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Sample records for cerebral aspergilloma case

  1. Cerebral aspergilloma in a SLE patient: A case report with short literature review

    OpenAIRE

    Chowdhury, Forhad Hossain; Haque, Mohammod Raziul; Khan, Shafiqul Kabir; Alam, Sarwar Morshed

    2014-01-01

    Aspergillosis of brain is very rare, and commonly seen in immunocompromised or immunosuppressed patient. Here, we report a cerebral aspergillosis condition in a late teen girl who is a Systemic Lupus Erythromatosis patient with steroid therapy. She developed headaches, vomitings, and convulsions. On the basis of clinical and neuroimaging, a diagnosis of cerebral tuberculoma was made, and she was put on anti-TB therapy, but she did not respond. Later, surgical partial excision biopsy confirmed...

  2. Aspergilloma of the maxillary sinus: report of a case

    International Nuclear Information System (INIS)

    Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan; Yu, Jae Jung

    2010-01-01

    Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

  3. Aspergilloma of the maxillary sinus: report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [School of Dentistry, Kung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung [Kangdong Scared Heart Hospital, Hallym Medical Center, Seoul (Korea, Republic of)

    2010-12-15

    Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

  4. Autopsy case of pulmonary aspergilloma. [After long chemotherapy for TB

    Energy Technology Data Exchange (ETDEWEB)

    II, Yohei; Akizuki, S

    1973-01-01

    A 73-year-old female received anti-TB chemotherapy for pulmonary tuberculosis for a long period and died from severe hemoptysis which suddenly developed after recovery from the disease. Autopsy showed a large aspergilloma in the upper lobe of the right lung. This case is reported along with a review of the literature on aspergillosis. (30 refs) (DLC)

  5. Pathology of pulmonary aspergillomas

    OpenAIRE

    Shah Rajeev; Vaideeswar Pradeep; Pandit Shobhana

    2008-01-01

    Aspergilloma refers to a fungal ball formed by saprophytic overgrowth of Aspergillus species and is seen secondary to cavitatory/cystic respiratory diseases. Paucity of clinical and pathological data of aspergilloma in India prompted us to analyze cases of aspergilloma over 15 years. The clinical features were recorded in all and correlated with detailed pathological examination. Aspergillomas were identified in 41 surgical excisions or at autopsy. There was male predominance; half the patien...

  6. Conjunctival Aspergilloma with Multiple Mulberry Nodules: A Case Report

    Directory of Open Access Journals (Sweden)

    Jiunn-Liang Chen

    2005-06-01

    Full Text Available A 30-year-old healthy female presented with a 1-year history of chronic mucous discharge, tearing, and irritation in the left eye. Slit-lamp examination revealed severe papillary and follicular reaction surrounding a movable subconjunctival mass on the left upper tarsal conjunctiva. Incision and curettage were performed to establish the diagnosis. Multiple peculiar black mulberry nodules were obtained. The clumps of septate hyphae seen with periodic acid-Schiff stain were characteristic of fungus ball (aspergilloma. The patient's symptoms improved significantly after surgery without any antifungal therapy. Although rarely reported, aspergillus is a common fungus in the conjunctiva that may seed into the subconjunctiva. We present this case to remind ophthalmologists of such a rare cause of recalcitrant conjunctival inflammation in immunocompetent patients.

  7. Pathology of pulmonary aspergillomas.

    Science.gov (United States)

    Shah, Rajeev; Vaideeswar, Pradeep; Pandit, Shobhana P

    2008-01-01

    Aspergilloma refers to a fungal ball formed by saprophytic overgrowth of Aspergillus species and is seen secondary to cavitatory/cystic respiratory diseases. Paucity of clinical and pathological data of aspergilloma in India prompted us to analyze cases of aspergilloma over 15 years. The clinical features were recorded in all and correlated with detailed pathological examination. Aspergillomas were identified in 41 surgical excisions or at autopsy. There was male predominance; half the patients were in their fourth decade. Episodic hemoptysis was the commonest mode of presentation (85.4%). Forty aspergillomas were complex, occurring in cavitatory lesions (82.9%) or in bronchiectasis (14.6%). Simple aspergilloma was seen as an incidental finding in only one. Tuberculosis was the etiological factor in 31 patients, producing cavitatory or bronchiectatic lesions; other causes were chronic lung abscess and bronchiectasis (unrelated to tuberculosis). Surgical resections are endorsed in view of high risk of unpredictable, life-threatening hemoptysis.

  8. Pathology of pulmonary aspergillomas

    Directory of Open Access Journals (Sweden)

    Shah Rajeev

    2008-07-01

    Full Text Available Aspergilloma refers to a fungal ball formed by saprophytic overgrowth of Aspergillus species and is seen secondary to cavitatory/cystic respiratory diseases. Paucity of clinical and pathological data of aspergilloma in India prompted us to analyze cases of aspergilloma over 15 years. The clinical features were recorded in all and correlated with detailed pathological examination. Aspergillomas were identified in 41 surgical excisions or at autopsy. There was male predominance; half the patients were in their fourth decade. Episodic hemoptysis was the commonest mode of presentation (85.4%. Forty aspergillomas were complex, occurring in cavitatory lesions (82.9% or in bronchiectasis (14.6%. Simple aspergilloma was seen as an incidental finding in only one. Tuberculosis was the etiological factor in 31 patients, producing cavitatory or bronchiectatic lesions; other causes were chronic lung abscess and bronchiectasis (unrelated to tuberculosis. Surgical resections are endorsed in view of high risk of unpredictable, life-threatening hemoptysis.

  9. Endobronchial aspergilloma: report of 10 cases and literature review.

    Science.gov (United States)

    Ma, Jeong Eun; Yun, Eun Young; Kim, You Eun; Lee, Gi Dong; Cho, Yu Ji; Jeong, Yi Yeong; Jeon, Kyoung-Nyeo; Jang, In Seok; Kim, Ho Cheol; Lee, Jong Deok; Hwang, Young Sil

    2011-09-01

    A retrospective investigation of the clinical and radiologic features as well as the bronchoscopic appearance was carried out in patients with endobronchial aspergilloma. Ten patients with endobronchial aspergilloma diagnosed by bronchoscopy and histological examination were identified at the Gyeongsang University Hospital of Korea, from May 2003 to May 2009. The patients included 9 men and 1 woman, and the age of the patients ranged from 36 to 76 (median, 58 years). The associated diseases or conditions were: previous pulmonary tuberculosis in 7 patients, lung cancer in 2 patients, pulmonary resection in 1 patient, and foreign body of the bronchus in 1 patient. The chest radiologic finding showed fibrotic changes as a consequence of previous tuberculosis infection in 6 patients and a mass-like lesion in 2 patients. Two patients had a co-existing fungus ball, and an endobronchial lesion was suspected in only 2 patients on the CT scan. The bronchoscopic appearance was a whitish to yellow necrotic mass causing bronchial obstruction in 7 patients, foreign body with adjacent granulation tissue and whitish necrotic tissue in 1 patient, whitish necrotic tissue at an anastomosis site in 1 patient, and a protruding mass with whitish necrotic tissue in 1 patient. An endobronchial aspergilloma is a rare presentation of pulmonary aspergilosis and is usually incidentally found in immunocompetent patients with underlying lung disease. It usually appears as a necrotic mass causing bronchial obstruction on bronchoscopy and can be confirmed by biopsy.

  10. Coinfection of Pulmonary Hydatid Cyst and Aspergilloma : Case Report and Systematic Review

    NARCIS (Netherlands)

    Aliyali, M.; Badali, H.; Shokohi, T.; Moazeni, M.; Nosrati, A.; Godazandeh, G.; Dolatabadi, S.; Nabili, M.

    2016-01-01

    Aspergilloma infection consists of a mass of fungal hyphae, inflammatory cells, fibrin, mucus, and tissue debris and can colonize lung cavities due to underlying diseases such as tuberculosis, sarcoidosis, bronchiectasis, cavitary lung cancer, neoplasms, ankylosing spondylitis, bronchial cysts, and

  11. Surgical treatment for pulmonary aspergilloma in seventeenth years old female: case report

    Science.gov (United States)

    Yanni, G. N.; Lubis, M.; Yoel, C.

    2018-03-01

    Aspergillosis is defined as a mycosis group caused by various pathogenic fungi of the Aspergillus genus. Aspergillus has more than 900 species that cause infection in human. The most common Aspergillus species that cause infection is Aspergillus fumigatus, about 90%. Other species, Aspergillus flavus, about 10% cause invasive disease. Have been reported a young girl 17-year-8-month-old woman was admitted to emergency with complaints of coughing up blood. The patient has diagnosed an aspergilloma and treated with thoracotomy bi-lobectomy right lower lung based on thorax scan. The patient took Fluconazole and surgical bilobectomyfor treated the aspergilloma and got improvement.

  12. Local administration of amphotericin B against aspergilloma in the prepontine cistern--case report.

    Science.gov (United States)

    Nabika, Shinya; Kiya, Katsuzo; Satoh, Hideki; Mizoue, Tatsuya; Araki, Hayato; Oshita, Jumpei

    2007-02-01

    A 21-year-old man presented with aspergilloma in the prepontine cistern that developed after treatment for cerebellar hematoma following rupture of an arteriovenous malformation. He became bedridden with neurological signs of tetraparesis, disturbed ocular movement, and bulbar palsy, despite alert consciousness. Repeat magnetic resonance imaging 1 year later revealed a space-occupying lesion in the prepontine cistern along the clivus. This multilobular enhanced mass lesion gradually enlarged towards the brainstem over the following 4 years, resulting in loss of spontaneous breathing and dependence on a mechanical respirator. Surgical treatment via a lateral suboccipital approach was selected to reduce the size of the mass lesion and confirm the diagnosis. Histological examination revealed the presence of Aspergillus fumigatus. Treatment with amphotericin B (1 mg/kg/day) and fluconazole (100 mg/kg/day) injected into the peripheral veins was initiated, but was stopped due to the appearance of renal dysfunction. An Ommaya tube was then inserted into the prepontine cistern via a transsylvian approach to provide high concentrations of amphotericin B around the granulomatous lesion. He gradually improved, corresponding to the decreased size of the aspergilloma just after surgery. Surgical reduction of granuloma combined with local administration of antifungal agent is a good treatment option in patients with aspergilloma refractory to systemic administration.

  13. Uncommon presentation of pulmonary aspergilloma

    Directory of Open Access Journals (Sweden)

    Baradkar V

    2009-01-01

    Full Text Available Cases of pulmonary aspergilloma without any predisposing factors are rarely reported. Clinical presentation varies from case to case. Here, we report a case of pulmonary aspergilloma in a 60-year-old male patient who was admitted to the Intensive Respiratory Care Unit with spontaneous pneumothorax. The patient had a history of dyspnea on exertion since 9 months and mild haemoptysis since the last 6 months. A computerised tomographic scan of the lungs showed a lesion in the left main bronchus along with obstructive emphysema of the right lung, moderate pneumothorax and mediastinal emphysema. Bronchoscopy was performed and the biopsy samples were processed for histopathological examination and culture on Sabouraud′s dextrose agar, which yielded growth of Aspergillus flavus. Repeat sputum samples also yielded the growth of A. flavus . The patient responded to intravenous liposomaamphotericin B and intercostal drainage.

  14. Cardiac Aspergilloma: A Rare Case of a Cardiac Mass Involving the Native Tricuspid Valve, Right Atrium, and Right Ventricle in an Immunocompromised Patient

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    Christina S. Chen-Milhone

    2018-01-01

    Full Text Available Aspergillus can cause devastating opportunistic infections in immunocompromised patients. Rarely does this fungus invade the heart, and when it does, survival is especially poor despite optimal medical and surgical treatment. We report a case of cardiac aspergilloma with involvement of the tricuspid valve and both the right atrium and ventricle found on a transthoracic echocardiogram in an immunocompromised patient after developing atrial fibrillation with rapid ventricular rate. The findings from this case suggest that early clinical suspicion is critical in early diagnosis and thus early treatment.

  15. A Rare Case of Intracavitary Fungus Ball (Aspergilloma in the Old Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Majzoobi MM

    2017-06-01

    Full Text Available Introduction: Pulmonary fungus ball is a rare complication in pre-existing pulmonary cavitary lesions, due to some chronic pulmonary diseases including tuberculosis, lung abscess and sarcoidosis. Fungus ball is mostly caused by aspergillus. In many patients, fungus ball is asymptomatic, but in a significant number of them it can develop cough and hemoptysis, which may be massive and fatal. The cornerstone of assessment is chest imaging, along with sputum culture or aspergillus antibody in patient's serum. The purpose of this report is increment in attention to this complication in patients with previous pulmonary tuberculosis (TB. Case Presentation: The patient was a 23-year-old woman with chief complaint of fever, cough and hemoptysis, who was hospitalized in the Infectious Diseases Ward of Farshchian Sina hospital in March 2016. She had a history of anti-TB therapy from two years before. Sputum and bronchoalveolar lavage (BAL were negative for cytology and Mycobacterium tuberculosis, but cultures of both samples were positive for Aspergillus niger. Her lung contrast-enhanced computerized tomography (CECT scan revealed the presence of a fungus ball inside the upper lobe cavity of right lung. After lobectomy, fungal mass was confirmed by histopathology. Conclusions: In patients with pulmonary complaints (especially hemoptysis and history of cavitary pulmonary tuberculosis, the differential diagnosis of community-acquired pneumonia, lung abscess, reactivation of tuberculosis and lung cancer as well as fungal infections should be considered.

  16. Typical and atypical presentations of aspergilloma

    International Nuclear Information System (INIS)

    Villajos, M.; Darnell, A.; Gallardo, X.; Castaner, E.; Mata, J. M.; Paedavila, E.

    1999-01-01

    To show the different forms of radiological presentations of aspergilloma, emphasizing the importance of recognizing the atypical forms. The explorations of 11 patients with aspergilloma were examined retrospectively between 1993 and 1997. These patients were studied using conventional X-rays and computed tomography (CT): Typical and atypical radiological findings were observed. In two patients, who presented recurrent hemoptysis, a percutaneous installation of amphotericin B was carried out with tomographic control. Out of the 11 patients, two were female and nine male. In eight of the cases the radiological findings showed an intercavity injury with different evolutionary forms, while in three of the cases there was a progressive pleural swelling. In the two patients treated pertinaciously, no significant radiological changes were observed, however, neither of them showed hemoptysis again. The pleural swelling adjacent to the cavity and/or the swelling of the cavity wall are atypical radiological presentations of the aspergilloma, that can accompany or precede the appearance of this illness. (Author) 7 refs

  17. Isolated Unilateral Pulmonary Artery Agenesis complicated by Symptomatic Aspergilloma

    LENUS (Irish Health Repository)

    Daly, A

    2017-11-01

    Isolated unilateral pulmonary artery agenesis is a rare diagnosis. Poor blood flow to the lung parenchyma renders the tissue susceptible to opportunistic infections. We present the unusual case of isolated unilateral pulmonary artery agenesis complicated by aspergilloma. Management options and considerations are discussed.

  18. Surgical treatment of aspergilloma grafted in hydatid cyst cavity

    Directory of Open Access Journals (Sweden)

    M. El Hammoumi

    2013-11-01

    Full Text Available Aspergilloma is a saprophytic infection that colonizes pre-existing cavities in the lung. These cavities are caused by tuberculosis, bronchiectasis, lung cancer and other pulmonary diseases. Development of aspergilloma in the residual cavities after pulmonary hydatid cyst surgery is rarely described in terms of coexistence of the two conditions. We describe 3 cases of pulmonary aspergilloma grafted in a residual cavity of cystectomy for hydatid disease. Resumo: Aspergiloma é uma infecção saprófita que coloniza cavidades pré-existentes no pulmão. Estas cavidades são causadas por tuberculose, bronquiectasias, cancro do pulmão e outras doenças pulmonares. O desenvolvimento de aspergiloma em cavidades residuais, após cirurgia pulmonar de quisto hidático, raramente é descrito em termos de coexistência das duas condições. Descrevemos 3 casos de enxerto de aspergiloma pulmonar numa cavidade residual de cistectomia para doença hidática. Keywords: Hydatid cyst, Aspergilloma, Surgery, Capitonnage, Palavras-chave: Quisto hidático, Aspergiloma, Cirurgia, Capitonagem

  19. Endobronchial Ultrasound-guided Transbronchial Needle Injection of Liposomal Amphotericin B for the Treatment of Symptomatic Aspergilloma.

    Science.gov (United States)

    Parikh, Mihir S; Seeley, Eric; Nguyen-Tran, Evelyn; Krishna, Ganesh

    2017-10-01

    Surgical treatment with lung resection has traditionally been the treatment of choice for pulmonary cavities containing aspergillomas that cause hemoptysis. Endobronchial ultrasound (EBUS) is a minimally invasive bronchoscopic technique that is commonly used for transbronchial needle aspiration of hilar and mediastinal lymph nodes as well as centrally located parenchymal lesions. Here, we describe a case of a 71-year-old woman who was found to have a cavitary lesion in the lung containing aspergillomas. Under direct ultrasound visualization with EBUS, liposomal amphotericin B was injected into the aspergillomas. These aspergillomas regressed after treatment. To our knowledge, this is the first reported treatment of aspergilloma with EBUS-guided transbronchial needle injection of liposomal amphotericin B.

  20. [Radiologic picture of maxillary sinus aspergilloma].

    Science.gov (United States)

    Kaczmarek, I; Bilska, J; Osmola, K; Nowaczyk, M T

    2010-06-01

    calcium deposits in inflammatory changed mucosa, that might suggest "foreign body" picture. In 1 to 3 years follow-up control there was a recurrence of symptoms in one case. Foreign body of maxillary sinus have to be differentiated with aspergilosis. Metallic "foreign body" view in maxillary sinus seems to be characteristic sign of aspergillosis. The most often form of maxillary sinus aspergilosis is aspergilloma.

  1. Medical image of the week: aspergilloma

    Directory of Open Access Journals (Sweden)

    Hsu W

    2014-05-01

    Full Text Available No abstract available. Article truncated after 150 words. A 69-year-old woman, a current smoker, with very severe chronic obstructive pulmonary disease and prior atypical mycobacterium, was found unresponsive by her family and intubated in the field by emergency medical services for respiratory distress. Her CT thorax showed severe emphysematous disease, apical bullous disease, and a large left upper lobe cavitation with debris (Figure 1. She was treated with broad-spectrum antibiotics and anti-fungal medications. Hemoptysis was never seen. Sputum cultures over a span of two weeks repeatedly showed Aspergillus fumigatus and outside medical records confirmed the patient had a known history of stable aspergilloma not requiring therapy. Aspergillomas usually arises in cavitary areas of the lung damaged by previous infections. The fungus ball is a combination of colonization by Aspergillus hyphae and cellular debris. Individuals with aspergillomas are usually asymptomatic or have mild symptoms (chronic cough and do not require treatment unless it begins to invade into the cavity ...

  2. Clinical and x-ray diagnosis of pulmonary aspergilloma

    International Nuclear Information System (INIS)

    Alyazov, S.I.; Manafov, S.S.; Gurbanaliev, I.G.

    1981-01-01

    Clinical and X-ray peculiarities of pulmonary alterations in patients with aspergilloma are analyzed. The diagnosis of pulmonary aspergilloma is shown to be based on the sum of characte-- ristic clinical and X-ray symptoms and data of mycologic sputum investigations and diffuse precipitation reaction according to Ouchterloni [ru

  3. Always expect the unexpected: lung abscess due to pseudomonas aeruginosa mimicking pulmonary aspergilloma in acute B-cell leukemia.

    Science.gov (United States)

    Dieks, J-K; von Bueren, A O; Schaefer, I-M; Menke, J; Lex, C; Krause, U; Zenker, D; Kühnle, I; Kramm, C M

    2013-11-01

    We report on a case of Pseudomonas aeruginosa sepsis and consecutive lung abscess in a 13-year-old patient with acute B-cell leukemia. At first, radiographic findings strongly suggested presence of pulmonary aspergilloma and only microbiological testing of the surgically enucleated mass revealed the correct underlying pathogen and confirmed final diagnosis. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Management of Severe Hemoptysis from Pulmonary Aspergilloma Using Endovascular Embolization

    International Nuclear Information System (INIS)

    Corr, Peter

    2006-01-01

    Purpose. To determine the effectiveness of endovascular embolization as a temporizing measure in the management of severe hemoptysis caused by intracavitary pulmonary aspergilloma. Methods. Patients presenting with hemoptysis, estimated to be more than 300 ml in the preceding 24 hr, in whom a radiological diagnosis of pulmonary aspergilloma was made on chest radiographs and/or computed tomography of the chest were subjected to bronchial and systemic arteriography and embolization using triacryl microspheres. Results. Twelve patients with upper lobe intracavitary aspergillomas were managed with embolization. In 11 patients hemoptysis stopped within 24 hr and with no recurrence over the next 4 weeks. In 1 patient hemoptysis persisted and an upper lobe lobectomy was performed. Conclusion. Embolization of bronchial and systemic arteries is an effective method for treating acute severe hemoptysis from intracavitary aspergillomas, allowing the patient time to recover for definitive surgical management

  5. Multiple cerebral aneurysms of middle cerebral artery. Case report

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    D.A. Nica1, Tatiana Rosca1, A. Dinca2, M. Stroi3, Mirela Renta4, A.V. Ciurea5

    2010-11-01

    Full Text Available Multiple cerebral aneurysms present awide variation in incidence with averages of13% at angiographic studies and 22.7% atautopsy.High blood pressue, cigarette smoking,stress and possible also age and female sexseem to be risk factors for multipleintracranial aneurysms (MIAn in patientsof working age who have suffered asubarachnoid hemorrhage (SAH.Aneurysms were situated on the same sidein one-third of the patients with twoaneurysms and the most common site wasthe middle cerebral artery (MCA. Tomanage these challenging lesionsneurosurgeons must use all availableinnovations and advances, includingdiagnostic, technical and perioperativeadjuncts. The author presents a case ofmiddle age female, with two saccularaneurysms situated on the same side (rightMCA, who was operated in our clinic, 20days after first SAH episode, I grade onHunt/Hess scale. The angio MRI wasperformed before, and control DSangiography after operation. After pterionalapproach, the author used themagnification, microsurgical technics,temporal clip, and two permanent Yasargilcurved clips. A postoperative good recoveryenable the patient go to work and drive onemonth later.

  6. Cerebral abscess in dog - a Case report

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    Juliana de Castro Cosme

    2015-03-01

    Full Text Available ABSTRACT. Cosme J.C., Silva M.A., Santos R.P., Andrade Júnior P.S.C. & Nunes L.C. Cerebral abscess in dog - a Case report. [Abscesso cerebreal em cão - Relato de caso.] Revista Brasileira de Medicina Veterinária, 37(1:15-19, 2015. Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alto Universitário, s/nº Cx Postal 16, Guararema, Alegre, ES 29500-000, Brasil. E-mail: louisiane.nunes@ufes.br; louisianecn@yahoo.com.br Cerebral abscess is an affection of the nervous system with rare manifestation in dogs, caused by proliferation of pyogenic bacteria. The aim of this work was to describe the clinical and pathological findings in a case of cerebral abscess in dog, as well as to discuss the adopted treatment procedures. A 48-day old, male labrador dog was examined at the veterinary hospital of the Federal University of Espírito Santo (UFES, exhibiting a lesion caused by trauma on the frontal left region of the skull. The animal presented signs of ataxia and apathy, and received antibiotic and anti-inflammatory treatment. The animal died 30 days after consultation. Among other macroscopic findings, necroscopic examination revealed cutaneous scabby lesion on the frontal left region of the skull, cerebellar herniation, and increase of the left hemiencephalon. Microscopical analyses showed neutrophilic leptomeningitis of brain, cerebellum and cord, neuropil vacuolation, and neutrophilic infiltrate in the perivascular Virchow-Robin spaces of the brain. Staphylococcus sp. was evidenced by microbiological isolation. The non-specificity of the clinical signs in cases of cerebral abscess may hinder the establishment of an early diagnosis, thus reducing the treatment and survival chances of the animal.

  7. Successful Treatment of Liver Aspergilloma by Caspofungin Acetate First-Line Therapy in a Non-Immunocompromised Patient

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    Hong-Juan Dong

    2012-09-01

    Full Text Available Aspergillosis remains to be a life-threatening complication in immunocompromised patients. However, Aspergillus infection can be observed in non-immunocompromised individuals in rare cases. We report a case of liver aspergilloma in a chronic aplastic anemia patient under relatively intact immune status. Therapeutic strategy for this rare condition was extensively discussed and caspofungin acetate single agent first-line therapy was applied after careful consideration. Encouraging clinical and radiologic improvements were achieved in response to the antifungal salvage. Our long-term follow-up study also revealed a favorable prognosis. Based on this experience, we suggest caspofungin acetate as first-line therapy for treatment plans of liver aspergilloma.

  8. A postural `stressed` cerebral HMPAO case study

    Energy Technology Data Exchange (ETDEWEB)

    Williams, R.C.; Jost, G.M.; Bolitho, L.; Grantham, M. [Wangaratta District Hospital, VIC (Australia)

    1998-03-01

    Full text: This case study represents an example of the utility of postural hypoperfusion stressed HMPAO SPECT. An elderly woman of 78 with a long history of giddiness was referred to our laboratory for examination of possible cerebral ischaemia. She had recurrent dizzy episodes, sometimes posture related, over the past few years and had suffered several falls. Cerebral DSA revealed minimal disease. CT scans were reported as normal. Carotid duplex Doppler studies revealed bilateral plaque disease in the carotid bulbs extending to the origins of the ICAs which were not significant stenoses. Postural symptoms were induced by standing the patient up rapidly and HMPAO was administered at the same time. A SPECT scan of the brain was performed. Quantitative analysis showed a left to right decrease of 10.8% in the temporo-occipital area, 5.6% in the temporo-parietal area and 2.5% in the cerebellar and parietal areas. Images revealed moderately reduced tracer concentration in the left half of the cerebellum and the left occipital region extending as far forward as the temporo-parietal region A repeat HMPAO SPECT scan without stress was normal. This would appear to indicate reversible ischaemia in the left posterior region, and is consistent with the reported symptoms. This case illustrates the usefulness of HMPAO in the diagnosis of reversible cerebral ischaemia.

  9. A postural 'stressed' cerebral HMPAO case study

    International Nuclear Information System (INIS)

    Williams, R.C.; Jost, G.M.; Bolitho, L.; Grantham, M.

    1998-01-01

    Full text: This case study represents an example of the utility of postural hypoperfusion stressed HMPAO SPECT. An elderly woman of 78 with a long history of giddiness was referred to our laboratory for examination of possible cerebral ischaemia. She had recurrent dizzy episodes, sometimes posture related, over the past few years and had suffered several falls. Cerebral DSA revealed minimal disease. CT scans were reported as normal. Carotid duplex Doppler studies revealed bilateral plaque disease in the carotid bulbs extending to the origins of the ICAs which were not significant stenoses. Postural symptoms were induced by standing the patient up rapidly and HMPAO was administered at the same time. A SPECT scan of the brain was performed. Quantitative analysis showed a left to right decrease of 10.8% in the temporo-occipital area, 5.6% in the temporo-parietal area and 2.5% in the cerebellar and parietal areas. Images revealed moderately reduced tracer concentration in the left half of the cerebellum and the left occipital region extending as far forward as the temporo-parietal region A repeat HMPAO SPECT scan without stress was normal. This would appear to indicate reversible ischaemia in the left posterior region, and is consistent with the reported symptoms. This case illustrates the usefulness of HMPAO in the diagnosis of reversible cerebral ischaemia

  10. Pulmonary aspergilloma: A rare differential diagnosis to lung cancer after positive FDG PET scan

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    Franziska Spycher

    2014-01-01

    Full Text Available Early diagnosis and treatment of lung cancer, one of the leading causes of cancer-related death, is important to improve morbidity and mortality. Therefore any suspect solitary pulmonary nodule should prompt the pursuit for a definitive histological diagnosis. We describe the case of a 55-years-old male ex-smoker, who was admitted to our hospital due to recurrent hemoptysis and dry cough. A CT scan showed an irregular nodule of increasing size (28 mm in diameter in the left lower lobe (LLL. A whole body PET-CT scan (643 MBq F-18 FDG i.v. was performed and confirmed an avid FDG uptake of the nodule in the LLL, highly suspicious of lung cancer, without any evidence of lymphogenic or hematogenic metastasis. Bronchoscopy was not diagnostic and due to severe adhesions after prior chest trauma and the central location of the nodule, a lobectomy of the LLL was performed. Surprisingly, histology showed a simple aspergilloma located in a circumscribed bronchiectasis with no evidence of malignancy. This is a report of an informative example of an aspergilloma, which presented with symptoms and radiological features of malignant lung cancer.

  11. Clinical and pathological study on 10 cases of cerebral lobe hemorrhage related with cerebral amyloid angiopathy

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    Xiao-qi LI

    2015-07-01

    Full Text Available Objective To summarize the clinical data and pathological features of 10 cases of cerebral lobar hemorrhage related with cerebral amyloid angiopathy (CAA diagnosed pathologically, thereby to improve the knowledge and diagnosis of the disease. Methods The clinical data of 10 cases of cerebral lobar hemorrhage related with CAA, collected in the General Hospital of Shenyang Command from 1983 up to now, were retrospectively analyzed, and the clinical and neuropathological features of these cases were summarized. Results Of the 10 patients, 2 suffered from single lobar hemorrhage and 8 multiple lobar hemorrhage, all of them were confirmed pathologically to have ruptured into the subarachnoid space. Pathological examination revealed microaneurysm in 2 cases, "double barrel" change in 4 cases, multiple arteriolar clusters in 5 cases, obliterative onion-liked intima change in 4 cases, and fibrinoid necrosis of vessel wall in 7 cases. In addition, neurofibrillary tangles were found in 8 cases, and senile plaque was observed in 5 cases. Conclusions Cerebral lobar hemorrhage related with CAA is mainly located in the parietal, temporal and occipital lobes, readily breaking into the subarachnoid space, and it is often multiple and recurrent. The CAA associated microvasculopathy was found frequently in the autopsy sample of CAA related cerebral lobar hemorrhage, and it may contribute to the pathogenesis of cerebral hemorrhage. DOI: 10.11855/j.issn.0577-7402.2015.07.04

  12. Complex Pulmonary Aspergilloma: Surgical Challenges in a Third World Setting

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    Bernadette Ngo Nonga

    2018-01-01

    Full Text Available Background. Surgery for pulmonary aspergilloma (PA, especially complex forms, is greatly challenging in a resource-poor setting such as Cameroon. We report our experience of surgical management of PA in this environment. Method. We prospectively assessed patients who underwent surgery for PA from January 2012 to May 2015, at the University Hospital Center of Yaoundé. Records were reviewed for demographics, history and physical examinations, radiological findings, surgical procedures, and outcomes. The study has received approval from the institutional ethics committees. Results. In total, 20 patients (17 males and 3 females (sex ratio, 5.66; mean age, 30 years; range, 23–65 years with a past history of tuberculosis were assessed. The median follow-up was 21.5 months. The primary symptom was hemoptysis, followed by cough and chest pain. All patients underwent surgical treatment and lung resection. Postoperative complications (bleeding, air leak, empyema, and severe anemia occurred in 4 patients and 1 patient died. Although 3 patients were lost to follow-up, the survival rate was 80% with improvement of the preoperative symptoms. Conclusion. Although surgery for complex aspergilloma is very challenging in environments such as ours, we believe that it is the best treatment modality for symptomatic diseases in our setting.

  13. Reversible cerebral vasconstriction syndrome: A case report

    International Nuclear Information System (INIS)

    Lee, Jeong Sub; Park, Ji Kang; Kim, Seung Hyoung; Jeong, Sun Young

    2013-01-01

    We report a 46-year-old woman patient with reversible cerebral vasoconstriction syndrome (RCVS). She presented with severe headache, multiple cerebral infarction, and multifocal severe stenosis in the intracranial arteries on magnetic resonance angiography (MRA). One month after the episode, a small bowel gastrointestinal stromal tumor (GIST) was incidentally detected during the evaluation of severe anemia and GIST was removed. Follow-up MRA was performed 3 months and 1 year after an initial attack of headache, and multifocal severe intracranial arterial stenotic lesions were completely resolved, she did not experience any episode of RCVS during the 2 years.

  14. Reversible cerebral vasconstriction syndrome: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Sub; Park, Ji Kang; Kim, Seung Hyoung; Jeong, Sun Young [Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2013-11-15

    We report a 46-year-old woman patient with reversible cerebral vasoconstriction syndrome (RCVS). She presented with severe headache, multiple cerebral infarction, and multifocal severe stenosis in the intracranial arteries on magnetic resonance angiography (MRA). One month after the episode, a small bowel gastrointestinal stromal tumor (GIST) was incidentally detected during the evaluation of severe anemia and GIST was removed. Follow-up MRA was performed 3 months and 1 year after an initial attack of headache, and multifocal severe intracranial arterial stenotic lesions were completely resolved, she did not experience any episode of RCVS during the 2 years.

  15. Old people's extensive traumatic cerebral infarction (analysis of 48 cases)

    International Nuclear Information System (INIS)

    Xu Wenhui

    2000-01-01

    Objective: To analyse clinically the genetic mechanism, clinical characteristics and the prognosis of old people's extensive traumatic cerebral infarction. Method: Forty eight such cases have been observed and analysed. Results: Old people's extensive traumatic cerebral infarction had its characteristics, which occurred mostly in the blood supply area of big branch blood vessels, and had observed nerve function defect. Conclusion: It has more clinical complication and bad prognosis. The death rate is high

  16. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    OpenAIRE

    Deniz Kamacı Şener; Özlem Taşkapılıoğlu; Nermin Kelebek Girgin; Bahattin Hakyemez; Mustafa Bakar; Yakup Tomak

    2012-01-01

    Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  17. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  18. [Analysis of 58 neonatal cases with cerebral infarction].

    Science.gov (United States)

    Li, Zhi-hua; Chen, Chao

    2013-01-01

    Cerebral infarction (CI) is one of severe diseases of central nervous system in neonates, and some infants with CI could have poor prognosis in the long term. This study aimed to analyze the clinical data and prognosis of all neonatal cases with cerebral infarction in recent years and to help future clinical work. Totally 58 neonatal cases with CI admitted to NICU of the hospital from January 1999 to December 2010 were included in this study. We analyzed all clinical data and prognosis by retrospective analysis. Fifty-two term babies and six preterm babies were included. There were altogether 51 cases with asphyxia and 7 with hemorrhagic cerebral infarction. Perinatal hypoxia-ischemia was the most common high-risk factor and it accounted for 46.6%. Seizure was the most frequent initial symptom and the most common clinical manifestation (accounted for 77.6%), and it was followed by intermittent cyanosis, apnea and lethargy. Cerebral CT scan and magnetic resonance imaging were major methods to help to make the diagnosis and they also had close relation with prognosis. Diffusion weighted imaging was very helpful to diagnose infarction in early stage. Left middle cerebral artery was the most common artery to be involved. Supportive therapy and symptomatic treatment were the main methods in the acute stage of neonatal cerebral infarction. Those babies with poor prognosis mostly had large infarction involving cerebral hemisphere, thalamus and basal ganglia. Neonatal cerebral infarction was a severe brain injury affecting long tern nervous system prognosis. Perinatal hypoxia was the most common high-risk factor and seizure was the most frequent initial symptom. Diffusion weighted imaging was valuable to diagnose infarction in early stage. Most of infants with poor prognosis had large infarction involving hemisphere, thalamus and basal ganglia. Early diagnosis with brain imaging would be helpful for rehabilitation therapy and improving prognosis.

  19. Rhino Cerebral Mucormycosis - A Case Report

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    N Eswar

    2006-01-01

    Full Text Available Rhino cerebral Mucormycosis is an opportunistic infection caused by a saprophytic fungus which is found in soil, decaying fruits and vegetables. Usually predisposing factors for this infection are poorly controlled diabetes, ketoacidosis, leukemia, immunodeficiency states, prolonged steroid therapy etc. The fungus once entering the susceptible host do cause highly invasive and fulminant infection usually with fatal outcome. Early recognition of this condition is highly essential to initiate immediate life saving measures.

  20. Aspergilloma of the brain: an overview

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    Nadkarni T

    2005-01-01

    Full Text Available Fungal infections of the central nervous system (CNS are almost always a clinical surprise. Their presentation is subtle, often without any diagnostic characteristics, and they are frequently mistaken for tuberculous meningitis, pyogenic abscess, or brain tumor. Granulocytopenia, cellular and humoral mediated immune dysfunction are predisposing factors to the development of CNS infections in immunosuppressed patients. Aspergillus fumigatus is the most common human pathogen in the genus Aspergillus .Maxillary sinusitis of dental origin or the lungs are the most common sites of primary Aspergillus infection. Infection reaches the brain directly from the nasal sinuses via vascular channels or is blood borne from the lungs and gastrointestinal tract. Single or multiple abscess formation with blood vessel invasion leading to thrombosis is a characteristic feature of Aspergillosis on neuropathologic examination. Aspergillosis should be considered in cases manifesting with acute onset of focal neurologic deficits resulting from a suspected vascular or space-occupying lesion especially in immunocompromised hosts. Aspergillosis is diagnosed on direct examinations and culture, however the diagnosis of aspergillosis of the CNS is difficult. Diagnosis of an intracranial mass lesion is best confirmed with a computed tomography or magnetic resonance imaging of the head with or without intravenous contrast. Aggressive neurosurgical intervention for surgical removal of Aspergillus abscesses, granulomas, and focally infracted brain; correction of underlying risk factors; Amphotericin B combined with flucytosine and treatment of the source of infection should form the mainstay of the management. Off late Liposomal Amphotericin B was found to be more effective and safe than conventional Amphotericin B in the management of Apergillus infections Only with a high index of suspicion, an aggressive approach to diagnosis, and rapid vigorous therapy may we hope to alter

  1. CEREBRAL METASTASES CANCER OF THE LARYNX: TWO CASE REPORTS

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    N. V. Sevyan

    2013-01-01

    Full Text Available Cerebral metastases cancer of the larynx are rare and poorly understood pathology, many questions of diagnostics and treatment of this pathology remain open. In the work presents clinical cases сerebral metastases cancer of the larynx. Special attention is paid to surgical treatment in complex with chemotherapy.

  2. Cerebral aneurysm associated with cardiac myxoma: Case Report

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    Branislava A. Ivanović

    2011-02-01

    Full Text Available Left atrial myxomas are a rare but well known cause of cerebrovascular accidents in young people. Cerebral embolism is the most common cause of cerebral ischemic stroke. The intracranial aneurysm is rarely associated with myxoma. We report the case of a patient who had an operation of PICA aneurysm due to subarachnoid hemorrhage ten months before the discovery of the large left atrial myxoma. Fortunately, the untimely diagnosis of the myxoma did not have other consequences. In order to prevent possible complications of we should keep in mind that these two apparently different entities could be associated.

  3. Cerebral Myiasis Associated with Artificial Cranioplasty Flap: A Case Report.

    Science.gov (United States)

    Giri, Sachin Ashok; Kotecha, Nitin; Giri, Deepali; Diyora, Batuk; Nayak, Naren; Sharma, Alok

    2016-03-01

    Cranioplasty is a commonly performed procedure for the repair of cranial defects. Various materials have been used for this procedure and have a good safety profile. Human cerebral myiasis is an exceedingly rare condition. It involves the invasion of live or dead human tissues by larvae of the insect species dipterous. We describe the first case of cerebral myiasis associated with an artificial cranioplasty bone flap. There was delayed cerebral cortex infestation of the species dipterous after cranioplasty with polymethyl methacrylate bone flap. The patient initially presented with an acute subdural hematoma and contaminated, comminuted frontal bone fracture that required craniectomy with interval cranioplasty at 3 months. Two years after the index procedure, the patient presented for neurosurgical follow-up because of 2 months of nonhealing ulcers and a foul smell emanating from the cranioplasty site, as well as acute onset of unilateral arm and leg weakness. Surgical exploration found live larvae invading the dura and cerebral cortex, an area that was thoroughly debrided with good outcomes for the patient. Cerebral myiasis can be managed via surgical and antibiotic therapy to obtain a good clinical outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. [A case of infected subdural hematoma accompanied by cerebral infarction].

    Science.gov (United States)

    Fujii, Norio; Naito, Yuichiro; Takanashi, Shigehiko; Ueno, Toshiaki; Nakagomi, Tadayoshi

    2013-05-01

    Infected subdural hematoma(ISH)is a rare disease caused by hematogenous infection of a preexisting subdural hematoma. We report a rare case of ISH accompanied by cerebral infarction. A 76-year-old man who had suffered a closed head injury 3 months before presented fever, headache and left hemiparesis during the medical treatment of acute cholangitis and obstructive jaundice with pancreatic cancer at the department of surgical gastroenterology. At the consultation, computed tomography(CT)scan indicated right chronic subdural hematoma. We performed a burr hole opening surgery on the same day. Abscess and hematoma was aspirated from the subdural space, and methicillin-resistant Staphylococcus aureus(MRSA)was detected in this specimen. Thus the diagnosis of the infected subdural hematoma was confirmed. However, despite the antibiotics therapy, follow-up CT showed a low-density area close to the residual abscess, which suggested cerebral infarction. Cerebral angiography showed a vasospasm at the cortical segment of the right middle cerebral artery near the residual abscess. Eventually we carried out a small craniotomy to evacuate the abscess. Our case showed that prompt surgical treatment is required in case of ISH and the whole hematoma and abscess should be removed as soon as possible with an image diagnosis and an additional surgical operation.

  5. Cerebral fat embolism. Case report and its computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Toshihisa; Sawada, Yusuke; Yukioka, Tetsuo; Nishide, Kazuyuki; Yoshioka, Toshiharu (Osaka Univ. (Japan). Faculty of Medicine)

    1982-11-01

    A case of cerebral fat embolism is reported. A 18-year-old patient with multiple bone fractures was in semicoma immediately after an injury. Brain CT showed no brain swelling or intracranial hematoma. Hypoxemia and alcoholemia were noted on admission, which returned to normal without improvement of consciousness level. In addition, respiratory symptoms with positive radiographic changes, tachycardia, pyrexia, sudden drop in hemoglobin level, and sudden thrombocytopenia developed. These symptoms were compatible with Gurd's criteria of systemic fat embolism. Eight days after injury, multiple low density areas appeared on CT and disappeared within the subsequent two weeks, and subdural effusion with cerebral atrophy developed. These CT findings were not considered due to cerebral trauma. Diagnosis of cerebral fat embolism was made. The subdural effusion was drained. Neurologic and pulmonary recoveries took place slowly and one month following the injury the patient became alert and exhibited fully coordinated limb movement. The CT scans of the present case well corresponded with hitherto reported pathological findings. Petechiae in the white matter must have developed on the day of injury, which could not be detected by CT examination. It is suggested that some petechial regions fused to purpuras and then gradually resolved when they were detected as multiple low density areas on CT. CT in the purpuras phase would have shown these lesions as high density areas. These lesions must have healed with formation of tiny scars and blood pigment which were demonstrated as the disappearance of multiple low density areas by CT examination. Cerebral atrophy and subsequent subdural effusion developed as a result of demyelination. The patient took the typical clinical course of cerebral fat embolism and serial CT scans served for its assessment.

  6. Radiology in cases of cerebral stroke

    International Nuclear Information System (INIS)

    Forsting, M.; Reith, W.; Kummer, R. von; Sartor, K.

    1993-01-01

    Today radiologic methods play an important role in the diagnosis of cerebral stroke. The aim of the radiologist, however, should not only be to classify the stroke into the four main categories (ischemic stroke, intracerebral bleeding, subarachnoid hemorrhage, sinovenous thrombis), but also to interprete the findings with regard to the etiology of the disease. The pattern of lesions gives information about the etiology of ischemic stroke; the correct interpretation of these lesion patterns allows one to optimize therapeutic decisions. This paper additionally focusses on the differential diagnosis of intracerebral hemorrhage and the CT and MR signs of sinovenous thrombosis. New developed concepts in the field of stroke therapy and prophylaxis call for authority and continuous education of the radiolgist on this topic. Pure descriptions of radiologic findings without an understanding of the pathogenesis of the disease will be ignored by the clinician. On the other hand, the radiologist can turn the therapeutic decisions in the right direction by combining morphological descriptions with pathogenetic orientated interpretations. In this way, the radiolgist can contribute to the reduction of costs in the public health system. (orig.) [de

  7. [A case of severe asthma exacerbation complicated with cerebral edema and diffuse multiple cerebral micro-bleeds].

    Science.gov (United States)

    Ohkura, Noriyuki; Fujimura, Masaki; Sakai, Asao; Fujita, Kentaro; Katayama, Nobuyuki

    2009-08-01

    A 36-year-old woman was admitted to the Intensive Care Unit for the treatment of severe asthma exacerbation. Her condition of asthma improved with systemic glucocorticosteroids, inhaled beta2-agonist, intravenous theophylline and inhaled anesthesia (isoflurane) under mechanical ventilation. Her consciousness was disturbed even after terminating isoflurane. Brain CT and MRI scan showed cerebral edema and diffuse multiple cerebral micro-bleeds. Glyceol, a hyperosmotic diuretic solution consisting of 10% glycerol and 5% fructose in saline, was administered to decrease cerebral edema. Her consciousness disturbance gradually recovered. Cerebral edema and hemorrhage improved. On the 69th hospital day, she was discharged from hospital without sequelae. This case is a rare one in which severe asthma exacerbation was complicated with cerebral edema and diffuse multiple cerebral hemorrhage. Inhaled anesthesia for asthma exacerbation should be used carefully to avoid delay of diagnosis of central nervous system complications.

  8. Fatal Cerebral Air Embolism: A Case Series and Literature Review

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    Rashmi Mishra

    2016-01-01

    Full Text Available Cerebral air embolism (CAE is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful. Retrograde rise of venous air to the cerebral circulation was the likely mechanism for venous CAE. The second patient was a 46-year-old female presenting with fever, shortness of breath, and hematemesis. She was febrile, tachypneic, and tachycardic and required intubation and mechanical ventilation. An orogastric tube inserted drained 2500 mL of bright red blood. Flexible laryngoscopy and esophagogastroduodenoscopy were performed. She also underwent central venous catheter placement. CT scan of head performed the next day due to absent brain stem reflexes revealed intravascular air within cerebral arteries. A transthoracic echocardiogram with bubble study ruled out patent foramen ovale. The patient had a paradoxical CAE in the absence of a patent foramen ovale.

  9. Cerebral metastasis masquerading as cerebritis: A case of misguiding history and radiological surprise!

    Directory of Open Access Journals (Sweden)

    Ashish Kumar

    2013-01-01

    Full Text Available Cerebral metastases usually have a characteristic radiological appearance. They can be differentiated rather easily from any infective etiology. Similarly, positive medical history also guides the neurosurgeon towards the possible diagnosis and adds to the diagnostic armamentarium. However, occasionally, similarities on imaging may be encountered where even history could lead us in the wrong direction and tends to bias the clinician. We report a case of a 40-year-old female with a history of mastoidectomy for otitis media presenting to us with a space occupying lesion in the right parietal region, which was thought pre-operatively as an abscess along with the cerebritis. Surprisingly, the histopathology proved it to be a metastatic adenocarcinoma. Hence, a ring enhancing lesion may be a high grade neoplasm/metastasis/abscess, significant gyral enhancement; a feature of cerebritis is not linked with a neoplastic etiology more often. This may lead to delayed diagnosis, incorrect prognostication and treatment in patients having coincidental suggestive history of infection. We review the literature and highlight the key points helping to differentiate an infective from a neoplastic pathology which may look similar at times.

  10. Imaging manifestation of cerebral gumma: report of 3 cases

    International Nuclear Information System (INIS)

    Wen Ming; Miao Tizong; Zheng Luping; Zhang Shilin

    2003-01-01

    Objective: To evaluate the imaging manifestations of cerebral gumma. Methods: Three cases of surgically proved cerebral gumma were analyzed. All patients had history of ultra-marriage sexual life, and the laboratory tests, including the serums and/or the cerebrospinal fluid test, highly indicated the diagnosis of syphilis. Pathological results demonstrated cerebral gumma after operation. Results: On CT scan, case 1 showed a 5.0 cm x 3.5 cm hypo-density area at left temporal lobe with obvious mass effect, and post-contrast CT scan revealed a rim enhancement. MR scanning was not performed. In case 2, a mixture lesion was detected on right frontal lobe on pre-contrast CT scan, and spot-like central enhancement and mild mass effect were demonstrated on postcontrast CT scan. Pre-contrast T 1 WI showed 2 round lesions situated at right frontal lobe (1.5 cm in diameter) and right periventricular areas (1.0 cm in diameter), separately, which showed iso-signal on T 1 WI and hyper-signal on T 2 WI, and ring-like enhancement with slight compression of the right lateral ventricle. In case 3, CT plain scan demonstrated multiple hypo-dense lesions, most of the lesions located on both frontal lobe and left temporal lobe, and enhanced CT scan was not performed. MR imaging revealed many nodule and mass lesions with hypo-signal on T 1 WI and hyper-signal on T 2 WI, located on both hemispheres with nodular or circular enhancement after injection of contrast media. Conclusion: The imaging manifestations of cerebral gumma were nonspecific. Thus, the preoperational diagnosis should be made combining the clinical, laboratory, and imaging data

  11. Cerebral cysticercosis: a review of 42 cases

    International Nuclear Information System (INIS)

    Machado, M.A.; Costa, G.

    1992-01-01

    Forty-two cases of cysticercosis involving the central nervous system using computed tomography are reviewed. The types of involvement were classified according to an evolutionary phase of the larva and its tomographic appearance. Four main types were identified: Type I - seven patients - cysts of several sizes with discrete or no enhancement which correspond to young cysticerci; Type II - nine patients - cystic lesions with ring enhancement with dense walls representing the initial regressive phase of the parasite associated to an adjacent oedema; Type III - three patients - calcifications, mainly intraparenchymatous, presenting enhancement in the periphery without associated oedema; Type IV - two patients - calcifications with no oedema nor enhancement, signifying a residual lesion produced by the parasite. Multiple lesions were present in 26 cases and about 50% of all patients suffered combined forms of neuro cysticercosis. (author)

  12. Obsessive Compulsive Disorder Case Following Cerebral Ischemia

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    Semra Bilge

    2011-09-01

    Full Text Available Obsessive compulsive disorder is characterised by recurrent, unwanted, distressing thoughts, images, impulses and associated behaviours which generally emerge in the 2nd or 3rd decades of life. Elderly onset cases are rare. A 71 year old patient was admitted to our hospital because of left-sided weakness. Neurological examination revealed left hemiparesis, mild dysphasia and anosognosia. Using cranial magnetic resonance, infarcts were found in the MCA territories, in the posterior portion of the middle temporal gyrus supplied by the cortical (inferior branch and in the internal capsule, globus pallidus and putamen portions supplied by the lenticolostriate branch. An occlusion was also present in the right internal carotid artery (ICA. Fifteen days after presentation he developed an abnormal fear of urine contamination. He showered and handwashed excessively and exhibited insomnia and anxiety. The patient knew that his behaviour was ridiculous but could not prevent it. Formal neuropsychological testing found his simple attention to be mildly impared. His visuospatial function and construction abilities were also impaired. Obsessive compulsive disorder is usually an early onset disease. However this report seeks to draw attention to late-onset cases such as this, which are due to a cerebrovascular disorder.

  13. [Cerebral gigantism. Review of the literature apropos of one case].

    Science.gov (United States)

    Maes, B; Caron, J; Couchot, J; Gross, A; Leutenegger, M

    The authors report a case of cerebral gigantism and review 83 cases found in the world literature. The diagnosis depends on the association of several factors, none of which alone are specific but which, on the whole, form a fairly characteristic picture. Large size at birth, leading only rarely to gigantism at adult age. Facial dysmorphia of acromegaloid type. Ecephalopathy with mental deficiency without any neuroradiological abnormality. Finally, endocrine investigations and somatotropic function were normal. No etiology has been found up to now. The most satisfactory theory is that of a hypothalamopituitary disturbance. Treatment may simple avoid excess height at adult age and is based on sex hormone therapy to accelerate bony maturation.

  14. Cerebral cysticercosis. A case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Tuch, P.S.; Saffer, D. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Neurology)

    1984-02-11

    Two cases of histologically proven cerebral cysticercosis are presented. In both cases subcutaneous tissue nodules, a rare feature, were present. Several disease patterns are apparent - meningeal, parenchymatous and ventricular, spinal cord lesions and mixed patterns. Epilepsy is by far the major presenting symptom of cysticercosis, which in turn plays a significant role in the causation of adult-onset epilepsy in Blacks. Despite its drawbacks, the haemag-glutination inhibition test remains the most satisfactory serological method at present available for the diagnosis of cysticercosis; it is positive in up to 85% of cases of proven cysticercosis. With the advent of computed tomography many cases of unsuspected cysticercosis (symptomatic or asymptomatic) are being discovered.

  15. Reversible cerebral vasoconstriction syndrome precipitated by airplane descent: Case report.

    Science.gov (United States)

    Hiraga, Akiyuki; Aotsuka, Yuya; Koide, Kyosuke; Kuwabara, Satoshi

    2017-10-01

    Background Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by segmental vasospasm. Vasoactive agents and childbirth have been reported as precipitating factors for RCVS; however, RCVS induced by altitude change or air travel has rarely been reported. Case We present a case of a 74-year-old woman who presented with thunderclap headache during airplane descent. Magnetic resonance angiography demonstrated segmental vasoconstriction that improved 9 days after onset. Conclusion These findings indicate that airplane descent may be a trigger of RCVS. The time course of headache in the present case was similar to that of prolonged headache attributed to airplane travel, indicating that RCVS during air travel may have previously been overlooked and that some headache attributed to airplane travel cases may represent a milder form of RCVS.

  16. Cerebral salt wasting: a report of three cases

    International Nuclear Information System (INIS)

    Younas, H.; Sabir, O.; Tarif, N.

    2015-01-01

    Hyponatremia secondary to the Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH) secretion is commonly observed in patients with various neurological disorders. Cerebral Salt Wasting (CSW) resulting in hyponatremia is also an infrequent occurrence in some patients with neurological disorders. Confusion in differentiating CSW from SIADH may arise since both results in similar electrolyte disturbances. Herein, we report three cases of CSW with intracranial afflictions. CSW was diagnosed on the basis of fractional excretion of urinary sodium and uric acid along with extremely low serum uric acid. Improvements in serum sodium levels after saline hydration and fludrocortisone administration further supported the diagnosis. (author)

  17. Cerebral hemorrhage without manifest motor paralysis. Reports of 5 cases

    Energy Technology Data Exchange (ETDEWEB)

    Taketani, T.; Dohi, I.; Miyazaki, T.; Handa, A. (Central Hospital of JNR, Tokyo (Japan))

    1982-01-01

    Before the introduction of computerized tomography (CT) there were some cases of intracerebral bleeding who were wrongly diagnosed as hypertensive encephalopathy or senile psychosis. We here report 5 cases who did not show any sign of motor paralysis. The clinical aspects of these cases were nausea and vomiting with dizziness (case 1), nausea and vomiting with slight headache (case 2), agnosia of left side with several kinds of disorientation (case 3), nausea and vomiting (case 4), and visual disturbance of right, lower quadrant (case 5). All of these cases showed no motor paralysis or abnormal reflex activities. By examination with CT each of them exhibited a high density area in the subcortical area of the right parietal lobe, the subcortical area of the right occipital lobe, the right temporal and parietal lobe, rather small portion of the left putamen and external capsule, and the subcortical area of left occipital lobe, respectively. Patients of cerebral hemorrhage without motor or sensory disturbances might often be taken for some psychic abnormality. We here have emphasized the importance of CT in such a group of patients. But for this technique, most of them would not be given adequate treatment and might be exposed to lifethreatening situations.

  18. Cerebral cavernous angioma. 16 cases. Aspects in CT and MR

    International Nuclear Information System (INIS)

    Pina, J.I.; Medrano, J.; Lasierra, R.; Benito, J.L. de; Feijoo, R.; Fernandez, J.A.; Villavieja, J.L.

    1995-01-01

    The cerebral cavernous angioma (CA) is included in the group of cerebral malformations that can not be detected angiographically. We present the retrospective study of 16 patients, diagnosed as having CA, comparing the data provided by CT and MR, as well as the contribution of cerebral angiography. (Author) 25 refs

  19. Comparatively rare case of a child-patient's cerebral echinococcus

    International Nuclear Information System (INIS)

    Todorov, A.; Simova, E.; Traykova, N.; Stoev, D.; Danev, V.

