 at 24 hours from 1.06 at 0 hour. Histologic evaluation demonstrated inflammatory cell infiltration into the meninges. MRI also identified the complications of meningitis such as ependymitis and hydrocephalus more effectively than CT. These results indicated that Fd-enhanced MRI detectred earlier the abnormal findingfs of bacterial meningitis and evaluated more effectively the complications of meningitis compared with CT. MRI was more useful than CT in evaluation of the bacterial meningitis

  9. Three-dimensional computed tomographic angiography in four patients with dissecting aneurysms of the vertebrobasilar system

    International Nuclear Information System (INIS)

    Recently, three-dimensional computed angiography (CTA) has been used for the diagnosis and treatment planning of cerebral aneurysm presenting with or without sub-arachnoid haemorrhage, but the diagnostic value of CTA has not been established. This study evaluated the vertebrobasilar system. Four patients with acute dissecting aneurysms were examined by CTA, including 3 women and 1 man with a mean age of 60.5 ± 8.5 years (range: 52-67 years). There were three patients with subarachnoid haemorrhage and one patient presenting with ischaemia. One patient underwent CTA twice and digital subtraction angiography (DSA) once, while one patient had both examinations three times. CTA was performed with a nonionic contrast medium (100 ml of iomeprol 350 mg I/ml) administrated via an auto-injector into an antecubital vein at 1.5-1.7 ml/s. To reconstruct three-dimensional images, the volume rendering method was utilized. All initial CTA studies were performed safely within 5 hours after onset. In patients with subarachnoid haemorrhage, all lesions were demonstrated by finding either the 'pear and string sign' or a 'double shadow' on CTA. In the patient presenting with ischaemia, 'pearl and string sign' and ' double shadow' was shown after the second CTA, and follow-up CTA was able to demonstrate the change of the lesion morphology. All lesions had more irregular luminal surfaces than the non-lesional segment of the involved vessels. CTA was safe in patients with acute vertebrobasilar dissection and demonstrated either the 'pearl and string sign' or a 'double shadow' which were commonly showed on DSA. An 'irregular luminal surface sign' on CTA seems to be one of the characteristics of vertebrobasilar dissection. The view shown by CTA is not less useful than that by DSA to diagnosis and treatment planning in the acute phase of vertebrobasilar dissection, and can be employed to follow the changes of lesion morphology over time. (author)

  10. MRI and {sup 1}H MRS findings in Smith-Lemli-Opitz syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Caruso, P.A. [Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Poussaint, T.Y. [Department of Radiology, Children' s Hospital, 300 Longwood Avenue, MA 02115, Boston (United States); Tzika, A.A.; Astrakas, L.G. [Department of Surgery, Massachusetts General Hospital, Boston, MA (United States); Zurakowski, D. [Department of Biostatistics, Children' s Hospital Boston, Boston, MA (United States); Elias, E.R. [Department of Pediatrics and Genetics, Children' s Hospital, Denver, CO (United States); School of Medicine, University of Colorado, Denver, CO (United States); Bay, C. [Department of Medical Genetics, Children' s Hospital of Pittsburgh, Pittsburgh, PA (United States); Irons, M.B. [Division of Clinical Genetics and Metabolism, Children' s Hospital Boston, Boston, MA (United States)

    2004-01-01

    Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive disorder characterized by a defect in cholesterol biosynthesis, associated with mental retardation and multisystem structural abnormalities. This study investigated the prevalence of congenital CNS abnormalities by MRI in a large series of patients with SLOS and the correlation of the clinical and biochemical findings with the results of MRI and {sup 1}H MRS. Eighteen patients were studied; all underwent MRI of the brain, and 16 had {sup 1}H MRS of the cerebral white matter. The ratios choline:NAA, lipid:NAA, and lipid:choline metabolite were found to be correlated with the clinical degree of disease severity, serum total sterol ratios (cholesterol/cholesterol + 7-dehydrocholesterol + 8-dehydrocholesterol) and in two cases with the effect of cholesterol therapy. Abnormal CNS findings were noted in five patients, including callosal abnormalities (n=4), Dandy-Walker variant (n=1), and arachnoid cyst (n=1). Holoprosencephaly was noted in one patient with a prevalence of 6%. Choline:NAA was elevated in seven patients. There was a statistically significant positive correlation between the lipid:choline ratio and the serum cholesterol precursor, 8-dehydrocholesterol. In two patients {sup 1}H MRS demonstrated abnormally elevated lipids prior to cholesterol therapy, which improved on therapy. The use of MRI and {sup 1}H MRS is an effective way to demonstrate brain structural abnormalities in patients with SLOS and may prove to be an effective method for the assessment of the effects of cholesterol replacement therapy in the brain. (orig.)

  11. CT of the infants and children with mental and/or physical handicaps

    International Nuclear Information System (INIS)

    Computed tomography (CT) was performed on 47 children and adolescents with mental and/or physical handicaps. Of these series, 22 cases of morphological change were noted. Another 25 cases showed no overt CT abnormality. These 47 cases were divided into three groups in the following manner. Group 1, with no CT abnormality; Group 2, with ventricular dilatation and/or cerebral atrophy, and Group 3, with a major morphological anomaly of the brain. Group 1 (25 cases) showed a marked dissociation between the CT findings and the IQ. EEG showed normal findings in two cases, diffuse abnormality in 5 cases, and focal abnormality in 9 cases. This group alone included 8 cases of athetosis. Group 2 (14 cases). Seven cases of EEG showed diffuse abnormality in 3 cases and focal abnormality in 4 cases. So-called cerebral palsy was noted in 11 cases. Group 3 (8 cases). This group included cases of hemihydranencephaly, porencephaly, agenesis of the corpus callosum, and arachnoid cyst. The mean and standard deviations of the IQ's in the groups are 57.1 +- 21.6, 65.2 +- 20.5, and 72.0 +- 8.0. That is, an inverted correlation between the CT abnormality and the IQ was noted. CT is a noninvasive study and a reasonable method of investigation for mentally handicapped children. DeMyer gave three categories of cerebral malformation: cytogenetic malformations, organogenetic disorders, and histogenetic disorders. On the other hand, EEG aimed at evaluating cerebral function and CT undertaken for morphological evaluation reveal no intimate correlation with one another. Rather, these two procedures each have their one value for the evaluation of the function and the structure of the brain. Mentally and/or physically handicapped patients without any overt cerebral anomaly have been found to be as follows: Murobushi, 12.29%; Malamud, 34%; Gross, 15.8%; Benda, 15%, and Hamada, 45.4%. (author)

  12. Liposomal cytarabine for central nervous system embryonal tumors in children and young adults.

    Science.gov (United States)

    Partap, Sonia; Murphy, Patricia A; Vogel, Hannes; Barnes, Patrick D; Edwards, Michael S B; Fisher, Paul G

    2011-07-01

    To assess the tolerability and efficacy of liposomal cytarabine (LC), an encapsulated, sustained-release, intrathecal (IT) formulation of cytosine arabinoside, in de novo and relapsed central nervous system (CNS) embryonal tumors in children and young adults. We studied retrospectively all patients less than age 30 at our institution treated consecutively with LC for medulloblastoma (MB), primitive neuroectodermal tumor (PNET), and atypical teratoid rhabdoid tumor (ATRT). Seventeen patients received LC (2 mg/kg up to 50 mg, every 2 weeks to monthly) at diagnosis of high-risk CNS embryonal tumor (2 PNET, 3 ATRT) or relapse of MB (12 MB; 9 had leptomeningeal metastases). Sixteen patients received concurrent systemic chemotherapy. A total of 108 doses were administered (IT 82, intraventricular 26) with a mean of six (range 1-16) treatments per patient. Only three administrations were associated with adverse effects of arachnoiditis or headache. None developed malignant cerebrospinal fluid (CSF) cytology while receiving LC. All the six evaluable patients with malignant CSF cytology and treated with at least two doses cleared their CSF (mean 3 doses, range 1-5). Median overall survival in relapse patients was 9.1 months. Five patients (4 de novo and 1 relapsed) remain alive in complete remission for a median 26.8 months from first LC. Liposomal cytarabine is an easily administered, well-tolerated, and active drug in patients with high-risk embryonal neoplasms. One-third of our cohort remains in remission from otherwise fatal diagnoses. Our findings warrant a phase II trial of LC in newly diagnosed or recurrent CNS embryonal tumors. PMID:20859651