    2012-01-01

    Full text: Echinococcosis is a parasitic condition with a wide spread in Bulgaria. The possibility of an extensive as well as various localization of the cysts is vastly accounted for. However, according to book references and data available, and medical practice, the brain is somewhat one of the loci with a rare occurrence. The authors panel has taken into consideration the case of an eight-year-old male, who was diagnosed through CT scan with a large cystic lesion in the left cerebral hemisphere with a temporal and parietal localization, as well as a partial destruction of the adjacent pyramid. The presence of an echinococcal cyst has been established through methods of surgical intervention, as well as histologic sample examination. The authors demonstrate the complete anatomical recovery of the encephalic structures of the patient through an ensuing routine CT scan

  20. Cerebral venous sinus thrombosis on MRI: A case series analysis

    Directory of Open Access Journals (Sweden)

    Sanjay M Khaladkar

    2014-01-01

    Full Text Available Background: Cerebral venous sinus thrombosis (CVST is a rare form of stroke seen in young and middle aged group, especially in women due to thrombus of dural venous sinuses and can cause acute neurological deterioration with increased morbidity and mortality if not diagnosed in early stage. Neurological deficit occurs due to focal or diffuse cerebral edema and venous non-hemorrhagic or hemorrhagic infarct. Aim and Objectives: To assess/evaluate the role of Magnetic Resonance Imaging (MRI and Magnetic Resonance Venography (MRV as an imaging modality for early diagnosis of CVST and to study patterns of venous thrombosis, in detecting changes in brain parenchyma and residual effects of CVST using MRI. Materials and Methods: Retrospective descriptive analysis of 40 patients of CVST diagnosed on MRI brain and MRV was done. Results: 29/40 (72.5% were males and 11/40 (27.5% were females. Most of the patients were in the age group of 21-40 years (23/40-57.5%. Most of the patients 16/40 (40% presented within 7 days. No definite cause of CVST was found in 24 (60% patients in spite of detailed history. In 36/40 (90% of cases major sinuses were involved, deep venous system were involved in 7/40 (17.5% cases, superficial cortical vein was involved in 1/40 (2.5% cases. Analysis of stage of thrombus (acute, subacute, chronic was done based on its appearance on T1 and T2WI. 31/40 (77.5% patients showed complete absence of flow on MRV, while 9/40 (22.5% cases showed partial flow on MR venogram. Brain parenchyma was normal in 20/40 (50% patients while 6/40 (15% cases had non-hemorrhagic infarct and 14/40 (35% patients presented with hemorrhagic infarct. Conclusion: Our study concluded that MRI brain with MRV is sensitive in diagnosing both direct signs (evidence of thrombus inside the affected veins and indirect signs (parenchymal changes of CVST and their follow up.

  1. A case of chronic subdural hematoma associated with an unruptured cerebral aneurysm detected by cerebral computed angiotomography

    International Nuclear Information System (INIS)

    Fukui, Keiji; Sadamoto, Kazuhiko; Ohue, Shiro; Takeda, Sadanori; Kimura, Hideki; Sakaki, Saburo.

    1986-01-01

    One case of chronic subdural hematoma associated with an unruptured cerebral aneurysm detected by cerebral computed angiotomography is reported. A 44-year-old female slipped and hit her head without loss of consciousness, one month ago. Recently she complained of headaches and visited the department of Neurosurgery, Washokai Sadamoto Hospital on May 21, 1985. There were no physical and neurological signs on examination. Plain CT scans showed a crescent-shaped high density area in the left frontal region with a slight mass sign. She was diagnosed as having a possible chronic subdural hematoma and further examination was recommended. Biplane ultrafast overlapping cerebral computed angiotomograms clearly demonstrated a so-called avascular area delineated by enhanced superficial cerebral vessels with contrast medium. Furthermore, a marked high density mass measuring 8 mm x 10 mm x 6 mm in diameters was simultaneously demonstrated around the right anterior clinoid process on the same image, suggesting a cerebral aneurysm. Right carotid angiograms showed a right internal carotid-posterior communicating junction aneurysm. The irrigation of the left chronic subdural hematoma was carried out on May 24 and the neck clipping of the right IC-PC junction aneurysm was done two weeks later. During the operation, there were no findings suggesting a previous subarachnoid hemorrhage from the aneurysm, but a bleb was found on the aneurysm. The post-operative course was uneventful. (J.P.N.)

  2. Cerebral venous sinus thrombosis in HIV-infected patients: report of 2 cases.

    Science.gov (United States)

    Mwita, Julius Chacha; Baliki, Kgomotso; Tema, Ludo

    2013-01-01

    Infection with the human immunodeficiency virus (HIV) is associated with increased risk of cerebrovascular disease; however Cerebral Venous Sinus Thrombosis (CVST) is rarely associated with HIV-related cerebrovascular events. We describe two cases of HIV-positive patients who, at the same time, presented to our hospital with deep cerebral venous thrombosis and stroke.

  3. Cerebral Toxoplasmosis in HIV/AIDS: A case report | Bedu-Addo ...

    African Journals Online (AJOL)

    This is a case of HIV infection with cerebral toxoplasmosis. Cerebral toxoplasmosis is an AIDS- related infection and is one of the causes of CNS mass lesions in AIDS. A 36-year-old male was admitted at Komfo Anokye Teaching Hospital (KATH) for a week. He had focal seizures for which he was treated as an “epileptic” ...

  4. Cerebral Venous Thrombosis and Headache--A Case-Series.

    Science.gov (United States)

    Sparaco, Marco; Feleppa, Michele; Bigal, Marcelo E

    2015-06-01

    Headache happens in the majority of patients with Cerebral Venous Thrombosis (CVT) being sometimes the sole manifestation of the disease. Herein we report a case-series of CVT, focusing on headache characteristics. Etiological, clinical, and radiological features of 25 consecutive adult patients with CVT were compiled from August 2005 to December 2013. Diagnosis of CVT was confirmed by brain magnetic resonance imaging and magnetic resonance venography. All patients underwent extensive systematic etiological and genetic work-up at admission. A structured questionnaire about the characteristics of headache was responded by all participants. Headache was reported by 23 out of 25 (92%) of participants, being by far the most frequent symptom. It was the sole manifestation in nearly one third of the patients (8/25, 32.0%). Headache was typically severe (19/23, 82.6%) and throbbing (16/23, 69.5%), with sudden onset (13/23, 56.5%) and non-remitting (20/23, 86.9%) characteristics. The sinus most frequently involved was the transverse sinus (24/25, 96.0%), either alone or in association with other sinuses. Headache is the most frequent symptom and sometimes the sole presentation of CVT. © 2015 American Headache Society.

  5. Traumatic occlusion of the anterior cerebral artery--case report.

    Science.gov (United States)

    Ishibashi, A; Kubota, Y; Yokokura, Y; Soejima, Y; Hiratsuka, T

    1995-12-01

    A 71-year-old female presented with posttraumatic occlusion of the anterior cerebral artery (ACA) after a road accident in which she was hit in the mid-frontal region. Initial computed tomography (CT) demonstrated frontal skull fractures and pneumocephalus. High density areas were also identified in the right basal cisterns, suggesting traumatic subarachnoid hemorrhage. She was alert on admission, but with attendant shock due to crush wounds. Her condition rapidly deteriorated and an emergency amputation of her left leg was performed. After aggressive treatment with transfusion and infusion, her systolic pressure increased to 120 mmHg. Her consciousness remained disturbed. Serial CT disclosed hemorrhagic infarction in the entire medial side of the right frontal lobe. Magnetic resonance angiography demonstrated decreased flow voids in the bilateral A1 segments and right ACA, and a basilar artery aneurysm, which was unruptured clinically. Three weeks after the injury, she regained consciousness. Six months later, she had motor aphasia and left upper extremity weakness. The clinicopathological mechanism causing the traumatic occlusion of the ACA in the present case was probably dissecting aneurysm.

  6. [Takayasu arteritis and cerebral venous thrombosis: report of a case].

    Science.gov (United States)

    Rodríguez de Mingo, E; Riofrío Cabeza, S; Villa Albuger, T; Velasco Blanco, M J

    2014-01-01

    Palpitations, paresthesias and anxiety are very common reasons of consultation in primary care. We report the case of a 40 year-old Caucasian woman who came to the clinic due to these symptoms, and was finally diagnosed with Takayasu arteritis. Later, she had an episode of headache, as the initial manifestation of cerebral venous thrombosis. Takayasu arteritis is a systemic vasculitis affecting medium and large arteries, mainly leacausing stenosis of the aorta and its branches. It most frequently affects Asian women, being much rarer in Europe. The primary care doctor plays a key role in the initial diagnosis and monitoring of patients with rare diseases, such as Takayasu arteritis, and must be a basic support for the patient and family, providing information and advice, and contributing with his work to reduce the vulnerability of this group. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  7. Cerebral edema associated to scorpion sting: a two-case sting report

    Directory of Open Access Journals (Sweden)

    N. O. Romero

    2005-12-01

    Full Text Available Scorpionism is a public health problem in some places in Mexico. The clinical symptoms of envenomation by scorpion sting are by sympathetic and parasympathetic stimulation, developing systemic and local symptoms. The Central Nervous System (CNS is one of the organs that are affected. In some cases, cerebral edema develops. In this report we present two pediatric cases with the association of envenomation by scorpion sting and cerebral edema. The first case developed severe cerebral edema, which progressed to a fatal outcome; and the other case developed mild cerebral edema with a satisfactory evolution. The pathophysiology of this complication is not well known and probably is the consequence of hypoxia, secondary to respiratory failure, laryngospasm and seizures that are manifestations of envenomation by scorpion sting.

  8. Case Report of a 52 Year Old Hypertensive with Cerebral ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    inability to move the left side of his body and other neurologic features suggestive of a right hemispheric ischaemic stroke. Brain. CT showed features of cerebral toxoplasmosis and .... Foundation for Education and Research. ofN eurological ...

  9. Case report Malaria: A cerebral approach | Court | Continuing ...

    African Journals Online (AJOL)

    An increasing number of patients with severe complicated Plasmodium falciparum malaria are presenting to South African hospitals, having travelled through malariaendemic countries from Central and East Africa. This report concerns an immigrant from Pakistan who developed severe cerebral malaria.

  10. Cerebral venous thrombosis after spinal anesthesia: case report

    Directory of Open Access Journals (Sweden)

    Flora Margarida Barra Bisinotto

    2017-05-01

    Full Text Available Introduction: Cerebral venous thrombosis (CVT is a rare but serious complication after spinal anesthesia. It is often related to the presence of predisposing factors, such as pregnancy, puerperium, oral contraceptive use, and malignancies. Headache is the most common symptom. We describe a case of a patient who underwent spinal anesthesia and had postoperative headache complicated with CVT. Case report: Male patient, 30 years old, ASA 1, who underwent uneventful arthroscopic knee surgery under spinal anesthesia. Forty-eight hours after the procedure, the patient showed frontal, orthostatic headache that improved when positioned supine. Diagnosis of sinusitis was made in the general emergency room, and he received symptomatic medication. In subsequent days, the headache worsened with holocranial location and with little improvement in the supine position. The patient presented with left hemiplegia followed by tonic–clonic seizures. He underwent magnetic resonance venography; diagnosed with CVT. Analysis of procoagulant factors identified the presence of lupus anticoagulant antibody. The patient received anticonvulsants and anticoagulants and was discharged on the eighth day without sequelae. Discussion: Any patient presenting with postural headache after spinal anesthesia, which intensifies after a plateau, loses its orthostatic characteristic or become too long, should undergo imaging tests to rule out more serious complications, such as CVT. The loss of cerebrospinal fluid leads to dilation and venous stasis that, coupled with the traction caused by the upright position, can lead to CVT in some patients with prothrombotic conditions. Resumo: Introdução: A trombose venosa cerebral (TVC é uma complicação rara, mas grave, após raquianestesia. Está frequentemente relacionada com a presença de fatores predisponentes, como gestação, puerpério, uso de contraceptivos orais e doenças malignas. O sintoma mais frequente é a cefaleia

  11. Multiple small hemorrhagic infarcts in cerebral air embolism: a case report.

    Science.gov (United States)

    Togo, Masaya; Hoshi, Taku; Matsuoka, Ryosuke; Imai, Yukihiro; Kohara, Nobuo

    2017-11-16

    Cerebral air embolism is a rare cause of cerebral infarction. In cerebral air embolism, T2 star-weighted imaging shows numerous spotty hypointense signals. Previous reports have suggested that these signals represent air in the brain and are gradually diminished and absorbed. We experienced two cases of cerebral air embolism, and in one of them, we conducted an autopsy. Case 1 was a 76-year-old Japanese man with lung cancer and emphysema. A spasmodic cough induced massive cerebral and cardiac air embolisms and the patient died because of cerebral herniation. T2 star-weighted imaging of brain magnetic resonance imaging showed multiple spotty low signals. Brain autopsy showed numerous spotty hemorrhagic infarcts in the area of T2 star-weighted imaging signals. Case 2 was an 85-year-old Japanese man with emphysema who suffered from acute stroke. Similar spotty T2 star-weighted imaging signals were observed and remained unchanged 2 months after the onset. These findings indicate that T2 star-weighted imaging in cerebral air embolism partially represents micro-hemorrhagic infarction caused by air bubbles that have migrated into the brain.

  12. Reversible Cerebral Vasoconstriction Syndrome in Pediatrics: A Case Series and Review.

    Science.gov (United States)

    Coffino, Samantha W; Fryer, Robert H

    2017-06-01

    Reversible cerebral vasoconstriction syndrome is a transient vasculopathy associated with severe headaches and stroke. In most cases of reversible cerebral vasoconstriction syndrome, there is a precipitating event or trigger, such as pregnancy, serotonin agonist treatment or illicit drug use. The authors present 2 pediatric cases of reversible cerebral vasoconstriction syndrome and review the previous 11 pediatric cases in the literature. In many instances, the clinical and radiographic features are similar in both pediatric and adult cases. In the pediatric group, reported potential triggers include trauma (1/13), exercise (2/13), water to the face (3/13), hypertension (3/13), and medication or substance use (4/13). One surprising difference is that 11 out of 13 pediatric patients with reversible cerebral vasoconstriction syndrome are male while most cases in adults are female. Many of the pediatric patients with reversible cerebral vasoconstriction syndrome were treated with a calcium channel blocker and the overall outcome of pediatric reversible cerebral vasoconstriction syndrome was good, with most patients experiencing a full recovery.

  13. Two Cases of Cerebral Air Embolism That Occurred during Esophageal Ballooning and Endoscopic Retrograde Cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Suyeon Park

    2016-03-01

    Full Text Available Cerebral air embolism is an extremely rare complication of endoscopic procedure and often life threatening. We present two cases of cerebral infarction due to air embolization caused by an endoscopic intervention. The first case occurred during esophageal balloon dilatation for the treatment of a stricture of an anastomosis site in a 59-year-old man and the second case occurred during endoscopic papillary balloon dilatation in a 69-year-old man who had distal common bile duct stones. After the procedure, cardiopulmonary instability and altered mental status were observed in both patients, and cerebral air embolism was diagnosed in both cases. Hyperbaric oxygen therapy was started in the first case, and high FiO2 therapy was applied in the second case. Although this complication is rare, patient outcomes can be improved if physicians are aware of this potential complication, and immediately begin proper management.

  14. Transient global amnesia after cerebral angiography still occurs: Case report and literature review

    DEFF Research Database (Denmark)

    Foss-Skiftesvik, Jon; Snoer, Agneta Henriette; Wagner, Aase

    2014-01-01

    Transient global amnesia is considered a very rare complication of diagnostic cerebral angiography, and has only been reported in a limited number of case reports more than 15 years ago. We describe a patient experiencing transient global amnesia following cerebral digital subtraction angiography....... While the condition by definition is self-limiting, its differential diagnoses may cause severe morbidity and/or mortality if left untreated. It is therefore important to build and maintain awareness of transient global amnesia as a possible complication of cerebral angiography....

  15. Association Between Anemia and Cerebral Venous Thrombosis: Case-Control Study

    NARCIS (Netherlands)

    Coutinho, Jonathan M.; Zuurbier, Susanna M.; Gaartman, Aafke E.; Dikstaal, Arienne A.; Stam, Jan; Middeldorp, Saskia; Cannegieter, Suzanne C.

    2015-01-01

    Anemia is often considered to be a risk factor for cerebral venous thrombosis (CVT), but this assumption is mostly based on case reports. We investigated the association between anemia and CVT in a controlled study. Unmatched case-control study: cases were adult patients with CVT included in a

  16. UNILATERAL ACTINOMYCOTIC TUBO-OVARIAN ABSCESS COMPLICATED WITH CEREBRITIS – A CASE REPORT

    OpenAIRE

    Marina Jakimovska; Borut Kobal

    2018-01-01

    Background: Tuboovarian abscess is a serious complication of pelvic inflammatory disease. Pelvic ac- tinomycosis may correlate with long term use of intra-uterine device (IUD), but is uncom- mon cause of inflammation, except in postmenopausal IUD users.1, 2 Tuboovarian abscess complicated with cerebritis is relatively uncommon condition. Methods: We present a rare case of a 56-years-old woman with IUD, developing tuboovarian abscess that complicated with cerebritis. Twenty days before adm...

  17. Radiosurgery for cerebral arteriovenous malformation during pregnancy: A case report focusing on fetal exposure to radiation

    OpenAIRE

    Nagayama, Kazuki; Kurita, Hiroki; Tonari, Ayako; Takayama, Makoto; Shiokawa, Yoshiaki

    2010-01-01

    Introduction: We present the case of a pregnant woman who underwent linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) and we discuss the fetal exposure to radiation. Clinical Presentation: A 20-year-old woman at 18 weeks of gestation presented with right cerebral hemorrhage and underwent urgent evacuation of the hematoma. She recovered well after surgery, but cerebral angiography after the surgery revealed a small deeply seated arteriovenous malformation (AVM) in the right fron...

  18. Sotos syndrome (cerebral gigantism: analysis of 8 cases

    Directory of Open Access Journals (Sweden)

    Melo Débora Gusmão

    2002-01-01

    Full Text Available Sotos syndrome or cerebral gigantism is characterized by macrocephaly, overgrowth, mental retardation and central nervous system abnormalities. Congenital heart defects may be present. We report 8 patients with this syndrome and relate their clinical features, neuroimaging and echocardiographic findings.

  19. Cerebral Venous-Sinus Thrombosis: A Case Series Analysis

    Directory of Open Access Journals (Sweden)

    Nahid Ashjazadeh

    2011-09-01

    Full Text Available Background: Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women. Methods: We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated. Results: The patients' mean age was 34.01±10.25. Eighty seven (70.16% were women and 37 (29.83% were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven (65.51% women took oral contraceptive pills. Twenty of 57 women (35.08% took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area (70.96%. High mortality and morbidity rates (14.51% and 35.48%, respectively were found in patients. Poor prognostic factors at the time of admission were stupor and coma (P=0.001 and evidence of hemorrhage in primary CT scan (P=0.005. Conclusion: Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it

  20. A Case of Apoplexy of Rathke’s Cleft Cyst Followed by Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    Yu-ichiro Ohnishi

    2015-01-01

    Full Text Available Rathke’s cleft cyst (RCC apoplexy is a rare clinical entity. We report a case of apoplexy of an RCC followed by cerebral infarction. A 67-year-old woman was found lying on the street unconscious. She had fallen from her motorbike. On referral to our hospital she gradually regained consciousness and presented with no neurological deficits. CT showed a round and slightly hyperdense area in the suprasellar region. However, the attending physician did not find this abnormal finding on CT and the patient was discharged the same day. Thirteen days after the first emergency visit she developed left hemiparesis and dysarthria. CT showed a round hypodense area in the suprasellar region. The change of the density in the suprasellar region on CT suggested the pituitary apoplexy. CT also showed a low density area in the territory of the right middle cerebral artery, which indicated the cerebral infarction. MR angiography revealed poor visibility and stenotic changes of right middle cerebral arteries. Transsphenoidal surgery was performed. Histopathological findings confirmed a hemorrhagic RCC. Postoperative MR angiography showed that the visibility and stenosis of right middle cerebral arteries were recovered. This is the rare case of apoplexy of an RCC followed by cerebral infarction.

  1. Epilepsy course in cerebral gangliogliomas: a study of 16 cases.

    Science.gov (United States)

    Casazza, M; Avanzini, G; Broggi, G; Fornari, M; Franzini, A

    1989-01-01

    From November 1979 to March 1988, 16 patients with cerebral gangliogliomas were investigated and underwent surgery at the Institute Neurologico "C. Besta" of Milan. Their age varied from 11 to 48 years. 15 of these patients presented with a seizure as the first and often the only neurological symptom. This report deals with the epileptologic and neuroradiologic features of these patients before and after surgical treatment.

  2. CT study of infantile cerebral vitamin B1 deficiency (analysis of 22 cases)

    International Nuclear Information System (INIS)

    Liu Bin; Xi Meifang; Wang Mengding; Wang Chaoxiu

    1998-01-01

    Purpose: To study the CT features of infantile cerebral vitamin B 1 deficiency. Methods: The authors retrospectively reviewed the clinical manifestations and CT findings of 22 cases of infantile vitamin B 1 deficiency. Results: The main clinical signs were seizure malaise dullness and vomiting. CT scans showed bilateral symmetrical hypodense foci in lenticular nucleus (20/22), head of caudate nucleus (15/22), thalamus (3/22), anterior limb of internal capsule (4/22), external capsule (1/22) and para-ventricle white matter (2/22), and in many cases, signs of cerebral atrophy. 22 cases received thiamine treatment and were fully recovered. Conclusion: The authors concluded that bilateral symmetric hypodense foci in lenticular nucleus thalamus, head of caudate nucleus, anterior limb of internal capsule, external capsule and para-ventricle white matter were important CT signs suggestive of infantile cerebral vitamin B 1 deficiency

  3. Pulmonary cavitary mass containing a mural nodule: differential diagnosis between intracavitary aspergilloma and cavitating lung cancer on contrast-enhanced computed tomography

    International Nuclear Information System (INIS)

    Park, Y.; Kim, T.S.; Yi, C.A.; Cho, E.Y.; Kim, H.; Choi, Y.S.

    2007-01-01

    Aim: The objective of this study was to identify whether there were any significant differences in the computed tomography (CT) findings of an intracavitary aspergilloma and a cavitating lung cancer containing a mural nodule. Materials and methods: The CT and histopathological findings of 12 patients (male:female ratio 3:9; aged 51-76 years) with cavitating lung cancer containing a mural nodule and 26 patients (male:female ratio 14:12; aged 29-72 years) with intracavitary aspergilloma were retrospectively reviewed. Results: The mural nodules within cavitating lung cancer were more enhanced (p < 0.001) and showed a nondependent location more frequently (p = 0.012) than those of intracavitary aspergillomas. The cavitary walls were thicker in cavitating lung cancer (mean 5.8 mm thick) than those in intracavitary aspergillomas (mean 2.6 mm thick; p = 0.035). Adjacent bronchiectasis and volume decrease of the involved lobe were observed more frequently in intracavitary aspergillomas than in cavitating lung cancers (p < 0.001 and p = 0.008, respectively). Conclusion: Whether a mural nodule within a cavitary lesion is contrast-enhanced or not is one of the most important features in making a differential diagnosis between an intracavitary aspergilloma and a cavitating lung cancer. Assessment of dependent location of a mural nodule within the cavity and wall thickness of the cavity itself can also be helpful for differentiation

  4. Pulmonary cavitary mass containing a mural nodule: differential diagnosis between intracavitary aspergilloma and cavitating lung cancer on contrast-enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Park, Y. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of); Kim, T.S. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)]. E-mail: tskim.kim@samsung.com; Yi, C.A. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of); Cho, E.Y. [Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of); Kim, H. [Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of); Choi, Y.S. [Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)

    2007-03-15

    Aim: The objective of this study was to identify whether there were any significant differences in the computed tomography (CT) findings of an intracavitary aspergilloma and a cavitating lung cancer containing a mural nodule. Materials and methods: The CT and histopathological findings of 12 patients (male:female ratio 3:9; aged 51-76 years) with cavitating lung cancer containing a mural nodule and 26 patients (male:female ratio 14:12; aged 29-72 years) with intracavitary aspergilloma were retrospectively reviewed. Results: The mural nodules within cavitating lung cancer were more enhanced (p < 0.001) and showed a nondependent location more frequently (p = 0.012) than those of intracavitary aspergillomas. The cavitary walls were thicker in cavitating lung cancer (mean 5.8 mm thick) than those in intracavitary aspergillomas (mean 2.6 mm thick; p = 0.035). Adjacent bronchiectasis and volume decrease of the involved lobe were observed more frequently in intracavitary aspergillomas than in cavitating lung cancers (p < 0.001 and p = 0.008, respectively). Conclusion: Whether a mural nodule within a cavitary lesion is contrast-enhanced or not is one of the most important features in making a differential diagnosis between an intracavitary aspergilloma and a cavitating lung cancer. Assessment of dependent location of a mural nodule within the cavity and wall thickness of the cavity itself can also be helpful for differentiation.

  5. SMART Syndrome: Case report of a rare complication after cerebral radiation therapy

    International Nuclear Information System (INIS)

    Truntzer, P.; Salze, P.; Monjour, A.; Gaultier, C.; Ahle, G.; Guillerme, F.; Boutenbat, G.; Atlani, D.; Stilhart, B

    2012-01-01

    The authors report a 71-year-old woman case who developed, 7 years after a cerebral radiation therapy for a parieto-occipital glioblastoma, a stroke-like migraine attacks after radiotherapy syndrome (SMART syndrome), a rare complication characterized by reversible neurologic deficits with migraine described after cerebral irradiation. Transient gyri-form reversible enhancement is found on MRI during crises. This case report allows discussing the clinical, iconographic presentation and the clinical outcome of this syndrome at the light of the literature publication. (authors)

  6. Parasitic lesion of the insula suggesting cerebral sparganosis: case report

    International Nuclear Information System (INIS)

    Cummings, T.J.; Madden, J.F.; McLendon, R.E.; Gray, L.; Friedman, A.H.

    2000-01-01

    Cerebral sparganosis, a parasitic disease, rarely produces a chronic active inflammatory response in the brain. Clinically and radiographically the process may mimic a neoplasm. We report a 30-year-old man who underwent surgical exploration for a mass in the insular cortex. Histology revealed a densely fibrotic mass heavily infiltrated with plasma cells and lymphocytes, in which were embedded parasitic forms consistent with sparganosis. We describe the MRI appearances and pathologic features. Intracranial mass lesions secondary to sparganosis must be considered in patients with a history of travel to endemic areas, especially Asia. (orig.)

  7. Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report.

    Science.gov (United States)

    Saito, Yuki; Aizawa, Yoshihiro; Monno, Koyuru; Nagashima, Koichi; Kurokawa, Sayaka; Osaka, Shunji; Akimoto, Takayoshi; Kamei, Satoshi; Tanaka, Masashi; Hirayama, Atsushi

    2017-05-10

    Cardiac myxoma is known to cause repeated events of cerebral embolism. Soft and irregularly shaped myxomas with high mobility are associated with a higher occurrence of cerebral embolism. In contrast, nonmobile cardiac myxomas with a round regular shape are rarely considered to be a cause of cerebral embolism. In this case, we present a patient with recurrent cerebral embolism associated with a small and nonmobile cardiac myxoma of round regular shape. A 76-year-old Japanese man presented to our hospital with weakness in his right upper extremity. He had a history of right frontal lobe infarction in the previous month. T2-weighted magnetic resonance imaging revealed an area of hyperintensity in the left precentral gyrus, indicating acute cerebral infarction. Transthoracic echocardiography revealed normal left ventricular function and no abnormalities. However, transesophageal echocardiography showed a small and nonmobile left atrial tumor with round regular shape attached to the ostium secundum of the atrial septum. Based on these findings, we diagnosed recurrent cerebral infarction due to embolization caused by left atrial myxoma, and cardiac tumor extraction was performed on hospitalization day 36. The excised tumor measured 0.6 × 0.6 × 0.5 cm and was diagnosed as cardiac myxoma by histologic examination. Even small and nonmobile cardiac myxomas with a round regular shape may cause recurrent cerebral infarction. The diagnosis of this type of atrial myxoma is elusive and transesophageal echocardiography was an effective method of detection. In a clinical situation, this type of cardiac myxoma may be overlooked as a cause of cerebral infarction.

  8. Recovery of activity of daily living in cases of cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Yoneyama, Kimihiro (St. Marianna Univ. School of Medicine, Kawasaki, Kanagawa (Japan))

    1983-11-01

    In 96 patients with supratentorial cerebral infarction, the recovery of activity of daily living (ADL) was studied in relation to computerized tomography (CT) findings in the acute stage. The average age was 64 and 78 out of 96 were first attack cases. The cases were divided into 3 groups on the basis of the CT findings. The N group had no low density area on CT. The S group had a small deep infarct around the basal ganglia and the L group showed a large infarct with a damaged cerebral cortex. Dilatation of the ventricles was measured by the methods of Meese and Huckman. Cortical atrophy estimated by summation of width of Sylvian fissures or parietal cortical sulci, expressed in percentages. Measurements for CT were performed in the subacute stage to exclude the effects of cerebral edema. ADL was categorized in five stages using Rankin's criteria in the first week and after the eighth week. Among the 3 groups, the L group had the worst ADL when examined eight weeks later. On the contrary, the N group showed the greatest improvement. Patients under 60 years old showed better recovery at the eight week, while in most patients aged 70 or more the improvement was less evident. Dilatation of ventricles and severity of cortical atrophy increased in proportion to age, especially in cases of cerebral infarcts. In patients with ventricular dilatation or severe cerebral atrophy. ADL improvement was lower. Recovery was low in cases with narrow cortical sulci. Recovery of ADL in reattack patients was lowest and larger dilatation of the ventricles than first attack cases was recognized. The size of cerebral infarction, ADL in the first week, the dilatation of lateral ventricles, the severity of cortical atrophy and age were found to be important factors in functional recovery.

  9. Let us save the brain with cerebral oximeter: Two case reports

    Directory of Open Access Journals (Sweden)

    İlknur Suidiye Şeker

    2017-01-01

    Full Text Available In the neonates, tracheal atresia and tracheoesophageal fistula (TEF surgery may result in hemodynamic instabilization, leading to cerebral perfusion insufficiency due to the retraction of the pulmonary vessels and truncus brachiocephalicus. We represented one male and one female neonates which were performed thoracoscopic primary repair of TEF through right thoracotomy at the 3th and 4th postpartum day. Anesthesia was induced using sodium thiopental (5 mg/kg, fentanyl 4 mcg, and rocuronium (0.5 mg/kg given through intravenous route. Sevoflurane 2% and 50% O2in air were used for the maintenance therapy. During the right lung compression to expose posterior esophagus, no value was observed on the pulse oximeter (PO probe placed on the right hand, and radial artery was not palpated. At the same time, oxygen saturation was observed as 96%–97% on the left foot probe. As the right cerebral oximeter values (rSO2 were rapidly decreased to 31%, the lung compression was ceased. Right pulse oximeter and right rSO2measurements return to the baseline levels. For the second case - different from the first case -both left and right rSO2was rapidly decreased to 40% levels and return to the baseline levels after was removed the retractors. Right PO and right and left cerebral rSO2values returned to baseline immediately when the retractor compression was ended During the operations involving the great vessels in neonates, cerebral perfusion could be preserved using cerebral oximeter. Cerebral oximeter is more efficient than pulse oximeter for detecting cerebral tissue oxygenation and could be helpful to minimize neuronal damage in the neonates.

  10. Cerebral Nocardiosis in a Renal Transplant Recipient: A Case Report

    Directory of Open Access Journals (Sweden)

    Srinivas K

    2000-01-01

    Full Text Available A 53-year-old renal allograft recipient developed nocardial cerebral abscess. It manifested clinically with encephalitis, polycythemia, convulsions, syndrome of inappropriate secretion of antidiuretic hormone (SIADH and a space-occupying lesion presenting as multiple ring shadows in the left fronto-parietal lobe on computerized tomography (CT scan of the brain. The initial clinical presentation included an afebrile patient with headache, convulsions and altered sensorium with no lateralising neurological deficit. He deteriorated later and developed coma with right hemiplegia. Purulent material was drained through left frontal craniotomy, and the culture confirmed the presence of nocardial infection. Despite aggressive therapy, the patient died a few days later. We conclude that high degree of early suspicion, diagnosis and prompt treatment should be stressed.

  11. Cerebral microangiopathies

    International Nuclear Information System (INIS)

    Linn, Jennifer

    2011-01-01

    Cerebral microangiopathies are a very heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 - 30 % of all ischemic strokes. Degenerative microangiopathy and sporadic cerebral amyloid angiography represent the typical acquired cerebral microangiopathies, which are found in over 90 % of cases. Besides, a wide variety of rare, hereditary microangiopathy exists, as e.g. CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), Fabrys disease and MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis, and Stroke-like episodes). (orig.)

  12. Cerebral venous thrombosis and secondary polycythemia in a case of nephrotic syndrome.

    Science.gov (United States)

    Nagaraju, Shankar Prasad; Bairy, Manohar; Attur, Ravindra Prabhu; Sambhaji, Charudutt Jayant

    2016-03-01

    Cerebral venous thrombosis (CVT) and polycythemia are considered as rare and life threatening complications of nephrotic syndrome. We report an unusual combination of both these complications in a case of nephrotic syndrome due to minimal change disease that was treated successfully. There was prompt and complete remission of nephrotic syndrome with steroid therapy, concurrent with complete resolution of polycythemia and CVT.

  13. Cerebral venous thrombosis and secondary polycythemia in a case of nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Shankar Prasad Nagaraju

    2016-01-01

    Full Text Available Cerebral venous thrombosis (CVT and polycythemia are considered as rare and life threatening complications of nephrotic syndrome. We report an unusual combination of both these complications in a case of nephrotic syndrome due to minimal change disease that was treated successfully. There was prompt and complete remission of nephrotic syndrome with steroid therapy, concurrent with complete resolution of polycythemia and CVT.

  14. Treatment of Pusher Syndrome in a patient after extensive cerebral infarction caused by cerebral embolism - case report

    Directory of Open Access Journals (Sweden)

    Piotr Porzych

    2017-08-01

    Full Text Available Pusher Syndrome is defined as a disorder of perception of body orientation in the frontal plane. It is mainly observed in patients after stroke in consequence to damage to the right or left hemisphere of the brain. Characteristic clinical symptoms in people affected by this syndrome are leaning towards the paralyzed side of the body and building massive resistance during passive correction. The consequence of such behavior are falls in the direction of the affected side. The paper presents the case of a patient who, after extensive right hemisphere cerebral hemorrhage, was admitted to the Chair and Department of Rehabilitation Medicine of the Dr Antoni Jurasz University Hospital No.1 in Bydgoszcz to improve. During treatment the patient was used the neurorehabilitation based on the Bobath concept.

  15. Neonatal risk factors for cerebral palsy in very preterm babies: case-control study.

    Science.gov (United States)

    Murphy, D. J.; Hope, P. L.; Johnson, A.

    1997-01-01

    OBJECTIVE: To identify neonatal risk factors for cerebral palsy among very preterm babies and in particular the associations independent of the coexistence of antenatal and intrapartum factors. DESIGN: Case-control study. SETTING: Oxford health region. SUBJECTS: Singleton babies born between 1984 and 1990 at less than 32 weeks' gestation who survived to discharge from hospital: 59 with cerebral palsy and 234 randomly selected controls without cerebral palsy. MAIN OUTCOME MEASURES: Adverse neonatal factors expressed as odds ratios and 95% confidence intervals. RESULTS: Factors associated with an increased risk of cerebral palsy after adjustment for gestational age and the presence of previously identified antenatal and intrapartum risk factors were patent ductus arteriosus (odds ratio 2.3; 95% confidence interval 1.2 to 4.5), hypotension (2.3; 1.3 to 4.7), blood transfusion (4.8; 2.5 to 9.3), prolonged ventilation (4.8; 2.5 to 9.0), pneumothorax (3.5; 1.6 to 7.6), sepsis (3.6; 1.8 to 7.4), hyponatraemia (7.9; 2.1 to 29.6) and total parenteral nutrition (5.5; 2.8 to 10.5). Seizures were associated with an increased risk of cerebral palsy (10.0; 4.1 to 24.7), as were parenchymal damage (32; 12.4 to 84.4) and appreciable ventricular dilatation (5.4; 3.0 to 9.8) detected by cerebral ultrasound. CONCLUSION: A reduction in the rate of cerebral palsy in very preterm babies requires an integrated approach to management throughout the antenatal, intrapartum, and neonatal periods. PMID:9040385

  16. Numerous cerebral hemorrhages in a patient with influenza-associated encephalitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Ye; Seong, Su Ok; Park, Noh Hyuck; Park, Chan Sup [Dept. of Radiology, Myongji Hospital, Goyang (Korea, Republic of)

    2016-02-15

    Influenza-associated encephalitis (IAE) is a complication of a common disease that is rare even during an epidemic. Awareness of magnetic resonance imaging features of IAE is important in treatment planning and prognosis estimation. Several reports have described necrotizing encephalopathy in children with influenza. However, few reports have described multifocal hemorrhages in both cerebral hemispheres in adults with concomitant infection with influenza A and B. Here, we describe a case of influenza A- and B-associated encephalitis accompanied by numerous cerebral hemorrhages.

  17. A Case Associated with Comorbidities Among Cerebral Infarction, Idiopathic Thrombocytopenic Purpura, and Triple X Syndrome

    Directory of Open Access Journals (Sweden)

    Hanjun Kim

    2014-06-01

    Full Text Available A 46-year-old female presented to the emergency room due to the chief complaint of left-sided weakness. By imaging study, she was diagnosed with cerebral infarction. Thrombolytic and antiplatelet agents were not considered due to the “golden hour” for treatment having passed and a low platelet count. The peripheral blood smear, bone marrow biopsy, and aspirate findings were consistent with immune thrombocytopenic purpura. The chromosome analysis revealed the 47,XXX karyotype. To the best of our knowledge, this is the first case report associated with the comorbidities of cerebral infarction, idiopathic thrombocytopenic purpura, and triple X syndrome.

  18. Simultaneous and sequential hemorrhage of multiple cerebral cavernous malformations: a case report.

    Science.gov (United States)

    Louis, Nundia; Marsh, Robert

    2016-02-09

    The etiology of cerebral cavernous malformation hemorrhage is not well understood. Causative physiologic parameters preceding hemorrhagic cavernous malformation events are often not reported. We present a case of an individual with sequential simultaneous hemorrhages in multiple cerebral cavernous malformations with a new onset diagnosis of hypertension. A 42-year-old white man was admitted to our facility with worsening headache, left facial and tongue numbness, dizziness, diplopia, and elevated blood pressure. His past medical history was significant for new onset diagnosis of hypertension and chronic seasonal allergies. Serial imaging over the ensuing 8 days revealed sequential hemorrhagic lesions. He underwent suboccipital craniotomy for resection of the lesions located in the fourth ventricle and right cerebellum. One month after surgery, he had near complete resolution of his symptoms with mild residual vertigo but symptomatic chronic hypertension. Many studies have focused on genetic and inflammatory mechanisms contributing to cerebral cavernous malformation rupture, but few have reported on the potential of hemodynamic changes contributing to cerebral cavernous malformation rupture. Systemic blood pressure changes clearly have an effect on angioma pressures. When considering the histopathological features of cerebral cavernous malformation architecture, changes in arterial pressure could cause meaningful alterations in hemorrhage propensity and patterns.

  19. Use of Hybrid Assistive Limb (HAL®) for a postoperative patient with cerebral palsy: a case report.

    Science.gov (United States)

    Mataki, Yuki; Kamada, Hiroshi; Mutsuzaki, Hirotaka; Shimizu, Yukiyo; Takeuchi, Ryoko; Mizukami, Masafumi; Yoshikawa, Kenichi; Takahashi, Kazushi; Matsuda, Mayumi; Iwasaki, Nobuaki; Kawamoto, Hiroaki; Wadano, Yasuyoshi; Sankai, Yoshiyuki; Yamazaki, Masashi

    2018-03-27

    The Hybrid Assistive Limb (HAL ® ) is an exoskeleton wearable robot suit that assists in voluntary control of knee and hip joint motion. There have been several studies on HAL intervention effects in stroke, spinal cord injury, and cerebral palsy. However, no study has investigated HAL intervention for patients with cerebral palsy after surgery. We report a case of using HAL in a postoperative patient with cerebral palsy. A 15-year-old boy was diagnosed with spastic diplegia cerebral palsy Gross Motor Function Classification System level IV, with knee flection contracture, equinus foot, and paralysis of the right upper extremity with adduction contracture. He underwent tendon lengthening of the bilateral hamstrings and Achilles tendons. Although the flexion contractures of the bilateral knees and equinus foot improved, muscle strength decreased after the soft tissue surgery. HAL intervention was performed twice during postoperative months 10 and 11. Walking speed, stride, and cadence were increased after HAL intervention. Post HAL intervention, extension angles of the knee in stance phase and hip in the pre-swing phase were improved. In the gait cycle, the proportion of terminal stance in the stance and swing phase was increased. Hybrid Assistive Limb intervention for postoperative patients with cerebral palsy whose muscle strength decreases can enhance improvement in walking ability. Further studies are needed to examine the safety and potential application of HAL in this setting.

  20. The importance of bilateral monitoring of cerebral oxygenation (NIRS): Clinical case of asymmetry during cardiopulmonary bypass secondary to previous cerebral infarction.

    Science.gov (United States)

    Matcan, S; Sanabria Carretero, P; Gómez Rojo, M; Castro Parga, L; Reinoso-Barbero, F

    2018-03-01

    Cerebral oximetry based on near infrared spectroscopy (NIRS) technology is used to determine cerebral tissue oxygenation. We hereby present the clinical case of a 12-month old child with right hemiparesis secondary to prior left middle cerebral artery stroke 8 months ago. The child underwent surgical enlargement of the right ventricular outflow tract (RVOT) with cardiopulmonary bypass. During cardiopulmonary bypass, asymmetric NIRS results were detected between both hemispheres. The utilization of multimodal neuromonitoring (NIRS-BIS) allowed acting on both perfusion pressure and anesthetic depth to balance out the supply and demand of cerebral oxygen consumption. No new neurological sequelae were observed postoperatively. We consider bilateral NIRS monitoring necessary in order to detect asymmetries between cerebral hemispheres. Although asymmetries were not present at baseline, they can arise intraoperatively and its monitoring thus allows the detection and treatment of cerebral ischemia-hypoxia in the healthy hemisphere, which if undetected and untreated would lead to additional neurological damage. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. [Cerebral gliosarcoma: clinico-pathologic study of 8 cases].

    Science.gov (United States)

    Ayadi, Lobna; Charfi, Slim; Khabir, Abdemajid; Kalle, Rim; Sellami, Ahmed; Makni, Saloua; Boudawara, Zaher; Sellami-Boudawara, Tahya

    2010-03-01

    Gliosarcomas are biphasic neoplasms composed of a glioblastoma admixed to a sarcomatous component with different lines of differentiation. Histogenesis of these tumors is still discussed. Our objective is to specify clinical and pathological characteristics of this rare neoplasm and to discuss its histogenesis. Retrospective study of eight cases of gliosarcomas diagnosed between January 1998 and December 2004. Clinical, radiological, therapeutic and follow-up data were reviewed. Histological features and immunohistochemical results were also included in this review. Five patients were male, three women with a median age of 50.7 (range 31-74 years). Symptoms were dominated by intracranial hypertension and paralysis. The most common location was parietal or temporo-parietal (5 cases: 62.5%). Pathological exam including histochemical and immunohistochemical study confirmed the diagnosis of gliosarcoma in all cases. Sarcomatous component had features of fibrosarcoma in 5 cases, osteosarcoma in 2 cases and malignant fibrous histiocytoma in 1 case. All patients were treated by surgical excision (complete in five cases and partial in three cases). Adjuvant radiotherapy was received in three cases. One patient was lost on follow-up. Two patients died from postoperative. complications and the five remaining patients died with a medium follow up of 9 months (extremes: 2-24 months). Clinical, radiological and follow-up features of gliosarcomas share great similarities with glioblastomas. Histopathological, histochemical and immunohistochemical studies are helpful in accuracy diagnosis. Recent cytogenetic and molecular data support a monoclonal origin for these tumors.

  2. Sport-specific fitness testing and intervention for an adolescent with cerebral palsy: a case report.

    Science.gov (United States)

    Kenyon, Lisa K; Sleeper, Mark D; Tovin, Melissa M

    2010-01-01

    This case report describes the development, implementation, and outcomes of a fitness-related intervention program that addressed the sport-specific goals of an adolescent with cerebral palsy. The participant in this case was a 16-year-old African American male with spastic diplegia. The participant joined his high school wrestling team and asked to focus his physical therapy on interventions that would improve his wrestling performance. An examination was performed using the muscle power sprint test, the 10 x 5-m sprint test, strength tests, the 10-m shuttle run test, and the Gross Motor Function Measure. The intervention consisted of interval training, which focused on the demands of wrestling. Scores on all tests and measures were higher after the intervention. The outcomes of this case report seem to support the use of a fitness-related intervention program for addressing the sport-specific goals of an adolescent with cerebral palsy.

  3. Hypercapnic cerebral edema presenting in a woman with asthma: a case report

    Directory of Open Access Journals (Sweden)

    McGee William T

    2011-05-01

    Full Text Available Abstract Introduction Common causes of non-traumatic acute cerebral edema include malignant hypertension, hyponatremia, anoxia, and cerebral vascular accident. The computed tomographic images and data obtained during care of the patient described in this case report provide evidence that hypercarbia can cause increased intracranial pressure and coma without permanent brain injury. Partial pressure of carbon dioxide evaluation for coma is essential to provide faster diagnosis and therapeutic correction in certain common critical disease states. We present the case of a patient in a coma associated with cerebral edema during a typical asthma exacerbation with hypercapnic respiratory failure. Case presentation An obese 63-year-old African American woman with asthma presented to our hospital with facial swelling and shortness of breath. Immediately following intubation for hypercapnic respiratory failure, she was noted to have a dilated, unresponsive right pupil. An emergent computed tomographic head scan revealed that she had increased intracranial pressure. A neurosurgeon agreed with the computed tomography interpretation and recommended no surgical intervention. The patient's respiratory acidosis was corrected with ventilatory management over several hours in the intensive care unit. Nine and one-half hours later a follow-up head computed tomographic scan was read as normal without cerebral edema. At 12 hours, the patient's right pupil was 5 mm in diameter and reactive. By 24 hours, her pupils were symmetrically equal and reactive. Her symptoms had improved, and she was extubated. A brain magnetic resonance imaging scan revealed no abnormalities. Conclusion Alteration of consciousness related to hypercapnia during respiratory failure is not generally thought to be related to cerebral edema. Respiratory acidosis resulting from hypercarbia is known to produce carbon dioxide narcosis and coma, but no current treatment algorithm suggests that rapid

  4. An intracranial aspergilloma with low signal on T2-weighted images corresponding to iron accumulation

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, K. [Dept. of Radiology, Kyoto Prefectural Univ. of Medicine (Japan); Dept. of Radiology, Univ. of Maryland Medical Center, Baltimore MD (United States); Zoarski, G.H.; Rothman, M.I.; Zagardo, M.T. [Dept. of Radiology, Univ. of Maryland Medical Center, Baltimore MD (United States); Nishimura, T. [Dept. of Radiology, Kyoto Prefectural Univ. of Medicine (Japan); Sun, C.C.J. [Dept. of Pathology, Univ. of Maryland Medical Center, Baltimore MD (United States)

    2001-07-01

    We present a case of cerebral aspergillosis in an immunocompetent patient. The MRI signal characteristics were compared with the histologic findings. Irregular low-signal zones were demonstrated between the wall of the abscess and the central necrosis on T2-weighted images; the pathology specimen revealed concentrated iron in these transitional zones but no hemosiderin. Iron is an essential element for the growth of fungal hyphae. The low-signal zones may represent the areas where there was active proliferation of aspergillus, and the unique location of the low signal may be a helpful imaging characteristic for the diagnosis of an aspergillus abscess. (orig.)

  5. Fatal Cerebral Edema With Status Epilepticus in Children With Dravet Syndrome: Report of 5 Cases.

    Science.gov (United States)

    Myers, Kenneth A; McMahon, Jacinta M; Mandelstam, Simone A; Mackay, Mark T; Kalnins, Renate M; Leventer, Richard J; Scheffer, Ingrid E

    2017-04-01

    Dravet syndrome (DS) is a well-recognized developmental and epileptic encephalopathy associated with SCN1A mutations and 15% mortality by 20 years. Although over half of cases succumb to sudden unexpected death in epilepsy, the cause of death in the remainder is poorly defined. We describe the clinical, radiologic, and pathologic characteristics of a cohort of children with DS and SCN1A mutations who developed fatal cerebral edema causing mass effect after fever-associated status epilepticus. Cases were identified from a review of children with DS enrolled in the Epilepsy Genetics Research Program at The University of Melbourne, Austin Health, who died after fever-associated status epilepticus. Five children were identified, all of whom presented with fever-associated convulsive status epilepticus, developed severe brain swelling, and died. All had de novo SCN1A mutations. Fever of 40°C or greater was measured in all cases. Signs of brainstem dysfunction, indicating cerebral herniation, were first noted 3 to 5 days after initial presentation in 4 patients, though were apparent as early as 24 hours in 1 case. When MRI was performed early in a patient's course, focal regions of cortical diffusion restriction were noted. Later MRI studies demonstrated diffuse cytotoxic edema, with severe cerebral herniation. Postmortem studies revealed diffuse brain edema and widespread neuronal damage. Laminar necrosis was seen in 1 case. Cerebral edema leading to fatal brain herniation is an important, previously unreported sequela of status epilepticus in children with DS. This potentially remediable complication may be a significant contributor to the early mortality of DS. Copyright © 2017 by the American Academy of Pediatrics.

  6. Fluid management of hypernatraemic dehydration to prevent cerebral oedema: a retrospective case control study of 97 children in China.

    Science.gov (United States)

    Fang, Chengqing; Mao, Jianhua; Dai, Yuwen; Xia, Yonghui; Fu, Haidong; Chen, Yifang; Wang, Yaping; Liu, Aimin

    2010-06-01

    To compare the fluid management of hypernatraemic dehydration in acute gastroenteritis in those who developed cerebral oedema (cases) versus those who did not (controls). A retrospective study of 97 cases of hypernatraemic dehydration at a tertiary children's hospital in China over five years, in which rehydration regimes of 49 children who developed cerebral oedema were compared with 48 children who made an uneventful recovery. Risk factors for cerebral oedema (vs. no cerebral oedema) were an initial fluid bolus (29/49 vs. 15/48, P=0.006), the mean rate of bolus infusion (14.7+/-2.2 vs. 10.8+/-1.4 mL/kg/hr, Pdehydration were too rapid a rate of rehydration, an initial fluid bolus to rapidly expand plasma volume and the severity of the hypernatraemia. Thus, we conclude that a uniformly slow rate of rehydration is the best way of preventing cerebral oedema.

  7. Isolated Posterior Cerebral Artery Dissection: Report of Three Cases

    National Research Council Canada - National Science Library

    Sherman, Paul M

    2005-01-01

    .... We present three cases of dissection of the P2 segment of the PCA. In two patients, an association with minor axial head trauma was documented, suggesting shearing injury of the PCA as it crosses over the free edge of the tentorium...

  8. Cerebral fat embolism after bilateral total knee replacement arthroplasty -A case report-

    OpenAIRE

    Chang, Ri-Na; Kim, Jong-Hak; Lee, Heeseung; Baik, Hee-Jung; Chung, Rack Kyung; Kim, Chi Hyo; Hwang, Tae-Hu

    2010-01-01

    Fat embolism syndrome is a rare and potentially lethal complication most commonly seen in long bone fractures and intramedullary manipulation. The clinical triad of fat embolism syndrome consists of mental confusion, respiratory distress, and petechiae. This study reports a case of cerebral fat embolism syndrome following elective bilateral total knee replacement. After an uneventful anesthesia and initial recovery, the patient developed neurologic symptoms nine hours postoperatively.

  9. MR Findings of Desmoplastic Cerebral Astrocytoma of Infancy. A case report

    International Nuclear Information System (INIS)

    Kim, J.H.; Kim, I.O.; Kim, W.S.; Kim, K.H.; Park, C. M.; Yeon, K.M.

    2003-01-01

    Desmoplastic cerebral astrocytoma of infancy (DCAI) presents as a large supratentorial mass consisting of a central cystic component and an enhancing solid component associated with peripheral dural attachment. We report the unusual MR findings of a DCAI that differed from previously reported cases in terms of the presence of calcification, which is not considered a feature of this tumor, and the absence of an enhancing peripheral dural component

  10. Cerebral Post-Transplant Lymphoproliferative Disorder Occurring after Renal Transplantation: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Jang Ho; Byun, Woo Mok; Kim, Hong Chul; Hwang, Min Su [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2012-04-15

    Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation and immunosuppression. A 36-year-old woman with a history of renal transplantation visited the hospital complaining of headache and on pathology was diagnosed with cerebral PTLD manifesting as multiple rim enhanced masses in both hemispheres. We report here a case of post-transplant lymphoproliferative disorder involving the cerebrum occurring after renal transplantation, and describe the MRI findings for this patient

  11. Cerebral Post-Transplant Lymphoproliferative Disorder Occurring after Renal Transplantation: A Case Report

    International Nuclear Information System (INIS)

    Suh, Jang Ho; Byun, Woo Mok; Kim, Hong Chul; Hwang, Min Su

    2012-01-01

    Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation and immunosuppression. A 36-year-old woman with a history of renal transplantation visited the hospital complaining of headache and on pathology was diagnosed with cerebral PTLD manifesting as multiple rim enhanced masses in both hemispheres. We report here a case of post-transplant lymphoproliferative disorder involving the cerebrum occurring after renal transplantation, and describe the MRI findings for this patient

  12. Unilateral delayed opercularization in a case of Sotos' syndrome (cerebral gigantism)

    Energy Technology Data Exchange (ETDEWEB)

    Barth, P.G.; Vlasveld, L.; Valk, J.

    1980-08-01

    A case of Sotos' syndrome (cerebral gigantism) is described. Pneumencephalography, performed at the age of 15 days, revealed abnormal separation of the opercula on the right. By comparing the contours with developmental anatomical features of this area it agreed with a foetal development of 24 weeks gestational age. Bilateral carotid angiography was normal. CT showed normal development of the Sylvian area at the age of 27 months.

  13. Unilateral delayed opercularization in a case of Sotos' syndrome (cerebral gigantism)

    International Nuclear Information System (INIS)

    Barth, P.G.; Vlasveld, L.; Valk, J.

    1980-01-01

    A case of Sotos' syndrome (cerebral gigantism) is described. Pneumencephalography, performed at the age of 15 days, revealed abnormal separation of the opercula on the right. By comparing the contours with developmental anatomical features of this area it agreed with a foetal development of 24 weeks gestational age. Bilateral carotid angiography was normal. CT showed normal development of the Sylvian area at the age of 27 months. (orig.)

  14. A Unique Case of Acute Cerebral Venous Sinus Thrombosis Secondary to Primary Varicella Zoster Virus Infection

    OpenAIRE

    Imam, Syed F; Lodhi, Omair ul haq; Fatima, Zainab; Nasim, Saneeya; Malik, Waseem T; Saleem, Muhammad Sabih

    2017-01-01

    Primary varicella zoster virus (VZV) infection, predominantly in the pediatric population, presents with pyrexia and a classic pruritic vesicular rash. In adults, although less common, it is more severe and linked to more complications. Neurological complications, which account for less than 1% of all VZV complications, include meningitis, encephalitis, arterial vasculopathy, and venous thrombosis. We present a case of a 39-year-old male who developed extensive cerebral venous sinus thrombosi...

  15. Study on the clinical usefulness of magnetic resonance imaging in cases of multiple cerebral infarction

    International Nuclear Information System (INIS)

    Miyashita, Kotaro

    1991-01-01

    The clinical significance of MRI in thrombotic multiple cerebral infarction was examined in 9 patients having recent lacunar stroke. Recent infarct was identified on Gd-enhanced MRI in 4 patients. For patients multiple small infarction, Gd-enhanced MRI made it possible to differentiate recent from other lesions. To clarify the significance of periventricular high intensity lesion (PVH) on T2-weighted MRI, hemodynamic and neuropsychologic examinations were carried out in 41 patients with multiple cerebral infarction. All the patients had PVH, which was classified into three grades as follows: grade I (n=16) showing only a thin high intensity band along the body of lateral ventricles; grade 2 (n=15) showing a definite high intensity area around the lateral ventricles; grade 3 (n=10) showing diffuse thick and irregular foci around the whole ventricle. In these patients, rCBF was measured by 133 Xe inhalation methods. Initial slope index was significantly higher in patients with grade 3 than those with grade I. Mini-mental state test score was significantly higher in patients with grade l than those with grade 2 and 3. Progression of PVH may be related with the reduction of the cerebral circulation and mental function in cases of multiple cerebral infarction. Ischemic and hemorrhagic lesions can be distinguished by MRI, because old intracerebral hemorrhage appear as hypointensity areas with or without hyperintensity area on T2w images. In 92 patients with multiple infarction, MRI was used to evaluate the incidence and distribution of coexisting old intracerebral hemorrhage. Old hemorrhage were found in 15 patients (16.3%). locating the site where hypertensive hemorrhage commonly occurred. High-field MRI is useful for assessing the coexistence of hemorrhage in hypertensive patients with multiple cerebral infarction. (N.K.)

  16. A Case Report of Maternal Cerebral Hemorrhage in Preterm Pregnancy.

    Science.gov (United States)

    Stein-Fredbeck, Leah; Rosenberg, Robert; Frank, Ralph

    Intracerebral hemorrhage is a rare event during pregnancy that can result in serious morbidity and mortality for the mother and infant. In this article, we describe a case involving a multiparous woman at 34 weeks gestation who presented with a 5-cm intracerebral bleed. Within 2 hours of presenting, she underwent an emergency cesarean and craniotomy to remove the hematoma. The woman's altered mental status fully abated, and she was discharged with minimal neurologic deficits. The newborn was born healthy. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  17. Cerebral Amyloid Angiopathy-Related Inflammation: Report of a Case with Very Difficult Therapeutic Management

    Directory of Open Access Journals (Sweden)

    Francesca Crosta

    2015-01-01

    Full Text Available Background. Cerebral amyloid angiopathy-related inflammation (CAA-ri results from autoimmune response to beta-amyloid deposits in cerebral vessels. Its clinical course and complications have seldom been described in literature. Case Report. In a patient presenting with delirium and left hemiparesis the diagnosis of CAA-ri was supported by the finding of elevated anti-amyloid autoantibodies in the cerebrospinal fluid (CSF. Steroid therapy produced significant improvements in clinical and investigational assessments, but after two months, it caused Acute Respiratory Distress Syndrome. After steroid therapy discontinuation the patient presented a rapidly progressive dementia, Guillain-Barré syndrome, new cerebral ischemic lesions, and thrombosis of the right cephalic and subclavian veins that were treated with subcutaneous heparin. After a week the patient died because of brain hemorrhage. Conclusion. This case suggests caution in steroid therapy discontinuation and antithrombotic therapy administration in patients with CAA-ri. The CSF search of anti-amyloid autoantibodies could be helpful to support the diagnosis.