  13. MR imaging of the cisternal segment of the posterior group of cranial nerves: Neurovascular relationships and abnormal changes

    International Nuclear Information System (INIS)

    pressed by arteries, 1 by arachnoid cyst, and 3 caused by tumors. Conclusion: Use of 3D-CISS sequence enables accurate identification of the cisternal segment of the PGCN, neurovascular relationships and abnormal changes caused by neurovascular compression or tumor.

  14. MR imaging of the cisternal segment of the posterior group of cranial nerves: Neurovascular relationships and abnormal changes

    Energy Technology Data Exchange (ETDEWEB)

    Liang Changhu, E-mail: tigerlch@163.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Du Yinglin, E-mail: duyinglinzhuo@sohu.co [Shandong Provincial Center for Disease Control and Prevention, Public Health Institute, 72, Jingshi Road, Jinan, Shandong (China); Xu Jinfa, E-mail: xuke5598@icom.c [Liao Cheng City People' s Hospital, Dongchang Road, Liaocheng, Shandong (China); Wu Lebin, E-mail: Lebinwu518@163.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Liu Cheng, E-mail: cacab2a@126.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Wang Ximing, E-mail: wxming369@163.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Wang Haiyan, E-mail: whyott@163.co [Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong (China); Yu Fuhua, E-mail: changhu1970@163.co [Weifang Medical College, 7166, West Road Baotong Weifang, Shandong (China)

    2010-07-15

    pressed by arteries, 1 by arachnoid cyst, and 3 caused by tumors. Conclusion: Use of 3D-CISS sequence enables accurate identification of the cisternal segment of the PGCN, neurovascular relationships and abnormal changes caused by neurovascular compression or tumor.

  15. Imaging Evaluation of Pediatric Sensorineural Hearing Loss in Potential Candidates for Cochlear Implantation.

    Science.gov (United States)

    Jallu, Aleena Shafi; Jehangir, Majid; Ul Hamid, Waqar; Pampori, Rafiq Ahmad

    2015-12-01

    Computerized tomography (CT) and magnetic resonance (MR) are complementary in the imaging of the labyrinth, the internal auditory canal and the brain in children with sensorineural hearing loss who are being evaluated for cochlear implantation. An accurate anatomical description of the inner ear is essential in the preoperative work up. Computerized tomography visualizes the bony structures, whereas MR can discern soft-tissue components including intra labyrinthine fluid, cerebrospinal fluid (CSF), nerves, and vessels within the IAC. This prospective study was conducted in the Department of Otorhinolaryngology, Head & Neck Surgery, Government Medical College, Srinagar. 40 children in the age group of 1-16 years with unidentified causes of bilateral SNHL were analysed radiologically over the period of 2 years from Dec 2011 to Jan 2014. Each patient underwent MRI and high resolution CT scanning of temporal bone in axial and coronal planes. Out of the 40 patients 22 were males (55 %) and 18 were females (45 %). 30 patients (72.5 %)in our study had normal radiological scans. Five patients (12.5 %) had B/L large vestibular aqueduct and two patients (5 %) had internal auditory canal stenosis with cochlear nerve hypoplasia on CT and MR imaging. Cochlear dysplasia was present in two patients (5 %) and semicircular canal dysplasia was present in one patient (2.5 %) as an isolated finding on HRCT. In addition isolated cochlear nerve hypoplasia was present in one patient (2.5 %). Hyperintense basal ganglia lesion suggestive of kernicterus was present in one patient (2.5 %) and hyperintense posterior parietal and occipital white matter lesions suggestive of congenital CMV infection was present in one patient (2.5 %) on MR imaging. Arachnoid cysts of middle cranial fossa was an incidental finding present in one patient. Radiological abnormalities of the inner ear are not uncommon. Computerized tomography and MRI are important modalities to analyze the inner ear in

  16. Assessing ventricular size: is subjective evaluation accurate enough? New MRI-based normative standards for 19-year-olds

    International Nuclear Information System (INIS)

    To create new standards for radiological indices of dilated ventricles and to compare these with subjectively assessed ventricular size. One hundred healthy controls (54 females), birth weight above 3,000 g, were followed throughout childhood as part of a longitudinal study of ex-prematures. All had a 3 Tesla brain magnetic resonance scan at age 17-20, and the following measurements were performed: biparietal and occipitofrontal diameters, width and depth of the frontal and occipital horns, diameter of the third ventricle and the frontal sub-arachnoid space. Ventricular size was judged subjectively by two neuroradiologists as being normal, or mildly, moderately or severely dilated. Head circumference was 31 mm higher for males than for females (95% confidence interval (CI) 25-28, p < 0.001). Similar, ventricular size except for the depth of the right frontal horn was larger for male; however, the observed differences were partly accounted for by the larger head circumference. Normative sex specific standards for different cerebral measurements were presented as mean and ranges and additional 2.5, 10, 50, 90, 97.5 percentiles. The mean depth of the left ventricle was larger than the right for males, with an observed difference of 0.6 mm in male (95% CI 0.2-0.9, p = 0.005). The mean width of the left ventricle was larger than the right for females, with an observed difference of 0.4 mm in male (95% CI 0.1-0.7, p = 0.018). Two subjects were judged to have moderately and 36 to have mildly dilated ventricles by observer one, while figures for observer two were one and 14. Overall, the two observers agreed on 15 having either mild or moderate dilatation (kappa 0.43). For both sexes, the mean depth of the frontal horns as well as of the larger occipital horns differed significantly between the no dilatation and the mild/moderate dilatation groups. In our unselected cohort of healthy 19-year-olds, a high total of 14% was diagnosed to have dilated cerebral ventricles when

  17. Scanning electron microscopy of chronically implanted intracortical microelectrode arrays in non-human primates

    Science.gov (United States)

    Barrese, James C.; Aceros, Juan; Donoghue, John P.

    2016-04-01

    Objective. Signal attenuation is a major problem facing intracortical sensors for chronic neuroprosthetic applications. Many studies suggest that failure is due to gliosis around the electrode tips, however, mechanical and material causes of failure are often overlooked. The purpose of this study was to investigate the factors contributing to progressive signal decline by using scanning electron microscopy (SEM) to visualize structural changes in chronically implanted arrays and histology to examine the tissue response at corresponding implant sites. Approach. We examined eight chronically implanted intracortical microelectrode arrays (MEAs) explanted from non-human primates at times ranging from 37 to 1051 days post-implant. We used SEM, in vivo neural recordings, and histology (GFAP, Iba-1, NeuN). Three MEAs that were never implanted were also imaged as controls. Main results. SEM revealed progressive corrosion of the platinum electrode tips and changes to the underlying silicon. The parylene insulation was prone to cracking and delamination, and in some instances the silicone elastomer also delaminated from the edges of the MEA. Substantial tissue encapsulation was observed and was often seen growing into defects in the platinum and parylene. These material defects became more common as the time in vivo increased. Histology at 37 and 1051 days post-implant showed gliosis, disruption of normal cortical architecture with minimal neuronal loss, and high Iba-1 reactivity, especially within the arachnoid and dura. Electrode tracts were either absent or barely visible in the cortex at 1051 days, but were seen in the fibrotic encapsulation material suggesting that the MEAs were lifted out of the brain. Neural recordings showed a progressive drop in impedance, signal amplitude, and viable channels over time. Significance. These results provide evidence that signal loss in MEAs is truly multifactorial. Gliosis occurs in the first few months after implantation but does

  18. Otocefalia: Presentación de dos casos

    Directory of Open Access Journals (Sweden)