  18. Cerebral gumma mimicking a brain tumor in a human immunodeficiency virus-negative patient: A case report

    International Nuclear Information System (INIS)

    Baek, Hye Jin; Kim, Woo Jin

    2013-01-01

    Syphilis has a broad spectrum of clinical manifestations, and the cerebral gumma is a kind of neurosyphilis which is rare and can be cured by appropriate antibiotic treatments. However, in clinical practices, diagnosis of cerebral syphilitic gumma is often difficult because imaging and laboratory findings revealed elusive results. Herein, we present a rare case of neurosyphilis presenting as cerebral gumma confirmed by histopathological examination, and positive serologic and cerebrospinal fluid analyses. This case report suggests that cerebral gumma should be considered as possible diagnosis for human immunodeficiency virus-negative patients with space-occupying lesion of the brain. And this case also provides importance of clinical suspicions in diagnosing neurosyphilis because syphilis serology is not routinely tested on patients with neurologic symptoms.

  19. Cerebral gumma mimicking a brain tumor in a human immunodeficiency virus-negative patient: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Hye Jin; Kim, Woo Jin [Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2013-09-15

    Syphilis has a broad spectrum of clinical manifestations, and the cerebral gumma is a kind of neurosyphilis which is rare and can be cured by appropriate antibiotic treatments. However, in clinical practices, diagnosis of cerebral syphilitic gumma is often difficult because imaging and laboratory findings revealed elusive results. Herein, we present a rare case of neurosyphilis presenting as cerebral gumma confirmed by histopathological examination, and positive serologic and cerebrospinal fluid analyses. This case report suggests that cerebral gumma should be considered as possible diagnosis for human immunodeficiency virus-negative patients with space-occupying lesion of the brain. And this case also provides importance of clinical suspicions in diagnosing neurosyphilis because syphilis serology is not routinely tested on patients with neurologic symptoms.

  20. From cerebral salt wasting to diabetes insipidus with adipsia: case report of a child with craniopharyngioma.

    Science.gov (United States)

    Raghunathan, Veena; Dhaliwal, Maninder Singh; Gupta, Aditya; Jevalikar, Ganesh

    2015-03-01

    Craniopharyngioma is associated with a wide and interesting variety of sodium states both by itself and following surgical resection. These are often challenging to diagnose, especially given their dynamic nature during the perioperative course. We present the case of a boy with craniopharyngioma who had hyponatremia due to cerebral salt wasting preoperatively, developed diabetes insipidus (DI) intraoperatively and proceeded to develop hypernatremia with adipsic DI. Cerebral salt wasting is a rare presenting feature of craniopharyngioma. Postoperative DI can be associated with thirst abnormalities including adipsia due to hypothalamic damage; careful monitoring and a high index of suspicion are required for its detection. Adipsic DI is a difficult condition to manage; hence a conservative surgical approach is suggested.

  1. Cerebral perfusion scintigraphy and the exploration of dementia syndromes: An illustration with five clinical cases

    International Nuclear Information System (INIS)

    Farid, K.; Perdrisot, R.; Habert, M.O.

    2007-01-01

    The epidemiological evidence suggests that individuals with higher education level have a reduced risk of developing dementia. Because cognitive reserve and its compensation mechanisms may modulate the clinical expression in neuro-degenerative pathology, it is important to study subjects who present mild cognitive disturbance with functional imaging. The cerebral SPECT has been used to determine regional uptake of radiotracer into the brain of patients with cognitive impairment. These abnormalities of blood flow were correlated with cognitive impairment. The cerebral SPECT is also useful to investigate preclinical dementia and to predict the evolution of cognitive disturbance. This article, reports some technical and semeiological notions and illustrate with five clinical cases the scintigraphic aspect of some dementia syndrome. (authors)

  2. Embryologic Association of Tornwaldt's Cyst with Cerebral Artery Abnormalities and Infarction: A Case Report

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    Michael F. Osborn

    2012-01-01

    Full Text Available Background and Purpose. Tornwaldt's cysts are rare nasopharyngeal lesions that develop from remnants of the embryonic notochord. Summary of Case. We reported a twelve-year-old female stroke patient with Tornwaldt's cysts, whose father also suffered a stroke at age fifty two with the presence of an abdominal aortic aneurysm, suggesting a genetic influence in this case. Conclusions. This paper suggests an etiologic connection between Tornwaldt's cysts and cerebral vasculature abnormalities by way of notochordal dysfunction during development, likely the result of perturbation of notochord-derived molecular cues during development or biogenesis.

  3. A case of cerebral cysticercosis detected by computed tomography

    International Nuclear Information System (INIS)

    Tomosugi, Tetsuzo; Gondo, Masazumi; Kanamaru, Reizo; Asakura, Tetsuhiko; Mihara, Tadahiro

    1983-01-01

    Cysticercosis is well known as a parasitic infection that commonly affects the central nervous system. A 60-year-old man, who once lived in the mainland of China in the 1940s, was admitted to the hospital complaining of the right motor weakness and speech disturbance. Neurological examinations revealed the right hemiparesis with increase of deep tendon reflexes and motor dysphasia. The skull x-ray films showed no abnormal finding, but many small fusiform calcifications were found in the x-ray films of soft tissues of the limbs. Brain CT demonstrated several small rounded and calcified high density areas and cystic low density areas in the parenchyma with a marked dilatation of the ventricular system. And a large cystic mass of the left fronto-parietal region compressed the body of the left lateral ventricle. After infusion of contrast medium, a small ring-enhanced density area in the frontal region was revealed. By a craniotomy, the large cyst, which had a bluish transparent wall, was totally extirpated. The nature of the cystic content was similar to that of the cerebro-spinal fluid. On histological examination of the cyst wall any scolex was not found, but papillary folds and typical three layers of cysticercosis were observed. The immunological testing for cysticercosis was positive on the serum of the patient. These findings confirmed the diagnosis of human cysticercosis. Wider applications of CT in clinical practice could discover more cases of cysticercosis in the recent situation of world wide communication of population. This report will be the first one of cysticercosis which mainly discussed about the findings of CT in the Japanese literature. (author)

  4. A case of radiation-induced skin ulcer, cerebral meningioma and skin cancer

    International Nuclear Information System (INIS)

    Matsuo, Yuki; Yano, Kenji

    2000-01-01

    We report a case of radiation-induced skin ulcer, cerebral meningioma, and skin cancer in a 69-year-old woman who had undergone local irradiation and application of radium directly to the skin for actinomycosis of the face at the age of twenty. Some forty to fifty years later, a skin ulcer in the preauricular area in the center of the radiodermatitis, cerebral meningioma in the right sphenoid ridge, and a keratotic skin tumor in the right auricle all developed within the previously irradiated region. The cerebral meningioma was extirpated. The skin ulcer was excised and covered with a forearm flap. After the skin tumor was excised and the subcutaneous tumor in the postauricular area was excised, the postoperative histopathological diagnosis was squamous cell carcinoma with lymph node metastasis. It was considered that the squamous cell carcinoma was derived from irradiated keratosis. Four months later, right neck lymph node dissection was performed. Both the meningioma and squamous cell carcinoma satisfied Cahan's criteria for radiation-induced tumors. So we diagnosed these as radiation-induced cerebral meningioma and squamous cell carcinoma. We haven't detected any recurrence of the squamous cell carcinoma for two years. We learned from this case that chronic radiation disturbances cause an irreversible reaction and various radiolesions, including malignancies, can occur after a long period of latency. It is important to never underestimate a small lesion in the irradiated area, to plan early preventive surgical treatment to remove skin that may have been over-subjected to irradiation, and to continue long-term follow-up for patients with chronic radiodermatitis. (author)

  5. A case of radiation-induced skin ulcer, cerebral meningioma and skin cancer

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    Matsuo, Yuki; Yano, Kenji [Kure National Hospital, Hiroshima (Japan)

    2000-10-01

    We report a case of radiation-induced skin ulcer, cerebral meningioma, and skin cancer in a 69-year-old woman who had undergone local irradiation and application of radium directly to the skin for actinomycosis of the face at the age of twenty. Some forty to fifty years later, a skin ulcer in the preauricular area in the center of the radiodermatitis, cerebral meningioma in the right sphenoid ridge, and a keratotic skin tumor in the right auricle all developed within the previously irradiated region. The cerebral meningioma was extirpated. The skin ulcer was excised and covered with a forearm flap. After the skin tumor was excised and the subcutaneous tumor in the postauricular area was excised, the postoperative histopathological diagnosis was squamous cell carcinoma with lymph node metastasis. It was considered that the squamous cell carcinoma was derived from irradiated keratosis. Four months later, right neck lymph node dissection was performed. Both the meningioma and squamous cell carcinoma satisfied Cahan's criteria for radiation-induced tumors. So we diagnosed these as radiation-induced cerebral meningioma and squamous cell carcinoma. We haven't detected any recurrence of the squamous cell carcinoma for two years. We learned from this case that chronic radiation disturbances cause an irreversible reaction and various radiolesions, including malignancies, can occur after a long period of latency. It is important to never underestimate a small lesion in the irradiated area, to plan early preventive surgical treatment to remove skin that may have been over-subjected to irradiation, and to continue long-term follow-up for patients with chronic radiodermatitis. (author)

  6. Spontaneous spinal epidural hematoma with hemiparesis mimicking acute cerebral infarction: Two case reports

    Science.gov (United States)

    Matsumoto, Hiroaki; Miki, Takanori; Miyaji, Yuki; Minami, Hiroaki; Masuda, Atsushi; Tominaga, Shogo; Yoshida, Yasuhisa; Yamaura, Ikuya; Matsumoto, Shigeo; Natsume, Shigeatsu; Yoshida, Kozo

    2012-01-01

    Context Acute hemiparesis is a common initial presentation of ischemic stroke. Although hemiparesis due to spontaneous spinal epidural hematoma (SSEH) is an uncommon symptom, a few cases have been reported and misdiagnosed as cerebral infarction. Design Case reports of SSEH with acute hemiparesis. Findings In these two cases, acute stroke was suspected initially and administration of intravenous alteplase therapy was considered. In one case, the presentation was neck pain and in the other case, it was Lhermitte's sign; brain magnetic resonance imaging (MRI) and magnetic resonance angiography were negative for signs of ischemic infarction, hemorrhage, or arterial dissection. Cervical MRI was performed and demonstrated SSEH. Conclusion Clinicians who perform intravenous thrombolytic treatment with alteplase need to be aware of this possible contraindication. PMID:22925753

  7. Frequency of risk factors of cerebral infarction in stroke patients. a study of 100 cases in naseer teaching hospital, peshawar

    International Nuclear Information System (INIS)

    Safeer, M.; Tariq, M.; Rehman, U.U.

    2008-01-01

    To study the risk factors of cerebral infarction in stroke patients. It is a descriptive hospital based study conducted at the Department of Medicine, Naseer Teaching Hospital, Peshawar from January 2005 to December 2005. One hundred patients of stroke with cerebral infarction confirmed on C.T. scan brain and more than twenty years of age were included. Risk factors for cerebral infarction were defined in terms of hypertension, diabetes mellitus, ischemic heart disease, smoking, dyslipidaemia, TIAs (transient ischemic attacks), carotid artery stenosis and family history of stroke. Data of 100 cases with cerebral infarction was recorded. Most of the patients had more than one risk factors for cerebral infarction. hypertension was commonest risk factor (55%), smoking (30%), ischemic heart disease (34%), diabetes mellitus) (26%), hyperlipedaemia (30%), atrial fibrillation (25%), carotid artery stenosis (27%), obesity (15%) and family history of stroke (12%). 39% of patients had physical inactivity. Males were slightly predominant than females (51% vs 49%) and mean age was 50 years. females were rather older with mean age of 53 years. Cerebral infarction accounts for 80% to 85% of cases of stroke, which is a common neurological disorder. It increases a burden of disability and misery for patients and their families. Most of the risk factors of cerebral infarction are modifiable, its prevention should be the main cause of concern for the community. (author)

  8. Sequential assessment of regional cerebral blood flow, regional cerebral blood volume, and blood-brain barrier in focal cerebral ischemia: a case report

    International Nuclear Information System (INIS)

    Di Piero, V.; Perani, D.; Savi, A.; Gerundini, P.; Lenzi, G.L.; Fazio, F.

    1986-01-01

    Regional CBF (rCBF) and regional cerebral blood volume (rCBV) were evaluated by N,N,N'-trimethyl-N'-(2)-hydroxy-3-methyl-5-[123I]iodobenzyl-1, 3-propanediamine-2 HCl- and /sup 99m/TC-labeled red blood cells, respectively, and single-photon emission computerized tomography (SPECT) in a patient with focal cerebral ischemia. Sequential transmission computerized tomography (TCT) and SPECT functional data were compared with clinical findings to monitor the pathophysiological events occurring in stroke. A lack of correlation between rCBF-rCBV distributions and blood-brain barrier (BBB) breakdown was found in the acute phase. In the face of more prolonged alteration of BBB, as seen by TCT enhancement, a rapid evolution of transient phenomena such as luxury perfusion was shown by SPECT studies. Follow-up of the patient demonstrated a correlation between the neurological recovery and a parallel relative improvement of the cerebral perfusion

  9. Ultrasonographic evaluation of cerebral arterial and venous haemodynamics in multiple sclerosis: a case-control study.

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    Pasquale Marchione

    Full Text Available OBJECTIVE: Although recent studies excluded an association between Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis (MS, controversial results account for some cerebrovascular haemodynamic impairment suggesting a dysfunction of cerebral autoregulation mechanisms. The aim of this cross-sectional, case-control study is to evaluate cerebral arterial inflow and venous outflow by means of a non-invasive ultrasound procedure in Relapsing Remitting (RR, Primary Progressive (PP Multiple Sclerosis and age and sex-matched controls subjects. MATERIAL AND METHODS: All subjects underwent a complete extra-intracranial arterial and venous ultrasound assessment with a color-coded duplex sonography scanner and a transcranial doppler equipment, in both supine and sitting position by means of a tilting chair. Basal arterial and venous morphology and flow velocities, postural changes in mean flow velocities (MFV of middle cerebral arteries (MCA, differences between cerebral venous outflow (CVF in clinostatism and in the seated position (ΔCVF and non-invasive cerebral perfusion pressure (CPP were evaluated. RESULTS: 85 RR-MS, 83 PP-MS and 82 healthy controls were included. ΔCVF was negative in 45/85 (52.9% RR-MS, 63/83 (75.9% PP-MS (p = 0.01 and 11/82 (13.4% controls (p<0.001, while MFVs on both MCAs in sitting position were significantly reduced in RR-MS and PP-MS patients than in control, particularly in EDSS ≥ 5 subgroup (respectively, 42/50, 84% vs. 66/131, 50.3%, p<0.01 and 48.3 ± 2 cm/s vs. 54.6 ± 3 cm/s, p = 0.01. No significant differences in CPP were observed within and between groups. CONCLUSIONS: The quantitative evaluation of cerebral blood flow (CBF and CVF and their postural dependency may be related to a dysfunction of autonomic nervous system that seems to characterize more disabled MS patients. It's not clear whether the altered postural control of arterial inflow and venous outflow is a specific MS condition or simply an

  10. A Cerebral Air Embolism That Developed Following Defecation in a Patient with Extensive Pulmonary Tuberculosis: A Case Report

    International Nuclear Information System (INIS)

    Oh, Ji Young; Park, Dong Woo; Hahm, Chang Kok; Park, Choong Ki; Lee, Seung Ro; Lee, Young Jun

    2010-01-01

    Cerebral air embolisms generally result from invasive procedures such as a percutaneous needle biopsy, chest tube insertion, central venous catheter access or removal, operations and so on. Likewise, they are mostly iatrogenically induced and present various degrees of severity depending on the number of air bubbles. With the exception of divers, the occurrence of a cerebral air embolism in the absence of invasive procedures is very rare. We report a case of a cerebral air embolism that developed following defecation and was detected by CT in a patient with extensive pulmonary tuberculosis

  11. A Cerebral Air Embolism That Developed Following Defecation in a Patient with Extensive Pulmonary Tuberculosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ji Young; Park, Dong Woo; Hahm, Chang Kok; Park, Choong Ki; Lee, Seung Ro; Lee, Young Jun [Hanyang University College of Medicine, Guri Hospital, Guri (Korea, Republic of)

    2010-08-15

    Cerebral air embolisms generally result from invasive procedures such as a percutaneous needle biopsy, chest tube insertion, central venous catheter access or removal, operations and so on. Likewise, they are mostly iatrogenically induced and present various degrees of severity depending on the number of air bubbles. With the exception of divers, the occurrence of a cerebral air embolism in the absence of invasive procedures is very rare. We report a case of a cerebral air embolism that developed following defecation and was detected by CT in a patient with extensive pulmonary tuberculosis

  12. Exacerbation of radiation induced meningioma due to hemorrhage after cerebral angiography. A case report

    International Nuclear Information System (INIS)

    Yamaguchi, Shinya; Matsuo, Yoshihiro; Uesaka, Toshio; Matsukado, Koichiro; Suzuki, Satoshi O.; Iwaki, Toru

    2011-01-01

    We report the case of a 34-year-old woman who exhibited acute deterioration in her condition after cerebral angiography for evaluation of a large meningioma. She had undergone surgery and irradiation for a glioma in the right occipital lobe 23 years before this episode. She experienced incapacity at work. On CT and MRI, a large meningioma was detected on the left frontal convexity; this tumor was thought to be radiation-induced. Cerebral angiography was performed to assess the vascularization of the tumor. Her condition began to deteriorate 2.5 h after the cerebral angiography. CT revealed an increase in the mass of the tumor, and a high density area in the tumor. We immediately removed the tumor. Histopathological examinationrevealed the tumor to be a meningothelial meningioma. New hemorrhagic foci were identified in the tumor. In addition, macrophages containing hemosiderin were detected, and some of the tumor vessels exhibited hyaline degeneration. We suspected that angiography triggered bleeding in the meningioma, which was already predisposed to hemorrhage. (author)

  13. Punding following posterior cerebral artery infarction: a case report and review of literature

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    Lin CI

    2017-03-01

    Full Text Available Cho-I Lin,1 Yu-Ching Lin,1–3 Wei-Chih Lien,1 Pei-Chun Hsieh,1 Sheng-Han Lin,1 Ta-Shen Kuan1,2 1Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 2Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan Introduction: Punding is a complex stereotyped behavior, characterized by excessiveness, non-goal orientation, and repetitiveness. It is mostly associated with Parkinson’s disease, and very few cases in non-Parkinson’s disease have been reported. We report a case of punding associated with supratentorial ischemic stroke.Case presentation: We present a 70-year-old man with left posterior cerebral artery infarction with quetiapine-induced punding manifesting as repetitive unidirectional body turning. Remission of punding behavior ensued after cessation of quetiapine and administration of clonazepam.Conclusion: This case describes the clinical course of quetiapine-induced punding in a patient with left posterior cerebral artery infarction. It suggests clonazepam may serve as a treatment option for poststroke punding. Keywords: punding, stereotyped behavior, stroke, quetiapine, clonazepam

  14. Cerebral Air Embolism in a Patient with a Tuberculous-Destroyed Lung during Commercial Air Travel: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hyun Seok; Jeong, Hae Woong; In, Hyun Sin [Dept. of Radiology, Pusan Paik Hospital, Inje University School of Medicine, Pusdan (Korea, Republic of)

    2011-08-15

    A cerebral air embolism is a rare cause of stroke, but may occur in patients undergoing invasive cardiac and pulmonary procedures, as well as in divers suffering pulmonary barotrauma from rapid ascent. A cerebral air embolism due to other causes, especially a change of air pressure from air travel, is particularly rare. Here, we report a case of cerebraenr embolism during commercial air travel in a patient with an tuberculous-destroyed lung.

  15. CEREBRAL CAVERNOUS MALFORMATION COEXISTING WITH PITUITARY ADENOMA, HASHIMOTO THYROIDITIS AND MENTAL ILLNESS: FIRST CASE REPORT.

    Directory of Open Access Journals (Sweden)

    Sara Guido

    2017-10-01

    Full Text Available Cerebral Cavernous Malformations (CCMs are vascular lesions involving brain capillaries. They may occur sporadically or be inherited as autosomal dominant character. Due to incomplete penetrance, CCMs incidence is underestimated and, overall sporadic cases, are often accidentally diagnosed. Rarely CCMs are linked to other pathological conditions. Here we present the first case in literature of a young woman affected by sporadic CCM, pituitary adenoma, Hashimoto thyroiditis and mental illness of unknown etiology. Symptoms’ analysis suggests that she may suffer of Hashimoto encephalopathy (HE, a condition that in very few cases develops together with Hashimoto thyroiditis. Genetic bases of HE are still unknown and symptomatology is very heterogeneous. This paper is a preliminary report of the case and is focused on complexity of clinical manifestations that makes the diagnosis uncertain. If our hypothesis will be confirmed by further analysis, our aim will be to clarify genetic causes of HE.

  16. Cerebral and subdural abscess with spatio-temporal multiplicity 12 years after initial craniotomy for acute subdural hematoma. Case report.

    Science.gov (United States)

    Wakui, Daisuke; Nagashima, Goro; Takada, Tatsuro; Ueda, Toshihiro; Itoh, Hidemichi; Tanaka, Yuichiro; Hashimoto, Takuo

    2012-01-01

    A 34-year-old man presented with a case of subdural empyema and cerebral abscess that developed 12 years after initial neurosurgical intervention for a traffic accident in 1998. Under a diagnosis of acute subdural hematoma and cerebral contusion, several neurosurgical procedures were performed at another hospital, including hematoma removal by craniotomy, external decompression, duraplasty, and cranioplasty. The patient experienced an epileptic seizure, and was referred to our hospital in March 2010. Magnetic resonance imaging revealed a cerebral abscess extending to the subdural space just under the previous surgical field. Surgical intervention was refused and antimicrobial treatment was initiated, but proved ineffective. Surgical removal of artificial dura and cranium with subdural empyema, and resection of a cerebral abscess were performed on May 12, 2010. No organism was recovered from the surgical samples. Meropenem and vancomycin were selected as perioperative antimicrobial agents. No recurrence of infection has been observed. Postneurosurgical subdural empyema and cerebral abscess are recently emerging problems. Infections of neurosurgical sites containing implanted materials occur in 6% of cases, usually within several months of the surgery. Subdural empyema and cerebral abscess developing 12 years after neurosurgical interventions are extremely rare. The long-term clinical course suggests less pathogenic organisms as a cause of infection, and further investigations to develop appropriate antimicrobial selection and adequate duration of antimicrobial administration for these cases are needed.

  17. The development of cerebral amyloid angiopathy in cerebral vessels. A review with illustrations based upon own investigated post mortem cases.

    Science.gov (United States)

    Mendel, T A; Wierzba-Bobrowicz, T; Lewandowska, E; Stępień, T; Szpak, G M

    2013-12-01

    The process of β-amyloid accumulation in cerebral vessels is presented. Cerebral amyloid angiopathy (CAA) was confirmed during an autopsy. It was diagnosed according to the Boston criteria. Cerebral amyloid angiopathy can involve all kinds of cerebral vessels (cortical and leptomeningeal arterioles, capillaries and veins). The development of CAA is a progressive process. β-amyloid appears first in the tunica media, surrounding smooth muscle cells, and in the adventitia. β-amyloid is progressively accumulated, causing a gradual loss of smooth muscle cells in the vessel wall and finally replacing them. Then, the detachment and delamination of the outer part of the tunica media results in the "double barrel" appearance, fibrinoid necrosis, and microaneurysm formation. Microbleeding with perivascular deposition of erythrocytes and blood breakdown products can also occur. β-amyloid can also be deposited in the surrounding of the affected vessels of the brain parenchyma, known as "dysphoric CAA". Ultrastructurally, when deposits of amyloid fibers were localized in or outside the arteriolar wall, the degenerating vascular smooth muscle cells were observed. In the Institute of Psychiatry and Neurology the study was carried out in a group of 48 patients who died due to intracerebral hemorrhage caused by sporadic CAA.

  18. Cervical spinal cord injury during cerebral angiography with MRI confirmation: case report

    Energy Technology Data Exchange (ETDEWEB)

    Bejjani, G.K.; Rizkallah, R.G.; Tzortidis, F. [Department of Neurosurgery, George Washington University Medical Center, Washington, DC (United States); Mark, A.S. [Department of Neuroradiology, Washington Hospital Center, Washington, DC (United States)

    1998-01-01

    We report the first case of MRI-documented cervical spinal cord injury during cerebral angiography. A 54-year-old woman underwent an angiogram for subarachnoid hemorrhage. Her head was secured in a plastic head-holder. At the end of the procedure, she was found to have a left hemiparesis. MRI revealed high signal in the cervical spinal cord. The etiology may have been mechanical due to patient positioning, or toxic, from contrast medium injection in the vessels feeding the spinal cord, or a combination of both. (orig.) With 3 figs., 26 refs.

  19. Phonologically based assessment and intervention in Spastic Cerebral Palsy: A case analysis

    Directory of Open Access Journals (Sweden)

    Michael A. Crary

    1981-11-01

    Full Text Available The articulation errors of one adult subject demonstrating a spastic variety of congenital cerebral palsy were evaluated via a phonological process analysis. This analysis indicated that a stopping process (replacement of fricatives with homorganic stops was the most detrimental to the subject's, intelligibility. Subsequent to this analysis a phonemic contrasting programme was initiated toward the goal of minimizing the influence of the stopping process. Results of  spontaneous speech sample analyses indicated that this approach was successful in increasing the percentage of correctly produced fricative patterns. Success in this case suggests the applicability of  a linguistically based intervention approach in structural/functional disturbances of speech articulation.

  20. Cerebral Venous Thrombosis Revealing Primary Sjögren Syndrome: Report of 2 Cases

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    A. Mercurio

    2013-01-01

    Full Text Available Sjögren syndrome (SS is an autoimmune disease of the exocrine glands, characterized by focal lymphocytic infiltration and destruction of these glands. Neurologic complications are quite common, mainly involving the peripheral nervous system (PNS. The most common central nervous system (CNS manifestations are myelopathy and microcirculation vasculitis. However, specific diagnostic criteria for CNS SS are still lacking. We report two cases of primary SS in which the revealing symptom was cerebral venous thrombosis (CVT in the absence of genetic or acquired thrombophilias.

  1. Radiooncologic considerations on the treatment of cerebral metastases, based on 140 cases

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    Falk, W.; Halama, J.M.; Halama, J.

    1985-01-01

    Cerebral metastases appear frequently and necessitate therapeutic measures. The authors report the incidence and particularities as well as the different modes of formation of metastases in the central nervous system. Surgical procedure should be carried out in case of favorable solitary metastases, young patients, and unknown primary tumors. Radiotherapy, which has proved for 30 years to be a valuable treatment method, has to be applied in a modified form in every case. Furthermore, the possibilities of chemotherapy should be studied and applied in a more intensive manner than hitherto. The chance of a one-year survival time is 22 to 44% for those patients presenting with an easily operable tumor. For the total group of radiotherapy patients suffering from various tumor types and generalized metastases, this rate is between 12% and 16%. Despite the short survival times, one should not forget that radiotherapy can produce many successful long-term results in case of cerebral metastases. Therapeutic nihilism is not the right attitude towards this problem.

  2. Advantages of carotid endarterectomy under local anaesthesia with minimal cerebral monitoring: an experience of 45 cases

    International Nuclear Information System (INIS)

    Bajwa, S.P.; Jameel, M.; Masood, N.

    2014-01-01

    Objective: To evaluate the benefits, efficacy and safety of local cervical plexus block in the performance of carotid endarterectomy, in the absence of sophisticated cerebral perfusion monitoring. Place and Duration of Study: This study was carried out at Combined Military Hospital (CMH) Lahore, Pakistan from January 2012 to May 2013. Study Design: Quasi-experimental study. Patients and Methods: A total of 45 cases of ASA II and ASA III physical status were operated for carotid endarterectomy under local block of cervical plexus. After thorough preanaesthetic assessment, the patients physical conditions were optimized before surgery. Premedication was given with midazolam and sedated during operation with small doses of propofol. Local anaesthesia (LA) was completed by injecting bupivacaine in cervical plexuses 2, C3 and C4 areas. During operation vital signs and adequacy of cerebral perfusion were monitored by keeping the patient awake and making clinical neurological observations. Verbal contact was maintained with the patient. Breathing patterns and motor power were assessed in contralateral upper and lower limbs. Postoperatively patients were interviewed and analgesia during operation was assessed with visual analogue scale. Surgeon's satisfaction regarding intraoperative analgesia was also noted. Patients who required added sedation or local anesthetic agent were also noted. Average duration of surgery time was two hours and average stay of the patients in hospital was five days. Results: Out of 45 patients, 37 patients (82%) had smooth and comfortable anaesthesia and analgesia. In only 1 patient (2.2%) LA had to be converted into general anaesthesia (GA). In 3 cases (7%) LA was supplemented. One patient (2.2%) developed hoarseness and difficulty in breathing and 1 patient (2.2%) developed hemiparesis intra-operatively; while 1 patient (2.2%) developed hypotension in the immediate postoperative period. One patient (2.2%) developed haematoma at infiltration

  3. Cerebral involvement in a patient with Goodpasture's disease due to shortened induction therapy: a case report

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    Preul Christoph

    2009-11-01

    Full Text Available Abstract Introduction Goodpasture's disease is a rare immunological disease with formation of pathognomonic antibodies against renal and pulmonary basement membranes. Cerebral involvement has been reported in several cases in the literature, yet the pathogenetic mechanism is not entirely clear. Case presentation A 21-year-old Caucasian man with Goodpasture's disease and end-stage renal disease presented with two generalized seizures after a period of mild cognitive disturbance. Blood pressure and routine laboratory tests did not exceed the patient's usual values, and examination of cerebrospinal fluid was unremarkable. Cerebral magnetic resonance imaging (MRI revealed multiple cortical and subcortical lesions on fluid-attenuated inversion recovery sequences. Since antiglomerular basement membrane antibodies were found to be positive with high titers, plasmapheresis was started. In addition, cyclophosphamide pulse therapy was given on day 13. Encephalopathy and MRI lesions disappeared during this therapy, and antiglomerular basement membrane antibodies were significantly reduced. Previous immunosuppressive therapy was performed without corticosteroids and terminated early after 3 months. The differential diagnostic considerations were cerebral vasculitis and posterior reversible encephalopathy syndrome. Vasculitis could be seen as an extrarenal manifestation of the underlying disease. Posterior reversible encephalopathy syndrome, on the other hand, can be triggered by immunosuppressive therapy and may appear without a hypertensive crisis. Conclusion A combination of central nervous system symptoms with a positive antiglomerular basement membrane test in a patient with Goodpasture's disease should immediately be treated as an acute exacerbation of the disease with likely cross-reactivity of antibodies with the choroid plexus. In our patient, a discontinuous strategy of immunosuppressive therapy may have favored recurrence of Goodpasture's disease.

  4. DKA with Severe Hypertriglyceridemia and Cerebral Edema in an Adolescent Boy: A Case Study and Review of the Literature

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    Tansit Saengkaew

    2016-01-01

    Full Text Available A 13-year-old adolescent boy with type 1 diabetes mellitus (1b presented with diabetic ketoacidosis (DKA and cerebral edema. Grossly lipemic serum and lipemia retinals due to extremely high triglyceride (TG level were observed without evidence of xanthoma or xanthelasma. Cerebral edema was treated by appropriate ventilation and mannitol administration. Normal saline was carefully given and regular insulin was titrated according to blood sugar levels. Triglyceride levels were reduced from 9,800 mg/dL to normal range within 9 days after conventional treatment was commenced without antilipid medication. Based on our review of the literature, this is the first reported case of confirmed pediatric DKA with severe hypertriglyceridemia and cerebral edema. In patients with DKA and hypertriglyceridemia, clinicians should be mindful of the possibility of associated acute pancreatitis and cerebral edema.

  5. Cerebral misery perfusion diagnosed using hypercapnic blood-oxygenation-level-dependent contrast functional magnetic resonance imaging: a case report

    Directory of Open Access Journals (Sweden)

    D'Souza Olympio

    2010-02-01

    Full Text Available Abstract Introduction Cerebral misery perfusion represents a failure of cerebral autoregulation. It is an important differential diagnosis in post-stroke patients presenting with collapses in the presence of haemodynamically significant cerebrovascular stenosis. This is particularly the case when cortical or internal watershed infarcts are present. When this condition occurs, further investigation should be done immediately. Case presentation A 50-year-old Caucasian man presented with a stroke secondary to complete occlusion of his left internal carotid artery. He went on to suffer recurrent seizures. Neuroimaging demonstrated numerous new watershed-territory cerebral infarcts. No source of arterial thromboembolism was demonstrable. Hypercapnic blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging was used to measure his cerebrovascular reserve capacity. The findings were suggestive of cerebral misery perfusion. Conclusions Blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging allows the inference of cerebral misery perfusion. This procedure is cheaper and more readily available than positron emission tomography imaging, which is the current gold standard diagnostic test. The most evaluated treatment for cerebral misery perfusion is extracranial-intracranial bypass. Although previous trials of this have been unfavourable, the results of new studies involving extracranial-intracranial bypass in high-risk patients identified during cerebral perfusion imaging are awaited. Cerebral misery perfusion is an important and under-recognized condition in which emerging imaging and treatment modalities present the possibility of practical and evidence-based management in the near future. Physicians should thus be aware of this disorder and of recent developments in diagnostic tests that allow its detection.

  6. Glioblastoma multiforme subterfuge as acute cerebral hemorrhage: A case report and literature review

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    Seidu A. Richard

    2018-04-01

    Full Text Available Hemorrhagic related Glioblastoma multiforme (GBM are rare and characterizes with severe clinical scuffle. The etiology of this presentation although not well known is believed to be multifactorial. We present a case as well as review on the pathogenesis of evolution of the hematoma into ring enhancing features of GBM on imaging studies. We present a case of 28 years old man who suddenly went into coma for 9 hours preceded with seizures that latest for 10 minutes. He had no focal neurological signs. CT-Scans images indicated acute cerebral hemorrhage near the frontal horn of the left ventricle with brain edema about the hemorrhagic lesion and MRI done a week later revealed a cerebral ring enhancing lesion. The lesion was partially resected during surgery and immunohistochemical staining confirmed GBM (WHO, grade 4. The diagnosis of intratumoral hemorrhage in GBM was very challenging at the initial stages but with time the hematoma evolved into ring enhancing images typical of GBM. It’s not every intracranial hematoma that is of pure vascular origin.

  7. A case of idiopathic cerebral calcification manifesting itself as a Parkinsonism

    International Nuclear Information System (INIS)

    Suzuki, Kenichi; Tone, Osamu; Yonemura, Naoteru

    1981-01-01

    This paper is a case presentation of a idiopathic cerebral calcification manifesting itself as a Parkinsonism. The patient, a 48-year-old female, was admitted to this hospital with a chief complaint of gait disturbance that had developed over the previous four months. On admission she was noted to have a slight dimunition of her mental capacity, a rigidity of her extremities (more pronounced in the lower limbs), and akinesia, though no tremor. CT scans revealed extensive areas of calcification in the central nervous system, encompassing the cerebral basal ganglia (corpus striatum), the cerebellum, the midbrain, and the gray and white matter of the cerebrum. There was no evidence of calcification in the spinal cord. Physical and laboratory examinations did not yield any findings suggestive of abnormalities in calcium metabolism, nor was there any indication that her condition was of a familial nature. The case was concluded, therefore, to be idiopathic. Amelioration in the symptoms occurred following the administration of L-dopa. (author)

  8. Un caso de infeccion humana por cisticerco racemoso cerebral de localizacion parenquimatosa en Valdivia, Chile A case of human cerebral infection by parenchymal racemose cysticercus in Valdivia, Chile

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    Eduardo Ortega

    1991-06-01

    Full Text Available Se presenta un caso clínico de infección por cisticerco racemoso cerebral de localización parenquimatosa en un paciente de la ciudad de Valdivia (Chile cuyo diagnóstico definitivo se efectuó a través del estudio morfológico del parásito. Se discute brevemente la escasa frecuencia de la localización parenquimatosa del cisticerco racemoso, así como su diagnóstico diferencial con otros estados larvarios de cestodos que desarrollan en el sistema nervioso.A clinical case of cerebral infection by parenchymal racemose cysticercus, diagnosed by means of morphological characteristics in a patient of Valdivia city is described. The rare frequency of parenquimal location of racemose cysticercus as well as its differential diagnosis with other larval stages of cestodes that develop in the brain and its treatment are discussed.

  9. Cerebral ischemia caused by Streptococcus bovis aortic endocarditis: case report Isquemia cerebral causada por endocardite aórtica pelo Streptococcus bovis: relato de caso

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    Leopoldo Santos-Neto

    2005-09-01

    Full Text Available Cerebral ischemic processes associated with infective endocarditis caused by Streptococcus bovis are rare; only 2 cases having been reported. Here we report a case of a 50-year-old man with S. bovis endocarditis who presented signs of frontal, parietal and occipital lobe cerebral ischemia. This is the first case reported in which the presence of hemianopsia preceded the endocarditis diagnosis. Initially, the clinical manifestations suggested a systemic vasculitis. Later, vegetating lesions were identified in the aortic valve and S. bovis grew in blood cultures. Antibiotic use and aortic valve replacement eliminated the infection and ceased thromboembolic events. A videocolonoscopy examination revealed no mucosal lesions as a portal of entry in this case, although such lesions have been encountered in up to 70% of reported cases of S. bovis endocarditis.A associação de isquemia cerebral e endocardite por Streptococcus bovis é um evento raro, tendo sido publicados apenas 2 casos anteriormente. Nós relatamos o caso de um homem de 50 anos com endocardite por S. bovis que apresentou sinais isquêmicos nos lobos frontal, parietal e occipital. Este é o primeiro caso em que a hemianopsia precedeu o diagnóstico de endocardite. Inicialmente, o quadro foi confundido com vasculite. Posteriormente, foi confirmada a presença de vegetações na válvula aórtica e a hemocultura identificou S. bovis. Os eventos tromboembólicos foram controlados com o uso de antibióticos e a troca da válvula aórtica. Estudo videocolonoscópico não identificou nenhuma lesão, apesar de lesões colônicas serem descritas em até 70% dos casos de indivíduos com endocardite por S. bovis.

  10. A comparative study of itraconazole in various dose schedules in the treatment of pulmonary aspergilloma in treated patients of pulmonary tuberculosis

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    Prahlad Rai Gupta

    2015-01-01

    Full Text Available Introduction: The optimal dose, duration, and efficacy of itraconazole in Indian patients of pulmonary aspergilloma (PA are not clearly defined. Therefore, a study was carried out, to resolve these issues in diagnosed cases of PA complicating old treated patients of pulmonary tuberculosis. Materials and Methods: The study patients randomly received itraconazole either in a fixed dose schedule of 200 mg (group I, 200 mg twice daily (group II or a variable dose schedule (group III, for 12 months. All the patients were followed up for the entire duration of the study for clinical, radiological, and immunological response. The side effects were recorded as and when reported by the patients and managed symptomatically. Results: A total of 60 patients were enrolled, 20, in each group. There were no intergroup differences with regard to age, sex, body weight, smoking status, alcohol intake, symptoms, Potassium hydroxide (KOH mount, fungal culture, pattern of radiological lesions or anti-aspergillus antibodies (anti-Asp-Ab titers. The radiological response was poor in group I patients, as compared to the other groups, at two months (P < 0.05. The dose of itraconazole was increased in five of the patients in group I due to poor response. A higher number of group II patients suffered side effects and the dose of itraconazole had to be decreased in three of these patients, but none of the patients on a variable dose schedule required a change in dose schedule. Conclusion: Thus, a weight-based variable dose schedule of itraconazole was found to be a more effective and safer modality in the management of PA than a fixed dose schedule.

  11. [A Case of Middle Cerebral Artery Stenosis Presented with Limb-Shaking TIA].

    Science.gov (United States)

    Uno, Junji; Mineta, Haruyuki; Ren, Nice; Takagishi, Sou; Nagaoka, Shintarou; Kameda, Katsuharu; Maeda, Kazushi; Ikai, Yoshiaki; Gi, Hidefuku

    2016-07-01

    Involuntary movement is a rare clinical manifestation of transient ischemic attack (TIA). However, limb-shaking TIA is well described presentation of carotid occlusive disease. We present the case of a patient who developed limb-shaking TIA associated with high-grade stenosis of middle cerebral artery (M1), which was treated with percutaneous transluminal angioplasty (PTA). The procedure was performed successfully without complication and the symptom disappeared immediately after the procedure. The patient remained free of symptoms at the 38-month follow-up. There was no tendency of restenosis of M1. In this case, PTA was technically feasible and beneficial for limb-shaking TIA with M1 stenosis. Limb-shaking TIA can be a symptom of high-grade stenosis of M1.

  12. Disseminated tuberculosis presenting as mesenteric and cerebral abscess in HIV infection: case report

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    Vinay Pandit

    Full Text Available Disseminated tuberculosis in HIV infection involves multiple organs. Pulmonary and lymph node involvement are the commonest form of tuberculosis in HIV infection [1, 2]. Other forms of tuberculosis in the absence of lung and lymph node involvement are rare. Various forms of abdominal [3, 4] and neurological [5, 6] tubercular involvement in HIV infection have been reported. But tuberculosis presenting simultaneously with mesenteric and brain abscess has not been reported yet. We report a case of disseminated tuberculosis presenting as mesenteric and cerebral abscess in a HIV case without involving lung and lymph nodes. Bone marrow smears and fine needle aspiration cytology (FNAC from mesenteric lesion were positive for acid fast bacilli (AFB and the diagnosis of tuberculosis was confirmed by positive polymerase chain reaction (PCR. He responded well to treatment with anti tubercular drugs.

  13. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases.

    Science.gov (United States)

    Boukobza, Monique; Crassard, Isabelle; Bousser, Marie-Germaine; Chabriat, Hugues

    2016-01-01

    The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with hemorrhagic infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it.

  14. Paediatric dissecting posterior cerebral aneurysms: report of two cases and review of the literature

    International Nuclear Information System (INIS)

    Vilela, Pedro; Goulao, Augusto

    2006-01-01

    Intracranial aneurysms in the paediatric population are uncommon, accounting for 2% to 6% of all aneurysms, and spontaneous arterial dissection is rarely reported as the cause of aneurysms in children, especially in the posterior cerebral artery. Two cases of paediatric spontaneous posterior cerebral artery dissecting aneurysms are reported, one in a 33-month-old male child presenting with aneurysmal rupture and subarachnoid haemorrhage and the other in a 9-year-old boy with an unruptured aneurysm. The first child was successfully treated by endovascular parent vessel occlusion without neurological deficit and in the second a spontaneous thrombosis of the aneurysm and its parent artery occurred associated with hydrocephalus and a favourable outcome. Dissecting aneurysms are dynamic lesions with variable and unpredictable evolution and close follow-up and/or early treatment is warranted. Spontaneous arterial dissection is a rare, probably still under-recognized, cause of intracranial aneurysms that may be responsible for a significant number of aneurysms and spontaneous aneurysmal thromboses in children. (orig.)

  15. Paediatric dissecting posterior cerebral aneurysms: report of two cases and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, Pedro; Goulao, Augusto [Garcia de Orta Hospital, Neuroradiology Department, Almada (Portugal)

    2006-08-15

    Intracranial aneurysms in the paediatric population are uncommon, accounting for 2% to 6% of all aneurysms, and spontaneous arterial dissection is rarely reported as the cause of aneurysms in children, especially in the posterior cerebral artery. Two cases of paediatric spontaneous posterior cerebral artery dissecting aneurysms are reported, one in a 33-month-old male child presenting with aneurysmal rupture and subarachnoid haemorrhage and the other in a 9-year-old boy with an unruptured aneurysm. The first child was successfully treated by endovascular parent vessel occlusion without neurological deficit and in the second a spontaneous thrombosis of the aneurysm and its parent artery occurred associated with hydrocephalus and a favourable outcome. Dissecting aneurysms are dynamic lesions with variable and unpredictable evolution and close follow-up and/or early treatment is warranted. Spontaneous arterial dissection is a rare, probably still under-recognized, cause of intracranial aneurysms that may be responsible for a significant number of aneurysms and spontaneous aneurysmal thromboses in children. (orig.)

  16. Cerebral oxygenation monitoring in patients with bilateral carotid stenosis undergoing urgent cardiac surgery: Observational case series

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    Dincer Aktuerk

    2016-01-01

    Full Text Available Background: Patients with significant bilateral carotid artery stenosis requiring urgent cardiac surgery have an increased risk of stroke and death. The optimal management strategy remains inconclusive, and the available evidence does not support the superiority of one strategy over another. Materials and Methods: A number of noninvasive strategies have been developed for minimizing perioperative stroke including continuous real-time monitoring of cerebral oxygenation with near-infrared spectroscopy (NIRS. The number of patients presenting with this combination (bilateral significant carotid stenosis requiring urgent cardiac surgery in any single institution will be small and hence there is a lack of large randomized studies. Results: This case series describes our early experience with NIRS in a select group of patients with significant bilateral carotid stenosis undergoing urgent cardiac surgery (n = 8. In contrast to other studies, this series is a single surgeon, single center study, where the entire surgery (both distal ends and proximal ends was performed during single aortic clamp technique, which effectively removes several confounding variables. NIRS monitoring led to the early recognition of decreased cerebral oxygenation, and corrective steps (increased cardiopulmonary bypass flow, increased pCO 2 , etc., were taken. Conclusion: The study shows good clinical outcome with the use of NIRS. This is our "work in progress," and we aim to conduct a larger study.

  17. Radiosurgery for cerebral arteriovenous malformation during pregnancy: A case report focusing on fetal exposure to radiation

    Science.gov (United States)

    Nagayama, Kazuki; Kurita, Hiroki; Tonari, Ayako; Takayama, Makoto; Shiokawa, Yoshiaki

    2010-01-01

    Introduction: We present the case of a pregnant woman who underwent linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) and we discuss the fetal exposure to radiation. Clinical Presentation: A 20-year-old woman at 18 weeks of gestation presented with right cerebral hemorrhage and underwent urgent evacuation of the hematoma. She recovered well after surgery, but cerebral angiography after the surgery revealed a small deeply seated arteriovenous malformation (AVM) in the right frontal lobe extending to the right basal ganglia. Methods and Results: We examined the diffuse AVM and treated it with LINAC-based SRS at 24 weeks of gestation. Before SRS, the fetus was exposed to a radiation dose of 8.26 mGy, which was estimated by conducting an experiment using an adult RANDO phantom, and a radiophotoluminescent (RPL) glass rod dosimeter (GRD) system. The patient underwent Caesarean delivery at 36 weeks of gestation and gave birth to a healthy baby. Conclusion: The exposure of fetus to radiation during SRS was exceedingly low. SRS can be used as an alternative treatment to microsurgery for resolving small deeply seated AVMs even in pregnant patients. PMID:22028762

  18. A Unique Case of Acute Cerebral Venous Sinus Thrombosis Secondary to Primary Varicella Zoster Virus Infection.

    Science.gov (United States)

    Imam, Syed F; Lodhi, Omair Ul Haq; Fatima, Zainab; Nasim, Saneeya; Malik, Waseem T; Saleem, Muhammad Sabih

    2017-09-16

    Primary varicella zoster virus (VZV) infection, predominantly in the pediatric population, presents with pyrexia and a classic pruritic vesicular rash. In adults, although less common, it is more severe and linked to more complications. Neurological complications, which account for less than 1% of all VZV complications, include meningitis, encephalitis, arterial vasculopathy, and venous thrombosis. We present a case of a 39-year-old male who developed extensive cerebral venous sinus thrombosis following primary VZV infection. Venous thrombosis in VZV has been suggested to be caused by autoantibodies against protein S, pre-existing hypercoagulability, or endothelial damage. The patient was acutely managed using intravenous acyclovir and heparin. Long-term anticoagulation therapy with warfarin was continued after discharge. We concluded that clinicians should be aware of the rare complications of this common pathology so that a timely diagnosis can be made, followed by prompt management. Further studies need to be done to better understand acute cerebral venous sinus thrombosis secondary to VZV.

  19. Case Report: A Case of Severe Cerebral Malaria Managed with Therapeutic Hypothermia and Other Modalities for Brain Edema.

    Science.gov (United States)

    Gad, AbdAllah; Ali, Sajjad; Zahoor, Talal; Azarov, Nick

    2018-04-01

    Malarial infections are uncommon in the United States and almost all reported cases stem from recent travelers coming from endemic countries. Cerebral malaria (CM) is a severe form of the disease usually affecting children and individuals with limited immunity. Despite proper management, mortality from CM can reach up to 25%, especially when it is associated with brain edema. Inefficient management of the edema may result in brain herniation and death. Uniform guidelines for management of CM-associated brain edema are lacking. In this report, we present a case of CM with associated severe brain edema that was successfully managed using a unique combination of therapeutic hypothermia, hypertonic saline, mannitol, and hyperventilation along with the antimalarial drugs quinidine and doxycycline. Our use of hypothermia was based on its proven benefit for improving neurological outcomes in post-cardiac arrest patients and previous in vitro research, suggesting its potential inhibitory role on malaria growth.

  20. Variations and Anomalies of the circle of Willis in Korean: Cerebral digital subtraction angiogram studies in 200 case

    International Nuclear Information System (INIS)

    Lee, Ouk; Chung, Gyoo Sik; Kim, So Sun; Huh, Jin Do; Kim, Ho Joon; Joh, Young Duk

    1989-01-01

    In order to evaluate the variations of the circle of Willis in Korean population, digital subtraction angiograms in 200 cases were retrospectively analyzed. There was non-visualization of the anterior communicating artery and the posterior communicating artery in 41 cases and this was the most common type 4 vessel cerebral angiogram (20.5%). Unilateral or bilateral non-visualization of the posterior communicating artery was noted in 40 case (20%). The fetal origin of the posterior cerebral artery from the internal carotid artery was seen in 22 cases (11%). In 20 out of 22 cases, there were non-visualization of either the anterior communicating or posterior communicating artery. Visualization of the anterior communicating artery was noted in 102 cases (51%) and of the posterior communicating artery in 87 cases (43.5%). Hypoplasia of the anterior cerebral artery was noted in 24 cases (12%). Non- visualization of the anterior communicating artery or unilateral posterior communicating artery is noted in 16 cases (8%). Non- visualization of the anterior communicating artery was seen in 14 cases (7%). The most common type in appearance of the basilar artery variation was straight type (Type 1: 51%) and the bifurcation of the basilar artery was most commonly located above the posterior clinoid process of the dorsum sellae (58%) on vertebral angiogram

  1. Evaluation of cerebral perfusion imaging with N-isopropyl-p-[123I]iodoamphetamine (IMP) in the cases of antiphospholipid syndrome

    International Nuclear Information System (INIS)

    Kato, Toru; Nanbu, Ichiro; Tohyama, Junko; Ohba, Satoru

    1995-01-01

    Five cases of antiphospholipid syndrome with mild headache, but without any neurological deficits and abnormal findings by CT and MRI, were examined by cerebral blood perfusion SPECT using N-isopropyl-p-[ 123 I] iodoamphetamine (IMP). Although three cases were performed quantification of cerebral blood flow with a microsphere method simultaneously, their values were within normal limits. Two of them showed focal low perfusion areas. One case had relatively low perfusion areas in the bilateral occipital lobes and the right temporal lobe, which improved after treatment. One of two had low perfusion in the bilateral occipital lobes. Other three cases only showed ununiformity of radioisotope uptake on the cerebral blood perfusion SPECT. Low perfusion areas in antiphospholipid syndrome might be caused by microarterial thrombosis, microvenous thrombosis or spasms, although they could be reversible. As early irreversible progress of cerebral blood flow, cerebral blood flow SPECT should be performed in cases of antiphospholipid syndrome with neurological complainments. (author)

  2. Evaluation of cerebral perfusion imaging with N-isopropyl-p-[{sup 123}I]iodoamphetamine (IMP) in the cases of antiphospholipid syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Toru; Nanbu, Ichiro; Tohyama, Junko; Ohba, Satoru [Nagoya City Univ. (Japan). Faculty of Medicine

    1995-01-01

    Five cases of antiphospholipid syndrome with mild headache, but without any neurological deficits and abnormal findings by CT and MRI, were examined by cerebral blood perfusion SPECT using N-isopropyl-p-[{sup 123}I] iodoamphetamine (IMP). Although three cases were performed quantification of cerebral blood flow with a microsphere method simultaneously, their values were within normal limits. Two of them showed focal low perfusion areas. One case had relatively low perfusion areas in the bilateral occipital lobes and the right temporal lobe, which improved after treatment. One of two had low perfusion in the bilateral occipital lobes. Other three cases only showed ununiformity of radioisotope uptake on the cerebral blood perfusion SPECT. Low perfusion areas in antiphospholipid syndrome might be caused by microarterial thrombosis, microvenous thrombosis or spasms, although they could be reversible. As early irreversible progress of cerebral blood flow, cerebral blood flow SPECT should be performed in cases of antiphospholipid syndrome with neurological complainments. (author).

  3. A Young Male with Spontaneous Ruptured Cerebral Arteriovenous Malformation (Case Report

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    Vitorino Modesto Santos

    2016-04-01

    Full Text Available Background: Cerebral arteriovenous malformation (AVM is considered a congenital condition characterized by arterial-venous connections in the absence of intermediate capillaries with circulatory and functional changes, inclusive on the cerebrospinal fluid (CSF dynamics. Case: A previously healthy young man with abrupt onset of intense headache followed by incoercible vomiting and generalized tonic-clonic seizures. On admission, he was in Glasgow scale IV with respiratory gasping, signs of decerebration and anisocoric mydriasis, and right paresis. Computed tomography showed left intraparenchymal hematoma and intraventricular blood. The abnormal vessels and blood clots were removed by neurosurgery. In early postoperative phase a large cerebrospinal fluid leak developed, and was aspirated and further controlled. The patient had respiratory complications, including pulmonary infection by Pseudomonas. Conclusions: After longstanding hospitalization, he was referred to other medical institution and home care. 

  4. Combined Ipsilateral Oculomotor Nerve Palsy and Contralateral Downbeat Nystagmus in a Case of Cerebral Infarction

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    Kosuke Matsuzono

    2014-04-01

    Full Text Available We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.

  5. Report of diffusion-weighted MRI in two cases with different cerebral hydatid disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitis, O.; Calli, C.; Yunten, N. [Ege Univ., Izmir (Turkey). Dept. of Radiology

    2004-02-01

    To present MRI findings in two cases of cerebral hydatid disease with an emphasis on diffusion-weighted imaging (DWI) findings of Echinococcus granulosus (EG) versus Echinococcus alveolaris (EA). EG lesions were isointense with cerebrospinal fluid in all sequences including DWI. On DWI, EA lesions remained hypointense on b = 1000 s/mm2 diffusion-weighted images. Apparent diffusion coefficient (ADC) values of EG and EA lesions were completely different from each other, 2.88 {+-} 0.24 x 10{sup -3} s/mm{sup 2} and 1.33 {+-} 0.15 x 10{sup -3} s/mm{sup 2}, respectively. The ADC values could not be used to discriminate from other differential diagnoses.

  6. Report of diffusion-weighted MRI in two cases with different cerebral hydatid disease

    International Nuclear Information System (INIS)

    Kitis, O.; Calli, C.; Yunten, N.

    2004-01-01

    To present MRI findings in two cases of cerebral hydatid disease with an emphasis on diffusion-weighted imaging (DWI) findings of Echinococcus granulosus (EG) versus Echinococcus alveolaris (EA). EG lesions were isointense with cerebrospinal fluid in all sequences including DWI. On DWI, EA lesions remained hypointense on b = 1000 s/mm2 diffusion-weighted images. Apparent diffusion coefficient (ADC) values of EG and EA lesions were completely different from each other, 2.88 ± 0.24 x 10 -3 s/mm 2 and 1.33 ± 0.15 x 10 -3 s/mm 2 , respectively. The ADC values could not be used to discriminate from other differential diagnoses

  7. Androgen-induced cerebral venous sinus thrombosis in a young body builder: case report

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    Azimi Amir

    2004-12-01

    Full Text Available Abstract Background Cerebral venous sinus thrombosis is an infrequent disease with a variety of causes. Pregnancy, puerperium, contraceptive pills and intracranial infections are the most common causes. The patient may present with headache, focal neurological deficits and seizures. The clinical outcome is highly variable and treatment with heparin is advised. Case presentation The patient is a 22 year old male who presented with headache, repeated vomiting and papilledema. He was a bodybuilder doing exercise since 5 years ago, who had used nandrolone decaonoate 25 milligrams intramuscularly during the previous 5 months. Brain MRI and MRV showed superior sagital and transverse sinus thrombosis and extensive investigations did not reveal any known cause. Conclusions We suggested that androgen was the predisposing factor in our patient. Androgens may increase coagulation factors or platelet activity and cause arterial or venous thrombosis. As athletes may hide using androgens it should be considered as a predisposing factor for thrombotic events in such patients.

  8. Chronic rhino-orbito-cerebral mucormycosis: A case report and review of the literature

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    Eva M. Gutiérrez-Delgado

    2016-03-01

    Full Text Available Mucormycosis is a life-threatening disease, were rhinocerebral infection is most commonly seen in the clinical setting. Chronic mucormycosis is a rare presentation that exhibits a challenging diagnosis. We describe the case of a 47 year old diabetic man with complains of left zygomatic arch swelling of 3 months evolution. He had received previous antibiotic treatment without improvement. Biopsy of maxillary sinus revealed the presence of non-septated, 90° angle branched hyphae compatible with zygomicetes. The patient was treated with surgical debridement and amphotericin B until there was no evidence of fungi in the tissue by biopsy. We reviewed chronic rhino-orbito-cerebral mucormycosis from 1964–2014 and 22 cases were found, being this the second case of chronic mucormycosis reported in Mexico. A quarter of the cases were seen in immunocompetent hosts. As only 20% of the causal agent can be isolated by culture, the diagnosis is mainly made by biopsy. Besides treatment with amphotericin B, posaconazole as alternative, and control of the underlying comorbidities, surgical debridement represents the corner stone therapy. We recommend at least 36 month follow-up, due to the 13% risk of recurrence. A chronic presentation has a general survival rate of approximately 83%.

  9. Meningiomatosis restricted to the left cerebral hemisphere with acute clinical deterioration: Case presentation and discussion of treatment options.

    Science.gov (United States)

    Ohla, Victoria; Scheiwe, Christian

    2015-01-01

    True multiple meningiomas are defined as meningiomas occurring at several intracranial locations simultaneously without the presence of neurofibromatosis. Though the prognosis does not differ from benign solitary meningiomas, the simultaneous occurrence of different grades of malignancy has been reported in one-third of patients with multiple meningiomas. Due to its rarity, unclear etiology, and questions related to proper management, we are presenting our case of meningiomatosis and discuss possible pathophysiological mechanisms. We illustrate the case of a 55-year-old female with multiple meningothelial meningeomas exclusively located in the left cerebral hemisphere. The patient presented with acute vigilance decrement, aphasia, and vomiting. Further deterioration with sopor and nondirectional movements required oral intubation. Emergent magnetic resonance imaging (MRI) with MR-angiography disclosed a massive midline shift to the right due to widespread, plaque-like lesions suspicious for meningeomatosis, purely restricted to the left cerebral hemisphere. Emergency partial tumor resection was performed. Postoperative computed tomography (CT) scan showed markedly reduction of cerebral edema and midline shift. After tapering the sedation a right-sided hemiparesis resolved within 2 weeks, leaving the patient neurologically intact. Although multiple meningeomas are reported frequently, the presence of meningeomatosis purely restricted to one cerebral hemisphere is very rare. As with other accessible and symptomatic lesions, the treatment of choice is complete resection with clean margins to avoid local recurrence. In case of widespread distribution a step-by-step resection with the option of postoperative radiation of tumor remnants may be an option.

  10. Cerebral Schistosomiasis Caused by Schistosoma mansoni: a Case Report with Clinical Analysis

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    M Li

    2009-05-01

    Full Text Available "nCentral nervous system involvement arising from schistosomiasis is uncommon. It may be produced most fre­quently by Schistosoma japonicum infection, but reports of S. mansoni presenting as an intracerebral mass lesion are particularly rare. The authors describe the case of a 35-year-old woman with a 3-month history of partial epilep­tic seizures and head­aches. She immigrated to Egypt 4 years ago and had worked in Iraq for 2 years after the immigration. The patient's gen­eral physical and neurological examinations were unremarkable. Magnetic resonance (MR imaging revealed an enhanc­ing lesion with surrounding edema and mild mass effect in the left frontal lobe. A stereotactic brain biopsy demonstrated intraparenchymal granulomas surrounding S. mansoni eggs. S. mansoni was identified by stool examination. Prednisone (1 mg/kg per day for 1 week, with gradual with­drawal during the following 3 weeks and praziquantel (2 doses at 20 mg/kg per day therapy was initiated. The patient's symptoms resolved following medical treatment and the follow-up MR imaging yielded normal findings. This case is the rare imported case of cerebral schistosomiasis in China and the neuroschistosomiasis should be considered as the patient lived in a region in which this disease is endemic.

  11. A case of left-sided unilateral spatial neglect owing to the cerebral infarction in the distribution of the right posterior cerebral artery

    International Nuclear Information System (INIS)

    Odagaki, Yuji; Oka, Iori; Kon, Yutaka; Asano, Yutaka

    1985-01-01

    We report a case of left-sided unilateral spatial neglect (USN) induced by the cerebral infarction in the distribution of right posterior cerebral artery (PCA). A 69-year-old, right-handed man, who had had a sudden onset of left hemiparesis in August 1983, was admitted to our hospital on January 16, 1984, because of nocturnal delirium. He became alert a few days after admission, but was euphoric and sometimes irritable. Neurologic examination disclosed left homonymous hemianopsia, dysarthria, left central facial weakness, spastic left hemiparesis, hyperactive reflexes on the left with no Babinski sign, left hemisensory loss, and left thalamic pain. On neuropsychologic examination it was revealed that he had a tendency to neglect the left half of his extrapersonal space. When asked to locate cities on a blank map of Japan, he located most of them not only on the right side of the map but also incorrectly. He also had a severe acalculia. There was gradual improvement in these neuropsychologic symptoms. CT demonstrated an area of decreased density in the territory of the right PCA, posterolateral portion of the right thalamus, and the posterior limb of right internal capsule, sparing parietal and temporal lobes. Single-photon emission computed tomography (SPECT) using the Xenon-133 inhalation method showed, however, diminished regional cerebral blood flow (rCBF) in an area larger than the area of infarction demonstrated by CT, including the right parieto-temporo-occipital junctional area, which has been considerd to be responsible for left-sided USN. The authors ascribed the patient's left-sided USN to the lesion of this area that was revealed not morphologically by CT but functionally by SPECT, although the possibility that the lesions of the medial portion of the right occipital lobe and/or subcortical lesions of such areas as the thalamus and the internal capsule more or less influenced the neuropsychologic symptoms could not be excluded. (author)

  12. UNILATERAL ACTINOMYCOTIC TUBO-OVARIAN ABSCESS COMPLICATED WITH CEREBRITIS – A CASE REPORT

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    Marina Jakimovska

    2018-02-01

    Full Text Available Background: Tuboovarian abscess is a serious complication of pelvic inflammatory disease. Pelvic ac- tinomycosis may correlate with long term use of intra-uterine device (IUD, but is uncom- mon cause of inflammation, except in postmenopausal IUD users.1, 2 Tuboovarian abscess complicated with cerebritis is relatively uncommon condition. Methods: We present a rare case of a 56-years-old woman with IUD, developing tuboovarian abscess that complicated with cerebritis. Twenty days before admittance to the Gynecologic clinic, she complained of fatigue and nausea, anorexia, vomiting and diarrhea. After an initial improvement for 5 days her symptoms recurred, profounded with sweating and fever up to 40 °C, leg weakness and walking difficulties, and weight loss. In that condition she was presented to our emergency room. There was no history of chronic disease. The patient had an IUD for the past 30 years. On physical examination the abdomen was tender, but without signs of peritoneal irritation. Laboratory studies revealed elevated CRP (107 mg/L, ESR (65mm/h and normal number of leukocytes (7.8 × 109/L. Ultrasound showed 8x4 cm left infraumbilical septated mass suspect for tubo-ovarian abscess.. She was hospitalized, IUD was removed and Metronidazol, Ciprofloxacin and Gentamycin were started parenterally. Tumor markers were negative. On the next day she developed neurologic symptoms with blindness and left-hemiparesis. MR angiography and CT of the head revealed local brain edema, suspect for cerebritis. Although the laboratory findings of inflammation were de- creasing, we changed the antimicrobial therapy with Cefotaxime and Kloksacilin (Orbenin instead of Metronidazol and Ciprofloxacin because of better blood-brain barrier transport. Cerebrospinal fluid tests for HSV, neurotropic viruses, malignant cells, TBC, echinoccocus, toxoplasmosis, cysticercosis, pathogenic bacteria, fungi, TILR2, and TNF alfa were nega- tive. A brain biopsy was preformed and

  13. Unusual Case of Cerebral Venous Thrombosis in Patient with Crohn's Disease

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    Inha Kim

    2015-05-01

    Full Text Available The development of cerebral venous thrombosis (CVT as a secondary complication of Crohn's disease (CD seems to be rare, but it is generally accepted that the disease activity of CD contributes to the establishment of a hypercoagulable state. Here, we describe a case of CVT that developed outside the active phase of CD. A 17-year-old male visited the emergency room because of a sudden onset of right-sided weakness and right-sided hypesthesia. He had been diagnosed with CD 1 year before and was on a maintenance regimen of mesalazine and azathioprine. He did not exhibit any symptoms indicating a CD flare-up (bloody stools, abdominal pain, complications, or weight loss. A brain MRI scan revealed an acute infarction of the left frontal cortex and a cortical subarachnoid hemorrhage. Additionally, a magnetic resonance venography revealed a segmental filling defect in the superior sagittal sinus and also the non-visualizability of some bilateral cortical veins. The characteristics of the present case suggest that the risk of CVT is most likely related to CD per se rather than disease activity associated with CD.

  14. Jogging Therapy for Hikikomori Social Withdrawal and Increased Cerebral Hemodynamics: A Case Report.

    Science.gov (United States)

    Nishida, Masaki; Kikuchi, Senichiro; Fukuda, Kazuhito; Kato, Satoshi

    2016-01-01

    Severe social withdrawal, called hikikomori, has drawn increased public attention. However, an optimal clinical approach and strategy of treatment has not been well established. Here, we report a case of hikikomori for which an exercise intervention using jogging therapy was effective, showing cerebral hemodynamic improvement. The patient was a 20 year old Japanese male who was hospitalized in order to evaluate and treat severe social withdrawal. Although depressive and anxiety symptoms partially subsided with sertraline alone, social withdrawal persisted due to a lack of self confidence. With his consent, we implemented exercise therapy with 30 minutes of jogging three times a week for three months. We did not change the pharmacotherapy, and his social withdrawal remarkably improved with continuous jogging exercise. Using near infrared spectroscopy to evaluate hemodynamic alteration, bilateral temporal hemodynamics considerably increased after the three-month jogging therapy. Regarding exercise therapy for mental illness, numerous studies have reported the effectiveness of exercise therapy for major depression. This case implied, however, that the applicability of exercise therapy is not limited to major depressive disorder. Jogging therapy may contribute to reinforcing self confidence associated with "resilience" in conjunction with neurophysiological modulation of neural networks.

  15. Measurement of cerebral blood flow by single photon emission computed tomography in cases of internal carotid artery occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Sunada, Ichiro [Osaka City Univ. (Japan). Faculty of Medicine

    1989-06-01

    Cerebral blood flow (CBF) was measured with {sup 133}xenon inhalation and single photon emission computed tomography in 33 cases of internal carotid artery occlusion, in the resting state and 25 minutes after acetazolamide administration. The patient population consisted of 24 males and nine females with a mean age of 57 years, who presented with transient ischemic attacks or stroke. Acetazolamide inhibits carbonic anhydrase, and CBF increases as a result of dilatation of cerebral arteries due to CO{sub 2} accumulation. The mean CBF was 46 ml/100 g/min on the affected hemisphere and 56 ml/100 g/min on the unaffected hemisphere. The mean CBF value obtained by the same method in 10 normal volunteers was 55 ml/100 g/min. The average increase in CBF after acetazolamide administration was 9% on the affected side and 17% on the unaffected side. The average increase in 10 normal volunteers was 32%. The reduced cerebral arterial reactivity to acetazolamide administration was bilateral in the patient group, suggesting that the cerebral arteries were dilated so as to maintain normal CBF. Extra-intracranial (EC-IC) bypass surgery was performed in nine patients. Preoperatively, the mean CBF was 48 ml/100 g/min on the affected side and 57 ml/100 g/min on the unaffected side. With postoperative acetazolamide administration, the percent increase in CBF rose from 13% to 22% on the affected side and from 17% to 23% on the unaffected side. The bilateral change toward normal in cerebral arterial reactivity to acetazolamide indicates that the dilated cerebral arteries returned to normal after EC-IC bypass surgery. This suggests that bypass surgery is effective in patients with internal carotid artery occlusion in whom ischemia is caused only by hemodynamic factors, and that measurement of CBF via acetazolamide loading is useful in identifying appropriate candidates for bypass surgery.

  16. Hemorrhage in cerebral metastasis from angiosarcoma of the heart: case report Hemorragia em metástase cerebral de angiossarcoma cardíaco: relato de caso

    Directory of Open Access Journals (Sweden)

    Pasquale Gallo

    2001-09-01

    Full Text Available The purpose of this article is to describe the clinical and pathological features of metastatic angiosarcoma in the central nervous system. Only a few cases of cerebral metastasis from angiosarcoma of the heart have been recorded in the literature; particulary related to intracerebral hemorrhage. A case of secondary cerebral angiosarcoma of the heart in a 33 years old man is presented. The initial symptoms were headache, vomiting, lethargy and aphasia. There was a mass in the left temporal lobe with hemorrhage and edema on the computerized tomography (CT. After 24 hours the neurological status worsened and another CT scan showed rebleeding on the tumor area. He underwent an emergency craniotomy but died two days after. Considering the longer survival of sarcoma patients with new modalities of treatment, the incidence of brain metastasis may increase, demanding a bether preventive and more aggressive approach. Besides, due to the hemorrhagic nature of such lesions, we suggest the imediate surgery to prevent a fast and lethal evolution because rebleeding.O propósito deste artigo é descrever os achados clínicos e patológicos das metástases de angiossarcoma no sistema nervoso central. Apenas poucos casos de metástases cerebrais de angiossarcoma cardíaco foram relatados na literatura, menos ainda relacionados a hemorragia intracerebral. Relatamos o caso de um tumor cerebral secundário a angiossarcoma cardíaco em um paciente masculino de 33 anos. Os sintomas iniciais foram: cefaléia, vômitos, letargia e afasia. A tomografia computadorizada mostrou massa no lobo temporal esquerdo associada a hemorragia e edema. Após 24 horas houve piora do estado neurológico e nova tomografia demonstrou ressangramento no leito tumoral. Foi submetido a uma craniotomia de urgência mas faleceu dois dias após. Considerando a longa sobrevida dos pacientes com sarcoma devido às novas modalidades terapêuticas, poderá aumentar a incidência de met

  17. Cerebral germinoma revealed through a polydipsic polyuric syndrome in a 10-year-old girl: case report

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    Van Lierde

    2017-10-01

    Full Text Available Cerebral germinoma is rare. Although the imaging of the germinoma is very evocative, it’s very polymorphic clinical expression is at the origin of misguided diagnosis, as illustrated in our case. We report the case of a 10-year-old girl with diabetes insipidus evolving for 12 months associated with a decrease in visual acuity. Brain MRI (Magnetic Resonance Imaging revealed a tumor process in the suprasellar region. The stereotaxic biopsy of the tumor confirmed the diagnosis of the hypothalamic germinoma, which allowed the patient to be treated by radiotherapy and chemotherapy. The incidence of cerebral germinoma, its clinical (principally diabetes insipidus and radiological features as well as therapeutic strategies are discussed hereby.

  18. Middle Cerebral Artery Stroke as Amusement Park Injury: Case Report and Review of the Literature

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    Abby Baumgartle

    2017-07-01

    Full Text Available Strokes as amusement park injuries are rare, but have been reported in the literature. Only about 20 cases of cerebrovascular accidents after amusement park visits have been described. We report a healthy 12-year-old boy who presented with facial droop, slurred speech, and inability to use his right arm after riding roller coasters at a local amusement park. He was evaluated and found to have a left middle cerebral artery (MCA infarction. The patient was treated with anticoagulants and has recovered with no major residual symptoms. It is likely that his neurological symptoms occurred due to the high head accelerations experienced on the roller coasters, which are more detrimental to children due to immature cervical spine development and muscle strength. Early diagnosis of dissection and stroke results in a favorable prognosis. Providers and parents should be aware of the potential risk of roller coasters and act quickly on neurologic changes in children that have recently been to an amusement park.

  19. A case of glutaric aciduria type I with unique abnormalities in the cerebral CT findings

    International Nuclear Information System (INIS)

    Yamaguchi, Seiji; Orii, Tadao; Yasuda, Kanji; Kohno, Yoshinori

    1987-01-01

    A first Japanese case of glutaric aciduria type I (GA-I) was described. She was a 7-month-old girl presenting with poor head control, irritability and sleeplessness. The profile of urinary organic acids by gas chromatography mass spectrometry (GC/MS) suggesting GA-I were confirmed by no activity of glutaryl-CoA dehydrogenase in the fibroblasts. The cerebral computer tomography (CT) showed marked changes such as large fluid collections on bilateral frontotemporal regions and a slight enlargement of bilateral ventricles. The amounts of urinary glutarate excretion decreased after restriction of lysine and tryptophan in her diet and administration of carnitine improved the carnitine levels in blood and urine, while these were less effective for the neurological symptoms. On the other hand, oral administration of lioresal, an analogue of gamma-aminobutyrate (GABA), cleared her symptoms such as ill temper, irritability and sleeplessness dramatically, and the abnormalities of the CT examinations were not more deteriorative until 2 years of her age at least. The neurological manifestations of GA-I seemed to be affected by the unusual metabolism of GABA in the central nervous system. (author)

  20. Apixaban for the treatment of cerebral venous thrombosis: A case series.

    Science.gov (United States)

    Rao, Shishir Keekana; Ibrahim, Mohammad; Hanni, Claudia M; Suchdev, Kushak; Parker, Dennis; Rajamani, Kumar; Mohamed, Wazim

    2017-10-15

    Venous thrombosis affecting cerebral veins and sinuses (CVT) is an uncommon neurological condition. Traditionally patients are treated with intravenous heparin followed by an oral vitamin K antagonist like warfarin. Direct oral anticoagulants (DOACs) may offer advantages over warfarin. There is evidence to demonstrate the effectiveness of both dabigatran and rivaroxaban. No data, however, has been published describing the use of apixaban in patients with CVT. Report of three cases of CVT and review literature on available treatment options; efficacy and safety of novel oral anticoagulants in patients with systemic thrombosis. All patients presented with typical features of CVT. After confirming the diagnosis, they were acutely treated with heparin and later discharged on apixaban. During follow up visits, they tolerated apixaban well and did not have any bleeding complications. Follow up scans showed resolution of the thrombus and recanalization. CVT is an uncommon neurological condition and is often complicated by associated intraparenchymal hemorrhage. Although not recommended in current guidelines, apixaban may be a safe and effective option for the treatment of CVT. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Radiation-induced cerebrovascular complications. A case of malignant lymphoma with middle cerebral artery obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Naito, Haruko; Koizumi, Nobuhiko; Nihei, Kenji; Taguchi, Nobuyuki [National Children' s Hospital, Tokyo (Japan); Tanaka, Haruki

    1982-01-01

    A 3-year-old boy with non-Hodgkin malignant lymphoma came to complete remission after combined chemotherapy, intrathecal methotrexate, and whole brain irradiation of 2,400 rad. Two years after diagnosis, he developed hemiparesis. CT scan showed cerebral infarction and hydrocephalus, and angiography revealed obstruction of the left middle cerebral artery. He survived with marked neurological deficits and no relapse of lymphoma. The literature was reviewed concerning complications after radiation to the brain.

  2. Bladder and Bowel Control in Children with Cerebral Palsy: Case-Control Study

    Science.gov (United States)

    Ozturk, Mustafa; Oktem, Faruk; Kisioglu, Nesimi; Demirci, Mustafa; Altuntas, Irfan; Kutluhan, Suleyman; Dogan, Malik

    2006-01-01

    Aim To determine the age of development of bladder and bowel control and the frequency of enuresis, encopresis, and urinary infections in children with cerebral palsy. Methods The study included 45 children with cerebral palsy who regularly attended a rehabilitation center in Isparta, Turkey, and two groups of age- and sex-matched children, 37 siblings of the children with cerebral palsy and 37 healthy children. Demographic data and information on the age of development of total bladder and bowel control and presence of possible urinary symptoms in children were collected from their caregivers by use of a questionnaire. Frequency of enuresis and encopresis was estimated among the children aged ≥5 years. A mid-way urinary sample was obtained from 40, 22, and 21 children in the cerebral palsy, siblings, and healthy children, respectively. Results The mean age of nighttime bladder and bowel control development was 47 months (95% confidence interval [CI], 35-58) and 45 (36-55) months, respectively, for the children with cerebral palsy, 35 months (95% CI, 24-46) and 26 months (95% CI, 24-28), respectively, for their siblings, and 27 months (95% CI, 22-33) and 25 months (95% CI, 23-27) months, respectively, for the healthy children. Among the children aged ≥5 years, enuresis was present in 11 of 34 children with cerebral palsy, 7 of 30 siblings, and 4 of 30 healthy children (P = 0.200), whereas encopresis was present in 5 children with cerebral palsy, one sibling, and one healthy child. Constipation was significantly more present in chidlren with cerebral palsy than in other two groups (P<0.001). Urine culture was positive in 13 children with cerebral palsy, 1 sibling, and 2 healthy chidlren (P = 0.024). There were no significant differences in other urinary symptoms and laboratory findings among the three groups. Conclusion The children with cerebral palsy gained bladder and bowel control at older age in comparison with their siblings and healthy children

  3. Early treatment for IgG4-related disease may prevent cognitive impairment caused by cerebral vasculitis: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Toshihiko Usami

    2018-03-01

    Full Text Available IgG4-related disease (IgG4-RD is a recently recognized disease entity. A 74-year-old male presented with transient headache. He was diagnosed IgG4-RD by pancreatic biopsy at the age of 72. Magnetic Resonance Imaging (MRI showed disseminated cerebral microbleeds and microinfarctions in time and space. It suggested cerebral vasculitis, however any causative factor were not confirmed. IgG4-RD rarely causes cerebral vasculitis. This might be a first case of an asymptomatic cerebral vasculitis due to IgG4-RD. Patient was started on oral prednisolone, and no neurological or neuropsychological symptom was clinically observed. The MRI findings improved after treatment, and revealed no indication of newly lesions at 6-months follow-up. Early treatment for IgG4-RD may be recommended to prevent irreversible cognitive dysfunction. Keywords: IgG4-related disease, Treatment, Cerebral vasculitis

  4. Cerebral and extracerebral vasoreactivity in symptomatic lacunar stroke patients: a case-control study.

    Science.gov (United States)

    Deplanque, Dominique; Lavallee, Philippa C; Labreuche, Julien; Gongora-Rivera, Fernando; Jaramillo, Arturo; Brenner, David; Abboud, Halim; Klein, Isabelle F; Touboul, Pierre-Jean; Vicaut, Eric; Amarenco, Pierre

    2013-08-01

    Whether cerebral artery endothelial dysfunction is a key factor of symptomatic lacunar stroke and cerebral small vessel disease remains unclear. Cerebral and extracerebral vasoreactivity were measured in 81 patients with recent symptomatic lacunar stroke and in 81 control subjects matched for main vascular risk factors. Cerebral vasoreactivity and carotid endothelial-dependent vasodilation were measured after five-minutes of carbon dioxide-induced hypercapnia. Brachial endothelial-dependent vasodilation was assessed after hyperemia induced by deflating a cuff around the forearm previously inflated to 200 mmHg for four-minutes. Carotid and brachial endothelial-independent vasodilation were measured five-minutes after administration of sublingual nitroglycerin 300 μg. Brain magnetic resonance imaging were analyzed in lacunar stroke patients. One-month after stroke onset, patients had more severely impaired cerebral vasoreactivitys than matched controls (mean ± standard deviation, 14·4 ± 12·1% vs. 19·4 ± 17·4%; P = 0·049). Severe alterations of both carotid and brachial endothelial-dependent and at a lesser degree of carotid and brachial endothelial-independent vasodilation were observed in both groups. After adjustment for confounders, subjects with a cerebral vasoreactivity value in the two lower tertiles (≤19·6%) were more likely to have had a symptomatic lacunar stroke (adjusted odds ratio, 3·78; 95% confidence interval, 1·42 to 10·08; P = 0·008). Only alteration of brachial endothelial-independent vasodilation correlated with parenchymal abnormalities, namely microbleeds and leukoaraiosis. While abnormalities in extracerebral vasoreactivity seem related to vascular risk factors, the severity of endothelial dysfunction in cerebral arteries may be determinant in the occurrence of symptomatic lacunar stroke in patients with small vessel disease. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke

  5. Focal treatment of spasticity using botulinum toxin A in cerebral palsy cases of GMFCS level V: evaluation of adverse effects

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    Ana Paula Tedesco

    2014-08-01

    Full Text Available Objective:To report on the experience of injections of botulinum toxin A (BTA in a series of patients with cerebral palsy of Gross Motor Function Classification System (GMFCS level V.Methods:This was a retrospective case series study on 33 patients with cerebral palsy of GMFCS level V who received 89 sessions of BTA application (of which 84 were Botox® and five were other presentations, in which the basic aim was to look for adverse effects.Results:The mean number of application sessions per patient was three, and the mean age at the time of each injection was 4 + 6 years (range: 1.6–13 years. The muscles that most frequently received injections were the gastrocnemius, hamstrings, hip adductors, biceps brachii and finger flexors. The mean total dose was 193 U and the mean dose per weight was 12.5 U/kg. Only one patient received anesthesia for the injections and no sedation was used in any case. No local or systemic adverse effects were observed within the minimum follow-up of one month.Conclusion:The absence of adverse effects in our series was probably related to the use of low doses and absence of sedation or anesthesia. According to our data, BTA can be safely used for patients with cerebral palsy of GMFCS level V, using low doses and preferably without sedation or anesthesia.

  6. Findings of 99mTc-HMPAO Regional Cerebral Blood Flow SPECT in a Case of Herpes Simplex Encephalitis

    International Nuclear Information System (INIS)

    Ahn, Myeong Im; Lee, Sung Yong; Kim, Jong Woo; Bahk, Yong Whee

    1989-01-01

    Herpes simplex encephalitis (HSE) is one of the fulminant necrotizing, often fatal sporadic form of the encephalitis caused by herpes simplex type I virus. Characteristically, there is early and almost constant involvement of one or both temporal lobes, although there are common additional areas of involvement. Appropriate early treatment following correct diagnosis by clinical findings, CSF study, EEG and several radiological studies including angiography, radionuclide studies, CT or MRI can reduce its mortality and severity of the sequelae. We report a case of HSE diagnosed by adjuvant study of 99m Tc-HMPAO regional cerebral blood flow SPECT, which showed a marked increase in bitemporal cerebral blood flow in a 24-year-old man.

  7. Cerebral relapse of metastatic gastrointestinal stromal tumor during treatment with imatinib mesylate: Case report

    Directory of Open Access Journals (Sweden)

    Waring Paul

    2004-10-01

    Full Text Available Abstract Background The management of unresectable or metastatic gastrointestinal stromal tumors (GISTs has previously been difficult as they are resistant to conventional chemotherapy and radiation. The development of imatinib mesylate has made a major impact on the management of advanced GISTs. It is apparent that there are sanctuary sites such as the central nervous system where imatinib does not achieve adequate concentrations. We describe the case of a man with metastatic GIST who experienced multiple cerebral relapses of disease while systemic disease progression appeared to be controlled by imatinib. Case presentation A 47-year-old man presented in July 1999 with a jejunal GIST with multiple hepatic metastases. The jejunal primary was resected and after unsuccessful cytoreductive chemotherapy, the liver metastases were also resected in December 1999. The patient subsequently relapsed in August 2001 with symptomatic hepatic, subcutaneous gluteal, left choroidal and right ocular metastases all confirmed on CT and PET scanning. Biopsy confirmed recurrent GIST. MRI and lumbar puncture excluded central nervous system involvement. The patient was commenced on imatinib 400 mg bd in September 2001 through a clinical trial. The symptoms improved with objective PET and CT scan response until December 2002 when the patient developed a right-sided foot drop. MRI scan showed a left parasagittal tumor which was resected and confirmed histologically to be metastatic GIST. Imatinib was ceased pre-operatively due to the trial protocol but recommenced in February 2003 on a compassionate use program. The left parasagittal metastasis recurred and required subsequent re-excision in September 2003 and January 2004. Control of the systemic GIST was temporarily lost on reduction of the dose of imatinib (due to limited drug supply but on increasing the dose back to 800 mg per day, systemic disease was stabilized for a period of time before generalised progression

  8. Large subgaleal hematoma producing turban head in 10 year boy with cerebral palsy: rare case report with review of literature

    Directory of Open Access Journals (Sweden)

    Tripathi Praveen Kumar

    2016-12-01

    Full Text Available Subgaleal hematomas (SGHs are not uncommon. Because the subgaleal space has no anatomical boundaries, SGHs usually involve a large space and are typically limited to the parietal region. Cases of SGHs involving whole of head are relatively rare. In this study we report a rare case of massive enlargement of head after SGH causing severe pain and giving an appearance of turban. A 10 year old, male patient with cerebral palsy presented with progressive enlargement of head attaining a size of turban due to habitual head banging and self-punching overhead. SGH drainage and hematoma aspiration were performed and the patient’s head size was restored.

  9. Evaluating the outcome of an individual functional therapy program focused on children with cerebral palsy and cerebral visual impairment: A multiple case study

    NARCIS (Netherlands)

    Salavati, M.; Rameckers, E.A.A.; Waninge, A.; Krijnen, W.P.; Schans, C.P. van der; Steenbergen, B.

    2018-01-01

    Background: To date, there is no evidence-based functional therapy programme available for children with both cerebral palsy (CP) and cerebral visual impairment (CVI). This study evaluates an individually targeted functional therapy programme adapted for these children experiencing difficulties with

  10. Cerebral relapse of metastatic gastrointestinal stromal tumor during treatment with imatinib mesylate: Case report

    International Nuclear Information System (INIS)

    Hughes, Brett; Yip, Desmond; Goldstein, David; Waring, Paul; Beshay, Victoria; Chong, Guan

    2004-01-01

    The management of unresectable or metastatic gastrointestinal stromal tumors (GISTs) has previously been difficult as they are resistant to conventional chemotherapy and radiation. The development of imatinib mesylate has made a major impact on the management of advanced GISTs. It is apparent that there are sanctuary sites such as the central nervous system where imatinib does not achieve adequate concentrations. We describe the case of a man with metastatic GIST who experienced multiple cerebral relapses of disease while systemic disease progression appeared to be controlled by imatinib. A 47-year-old man presented in July 1999 with a jejunal GIST with multiple hepatic metastases. The jejunal primary was resected and after unsuccessful cytoreductive chemotherapy, the liver metastases were also resected in December 1999. The patient subsequently relapsed in August 2001 with symptomatic hepatic, subcutaneous gluteal, left choroidal and right ocular metastases all confirmed on CT and PET scanning. Biopsy confirmed recurrent GIST. MRI and lumbar puncture excluded central nervous system involvement. The patient was commenced on imatinib 400 mg bd in September 2001 through a clinical trial. The symptoms improved with objective PET and CT scan response until December 2002 when the patient developed a right-sided foot drop. MRI scan showed a left parasagittal tumor which was resected and confirmed histologically to be metastatic GIST. Imatinib was ceased pre-operatively due to the trial protocol but recommenced in February 2003 on a compassionate use program. The left parasagittal metastasis recurred and required subsequent re-excision in September 2003 and January 2004. Control of the systemic GIST was temporarily lost on reduction of the dose of imatinib (due to limited drug supply) but on increasing the dose back to 800 mg per day, systemic disease was stabilized for a period of time before generalised progression occurred. This case illustrates that the brain can be a

  11. Cerebral toxoplasmosis: case review and description of a new imaging sign

    International Nuclear Information System (INIS)

    Masamed, R.; Meleis, A.; Lee, E.W.; Hathout, G.M.

    2009-01-01

    Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

  12. Cerebral toxoplasmosis: case review and description of a new imaging sign

    Energy Technology Data Exchange (ETDEWEB)

    Masamed, R. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States)], E-mail: rmasamed@mednet.ucla.edu; Meleis, A. [Princeton University, New Jersey, CA (United States); Lee, E.W. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Hathout, G.M. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, Olive View UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, West L.A. VA Medical Center, Los Angeles, CA (United States)

    2009-05-15

    Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

  13. Case of radiation necrosis with vascular changes on main cerebral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Y; Okada, H; Mineura, K; Kodama, N [Tohoku Univ., Sendai (Japan). School of Medicine

    1982-03-01

    A 64-year-old woman had received radiotherapy, following surgery of a chromophobe pituitary adenoma. Six years after irradiation she began to complain of headache and dementia. Right vertebrogram demonstrated a right temporal mass lesion, stenosis and dilatation of middle cerebral artery and posterior communicating artery in the field of irradiation. CT scan showed the irregular low density area at the right temporal region, and the irregular enhancement after an intravenous injection of contrast medium was seen at the small part of affected area. From these findings, radiation necrosis at the right temporal lobe was diagnosed. Reports of vascular changes of the main cerebral arteries due to radiation are rare.

  14. A case with post-irradiation cerebral vascular disease accompanied by Cushing's disease

    International Nuclear Information System (INIS)

    Shinoda, Keiichi; Kuriyama, Takanobu; Kimura, Fumiharu; Kawamura, Hiroshi; Takamatsu, Junta; Mozai, Toshiji

    1986-01-01

    A 37-year-old man with Cushing's disease developed cerebral infarction 13 years after Co-60 irradiation of a total dose of 60 Gy for pituitary adenoma. Cerebral angiography showed stenosis or occlusion of the bilateral carotid arteries and basilar artery which were in the radiation fields. A basophilic adenoma was resected, and symptoms of Cushing's disease have resolved. The vascular lesions are likely to be not only radiation-induced, but also stimulated by hyperlipemia and hypertension associated with Cushing's disease. It is recommended to eliminate factors, such as hyperlipemia and hypertension, stimulatig vascular damage in the management of patients treated with radiation therapy. The relevant literature is reviewed. (Namekawa, K.)

  15. Cancer and risk of cerebral venous thrombosis: a case-control study

    NARCIS (Netherlands)

    Silvis, S. M.; Hiltunen, S.; Lindgren, E.; Jood, K.; Zuurbier, S. M.; Middeldorp, S.; Putaala, J.; Cannegieter, S. C.; Tatlisumak, T.; Coutinho, J. M.

    2018-01-01

    Background: Cancer is an established risk factor for leg vein thrombosis and pulmonary embolism. Controlled studies assessing the risk of cerebral venous thrombosis (CVT) in patients with cancer have not been performed. Objective: To assess whether cancer is a risk factor for CVT. Patients/Methods:

  16. Surgical treatment of neglected hip fracture in children with cerebral palsy: case report and review of the literature.

    Science.gov (United States)

    Toro, Giuseppe; Moretti, Antimo; Toro, Gabriella; Tirelli, Assunta; Calabrò, Giampiero; Toro, Antonio; Iolascon, Giovanni

    2017-01-01

    A clinical case of a 15-year-old cerebral palsy child with a Sandhu type 2 neglected femoral neck fracture is presented. The patient was treated using cannulated screws and cancellous bone graft augmented with mesenchymal stem cells. At 6 months after the surgery complete fracture healing was observed. To early diagnose this fractures, it is mandatory to perform a comprehensive clinical and radiological evaluation including also a second level imaging. The use of cannulated screws with cancellous bone graft and MSCs is a viable treatment option in these patients.

  17. A case of pseudoaneurysm due to fungus ball within the progressive massive fibrosis in a patient with pneumoconiosis: Computed tomography-pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Geun; Ryu, Dae Shick; Park, Man Soo; Choi, Soo Jung; Kang, Chae Hoon; Shin, Dong Rock; Ahn, Jae Hong [Dept. of Radiology, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung (Korea, Republic of)

    2016-09-15

    We reported a case of pseudoaneurysm in the upper lobar branch of the right pulmonary artery, which was caused by a fungus ball within the progressive massive fibrosis (PMF) in a patient with pneumoconiosis. Coil embolization of the pseudoaneurysm initially stopped the bleeding. After right upper lobe lobectomy to prevent the recurrent hemoptysis, pathology confirmed pseudoaneurysm within the PMF due to aspergilloma.

  18. ''Dural tail'' adjacent to a giant posterior cerebral artery aneurysm: case report and review of the literature

    International Nuclear Information System (INIS)

    Good, C.D.; Kingsley, D.P.E.; Taylor, W.J.; Harkness, W.F.

    1997-01-01

    The ''dural tail'' sign on gadolinium (Gd-DTPA)-enhanced MRI has been described in association with meningiomas. Various series with histopathological correlation have shown that in some cases there is tumour invasion into the dura mater, but in the majority of cases it represents a hypervascular, non-neoplastic reaction. While this sign was originally thought to be specific for meningioma, subsequent case reports have described the presence of a dural tail in other intra- and extra-axial lesions. We present a patient with a giant aneurysm arising from the P2 segment of the right posterior cerebral artery, adjacent to the tentorium, with a prominent dural tail on Gd-DTPA-enhanced MRI. In this location, differentiation of an aneurysm from a meningioma was critical. (orig.). With 2 figs

  19. Cigarette smoking and risk of cerebral sinus thrombosis in oral contraceptive users: a case-control study.

    Science.gov (United States)

    Ciccone, A; Gatti, A; Melis, M; Cossu, G; Boncoraglio, G; Carriero, M R; Iurlaro, S; Agostoni, E

    2005-12-01

    Idiopathic cerebral sinus thrombosis (CST) can cause death and serious neurological disability. It is unknown whether smoking, a major risk factor for arterial stroke, is a risk factor also for CST. This work explored the association between smoking and CST in a hospital-based, multicentric, case-control study. In order to avoid the confounding effect of the different risk factors for CST, we analysed the homogeneous subgroup of oral contraceptive users. We compared the prevalence of smoking in a group of 43 young women with CST (cases), whose oral contraceptive use was the only known risk factor, with a sample of 255 healthy contraceptive users of similar age (controls). The prevalence of smoking in cases and controls was similar (26% vs. 29%). The age and geographic area-adjusted odds ratio was 0.9; 95% confidence interval, 0.4-1.8; p=0.7. Smoking in oral contraceptive users does not appear to be associated with CST.

  20. Cerebral gray matter volume losses in essential tremor: A case-control study using high resolution tissue probability maps.

    Science.gov (United States)

    Cameron, Eric; Dyke, Jonathan P; Hernandez, Nora; Louis, Elan D; Dydak, Ulrike

    2018-03-10

    Essential tremor (ET) is increasingly recognized as a multi-dimensional disorder with both motor and non-motor features. For this reason, imaging studies are more broadly examining regions outside the cerebellar motor loop. Reliable detection of cerebral gray matter (GM) atrophy requires optimized processing, adapted to high-resolution magnetic resonance imaging (MRI). We investigated cerebral GM volume loss in ET cases using automated segmentation of MRI T1-weighted images. MRI was acquired on 47 ET cases and 36 controls. Automated segmentation and voxel-wise comparisons of volume were performed using Statistical Parametric Mapping (SPM) software. To improve upon standard protocols, the high-resolution International Consortium for Brain Mapping (ICBM) 2009a atlas and tissue probability maps were used to process each subject image. Group comparisons were performed: all ET vs. Controls, ET with head tremor (ETH) vs. Controls, and severe ET vs. An analysis of variance (ANOVA) was performed between ET with and without head tremor and controls. Age, sex, and Montreal Cognitive Assessment (MoCA) score were regressed out from each comparison. We were able to consistently identify regions of cerebral GM volume loss in ET and in ET subgroups in the posterior insula, superior temporal gyri, cingulate cortex, inferior frontal gyri and other occipital and parietal regions. There were no significant increases in GM volume in ET in any comparisons with controls. This study, which uses improved methodologies, provides evidence that GM volume loss in ET is present beyond the cerebellum, and in fact, is widespread throughout the cerebrum as well. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Cerebral salt-wasting syndrome after hematopoietic stem cell transplantation in adolescents: 3 case reports

    Directory of Open Access Journals (Sweden)

    Yeon Jin Jeon

    2015-12-01

    Full Text Available Cerebral salt-wasting syndrome (CSWS is a rare disease characterized by a extracellular volume depletion and hyponatremia induced by marked natriuresis. It is mainly reported in patients who experience a central nervous system insult, such as cerebral hemorrhage or encephalitis. The syndrome of inappropriate antidiuretic hormone secretion is a main cause of severe hyponatremia after hematopoietic stem cell transplantation, whereas CSWS is rarely reported. We report 3 patients with childhood acute leukemia who developed CSWS with central nervous system complication after hematopoietic stem cell transplantation. The diagnosis of CSW was made on the basis of severe hyponatremia accompanied by increased urine output with clinical signs of dehydration. All patients showed elevated natriuretic peptide and normal antidiuretic hormone. Aggressive water and sodium replacement treatment was instituted in all 3 patients and 2 of them were effectively recovered, the other one was required to add fludrocortisone administration.

  2. Sleep apnea termination decreases cerebral blood volume: a near-infrared spectroscopy case study

    Science.gov (United States)

    Virtanen, Jaakko; Noponen, Tommi; Salmi, Tapani; Toppila, Jussi; Meriläinen, Pekka

    2009-07-01

    Medical near-infrared spectroscopy (NIRS) can be used to estimate cerebral haemodynamic changes non-invasively. Sleep apnea is a common sleep disorder where repetitive pauses in breathing decrease the quality of sleep and exposes the individual to various health problems. We have measured oxygenated and deoxygenated haemoglobin concentration changes during apneic events in sleep from the forehead of one subject using NIRS and used principal component analysis to extract extracerebral and cortical haemodynamic changes from NIRS signals. Comparison of NIRS signals with EEG, bioimpedance, and pulse oximetry data suggests that termination of apnea leads to decreases in cerebral blood volume and flow that may be related to neurological arousal via neurovascular coupling.

  3. Autopsy case of undiagnosed gangliocytoma in the medulla oblongata complicated with cerebral palsy.

    Science.gov (United States)

    Takahashi, Motonori; Kondo, Takeshi; Morichika, Mai; Kuse, Azumi; Nakagawa, Kanako; Asano, Migiwa; Ueno, Yasuhiro

    2016-03-01

    A Japanese man in his 30s who had congenital cerebral palsy was found unresponsive in bed. His death was confirmed after resuscitation attempts. He had a history of occasional falling (despite the use of walking sticks and a wheelchair) owing to a slowly progressive gait disturbance, and had a medical examination without full neurological re-examination. Autopsy revealed gangliocytoma in the medulla oblongata, which was diagnosed as the cause of death. Although gangliocytoma is a well-differentiated benign tumor, the almost total replacement of the medulla oblongata by the tumor cells was assumed to result in ataxia via the olivocerebellar tract and secondary cerebellar atrophy, followed by central hypoventilation and death of the patient. The symptoms caused by gangliocytoma may be overlooked owing to long-standing cerebral palsy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. A case of cerebral reversible vasoconstriction syndrome triggered by repetition transcranial magnetic stimulation.

    Science.gov (United States)

    Sato, Mamiko; Yamate, Koji; Hayashi, Hiromi; Miura, Toyoaki; Kobayashi, Yasutaka

    2017-08-31

    A 75-year-old man was admitted for combined low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy. Five days after the initiation of rTMS, he developed hypotension and temporary exacerbation of the right hemiplegia with thunderclap headache. MRA showed segmental stenosis of the left middle cerebral artery, which findings were improved at 9 days after the onset of the headache. He was diagnosed as having the reversible cerebral vasoconstriction syndrome (RCVS). The rTMS was recognized as safe rehabilitation treatment. However, it is necessary to recognize that RCVS can become one of the precipitants. This is the first report of RCVS triggered by rTMS.

  5. A case of radiation necrosis with vascular changes on main cerebral arteries

    International Nuclear Information System (INIS)

    Ishibashi, Yasuhiko; Okada, Hitoshi; Mineura, Katsuyoshi; Kodama, Namio

    1982-01-01

    A 64-year-old woman had received radiotherapy, following surgery of a chromophobe putuitary adenoma. Six years after irradiation she began to complain of headache and dementia. Right vertebrogram demonstrated a right temporal mass lesion, stenosis and dilatation of middle cerebral artery and posterior communicating artery in the field of irradiation. CT scan showed the irregular low density area at the right temporal region, and the irregular enhancement after an intravenous injection of contrast medium was seen at the small part of affected area. From these findings, radiation necrosis at the right temporal lobe was diagnosed. As vascular changes of the main cerebral arteries due to radiation are rare, we discussed on them from ever reported literature. (author)

  6. A Case of Isolated Middle Cerebral Artery Stenosis with Hemichorea and Moyamoya Pattern Collateralization

    Directory of Open Access Journals (Sweden)

    Seok Jong Chung

    2013-05-01

    Full Text Available Isolated middle cerebral artery (MCA stenosis in young patients with no other medical condition may be a unique pathologic entity with a benign long-term course. Generally, moyamoya disease shows a progression of stenosis from internal cerebral artery (ICA to other intracranial vessel. A 26-year-old woman was admitted for choreic movements of the right arm and leg. Brain magnetic resonance imaging showed no stroke. Conventional angiography revealed 48% stenosis of the left M1 without ICA stenosis. Single photon emission computed tomography revealed perfusion asymmetry after acetazolamide injection, suggesting decreased uptake in the left basal ganglia and the cerebral cortex. Her hemichorea was mildly decreased with risperidone. One year later, follow-up angiography showed complete occlusion of the left M1 with neovascularization suggestive of moyamoya disease. The patient underwent bypass surgery and her hemichorea disappeared. This may be an atypical presentation of moyamoya disease. The bypass surgery was an effective measure for restoring the vascular insufficiency and, resultantly, controlling her hemichorea.

  7. Assistive technology for promoting adaptive skills of children with cerebral palsy: ten cases evaluation.

    Science.gov (United States)

    Stasolla, Fabrizio; Caffò, Alessandro O; Perilli, Viviana; Boccasini, Adele; Damiani, Rita; D'Amico, Fiora

    2018-05-06

    To extend the use of assistive technology for promoting adaptive skills of children with cerebral palsy. To assess its effects on positive participation of ten participants involved. To carry out a social validation recruiting parents, physiotherapists and support teachers as external raters. A multiple probe design was implemented for Studies I and II. Study I involved five participants exposed to a combined program aimed at enhancing choice process of preferred items and locomotion fluency. Study II involved five further children for a combined intervention finalized at ensuring them with literacy access and ambulation responses. Study III recruited 60 external raters for a social validation assessment. All participants improved their performance, although differences among children occurred. Indices of positive participation increased as well. Social raters favorably scored the use of both technology and programs. Assistive technology-based programs were effective for promoting independence of children with cerebral palsy. Implications for Rehabilitation A basic form of assistive technology such as a microswitch-based program may be useful and helpful for supporting adaptive skills of children with cerebral palsy and different levels of functioning. The same program may improve the participants' indices of positive participation and constructive engagement with beneficial effects on their quality of life. The positive social rating provided by external experts sensitive to the matter may recommend a favorable acceptance and implementation of the program in daily settings.

  8. Acupuncture Combined with Music Therapy for Treatment of 30 Cases of Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    YU Hai-bo; LIU Yong-feng; WU Li-xiong; CHEN Zheng-qiu

    2009-01-01

    Objective: To observe clinical therapeutic effects of acupuncture combined with music therapy for treatment of cerebral palsy. Methods: Sixty children with cerebral palsy were randomly divided into an acupuncture group (Group Acup.) and an acupuncture plus music group (Group Acup.+ M). Simple acupuncture was applied in Group Acup., and acupuncture at 5 groups of points plus music were applied in Group Acup. +M. The treatment was given once every two days with 3 treatments weekly, and 36 treatments constituted a therapeutic course. Therapeutic effects including movement improvement were observed for comparison after 3 courses of treatments. Results: The comprehensive functions were elevated in both groups, and the total effective rate in Group Acup. + M was obviously better than that in Group Acup (P<0.05). Movement functions were also improved in both groups, but the differences in improvement of creeping and kneeling, standing, and walking were significant between the two groups (P<0.01), showing the effect in Group Acup. +M was better than that in Group Acup.. Conclusion: The therapy of acupuncture plus music gained better therapeutic effect on cerebral palsy than simple acupuncture, which provided new thoughts for treating the disease by comprehensive therapies.

  9. Common late-onset subcortical cerebral hemorrhage following excessive alcohol consumption: a case report

    International Nuclear Information System (INIS)

    Incedayi, M.; Sivrioglu, A.; Velioglu, M.; Aribal, S.; Sonmez, G.; Basekim, C.

    2012-01-01

    Full text: 50 year old male patient who was suffering from cooperation disorder and bilaterally blindness was admitted to our emergency service. He was addicted to alcohol and had excessive alcohol consumption the day before. Cranial nonenhanced CT was normal. T2 weighed MR imaging performed at 1,5 T unit showed high signal intensity in bilateral putaminal foci. In this localization diffusion-weighed images (DWI) were hyperintense due to restricted diffusion and low ADC values. After two weeks, drowsiness and confusion were appeared suddenly. Cranial nonenhanced CT was showed extensive subcortical white matter and basal ganglia abnormalities consistent with edema and hemorrhagic changes. The patient was transferred to intensive care unit and died after one day. In methanol intoxication, cerebral and intraventricular hemorrhage, cerebellar necrosis, diffuse cerebral edema, bilateral subcortical white matter necrosis and edema were defined It should also be known that 2 or 3 weeks after ingestion of methyl alcohol, the deterioration of the patient's general situation is responsible for cerebral subcortical hemorrhage. We have also thought that patients' mortality and morbidity can be reduced with radiological imaging due to early diagnosis

  10. Role of advanced magnetic resonance imaging techniques in diagnosis of cerebral toxoplasmosis in immunocompromised patients: A case report

    Directory of Open Access Journals (Sweden)

    Inderpreet Singh

    2014-01-01

    Full Text Available Cerebral toxoplasmosis commonly affects patients with advanced HIV infection. Toxoplasmosis can be severe and debilitating in patients with Central Nervous System (CNS involvement and the condition may be fatal in patients if not suspected and treated early and adequately. Hence, imaging plays an important role in diagnosis and following during treatment in cases of suspected toxoplasmosis. We report a case of a 51-years-old man who was a known sero-positive since 2 years and presented with altered sensorium. Magnetic Resonance Imaging (MRI scan of the brain showed multiple heterogeneously enhancing lesions in bilateral cerebral as well as cerebellar hemispheres and some of them showed "eccentric target sign." MR spectroscopy showed features of reduced NAA, mildly increased choline, and lipid lactate peak. MR perfusion study showed reduced perfusion favoring diagnosis of cerebellar toxoplasmosis. Patient was started on a combination of pyrimethamine plus sulfadiazine for toxoplasmosis. Follow up MRI after 20 days and 45 days from start of treatment showed significant resolution of the lesions supporting our radiological diagnosis.

  11. Cerebral Venous Thrombosis and Venous Infarction: Case Report of a Rare Initial Presentation of Smoker’s Polycythemia

    Directory of Open Access Journals (Sweden)

    Mihir Raval

    2010-11-01

    Full Text Available Introduction: Cerebral venous thrombosis is a rare initial presentation of polycythemia. If diagnosed early, treatment can reduce mortality and morbidity significantly. Often it may present with headache as the only complaint, and thus the diagnosis is likely to be missed. Case Presentation: A medically stable 31-year-old male, a chronic smoker with a ∼17 pack-year history of smoking, was admitted to the emergency room with a 2-week history of gradually worsening, severe, throbbing headache in the occipital region sensitive to light. Initial neurological examination was positive only for some involuntary motor tics of the left leg. Initial laboratory workup showed hemoglobin of 20 g/dl and hematocrit of 56.5%. The carboxyhemoglobin level was normal, but the oxygen dissociation curve was shifted to the left. Further evaluation by MRI and MRA of the brain suggested extensive and complete thrombosis of the superior sagittal sinus, right transverse sinus and right sigmoid sinus with a small venous infarct in the right parafrontal region. Given that the patient first presented with a thrombotic event, workup for primary polycythemia and hypercoagulable disorders was carried out, including JAK2 mutation evaluation, which was negative. This left us with smoking as the only risk factor and possible cause for secondary polycythemia. He improved significantly with phlebotomy and anticoagulation treatment. Conclusion: This case illustrates a rare but severe complication of secondary polycythemia stressing the importance of being aware of the risk of developing cerebral thrombosis in patients with chronic smoking exposure.

  12. Relationship between intracranial hypertension and cerebral blood flow after craniotomy in cases with traumatic acute subdural hematoma

    International Nuclear Information System (INIS)

    Karibe, Hiroshi; Onuma, Takehide; Kameyama, Motonobu; Nimura, Taro; Hirano, Takayuki; Kubota, Keiichi

    2008-01-01

    The purpose of this study is to investigate relationship between the duration of initial intracranial hypertension and postoperative cerebral blood flow (CBF) changes in cases with traumatic acute subdural hematoma (ASDH). Intracerebral pressure (ICP) was monitored using ICP catheter in 17 cases with unilateral traumatic ASDH. ICP monitoring was started before craniotomy, and was continued for 7 days. CBF was quantitatively measured at 7 days after craniotomy with 123 I-infetamine (IMP) single photon emission computed tomography (SPECT). Clinical outcome was evaluated using Glasgow Outcome Scale (GOS) at the time of discharge. Patients were divided into 2 groups by the duration of intracranial hypertension: patients who presented with intracranial hypertension (>25 mmHg) and received surgical decompression within 6 hours after deterioration (group A, n=9), and patients who presented with intracranial hypertension and received surgical decompression more than 6 hours after deterioration (group B, n=6). In group A, 7 of 9 patients demonstrated ipsilateral hemispheric hyperperfusion, and the clinical outcome was relatively favorable: Good Recovery (GR) 4 cases, Moderately Disabled (MD) 4 cases, and Severely Disabled (SD) 1 case. In group B, 5 of 6 patients demonstrated ipsilateral hemispheric hypoperfusion, and the clinical outcome was unfavorable: SD 4 cases, and Dead 2 cases. These results suggest that the duration of intracranial hypertension affects on postoperative CBF changes. Duration of intracranial hypertension may also affect on clinical outcome directly, or secondary by altering postoperative CBF changes in patients with traumatic ASDH. (author)

  13. The Role of Intraoperative Cerebral Angiography in Transorbital Intracranial Penetrating Trauma: A Case Report and Literature Review.

    Science.gov (United States)

    Riley, Jonathan P; Boucher, Andrew B; Kim, Denise S; Barrow, Daniel L; Reynolds, Matthew R

    2017-01-01

    present case). Given that CT angiography and intraoperative videoangiography may miss a potentially treatable traumatic arterial injury, IOA can help determine whether cerebral revascularization may be necessary. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Dialysis Disequilibrium Syndrome-Induced Cerebral Edema in a Patient with Uremia Following Hemodialysis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Min; Kim, Heung Cheol [Dept. of Radiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2012-03-15

    Dialysis disequilibrium syndrome is a metabolic complication that can be caused by rapid removal of plasma urea during hemodialysis. Dialysis disequilibrium syndrome can lead to osmotic demyelinating syndrome. This case report describes one case of encephalopathy accompanied by dialysis disequilibrium syndrome with imaging findings acquired immediately after hemodialysis in a 55-year-old woman with chronic renal failure. The patient was observed to present repetitive seizures and sudden deterioration of consciousness immediately after hemodialysis. Shortly after the onset of symptoms, the patient underwent a CT scan. The imaging findings of the CT scan reveal symmetrical diffuse white matter edema of bilateral cerebral hemispheres that extends to the pons along the internal capsule. A follow-up MRI taken two years later shows that reversible changes without damage have occurred in the lesions. The patient can thus be seen to present symptoms characteristically associated with dialysis disequilibrium syndrome, while brain imaging reveals dif-fuse reversible brain edema.

  15. Dyke-Davidoff-Masson syndrome: case report of fetal unilateral ventriculomegaly and hypoplastic left middle cerebral artery

    OpenAIRE

    Piro, Ettore; Piccione, Maria; Marrone, Gianluca; Giuffr?, Mario; Corsello, Giovanni

    2013-01-01

    Prenatal ultrasonographic detection of unilateral cerebral ventriculomegaly arises suspicion of pathological condition related to cerebrospinal fluid flow obstruction or cerebral parenchimal pathology. Dyke-Davidoff-Masson syndrome is a rare condition characterized by cerebral hemiatrophy, calvarial thickening, skull and facial asymmetry, contralateral hemiparesis, cognitive impairment and seizures. Congenital and acquired types are recognized and have been described, mainly in late childhood...

  16. Indocyanine Green Videoangiography for Surgery of a Ruptured Dissecting Aneurysm in the Precommunicating Anterior Cerebral Artery: A Technical Case Report.

    Science.gov (United States)

    Nagai, Yasunori; Goto, Masanori; Toda, Hiroki; Nishida, Namiko; Yoshimoto, Naoya; Iwasaki, Koichi

    2017-08-01

    Indocyanine green videoangiography (ICG-VA) is an important intraoperative adjunct for saccular aneurysm surgery, but its efficacy in surgery for dissecting aneurysms has rarely been reported. The authors describe the usefulness of preclipping ICG-VA in a rare case of a ruptured dissecting aneurysm located at the precommunicating (A1) segment of the anterior cerebral artery. A 52-year-old woman, with no history of connective tissue diseases or vascular disorders, presented with sudden headache and convulsion. The CT scan showed that the patient had subarachnoid hemorrhage. Angiography showed a dissecting aneurysm in the left A1 segment of the anterior cerebral artery. Thus, the patient underwent trapping of the dissecting aneurysm. ICG-VA was used as an intraoperative adjunct before and after clipping. The preclipping ICG-VA showed the heterogeneously bright dissecting aneurysm and branching arteries even in the presence of hematoma. Preclipping ICG-VA may enhance the advantage of direct surgery for dissecting aneurysm by allowing visualization of the extent of the dissected vascular wall and the related branching arteries. ICG-VA can be an indispensable adjunct to minimize the compromise from the surgical treatment for intracranial dissecting aneurysms. Copyright © 2017 by the Congress of Neurological Surgeons

  17. An autopsied case of MV2K + C-type sporadic Creutzfeldt-Jakob disease presenting with widespread cerebral cortical involvement and Kuru plaques.