    Gerardo Tovitto

    2007-12-01

    pregnancy, under endovenous anesthesia. The ultrasound study at 27 weeks revealed polihydramnios, meroanencephaly and arachnoid cysts. After premature labor at 28 weeks, a female alive new born, with microcephaly and face malformations given by otocefalia and aprosopia was obtained, and dies two minutes after been born. Morphological study was performed to both products in Embriology Unit of The University of Los Andes

  19. Related immune response of clinic heterogeneity and pathology in neurocysticercosis%脑囊虫病临床异质性、病理变化与免疫反应

    Institute of Scientific and Technical Information of China (English)

    陈小华; 谷俊朝

    2012-01-01

    脑囊虫病,由猪囊尾蚴寄生于中枢神经系统引起.脑囊虫病临床异质性表现为从无症状到颅内高压、脑积水、蛛网膜炎、癫痫,甚至死亡.脑囊虫病病理变化表现为血脑屏障破坏、脑实质肉芽肿形成、局部及外周多种免疫细胞共同参与.脑囊虫病的临床异质性与病理变化均与宿主抗猪囊尾蚴免疫反应密切相关.本文就与脑囊虫病临床异质性、病理变化相关的抗囊尾蚴免疫、影响因素(囊尾蚴发育阶段、大小、数量、位置、基因组学;宿主年龄、性别、遗传背景)与免疫机制等做一综述.%Neurocysticercosis (NO is caused by infection of the central nervous system with Taenia solium metacestode (Cysticercus). Clinical heterogeneity of NC can range from a totally asymptomatic course to severe illness, with intracra-nial hypertension, hydrocephalus, arachnoiditis, seizures, and even death. Pathologic changes caused by NC include breakdown of the blood-brain barrier, parenchymal granuloma formation, involvement of various local and systemic im-munocytes. Both the clinical heterogeneity of NC and the pathologic changes it leads to are closely related to host immune response. This article reviews the immune response in relation to the clinical heterogeneity and pathologic changes of NC, influencing factors (developmental stages, size, number, location, and genetics of Taenia solium as well as the age, gender, and genetics of the host), and mechanisms of immune response to NC.

  20. Brain Tumors and Brain Tumor Research Progress in Image Classification%脑肿瘤及脑肿瘤图像分类的研究进展

    Institute of Scientific and Technical Information of China (English)

    俞海平; 邬立保

    2011-01-01

    Many methods of brain tumor classification,there is no uniform classification^! A variety of tumors and pathological features of the different tissue, the study of benign and malignant, and things are not the same characteristics. Usually can be classified as histological.-(l) Originated in glial tumors: astrocytoma, less support glial cell tumors, medulloblastoma, etc.(2) Originated in meningeal tumors: meningioma, meningeal sarcoma, arachnoid cyst.(3) Originated in the pituitary tumors: tired color cell adenoma, acidophilic, basophilic cell adenoma.(4) Originated in cranial nerve tumors: acoustic neuroma, trigeminal nerve sheath tumors and other tumors.(S) Originated from residual embryonic tissue: craniopharyngioma, chordoma, dermoid cyst (6) Originated in vascular cells: vascular tumors and vascular reticular cell tumor, etc.(7) Transfer or by other parts of the tumor invasion: a variety of metastatic tumors, and nasopharyn-geal carcinoma, etc.%脑肿瘤分类的方法很多,目前尚无统一的分类方法,并且各种肿瘤的组织发生与病理特征不同,其良性与恶性以及物学特性也不一样.通常按组织学可分类如下:(1)发源于神经胶质的肿瘤:星形细胞瘤、少支胶质细胞瘤、髓母细胞瘤等.(2)发源于脑膜的肿瘤:脑膜瘤、脑膜内瘤、蛛网膜囊肿等.(3)发源于垂体的肿瘤:厌色细胞腺瘤,嗜酸、嗜碱性细胞腺瘤.(4)发源于颅神经的肿瘤:听神经瘤、三叉神经瘤等各种神经鞘瘤.(5)发源于胚胎残余组织:颅咽管瘤、脊索瘤、皮样囊肿等.(6)发源于血管细胞:血管瘤及血管网织细胞瘤等.(7)由其它部位转移或侵入的肿瘤:各种转移瘤及鼻咽癌等.