    Science.gov (United States)

    Iwasaki, Yasushi; Saito, Yufuko; Aiba, Ikuko; Kobayashi, Atsushi; Mimuro, Maya; Kitamoto, Tetsuyuki; Yoshida, Mari

    2017-06-01

    MV2-type sporadic Creutzfeldt-Jakob disease (sCJD), which was previously called "Kuru-plaque variant", was gradually revealed to have a wide spectrum and has been classified into three pathological subtypes: MV2K, MV2C and MV2K + C. We herein describe the detailed clinical findings and neuropathologic observations from an autopsied MV2K + C-type Japanese sCJD case with widespread cerebral cortical pathology and Kuru plaques. In the early stages of the disease, the patient exhibited gait disturbance with ataxia and dysarthria as well as gradual appearance of cognitive dysfunction. Diffusion-weighted images (DWI) on MRI revealed extensive cerebral cortical hyperintensity. Pathologic investigation revealed extensive spongiform change in the cerebral cortex, particularly in the deeper layers. Vacuole size varied, and some were confluent. Prion protein (PrP) immunostaining revealed extensive PrP deposition in the cerebral cortex, basal ganglia, thalamus, cerebellum, brainstem and spinal cord. In the cerebral cortex, synaptic-type, Kuru plaque-like, and coarse plaque-type PrP depositions were mainly observed, along with some perivacuolar-type PrP depositions. Kuru plaques and coarse plaque-type PrP depositions also were observed in the cerebellar cortex. PrP gene analysis revealed no mutations, and polymorphic codon 129 exhibited Met/Val heterozygosity. Western blot analysis revealed a mixture of intermediate-type PrP Sc and type 2 PrP Sc . Based on previous reports regarding MV2-type sCJD and the clinicopathologic findings of the present case, we speculated that it may be possible to clinically distinguish each MV2 subtype. Clinical presentation of the MV2K + C subtype includes predominant cerebral cortical involvement signs with ataxia and DWI hyperintensity of the cerebral cortex on MRI. © 2016 Japanese Society of Neuropathology.

  18. Analysis of 58 neonatal cases with cerebral infarction%新生儿脑梗死58例分析

    Institute of Scientific and Technical Information of China (English)

    李志华; 陈超

    2013-01-01

    目的 分析近年来收治的58例新生儿脑梗死病例的临床资料及预后,为临床诊治提供可借鉴的经验.方法 对复旦大学附属儿科医院新生儿科1999年1月至2010年12月收治的58例新生儿脑梗死病例的临床资料及随访结果进行回顾性分析.结果 58例脑梗死患儿中52例为足月儿,6例为早产儿.缺血性梗死51例(占87.9%),出血性梗死7例(占12.1%).围产期缺氧缺血是最常见的高危因素(占46.6%).惊厥是新生儿脑梗死最常见的首发症状及病程中最多见的临床表现(占77.6%),其次为阵发性青紫、呼吸暂停及反应差.新生儿脑梗死最易累及大脑中动脉,且左侧多见.新生儿脑梗死急性期以支持和对症治疗为主.预后不良的患儿中,梗死多累及深部灰质核团或波及多个脑叶.结论 围产期缺氧是常见的高危因素.惊厥是最常见的早期临床表现.弥散加权成像技术对急性期脑梗死的诊断价值较高.不良预后的患儿中,梗死多累及深部灰质或范围较广.早期发现、结合头颅影像学检查作出诊断,对于指导康复治疗、改善预后有积极的意义.%Objective Cerebral infarction (CI) is one of severe diseases of central nervous system in neonates,and some infants with CI could have poor prognosis in the long term.This study aimed to analyze the clinical data and prognosis of all neonatal cases with cerebral infarction in recent years and to help future clinical work.Method Totally 58 neonatal cases with CI admitted to NICU of the hospital from January 1999 to December 2010 were included in this study.We analyzed all clinical data and prognosis by retrospective analysis.Results Fifty-two term babies and six preterm babies were included.There were altogether 51 cases with asphyxia and 7 with hemorrhagic cerebral infarction.Perinatal hypoxia-ischemia was the most common high-risk factor and it accounted for 46.6%.Seizure was the most frequent initial symptom and

  19. Posttraumatic cerebral infarction due to progressive occlusion of the internal carotid artery after minor head injury in childhood: a case report.

    Science.gov (United States)

    Matsumoto, Hiroaki; Kohno, Kanehisa

    2011-07-01

    Although minor head injury in childhood is a common occurrence and usually no complications, posttraumatic cerebral infarction has rarely been reported. Such infarction is characterized by occlusion of the lateral lenticulostriate artery. The authors report an atypical case of posttraumatic occlusion of the internal carotid artery (ICA) after minor head injury in childhood. A healthy 16-year-old boy was hit on the head by a pitch while playing baseball. He developed a transient ischemic attack involving the left extremities 15 min after the accident. Initial magnetic resonance imaging revealed neither hemorrhage nor infarction, and MR angiography demonstrated mild stenosis of the right carotid fork. Conservative therapy was started. However, 24 h after the accident, he suddenly developed left hemiparesis. Emergent neuroimaging demonstrated progressive occlusion of the supraclinoid portion of the right ICA and cerebral infarction of the deep white matter in the right frontal lobe. The hemiparesis deteriorated and the infarction area continued to expand on a daily. The patient underwent emergent superficial temporally artery-middle cerebral artery (STA-MCA) bypass. Intraoperative observation demonstrated that the supraclinoid portion of the right ICA was not thrombosed but pale with low tension and did not appear dissected. He fully recovered by 2 weeks after the operation. Postoperative investigations showed gradual improvement of the ICA occlusion. Minor head injury can cause cerebral infarction in childhood, although this is rare. If conservative therapy cannot prevent progressive cerebral infarction, STA-MCA bypass should be considered in case of the ICA occlusion.

  20. Spontaneous dissections of the anterior cerebral artery: a meta-analysis of the literature and three recent cases

    Energy Technology Data Exchange (ETDEWEB)

    Hensler, Johannes; Jensen-Kondering, Ulf; Jansen, Olav [University Hospital Schleswig-Holstein (UKSH), Department of Radiology and Neuroradiology, Kiel (Germany); Ulmer, Stephan [Medical Radiological Institute, Neuroradiology, Zurich (Switzerland)

    2016-10-15

    Spontaneous dissections of intracranial arteries are rare, but important causes of stroke, especially in younger patients. Dissections of the anterior cerebral artery (ACA) have been reported only very rarely in the European and North American populations but might be more prevalent than previously thought. This paper describes the presenting pattern of the disease, the clinical and imaging findings, as well as endovascular therapeutical options with respect to a meta-analysis of cases reported in the literature. Additionally, own observations in three recent representative cases are discussed. Overall, 80 cases from recent literature were included to the meta-analysis. The median age was 51 (35-82) years. Ischemia alone was described in 58 cases (73 %), subarachnoid hemorrhage (SAH) in 8 cases (10 %), and a combination of both in 14 cases (17 %). Radiological diagnosis including use of thin-layered 3T-MRI vessel wall imaging with black blood technique was verified by double lumen, by a string sign or string and pearl sign, or by a vessel wall hematoma in 23 (32 %), 62 (89 %), and 14 (20 %) cases, respectively. Interventional or surgical treatment was performed in 7 cases. A good clinical recovery was achieved in 77 % of cases. Dissections of the ACA mostly cause ischemia, but can cause SAH or a combination of both in a relatively young population. Detailed neuroradiological diagnosis including 3T-MRI vessel wall imaging is required as a double lumen, isolated stenosis due to vessel wall hematoma, or the secondary development of a pseudoaneurysm might occur. Interventional therapy is the primary therapy for these vascular complications. (orig.)

  1. Spontaneous dissections of the anterior cerebral artery: a meta-analysis of the literature and three recent cases

    International Nuclear Information System (INIS)

    Hensler, Johannes; Jensen-Kondering, Ulf; Jansen, Olav; Ulmer, Stephan

    2016-01-01

    Spontaneous dissections of intracranial arteries are rare, but important causes of stroke, especially in younger patients. Dissections of the anterior cerebral artery (ACA) have been reported only very rarely in the European and North American populations but might be more prevalent than previously thought. This paper describes the presenting pattern of the disease, the clinical and imaging findings, as well as endovascular therapeutical options with respect to a meta-analysis of cases reported in the literature. Additionally, own observations in three recent representative cases are discussed. Overall, 80 cases from recent literature were included to the meta-analysis. The median age was 51 (35-82) years. Ischemia alone was described in 58 cases (73 %), subarachnoid hemorrhage (SAH) in 8 cases (10 %), and a combination of both in 14 cases (17 %). Radiological diagnosis including use of thin-layered 3T-MRI vessel wall imaging with black blood technique was verified by double lumen, by a string sign or string and pearl sign, or by a vessel wall hematoma in 23 (32 %), 62 (89 %), and 14 (20 %) cases, respectively. Interventional or surgical treatment was performed in 7 cases. A good clinical recovery was achieved in 77 % of cases. Dissections of the ACA mostly cause ischemia, but can cause SAH or a combination of both in a relatively young population. Detailed neuroradiological diagnosis including 3T-MRI vessel wall imaging is required as a double lumen, isolated stenosis due to vessel wall hematoma, or the secondary development of a pseudoaneurysm might occur. Interventional therapy is the primary therapy for these vascular complications. (orig.)

  2. Anterior cruciate ligament reconstruction in a patient with Athetoid cerebral palsy: a case report

    Directory of Open Access Journals (Sweden)

    Tajima Takuya

    2012-10-01

    Full Text Available Abstract Recent years have seen ACL reconstruction performed in a broad range of patients, regardless of age, sex or occupation, thanks to great advances in surgical techniques, instrumentation and the basic research. Favorable results have been reported; however, we have not been able to locate any reports describing ACL reconstruction in patients with athetoid cerebral palsy. We present herein a previously unreported anterior cruciate ligament (ACL reconstruction performed in a patient with athetoid cerebral palsy. The patient was a 25-year-old woman with level II athetoid cerebral palsy according to the Gross Motor Function Classification System. She initially injured her right knee after falling off a bicycle. Two years later, she again experienced right-knee pain and a feeling of instability. A right-knee ACL tear and avulsion fracture was diagnosed upon physical examination and confirmed with magnetic resonance imaging (MRI and X-ray examination at that time. An ACL reconstruction using an autologous hamstring double-bundle graft was performed for recurrent instability nine years after the initial injury. Cast immobilization was provided for 3 weeks following surgery and knee extension was restricted for 3 months with the functional ACL brace to prevent hyperextension due to involuntary movement. Partial weight-bearing was started 1 week postoperatively, with full weight-bearing after 4 weeks. The anterior drawer stress radiography showed a 63% anterior displacement of the involved tibia on the femur six months following the surgery, while the contralateral knee demonstrated a 60% anterior displacement of the tibia. The functional ACL functional brace was then removed. A second-look arthroscopy was performed 13 months after the ACL reconstruction, and both the anteromedial and posterolateral bundles were in excellent position as per Kondo’s criteria. The Lachman and pivot shift test performed under anesthesia were also negative. An

  3. Hyperlexia and ambient echolalia in a case of cerebral infarction of the left anterior cingulate cortex and corpus callosum.

    Science.gov (United States)

    Suzuki, Tadashi; Itoh, Shouichi; Hayashi, Mototaka; Kouno, Masako; Takeda, Katsuhiko

    2009-10-01

    We report the case of a 69-year-old woman with cerebral infarction in the left anterior cingulate cortex and corpus callosum. She showed hyperlexia, which was a distinctive reading phenomenon, as well as ambient echolalia. Clinical features also included complex disorders such as visual groping, compulsive manipulation of tools, and callosal disconnection syndrome. She read words written on the cover of a book and repeated words emanating from unrelated conversations around her or from hospital announcements. The combination of these two features due to a focal lesion has never been reported previously. The supplementary motor area may control the execution of established subroutines according to external and internal inputs. Hyperlexia as well as the compulsive manipulation of tools could be interpreted as faulty inhibition of preexisting essentially intact motor subroutines by damage to the anterior cingulate cortex reciprocally interconnected with the supplementary motor area.

  4. Treatment of Cerebral Palsy with Stem Cells: A Report of 17 Cases.

    Science.gov (United States)

    Abi Chahine, Nassim H; Wehbe, Tarek W; Hilal, Ramzi A; Zoghbi, Victoria V; Melki, Alia E; Habib, Emil B Bou

    2016-05-30

    Cerebral Palsy (CP) is a disabling condition that affects a child's life and his/her family irreversibly. It is usually a non-progressive condition but improvement over time is rarely seen. The condition can be due to prenatal hypoxia, metabolic, genetic, infectious, traumatic or other causes. It is therefore a heterogeneous group that results in functional motor disability associated with different degrees of cognitive abnormalities. There are no treatments that can cure or even improve CP and the best available approach aims at functional, social and nutritional supportive care and counseling. In this paper, we report 17 sequential patients with CP treated with intrathecal administration of Bone Marrow Mononuclear Cells (BMMC). All patients had an uneventful post-injection course with 73% of the evaluable patients treated having a good response using the Gross Motor Function Classification System (GMFCS). The average improvement was 1.3 levels on the GMFCS with cognitive improvements as well.

  5. Marchiafava-Bignami disease with dementia: severe cerebral metabolic depression revealed by PET. Case report

    International Nuclear Information System (INIS)

    Pappata, S.; Chabriat, H.; Levasseur, M.; Legault-Demare, F.; Baron, J.C.

    1994-01-01

    The Cerebral Metabolic Rate of Glucose (CMRGlu) was measured with positron emission tomography and 18 F-FDG in a patient with Marchiafava-Bignami Disease (MBD)-related dementia. Despite MRI evidence of lesions essentially limited to the corpus callosum (CC), but consistent with the cognitive pattern of cortical dementia, the CMRGlu was markedly reduced in the frontal and temporo-parieto-occipital association cortices. Disruption of cortico-cortical networks crossing the CC presumably contributed to, but may not in and by itself explain, the severity of the clinical-metabolic findings in this patient. An additional role could be played by microscopic white matter lesions and/or neocortical neuronal loss, which have been occasionally observed in post-mortem studies of MBD patients. (authors)

  6. Systemic aspergilloma post aortic root surgery following coronary artery stenting: diagnostic and management dilemma

    Science.gov (United States)

    Hussein, Nabil; Qamar, Sombul; Abid, Qamar

    2015-01-01

    Aspergillus infections such as Aspergillus endocarditis were once relatively rare occurrences, however, due to the increased use of intracardiac devices, the incidence has grown. With mortality rates close to 100%, in medically treated cases, it is paramount that early diagnosis and treatment are performed. An immunocompetent aviculturist presented 8 months post aortic root replacement for severe aortic regurgitation with a composite graft, with central crushing chest pain. Investigations confirmed ST elevation inferior myocardial infarction due to stenosis of the origin of the right coronary artery, which was stented. Echocardiogram demonstrated a mobile mass posterior to the left ventricular outflow tract. Following referral to our cardiothoracic surgeons, a polypoidal mass covering the right ostial button was noted along with systemic complications of the disease. Emergency redo aortic valve replacement with a homograft and coronary artery bypass was performed. Histological analysis confirmed A. fumigatus and the patient was started on intravenous voriconazole. PMID:26025972

  7. Cerebral malaria: susceptibility weighted MRI

    Directory of Open Access Journals (Sweden)

    Vinit Baliyan

    2015-03-01

    Full Text Available Cerebral malaria is one of the fatal complications of Plasmodium falciparum infection. Pathogenesis involves cerebral microangiopathy related to microvascular plugging by infected red blood cells. Conventional imaging with MRI and CT do not reveal anything specific in case of cerebral malaria. Susceptibility weighted imaging, a recent advance in the MRI, is very sensitive to microbleeds related to microangiopathy. Histopathological studies in cerebral malaria have revealed microbleeds in brain parenchyma secondary to microangiopathy. Susceptibility weighted imaging, being exquisitely sensitive to microbleeds may provide additional information and improve the diagnostic accuracy of MRI in cerebral malaria.

  8. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  9. Clinical usefulness of augmented reality using infrared camera based real-time feedback on gait function in cerebral palsy: a case study.

    Science.gov (United States)

    Lee, Byoung-Hee

    2016-04-01

    [Purpose] This study investigated the effects of real-time feedback using infrared camera recognition technology-based augmented reality in gait training for children with cerebral palsy. [Subjects] Two subjects with cerebral palsy were recruited. [Methods] In this study, augmented reality based real-time feedback training was conducted for the subjects in two 30-minute sessions per week for four weeks. Spatiotemporal gait parameters were used to measure the effect of augmented reality-based real-time feedback training. [Results] Velocity, cadence, bilateral step and stride length, and functional ambulation improved after the intervention in both cases. [Conclusion] Although additional follow-up studies of the augmented reality based real-time feedback training are required, the results of this study demonstrate that it improved the gait ability of two children with cerebral palsy. These findings suggest a variety of applications of conservative therapeutic methods which require future clinical trials.

  10. Malaria cerebral Cerebral malaria

    Directory of Open Access Journals (Sweden)

    Carlos Hugo Zapata Zapata

    2003-03-01

    Full Text Available La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC. Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia.

  11. Short- and long-term effects of synchronized metronome training in children with hemiplegic cerebral palsy: a two case study.

    Science.gov (United States)

    Johansson, Anna-Maria; Domellöf, Erik; Rönnqvist, Louise

    2012-01-01

    Children with cerebral palsy (CP) require individualized long-term management to maintain and improve motor functions. The objective of this study was to explore potential effects of synchronized metronome training (SMT) on movement kinematics in two children diagnosed with spastic hemiplegic CP (HCP). Both children underwent 4-weeks/12 sessions of SMT by means of the Interactive Metronome (IM). Optoelectronic registrations of goal-directed uni- and bimanual upper-limb movements were made at three occasions; pre-training, post completed training and at 6-months post completed training. Significant changes in kinematic outcomes following IM training were found for both cases. Findings included smoother and shorter movement trajectories in the bimanual condition, especially for the affected side. In the unimanual condition, Case I also showed increased smoothness of the non-affected side. The observed short- and long-term effects on the spatio-temporal organization of upper-limb movements need to be corroborated and extended by further case-control studies.

  12. The combined vaginal contraceptive ring, nuvaring, and cerebral venous sinus thrombosis: a case report and review of the literature.

    Science.gov (United States)

    Kolacki, Christian; Rocco, Vito

    2012-04-01

    Combined oral contraceptives are known to confer a risk of venous thromboembolism, including cerebral venous sinus thrombosis (CVST), to otherwise healthy women. NuvaRing (Organon USA, Inc., Roseland, NJ) is a contraceptive vaginal ring that delivers 120 μg of etonogestrel and 15 μg of ethinyl estradiol per day. Its use has been associated with rare venous thromboembolic events, but few cases of CVST associated with NuvaRing have been reported. To describe a case that illustrates the increased risk of CVST associated with use of NuvaRing. We describe the case of a NuvaRing user who presented to our emergency department with a headache, who was diagnosed with CVST. Evidence suggests that NuvaRing has at least as much prothrombotic potential as combined oral contraceptives. Thus, emergency physicians should suspect serious venous thromboembolic events, including CVST, deep venous thrombosis, and pulmonary embolism, in NuvaRing users in the proper clinical setting. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Two cases of thrombosed giant middle cerebral aneurysms presenting an unusual low-density area on a CT scan

    International Nuclear Information System (INIS)

    Fuwa, Isao; Matsukado, Yasuhiko; Otsuka, Tadahiro; Kodama, Takafumi; Wada, Hidetaka.

    1985-01-01

    We describe two cases of thrombosed giant middle cerebral aneurysms presenting an unusual low-density area on a CT scan. The first case was a 53-year-old woman who presented progressive motor difficulty and mental disturbance. A CT scan showed a large, round, high-density area with a clear margin in the right temporal and paraventricular regions. A low-density area extended around the large high-density lesion, and the ventricular system was shifted to the contralateral side. A thrombosed giant aneurysm with significant brain edema was confirmed surgically. The second case was a 66-year-old woman who had a history of severe headache and vomiting. A CT scan showed a ring-like calcification located in the right basal ganglia. A cystic low density, which compressed the right anterior horn, was observed in the right frontal region. Right carotid angiography revealed an aneurysm arising from the M 1 portion. The patient died before surgical intervention; however, neuroradiological examination indicated a liquefied clot in the thrombosed giant aneurysm. The etiology of the unusual low density was discussed in relation to the CT findings of the giant aneurysm. (author)

  14. Two cases of thrombosed giant middle cerebral aneurysms presenting an unusual low-density area on a CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Fuwa, Isao; Matsukado, Yasuhiko; Otsuka, Tadahiro; Kodama, Takafumi; Wada, Hidetaka

    1985-12-01

    We describe two cases of thrombosed giant middle cerebral aneurysms presenting an unusual low-density area on a CT scan. The first case was a 53-year-old woman who presented progressive motor difficulty and mental disturbance. A CT scan showed a large, round, high-density area with a clear margin in the right temporal and paraventricular regions. A low-density area extended around the large high-density lesion, and the ventricular system was shifted to the contralateral side. A thrombosed giant aneurysm with significant brain edema was confirmed surgically. The second case was a 66-year-old woman who had a history of severe headache and vomiting. A CT scan showed a ring-like calcification located in the right basal ganglia. A cystic low density, which compressed the right anterior horn, was observed in the right frontal region. Right carotid angiography revealed an aneurysm arising from the M/sub 1/ portion. The patient died before surgical intervention; however, neuroradiological examination indicated a liquefied clot in the thrombosed giant aneurysm. The etiology of the unusual low density was discussed in relation to the CT findings of the giant aneurysm.

  15. Dyke-Davidoff-Masson syndrome: case report of fetal unilateral ventriculomegaly and hypoplastic left middle cerebral artery.

    Science.gov (United States)

    Piro, Ettore; Piccione, Maria; Marrone, Gianluca; Giuffrè, Mario; Corsello, Giovanni

    2013-05-14

    Prenatal ultrasonographic detection of unilateral cerebral ventriculomegaly arises suspicion of pathological condition related to cerebrospinal fluid flow obstruction or cerebral parenchimal pathology. Dyke-Davidoff-Masson syndrome is a rare condition characterized by cerebral hemiatrophy, calvarial thickening, skull and facial asymmetry, contralateral hemiparesis, cognitive impairment and seizures. Congenital and acquired types are recognized and have been described, mainly in late childhood, adolescence and adult ages. We describe a female infant with prenatal diagnosis of unilateral left ventriculomegaly in which early brain MRI and contrast enhanced-MRI angiography, showed cerebral left hemiatrophy associated with reduced caliber of the left middle cerebral artery revealing the characteristic findings of the Dyke-Davidoff-Masson syndrome. Prenatal imaging, cerebral vascular anomaly responsible for the cerebral hemiatrophy and the early clinical evolution have never been described before in such a young child and complete the acquired clinical descriptions in older children. Differential diagnosis, genetic investigations, neurophysiologic assessments, short term clinical and developmental follow up are described. Dyke-Davidoff-Masson syndrome must be ruled out in differential diagnosis of fetal unilateral ventriculomegaly. Early clinical assessment, differential diagnosis and cerebral imaging including cerebral MRI angiography allow the clinicians to diagnose also in early infancy this rare condition.

  16. Neurofibromatosis, stroke and basilar impression: case report Neurofibromatose, acidente vascular cerebral e impressão basilar: relato de caso

    Directory of Open Access Journals (Sweden)

    ELCIO JULIATO PIOVESAN

    1999-06-01

    Full Text Available Neurofibromatosis type 1 (NF1 can virtually affect any organ, presenting most frequently with "cafe au lait" spots and neurofibromas. Vasculopathy is a known complication of NF1, but cerebrovascular disease is rare. We report the case of a 51-year-old man admitted to the hospital with a history of stroke four months before admission. On physical examination, he presented various "cafe au lait" spots and cutaneous neurofibromas. Neurologic examination demonstrated right-sided facial paralysis, right-sided hemiplegia, and aphasia. Computed tomography scan of head showed hypodense areas in the basal ganglia and centrum semiovale. Radiographs of cranium and cervical spine showed basilar impression. Angiography revealed complete occlusion of both vertebral and left internal carotid arteries, and partial stenosis of the right internal carotid artery. A large network of collateral vessels was present (moyamoya syndrome. It is an uncommon case of occlusive cerebrovascular disease associated with NF1, since most cases described in the literature are in young people, and tend to spare the posterior cerebral circulation. Basilar impression associated with this case may be considered a pure coincidence, but rare cases of basilar impression and NF1 have been described.A neurofibromatose tipo 1 (NF1 pode acometer qualquer órgão mas as apresentações mais frequente são manchas café com leite e neurofibromas. O envolvimento de vasos é complicação conhecida da NF1, mas a doença cerebrovascular é rara. Relatamos o caso de paciente do sexo masculino de 51 anos com história de acidente vascular cerebral há quatro meses da admissão. Ao exame físico apresentava várias manchas café com leite e neurofibromas cutâneos. O exame neurológico demonstrou acometimento facial direito, hemiplegia direita e afasia. Tomografia computadorizada de crânio mostrou áreas hipodensas nos gânglios basais e centros semi-ovais. Radiografias do crânio e coluna cervical

  17. Assessing mouse alternatives to access to computer: a case study of a user with cerebral palsy.

    Science.gov (United States)

    Pousada, Thais; Pareira, Javier; Groba, Betania; Nieto, Laura; Pazos, Alejandro

    2014-01-01

    The purpose of this study is to describe the process of assessment of three assistive devices to meet the needs of a woman with cerebral palsy (CP) in order to provide her with computer access and use. The user has quadriplegic CP, with anarthria, using a syllabic keyboard. Devices were evaluated through a three-step approach: (a) use of a questionnaire to preselect potential assistive technologies, (b) use of an eTAO tool to determine the effectiveness of each devised, and (c) a conducting semi-structured interview to obtain qualitative data. Touch screen, joystick, and trackball were the preselected devices. The best device that met the user's needs and priorities was joystick. The finding was corroborated by both the eTAO tool and the semi-structured interview. Computers are a basic form of social participation. It is important to consider the special needs and priorities of users and to try different devices when undertaking a device-selection process. Environmental and personal factors have to be considered, as well. This leads to a need to evaluate new tools in order to provide the appropriate support. The eTAO could be a suitable instrument for this purpose. Additional research is also needed to understand how to better match devices with different user populations and how to comprehensively evaluate emerging technologies relative to users with disabilities.

  18. Norepinephrine as a Potential Aggravator of Symptomatic Cerebral Vasospasm: Two Cases and Argument for Milrinone Therapy

    Directory of Open Access Journals (Sweden)

    F. A. Zeiler

    2014-01-01

    Full Text Available Background. During hypertensive therapy for post-subarachnoid hemorrhage (SAH symptomatic vasospasm, norepinephrine is commonly used to reach target blood pressures. Concerns over aggravation of vasospasm with norepinephrine exist. Objective. To describe norepinephrine temporally related deterioration in neurological examination of two post-SAH patients in vasospasm. Methods. We retrospectively reviewed two charts of patients with delayed cerebral ischemia (DCI post-SAH who deteriorated with norepinephrine infusions. Results. We identified two patients with DCI post-SAH who deteriorated during hypertensive therapy with norepinephrine. The first, a 43-year-old male presented to hospital with DCI, failed MABP directed therapy with rapid deterioration in exam with high dose norepinephrine and MABP of 140–150 mm Hg. His exam improved on continuous milrinone and discontinuation of norepinephrine. The second, a 39-year-old female who developed DCI on postbleed day 8 responded to milrinone therapy upfront. During further deterioration and after angioplasty, norepinephrine was utilized to drive MABP to 130–140 mm Hg. Progressive deterioration in examination occurred after angioplasty as norepinephrine doses escalated. After discontinuation of norepinephrine and continuation of milrinone, function dramatically returned but not to baseline. Conclusions. The potential exists for worsening of DCI post-SAH with hypertensive therapy directed by norepinephrine. A potential role exists for vasodilation and inotropic directed therapy with milrinone in the setting of DCI post-SAH.

  19. The Case for Musical Instrument Training in Cerebral Palsy for Neurorehabilitation.

    Science.gov (United States)

    Alves-Pinto, Ana; Turova, Varvara; Blumenstein, Tobias; Lampe, Renée

    2016-01-01

    Recent imaging studies in cerebral palsy (CP) have described several brain structural changes, functional alterations, and neuroplastic processes that take place after brain injury during early development. These changes affect motor pathways as well as sensorimotor networks. Several of these changes correlate with behavioral measures of motor and sensory disability. It is now widely acknowledged that management of sensory deficits is relevant for rehabilitation in CP. Playing a musical instrument demands the coordination of hand movements with integrated auditory, visual, and tactile feedback, in a process that recruits multiple brain regions. These multiple demands during instrument playing, together with the entertaining character of music, have led to the development and investigation of music-supported therapies, especially for rehabilitation with motor disorders resulting from brain damage. We review scientific evidence that supports the use of musical instrument playing for rehabilitation in CP. We propose that active musical instrument playing may be an efficient means for triggering neuroplastic processes necessary for the development of sensorimotor skills in patients with early brain damage. We encourage experimental research on neuroplasticity and on its impact on the physical and personal development of individuals with CP.

  20. The Case for Musical Instrument Training in Cerebral Palsy for Neurorehabilitation

    Directory of Open Access Journals (Sweden)

    Ana Alves-Pinto

    2016-01-01

    Full Text Available Recent imaging studies in cerebral palsy (CP have described several brain structural changes, functional alterations, and neuroplastic processes that take place after brain injury during early development. These changes affect motor pathways as well as sensorimotor networks. Several of these changes correlate with behavioral measures of motor and sensory disability. It is now widely acknowledged that management of sensory deficits is relevant for rehabilitation in CP. Playing a musical instrument demands the coordination of hand movements with integrated auditory, visual, and tactile feedback, in a process that recruits multiple brain regions. These multiple demands during instrument playing, together with the entertaining character of music, have led to the development and investigation of music-supported therapies, especially for rehabilitation with motor disorders resulting from brain damage. We review scientific evidence that supports the use of musical instrument playing for rehabilitation in CP. We propose that active musical instrument playing may be an efficient means for triggering neuroplastic processes necessary for the development of sensorimotor skills in patients with early brain damage. We encourage experimental research on neuroplasticity and on its impact on the physical and personal development of individuals with CP.

  1. Cerebral venous angiomas

    International Nuclear Information System (INIS)

    Agnoli, A.L.; Hildebrandt, G.

    1985-01-01

    Clinical symptoms and radiological signs in 15 patients with cerebral venous malformations are presented and the diagnostic problems discussed. The circulation time in combination with cerebral malformations and angiomas of the scalp are described. CT findings in cases of venous malformations of the brain stem are evaluated. Spot-like enhancement, as well as sharply demarcated round shaped enhancement are characteristic for venous angiomas. Cavernous angiomas usually present as homogenous or inhomogenous round shaped enhanced areas. (Author)

  2. Executive function and cerebral blood flow on dorsolateral prefrontal cortex in cases of subcortical infarction

    International Nuclear Information System (INIS)

    Hasegawa, Akira; Utsumi, Hiroya

    2006-01-01

    In order to clarify the extent of dysexecutive function of patients with subcortical infarctions, participants of this study underwent neuropsychological tests and single photon emission computerized tomography (SPECT). These participants were categorized into two groups; patients with basal ganglia lesions (BG group) (n=5) and those with white matter lesions (WM group) (n=12). Participants were administered executive function tests as a part of a comprehensive neuropsychological battery. Administered executive measures included the Wisconsin Card Sorting Test (WCST), the Ruff Figural Fluency Test (RFFT), the Controlled Oral Word Association Test (COWAT), and the Trait Making Test; Parts A and B. There were no group differences in their age, years of education and global cognitive performance. Student's t-tests were conducted to determine group differences in executive function. As a result, the number of total errors, the number of perseverative errors and the number of categories completed on the WCST were significantly worse for the BG group than for the WM group. These groups did not differ on other measures administered. In addition, all participants underwent SPECT, and their results were compared with the normal control data. Hypoperfusion was found on parts of the bilateral frontal, temporal, and parietal lobes for the BG and WM groups. These tendencies stood out in the right hemisphere of the BG group. The BG group exhibited decreased cerebral blood flow (CBF) on the area of right side dorsolateral prefrontal cortex (DLPFC) (e.g., Brodmann area 44). These analyses revealed that individuals with BG lesions showed significant executive declines that might be associated with decreased CBF in the subcortical-frontal system. It may support the idea that BG is connected with DLPFC via frontal-subcortical neuronal circuit. Patients with BG lesions may experience dysexecutive function due to the phenomenon of diaschisis from the disruption of this circuit. (author)

  3. Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

    Science.gov (United States)

    Farrell, Elizabeth; Naber, Erin; Geigle, Paula

    2010-01-01

    This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

  4. IgE- and IgG mediated severe anaphylactic platelet transfusion reaction in a known case of cerebral malaria

    Directory of Open Access Journals (Sweden)

    B Shanthi

    2013-01-01

    Full Text Available Background: Allergic reactions occur commonly in transfusion practice. However, severe anaphylactic reactions are rare; anti-IgA (IgA: Immunoglobulin A in IgA-deficient patients is one of the well-illustrated and reported causes for such reactions. However, IgE-mediated hypersensitivity reaction through blood component transfusion may be caused in parasitic hyperimmunization for IgG and IgE antibodies. Case Report: We have evaluated here a severe anaphylactic transfusion reaction retrospectively in an 18year-old male, a known case of cerebral malaria, developed after platelet transfusions. The examination and investigations revealed classical signs and symptoms of anaphylaxis along with a significant rise in the serum IgE antibody level and IgG by hemagglutination method. Initial mild allergic reaction was followed by severe anaphylactic reaction after the second transfusion of platelets. Conclusion: Based on these results, screening of patients and donors with mild allergic reactions to IgE antibodies may help in understanding the pathogenesis as well as in planning for preventive desensitization and measures for safe transfusion.

  5. A home-based body weight supported treadmill training program for children with cerebral palsy: A case series.

    Science.gov (United States)

    Kenyon, Lisa K; Westman, Marci; Hefferan, Ashley; McCrary, Peter; Baker, Barbara J

    2017-07-01

    Contemporary approaches to the treatment of cerebral palsy (CP) advocate a task-specific approach that emphasizes repetition and practice of specific tasks. Recent studies suggest that body-weight-supported treadmill training (BWSTT) programs may be beneficial in clinical settings. The purposes of this case series were to explore the outcomes and feasibility of a home-based BWSTT program for three children with CP. Three children with CP at Gross Motor Function Classification System (GMFCS) Levels III or IV participated in this case series. Examination included the Functional Assessment Questionnaire (FAQ), the 10-meter walk test, the Gross Motor Function Measure (GMFM-66), and the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT). A harness system was used to conduct the BWSTT program over an 8-12 week period. All of the families reported enjoying the BWSTT program and found the harness easy to use. Participant 2 increased from a 2 to a 4 on the FAQ, while Participant 3 increased from a 6 to a 7. Two of the participants demonstrated post-intervention improvements in functional mobility. In addition to mobility outcomes, future research should explore the potential health benefits of a home-based BWSTT program.

  6. Fenestration of the anterior cerebral artery

    International Nuclear Information System (INIS)

    Ito, J.; Washiyama, K.; Hong Kim, C.; Ibuchi, Y.

    1981-01-01

    Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed. (orig.)

  7. Fonsecaea pedrosoi cerebral phaeohyphomycosis ("chromoblastomycosis": first human culture-proven case reported in Brazil Feohifomicose cerebral ("cromoblastomicose" por Fonsecaea pedrosoi: primeiro caso demonstrado por cultura do fungo no Brasil

    Directory of Open Access Journals (Sweden)

    José Paulo S. Nóbrega

    2003-08-01

    Full Text Available Cerebral phaeohyphomycosis ("chromoblastomycosis" is a rare intracranial lesion. We report the first human culture-proven case of brain abscesses due to Fonsecaea pedrosoi in Brazil. The patient, a 28 year-old immunocompetent white male, had ocular manifestations and a hypertensive intracranial syndrome. Magnetic resonance imaging (MRI of the brain revealed a main tumoral mass involving the right temporo-occipital area and another smaller apparently healed lesion at the left occipital lobe. A cerebral biopsy was performed and the pathological report was cerebral chromoblastomycosis. The main lesion was enucleated surgically and culture of the necrotic and suppurative mass grew a fungus identified as Fonsecaea pedrosoi. The patient had received a knife wound sixteen years prior to his hospitalization and, more recently, manifested a pulmonary granulomatous lesion in the right lung with a single non-pigmented form of a fungus present. It was speculated that the fungus might have gained entrance to the host through the skin lesion, although a primary respiratory lesion was not excluded. The patient was discharged from the hospital still with ocular manifestations and on antimycotic therapy and was followed for eight months without disease recurrence. Few months after he had complications of the previous neuro-surgery and died. A complete autopsy was performed and no residual fungal disease was found.A Feohifomicose cerebral ("cromoblastomicose" é uma lesão rara. Apresentamos o primeiro caso desta entidade com cultura do abscesso cerebral, devido a Fonsecaea pedrosoi. O paciente, um homem de 28 anos de idade, imunocompetente, apresentou manifestações oculares e síndrome de hipertensão intracraniana. Imagens de ressonância magnética (MRI cerebral mostraram massa tumoral envolvendo a área temporo-occipital direita e outra lesão menor, possivelmente cicatricial, no lobo occipital esquerdo. Biopsia cerebral mostrou cromoblastomicose cerebral

  8. CT and MRI demonstration of cerebral edema in preeclampsia: a report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Versluis, P.J. [Dept. of Radiology, Univ. Hospital, Maastricht (Netherlands); Ouden, M. den [Dept. of Obstetrics and Gynecology, Univ. Hospital, Maastricht (Netherlands); Wilmink, J.T. [Dept. of Radiology, Univ. Hospital, Maastricht (Netherlands); Hasaart, T.H.M. [Dept. of Obstetrics and Gynecology, Univ. Hospital, Maastricht (Netherlands)

    1994-10-01

    This report describes two cases with transient blindness and temporary CT and MRI abnormalities, occurring, however, in preeclampsia instead of eclampsia. Factors involved in the clinical and imaging presentation are discussed. (orig./MG)

  9. CT and MRI demonstration of cerebral edema in preeclampsia: a report of two cases

    International Nuclear Information System (INIS)

    Versluis, P.J.; Ouden, M. den; Wilmink, J.T.; Hasaart, T.H.M.

    1994-01-01

    This report describes two cases with transient blindness and temporary CT and MRI abnormalities, occurring, however, in preeclampsia instead of eclampsia. Factors involved in the clinical and imaging presentation are discussed. (orig./MG)

  10. Cerebral candiasis: CT studies in a case of brain abscess and granuloma due to candida albicans

    International Nuclear Information System (INIS)

    Thron, A.; Wiethoelter, H.

    1982-01-01

    The CT features of a young female patient suffering from systemic candidiasis with intracerebral manifestation are reported. The definite diagnosis was made by spinal fluid cultures. The diffuse granulomatous lesions as well as an abscess formation remitted after specific therapy with 5-fluorocytosine and amphotericin B for now more than 1 year. In contrast to reports of other cases with mycosis of the central nervous system this case of candidiasis shows lesions of primarily increased attenuation coefficients. (orig.)

  11. Cerebral candiasis: CT studies in a case of brain abscess and granuloma due to candida albicans

    Energy Technology Data Exchange (ETDEWEB)

    Thron, A.; Wiethoelter, H.

    1982-08-01

    The CT features of a young female patient suffering from systemic candidiasis with intracerebral manifestation are reported. The definite diagnosis was made by spinal fluid cultures. The diffuse granulomatous lesions as well as an abscess formation remitted after specific therapy with 5-fluorocytosine and amphotericin B for now more than 1 year. In contrast to reports of other cases with mycosis of the central nervous system this case of candidiasis shows lesions of primarily increased attenuation coefficients.

  12. Disturbances in the cerebral perfusion of human immune deficiency virus-1 seropositive asymptomatic subjects: A quantitative tomography study of 18 cases

    International Nuclear Information System (INIS)

    Tran Dinh, Y.R.; Mamo, H.; Cervoni, J.; Caulin, C.; Saimot, A.C.

    1990-01-01

    Quantitative measurements of cerebral blood flow (CBF) by xenon-133 ( 133 Xe) tomography, together with magnetic resonance imaging (MRI), electroencephalography (EEG), psychometric tests, and laboratory analyses were performed on 18 human immunodeficiency virus 1 (HIV-1) seropositive asymptomatic subjects. Abnormalities of cerebral perfusion were observed in 16 cases (88%). These abnormalities were particularly frequent in the frontal regions (77% of cases). MRI demonstrated leucoencephalopathy in only two cases. EEG showed only induced diffuse abnormalities in two cases. Psychometric tests showed restricted moderate disturbances in 55% of patients. These disturbances mostly concerned those sectors involved in cognitive functions and memorization. These results indicate that quantitative measurements of CBF by 133 Xe-SPECT is capable of detecting abnormalities of cerebral perfusion at a very early stage (Phase II) of HIV-1 infection. These abnormalities are indications of disturbances resulting from unidentified metabolic or vascular lesions. This technique appears to be superior to MRI at this stage of the disease's development. It could provide objective information leading to earlier treatment, and prove useful in evaluating potential antiviral chemotherapy

  13. ANCA-Negative Churg-Strauss Syndrome Presenting as Acute Multiple Cerebral Infarcts: A Case Report.

    Science.gov (United States)

    Psychogios, Klearchos; Evmorfiadis, Ilias; Dragomanovits, Spyros; Stavridis, Athanasios; Takis, Konstantinos; Kaklamanis, Loukas; Stathis, Pantelis

    2017-03-01

    Eosinophilic granulomatosis with polyangiitis (EGPA, previously named Churg-Strauss syndrome) is a form of necrotizing vasculitis occurring in patients with asthma and eosinophilia. Ischemic stroke is a relatively rare complication of the disease. We report a case of a 63-year-old woman with multiple embolic infarcts, hypereosinophilia (for >7 years), and skin rash. Elevated cardiac enzymes and cardiac magnetic resonance imaging were consistent with endomyocarditis. The simultaneous presence of history of asthma, sinusitis, hypereosinophilia, and vasculitis led to the diagnosis of EGPA. This case contributes to the recent debate of the 2 possible presentations of the disease according to the ANCA (antineutrophil cytoplasmic antibodies) status. We furthermore underscore the need for careful differential diagnosis of the "ANCA negative" cases with persistent hypereosinophilia from the idiopathic hypereosinophilic syndrome. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Acute presentation of gestational diabetes insipidus with pre-eclampsia complicated by cerebral vasoconstriction: a case report and review of the published work.

    Science.gov (United States)

    Mor, Amir; Fuchs, Yael; Zafra, Kathleen; Haberman, Shoshana; Tal, Reshef

    2015-08-01

    Gestational diabetes insipidus (GDI) is a rare, self-limited complication of pregnancy. As it is related to excess placental vasopressinase enzyme activity, which is metabolized in the liver, GDI is more common in pregnancies complicated by conditions associated with liver dysfunction. We present a case of a 41-year-old woman at 38 weeks' gestation who presented with pre-eclampsia with severe features, including impaired liver function and renal insufficiency. Following cesarean section she was diagnosed with GDI, which was further complicated by cerebral vasoconstriction as demonstrated by magnetic resonance angiography. This case raises the possibility that cerebral vasoconstriction may be related to the cause of GDI. A high index of suspicion of GDI should be maintained in patients who present with typical signs and symptoms, especially in the setting of pregnancy complications associated with liver dysfunction. © 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

  15. An unusual case of cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy with occipital lobe involvement.

    Science.gov (United States)

    Trikamji, Bhavesh; Thomas, Mariam; Hathout, Gasser; Mishra, Shrikant

    2016-01-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an autosomal dominant angiopathy caused by a mutation in the notch 3 gene on chromosome 19. Clinically, patients may be asymptomatic or can present with recurrent ischemic episodes and strokes leading to dementia, depression, pseudobulbar palsy, and hemi- or quadraplegia. Additional manifestations that have been described include migraine (mostly with aura), psychiatric disturbances, and epileptic seizures. Neuroimaging is essential to the diagnosis of CADASIL. On imaging CADASIL is characterized by symmetric involvement by confluent lesions located subcortically in the frontal and temporal lobes as well as in the insula, periventricularly, in the centrum semiovale, in the internal and external capsule, basal ganglia, and brain stem; with relative sparing of the fronto-orbital and the occipital subcortical regions. We describe a 49 year old male with CADASIL with absence of temporal lobe findings on MRI but predominant lesions within the periventricular white matter, occipital lobes with extension into the subcortical frontal lobes, corpus callosum and cerebellar white matter. Although CADASIL characteristically presents with anterior temporal lobe involvement, these findings may be absent and our case addresses the atypical imaging findings in CADASIL.

  16. Improving balance, mobility, and dual-task performance in an adolescent with cerebral palsy: A case report.

    Science.gov (United States)

    Fisher-Pipher, Sarah; Kenyon, Lisa K; Westman, Marci

    2017-07-01

    Improving functional mobility is often a desired outcome for adolescents with cerebral palsy (CP). Traditional neurorehabilitation approaches are frequently directed at impairments; however, improvements may not be carried over into functional mobility. The purpose of this case report was to describe the examination, intervention, and outcomes of a task-oriented physical therapy intervention program to improve dynamic balance, functional mobility, and dual-task performance in an adolescent with CP. The participant was a 15-year-old girl with spastic triplegic CP (Gross Motor Classification System Level II). Examination procedures included the Canadian Occupational Performance Measure, 6-minute walk test, Muscle Power Sprint Test, 10 x 5-meter sprint test, Timed Up and Down Stairs Test, Gross Motor Function Measure, Gillette Functional Assessment Questionnaire, and functional lower extremity strength tests. Intervention focused on task-oriented dynamic balance and mobility tasks that incorporated coordination and speed demands as well as task-specific lower extremity and trunk strengthening activities. Dual task demands were integrated into all intervention activities. Post-intervention testing revealed improvements in cardiovascular endurance, anaerobic power, agility, stair climbing, gross motor skills, and mobility. The participant appeared to benefit from a task-oriented program to improve dynamic balance, functional mobility, and dual-task performance.

  17. De novo formation of cerebral cavernous malformation in a patient with intractable epilepsy: case report and review.

    Science.gov (United States)

    Colpan, Mustafa Efkan; Uckardesler, Levent; Sekerci, Zeki; Slavin, Konstantin

    2010-07-01

    The exact origin and process of development of cerebral cavernous malformations (CCMs) is currently unknown. In this article, the authors present de novo CCM formation in a patient with intractable epilepsy and discuss the pathogenesis of CCM in light of several current theories. A 34-year-old man presented with a 10-year history of intractable seizures. His neurological examination was normal, and the initial magnetic resonance imaging (MRI) was suggestive of right mesial temporal sclerosis (MTS). Follow-up MRI study showed development of CCM in the right frontal region. Subsequently, invasive monitoring revealed right temporal seizure source, prompting right temporal lobectomy that resulted in abolition of epilepsy. Histological diagnosis of CCM was confirmed after the lesion was removed in a separate surgery. The patient recovered to normal lifestyle without any complications. This appears to be a first documented case of de novo CCM formation in the setting of intractable epilepsy with ipsilateral MTS. Since the possibility of lesion development cannot be ruled out based on clinical examination, updated imaging and thorough neurophysiological workup are needed for successful treatment of patients with intractable epilepsy.

  18. An unusual case of cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy with occipital lobe involvement

    Directory of Open Access Journals (Sweden)

    Bhavesh Trikamji

    2016-01-01

    Full Text Available Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL is an autosomal dominant angiopathy caused by a mutation in the notch 3 gene on chromosome 19. Clinically, patients may be asymptomatic or can present with recurrent ischemic episodes and strokes leading to dementia, depression, pseudobulbar palsy, and hemi- or quadraplegia. Additional manifestations that have been described include migraine (mostly with aura, psychiatric disturbances, and epileptic seizures. Neuroimaging is essential to the diagnosis of CADASIL. On imaging CADASIL is characterized by symmetric involvement by confluent lesions located subcortically in the frontal and temporal lobes as well as in the insula, periventricularly, in the centrum semiovale, in the internal and external capsule, basal ganglia, and brain stem; with relative sparing of the fronto-orbital and the occipital subcortical regions. We describe a 49 year old male with CADASIL with absence of temporal lobe findings on MRI but predominant lesions within the periventricular white matter, occipital lobes with extension into the subcortical frontal lobes, corpus callosum and cerebellar white matter. Although CADASIL characteristically presents with anterior temporal lobe involvement, these findings may be absent and our case addresses the atypical imaging findings in CADASIL.

  19. Subarachnoid hematoma of the craniocervical junction and upper cervical spine after traumatic cerebral contusion: case report.

    Science.gov (United States)

    Di Rienzo, Alessandro; Iacoangeli, Maurizio; Alvaro, Lorenzo; Colasanti, Roberto; Moriconi, Elisa; Gladi, Maurizio; Nocchi, Niccolò; Scerrati, Massimo

    2013-01-01

    Spinal subarachnoid hematoma (SSH) is a rare condition, more commonly occurring after lumbar puncture for diagnostic or anesthesiological procedures. It has also been observed after traumatic events, in patients under anticoagulation therapy or in case of arteriovenous malformation rupture. In a very small number of cases no causative agent can be identified and a diagnosis of spontaneous SSH is established. The lumbar and thoracic spine are the most frequently involved segments and only seven cases of cervical spine SSH have been described until now. Differential diagnosis between subdural and subarachnoid hematoma is complex because the common neuroradiological investigations, including a magnetic resonance imaging (MRI), are not enough sensitive to exactly define clot location. Actually, confirmation of the subarachnoid location of bleeding is obtained at surgery, which is necessary to resolve the fast and sometimes dramatic evolution of clinical symptoms. Nonetheless, there are occasional reports on successful conservative treatment of these lesions. We present a peculiar case of subarachnoid hematoma of the craniocervical junction, developing after the rupture of a right temporal lobe contusion within the adjacent arachnoidal spaces and the following clot migration along the right lateral aspect of the foramen magnum and the upper cervical spine, causing severe neurological impairment. After surgical removal of the hematoma, significant symptom improvement was observed.

  20. Super-selective Balloon Test Occlusion of the Posterior Communicating Artery in the Treatment of a Posterior Cerebral Artery Fusiform Aneurysm: a Case Report

    OpenAIRE

    Isozaki, Makoto; Arai, Hiroshi; Neishi, Hiroyuki; Kitai, Ryuhei; Kikuta, Ken-ichiro

    2016-01-01

    We report the case of a 49-year-old man with underlying hypertension who developed diplopia lasting 2 months. Magnetic resonance imaging and digital subtraction angiography showed multi-lobular unruptured aneurysms in the P2 portion of the posterior cerebral artery (PCA) migrating into the interpeduncular cistern of the midbrain. Because the shapes of the aneurysms were serpentine fusiform and the posterior communicating artery (PCoA) was the fetal type, we planned anastomosis of the occipita...

  1. Severe cerebral vasospasm in chronic cocaine users during neurointerventional procedures: A report of two cases.

    Science.gov (United States)

    García-Bermejo, Pablo; Rodríguez-Arias, Carlos; Crespo, Eduardo; Pérez-Fernández, Santiago; Arenillas, Juan F; Martínez-Galdámez, Mario

    2015-02-01

    Cocaine is a widespread recreational drug that has the potential to induce neurological vascular diseases, including ischaemic and haemorrhagic stroke. Although arterial vasospasm has been suggested as a pathogenic factor in the development of neurovascular complications, it remains unclear whether cocaine users carry an increased risk to suffer iatrogenic vasospasm during endovascular procedures. We report the case of two patients with a history of cocaine abuse, who developed unusual severe vasospasms during different interventional procedures. The first case occurred in a middle-aged woman with an unruptured left internal carotid artery bifurcation aneurysm who was scheduled for treatment by remodelling assisted coiling. Just after the placement of the remodelling balloon, a severe occlusive vasospasm interrupted the procedure. The second case happened to a 46-year-old man with a non-aneurysmal subarachnoid haemorrhage and a symptomatic vasospasm in the right-sided anterior circulation who developed another occlusive vasospasm after the first attempt at transluminal balloon angioplasty. Further research is needed to establish a relation between cocaine use and increased risk of iatrogenic vasospasm in endovascular procedures, but we suggest practitioners be extremely cautious when treating this subgroup of patients. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  2. Cerebral aspergillosis due to Aspergillus fumigatus in AIDS patient: first culture - proven case reported in Brazil Aspergilosis cerebral causada por Aspergillus fumigatus en paciente con SIDA: primer reporte de caso demostrado por cultivo en Brasil

    Directory of Open Access Journals (Sweden)

    José E. Vidal

    2005-06-01

    Full Text Available Cerebral aspergillosis is a rare cause of brain expansive lesion in AIDS patients. We report the first culture-proven case of brain abscess due to Aspergillus fumigatus in a Brazilian AIDS patient. The patient, a 26 year-old male with human immunodeficiency virus (HIV infection and history of pulmonary tuberculosis and cerebral toxoplasmosis, had fever, cough, dyspnea, and two episodes of seizures. The brain computerized tomography (CT showed a bi-parietal and parasagittal hypodense lesion with peripheral enhancement, and significant mass effect. There was started anti-Toxoplasma treatment. Three weeks later, the patient presented mental confusion, and a new brain CT evidenced increase in the lesion. He underwent brain biopsy, draining 10 mL of purulent material. The direct mycological examination revealed septated and hyaline hyphae. There was started amphotericin B deoxycholate. The culture of the material demonstrated presence of the Aspergillus fumigatus. The following two months, the patient was submitted to three surgeries, with insertion of drainage catheter and administration of amphotericin B intralesional. Three months after hospital admission, his neurological condition suffered discrete changes. However, he died due to intrahospital pneumonia. Brain abscess caused by Aspergillus fumigatus must be considered in the differential diagnosis of the brain expansive lesions in AIDS patients in Brazil.La aspergilosis cerebral es una causa rara de lesión expansiva cerebral en pacientes con SIDA. Presentamos el primer reporte de un absceso cerebral causado por Aspergillus fumigatus en un paciente brasileño con SIDA. El paciente, de 26 años de edad, presentaba antecedentes de infección por el virus de la inmunodeficiencia humana (VIH, tuberculosis pulmonar y toxoplasmosis cerebral. Manifestó fiebre, tos, disnea y dos episódios de convulsiones. La tomografía computadorizada (TC demostró una lesión hipodensa parasagital y bi-parietal con

  3. Cerebral vasculitis

    International Nuclear Information System (INIS)

    Greenan, T.J.; Grossman, R.I.

    1990-01-01

    This paper reviews retrospectively MR, CT, and angiographic findings in patients with cerebral vasculitis in order to understand the strengths and weaknesses of the various imaging modalities, as well as the spectrum of imaging abnormalities in this disease entity. Studies were retrospectively reviewed in 12 patients with cerebral vasculitis proved by means of angiography and/or brain biopsy

  4. An autopsy case of cerebral radiation necrosis simulating recurrent malignant glioma

    Energy Technology Data Exchange (ETDEWEB)

    Shibuya, Tadashi; Kushi, Hidehiko; Miyagi, Atsushi; Miyagami, Mitsusuke; Tsubokawa, Takashi (Nihon Univ., Tokyo (Japan). School of Medicine)

    1993-01-01

    The present case was a 60-year-old man. After removal of a malignant glioma (astrocytoma grade 3), radiation therapy was performed. From 1 year and 2 months after radiation therapy, disturbance of consciousness and right hemiparesis appeared. An abnormal shadow was noted on CT scan in the region from which the tumor had been extracted. Recurrence of the tumor was thus suspected. The symptoms were not relieved by steroid therapy or ACNU chemotherapy. The disturbance of consciousness gradually became aggravated and was complicated with respiration disorder. The patient died after a total course of 3 years and 6 months from the initial treatment. The findings of CT scans suggested a polymorphological tumor mass occupying the left frontal lobe with invasion to the right hemisphere via the corpus callosum. The gross and histological findings at autopsy mainly consisted of an extensive coagulation necrosis focus. There was also extensive vascular disturbance probably ascribable to radiation damage. Extensive investigations for residual tumor cells yielded negative results. The findings of CT scans were therefore considered to reflect changes in radiation necrosis with time. In the present case, autopsy findings, clinical course and image findings resembled those of recurrent malignant glioma but no residual tumor cells at the histological level. (author).

  5. [The acute renal and cerebral toxicity of lithium: a cerebro-renal syndrome? A case report].

    Science.gov (United States)

    Prencipe, M; Cicchella, A; Del Giudice, A; Di Giorgio, A; Scarlatella, A; Vergura, M; Aucella, F

    2013-01-01

    This descriptive report describes the case of a 50 year-old woman with bipolar disorder, whose maintenance therapy comprised risperidone, sodium valproato and lithium carbonate without any past occurrence of toxicity. Her past medical history was significant for hypertension, cardiopathy and obesity. She presented with a 1-week history of fever, increasing confusion and slurred speech. At presentation, the patient was somnolent. Laboratory investigations revealed a serum creatinine of 3,6 mg/dl, BUN 45 mg/dl serum lithium 3,0 mEq/L with polyuria defined as more than 3 litres a day. EEG and ECG were abnormal. CT brain scanning and lumbar puncture were negative for brain haemorrage or infection. Lithium toxicity causes impairment of renal concentration and encephalopathy due to lithium recirculation, a mechanism responsible for the so-called cerebro-renal syndrome, where dialysis plays an important role in treatment.The patient was treated with continous veno-venous haemodiafiltration (CVVHDF) over 35 hours with gradual improvement of her general condition and efficacy of renal concentration. Our case highlights a few important points. Lithium nefrotoxicity and neurotoxicity can cause a cerebro-renal syndrome even when serum lithium levels are not particularly raised (2,5-3,5 mEq/L). Haemodialysis is the treatment of choice to reduce the molecular mechanisms of lithium-related changes in urinary concentration and reinstate dopaminergic activity in the brain.

  6. An autopsy case of cerebral radiation necrosis simulating recurrent malignant glioma

    International Nuclear Information System (INIS)

    Shibuya, Tadashi; Kushi, Hidehiko; Miyagi, Atsushi; Miyagami, Mitsusuke; Tsubokawa, Takashi

    1993-01-01

    The present case was a 60-year-old man. After removal of a malignant glioma (astrocytoma grade 3), radiation therapy was performed. From 1 year and 2 months after radiation therapy, disturbance of consciousness and right hemiparesis appeared. An abnormal shadow was noted on CT scan in the region from which the tumor had been extracted. Recurrence of the tumor was thus suspected. The symptoms were not relieved by steroid therapy or ACNU chemotherapy. The disturbance of consciousness gradually became aggravated and was complicated with respiration disorder. The patient died after a total course of 3 years and 6 months from the initial treatment. The findings of CT scans suggested a polymorphological tumor mass occupying the left frontal lobe with invasion to the right hemisphere via the corpus callosum. The gross and histological findings at autopsy mainly consisted of an extensive coagulation necrosis focus. There was also extensive vascular disturbance probably ascribable to radiation damage. Extensive investigations for residual tumor cells yielded negative results. The findings of CT scans were therefore considered to reflect changes in radiation necrosis with time. In the present case, autopsy findings, clinical course and image findings resembled those of recurrent malignant glioma but no residual tumor cells at the histological level. (author)

  7. [Dissociations between music and language functions after cerebral resection: A new case of amusia without aphasia].

    Science.gov (United States)

    Peretz, I; Belleville, S; Fontaine, S

    1997-12-01

    We present the neuropsychological study of a patient, I.R., who sustained bilateral damage to the temporal lobes and to the right frontal lobe as a result of successive brain surgeries that occurred ten years earlier. The patient is 40 years old and right-handed; she had no special training in music or in language, representing, therefore, the large majority of listeners. Her performance is compared to that of four neurologically intact subjects who are closely matched in terms of education, sex and age. In the present study, we report I.R.'s performance on various tests aiming at assessing her general cognitive functioning with a particular focus on auditory aspects. The results show that, despite extensive damage to her auditory cortex, I.R.'s speech abilities are essentially intact (see Tables 1 and 2). The only impairments that are detected in the language domain are related to a short-term memory deficit, to some abnormal sensitivity to retroactive interference in long-term memory (see Table 3) and to articulation. These difficulties do not, however, affect linguistic communication, which is obviously undisturbed I.R. is not aphasic). Similarly, I.R. does not experience any difficulty in the recognition and memorization of familiar sounds such as animal cries, traffic noises and the like (see Tables 5 and 7). In contrast, I.R. is severely impaired in most musical abilities: She can no longer discriminate nor identify melodies that were once highly familiar to her; she can no longer discriminate nor memorize novel melodies (see Table 4). Her pattern of musical losses is compatible with a basic and severe perceptual deficit that compromises access to and registration in memory systems. The observation that the auditory impairment affects music and spares language and environmental sounds refers to a neuropsychological condition that is known as music agnosia. I.R. represents, to our knowledge, the fourth case of music agnosia available in the literature (Peretz

  8. Korsakoff syndrome from retrochiasmatic suprasellar lesions: rapid reversal after relief of cerebral compression in 4 cases.

    Science.gov (United States)

    Savastano, Luis E; Hollon, Todd C; Barkan, Ariel L; Sullivan, Stephen E

    2018-06-01

    Korsakoff syndrome is a chronic memory disorder caused by a severe deficiency of thiamine that is most commonly observed in alcoholics. However, some have proposed that focal structural lesions disrupting memory circuits-in particular, the mammillary bodies, the mammillothalamic tract, and the anterior thalamus-can give rise to this amnestic syndrome. Here, the authors present 4 patients with reversible Korsakoff syndromes caused by suprasellar retrochiasmatic lesions compressing the mammillary bodies and adjacent caudal hypothalamic structures. Three of the patients were found to have large pituitary macroadenomas in their workup for memory deficiency and cognitive decline with minimal visual symptoms. These tumors extended superiorly into the suprasellar region in a retrochiasmatic position and caused significant mass effect in the bilateral mammillary bodies in the base of the brain. These 3 patients had complete and rapid resolution of amnestic problems shortly after initiation of treatment, consisting of resection in 1 case of nonfunctioning pituitary adenoma or cabergoline therapy in 2 cases of prolactinoma. The fourth patient presented with bizarre and hostile behavior along with significant memory deficits and was found to have a large cystic craniopharyngioma filling the third ventricle and compressing the midline diencephalic structures. This patient underwent cyst fenestration and tumor debulking, with a rapid improvement in his mental status. The rapid and dramatic memory improvement observed in all of these cases is probably due to a reduction in the pressure imposed by the lesions on structures contiguous to the third ventricle, rather than a direct destructive effect of the tumor, and highlights the essential role of the caudal diencephalic structures-mainly the mammillary bodies-in memory function. In summary, large pituitary lesions with suprasellar retrochiasmatic extension and third ventricular craniopharyngiomas can cause severe Korsakoff

  9. [Processes of logical thought in a case of cerebral vascular lesion].

    Science.gov (United States)

    Blanco Men ndez, R; Aguado Balsas, A M

    Reasoning and logical thought processes have traditionally been attributed to frontal lobe function or,on the other hand, have been considered as diffuse functions of the brain. However, there is today evidence enough about the possibility to find dissociations in thought processes, depending on logical structure of the experimental tasks and referring to different areas of the brain, frontal and post rolandic ones. To study possible dissociations between thought structures corresponding to categorical and relational logic, on one hand, and propositional logic on the other hand. The case of a brain injured patient with vascular etiology, localized in left frontal parietal cortex, is presented. A specific battery of reasoning tests has been administered. . A differential performance at some reasoning experimental tasks has been found depending on such logical conceptual structures. The possibility of establishing dissociations among certain logical thought and intelectual functions depending on localization of possible brain lesion (frontal versus temporal) is discussed.

  10. [Simultanagnosia and scene agnosia induced by right posterior cerebral artery infarction: a case report].

    Science.gov (United States)

    Kobayashi, Yasutaka; Muramatsu, Tomoko; Sato, Mamiko; Hayashi, Hiromi; Miura, Toyoaki

    2015-01-01

    A 68-year-old man was admitted to our hospital for rehabilitation of topographical disorientation. Brain magnetic resonance imaging revealed infarction in the right medial side of the occipital lobe. On neuropsychological testing, he scored low for the visual information-processing task; however, his overall cognitive function was retained. He could identify parts of the picture while describing the context picture of the Visual Perception Test for Agnosia but could not explain the contents of the entire picture, representing so-called simultanagnosia. Further, he could morphologically perceive both familiar and new scenes, but could not identify them, representing so-called scene agnosia. We report this case because simultanagnosia associated with a right occipital lobe lesion is rare.

  11. Endovascular treatment of incoercible epistaxis and epidural cerebral hematoma. A case report.

    Science.gov (United States)

    Bortoluzzi, M; Pavia, M

    2006-09-15

    A young patient with a facial trauma after a road accident was admitted to our department with incoercible epistaxis. A CT scan showed a right pterional acute epidural hematoma (EDH). Angiography demonstrated multiple sources of bleeding of the right sphenopalatine arteries, cause of the epistaxis, and an intracranial leakage of the right middle meningeal artery, responsible for the EDH. The patient immediately underwent embolization of the right internal maxillary artery and right middle meningeal artery. The procedure stopped the epistaxis and no further enlargement of the EDH was observed, avoiding its surgical treatment. Endovascular surgery may be an effective procedure to stop the arterial meningeal bleeding sustaining acute EDH and may be a useful tool in the management of special cases of post traumatic EDH.

  12. Regional cerebral blood studies by the xenon-133 inhalation method in cases of cerebrovascular diseases

    International Nuclear Information System (INIS)

    Shimomura, Takahide

    1982-01-01

    rCBF was measured 428 times in 191 patients and 15 healthy volunteers by the Xenon-133 inhalation technique. The two-compartment analysis and the estimate of initial slope index were performed. There was no difference in blood flow between the two hemispheres in the 15 healthy volunteers, whose mean age was 36.5 +- 13.5 years (F 1 , right: 83.1 +- 11.4; left: 85.1 +- 12.1; 1Sl, right: 51.6 +- 6.3; left: 52.4 +- 6.0). Good correlation with a correlation coefficient of 0.965 was observed between the value obtained by the Xenon-133 inhalation and intracarotid methods in 14 patients with brain diseases. Reproducibilities of the Xenon-133 inhalation technique by serial measurement of rCBF at intervals of 30 - 40 minutes and 3 - 5 days were almost the same, with a variation coefficient of 3.7% and a correlation coefficient of 0.98. Repeated rCBF measurement by the Xenon-133 inhalation was performed during a long follow-up period of up to 1 year after bypass surgery. In 28 adult patients with occlusive cerebrovascular disease, CBF values of most patients stabilized in normal range within 3 months after the operation. In 12 patients with Moyamoya disease, CBF values were distributed over a wide range preoperatively, and increased gradually and tended to stabilize in the relatively subnormal range within 3 months after operation. This clinical experience indicates that the Xenon-133 inhalation method is a useful and safe procedure for the determination of rCBF, especially for repeated studies in cases with bypass surgery during long postoperative follow-up periods and for measurement of rCBF in child cases. (J.P.N.)

  13. The Transcranial Doppler Sonography for Optimal Monitoring and Optimization of Cerebral Perfusion in Aortic Arch Surgery: A Case Series.

    Science.gov (United States)

    Ghazy, Tamer; Darwisch, Ayham; Schmidt, Torsten; Nguyen, Phong; Elmihy, Sohaila; Fajfrova, Zuzana; Zickmüller, Claudia; Matschke, Klaus; Kappert, Utz

    2017-06-16

    To analyze the feasibility and advantages of transcranial doppler sonography (TCD) for monitoring and optimization of selective cerebral perfusion (SCP) in aortic arch surgery. From April 2013 to April 2014, nine patients with extensive aortic pathology underwent surgery under moderate hypothermic cardiac arrest with unilateral antegrade SCP under TCD monitoring in our institution. Adequate sonographic window and visualization of circle of Willis were to be confirmed. Intraoperatively, a cerebral cross-filling of the contralateral cerebral arteries on the unilateral SCP was to be confirmed with TCD. If no cross-filling was confirmed, an optimization of the SCP was performed via increasing cerebral flow and increasing PCO2. If not successful, the SCP was to be switched to bilateral perfusion. Air bubble hits were recorded at the termination of SCP. A sonographic window was confirmed in all patients. Procedural success was 100%. The mean operative time was 298 ± 89 minutes. Adequate cross-filling was confirmed in 8 patients. In 1 patient, inadequate cross-filling was detected by TCD and an optimization of cerebral flow was necessary, which was successfully confirmed by TCD. There was no conversion to bilateral perfusion. Extensive air bubble hits were confirmed in 1 patient, who suffered a postoperative stroke. The 30-day mortality rate was 0. Conclusion: The TCD is feasible for cerebral perfusion monitoring in aortic surgery. It enables a confirmation of adequacy of cerebral perfusion strategy or the need for its optimization. Documentation of calcific or air-bubble hits might add insight into patients suffering postoperative neurological deficits.

  14. Heat rate variability and dyssomnia and their correlations to neurological defects in cerebral infarction patients complicated by insomnia A concurrent non-randomized case-control study

    Institute of Scientific and Technical Information of China (English)

    Jianping Chu; Xueli Shen; Jun Fan; Changhai Chen; Shuyang Lin

    2008-01-01

    BACKGROUND: Heart rate variability refers to the beat-to-beat alteration in heart rate. It is usually a slight periodic variation of R-R intervals. Much information of autonomic nerve system balance can be obtained by measuring the heart rate variability of patients. It remains to be shown whether heart rate variability can be used as an index for determining the severity of insomnia and cerebral infarction. OBJECTIVE: This study aimed to analyze the correlation for each frequency spectrum parameter of heart rate variability with an insomnia index, as well as the degree of neurological defects in patients with simple cerebral infarction and cerebral infarction complicated by insomnia. The goal was to verify the feasibility of frequency spectrum parameters for heart rate variability as a marker for insomnia and cerebral infarction. DESIGN: A case-control observation. SETTING: Department of Neurology, First Hospital Affiliated to China Medical University. PARTICIPANTS: Sixty inpatients, and/or outpatients, with cerebral infarction were admitted to the 202 Hospital of Chinese PLA between December 2005 and October 2006, confirmed by CT, and recruited to the study. According to the insomnia condition (insomnia is defined by a Pittsburgh Sleep Quality Index score > 7), the patients were assigned to a simple cerebral infarction group and a cerebral infarction complicated by insomnia group, with 30 subjects in each group. Thirty additional subjects, who concurrently received ex-aminations and were confirmed to not suffer from cerebral infarction and insomnia, were recruited into the control group. Written informed consent was obtained from each subject for laboratory specimens. The pro-tocol was approved by the Hospital's Ethics Committee. METHODS: Following admission, each subject's neurological impairment was assessed with the National Institutes of Health Stroke Scale and Pittsburgh Sleep Quality Index. Heart rate variability of each subject was measured with an

  15. Cerebral vasculitis associated with cocaine abuse

    International Nuclear Information System (INIS)

    Kaye, B.R.; Fainstat, M.

    1987-01-01

    A case of cerebral vasculitis in a previously healthy 22-year-old man with a history of cocaine abuse is described. Cerebral angiograms showed evidence of vasculitis. A search for possible causes other than cocaine produced no results. The authors include cocaine with methamphetamines, heroin, and ephedrine as illicit drugs that can cause cerebral vasculitis

  16. Cerebral toksoplasmose primaert diagnosticeret som tumor

    DEFF Research Database (Denmark)

    Cortsen, M E; Skøt, J; Skriver, E B

    1992-01-01

    Three cases of cerebral toxoplasmosis as the presenting manifestation of AIDS are reported. The initial diagnoses were brain tumors because of the cerebral mass lesions which resembled glioblastoma. In the light of the increasing occurrence of AIDS, attention is drawn to cerebral toxoplasmosis...

  17. Papaverine is a confounding factor in neurological assessment after cerebral aneurysm clipping: Report of three cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Veena Sheshadri

    2016-01-01

    Full Text Available Intracisternal papaverine instillation is being used across many centers after cerebral aneurysm clipping to prevent and treat cerebral vasospasm. Pupillary dilatation secondary to papaverine can interfere with the neurological assessment postoperatively. This report describes pupillary changes in three patients following the papaverine application after craniotomy and aneurysm clipping, with one patient developing contralateral pupillary dilatation and the other two having bilateral pupillary dilatation. The pupillary changes resolved over 30 min to 4 h postoperatively. We conclude that pupillary changes following papaverine instillation could be a transient phenomenon and should not be considered ominous in absence of new onset neurological deficits. Intraoperative somatosensory evoked potential monitoring also helped in postoperative decision making in all our cases.

  18. Sotos syndrome (cerebral gigantism): a clinical and radiological study of 14 cases from Saudi Arabia.

    Science.gov (United States)

    al Rashed, A A; al-Jarallah, A A; Salih, M A; Kolawole, T; al-Jarallah, J

    1999-06-01

    Fourteen children (of Arab ethnic origin) with Sotos syndrome are described. They were referred to King Khalid University Hospital, Riyadh between July 1992 and June 1997. Their phenotypic characteristics were compared with established diagnostic criteria. There was a male:female ratio of 1.3:1 and a high rate of consanguinity (36%) among parents. At birth, 54% were large and about one-third showed increased height and occipitofrontal head circumference (OFHC). The neonatal histories revealed respiratory and feeding problems in 21%, followed later by delayed motor milestones and speech development in 57%. During childhood, weight, height and OFHC increased further to > 97th centile in 71%, 71% and 93%, respectively. A seizure disorder affected 43%, and 75% had mental retardation (IQ < 70). A non-specific EEG abnormality was found in half of those with seizures. Cranial CT/MRI showed ventricular dilatation in 15% and one patient had corpus callosum dysgenesis. Abdominal ultrasound revealed hydronephrosis in two patients. Radiological cephalometric measurements showed relative prognathism in cases of Sotos syndrome compared with controls (p = 0.003). The study highlights the importance of considering Sotos syndrome in children who present with psychomotor delay.

  19. Case Report: Emergency awake craniotomy for cerebral abscess in a patient with unrepaired cyanotic congenital heart disease [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Corinne D’Antico

    2016-10-01

    Full Text Available We report the case of a 39-year-old male with complex cyanotic congenital heart disease undergoing emergency craniotomy for a cerebral abscess. Maintenance of intraoperative hemodynamic stability and adequate tissue oxygenation during anesthesia may be challenging in patients with cyanotic congenital heart disease. In this case, we decided to perform the surgery as an awake craniotomy after interdisciplinary consensus. We discuss general aspects of anesthetic management during awake craniotomy and specific concerns in the perioperative care of patients with congenital heart disease.

  20. Case Report: Emergency awake craniotomy for cerebral abscess in a patient with unrepaired cyanotic congenital heart disease [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Corinne D’Antico

    2017-02-01

    Full Text Available We report the case of a 39-year-old male with complex cyanotic congenital heart disease undergoing emergency craniotomy for a cerebral abscess. Maintenance of intraoperative hemodynamic stability and adequate tissue oxygenation during anesthesia may be challenging in patients with cyanotic congenital heart disease. In this case, we decided to perform the surgery as an awake craniotomy after interdisciplinary consensus. We discuss general aspects of anesthetic management during awake craniotomy and specific concerns in the perioperative care of patients with congenital heart disease.

  1. Duplicated middle cerebral artery

    Science.gov (United States)

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an inferior branch of the main MCA. The DMCA and the MCA had perforating arteries. The aneurysm was clipped without complications. The observation of perforating arteries in our patient confirms that the DMCA may have perforating arteries. This is very important to be considered in cerebral aneurysms surgery. Moreover, the DMCA may potentially serve as a collateral blood supply to the MCA territory in cases of MCA occlusion. PMID:22140405

  2. The cerebral cost of breathing: an FMRI case-study in congenital central hypoventilation syndrome.

    Directory of Open Access Journals (Sweden)

    Mike Sharman

    Full Text Available Certain motor activities--like walking or breathing--present the interesting property of proceeding either automatically or under voluntary control. In the case of breathing, brainstem structures located in the medulla are in charge of the automatic mode, whereas cortico-subcortical brain networks--including various frontal lobe areas--subtend the voluntary mode. We speculated that the involvement of cortical activity during voluntary breathing could impact both on the "resting state" pattern of cortical-subcortical connectivity, and on the recruitment of executive functions mediated by the frontal lobe. In order to test this prediction we explored a patient suffering from central congenital hypoventilation syndrome (CCHS, a very rare developmental condition secondary to brainstem dysfunction. Typically, CCHS patients demonstrate efficient cortically-controlled breathing while awake, but require mechanically-assisted ventilation during sleep to overcome the inability of brainstem structures to mediate automatic breathing. We used simultaneous EEG-fMRI recordings to compare patterns of brain activity between these two types of ventilation during wakefulness. As compared with spontaneous breathing (SB, mechanical ventilation (MV restored the default mode network (DMN associated with self-consciousness, mind-wandering, creativity and introspection in healthy subjects. SB on the other hand resulted in a specific increase of functional connectivity between brainstem and frontal lobe. Behaviorally, the patient was more efficient in cognitive tasks requiring executive control during MV than during SB, in agreement with her subjective reports in everyday life. Taken together our results provide insight into the cognitive and neural costs of spontaneous breathing in one CCHS patient, and suggest that MV during waking periods may free up frontal lobe resources, and make them available for cognitive recruitment. More generally, this study reveals how the

  3. Spatially extended versus frontal cerebral near-infrared spectroscopy during cardiac surgery: a case series identifying potential advantages

    Science.gov (United States)

    Rummel, Christian; Basciani, Reto; Nirkko, Arto; Schroth, Gerhard; Stucki, Monika; Reineke, David; Eberle, Balthasar; Kaiser, Heiko A.

    2018-01-01

    Stroke due to hypoperfusion or emboli is a devastating adverse event of cardiac surgery, but early detection and treatment could protect patients from an unfavorable postoperative course. Hypoperfusion and emboli can be detected with transcranial Doppler of the middle cerebral artery (MCA). The measured blood flow velocity correlates with cerebral oxygenation determined clinically by near-infrared spectroscopy (NIRS) of the frontal cortex. We tested the potential advantage of a spatially extended NIRS in detecting critical events in three cardiac surgery patients with a whole-head fiber holder of the FOIRE-3000 continuous-wave NIRS system. Principle components analysis was performed to differentiate between global and localized hypoperfusion or ischemic territories of the middle and anterior cerebral arteries. In one patient, we detected a critical hypoperfusion of the right MCA, which was not apparent in the frontal channels but was accompanied by intra- and postoperative neurological correlates of ischemia. We conclude that spatially extended NIRS of temporal and parietal vascular territories could improve the detection of critically low cerebral perfusion. Even in severe hemispheric stroke, NIRS of the frontal lobe may remain normal because the anterior cerebral artery can be supplied by the contralateral side directly or via the anterior communicating artery.

  4. Evaluation of Hemodynamic Properties of Cerebral Venous Drainage in Patients with Multiple Sclerosis: A Case-Control Study

    International Nuclear Information System (INIS)

    Jandaghi, Ali Babaei; Amanian, Dayan; Roudbari, Seyed Ali; Kanafi, Alireza Rajabzadeh; Pourghorban, Ramin

    2014-01-01

    The purpose of this study was to compare patients with multiple sclerosis and healthy control subjects as regards hemodynamics of cerebral venous drainage. Between December 2012 and May 2013, 44 consecutive patients with multiple sclerosis and 44 age- and sex-matched healthy subjects underwent the B-mode, color Doppler, and duplex Doppler evaluations of the internal jugular vein (IJV) and vertebral vein. The following four parameters were investigated: IJV stenosis, reversal of postural control of the cerebral venous outflow pathways, absence of detectable blood flow in the IJVs and/or vertebral veins, and reflux in the IJVs and/or vertebral veins in the sitting or supine position. In the study group, IJV stenosis, postural control reversal of the cerebral venous outflow pathways, and absence of flow in the IJVs and/or vertebral veins were found in 3 (6.8%), 2 (4.5%), and 3 (6.8%) patients, respectively. In the control group, IJV stenosis (P=0.12), postural control reversal of the cerebral venous outflow pathways (P=0.50), and absence of flow (P=0.12) were not detected. Abnormal reflux was found neither in multiple sclerosis patients nor in healthy subjects. No significant difference in the cerebral venous drainage through the IJV or vertebral vein was found between patients with multiple sclerosis and healthy subjects within any of the investigated ultrasonographic parameters

  5. Cerebral edema associated with acute hepatic failure.

    OpenAIRE

    Fujiwara, Masachika; Watanabe, Akiharu; Yamauchi, Yasuhiko; Hashimoto, Makoto; Nakatsukasa, Harushige; Kobayashi, Michio; Higashi, Toshihiro; Nagashima, Hideo

    1985-01-01

    The clinicopathological findings of cerebral edema were investigated in patients with acute hepatic failure autopsied at Okayama University Hospital between 1970 and 1980 retrospectively. Nine (64%) of 14 hepatic failure cases were found to have cerebral edema during a post-mortem examination of the brain. Clinical features of the patients with cerebral edema were not significantly different from those of the patients without cerebral edema. However, general convulsions were observed more fre...

  6. EFFECT OF ORTHOTIC SUBTALAR ALIGNMENT WITH CO-ACTIVATION EXERCISE FOR ALTERATION IN GAIT ENDURANCE IN A CHILD WITH CEREBRAL PALSYSINGLE CASE STUDY

    Directory of Open Access Journals (Sweden)

    K. Vadivelan

    2016-10-01

    significantly good results in this case study of a child with cerebral palsy. The Co-activation exercise with Supra Malleolar Orthotic support reduces the intensity of symptoms and improved gait parameters in cerebral palsy child.

  7. Reduced Serum Level of Interleukin-10 is Associated with Cerebral Infarction: A Case-Control and Meta-Analysis Study.

    Science.gov (United States)

    Zhu, Yifei; Yang, Haiqing; Diao, Zengyan; Li, Yi; Yan, Chuanzhu

    2016-05-01

    IL-10 expression limits inflammation and restricts the size of CNS damage from stroke. In this study, we examined the correlation between cerebral infarction (CI) and serum levels of interleukin-10 (IL-10) using a combination of case-control study and meta-analysis of published data, with an aim of understanding the relevance of serum IL-10 levels to CI development. This study enrolled a total of 169 CI patients admitted to the Second Hospital of Hebei Medical University between May 2011 and November 2014. During the same period, a group of 145 individuals were recruited at the same hospital as healthy controls after thorough physical examination. Serum IL-10 levels were measured by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 (IBM, 2010, Chicago, IL, USA) and Comprehensive Meta-Analysis 2.0 (CMA 2.0) software were used for data analysis. Serum levels of IL-10 (pg/mL) were significantly lower in CI patients when compared to healthy controls (15.36 ± 3.21 vs. 21.64 ± 5.17, t = 13.12, P 0.05). Logistic regression analysis indicated that, with the exception of triglyceride (TG) and uric acid (UA) levels (both P > 0.05), the other seven parameters, including fasting blood glucose (FPG), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), creatinine (Cr), systolic blood pressure (SBP), and diastolic blood pressure (DBP), strongly correlated with CI development (all P analysis of pooled data from nine case-control studies revealed an inverse correlation between the serum IL-10 levels and CI (SMD = 1.797, 95% CI 0.785~2.810, P = 0.001). Subgroup analysis based on country showed that low serum levels of IL-10 may be the major risk factor for CI in Croatia (SMD = 2.961, 95% CI 2.480~3.443, P analysis based on ethnicity showed that IL-10 serum levels and CI displayed negative relationship in Asians (SMD = 2.522, 95% CI 0.468~4.576, P = 0.016) but not in Caucasians (P > 0.05). Our study provided convincing evidence that the patients

  8. Combined treatment using acupuncture and music therapy on children with cerebral palsy Gross motor function measure comparison In 60 cases

    Institute of Scientific and Technical Information of China (English)

    Lixiong Wu; Haibo Yu; Yongfeng Liu

    2008-01-01

    BACKGROUND: The use of acupuncture has received recognition to effectively treat cerebral palsy. Moreover, music therapy can be used to modify treatment of cerebral palsy. OBJECTIVE: To study the effects of combined treatment using acupuncture and music therapy on gross motor function measure (GMFM) of children with cerebral palsy, compared with acupuncture treatment alone. DESIGN, TIME AND SETTING: Randomized, controlled, clinical study. The experiment was conducted in Shenzhen Hospital of Traditional Chinese Medicine between January 2007 and September 2007. PARTICIPANTS: All children with cerebral palsy in the trial were from the outpatient department of Shenzhen Hospital of Traditional Chinese Medicine. The children were randomly divided into two groups: 30 children in Group B received acupuncture and music therapy, while 30 children in Group A received only acupuncture therapy. METHODS: Subjects in Groups A and B received acupuncture based on syndrome differentiation. The main acupoints were necessary for all participants. At first, flash needling was applied to the acupoints. For the remaining acupoints, the technique of transverse needling was applied to the head acupoints, and perpendicular needling was used for the other points. The inserted needles were twirled and then maintained for 30 minutes. The needle was twirled for one second every other 10 minutes, without reinforcing-reducing techniques. The therapy was performed every other day. The trial consisted of three periods each, and lasted for 84 days. Subjects in Group B received music therapy. They listened to music that they preferred while acupuncture was being performed. Following acupuncture, they were allowed to perform musical activities, such as percussion, singing, and dancing. The music therapy was scheduled for one hour, including listening to music for 30 minutes and music activities for 30 minutes. MAIN OUTCOME MEASURES: The comprehensive functional evaluation scale of cerebral palsy and

  9. High Altitude Cerebral Edema

    Science.gov (United States)

    1986-03-01

    described neuropathological findings of cerebral edema and wi4espread petechial hemorrhages in two HAPE fatalities and later reported (52...lethargy, thirst, indigestion, hysterical outburst o: other behavior disturbances, decreased concentration, fever , couhh and peripheral edema (52...autopsy results from the two fatalities in their series. In both cases multiple, widespread petechial hemorrhages were noted throughout the brain. One

  10. [Cerebral aspergillosis].

    Science.gov (United States)

    Tattevin, P; Jauréguiberry, S; Gangneux, J-P

    2004-05-01

    The brain is almost always a localization of invasive aspergillosis, after hematogenous spread from pulmonary aspergillosis. Brain aspergilosis is not rare and is one of the worst prognosis factors of invasive aspergillosis. The incidence of this severe mycosis is currently on the rise due to the development of major immunosuppressive treatments. Brain aspergillosis is noteworthy for its vascular tropism, leading to infectious cerebral vasculitis, mainly involving thalamoperforating and lenticulostriate arteries, with a high frequency of thalamic or basal nuclei lesions. Extra-neurologic features that suggest this diagnosis are: i) risk factors for invasive aspergillosis (major or prolonged neutropenia, hematologic malignancies, prolonged corticosteroid treatment, bone marrow or solid organ transplant, AIDS); ii) persistent fever not responding to presumptive antibacterial treatment; iii) respiratory signs (brain aspergillosis is associated with pulmonary aspergillosis in 80 to 95 p. 100 of cases). Perspectives. Two recent major improvements in brain aspergillosis management must be outlined: i) for diagnostic purposes, the development of testing for Aspergillus antigenemia (a non-invasive procedure with good diagnostic value for invasive aspergillosis); ii) for therapeutic purposes, the demonstration that voriconazole is better than amphotericin B in terms of clinical response, tolerance and survival, for all types of invasive aspergillosis, the benefit being probably even greater in case of brain aspergillosis because of the good diffusion of voriconazole into the central nervous system. Brain aspergillosis is a severe emerging opportunistic infection for which diagnostic and therapeutic tools have recently improved. Thus, this diagnostic must be suspected early, especially in the immunocompromised patient, in the event of respiratory symptoms and when the brain lesions are localized in the central nuclei and the thalamus.

  11. MRI of cerebral alveolar echinococcosis

    International Nuclear Information System (INIS)

    Tunaci, M.; Tunaci, A.; Engin, G.; Oezkorkmaz, B.; Ahishali, B.; Rozanes, I.

    1999-01-01

    Cerebral alveolar echinococcosis is rare. We report a case with multiple intracranial masses which show cauliflower-like contrast enhancement pattern on MRI. The lesions originated from hepatic involvement with invasion of the inferior vena cava. (orig.)

  12. Importance of speech production for phonological awareness and word decoding: the case of children with cerebral palsy.

    NARCIS (Netherlands)

    Peeters, M.; Verhoeven, L.; Moor, J.M.H. de; Balkom, H. van

    2009-01-01

    The goal of this longitudinal study was to investigate the precursors of early reading development in 52 children with cerebral palsy at kindergarten level in comparison to 65 children without disabilities. Word Decoding was measured to investigate early reading skills, while Phonological Awareness,

  13. Importance of Speech Production for Phonological Awareness and Word Decoding: The Case of Children with Cerebral Palsy

    Science.gov (United States)

    Peeters, Marieke; Verhoeven, Ludo; de Moor, Jan; van Balkom, Hans

    2009-01-01

    The goal of this longitudinal study was to investigate the precursors of early reading development in 52 children with cerebral palsy at kindergarten level in comparison to 65 children without disabilities. Word Decoding was measured to investigate early reading skills, while Phonological Awareness, Phonological Short-term Memory (STM), Speech…

  14. Changes in Muscle Activation Following Ankle Strength Training in Children with Spastic Cerebral Palsy: An Electromyography Feasibility Case Report

    Science.gov (United States)

    Olsen, Jamie E.; Ross, Sandy A.; Foreman, Matthew H.; Engsberg, Jack R.

    2013-01-01

    Children with cerebral palsy (CP) are likely to experience decreased participation in activities and less competence in activities of daily living. Studies of children with spastic CP have shown that strengthening programs produce positive results in strength, gait, and functional outcomes (measured by the Gross Motor Function Measure). No…

  15. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

    Hachinski, V C; Olesen, Jes; Norris, J W

    1977-01-01

    Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...... prodromal symptoms, a decrease in cerebral blood flow has been demonstrated during the aura. Occasionally, this flow decrease persists during the headache phase. In common migraine, where such prodromata are not seen, a flow decrease has not been demonstrated. During the headache phase of both types...... of migraine, rCBF has usually been found to be normal or in the high range of normal values. The high values may represent postischemic hyperemia, but are probably more frequently secondary to arousal caused by pain. Thus, during the headache phase rCBF may be subnormal, normal or high. These findings do...

  16. Cerebral fat embolism

    International Nuclear Information System (INIS)

    Sakamoto, Toshihisa; Sawada, Yusuke; Yukioka, Tetsuo; Nishide, Kazuyuki; Yoshioka, Toshiharu

    1982-01-01

    A case of cerebral fat embolism is reported. A 18-year-old patient with multiple bone fractures was in semiconma immediately after an injury. Brain CT showed no brain swelling or intracranial hematoma. Hypoxemia and alcoholemia were noted on admission, which returned to normal without improvement of consciousness level. In addition, respiratory symptoms with positive radiographic changes, tachycardia, pyrexia, sudden drop in hemoglobin level, and sudden thrombocytopenia developed. These symptoms were compatible with Gurd's criteria of systemic fat embolism. Eight days after injury, multiple low density areas appeared on CT and disappeared within the subsequent two weeks, and subdural effusion with cerebral atrophy developed. These CT findings were not considered due to cerebral trauma. Diagnosis of cerebral fat embolism was made. The subdural effusion was drained. Neurologic and pulmonary recoveries took place slowly and one month following the injury the patient became alert and exhibited fully coordinated limb movement. The CT scans of the present case well corresponded with hitherto reported pathological findings. Petechiae in the white matter must have developed on the day of injury, which could not be detected by CT examination. It is suggested that some petechial regions fused to purpuras and then gradually resolved when they were detected as multiple low density areas on CT. CT in the purpuras phase would have shown these lesions as high density areas. These lesions must have healed with formation of tiny scars and blood pigment which were demonstrated as the disappearance of multiple low density areas by CT examination. Cerebral atrophy and subsequent subdural effusion developed as a result of demyelination. The patient took the typical clinical course of cerebral fat embolism and serial CT scans served for its assessment. (author)

  17. Cerebral infarction following intracranial hemorrhage in pediatric Moyamoya disease - A case report and brief review of literature

    Directory of Open Access Journals (Sweden)

    Soumya Patra

    2012-01-01

    Full Text Available Moyamoya disease is a clinical entity characterized by progressive cerebrovascular occlusion with spontaneous development of a collateral vascular network called Moyamoya vessels. This disease mainly manifests as cerebral ischemia. Intracranial bleeding is another major presentation of patients with Moyamoya disease. We report here a 12-year-old male child who presented with severe headache, vomiting and meningismus. Initial neuroimaging study with noncontrast computed tomography scan revealed fresh intraventricular hemorrhage in right-sided lateral ventricle. Magnetic resonance imaging with angiography of brain was done 5 days later when the child developed right-sided hemiparesis, and the diagnosis of Moyamoya disease was confirmed along with lacunar infarction of right posterior peri and paraventricular area and in the left paraventricular area and centrum semiovale. Simultaneous presence of cerebral infarction along with intraventricular hemorrhage in adult with bleeding-type Moyamoya disease is reported in literature, but it is a rare entity in a child.

  18. Change in functional balance after an exercise program with Nintendo Wii in Latino patients with cerebral palsy: a case series.

    Science.gov (United States)

    Gatica-Rojas, Valeska; Cartes-Velásquez, Ricardo; Méndez-Rebolledo, Guillermo; Olave-Godoy, Felipe; Villalobos-Rebolledo, David

    2016-08-01

    [Purpose] This study aimed to explore the possibility of improving functional balance using an exercise program with Nintendo and the Balance Board peripheral in subjects with cerebral palsy. [Subjects and Methods] This study included 4 male outpatients of a neurological center. All participants received an exercise program based on the use of Nintendo with the Balance Board peripheral. Training consisted of three 25-min sessions per week for 6 weeks. Each session was guided by a physical therapist. Timed up-and-go and one-leg standing tests were conducted before and after the intervention. [Results] All subjects showed significant improvements in the results of the timed up-and-go test. However, there were no significant changes in the results of the one-leg standing test. [Conclusion] The exercise protocol involving Nintendo with the Balance Board peripheral appears to improve functional dynamic balance in patients with cerebral palsy. However, static functional balance does not improve after 6 weeks of training.

  19. [Multiple cerebral infarctions in a patient with hypereosinophilic syndrome with Löffler endocarditis: a case report].

    Science.gov (United States)

    Ishii, Junko; Yamamoto, Shiro; Yoshimura, Hajime; Todo, Kenichi; Kawamoto, Michi; Kohara, Nobuo

    2015-01-01

    An 82-year-old woman with a history of asthma was admitted to our hospital because of dyspnea. On admission, laboratory testing showed a white blood cell count of 17,700/μl with hypereosinophilia of 9,204/μl (52% of all white blood cells). Various examinations, including a bone marrow biopsy for the cause of eosinophilia, were unremarkable. The patient was diagnosed with hypereosinophilic syndrome (HES). Treatment with intravenous methylprednisolone was initiated. The patient's eosinophil count normalized within 1 day. On the 6th day, she developed left-sided hemiparesis. Magnetic resonance imaging (MRI) of the brain showed acute multiple infarcts in arterial border zones of bilateral cerebral and cerebellar hemispheres, and in bilateral basal ganglia and the thalamus. Magnetic resonance angiography was normal. Coagulation factors were normal, except for an elevated D-dimer level (12.9 μg/ml). A transthoracic echocardiogram showed thickening of the left ventricular endocardium with immobile thrombus, compatible with Löffler endocarditis. Treatment with oral prednisolone was started at 30 mg/day and then tapered to a maintenance dose of 5 mg/day. Anticoagulation was concurrently started for prevention of stroke. Ten months later, an echocardiogram showed that the thrombus had decreased in size, and MRI revealed no new cerebral infarctions. The cause of cerebral infarction in patients with hypereosinophilia is thought to be thromboembolism or cerebrovascular endothelial toxicity of eosinophils. In this patient, the cerebral infarcts may have been the result of embolism from the left ventricular thrombus. Because HES with Löffler endocarditis is frequently associated with a poor prognosis, cardiovascular problems should be evaluated and treatment started as soon as possible.

  20. Changes in cerebral haemodynamics in cases of post-lumbar puncture headache: a prospective transcranial Doppler ultrasound study

    International Nuclear Information System (INIS)

    Goebel, H.; Klostermann, H.; Lindner, V.; Schenkl, S.

    1990-01-01

    Transcranial Doppler ultrasonography was used in 45 patients to investigate if changes in haemodynamics in the major arteries of the brain base occurred after lumbar puncture and whether or not patients with or without post-lumbar puncture headache differ with respect to their cerebral haemodynamic parameters before and after lumbar puncture. Before lumbar puncture, patients with post-lumbar puncture headache differed from patients withoput post-lumbar puncture headache in that they showed significantly higher flow velocities and significant asymmetry of flow velocities with lateralization to the right. Patients without post-lumbar puncture headache, on the other hand, showed non-significant flow velocity lateralization to the left. Forty-eight hours after lumbar puncture, both groups demonstrated symmetrical flow velocities. In addition, only patients with post-lumbar puncture headache showed a significant reduction in the flow velocity of the right middle cerebral artery. These findings suggest that it is not only absolute flow velocity that plays a part in the event of headache; the interhemispheric relation of cerebral haemodynamics also plays a fundamental role. 14 refs., 3 figs., 2 tabs

  1. [Cerebral protection].

    Science.gov (United States)

    Cattaneo, A D

    1993-09-01

    Cerebral protection means prevention of cerebral neuronal damage. Severe brain damage extinguishes the very "human" functions such as speech, consciousness, intellectual capacity, and emotional integrity. Many pathologic conditions may inflict injuries to the brain, therefore the protection and salvage of cerebral neuronal function must be the top priorities in the care of critically ill patients. Brain tissue has unusually high energy requirements, its stores of energy metabolites are small and, as a result, the brain is totally dependent on a continuous supply of substrates and oxygen, via the circulation. In complete global ischemia (cardiac arrest) reperfusion is characterized by an immediate reactive hyperemia followed within 20-30 min by a delayed hypoperfusion state. It has been postulated that the latter contributes to the ultimate neurologic outcome. In focal ischemia (stroke) the primary focus of necrosis is encircled by an area (ischemic penumbra) that is underperfused and contains neurotoxic substances such as free radicals, prostaglandins, calcium, and excitatory neurotransmitters. The variety of therapeutic effort that have addressed the question of protecting the brain reflects their limited success. 1) Barbiturates. After an initial enthusiastic endorsement by many clinicians and years of vigorous controversy, it can now be unequivocally stated that there is no place for barbiturate therapy following resuscitation from cardiac arrest. One presumed explanation for this negative statement is that cerebral metabolic suppression by barbiturates (and other anesthetics) is impossible in the absence of an active EEG. Conversely, in the event of incomplete ischemia EEG activity in usually present (albeit altered) and metabolic suppression and hence possibly protection can be induced with barbiturates. Indeed, most of the animal studies led to a number of recommendations for barbiturate therapy in man for incomplete ischemia. 2) Isoflurane. From a cerebral

  2. Cerebral amyloid angiopathy-related inflammation presenting with steroid-responsive higher brain dysfunction: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Maeda Yasushi

    2011-09-01

    Full Text Available Abstract A 56-year-old man noticed discomfort in his left lower limb, followed by convulsion and numbness in the same area. Magnetic resonance imaging (MRI showed white matter lesions in the right parietal lobe accompanied by leptomeningeal or leptomeningeal and cortical post-contrast enhancement along the parietal sulci. The patient also exhibited higher brain dysfunction corresponding with the lesions on MRI. Histological pathology disclosed β-amyloid in the blood vessels and perivascular inflammation, which highlights the diagnosis of cerebral amyloid angiopathy (CAA-related inflammation. Pulse steroid therapy was so effective that clinical and radiological findings immediately improved. CAA-related inflammation is a rare disease, defined by the deposition of amyloid proteins within the leptomeningeal and cortical arteries associated with vasculitis or perivasculitis. Here we report a patient with CAA-related inflammation who showed higher brain dysfunction that improved with steroid therapy. In cases with atypical radiological lesions like our case, cerebral biopsy with histological confirmation remains necessary for an accurate diagnosis.

  3. CT findings in patients with cerebral palsy

    International Nuclear Information System (INIS)

    Konno, Kimiichi

    1982-01-01

    Clinical findings and CT findings in 73 cases of cerebral palsy were studied. The causes of cerebral palsy were presumed to be as follows: abnormal cerebral development (36%), asphyxial delivery (34%), and immature delivery (19%), etc. CT findings were abnormal in 58% of the 73 cases, 83% of the spastic tetraplegia patients and all of the spastic hemiplegia patients showed abnormal CT findings. All the patients with spastic monoplegia presented normal CT findings. In 75% of the spastic hemiplegia cases, the CT abnormalities were due to cerebral parenchymal abnormality such as porencephaly and regional low absorption. In cases of spastic tetraplegia, cerebral parenchymal abnormality was found only in 10%. Cortical atrophy was found only in 15 of the 73 cases, whereas central atrophy was found in 36 cases. (Ueda, J.)

  4. CT of cerebral hydatid disease

    Energy Technology Data Exchange (ETDEWEB)

    Rudwan, M.A.; Khaffaji, S.

    1988-12-01

    Six cases of cerebral hydatid disease (CHD) were seen in Kuwait over a period of 8 years. The typical CT appearance of a large well-defined spherical nonenhanced unilocular cyst was seen in four cases. Two unusual but characteristic types of calcification were seen, one in each of the remaining two cases.

  5. CT of cerebral hydatid disease

    International Nuclear Information System (INIS)

    Rudwan, M.A.; Khaffaji, S.

    1988-01-01

    Six cases of cerebral hydatid disease (CHD) were seen in Kuwait over a period of 8 years. The typical CT appearance of a large well-defined spherical nonenhanced unilocular cyst was seen in four cases. Two unusual but characteristic types of calcification were seen, one in each of the remaining two cases. (orig.)

  6. [Impact of a virtual reality-based intervention on motor performance and balance of a child with cerebral palsy: a case study].

    Science.gov (United States)

    Pavão, Silvia Leticia; Arnoni, Joice Luiza Bruno; de Oliveira, Alyne Kalyane Câmara; Rocha, Nelci Adriana Cicuto Ferreira

    2014-12-01

    To verify the effect of an intervention protocol using virtual reality (VR) on the motor performance and balance of a child with cerebral palsy (CP). To comply with the proposed objectives, a 7-year old child with spastic hemiplegic cerebral palsy (cP), GMFcS level I, was submitted to a physiotherapy intervention protocol of 12 45-minute sessions, twice a week, using virtual reality-based therapy. The protocol used a commercially-available console (XBOX(®)360 Kinect(®)) able to track and reproduce body movements on a screen. Prior to the intervention protocol, the child was evaluated using the Motor Development Scale (MDS) and the Pediatric Balance Scale (PBS) in order to assess motor development and balance, respectively. Two baseline assessments with a 2-week interval between each other were carried out for each tool. Then, the child was re-evaluated after the twelfth session. The results showed no changes in the two baseline scores. After the intervention protocol, the child improved his scores in both tools used: the PBS score increased by 3 points, reaching the maximal score, and the MDS increased from a much inferior motor performance to just an inferior motor performance. The evidence presented in this case supports the use of virtual reality as a promising tool to be incorporated into the rehabilitation process of patients with neuromotor dysfunction. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  7. Balloon occlusion of the internal carotid artery in 40 cases of giant intracavernous aneurysm: Technical aspects, cerebral monitoring, and results

    International Nuclear Information System (INIS)

    Vazquez Anon, V.; Aymard, A.; Gobin, Y.P.; Casasco, A.; Rueffenacht, D.; Khayata, M.H.; Merland, J.J.; Abizanda, E.; Redondo, A.

    1992-01-01

    We have studied the results of carotid occlusion in the treatment of giant intracavernous carotid artery (ICA) aneurysms in 40 patients. Clinical, angiographic, Doppler and cerebral blood flow (CBF) criteria for tolerance of occlusion are discussed. The patients had headaches (47.5%), cranial nerve compression (87.5%), decreased visual acuity (20%), ruptured aneurysm (15%) and 5% were asymptomatic. Balloon occlusion tests were performed under light sedation anaesthesia; a successful test required perfect clinical tolerance and adequate angiographic collateral circulation in arterial, parenchymatous, and venous phases. Additional criteria included xenon 133 CBF measurements, and transcranial Doppler sonography of the middle cerebral artery. According to these criteria, 5 patients did not tolerate test occlusion and required an extra-intracranial (EC-IC) bypass. Mean follow-up was 4.7 years. All patients were radiologically cured of their aneurysm, and in 35 the symptoms resolved, although 3 had persistent ocular motor nerve palsies, and in 4 visual defects were unchanged. Complications were 1 permament and 3 transient neurological deficits. Balloon occlusion of the ICA is an effective, reliable form of treatment for intracavernous giant aneurysm and should replace surgical ligation of the cervical carotid artery. With CBF or Doppler monitoring, the risk of neurological deficit is diminished. EC-IC bypass prior to ICA occlusion is indicated if test occlusion is not tolerated. (orig.)

  8. Trombose de seios venosos cerebrais: Estudo de 15 casos e revisão de literatura Cerebral venous thrombosis: Study of fifteen cases and review of literature

    Directory of Open Access Journals (Sweden)

    Paulo Pereira Christo

    2010-01-01

    Full Text Available OBJETIVO: Analisar uma série de 15 pacientes com trombose venosa cerebral (TVC e comparar os resultados com dados da literatura. MÉTODOS: Foram avaliados, por meio de estudo retrospectivo, transversal e descritivo, as características epidemiológicas, o quadro clínico, os fatores de risco e o prognóstico de 15 pacientes com TVC admitidos no serviço de Neurologia da Santa Casa de Belo Horizonte no período de abril de 2007 a Dezembro de 2008. RESULTADOS: O diagnóstico de TVC foi confirmado por exame de ressonância nuclear magnética de encéfalo em 14 casos e por angiografia cerebral em um caso. Os principais fatores de risco identificados foram o uso do anticoncepcional oral (40% e uma história prévia ou familiar de trombose venosa profunda. Trombofilia foi encontrada em dois pacientes (13%. O seio mais acometido foi o transverso (73%, seguido pelo sagital superior, em 53%. Quatro pacientes apresentaram acidente vascular cerebral e outros 5 apresentaram-se apenas com cefaleia isolada. Doze pacientes foram tratados com heparina e anticoagulação oral sequencial. CONCLUSÃO: A terapêutica com heparina na fase aguda seguida do anticoagulante oral demonstrou-se segura e eficaz na prevenção da progressão da doença, de sua recidiva e na rápida recuperação do quadro neurológico de todos os pacientes tratados. A TVC deve ser considerada no diagnóstico de cefaleia secundária mesmo em pacientes com ausência de outros sinais ou sintomas.OBJECTIVE: To analyze a series of 15 patients with cerebral venous thrombosis (CVT who had follow-ups at the neurology service of Santa Casa de Belo Horizonte Hospital from April, 2007 to December, 2008. These results were compared with data in literature. METHODS: Cases were evaluated by retrospective study of the epidemiologic characteristics, signs and symptoms, risk factors and prognosis of 15 patients with cerebral venous thrombosis. RESULTS: Diagnoses were reached through magnetic resonance

  9. Two novel cases of cerebral haemorrhages at the neonatal period associated with inherited factor VII deficiency, one of them revealing a new nonsense mutation (Ser52Stop).

    Science.gov (United States)

    Giansily-Blaizot, Muriel; Aguilar-Martinez, Patricia; Briquel, Marie-Elisabeth; d'Oiron, Roseline; De Maistre, Emmanuel; Epelbaum, Serge; Schved, Jean-François

    2003-02-01

    Factor VII (FVII) is a plasma glycoprotein that plays a key role in the initiation of blood coagulation cascade. Inherited FVII deficiency is a rare autosomal recessive disorder with a wide heterogeneous clinical pattern. The severe form may be associated with intracranial haemorrhages occurring closely to birth with a high mortality rate. In the present article, we report two novel cases of neonatal intracerebral bleeding associated with FVII activity levels below 1% of normal. FVII genotyping investigations revealed particular genotypes including the deleterious Cys135Arg mutation and a novel Ser52Stop nonsense mutation at the homozygous state. Both mutations, through different mechanisms, are expected to be inconsistent with the production of functional FVII. These putative mechanisms are discussed through a review of the literature on phenotypic and genotypic characteristics of cerebral haemorrhages in severe inherited FVII deficiency.

  10. Confirming and denying in co-construction processes: a case study of an adult with cerebral palsy and two familiar partners.

    Science.gov (United States)

    Hörmeyer, Ina; Renner, Gregor

    2013-09-01

    For individuals with complex communication needs, one of the most frequent communicative strategies is the co-construction of meaning with familiar partners. This preliminary single-case study gives insight into a special sequential pattern of co-construction processes - the search sequence - particularly in relation to the processes of confirming and denying meanings proposed by familiar interaction partners. Five different conversations between an adult with cerebral palsy and complex communication needs and two familiar co-participants were videotaped and analyzed using the methodology of conversation analysis (CA). The study revealed that confirmations and denials are not simply two alternative actions, but that several possibilities to realize confirmations and denials exist that differ in their frequency and that have different consequences for the sequential context. This study of confirmations and denials demonstrates that co-construction processes are more complex than have previously been documented.

  11. Regional Cerebral Blood-Flow with 99mTc-ECD Brain Perfusion SPECT in Landau-Kleffner Syndrome: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Reza Nemati

    2014-01-01

    Full Text Available Landau-Kleffner syndrome (LKS is a rare childhood disorder characterized by acquired aphasia and epilepsy. 99mTc-ECD SPECT imaging was performed in two right-handed children with LKS. A relative decrease in perfusion was found in the left frontal-temporal cortices of both patients as well as in the left and right parietal cortices of one patient with aphasia, without clinical epilepsy. The degree of regional cerebral perfusion impairment did not correlate with the severity of the clinical and EEG abnormalities, but the area of hypoperfusion was compatible with the speech area of the brain. Overall, although asymmetrical temporoparietal perfusion appears as a common finding in LKS, SPECT findings in LKS alone cannot elucidate the pathogenic features of the disorder in the brain. Here, we present two cases of LKS in which we investigated SPECT perfusion scans.

  12. Use of computer access technology as an alternative to writing for a pre-school child with athetoid cerebral palsy--a case report.

    Science.gov (United States)

    Dhas, Brightlin Nithis; Samuel, Preethy Sarah; Manigandan, C

    2014-07-01

    The purpose of this study was to demonstrate the use of an outcome-driven model of decision-making in the implementation of computer access technology (CAT) for a pre-school child with athetoid cerebral palsy. The child did not have the fine motor skills required to hold a pencil but had the cognitive abilities to learn to write; therefore, we explored the use of a CAT device to enable written communication. Case study methodology was used to describe the selection process, child-level outcomes, and clinical challenges faced by the therapist in the use of a consortium model that was designed for an outcome-driven model of decision-making. The critical role of an occupational therapist in this process using a family-centered approach is discussed.

  13. Case-control study of six genes asymmetrically expressed in the two cerebral hemispheres: association of BAIAP2 with attention-deficit/hyperactivity disorder

    DEFF Research Database (Denmark)

    Ribasés, Marta; Bosch, Rosa; Hervás, Amaia

    2009-01-01

    BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neuropsychiatric disease that persists into adulthood in at least 30% of patients. There is evidence suggesting that abnormal left-right brain asymmetries in ADHD patients may be involved in a variety of ADHD......-related cognitive processes, including sustained attention, working memory, response inhibition and planning. Although mechanisms underlying cerebral lateralization are unknown, left-right cortical asymmetry has been associated with transcriptional asymmetry at embryonic stages and several genes differentially...... expressed between hemispheres have been identified. METHODS: We selected six functional candidate genes showing at least 1.9-fold differential expression between hemispheres (BAIAP2, DAPPER1, LMO4, NEUROD6, ATP2B3, and ID2) and performed a case-control association study in an initial Spanish sample of 587...

  14. Multiple cerebral and cerebellar infarcts as the first clinical manifestation in a patient with Churg-Strauss syndrome: case report and literature review.

    Science.gov (United States)

    Cheng, Meng-Ju; Huang, Pai-Hao; Liao, Pin-Wen; Chen, Jen-Tse; Chiang, Tsuey-Ru

    2012-12-01

    Churg-Strauss syndrome (CSS) is a rare autoimmune disease with small-vessel vasculitis. Neurological manifestation of CSS is common. Central nervous system is less frequently involved than that of peripheral nervous system. We report a case of 60-year-old man who presented with acute onset of right hemiparesis and impaired cognition. The presence of hypereosinophilia, asthma, sinusitis and extravascular eosinophil accumulation led to the diagnosis of Churg-Strauss syndrome. Brain magnetic resonance imaging (MRI) revealed multiple infarcts in bilateral cerebral and cerebellar hemispheres. The neurophysiology study did not reveal peripheral neuropathy. The patient was effectively treated with methylprednisolone, cyclophosphamide and warfarin. Symptoms and signs of central nervous system can be the initial neurological manifestation of CSS patients. CSS should be considered while patients have stroke and hypereosinophilia. In our patient, there is a good response to timely steroid, immunosuppressant and anticoagulant therapies.

  15. A Case Study: Effect of Progressive Resistance and Balance Training on Upper Trunk Muscle Strength of Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Mehrnoush Ismailiyan

    2016-04-01

    Conclusion The results of this study showed that 8 weeks of progressive resistance and balance training (in combination has increased muscle strength in children with cerebral palsy. The present research showed that resistance and balanced trainings have significant effects on muscle strength of children with CP. It seems that these practices have been effective, especially for the wrist flexor and elbow flexor muscles. It can be said that the increase in the muscles of children with CP was due to practice principle along with increase in neuronal compatibility. One of the important points in the effectiveness of resistance training is the intensity of training. The results showed that resistance and balanced trainings increase the muscle strength of children with CP. This power could be partly due to increase in muscle volume and partly due to anabolic hormones.

  16. United Cerebral Palsy

    Science.gov (United States)

    ... your local affiliate Find your local affiliate United Cerebral Palsy United Cerebral Palsy (UCP) is a trusted resource for individuals with Cerebral Palsy and other disabilities and their networks. Individuals with ...

  17. Employees with Cerebral Palsy

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  18. Birth Defects: Cerebral Palsy

    Science.gov (United States)

    ... Loss > Birth defects & other health conditions > Cerebral palsy Cerebral palsy E-mail to a friend Please fill in ... this page It's been added to your dashboard . Cerebral palsy (also called CP) is a group of conditions ...

  19. Role of 99mTc-ECD brain SPECT in the detection of cerebral perfusion abnormality in cases of Attention Deficit Hyperactivity Disorder

    International Nuclear Information System (INIS)

    Kumar, A.; Phom, H.; Thomas, E.J.; Tripathi, M.; Chandrashekar, N.; Bal, C.S.; Zamir, H.; Gulati, S.; Kalra, V.

    2002-01-01

    Aim: A randomized placebo controlled drug trial with Mentat, a herbal pharmacological agent, was initiated in January 2000 in the department of pediatrics at AIIMS, New Delhi, to compare the efficacy of Mentat with a placebo in school children with Attention Deficit Hyperactivity Disorder (ADHD). Materials and Methods: Contact was established with 12 Public schools in Delhi, to identify poor performers in classes I-V (age 6-12 yrs.). About 195 children with poor school performance were recruited in the study. They were screened for causes of poor performance, which included attention problems, hyperactivity, behavior problems, emotional problems, mental sub-normality and learning disability. ADHD suspected children were identified using the Malin's WISC, Connor's rating scale, Problem Behavior checklist, Bender Gestalt test and some sub tests of the Kaufman's Assessment Battery for Children (K-ABC). Sixty children diagnosed as ADHD (using DSM-IV criteria), with an IQ between 90-110, were enrolled into the study. Of the 60 children randomized in the study, 30 received Mentat and 30 received an identical looking placebo. The drug/Placebo was given for a six-month period. 99mTC-ECD brain SPECT was performed in a subset of 34 children with ADHD. Results: Abnormal cerebral perfusion was seen in 23/34; thalamic hypoperfusion in 11, basal ganglia hypoperfusion in 9, thalamus and basal ganglia hypoperfusion in 2 and basifrontal hypoperfusion in 1. So far, in ten children with abnormal pretreatment scans, post treatment scans have also been done. In mentat group, 2/5 children showed normalization of perfusion abnormality after treatment whereas in placebo group, 1/5. Conclusion: This study suggests that there is selective focal cerebral hypoperfusion in cases of ADHD and 99mTc-ECD brain SPECT can be used for evaluation and further monitoring of therapeutic outcome in such cases

  20. Oculoauriculovertebral spectrum and cerebral anomalies

    NARCIS (Netherlands)

    Schrander-Stumpel, C. T.; de Die-Smulders, C. E.; Hennekam, R. C.; Fryns, J. P.; Bouckaert, P. X.; Brouwer, O. F.; da Costa, J. J.; Lommen, E. J.; Maaswinkel-Mooy, P. D.

    1992-01-01

    We report on three Dutch children with a clinical diagnosis of oculoauriculovertebral spectrum (OAVS) and hydrocephalus. The clinical features are compared to 15 published cases of OAVS and hydrocephalus. Several other cerebral abnormalities were present in the whole group. About half of the cases

  1. Cerebral gigantism with West syndrome.

    Science.gov (United States)

    Ray, Munni; Malhi, P; Bhalla, A K; Singhi, P D

    2003-07-01

    A case of cerebral gigantism (Sotos syndrome) with West syndrome in a one-year-old male child is reported. The case had a large stature, typical facies and neurodevelopmental delay along with infantile spasms, which were refractory to treatment with valproate and clonazepam.

  2. Three Case Reports of Successful Vibration Therapy of the Plantar Fascia for Spasticity Due to Cerebral Palsy-Like Syndrome, Fetal-Type Minamata Disease.

    Science.gov (United States)

    Usuki, Fusako; Tohyama, Satsuki

    2016-04-01

    Fetal-type Minamata disease is caused by the exposure to high concentrations of methylmercury in the fetal period and shows cerebral palsy-like clinical features. Relief of spasticity is a major task of rehabilitation to improve their activities of daily living. Here we report the effect of long-term vibration therapy on bilateral lower-limb spasticity in 3 patients with fetal-type Minamata disease. We used a simple, inexpensive, and noninvasive approach with hand-held vibration massagers, which were applied to the plantar fascia at 90 Hz for 15 minutes. The effect was observed soon after the first treatment and resulted in better performance of the repetitive facilitation. Vibration therapy for 1 year improved Modified Ashworth Scale for the ankle flexors in 2 cases. The labored gait improved and gait speed increased in another case. Continued vibration therapy for another 1 year further improved Modified Ashworth Scale score and range of motion of ankle dorsiflexion in 1 case. This case showed the decreased amplitude of soleus H-reflex after the 15-minute vibration therapy, suggesting that α-motor neuron excitability was suppressed. Vibration therapy using a hand-held vibration massager may offer safe and effective treatment for lower-limb spasticity in patients with chronic neurological disorders.

  3. Haplotype-based case-control study between human apurinic/apyrimidinic endonuclease 1/redox effector factor-1 gene and cerebral infarction.

    Science.gov (United States)

    Naganuma, Takahiro; Nakayama, Tomohiro; Sato, Naoyuki; Fu, Zhenyan; Yamaguchi, Mai; Soma, Masayoshi; Aoi, Noriko; Usami, Ron; Doba, Nobutaka; Hinohara, Shigeaki

    2009-10-01

    The aim of this study was to investigate the relationship between cerebral infarction (CI) and the human apurinic/apyrimidinic endonuclease 1/redox effector factor-1 (APE1/REF-1) gene using single-nucleotide polymorphisms (SNPs) and a haplotype-based case-control study. We selected 5 SNPs in the human APE1/REF1 gene (rs1760944, rs3136814, rs17111967, rs3136817 and rs1130409), and performed case-control studies in 177 CI patients and 309 control subjects. rs17111967 was found to have no heterogeneity in Japanese. The overall distribution of the haplotype-based case-control study constructed by rs1760944, rs3136814 and rs1130409 showed a significant difference. The frequency of the G-C-T haplotype was significantly higher in the CI group than in the control group (2.5% vs. 0.0%, p>0.001). Based on the results of the haplotype-based case-control-study, the G-C-T haplotype may be a genetic marker of CI, and the APE1/REF-1 gene may be a CI susceptibility gene.

  4. Cerebral venous thrombosis

    International Nuclear Information System (INIS)

    Soralova, T.; Sevcikova, H.; Petersky, D.

    2014-01-01

    We decided to process this theme due to its nonspecific clinical features as they often cause diagnostic problems not only to clinicians but also to diagnostic. It is important to think of this disease mainly in young women who administer hormonal contraception. Imaging methods play the crucial role in diagnostic of cerebral venous sinus thrombosis. The gold standard is a native CT of brain which shows the venous sinus thrombosis as a hyperdense lesion in the locus of the sinus (dense triangle sign), CT venography shows the sinus thrombosis as a defect in a contrast filling of the venous sinus (empty delta sign). Other investigative methods are magnetic resonance imaging or MRA. In short we also mention quite a rare but more serious thrombosis of profound cerebral veins v. cerebri magna-Galeni, vv. cerebri internae). The importance of early diagnostic and non specificity of symptoms is presented in 3 clinical cases that are the part of this work. (author)

  5. Aneurisma de artéria cerebral em criança com síndrome da imunodeficiência adquirida: relato de caso Cerebral arterial aneurysm in a child with acquired immunodeficiency syndrome: case report

    Directory of Open Access Journals (Sweden)

    Arnolfo de Carvalho Neto

    2001-06-01

    Full Text Available A dilatação aneurismática dos vasos do polígono de Willis é manifestação incomum da infecção pelo vírus da imunodeficiência adquirida (HIV, tendo sido relatados, até o momento, 15 casos na literatura. O presente estudo tem por objetivo relatar um novo caso dessa apresentação rara, além de revisar aspectos importantes relacionados à mesma. Um paciente, do sexo masculino, 6 anos de idade, com síndrome da imunodeficiência adquirida (AIDS de transmissão perinatal e tetraparesia, desenvolveu sintomas caracterizados por episódios de crises distônicas. A tomografia computadorizada de crânio, que inicialmente era normal, mostrou dilatação aneurismática dos vasos do polígono de Willis. A revisão de literatura demonstra que os principais achados patológicos em casos similares, são, principalmente, fibrose de camada média com destruição da lâmina interna e hiperplasia da íntima. A etiologia da vasculite não é conhecida, acreditando-se que o vírus da varicela-zoster e o próprio HIV possam estar relacionados à mesma. Conclui-se que, apesar de incomum, tal complicação apresenta grande importância pelo fato dos aneurismas colocarem esses pacientes em grupo de alto risco para acidentes vasculares. A sobrevida relatada na literatura é de menos de 6 meses após o diagnóstico da arteriopatia aneurismática cerebral.Cerebral aneurysmal arteriopathy of the circle of Willis is an uncommon manifestation of acquired human immunodeficiency virus (HIV infection and up to now only 15 cases have been published in the literature. For this reason we add our experience of this rare case, and review the most important aspects related to this entity. The patient is a 6 year old male with perinatal transmitted AIDS, tetraparethic, developed symptoms characterized by episodes of dystonic postures. The computed tomography of the brain showed aneurismal arteriopathy of the circle of Willis. He had a previous normal examination. The review

  6. Clinical application of cerebral dynamic perfusion studies

    International Nuclear Information System (INIS)

    DeLand, F.H.

    1975-01-01

    Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

  7. Cerebral palsy

    International Nuclear Information System (INIS)

    Truwit, C.L.; Barkovich, A.J.; Koch, T.; Ferreiro, D.

    1990-01-01

    This paper reviews cranial MR findings in patients with cerebral palsy (CP) to clarify and categorize this disorder. The MR images of 40 patients with clinical CP were retrospectively reviewed. All patients suffered either varying spastic plegias, hypotonicity, or choreoathetosis. Concomitantly, the patients suffered from static encephalopathy, developmental delay, and/or microcephaly. Twenty-four patients were born at or near term, 10 were premature, and incomplete birth histories were available in six. The MR images revealed mild to severe degrees of white matter damage in 24 patients (12 term, nine premature, three unknown)

  8. CT findings of cerebral fat embolism

    International Nuclear Information System (INIS)

    Mashiyama, Shoji; Kawakami, Kiyoshi; Ohtsuki, Taisuke; Ishibashi, Takao.

    1986-01-01

    A case of cerebral fat embolism following multiple bone fractures is presented. A 27-year-old patient was admitted to our clinic 50 minutes after a traffic accident. He was somnolent on admission, but his consciousness level was gradually raised and respiratory symptoms (dyspnea, bloody sputum) appeared with petechiae of his conjunctiva and chest. We diagnosed cerebral fat embolism. On CT scan we found multiple high-density areas, which gradually turned into multiple low-density areas. Subsequent cerebral atrophy and subdural effusion developed one month after the injury. This patient showed a typical clinical course and CT findings of cerebral fat embolism. (author)

  9. A clinical study of cerebral vaso paralysis during a period of cerebral vasospasm after subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Watanabe, Toshiichi; Sasaki, Takehiko; Nakagawara, Jyoji

    2011-01-01

    We employ the 123 I-infinitum (Imp) single photon emission computed tomography (SPECT) dual table autoradiography (Arg) method and stereotactic extraction estimation (SEE) analysis 7 or 8 days after subarachnoid hemorrhage (SAH) onset to predict cerebral vasospasm. We report new findings of cerebral vasoparalysis during a period of cerebral vasospasm after SAH. From January 1, 2005 to April 30, 2008, we encountered 330 cases of aneurysmal SAH, and treated 285 cases. Of these, 65 were excluded as unsuitable for this study, for reasons such as lack of SPECT data, external decompression, admission over 7 days from SAH onset. We studied 220 cases treated by microsurgical clipping (n=178) or endovascular coil embolization (n=42). Vasoparalysis was defined as a rise in resting cerebral blood flow (CBF) and a loss of vascular reserve on SEE analysis of CBF-SPECT. Vasoparalysis occurred in 15 cases (6.8%). Of these, 9 cases (60.0%) had cerebral hematoma, temporary clips had been used in the operation for 8 cases (53.3%), 9 cases (60.0%) experienced postoperative cerebral infarction, and 3 cases (20.0%) had postoperative convulsions. Vasoparalysis occurs in relation to perioperative cerebral damage. In terms of the loss of vascular reserve following SAH, vasoparalysis resembles hemodynamic cerebral ischemia, although the conditions are quite different. Differentiating between these 2 conditions is important, as different forms of management are required. Dual table ARG and SEE analysis are very useful for the evaluating these 2 conditions. (author)

  10. Robotics and gaming to improve ankle strength, motor control, and function in children with cerebral palsy--a case study series.

    Science.gov (United States)

    Burdea, Grigore C; Cioi, Daniel; Kale, Angad; Janes, William E; Ross, Sandy A; Engsberg, Jack R

    2013-03-01

    The objective of this study was to investigate the feasibility of game-based robotic training of the ankle in children with cerebral palsy (CP). The design was a case study, 12 weeks intervention, with no follow-up. The setting was a university research laboratory. The participants were a referred sample of three children with cerebral palsy, age 7-12, all male. All completed the intervention. Participants trained on the Rutgers Ankle CP system for 36 rehabilitation sessions (12 weeks, three times/week), playing two custom virtual reality games. The games were played while participants were seated, and trained one ankle at-a-time for strength, motor control, and coordination. The primary study outcome measures were for impairment (DF/PF torques, DF initial contact angle and gait speed), function (GMFM), and quality of life (Peds QL). Secondary outcome measures relate to game performance (game scores as reflective of ankle motor control and endurance). Gait function improved substantially in ankle kinematics, speed and endurance. Overall function (GMFM) indicated improvements that were typical of other ankle strength training programs. Quality of life increased beyond what would be considered a minimal clinical important difference. Game performance improved in both games during the intervention. This feasibility study supports the assumption that game-based robotic training of the ankle benefits gait in children with CP. Game technology is appropriate for the age group and was well accepted by the participants. Additional studies are needed however, to quantify the level of benefit and compare the approach presented here to traditional methods of therapy.

  11. Computerized tomography of cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, K; Mihara, T; Kobayashi, E; Yamamoto, K; Kusumoto, K [Kagoshima Univ. (Japan). Faculty of Medicine

    1978-12-01

    In 120 cases of patients with cerebral infarction, the affected areas in the CT images were analyzed with special reference to the site, the size, and the extension. Moreover, on 39 scans of 34 cases examined with 8 weeks after the onset of strokes, the CT images were analyzed from the viewpoint of the presence of a mass effect, edema, contrast enhancement, and the accompanying hemorrhage. From these investigations, the authors have obtained the following results; 1) The greatest incidence of infarcts was in the area supplied by the middle cerebral artery (57% of the cases), and, among those, the area of the lenticulostriate arteries showed the highest incidence (53%). Even in the posterior fossa, infarcts were found in 6% of the cases. These findings are coincident with those in autopsied cases. 2) Putaminal infarcts and infarctions occurring in the area supplied by the calcarine artery seemed to be uniformity of the arcuate pattern. 3) Most of the infarcts in the perfusion area of the anterior cerebral artery and the basal ganglia were found to be small and multifocal; they were thought to correspond with water-shed and/or lacunar infarcts. 4) In approximately 25% of the cases examined within 8 weeks after the onset of strokes, the CT images revealed mass effects which had never been observed after more than 3 weeks. In conclusion, the presence of a mass effect, accompanying hemorrhage, and contrast enhancement detected by CT should lead us to reconsider the conventional management of cerebral infarction.

  12. Neonatal cerebral infarction

    International Nuclear Information System (INIS)

    Fujimoto, Shinji; Togari, Hajime; Sobajima, Hisanori; Suzuki, Shigesumi; Wada, Yoshiro; Yokochi, Kenji; Nishimura, Yutaka; Inukai, Kazuhisa; Futamura, Masahide.

    1992-01-01

    In a retrospective multi-center study, we investigated eighteen infants with unilateral cerebral infarctions confirmed by computed tomography (CT) scans. The initial symptoms were observed in all the patients between 0 and 3 days of age. Convulsions or apneic attacks were the initial symptoms in all but one. Only 4 patients had complicated obstetric histories and none showed polycythemia or electrolyte abnormalities. All of the initial CT scans revealed unilaterally localized hypodense areas. In 10, the initial CT scans were performed within 24 hours after the clinical onset. In 16, the lesions were within the territory of the middle cerebral artery, 9 of which also involved the cortico-spinal tract (CST). In the remaining 2 patients, the lesions were located whithin the territory of the posterior cerebral artery. None of the 9 patients without CST involvement developed hemiplegia, whereas 5 (56%) of the 9 with CST involvement had hemiplegia, which is a fairly low incidence compared with that in adult cases. This difference was thought to be related to neonatal brain plasticity. (author)

  13. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Cerebral Palsy KidsHealth / For Teens / Cerebral Palsy What's in this ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  14. TREATMENT OF INTERNAL CAROTID ARTERY OCCLUSION USING PROXIMAL CEREBRAL PROTECTION DEVICE AND ITS EFFECT ON THE BLOOD PRESSURE DYNAMICS. CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    F. В. Shukurov

    2018-01-01

    Full Text Available In 2016, according to the Ministry of Health of the Russian Federation, about 200 thousand people died from stroke. Strokes are considered as the main cause of disability of the population, causing huge economic damage to the country. One of the most common causes of ischemic stroke is atherosclerosis of the branches of the aortic arch. The most common localization of atherosclerotic plaques is the extracranial section of the carotid arteries – bifurcation and ostium of the common carotid artery and the internal carotid artery. Recanalization of occlusion of the internal carotid artery until recently was an insoluble task for interventional surgery due to the high risk of distal embolization. The invention and use of the proximal cerebral protection device, which ensure the complete cessation of blood flow, has changed the situation. Effect of carotid revascularization on arterial hypertension, due to the effect on the baroreceptors of the carotid plexus by balloon angioplasty, which leads to a reflex decrease in arterial pressure, is an additional advantage of the endovascular technique in some cases. This effect requires further study. One also needs to pay careful attention to the diagnosis and imaging of carotid artery lesions before procedure. This clinical case is the illustration that an adequate assessment of the risk factors for intraoperative complications allows to achieve maximum results of endovascular treatment.

  15. MR imaging of cerebral palsy

    International Nuclear Information System (INIS)

    Saginoya, Toshiyuki; Yamaguchi, Keiichiro; Kuniyoshi, Kazuhide

    1996-01-01

    We evaluated 35 patients with cerebral palsy on the basis of MR imaging findings in the brain. The types of palsy were spastic quadriplegia (n=11), spastic diplegia (n=9), spastic hemiplegia (n=2), double hemiplegia (n=1), athetosis (n=10) and mixed (n=2). Of all patients, 28 (80%) generated abnormal findings. In spastic quadriplegia, although eight cases revealed severe brain damage, two cases showed no abnormal findings in the brain. One of the three had cervical cord compression caused by atlanto-axial subluxation. In spastic diplegia, the findings were divided according to whether the patient was born at term or preterm. If the patient had been born prematurely, the findings showed periventricular leukomalacia and abnormally high intensity in the posterior limbs of the internal capsule on T2-weighted images. MR imaging in spastic hemiplegia revealed cerebral infarction. In the athetoid type, half of all cases showed either no abnormal findings or slight widening of the lateral ventricle. Three cases showed abnormal signals of the basal ganglia. The reason why athetoid-type palsy did not show severe abnormality is unknown. We believe that MR imaging is a useful diagnostic modality to detect damage in the brain in cerebral palsy and plays an important role in the differentiation of cerebral palsy from the spastic palsy disease. (author)

  16. MR imaging of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Saginoya, Toshiyuki [Urasoe General Hospital, Okinawa (Japan); Yamaguchi, Keiichiro; Kuniyoshi, Kazuhide [and others

    1996-06-01

    We evaluated 35 patients with cerebral palsy on the basis of MR imaging findings in the brain. The types of palsy were spastic quadriplegia (n=11), spastic diplegia (n=9), spastic hemiplegia (n=2), double hemiplegia (n=1), athetosis (n=10) and mixed (n=2). Of all patients, 28 (80%) generated abnormal findings. In spastic quadriplegia, although eight cases revealed severe brain damage, two cases showed no abnormal findings in the brain. One of the three had cervical cord compression caused by atlanto-axial subluxation. In spastic diplegia, the findings were divided according to whether the patient was born at term or preterm. If the patient had been born prematurely, the findings showed periventricular leukomalacia and abnormally high intensity in the posterior limbs of the internal capsule on T2-weighted images. MR imaging in spastic hemiplegia revealed cerebral infarction. In the athetoid type, half of all cases showed either no abnormal findings or slight widening of the lateral ventricle. Three cases showed abnormal signals of the basal ganglia. The reason why athetoid-type palsy did not show severe abnormality is unknown. We believe that MR imaging is a useful diagnostic modality to detect damage in the brain in cerebral palsy and plays an important role in the differentiation of cerebral palsy from the spastic palsy disease. (author)

  17. Cerebral MR imaging in vasculitis

    International Nuclear Information System (INIS)

    Ott, D.; Geissler, A.; Peter, H.H.

    1990-01-01

    This paper evaluates the diagnostic sensitivity and specificity of MR imaging for the detection of cerebral involvement in vasculitis. Seventy-six patient with proved systematic vasculitis and two with isolated cerebral vasculitis were examined. Half of them had central nervous system symptoms. T2-weighted sequences were performed at 2 T in most cases. All but two symptomatic and one-third of the asymptomatic patients showed pathologic changes in the white matter. The distribution and shape of lesions depend on the caliber of the involved vessel. In small-vessel vasculitis, the distribution was mostly subcortical, the average size was 0.5--10 mm, and lesions were predominantly round

  18. Cerebral white matter hypoplasia

    International Nuclear Information System (INIS)

    Dietrich, R.B.; Shields, W.D.; Sankar, R.

    1990-01-01

    This paper demonstrates the MR imaging findings in children with cerebral white matter hypoplasia (CWMH). The MR studies of four children, aged 3-7 y (mean age, 2.3 y) with a diagnosis of CWMH were reviewed. In all cases multiplanar T1-weighted and T2-weighted spin-echo images were obtained. All children had similar histories of severe developmental delay and nonprogressive neurologic deficits despite normal gestational and birth histories. In two cases there was a history of maternal cocaine abuse. Autopsy correlation was available in one child. The MR images of all four children demonstrated diffuse lack of white matter and enlarged ventricles but normal-appearing gray matter. The corpus callosum, although completely formed, was severely thinned. There was no evidence of gliosis or porencephaly, and the distribution of myelin deposition was normal for age in all cases. Autopsy finding in one child correlated exactly with the MR finding

  19. Cerebral oxygen desaturation during beach chair position

    NARCIS (Netherlands)

    Moerman, Annelies T.; de Hert, Stefan G.; Jacobs, Tom F.; de Wilde, Lieven F.; Wouters, Patrick F.

    2012-01-01

    Cases of ischaemic brain damage have been reported in relatively healthy patients undergoing shoulder surgery in the beach chair position. Unrecognised cerebral hypoperfusion may have contributed to these catastrophic events, indicating that routine anaesthesia monitoring may not suffice.

  20. Cerebrovascular risk factors for patients with cerebral watershed infarction: A case-control study based on computed tomography angiography in a population from Southwest China.

    Science.gov (United States)

    Dong, Mei-Xue; Hu, Ling; Huang, Yuan-Jun; Xu, Xiao-Min; Liu, Yang; Wei, You-Dong

    2017-07-01

    To determine cerebrovascular risk factors for patients with cerebral watershed infarction (CWI) from Southwest China.Patients suffering from acute ischemic stroke were categorized into internal CWI (I-CWI), external CWI (E-CWI), or non-CWI (patients without CWI) groups. Clinical data were collected and degrees of steno-occlusion of all cerebral arteries were scored. Arteries associated with the circle of Willis were also assessed. Data were compared using Pearson chi-squared tests for categorical data and 1-way analysis of variance with Bonferroni post hoc tests for continuous data, as appropriate. Multivariate binary logistic regression analysis was performed to determine independent cerebrovascular risk factors for CWI.Compared with non-CWI, I-CWI had higher degrees of steno-occlusion of the ipsilateral middle cerebral artery, ipsilateral carotid artery, and contralateral middle cerebral artery. E-CWI showed no significant differences. All the 3 arteries were independent cerebrovascular risk factors for I-CWI confirmed by multivariate binary logistic regression analysis. I-CWI had higher degrees of steno-occlusion of the ipsilateral middle cerebral artery compared with E-CWI. No significant differences were found among arteries associated with the circle of Willis.The ipsilateral middle cerebral artery, carotid artery, and contralateral middle cerebral artery were independent cerebrovascular risk factors for I-CWI. No cerebrovascular risk factor was identified for E-CWI.

  1. Cerebral Vasculitis

    Directory of Open Access Journals (Sweden)

    Fariborz Khorvash

    2017-02-01

    Full Text Available Introduction: Vasculitis is an inflammation systems may be involved of blood vessels due to various origins. Vessels of the peripheral and/or central nervous. Vasculitis of the CNS is rare and occurs in the context of systemic diseases or as primary angiitis of the CNS. Epidemiology: The overall incidence of primary vasculitis is about 40/1,000,000 persons [excluding giant cell (temporal arteritis, GCA]. Its incidence increases with age. The incidence of GCA is much higher (around 200/1,000,000 persons in the age group[50 years. Clinical Presentation: Clinical and pathological presentation in CNS vasculitis represents a wide spectrum. Among others, headache, cranial nerve affections, encephalopathy, seizures, psychosis, myelitis, stroke, intracranial haemorrhage and aseptic meningoencephalitis are described. Primary and secondary vasculitides leading more frequently to CNS manifestations are discussed. Primary and secondary Vasculitides: Including Giant Cell (Temporal Arteritis , Takayasu arteritis, Polyarteritis nodosa, Primary angiitis of the CNS, Wegener’s granulomatosis, and Connective tissue diseases, such as systemic lupus erythematosus (SLE, scleroderma, rheumatoid arthritis, mixed connective disease and Sjögren syndrome, are systemic immune-mediated diseases that lead to multiple organ affections. Cerebral Vasculitis: Imaging and Differential Diagnosis: Vasculitides represent a heterogeneous group of inflammatory diseases that affect blood vessel walls of varying calibers (inflammatory vasculopathy. Since the devastating symptoms of CNS vasculitis are at least partially reversible, early diagnosis and appropriate treatment are important. In order to establish a differential diagnosis clinical features, disease progression, age of onset, blood results, as well as CSF examinations have to be taken into consideration. Neuroimaging techniques, such as MRI and DSA, play a central role in the diagnosis and disease monitoring .The diagnostic

  2. Super-selective Balloon Test Occlusion of the Posterior Communicating Artery in the Treatment of a Posterior Cerebral Artery Fusiform Aneurysm: a Case Report.

    Science.gov (United States)

    Isozaki, Makoto; Arai, Hiroshi; Neishi, Hiroyuki; Kitai, Ryuhei; Kikuta, Ken-Ichiro

    2016-10-01

    We report the case of a 49-year-old man with underlying hypertension who developed diplopia lasting 2 months. Magnetic resonance imaging and digital subtraction angiography showed multi-lobular unruptured aneurysms in the P2 portion of the posterior cerebral artery (PCA) migrating into the interpeduncular cistern of the midbrain. Because the shapes of the aneurysms were serpentine fusiform and the posterior communicating artery (PCoA) was the fetal type, we planned anastomosis of the occipital artery to the P4 portion of the PCA followed by endovascular obliteration of the parent artery including the aneurysms. Endovascular treatment was performed via a femoral approach one week after the anastomosis. Super-selective balloon test occlusion (BTO) of the PCoA was performed by using an occlusion balloon microcatheter before endovascular treatment. Occlusion of the proximal segment of the PCoA induced disturbance of consciousness of the patient. Occlusion of the distal segment other than the first point of the PCoA did not induce any neurological symptoms. The information from this super-selective BTO helped us to perform precise endovascular obliteration. The aneurysm was successfully obliterated, and the diplopia almost disappeared in a few months. Super-selective BTO of the PCoA might be a useful method for preventing ischemic complications due to occlusion of invisible perforators.

  3. Treatment of giant and large fusiform middle cerebral artery aneurysms with excision and interposition radial artery graft in a 4-year-old child: case report.

    Science.gov (United States)

    Mrak, Goran; Paladino, Josip; Stambolija, Vasilije; Nemir, Jakob; Sekhar, Laligam N

    2014-03-01

    We report an unusual case of complex giant and large fusiform aneurysms not amenable for clipping or coiling in a 4-year-old child managed with aneurysm resection and radial artery interposition graft. A 4-year-old child presented with repeated severe headache and vomiting. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography and digital subtraction angiography showed a giant fusiform aneurysm on the right middle cerebral artery (MCA). Because of the complex shape, endovascular treatment or clip reconstruction was not possible, and a bypass procedure was planned. Right frontotemporal craniotomy and orbitotomy was performed. Two aneurysms involving the M1 segment of the MCA were found in line, 1 giant, and the other large in size. The aneurysms were resected and treated with short radial artery interposition graft, which was narrower than the proximal or distal MCA. The child recovered normally, and the bypass was patent after 1 year. Large fusiform MCA aneurysms may be difficult to treat, but there are treatment options that include a bypass procedure. Resection and short interposition radial artery graft is an excellent but rare treatment option in a very young child. This was a very successful treatment in this child.

  4. Cerebral computerized tomography findings in AIDS patients

    International Nuclear Information System (INIS)

    Hol, P.K.; Dunlop, O.

    1997-01-01

    A cerebral CT was performed in 82 of 525 AIDS patients, with positive findings in 46 cases. These findings included cerebral atrophy in 28 cases, pathological demyelinisation in two, progressive multifocal leukoencephalopathy in one, toxoplasmoses in 11, lymphomas in seven, infarction in one and one subdural haematoma. The radiological findings are correlated to pathology and clinical symptoms. The authors point out the importance of these findings for correct interpretation of the CT scans. 11 refs., 7 figs., 2 tabs

  5. Case Report: Microsurgical excision of grade 5 cerebral AVM [version 2; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Sunil Munakomi

    2016-07-01

    Full Text Available In this case report, we discuss the microsurgical management of a Spetzler-Martin grade 5 arteriovenous malformation (AVM in a young boy who presented with a hemorrhagic episode and had a high calculated risk of rebleeding. We also outline the rationale for choosing the management option.

  6. Postpartum hypernatremic cerebral encephalopathy with osmotic myelinolysis: Report of two cases and review with emphasis on magnetic resonance imaging findings

    Directory of Open Access Journals (Sweden)

    Santosh Rai Phajir Vishwanath

    2015-01-01

    Full Text Available Postpartum complications are diverse. Electrolyte imbalance with hypernatremia can occur secondary to underlying postpartum complication or can arise de novo. Hypernatremia causes demyelination similar to hyponatremia but predominantly involves extra-pontine structures. Here, we present two cases, one classical and another a variant of a recently described entity called postpartum hypernatremic encephalopathy with osmotic demyelination. The more classical appearance is altered signal intensity changes in the posterior limb of internal capsules, external capsule, crus cerebri, corticopontine tracts, middle cerebellar peduncle, hippocampus, fornix, and cerebellar white matter with classical wine glass appearance on coronal T2-weighted images. The nonclassical case shows a different and atypical imaging finding of the same disease with small focal transient altered signal intensity changes in the splenium of corpus callosum. Both the patients recovered with conservative management of the electrolyte imbalance.

  7. Pure Motor Stroke Secondary to Cerebral Infarction of Recurrent Artery of Heubner after Mild Head Trauma: A Case Report

    OpenAIRE

    Yilmaz, Ali; Kizilay, Zahir; Ozkul, Ayca; ?irak, Bayram

    2016-01-01

    BACKGROUND: The recurrent Heubner's artery is the distal part of the medial striate artery. Occlusion of the recurrent artery of Heubner, classically contralateral hemiparesis with fasciobrachiocrural predominance, is attributed to the occlusion of the recurrent artery of Heubner and is widely known as a stroke syndrome in adults. However, isolated occlusion of the deep perforating arteries following mild head trauma also occurs extremely rarely in childhood. CASE REPORT: Here we report t...

  8. Primary cerebral lymphoma: radiological findings

    International Nuclear Information System (INIS)

    Ruiz, J.C.; Grandse, D.; Equidazu, J.; Elizagaray, E.; Grande, J.; Carrandi, J.

    1990-01-01

    We present four cases of primary cerebral lymphoma in non-immunodepressed adult patients. All cases were dsemonstrated with pathological study. CAT study showed solitary or multiple isodense lesions, which incorporated avidly and homoneneously the contrast. Arteriography performed in three patients and magnetic resonance, performed in one did not help for diagnosis. We also review the radiological findings obtained with different imaging methods, and suggest the criteria which could be useful for early diagnosis (Author)

  9. Cerebral organization of oral and signed language responses: case study evidence from amytal and cortical stimulation studies.

    Science.gov (United States)

    Mateer, C A; Rapport, R L; Kettrick, C

    1984-01-01

    A normally hearing left-handed patient familiar with American Sign Language (ASL) was assessed under sodium amytal conditions and with left cortical stimulation in both oral speech and signed English. Lateralization was mixed but complementary in each language mode: the right hemisphere perfusion severely disrupted motoric aspects of both types of language expression, the left hemisphere perfusion specifically disrupted features of grammatical and semantic usage in each mode of expression. Both semantic and syntactic aspects of oral and signed responses were altered during left posterior temporal-parietal stimulation. Findings are discussed in terms of the neurological organization of ASL and linguistic organization in cases of early left hemisphere damage.

  10. Acute posterior multifocal placoid pigment epitheliopathy associated with cerebral vasculitis.

    Science.gov (United States)

    Weinstein, J M; Bresnick, G H; Bell, C L; Roschmann, R A; Brooks, B R; Strother, C M

    1988-09-01

    Acute multifocal posterior placoid pigment epitheliopathy (APMPPE) is an unusual self-limited retinal disorder that has been associated with various systemic complications. To our knowledge, three prior cases associated with cerebral vasculitis have been described. This article describes a patient with APMPPE and angiographically documented cerebral vasculitis who was notable because of (a) the presence of two different cerebral ischemic events, occurring 1 month apart, and (b) the long latency (3 months) between the onset of ocular symptoms and the second cerebral ischemic event. Recognition of the association between APMPPE and cerebral vasculitis may permit early treatment of CNS involvement and prevention of morbidity.

  11. The relation of breech presentation at term to cerebral palsy

    DEFF Research Database (Denmark)

    Krebs, L; Topp, M; Langhoff-Roos, J

    1999-01-01

    OBJECTIVE: To examine the relation between breech delivery and cerebral palsy, considering the influence of intrauterine growth, low Apgar score at birth, and mode of delivery. DESIGN: Register-based, case-control study. POPULATION: A cohort of infants with cerebral palsy born between 1979 and 1986...... in East Denmark, identified by linkage of the cerebral palsy register with the national birth register. Discharge letters from births of breech infants with cerebral palsy were reviewed. MAIN OUTCOME MEASURES: Presentation, mode of delivery, gestational age, birthweight, Apgar score, type of cerebral...

  12. Clinical and neuroradiological studies of eclampsia. Cerebral vasospasm and relation to the brain edema

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Yasuhiro; Niwa, Hisayoshi; Ando, Tetsuo; Yasuda, Takeshi; Yanagi, Tsutomu [Nagoya Daini Red Cross Hospital, Aichi (Japan)

    1995-04-01

    Clinical and neuroradiological studies involving cerebral angiography were conducted in four patients with eclampsia. In three cases (case 1, 2 and 4), neurological focal signs, abnormal low density areas on cranial CT and T{sub 2} high intensity areas on cranial MRI disappeared within a month. But in one case (case 3), cerebral infarction occurred and right hemiparesis and aphasia persisted. Cerebral angiography in the acute phase demonstrated vasospasm in all cases and arterial occlusion in the middle cerebral artery due to vasospasm in case 3. Angiography demonstrated several types of spasms, including diffuse, peripheral and multi local. Furthermore, in some cases, diffuse vasospasms were recognized at the siphon and extracranial portions of the internal carotid artery. In one case (Case 4), segmental vasospasms were detected in the bilateral vertebral arteries. Three to four weeks later, follow-up cerebral angiography was performed in three cases. Cerebral vasospasms had partially or completely recovered. Subarachnoid hemorrhage (SAH) was excluded by lumbar puncture and neuroradiological findings in all cases. We concluded that eclampsia itself causes cerebral vasospasm and that the mechanism of vasospasm is different from that of SAH, since cerebral vasospasm occurred in the extracranial cerebral arteries. We suspected that cerebral vasospasm in eclampsia causes cerebral ischemia, which leads to cytotoxic edema and dysfunction of the blood-brain barrier (BBB) and cerebral autoregulation. With this background, brain edema, especially vasogenic edema, may easily occur and clinical symptoms of eclampsia may appear when the blood pressure rapidly increases. (author).

  13. Clinical and neuroradiological studies of eclampsia. Cerebral vasospasm and relation to the brain edema

    International Nuclear Information System (INIS)

    Ito, Yasuhiro; Niwa, Hisayoshi; Ando, Tetsuo; Yasuda, Takeshi; Yanagi, Tsutomu

    1995-01-01

    Clinical and neuroradiological studies involving cerebral angiography were conducted in four patients with eclampsia. In three cases (case 1, 2 and 4), neurological focal signs, abnormal low density areas on cranial CT and T 2 high intensity areas on cranial MRI disappeared within a month. But in one case (case 3), cerebral infarction occurred and right hemiparesis and aphasia persisted. Cerebral angiography in the acute phase demonstrated vasospasm in all cases and arterial occlusion in the middle cerebral artery due to vasospasm in case 3. Angiography demonstrated several types of spasms, including diffuse, peripheral and multi local. Furthermore, in some cases, diffuse vasospasms were recognized at the siphon and extracranial portions of the internal carotid artery. In one case (Case 4), segmental vasospasms were detected in the bilateral vertebral arteries. Three to four weeks later, follow-up cerebral angiography was performed in three cases. Cerebral vasospasms had partially or completely recovered. Subarachnoid hemorrhage (SAH) was excluded by lumbar puncture and neuroradiological findings in all cases. We concluded that eclampsia itself causes cerebral vasospasm and that the mechanism of vasospasm is different from that of SAH, since cerebral vasospasm occurred in the extracranial cerebral arteries. We suspected that cerebral vasospasm in eclampsia causes cerebral ischemia, which leads to cytotoxic edema and dysfunction of the blood-brain barrier (BBB) and cerebral autoregulation. With this background, brain edema, especially vasogenic edema, may easily occur and clinical symptoms of eclampsia may appear when the blood pressure rapidly increases. (author)

  14. Pure Motor Stroke Secondary to Cerebral Infarction of Recurrent Artery of Heubner after Mild Head Trauma: A Case Report.

    Science.gov (United States)

    Yilmaz, Ali; Kizilay, Zahir; Ozkul, Ayca; Çirak, Bayram

    2016-03-15

    The recurrent Heubner's artery is the distal part of the medial striate artery. Occlusion of the recurrent artery of Heubner, classically contralateral hemiparesis with fasciobrachiocrural predominance, is attributed to the occlusion of the recurrent artery of Heubner and is widely known as a stroke syndrome in adults. However, isolated occlusion of the deep perforating arteries following mild head trauma also occurs extremely rarely in childhood. Here we report the case of an 11-year-old boy with pure motor stroke. The brain MRI showed an acute ischemia in the recurrent artery of Heubner supply area following mild head trauma. His fasciobrachial hemiparesis and dysarthria were thought to be secondary to the stretching of deep perforating arteries leading to occlusion of the recurrent artery of Heubner. Post-traumatic pure motor ischemic stroke can be secondary to stretching of the deep perforating arteries especially in childhood.

  15. Expansive hematoma in delayed cerebral radiation necrosis in patients treated with T-DM1: a report of two cases

    International Nuclear Information System (INIS)

    Mitsuya, Koichi; Watanabe, Junichiro; Nakasu, Yoko; Hayashi, Nakamasa; Harada, Hideyuki; Ito, Ichiro

    2016-01-01

    Multiple new targeted agents have been developed for patients with human epidermal growth factor receptor type 2 (HER2) – positive breast cancer. Patients with HER2– positive breast cancer will develop brain metastases with greater incidence than patients with non-HER2 cancers, and many of them will undergo stereotactic radiosurgery (SRS) or other CNS radiotherapy. The interaction between radiation effects and new targeted agents is not well understood. We report two cases suggesting a novel adverse effect of T-DM1 (trastuzumab emtansine) on symptomatic enlargement of radiation necrosis (RN) after SRS. Two patients with HER2-positive breast cancer had received SRS for single brain metastasis more than 5-years ago. They had been heavily treated for HER2-positive metastatic breast cancer (trastuzumab and pacritaxel, lapatinib and capecitabine). They initiated T-DM1 therapy for progressive systematic disease 5.5 years after stereotactic irradiation, when a small RN was recognized on brain MR images of each patient. The RN lesions increased in size and became symptomatic during 13 or 14 months of T-DM1 treatment. The patients underwent surgical resection of the lesion. Pathological examination revealed necrosis, hematoma, granulation tissue and telangiectasia without neoplastic cells. A potential enhancement of RN by T-DM1 in the brain may be one of important adverse events associated with the use of T-DM1 for patients after SRS. These cases highlight the need of careful follow-up when combining new systemic targeted therapies and SRS for brain metastases

  16. Dynamic digitized cerebral parenchymography

    International Nuclear Information System (INIS)

    Theron, J.; Alachkar, F.; Nelson, M.; Mazia, D.

    1992-01-01

    Aortic arch injections centred on the head have been performed routinely in patients with cerebral ischaemia. Digital angiograms with modified windowing (low and narrow) have been used. This 'cerebral' arch injection allows much improved analysis of the cerebral parenchymal vascularization, giving better understanding of hemispheric ischaemia and making the decision about revascularization more rational. (orig.)

  17. Cerebral mass lesion due to cytomegalovirus in a patient with AIDS: case report and literature review Lesão expansiva cerebral devida a citomegalovírus: relato de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    José E. Vidal

    2003-12-01

    Full Text Available Cytomegalovirus (CMV disease in acquired immunodeficiency syndrome (AIDS patients most commonly presents as chorioretinitis and gastro-intestinal infection. Neurological involvement due to CMV may cause several clinical presentations: polyradiculitis, myelitis, encephalitis, ventriculo-encephalitis, and mononeuritis multiplex. Rarely, cerebral mass lesion is described. We report a 39 year-old woman with AIDS and previous cerebral toxoplasmosis. She presented with fever, seizures, and vulval ulcers. Her chest X-ray showed multiple lung nodules, and a large frontal lobe lesion was seen in a brain computed tomography scan. She underwent a brain biopsy through a frontal craniotomy, but her condition deteriorated and she died in the first postoperative day. Histopathological studies and immunohistochemistry disclosed CMV disease, and there was no evidence of cerebral toxoplasmosis, bacterial, mycobacterial or fungal infection. CMV disease should be considered in the differential diagnosis of cerebral mass lesion in AIDS patients. High suspicion index, timely diagnostic procedures (surgical or minimally invasive, and proper utilization of prophylactic and therapeutic medication could improve outcome of these patients.As doenças causadas pelo citomegalovírus (CMV em pacientes com a síndrome da imunodeficiência adquirida apresentam-se principalmente como corioretinite ou comprometimento gastrointestinal. No sistema nervoso central, o CMV pode causar diversas síndromes clínicas: poliradiculite, mielite, encefalite, ventrículo-encefalite e mononeurite múltipla. Raramente, lesões expansivas cerebrais são descritas. Os autores relatam o caso de uma paciente de 39 anos com antecedentes de infecção pelo HIV e toxoplasmose cerebral, que apresentou-se com febre, convulsões e úlceras vulvares. O raios-X de tórax demonstrou múltiplos nódulos pulmonares e a tomografia computadorizada de crânio evidenciou extensa lesão no lobo frontal esquerdo

  18. Cerebral perfusion scintigraphy and the exploration of dementia syndromes: An illustration with five clinical cases; Scintigraphie cerebrale de perfusion et exploration des syndromes dementiels: illustration a l'aide de cinq cas cliniques

    Energy Technology Data Exchange (ETDEWEB)

    Farid, K.; Perdrisot, R. [Centre Hospitalier Universitaire de Poitiers, Service de Medecine Nucleaire, 86 - Poitiers (France); Habert, M.O. [Centre Hospitalier Universitaire de Pitie-Salpetriere, Service de Medecine Nucleaire, 75 - Paris (France)

    2007-02-15

    The epidemiological evidence suggests that individuals with higher education level have a reduced risk of developing dementia. Because cognitive reserve and its compensation mechanisms may modulate the clinical expression in neuro-degenerative pathology, it is important to study subjects who present mild cognitive disturbance with functional imaging. The cerebral SPECT has been used to determine regional uptake of radiotracer into the brain of patients with cognitive impairment. These abnormalities of blood flow were correlated with cognitive impairment. The cerebral SPECT is also useful to investigate preclinical dementia and to predict the evolution of cognitive disturbance. This article, reports some technical and semeiological notions and illustrate with five clinical cases the scintigraphic aspect of some dementia syndrome. (authors)

  19. Biochemical changes related to hypoxia during cerebral aneurysm surgery: combined microdialysis and tissue oxygen monitoring: case report.

    Science.gov (United States)

    Hutchinson, P J; Al-Rawi, P G; O'Connell, M T; Gupta, A K; Pickard, J D; Kirkpatrick, P J

    2000-01-01

    The objective of this study was to monitor brain metabolism on-line during aneurysm surgery, by combining the use of a multiparameter (brain tissue oxygen, brain carbon dioxide, pH, and temperature) sensor with microdialysis (extracellular glucose, lactate, pyruvate, and glutamate). The case illustrates the potential value of these techniques by demonstrating the effects of adverse physiological events on brain metabolism and the ability to assist in both intraoperative and postoperative decision-making. A 41-year-old woman presented with a World Federation of Neurological Surgeons Grade I subarachnoid hemorrhage. Angiography revealed a basilar artery aneurysm that was not amenable to coiling, so the aneurysm was clipped. Before the craniotomy was performed, a multiparameter sensor and a microdialysis catheter were inserted to monitor brain metabolism. During the operation, the brain oxygen level decreased, in relation to biochemical changes, including the reduction of extracellular glucose and pyruvate and the elevation of lactate and glutamate. These changes were reversible. However, when the craniotomy was closed, a second decrease in brain oxygen occurred in association with brain swelling, which immediately prompted a postoperative computed tomographic scan. The scan demonstrated acute hydrocephalus, requiring external ventricular drainage. The patient made a full recovery. The monitoring techniques influenced clinical decision-making in the treatment of this patient. On-line measurement of brain tissue gases and extracellular chemistry has the potential to assist in the perioperative and postoperative management of patients undergoing complex cerebrovascular surgery and to establish the effects of intervention on brain homeostasis.

  20. Bilateral visual loss and cerebral infarction after spleen embolization in a trauma patient with idiopathic thrombocytopenic purpura: A case report.

    Science.gov (United States)

    Wang, Wei-Ting; Li, Yu-Yu; Lin, Wan-Ching; Chen, Jen-Yin; Lan, Kuo-Mao; Sun, Cheuk-Kwan; Hung, Kuo-Chuan

    2018-04-01

    Splenic artery embolization (SAE) is a common procedure in trauma patients with blunt splenic injuries. We report a case of acute ischemic stroke following orthopedic surgery in a patient with post-SAE reactive thrombocytosis. A 37-year-old woman with idiopathic thrombocytopenic purpura (ITP) suffered from multiple trauma scheduled for open reduction and internal fixation for right tibial and left radius fracture five days after SAE. The patient did not have any thromboembolic complications, although the platelet counts increased from 43 × 10/L to 568 × 10/L within two days after SAE. Surgery was completed under general anesthesia with tracheal intubation without complications. The patient complained of visual loss followed by limb weakness on the fourth and eighth hour postoperatively. Magnetic resonance imaging (MRI) of head demonstrated ischemic change over bilateral basal ganglia, and occipital areas, suggesting the diagnosis of cortical blindness. To suppress platelet count and avoid platelet hyper-aggregation, anti-platelet drug (i.e., oral aspirin 100 mg daily), hydration, and hydroxyurea (i.e., 20 mg/kg daily) were used for the treatment of reactive thrombocytosis. Although right-sided hemiparesis persisted, the patient reported mild visual recovery. She was discharged four months after SAE with active rehabilitation. Our report highlights an increased risk of acute arterial thromboembolic events in patients with reactive thrombocytosis, especially those undergoing surgery.

  1. A case of cerebral and intraocular involvements which responded to irradiation in malignant lymphoma of the breast

    International Nuclear Information System (INIS)

    Suzuka, Takayuki; Koike, Tohru; Shimazaki, Chihiro

    1983-01-01

    This paper reports a case of malignant lymphoma which was originated from the breast, followed by multiple involvement in the brain, and finally developed intraocular infiltration. These lesions disappeared by irradiation therapy. A 51 years old housewife was admitted to our hospital for the further evaluation and treatment of decreased bilateral visual acuity on May 1981. On May 1976, she noticed a solid tumor of the left breast, and total mastectomy disclosed malignant lymphoma (non-Hodgkin lymphoma, lymphocytic type). On August 1980, she developed diplopia and amnesia. CT scan revealed multiple involvements in brain and cobalt therapy resulted in good response. The ophthalmologic diagnosis was uveitis, but it was impossible to rule out the ophthalmic infiltration of malignant lymphoma and 60 Co irradiation (total 2,976 rad) to the bilateral eyes and systemic CHOP therapy were carried out. Consequently, her visual acuity recovered to 0.6, and she is now following ambulatory course. Although non-Hodgkin lymphomas have been reported to originate frequently from non lymphoid tissues, the breast as the primary site is rare and the intracerebral infiltration as an involvement of central nervous system is quite rare. Furthermore, malignant lymphoma of the eyes, especially intraocular involvement is infrequent in incidence. The diagnosis of uveitis due to malignant lymphoma is considered to be difficult because of lack in specific findings. (author)

  2. The "black evil" affecting patients with diabetes: a case of rhino orbito cerebral mucormycosis causing Garcin syndrome

    Directory of Open Access Journals (Sweden)

    Narayanan S

    2017-03-01

    Full Text Available Santhosh Narayanan,1 Geetha Panarkandy,1 Gomathy Subramaniam,2 Chandni Radhakrishnan,1 NK Thulaseedharan,1 Neeraj Manikath,1 Sreejith Ramaswamy,1 Suma Radhakrishnan,3 Danish Ekkalayil1 1Department of General Medicine, 2Department of Radiodiagnosis, 3Department of Otorhinolaryngology, Government Medical College, Kozhikode, Kerala, India Abstract: Mucormycosis is a life-threatening infection affecting patients with diabetes. It is an angioinvasive disease often resistant to treatment with a debilitating course and high mortality. Here, we report a case of a 45 year old woman with type 2 diabetes mellitus who presented to us with history of right-sided ptosis and facial palsy, and subsequently developed loss of vision and palatal palsy. She was in diabetic ketoacidosis. Nervous system examination revealed involvement of right second, third, fourth, sixth, seventh, ninth, and tenth cranial nerves, suggestive of Garcin syndrome. The hard palate had been eroded with formation of black eschar. Computed tomography of paranasal sinuses revealed right maxillary and ethmoid sinusitis, with spread of inflammation to infratemporal fossa and parapharynygeal neck spaces. Debridement of sinus mucosa was done, and culture of the same yielded growth of rhizopus species. Histopathological examination of the tissue showed angioinvasion and fungal hyphae suggestive of mucormycosis. She was treated with amphotericin B, posaconazole, and periodic nasal sinus debridement, but her general condition worsened after 8 weeks due to secondary sepsis and she succumbed to death. Keywords: diabetes, rhinoorbitocerebral, mucormycosis, garcin syndrome

  3. An unusual case of cerebral penetrating injury by a driven bone fragment secondary to blunt head trauma.

    Science.gov (United States)

    Lee, Jae Il; Ko, Jun Kyeung; Cha, Seung Heon; Han, In Ho

    2011-12-01

    Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right temple while cutting the rod. Initial brain computed tomography (CT) and magnetic resonance imaging demonstrated scanty subdural hematoma at right temporal lobe and left falx and intracerebral hematoma at both frontal lobes. Facial CT with 3-D reconstruction images showed a small bony defect at the right sphenoid bone's greater wing and a small bone fragment at the left frontal lobe, crossing the falx. We present the unusual case of a temple trauma patient in whom a sphenoid bone fragment migrated from its origin upward, to the contralateral frontal lobe, producing hematoma along its trajectory.

  4. Microsurgical Repair of Ruptured Aneurysms Associated with Moyamoya-Pattern Collateral Vessels of the Middle Cerebral Artery: A Report of Two Cases.

    Science.gov (United States)

    Lang, Min; Moore, Nina Z; Witek, Alex M; Kshettry, Varun R; Bain, Mark D

    2017-09-01

    Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe 2 cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. The first patient was a 61-year-old man who presented with right frontal and intraventricular hemorrhage. Angiography revealed chronic right M1 occlusion and a 3-mm spherical lenticulostriate aneurysm. The frontal lobe hematoma was evacuated to reveal the aneurysm, which was safely cauterized and resected by coagulating and dividing the lenticulostriate parent vessel. The procedure was carried out with neuronavigation guidance and intraoperative neuromonitoring. The patient was discharged with no neurologic deficits. The second patient was a 53-year-old woman who presented with subarachnoid and intracerebral hemorrhage. Computed tomography angiogram showed a 2-mm saccular MCA aneurysm. Emergency left decompressive hemicraniectomy and hematoma evacuation were performed. The aneurysm, arising from a small collateral type vessel, was safely clipped without complications. Postoperative angiography revealed absence of the superior MCA trunk with a dense network of collateral vessels at the site of the clipped aneurysm. The patient recovered well and was ambulating independently 6 months postoperatively. No rebleeding occurred in the 2 patients. Our experience suggests that patients with MCA occlusion can harbor associated aneurysms related to flow through collateral vessels and can present with hemorrhage. Microsurgical repair of these aneurysms can be performed safely to prevent rebleeding. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. [Localized invasive intracranial aspergillosis with multiple cranial nerve failure -- case report and review of the literature].

    Science.gov (United States)

    Winkler, F; Seelos, K; Hempel, J M; Pfister, H-W

    2002-12-01

    Contrary to the more frequent hematogenously spread cerebral aspergillosis, localized invasive intracranial aspergillosis is a fungal infection that can also occur in patients who are not severely immunosuppressed. This illness can be effectively treated in some of these patients by early and rigorous therapy. Localized invasion of the fungus, generally from one of the nasal sinuses, causes intracranial growth mainly along the base of the skull and larger vessels,where fibrous, granulomatous tissue develops. This generally leads to damage of the cranial nerves (primarily I-VI) as well as localized pain syndromes. We report on the clinical course documented by MRI of a patient with localized invasive intracranial aspergillosis who had multiple failure of cranial nerves following surgery for an aspergilloma of the maxillary sinus. Clinical course, imaging findings, and treatment of the illness are discussed with a review of the relevant literature.

  6. Effects of Milrinone continuous intravenous infusion on global cerebral oxygenation and cerebral vasospasm after cerebral aneurysm surgical clipping

    Directory of Open Access Journals (Sweden)

    Mohamed A. Ghanem

    2014-01-01

    Conclusions: Milrinone improved significantly the global cerebral oxygenation and reduced the incidence of cerebral vasospasm during the dangerous period of cerebral spasm after cerebral aneurysm clipping.

  7. The serpentine mitral valve and cerebral embolism

    Directory of Open Access Journals (Sweden)

    Ker James

    2011-02-01

    Full Text Available Abstract Valvular strands, well-delineated filiform masses, attached to cardiac valve edges are associated with cerebral embolism and stroke. Strokes, caused by emboli from valvular strands, tend to occur among younger persons. In this case report a valvular strand, giving a peculiar serpentine appearance to the mitral valve is described. This mitral valvular strand was the only explanation for an episode of cerebral embolism, presenting with a transient right sided hemiparesis. It is proposed that a randomized study involving combined treatment with aspirin and clopidogrel is warranted in young patients with valvular strands, presenting with a first episode of cerebral embolism.

  8. Validation of a Cerebral Palsy Register

    DEFF Research Database (Denmark)

    Topp, Monica; Langhoff-Roos, Jens; Uldall, P.

    1997-01-01

    OBJECTIVES: To analyse completeness and validity of data in the Cerebral Palsy Register in Denmark, 1979-1982. METHODS: Completeness has been assessed by comparing data from The Danish National Patient Register (DNPR) with the cases included in the Cerebral Palsy Register (CPR). Agreement between......, but gestational age was subject to a systematic error, and urinary infections in pregnancy (kappa = 0.43) and placental abruption (kappa = 0.52) were seriously under-reported in the CPR. CONCLUSIONS: Completeness of the Cerebral Palsy Register in Denmark, 1979-1982, has been assessed to maximal 85%, emphasizing...

  9. The Cerebral Cost of Breathing: An fMRI Case-Study in Congenital Central Hypoventilation Syndrome

    Science.gov (United States)

    Sharman, Mike; Gallea, Cécile; Lehongre, Katia; Galanaud, Damien; Nicolas, Nathalie; Similowski, Thomas; Cohen, Laurent; Straus, Christian; Naccache, Lionel

    2014-01-01

    Certain motor activities - like walking or breathing - present the interesting property of proceeding either automatically or under voluntary control. In the case of breathing, brainstem structures located in the medulla are in charge of the automatic mode, whereas cortico-subcortical brain networks - including various frontal lobe areas - subtend the voluntary mode. We speculated that the involvement of cortical activity during voluntary breathing could impact both on the “resting state” pattern of cortical-subcortical connectivity, and on the recruitment of executive functions mediated by the frontal lobe. In order to test this prediction we explored a patient suffering from central congenital hypoventilation syndrome (CCHS), a very rare developmental condition secondary to brainstem dysfunction. Typically, CCHS patients demonstrate efficient cortically-controlled breathing while awake, but require mechanically-assisted ventilation during sleep to overcome the inability of brainstem structures to mediate automatic breathing. We used simultaneous EEG-fMRI recordings to compare patterns of brain activity between these two types of ventilation during wakefulness. As compared with spontaneous breathing (SB), mechanical ventilation (MV) restored the default mode network (DMN) associated with self-consciousness, mind-wandering, creativity and introspection in healthy subjects. SB on the other hand resulted in a specific increase of functional connectivity between brainstem and frontal lobe. Behaviorally, the patient was more efficient in cognitive tasks requiring executive control during MV than during SB, in agreement with her subjective reports in everyday life. Taken together our results provide insight into the cognitive and neural costs of spontaneous breathing in one CCHS patient, and suggest that MV during waking periods may free up frontal lobe resources, and make them available for cognitive recruitment. More generally, this study reveals how the active

  10. Microembolism after cerebral angiography

    International Nuclear Information System (INIS)

    Manaka, Hiroshi; Sakai, Hideki; Nagata, Izumi

    2000-01-01

    Acute microemboli are detected more precisely with the recently developed diffusion-weighted MR imaging (DWI). We happened to obtain 24 DWIs after 350 diagnostic cerebral angiographies in 1999. DWIs after cerebral angiographies showed bright lesions in 7 patients (28%), of whom 6 had no neurological symptoms after cerebral angiography. Seven of the 24 patients had risk factors for arteriosclerosis. Only one patient had embolic events due to angiography. Microemboli related to cerebral angiographies are inevitable in some patients. Most are silent, however, we should investigate the cause of microemboli and should make cerebral angiography safer. (author)

  11. Computed tomographic findings of cerebral paragonimiasis

    International Nuclear Information System (INIS)

    Sung, Nak Kwan; Nam, Kyung Jin; Park, Churl Min; Eun, Chung Kie; Lee, Sun Wha

    1983-01-01

    Paragonimiasis is widely distributed in Far East and Southeast Asia, particularly in Korea. The central nervous system is the most frequent location for paragonimiasis outside the lungs. We analyzed the computed tomographic findings of 17 cases which were diagnosed pathologically and clinically as cerebral paragonimiasis. The results were as follows: 1. The ratio of male to female was 10 : 7 and about 88% of cases were under the age of 40 years. 2. The common locations of cerebral paragonimiasis were the occipital (12 cases) and temporal (11 cases) lobes. 3. Precontrast CT findings of cerebral paragonimiasis were low density with calcifications in 6 cases, low and isodensities in 4 cases, mixed densities in 3 cases, only low density in 2 cases and only calcification in 2 cases. Hydrocephalus (7 cases), mass effect (6 cases), atrophic change (6 cases) and cyst formation (3 cases) were associated. 4. The shape of calcifications in CT scan were soap-bubble or ring in 6 cases, nodular or oval in 6 cases, stipple in 4 cases and amorphous conglomerated in 2 cases. 5. The contrast -enhanced 8 cases were 5 ring or rim like, 2 nodular and 1 irregular enhancements, while 9 cases were not enhanced

  12. Hyperdense lesions in CT of cerebral toxoplasmosis

    International Nuclear Information System (INIS)

    Quinones Tapia, D.; Ramos Amador, A.; Monereo Alonso, A.

    1994-01-01

    We report a case of cerebral toxoplasmosis in a patient with stage IV C 1 AIDS who presented hyperdense CT images 13 days after beginning antitoxoplasma treatment. These lesions could be caused by calcifications or blood. The attenuation values lead us to believe that they are calcium. Intracranial calcification in adult cerebral toxoplasmosis is an uncommon finding. Its presence in AIDS patients should not suggest any etiology other than toxoplasmosis. (Author) 16 refs

  13. Combined treatment of methylprednisolone pulse and memantine hydrochloride prompts recovery from neurological dysfunction and cerebral hypoperfusion in carbon monoxide poisoning: a case report.

    Science.gov (United States)

    Iwamoto, Konosuke; Ikeda, Ken; Mizumura, Sunao; Tachiki, Kazuhiro; Yanagihashi, Masaru; Iwasaki, Yasuo

    2014-03-01

    A 49-year-old healthy man developed sudden unconsciousness under inadequate ventilation. Blood gas analysis showed carboxyhemoglobin of 7.3%. After normobaric oxygen therapy, he recovered completely 7 days later. At 3 weeks after carbon monoxide (CO) exposures, memory and gait disturbances appeared. Neurological examination revealed Mini-Mental State Examination (MMSE) score of 5 of 30 points, leg hyper-reflexia with Babinski signs, and Parkinsonism. Brain fluid-attenuated inversion recovery imaging disclosed symmetric hypointense lesions in the thalamus and the globus pallidus, and hyperintense lesions in the cerebral white matter. Brain single-photon emission tomography (SPECT) scanning with (99m)Technesium-ethyl cysteinate dimer displayed marked hypoperfusion in the cerebellum, the thalamus, the basal ganglia, and the entire cerebral cortex. He was diagnosed as CO poisoning and treated with hyperbaric oxygen therapy. The neurological deficits were not ameliorated. At 9 weeks after neurological onset, methylprednisolone (1000 mg/day, intravenous, 3 days) and memantine hydrochloride (20 mg/day, per os) were administered. Three days later, MMSE score was increased from 3 to 20 points. Neurological examination was normal 3 weeks later. Brain SPECT exhibited 20% increase of regional cerebral blood flows in the cerebellum, the thalamus, the basal ganglia, and the entire cerebral cortex. These clinicoradiological changes supported that the treatment with steroid pulse and memantine hydrochloride could prompt recovery from neurological dysfunction and cerebral hypoperfusion. Further clinical trials are warranted whether such combined therapy can attenuate neurological deficits and cerebral hypoperfusion in patients with CO poisoning. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Cerebral Palsy: Still A Social Problem

    Directory of Open Access Journals (Sweden)

    Angom Bisharda

    1997-08-01

    Full Text Available Research Problem: What arc the social aspects of cerebral palsy?Objective: To determine the extent and severity of neuromuscular involvement in cases of cerebral palsy and to find out the associated defects among these children.Study Design: Cross sectional study.Setting: Tertiary care hospital, outdoor patients.Participants: Children in the age group of 0 - 12 years.Sample Size: 120 children suffering from cerebral palsy.Study Variables: Social factors, neuromuscular involvement.Statistical Analysis: By proportionsResult: Out of 120 cases, maximum number of cases (66.6% were in the age group of 1- 4 years. 83 cases ( 69.16% were males. Among the various types, spastic type was the commonest (87.5%. Of these spastic cases, 52 (49.52% had quadriplegia. No case of tremor and rigidity was seen. Delayed milestones was the commonest associated disorder, seen in 107 (89.16% cases, followed by speech defect in 58(48.3% cases, visual defect in 34(28.3% cases and convulsions in 24 (20.0% cases. Hearing defect was seen in 5 cases (4.16% only.Conclusion: More concerted efforts arc required to identify children with cerebral palsy and rehabilitate them for the betterment of society.

  15. Cerebral Palsy: Still A Social Problem

    Directory of Open Access Journals (Sweden)

    Angom Bisharda

    1997-08-01

    Full Text Available Research Problem: What arc the social aspects of cerebral palsy? Objective: To determine the extent and severity of neuromuscular involvement in cases of cerebral palsy and to find out the associated defects among these children. Study Design: Cross sectional study. Setting: Tertiary care hospital, outdoor patients. Participants: Children in the age group of 0 - 12 years. Sample Size: 120 children suffering from cerebral palsy. Study Variables: Social factors, neuromuscular involvement. Statistical Analysis: By proportions Result: Out of 120 cases, maximum number of cases (66.6% were in the age group of 1- 4 years. 83 cases ( 69.16% were males. Among the various types, spastic type was the commonest (87.5%. Of these spastic cases, 52 (49.52% had quadriplegia. No case of tremor and rigidity was seen. Delayed milestones was the commonest associated disorder, seen in 107 (89.16% cases, followed by speech defect in 58(48.3% cases, visual defect in 34(28.3% cases and convulsions in 24 (20.0% cases. Hearing defect was seen in 5 cases (4.16% only. Conclusion: More concerted efforts arc required to identify children with cerebral palsy and rehabilitate them for the betterment of society.

  16. Cerebral toxoplasmosis in AIDS

    International Nuclear Information System (INIS)

    Christ, F.; Steudel, H.; Klotz, D.; Bonn Univ.; Bonn Univ.

    1986-01-01

    Since 1982 (Hauser and co-workers), literature has reported focal cerebral tissue charges in AIDS patients whose diagnosis was unclear at first but which could be identified finally as florid toxoplasmosis encephalitis by biopsy and autopsy. It was found that the value of otherwise reliable serological tests (KBR, Sabin-Feldmann tests, etc.) is questionable in patients with severely impaired or incompetent immune systems, and, in particular, that a negative or uncharacteristic test result may not preclude any opportunistic infection process. Furthermore, isolation of Toxoplasma gondii or specific antibodies from the cerebrospinal fluid will be successful in exceptional cases only. In patients with AIDS or lymphadenopathy syndrome, the differential diagnosis will have to include - first and foremost - reactivated toxoplasma infection (not newly acquired, as a rule) if central neurological symptoms occur. (orig.) [de

  17. MRI diagnosis of the cerebral schistosomiasis

    International Nuclear Information System (INIS)

    Liu Hanqiu; Chen Yuanjun

    2002-01-01

    Objective: To discuss MRI appearance of the cerebral schistosomiasis and its clinical value through analyzing the MRI features and post-surgery pathological findings. Methods: MRI features of the cerebral schistosomiasis in 16, pathologically (n = 6) or clinically (n = 10) proved cases were analyzed retrospectively, and compared with the post-surgery pathological findings in 6 cases. Results: Single masses were found in 11 cases (11/16), and multiple masses in 5 eases (5/16), amounting to 23 masses . fifteen masses (15/23) were located in right cerebral hemisphere, including frontal lobe (n = 2), frontoparietal lobe (n = 5) , and occipitoparietal lobe (n 8), while 8 masses (8/23) in left cerebral hemisphere, including frontal lobe (n = 1), frontoparietal lobe (n = 3), and occipitoparietal lobe (n = 4). The nodular masses were isointense with the gray mass like 'island', and 12 cases (12/16) show the 'gigantic hand' form of edema around them. After IV administration of Gd-DTPA, 15 cases (15/16) revealed multiple closely spaced, intensely enhancing modules, 1-3 mm in diameter, distributed throughout the mass. Seven cases misdiagnosed by CT were revised by MRl. Conclusion: The MRI appearance of the cerebral schistosomiasis is characteristic, and MRI is the most valuable tool to diagnose it without injury

  18. Cerebral asymmetry in a selected Chinese population

    International Nuclear Information System (INIS)

    Wang, Y.X.; He, G.X.; Tong, G.H.; Wang, D.B.; Xu, K.Y.

    1999-01-01

    Previous studies have demonstrated anatomical differences between the two cerebral hemispheres and ethnic differences in cerebral asymmetry. This study examined asymmetry of Chinese living in Shanghai. Measurements were taken across the frontal, mid-cerebral and occipital regions from normal head computed tomography (CT) scans of 200 Chinese Shanghai residents (100 male and 100 female, aged 6-73 years, average 48.7 years). The results were compared with reported data in the literature. The following results were found: (i) In the frontal region the right side was larger than the left in 57.5% of cases, equal in 10.5% and smaller in 32% of cases; in the mid-cerebral region the right side was larger than the left in 65.5% of cases, equal in 12.5% and smaller in 22% of cases; in the occipital regions the right side was larger than the left in 34.5% of cases, equal in 8.5% and smaller in 57% of cases. The average right-left differences between the frontal, mid-cerebral and occipital regions were 0.43 mm, 0.9 mm and 0.4 mm respectively. No difference in cerebral asymmetry existed between males and females. The occipital lobes showed the greatest individual asymmetry. The distribution of cerebral asymmetry of Chinese in Shanghai showed similarity to North American Whites rather than North American Blacks, but the average right-left differences were smaller than those of Whites. Copyright (1999) Blackwell Science Pty Ltd

  19. Comparative Study of Cerebral Protection during Surgery of Thoracic Aortic Aneurysm

    OpenAIRE

    Sueda, Taijiro; Nomimura, Takayuki; Kagawa, Tetsuya; Morita, Satoru; Hayashi, Saiho; Orihashi, Kazumasa; Shikata, Hiroo; Ryuu, Gou; Hamanaka, Yoshiharu; Matsuura, Yuichiro; Kawaue, Yasushi; Kanehiro, Keiichi; Ishihara, Hiroshi

    1992-01-01

    During the past 5 years, 30 cases of thoracic aortic aneurysm were treated. Selective cerebral perfusion (SCP) and retrograde cerebral perfusion (RCP) were conducted for cerebral protection during aortic cross clamping. SCP was carried out in 5 cases of dissecting aneurysm (all Stanford type A, including a case of AAE) and 3 cases of arch aneurysm. RCP was conducted in 5 cases of dissecting aneurysm (4 Stanford type A; 1 Stanford type B with retrograde dissection) and 2 cases of aortic arch a...

  20. Processo de indicação do implante coclear em uma criança com paralisia cerebral: estudo de caso Indication process of cochlear implant for a child with cerebral palsy: a case report

    Directory of Open Access Journals (Sweden)

    Maria Jaquelini Dias dos Santos

    2011-12-01

    Full Text Available A paralisia cerebral (PC é o transtorno motor mais frequente na infância, podendo apresentar outras deficiências associadas, inclusive a deficiência auditiva. Estudos sobre a indicação do implante coclear (IC em crianças com PC e deficiência auditiva são restritos internacionalmente, e no Brasil, inexistentes. Desta maneira, o objetivo do estudo foi descrever o processo de avaliação pré-cirúrgica de uma criança com PC candidata ao IC. O estudo foi realizado com um menino, com 2 anos e 6 meses de idade, com PC e deficiência auditiva bilateral. O protocolo pré-cirúrgico seguiu os procedimentos já utilizados no Hospital de Reabilitação de Anomalias Craniofaciais, compreendendo: avaliações fonoaudiológicas, neurológica, otorrinolaringológica e psicológica, por meio de observações clinicas, questionários, e exames radiológicos. O paciente foi diagnosticado com espectro da neuropatia auditiva de grau profundo bilateral, quadriparesia atetóide de grau moderado, atraso global do desenvolvimento, exceto na função visual, comportamento comunicativo intencional presente, bom contato social, ausência de comprometimentos intelectuais ou outras deficiências associadas ao quadro da PC e família integrada ao tratamento. De acordo com os resultados obtidos, o paciente foi considerado apto para cirurgia de IC, e permanece em acompanhamento sistemático no respectivo programa. Ressalta-se a importância de uma etapa pré-cirúrgica ampla e estruturada para crianças com paralisia cerebral e candidatas ao IC. Por meio de instrumentos de avaliação direcionados aos aspectos globais do desenvolvimento, é possível obter informações específicas que enriquecem as orientações dadas aos pais sobre o prognóstico da criança e possibilitam traçar metas reais de reabilitação auditiva.Cerebral palsy (CP is the most common motor disorder in childhood, and is usually associated with other disabilities, including hearing impairment

  1. Cerebral vasculitis associated with Schistosoma mansoni infection

    Directory of Open Access Journals (Sweden)

    Camuset Guillaume

    2012-09-01

    Full Text Available Abstract Background Cerebral involvement in schistosomiasis is not rare, but it is underdiagnosed because of the lack of clinical suspicion and the frequency of asymptomatic forms. Neurologic complications are generally supported by granuloma formation around ectopic eggs which have migrated to the brain. Moreover, vascular lesions and cerebral arteritis have been well documented in histopathological studies. Nevertheless, cerebral vasculitis in later stages of the Schistosoma mansoni infection have not yet been described in living subjects. Case presentation A 28-year-old french woman had a stroke linked with cerebral vasculitis, 6 monthes after returning from Burkina-Faso. At the same time, a S. mansoni disseminated infection was diagnosed. She suffered from a new stroke after undertaking praziquantel therapy, which lead us to associate the S. mansoni infection and cerebral vasculitis. Conclusion This is the first report of such association, since cerebral vasculitis has never been described in later stages of the S. mansoni infection. Although the causal link between the two pathologies could not be proved, we suggest that S. mansoni is able to cause severe vascular damage in cerebral vessels. Schistosomiasis must be investigated in the event of a brain infarct in young people, particularly in patients originating or returning from an endemic area.

  2. Cerebellar malformations alter regional cerebral development.

    Science.gov (United States)

    Bolduc, Marie-Eve; Du Plessis, Adre J; Evans, Alan; Guizard, Nicolas; Zhang, Xun; Robertson, Richard L; Limperopoulos, Catherine

    2011-12-01

    The aim of this study was to compare total and regional cerebral volumes in children with isolated cerebellar malformations (CBMs) with those in typically developing children, and to examine the extent to which cerebellar volumetric reductions are associated with total and regional cerebral volumes. This is a case-control study of children diagnosed with isolated CBMs. Each child was matched on age and sex to two typically developing children. Using advanced three-dimensional volumetric magnetic resonance imaging, the cerebrum was segmented into tissue classes and partitioned into eight regions. Analysis of variance was used to compare cerebral volumes between children with CBMs and control children, and linear regressions to examine the impact of cerebellar volume reduction on cerebral volumes. Magnetic resonance imaging was performed at a mean age of 27 months in 20 children (10 males, 10 females) with CBMs and 40 typically developing children. Children with CBMs showed significantly smaller deep grey matter nuclei (p developing children. Greater cerebellar volumetric reduction in children with CBMs was associated with decreased total cerebral volume and deep grey matter nuclei (p = 0.02), subgenual white/grey matter (p = 0.001), midtemporal white (p = 0.02) and grey matter (p = 0.01), and parieto-occipital grey matter (p = 0.004). CBMs are associated with impaired regional cerebral growth, suggesting deactivation of principal cerebello-cerebral pathways. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

  3. Cerebral hemorrhage caused by amyloid angiopathy

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Tomonaga, Masanori; Yoshimura, Masahiro; Yamanouchi, Hiroshi; Shimada, Hiroyuki.

    1985-01-01

    Cerebral hemorrhage caused by amyloid angiopathy was studied clinicopathologically, with special attention given to the CT images. Cerebral hemorrhage caused by amyloid angiopathy is characterized, by a lobar-type hemorrhage involving the cortex, with direct extension into the subarachnoid space. Multiple hemorrhages are frequent, and cortical infarctions are present as complications in elderly patients without risk factors. CT scans taken in 5 cases demonstrated lobar hemorrhages in superficial locations, frequently in multiple sites or recurrently, with surrounding edema and mass effect. A subarachnoid extension of the hemorrhage through the superficial cortex, proven pathologically in all cases, was noted by CT in 4 of the 5 cases. However, cortical infarction was not detected by CT in any case. Therefore, CT is of value in the diagnosis of cerebral hemorrhage due to amyloid angiopathy based on distinctive findings such as a lobar hemorrhage in superficial regions, with extension into the subarachnoid space, frequently in multiple sites or recurrently. (author)

  4. Does preoperative measurement of cerebral blood flow with acetazolamide challenge in addition to preoperative measurement of cerebral blood flow at the resting state increase the predictive accuracy of development of cerebral hyperperfusion after carotid endarterectomy? Results from 500 cases with brain perfusion single-photon emission computed tomography study.

    Science.gov (United States)

    Oshida, Sotaro; Ogasawara, Kuniaki; Saura, Hiroaki; Yoshida, Koji; Fujiwara, Shunro; Kojima, Daigo; Kobayashi, Masakazu; Yoshida, Kenji; Kubo, Yoshitaka; Ogawa, Akira

    2015-01-01

    The purpose of the present study was to determine whether preoperative measurement of cerebral blood flow (CBF) with acetazolamide in addition to preoperative measurement of CBF at the resting state increases the predictive accuracy of development of cerebral hyperperfusion after carotid endarterectomy (CEA). CBF at the resting state and cerebrovascular reactivity (CVR) to acetazolamide were quantitatively assessed using N-isopropyl-p-[(123)I]-iodoamphetamine (IMP)-autoradiography method with single-photon emission computed tomography (SPECT) before CEA in 500 patients with ipsilateral internal carotid artery stenosis (≥ 70%). CBF measurement using (123)I-IMP SPECT was also performed immediately and 3 days after CEA. A region of interest (ROI) was automatically placed in the middle cerebral artery territory in the affected cerebral hemisphere using a three-dimensional stereotactic ROI template. Preoperative decreases in CBF at the resting state [95% confidence intervals (CIs), 0.855 to 0.967; P = 0.0023] and preoperative decreases in CVR to acetazolamide (95% CIs, 0.844 to 0.912; P state (difference between areas, 0.173; P state (P state increases the predictive accuracy of the development of post-CEA hyperperfusion.

  5. Cerebral (18)FluoroDeoxy-Glucose Positron Emission Tomography in paediatric anti N-methyl-D-aspartate receptor encephalitis: A case series.

    Science.gov (United States)

    Lagarde, Stanislas; Lepine, Anne; Caietta, Emilie; Pelletier, Florence; Boucraut, José; Chabrol, Brigitte; Milh, Mathieu; Guedj, Eric

    2016-05-01

    Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a frequent and severe cause of encephalitis in children with potential efficient treatment (immunotherapy). Suggestive clinical features are behavioural troubles, seizures and movement disorders. Prompt diagnosis and treatment initiation are needed to guarantee favourable outcome. Nevertheless, diagnosis may be challenging because of the classical ancillary test (magnetic resonance imaging (MRI), electroencephalogram, standard cerebro-spinal fluid analysis) have limited sensitivity. Currently, immunological analyses are needed for the diagnostic confirmation. In adult patients, some studies suggested a potential role of cerebral (18)FluoroDeoxy-Glucose Positron Emission Tomography (FDG-PET) in the evaluation of anti-NMDAR encephalitis. Nevertheless, almost no data exist in paediatric population. We report retrospectively clinical, ancillary tests and cerebral FDG-PET data in 6 young patients (median age=10.5 years, 4 girls) with immunologically confirmed anti-NMDAR encephalitis. Our patients presented classical clinical features of anti-NMDAR encephalitis with severe course (notably four patients had normal MRI). Our series shows the feasibility and the good sensitivity of cerebral FDG-PET (6/6 patients with brain metabolism alteration) in paediatric population. We report some particular features in this population: extensive, symmetric cortical hypometabolism especially in posterior areas; asymmetric anterior focus of hypermetabolism; and basal ganglia hypermetabolism. We found also a good correlation between the clinical severity and the cerebral metabolism changes. Moreover, serial cerebral FDG-PET showed parallel brain metabolism and clinical improvement. Our study reveals the existence of specific patterns of brain metabolism alteration in anti-NMDAR encephalitis in paediatric population. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  6. NMR imaging of cerebral infarction

    International Nuclear Information System (INIS)

    Takusagawa, Yoshihiko; Yamaoka, Naoki; Doi, Kazuaki; Okada, Keisei

    1987-01-01

    One hundred and five patients with cerebral infarction were studied by nuclear magnetic resonance (NMR) CT (resistive type of magnet with strength of 0.1 tesla) and X-ray CT. Pulse sequences used saturation recovery (Tr = 600 mSec), Inversion recovery (Tr = 500 mSec, Td = 300 mSec) and spin echo (Tr = 1500 mSec, Te = 40, 80, 120, 160 mSec). Fifteen cases were examined by NMR-CT within 24 hours from onset. Proton NMR imaging could not detect cerebral ischemia as early as 2 hours after onset, but except could detect the lesions in Se image the area of cerebral infarct 3 hours after onset. After 5 hours from onset image changes in SE were evident and corresponded to the area of cerebral infarct, but image changes in IR could not fully delineate the infarcted area. NMR images of 41 year-old woman with cerebral embolism by MCA trunck occlusion associated with mitral stenosis were presented, and NMR-CT was examined 10 hours, 9th and 43th days after episode of MCA occlusion. Sixty patents (64 times) with lacunar infarction were studied by NMR-CT and X-ray CT. The inversion recovery images were used mainly for detection of lesions and comparison with X-ray CT. In 160 lesions which were detected by NMR-CT or X-ray CT, could 156 lesions be detected by NMR-CT and 78 lesions by X-ray CT. Inversion recovery images were more useful for detection of lacunes than X-ray CT. Calculated T1 and T2 values prolonged with time course from onset. (author)

  7. Cerebral blood flow and cerebral oxygen metabolism in thalamic hemorrhage

    International Nuclear Information System (INIS)

    Yasui, Nobuyuki; Asakura, Ken

    1987-01-01

    Cerebral blood flow (CBF), cerebral oxygen consumption (CMRO 2 ), oxygen extraction fraction (OEF) and cerebral blood volume (CBV) were studied in 20 cases of thalamic hemorrhage using positron CT and 15 O labeled gas steady-state inhalation method. CBF reduction was limited around the thalamus in the small sized hematoma. CBF were significantly diminished in the mean cortical, parietal, temporal, basal ganglia and thalamic area ipsilateral and cerebellar cortex contralateral to the medium sized hematoma. There was bilateral and diffuse CBF reduction in the large sized hematoma which was caused by increased intracranial pressure. CMRO 2 value were similary changed as CBF. OEF change showed within normal limit. Diffuse CBV reduction was observed in the large sized hematoma. This reduction was the result of decreased vascular bed caused by mass effect of the hematoma and hydrocephalus. Effect of surgical treatment such as ventricular drainage and hematoma evacuation were also discussed in correlation to CBF in some case using positron and single photon ECT. (author)

  8. Obstruction of cerebral arteries in childhood stroke

    International Nuclear Information System (INIS)

    Velkey, I.; Lombay, B.; Panczel, G.

    1992-01-01

    Middle cerebral artery obstruction in children is reviewed by our two cases. Ischemic childhood stroke was caused by moyamoya disease in the first, and by fibromuscular dysplasia in the second patient. In both cases transcranial Doppler sonography and cranial CT were performed, but the final diagnosis was made by angiography. The importance of angiography in childhood stroke is emphasized. (orig.)

  9. Association of Lead Levels and Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Neha Bansal MD

    2017-03-01

    Full Text Available Background: Cerebral palsy is a common motor disability in childhood. Raised lead levels affect cognition. Children with cerebral palsy may have raised lead levels, further impairing their residual cognitive motor and behavioral abilities. Environmental exposure and abnormal eating habits may lead to increased lead levels. Aims and Objectives: To measure blood lead levels in children with cerebral palsy and compare them with healthy neurologically normal children. To correlate blood lead levels with environmental factors. Material and Methods: Design: Prospective case-control study. Setting: Tertiary care hospital. Participants: Cases comprised 34 children with cerebral palsy, and controls comprised 34 neurologically normal, age- and sex-matched children. Methods: Clinical and demographic details were recorded as per proforma. Detailed environmental history was recorded to know the source of exposure to lead. These children were investigated and treated as per protocol. Venous blood was collected in ethylenediaminetetraacetic acid vials for analysis of blood lead levels. Lead levels were estimated by Schimadzu Flame AA-6800 (atomic absorption spectrophotometer. Data were analyzed using SPSS version 17. P < .05 was taken as significant. Results: Mean blood lead levels were 9.20 ± 8.31 µg/dL in cerebral palsy cases and 2.89 ± 3.04 µg/dL in their controls (P < .001. Among children with cerebral palsy, 19 (55.88% children had blood lead levels ≥5 µg/dL. Lead levels in children with pica were 12.33 ± 10.02 µg/dL in comparison to children with no history of pica, 6.70 ± 4.60 µg/dL (P = .029. No correlation was found between hemoglobin and blood lead levels in cases and controls. Conclusion: In our study, blood lead levels are raised in children with cerebral palsy. However, further studies are required to show effects of raised levels in these children.

  10. Tuberothalamic artery infarction following coil embolization of a ruptured posterior communicating artery aneurysm belonging to a transitional type posterior cerebral artery. A case report.

    Science.gov (United States)

    Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk

    2013-09-01

    There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirmed pre-operatively by Allcock's test.

  11. Tuberothalamic Artery Infarction Following Coil Embolization of a Ruptured Posterior Communicating Artery Aneurysm Belonging to a Transitional Type Posterior Cerebral Artery: A Case Report

    OpenAIRE

    Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk

    2013-01-01

    There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirm...

  12. SPASTIC FORM OF CEREBRAL PALSY, EPILEPSY WITH BENIGN EPILEPTIFORM DISCHARGE OF CHILDHOOD ON ELECTROENCEPHALOGRAM, AND IATROGENIC STEVENS–JOHNSON SYNDROME (CASE DESCRIPTION

    Directory of Open Access Journals (Sweden)

    A. S. Kotov

    2016-01-01

    Full Text Available The article describes the phenomenon of dual pathology – a combination of structural changes in the brain and benign epileptiform discharge of childhood on electroencephalogram. The uniqueness lies in the observation that the child, since birth suffering from spastic form of cerebral palsy and severe epilepsy, demonstrated the development of Stevens–Johnson syndrome due to intolerance of one of the antiepileptic drugs. Therapeutic approaches to overcome a whole range of violations are discussed in the article.

  13. Herpes Simplex Encephalitis Complicated by Cerebral Hemorrhage during Acyclovir Therapy.

    Science.gov (United States)

    Harada, Yukinori; Hara, Yuuta

    2017-01-01

    Herpes simplex encephalitis (HSE) can be complicated by adverse events in the acute phase. We herein present the case of a 71-year-old woman with HSE complicated by cerebral hemorrhage. She presented with acute deterioration of consciousness and fever and was diagnosed with HSE based on the detection of herpes simplex virus-1 in the cerebrospinal fluid by a polymerase chain reaction. The cerebral hemorrhage developed during acyclovir therapy; however, its diagnosis was delayed for 2 days. After the conservative treatment of the cerebral hemorrhage, the patient made a near-complete recovery. Cerebral hemorrhage should be considered as an acute-phase complication of HSE.

  14. Cerebral hemorrhagic infarction after radiation for pituitary adenoma

    International Nuclear Information System (INIS)

    Ogaki, Satoko; Suzuki, Masatsune; Shimano, Hitoshi; Toyoshima, Hideo; Sone, Hirohito; Okuda, Yukichi; Yamada, Nobuhiro

    2002-01-01

    We report a case of cerebral hemorrhagic infarction after radiation for pituitary adenoma. A 55-year-old woman was hospitalized to check for aldosteronism, post-operative pituitary function, and recurrence of thyroid cancer. She had short-term memory disturbance beginning two months prior to admission. Brain MRI showed a T1 and T2 high intensity lesion of her left anterolateral thalamus. Brain MRA revealed a narrowing in her left middle cerebral artery. The abnormal brain lesion was diagnosed as cerebral hemorrhagic infarction. She had received radiation therapy for pituitary adenoma 20 years earlier. It was considered that her cerebral hemorrhagic infarction was caused by radiation therapy. (author)

  15. Imaging findings and cerebral perfusion in arterial ischemic stroke due to transient cerebral arteriopathy in children; Achados de imagem e perfusao arterial cerebral em acidente vascular cerebral isquemico devido a arteriopatia transitoria em crianca

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa Junior, Alcino Alves, E-mail: alcinojr@uol.com.br [Departamento de Diagnostico por Imagem, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Ellovitch, Saada Resende de Souza [Neuropediatria, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Pincerato, Rita de Cassia Maciel [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2012-04-15

    We report the case of a 4-year-old female child who developed an arterial ischemic stroke in the left middle cerebral artery territory, due to a proximal stenosis of the supraclinoid internal carotid artery, most probably related to transient cerebral arteriopathy of childhood. Computed tomography scan, magnetic resonance imaging, perfusion magnetic resonance and magnetic resonance angiography are presented, as well as follow-up by magnetic resonance and magnetic resonance angiography exams. Changes in cerebral perfusion and diffusion-perfusion mismatch call attention. As far as we know, this is the first report of magnetic resonance perfusion findings in transient cerebral arteriopathy. (author)

  16. Cerebral trypanosomiasis and AIDS

    Directory of Open Access Journals (Sweden)

    Antunes Apio Claudio Martins

    2002-01-01

    Full Text Available A 36 year-old black female, complaining of headache of one month's duration presented with nausea, vomiting, somnolence, short memory problems, loss of weight, and no fever history. Smoker, intravenous drugs abuser, promiscuous lifestyle. Physical examination: left homonimous hemianopsia, left hemiparesis, no papilledema, diffuse hyperreflexia, slowness of movements. Brain CT scan: tumor-like lesion in the splenium of the corpus calosum, measuring 3.5 x 1.4 cm, with heterogeneous enhancing pattern, sugesting a primary CNS tumor. Due to the possibility of CNS infection, a lumbar puncture disclosed an opening pressure of 380 mmH(20; 11 white cells (lymphocytes; glucose 18 mg/dl (serum glucose 73 mg/dl; proteins 139 mg/dl; presence of Trypanosoma parasites. Serum Elisa-HIV tests turned out to be positive. Treatment with benznidazole dramatically improved clinical and radiographic picture, but the patient died 6 weeks later because of respiratory failure. T. cruzi infection of the CNS is a rare disease, but we have an increasing number of cases in HIV immunecompromised patients. Diagnosis by direct observation of CSF is uncommon, and most of the cases are diagnosed by pathological examination. It is a highly lethal disease, even when properly diagnosed and treated. This article intends to include cerebral trypanosomiasis in the differential diagnosis of intracranial space-occupying lesions, especially in immunecompromised patients from endemic regions.

  17. Discussion on the treatment of cerebral ischemia-reperfusion injuries following intra-arterial thrombolysis

    International Nuclear Information System (INIS)

    Tian Hong; Song Chuan; Fan Ruxiong; Zhou Huchuan; Zhang Yubo; Zang Qiaoli; Zhang Yunquan; Liu Lei

    2011-01-01

    Objective: To investigate the therapeutic method of cerebral ischemia-reperfusion injuries occurred after arterial thrombolytic therapy for acute cerebral infarction. Methods: Thirty-five patients, encountered in authors' Department since Oct. 2005, with cerebral ischemia-reperfusion injuries, which occurred after thrombolytic therapy by using arterial perfusion of urokinase for acute cerebral infarction, were enrolled in this study. The clinical data were retrospectively analyzed. Results: After the thrombolytic therapy, completer or partial recanalization of the occluded cerebral arteries was obtained in 33 cases, while secondary cerebral hemorrhage occurred in 13 cases, of whom cerebral parenchyma bleeding was seen in 2 and hemorrhagic infarction in 11. Different degrees of cerebral edema were found in all 33 cases. Among them significant shift of the midline structures was detected in 18 (54.5%), which was manifested clinically as the worsening of disturbance of consciousness. Strict control of blood pressure, prompt adjustment of dehydration medication, strengthening the cerebral protection measures, cerebral decompression by fenestration, etc. were carried out. All the patients took a turn for the better and were out of danger with remarkable improvement of neurological functions except one patient who died from massive intracerebral hemorrhage. Conclusion: Usually, different degrees of reperfusion injuries will develop after thrombolytic therapy for cerebral arterial infarction. Strictly controlling blood pressure, promptly adjusting dehydration medication and strengthening cerebral protection are the keys to reduce the severity of cerebral reperfusion injuries. (authors)

  18. Cerebral venous angioma

    International Nuclear Information System (INIS)

    Inagawa, Tetsuji; Taguchi, Haruyoshi; Kamiya, Kazuko; Yano, Takashi; Nakajima, Reiko

    1984-01-01

    This report presents a 27-year-old male patient who was diagnosed as having cerebral venous angioma in the postero-temporal area by CT scan and cerebral angiography. The patient improved by removing angioma with electrocoagulation of medullary veins. (Namekawa, K.)

  19. Isquemia cerebral como manifestación inicial de un mixoma atrial izquierdo: Reporte de un caso Brain ischemia as initial sign of a left atrial myxoma: Report of one case

    Directory of Open Access Journals (Sweden)

    Luis F Osio

    2008-04-01

    Full Text Available Los tumores primarios del corazón son raros; 75% de éstos son benignos y cerca de la mitad de los benignos son mixomas que, en la mayoría de los casos, se encuentran en las cavidades izquierdas. Las manifestaciones clínicas de los mixomas dependen del sitio de localización del tumor. Sin embargo, se afirma que la isquemia cerebral es la manifestación clínica inicial en un tercio de los mixomas atriales. Se presenta el caso de un paciente de género masculino, de 65 años de edad, en quien la primera manifestación clínica de mixoma atrial fue un evento cerebral vascular isquémico.Primary heart tumors are rare; 75% of them are benign and almost half of the benign ones are mixomas that in most cases are located in the left cavities. Clinical manifestations of myxomas depend on its localization site. Nevertheless, it is accepted that brain ischemia is the initial clinical manifestation in a third of atrial myxomas. The case of a 65 years old male patient in whom the first clinical manifestation of an atrial myxoma was an ischemic cerebrovascular event, is presented.

  20. Association of Lead Levels and Cerebral Palsy

    Science.gov (United States)

    Bansal, Neha; Aggarwal, Anju; Faridi, M. M. A.; Sharma, Tusha; Baneerjee, B. D.

    2017-01-01

    Background: Cerebral palsy is a common motor disability in childhood. Raised lead levels affect cognition. Children with cerebral palsy may have raised lead levels, further impairing their residual cognitive motor and behavioral abilities. Environmental exposure and abnormal eating habits may lead to increased lead levels. Aims and Objectives: To measure blood lead levels in children with cerebral palsy and compare them with healthy neurologically normal children. To correlate blood lead levels with environmental factors. Material and Methods: Design: Prospective case-control study. Setting: Tertiary care hospital. Participants: Cases comprised 34 children with cerebral palsy, and controls comprised 34 neurologically normal, age- and sex-matched children. Methods: Clinical and demographic details were recorded as per proforma. Detailed environmental history was recorded to know the source of exposure to lead. These children were investigated and treated as per protocol. Venous blood was collected in ethylenediaminetetraacetic acid vials for analysis of blood lead levels. Lead levels were estimated by Schimadzu Flame AA-6800 (atomic absorption spectrophotometer). Data were analyzed using SPSS version 17. P pica were 12.33 ± 10.02 µg/dL in comparison to children with no history of pica, 6.70 ± 4.60 µg/dL (P = .029). No correlation was found between hemoglobin and blood lead levels in cases and controls. Conclusion: In our study, blood lead levels are raised in children with cerebral palsy. However, further studies are required to show effects of raised levels in these children. PMID:28491920

  1. Is fasting necessary for elective cerebral angiography?

    Science.gov (United States)

    Kwon, O-K; Oh, C W; Park, H; Bang, J S; Bae, H-J; Han, M K; Park, S-H; Han, M H; Kang, H-S; Park, S-K; Whang, G; Kim, B-C; Jin, S-C

    2011-05-01

    In order to prevent unexpected events such as aspiration pneumonia, cerebral angiography has been performed under fasting in most cases. We investigated prospectively the necessity of fasting before elective cerebral angiography. The study is an open-labeled clinical trial without random allocation. In total, 2554 patients who underwent elective cerebral angiography were evaluated on development of nausea, vomiting, and pulmonary aspiration during and after angiography. Potential risks and benefits associated with fasting were provided in written documents and through personal counseling to patients before the procedure. The patients chose their fasting or nonfasting option. No restriction in diet was given after angiography. The patients were observed for 24 hours. Nausea and vomiting during and within 1 hour after angiography was considered as a positive event associated with cerebral angiography. The overall incidence of nausea and vomiting during and within 1 hour after angiography was 1.05% (27/2554 patients). There was no patient with pulmonary aspiration. No statistical difference in nausea and vomiting development between the fasting and the diet groups was found. The incidence of nausea and vomiting associated with cerebral angiography is low and not affected by diet or fasting. Pulmonary aspiration had no difference between the diet and the fasting group. Our study suggests that fasting may not be necessary for patients who undergo elective cerebral angiography.

  2. Hyperacute unilateral contrast-induced parotiditis during cerebral angiography

    Directory of Open Access Journals (Sweden)

    Song J. Kim, MD

    2018-02-01

    Full Text Available An uncommon complication of iodinated contrast administration is the development of bilateral sialadenitis. We report a unique case of hyperacute unilateral parotiditis during diagnostic cerebral angiography of the external carotid artery, which mimicked possible iatrogenic vascular event associated with cerebral endovascular procedures. Discussion includes the differential diagnosis, diagnostic studies, and treatments for this unusual condition.

  3. Autonomic dysfunction and impaired cerebral autoregulation in cirrhosis

    DEFF Research Database (Denmark)

    Frøkjaer, Vibe G; Strauss, Gitte I; Mehlsen, Jesper

    2006-01-01

    .0+/-2.0 bpm) compared to the controls (21.7+/-2.2 bpm, p=0.001, Tukey' test). Systolic blood pressure fell during head-up tilt only in patients with severe cirrhosis. Our results imply that cerebral autoregulation was impaired in the most severe cases of liver cirrhosis, and that those with impaired cerebral...

  4. Cerebral hemodynamics and functional prognosis in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Hirai, Osamu; Nishikawa, Michio; Watanabe, Shu; Yamakawa, Hiroyasu; Kinoshita, Yoshimasa; Uno, Akira; Handa, Hajime (Hamamatsu Rosai Hospital, Shizuoka (Japan))

    1989-11-01

    The functional outcome of cerebral hemodynamics in the chronic stage of juvenile hydrocephalus was determined using single photon emission computed tomography (SPECT). Five patients including three with aqueductal stenosis, one with post-meningitic hydrocephalus, and one case with hydrocephalus having developed after repair of a huge occipital encephalocele. Early images of cerebral blood flow (CBF) were obtained 25 minutes after intravenous injection of 123-I-iodoamphetamine (IMP), and late images were scanned 3 hours later. Cerebral blood volume (CBV) was also measured using {sup 99m}Tc in three patients. Twenty cases with adult communicating hydrocephalus were also investigated from the point of view of shunt effectiveness. Although there was no remarkable change in the cerebrovascular bed in the juvenile cases, CBF of the remnant brain parenchyma was good irrespective of the degree of ventricular dilatation. There was a periventricular-related IMP uptake in each case; however, it somehow matched the ventricular span. Functional outcome one to 23 years after the initial shunt operation was good in every case, despite multiple shunt revisions. Redistribution on late images had no bearing on clinical states. In adult cases, 8 patients with effective shunting demonstrated a relatively localized periventricular low perfusion, with preoperative increased cerebrospinal fluid (CSF) pressure. On the contrary, 12 patients with no improvement with or without ventricular-reduced IMP uptake, despite low CSF pressure. The present study indicates that periventricular hemodynamics may play an important role in cerebral function compromised by hydrocephalus. (J.P.N.).

  5. Cerebral hemodynamics and functional prognosis in hydrocephalus

    International Nuclear Information System (INIS)

    Hirai, Osamu; Nishikawa, Michio; Watanabe, Shu; Yamakawa, Hiroyasu; Kinoshita, Yoshimasa; Uno, Akira; Handa, Hajime

    1989-01-01

    The functional outcome of cerebral hemodynamics in the chronic stage of juvenile hydrocephalus was determined using single photon emission computed tomography (SPECT). Five patients including three with aqueductal stenosis, one with post-meningitic hydrocephalus, and one case with hydrocephalus having developed after repair of a huge occipital encephalocele. Early images of cerebral blood flow (CBF) were obtained 25 minutes after intravenous injection of 123-I-iodoamphetamine (IMP), and late images were scanned 3 hours later. Cerebral blood volume (CBV) was also measured using 99m Tc in three patients. Twenty cases with adult communicating hydrocephalus were also investigated from the point of view of shunt effectiveness. Although there was no remarkable change in the cerebrovascular bed in the juvenile cases, CBF of the remnant brain parenchyma was good irrespective of the degree of ventricular dilatation. There was a periventricular-related IMP uptake in each case; however, it somehow matched the ventricular span. Functional outcome one to 23 years after the initial shunt operation was good in every case, despite multiple shunt revisions. Redistribution on late images had no bearing on clinical states. In adult cases, 8 patients with effective shunting demonstrated a relatively localized periventricular low perfusion, with preoperative increased cerebrospinal fluid (CSF) pressure. On the contrary, 12 patients with no improvement with or without ventricular-reduced IMP uptake, despite low CSF pressure. The present study indicates that periventricular hemodynamics may play an important role in cerebral function compromised by hydrocephalus. (J.P.N.)

  6. Acute Cerebral Insufficiency in Patients with Severe Forms of Alcoholic Psychoses

    Directory of Open Access Journals (Sweden)

    V. V. Zverev

    2006-01-01

    Full Text Available The paper summarizes the results of studies of cerebral metabolism in 38 patients with delirium tremens. The findings have led to the conclusion that the leading factor of the pathogenesis of acute cerebral insufficiency in this case is energy deficiency caused by impaired cerebral glucose utilization rather than hypoxia itself.

  7. MR findings of cerebral palsy

    International Nuclear Information System (INIS)

    Yoon, Sang Hum; Chang, Seung Kuk; Cho, Mee Young; Park, Dong Woo; Kim, Jong Deok; Eun, Choong Ki

    1994-01-01

    To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage

  8. MR findings of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sang Hum; Chang, Seung Kuk; Cho, Mee Young; Park, Dong Woo; Kim, Jong Deok; Eun, Choong Ki [Pusan Paik Hospital, Pusan (Korea, Republic of)

    1994-11-15

    To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage.

  9. Behcet's disease with cerebral vasculitis

    International Nuclear Information System (INIS)

    Scardamaglia, L.; Desmond, P.M.; Gonzales, M.F.; Bendrups, A.; Brodtmann, A.

    2001-01-01

    The case presented illustrates the diagnostic dilemma off neurological involvement in Behcet's disease and other inflammatory diseases. 'Psychiatric' symptoms were present for 2 years without abnormalities on SPECT or MRI and without CSF pleocytosis. Even at the time of fitting, no CSF abnormalities were observed. The preceding psychiatric presentations may have been due to cerebral vasculitis that was exacerbated by withdrawal of steroids. Magnetic resonance imaging is currently the most sensitive imaging modality. Lesions are usually in the brainstem, cerebellum, basal ganglia region or periventricular white matter, and the pons and the mesencephalon are commonly affected. In our patient there was no diencephalic or brainstem involvement. The inflammatory process can appear as a very large lesion, with gadolinium enhancement and significant mass effect, as in our patient. Brain magnetic resonance imaging. Postgadolinium-diethylenetriamine pentaacetic acid, axial image shows two large lesions in the right frontal lobe, with the larger, posterior lesion demonstrating vivid ring enhancement. A central nodule is isodense, with the cerebral white matter within the larger lesion. Surrounding low T 1 signal involves the hemispheric white matter without cortical extension and is consistent with vasogenic oedema. Minor mass effect is demonstrated with bowing of the anterior falx cerebri to the left. Biopsy shows prominent fibrinoid necrosis in small calibre postcapillary venules and cerebral white matter. There are surrounding acute and chronic inflammatory cells and nuclear debris, consistent with vasculitis

  10. Contrast MR imaging of acute cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kogame, Saeko; Syakudo, Miyuki; Inoue, Yuichi (Osaka City Univ. (Japan). Faculty of Medicine) (and others)

    1992-04-01

    Thirty patients with acute and subacute cerebral infarction (13 and 17 deep cerebral infarction) were studied with 0.5 T MR unit before and after intravenous injection of Gd-DTPA. Thirteen patients were studied within 7 days after neurological ictus, 17 patients were studied between 7 and 14 days. Two types of abnormal enhancement, cortical arterial and parenchymal enhancement, were noted. The former was seen in 3 of 4 cases of very acute cortical infarction within 4 days after clinical ictus. The latter was detected in all 7 cases of cortical infarction after the 6th day of the ictus, and one patient with deep cerebral infarction at the 12th day of the ictus. Gd-DTPA enhanced MR imaging seems to detect gyral enhancement earlier compared with contrast CT, and depict intra-arterial sluggish flow which was not expected to see on contrast CT scans. (author).

  11. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Katsumi [Department of Radiology, Kyoto City Hospital, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, 604-8845 Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko [Department of Pediatric Neurology, St. Joseph Hospital for Handicapped Children, 603-8323 Kyoto (Japan)

    2002-10-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  12. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    International Nuclear Information System (INIS)

    Hayakawa, Katsumi; Kanda, Toyoko; Yamori, Yuriko

    2002-01-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  13. Severe cerebral desaturation during shoulder arthroscopy in the beach-chair position

    DEFF Research Database (Denmark)

    Dippmann, Christian; Winge, Søren; Nielsen, Henning Bay

    2010-01-01

    During shoulder arthroscopy in the beach-chair position, cerebral ischemia may be a serious complication because prolonged hypotension may affect regional cerebral oxygen supply. We present the cases of 2 patients in whom a reduction in mean arterial pressure after anesthesia provoked a decrease...... cerebral oxygenation. During surgery in the beach-chair position, hypotension must be avoided, and in all patients regional, cerebral oxygenation should be monitored and optimized....

  14. Case-control study of six genes asymmetrically expressed in the two cerebral hemispheres: association of BAIAP2 with attention-deficit/hyperactivity disorder

    DEFF Research Database (Denmark)

    Ribasés, Marta; Bosch, Rosa; Hervás, Amaia

    2009-01-01

    BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neuropsychiatric disease that persists into adulthood in at least 30% of patients. There is evidence suggesting that abnormal left-right brain asymmetries in ADHD patients may be involved in a variety of ADHD...... results support the participation of BAIAP2 in the continuity of ADHD across life span, at least in some of the populations analyzed, and suggest that genetic factors potentially influencing abnormal cerebral lateralization may be involved in this disorder....

  15. Cerebral CT appearances of toxic encephalopathy of tetramine

    International Nuclear Information System (INIS)

    Zheng Wenlong; Wu Aiqin; Xu Chongyong; Ying Binyu; Hong Ruizhen

    2003-01-01

    Objective: To investigate the cerebral CT appearances of toxic encephalopathy of tetramine and improve the recognition on this disease. Methods: Four cases of toxic encephalopathy of tetramine were collected and their cerebral CT appearances were retrospectively analyzed. Results: Cerebral CT appearances in acute phase (within 8 days): (1) cerebral edema in different degree. CT abnormalities consisted of cortical hypodensities and complete loss of gray-white matter differentiation. The CT value were in 11-13 HU, and to be watery density in serious case, (2) subarachnoid hemorrhage. It demonstrated the signs of poisoning hypoxic ischemic encephalopathy in chronic phase. Conclusion: The cerebral CT appearances of toxic encephalopathy of tetramine had some character in acute phase and it can predict the serious degree of intoxication, but there was no characteristic findings in chronic phase

  16. Dominant inheritance of cerebral gigantism.

    Science.gov (United States)

    Zonana, J; Sotos, J F; Romshe, C A; Fisher, D A; Elders, M J; Rimoin, D L

    1977-08-01

    Cerebral gigantism is a syndrome consisting of characteristic dysmorphic features, accelerated growth in early childhood, and variable degrees of mental retardation. Its etiology and pathogenesis have not been defined. Three families are presented with multiple affected members. The vertical transmission of the trait and equal expression in both sexes in these families indicates a genetic etiology with a dominant pattern of inheritance, probably autosomal. As in previously reported cases, extensive endocrine evaluation failed to define the pathogenesis of the accelerated growth present in this disorder.

  17. Hyperthyroidism and cerebral venous thrombosis.

    Science.gov (United States)

    Mouton, S; Nighoghossian, N; Berruyer, M; Derex, L; Philippeau, F; Cakmak, S; Honnorat, J; Hermier, M; Trouillas, P

    2005-01-01

    The demonstration of an underlying prothrombotic condition in cerebral venous thrombosis (CVT) may have important practical consequences in terms of prevention. Thyrotoxicosis through a hypercoagulable state may be a predisposing factor for CVT. The authors present the cases of 4 patients who developed CVT and hyperthyroidism. At the acute stage, hyperthyroidism was associated with an increase in factor VIII (FVIII). At follow-up, FVIII level remained increased in 2 patients. Hyperthyroidism may have an impact on FVIII level. Accordingly in patients with hyperthyroidism and neurological symptoms, the diagnosis of CVT should be considered and an exhaustive coagulation screening may be appropriate. (c) 2005 S. Karger AG, Basel.

  18. Schizencephaly/congenital cerebral clefts

    International Nuclear Information System (INIS)

    Friedman, H.; Naidich, T.P.

    1987-01-01

    Schizencephaly (from the Greek meaning ''split brain''), is a term developed in the 1940s to explain symmetric clefts in the brain seen at autopsy in children with histories of severe neurologic defects. Use of the term has been expanded to include a variety of cerebral clefts. A review of the experience at Children's Memorial Hospital as well as case materials made available to the authors are presented, including CT, MR imaging, and US findings. Theories of etiology and pathogenesis of these congenital clefts, associated anomalies, and the spectrum of appearance of these clefts are discussed

  19. Cerebral Palsy (For Parents)

    Science.gov (United States)

    ... Going to an Occupational Therapist Scoliosis In the Band: Jens' Story Cerebral ... KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995- ...

  20. Cerebral Contusions and Lacerations

    Science.gov (United States)

    ... Contusions and Lacerations Concussion Diffuse Axonal Injury Intracranial Hematomas Skull Fracture Sports-Related Concussion Cerebral contusions are ... Contusions and Lacerations Concussion Diffuse Axonal Injury Intracranial Hematomas Skull Fracture Sports-Related Concussion NOTE: This is ...

  1. Cerebral toxoplasmosis after haematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Agnieszka Zaucha-Prażmo

    2017-05-01

    Full Text Available Toxoplasmosis is an opportunistic infection caused by the parasite Toxoplasma gondii. The infection is severe and difficult to diagnose in patients receiving allogeneic haematopoietic stem cell transplantation (HSCT. It frequently involves the central nervous system. The case is presented of cerebral toxoplasmosis in a 17-year-old youth with Fanconi anaemia treated with haematopoietic stem cell transplantation (HSCT

  2. Vascular permeability in cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao

    2015-01-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observ...

  3. Cerebral cartography and connectomics

    OpenAIRE

    Sporns, Olaf

    2015-01-01

    Cerebral cartography and connectomics pursue similar goals in attempting to create maps that can inform our understanding of the structural and functional organization of the cortex. Connectome maps explicitly aim at representing the brain as a complex network, a collection of nodes and their interconnecting edges. This article reflects on some of the challenges that currently arise in the intersection of cerebral cartography and connectomics. Principal challenges concern the temporal dynamic...

  4. Nanomedicine in cerebral palsy

    Science.gov (United States)

    Balakrishnan, Bindu; Nance, Elizabeth; Johnston, Michael V; Kannan, Rangaramanujam; Kannan, Sujatha

    2013-01-01

    Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. PMID:24204146

  5. Cerebral angiographic findings in thromboangiitis obliterans

    International Nuclear Information System (INIS)

    No, Young J.; Lee, Eun M.; Kim, Jong S.; Lee, Deok H.

    2005-01-01

    Transient ischemic attacks (TIAs) or ischemic stroke may complicate thromboangiitis obliterans (TAO). However, there has been debate regarding the mechanism of ischemic stroke in TAO. We report the case of a patient with TAO who developed repeated TIAs. An angiogram showed multiple alternative areas of arterial occlusions in the distal segments of both middle cerebral arteries. Extensive collateral vessels around the occluded segment were also observed, which resembled the ''tree root'' or ''corkscrew'' vessels described in the peripheral arteries in TAO. Our patient illustrates that cerebral manifestations of TAO may occur with vascular changes that are identical with those encountered in the limb arteries in TAO. (orig.)

  6. Progressive cerebral atrophy in neuromyelitis optica.

    Science.gov (United States)

    Warabi, Yoko; Takahashi, Toshiyuki; Isozaki, Eiji

    2015-12-01

    We report two cases of neuromyelitis optica patients with progressive cerebral atrophy. The patients exhibited characteristic clinical features, including elderly onset, secondary progressive tetraparesis and cognitive impairment, abnormally elevated CSF protein and myelin basic protein levels, and extremely highly elevated serum anti-AQP-4 antibody titer. Because neuromyelitis optica pathology cannot switch from an inflammatory phase to the degenerative phase until the terminal phase, neuromyelitis optica rarely appears as a secondary progressive clinical course caused by axonal degeneration. However, severe intrathecal inflammation and massive destruction of neuroglia could cause a secondary progressive clinical course associated with cerebral atrophy in neuromyelitis optica patients. © The Author(s), 2015.

  7. Case series

    African Journals Online (AJOL)

    ebutamanya

    2015-01-20

    Jan 20, 2015 ... The brainstem, cerebral white matter, basal ganglia, internal capsule, thalamus and spinal cord were involved in forty four, thirty one, thirty, twenty nine, seventeen and four patients, respectively. The cerebral peduncle was the brainstem structure mainly involved with thirty cases followed by the pons with, ...

  8. Computed tomographic findings of cerebral paragonimiasis

    International Nuclear Information System (INIS)

    Bae, Weon Tae; Jung, Min Ki; Kang, Heoung Keun; Chung, Hyon De

    1988-01-01

    Authors analyzed the computed tomographic (CT) findings of 19 cases pathologically and clinically proven cerebral paragonimiasis that were performed at Chonnam University Hospital from April 1983 through March 1987. The results were as follows: 1. Male to female ratio was 15:4 and the most prevalent age group was 3rd decade (7 cases). The common symptoms were epileptic seizure (16 cases) and headache (12 cases). 2. The multiplicity of cerebral paragonimiasis was 7 of 19 cases and the distributions of lesion were occipital (11 cases), temporal (6 cases), frontal (5 cases) and parietal (5 cases) lobe. 3. The calcification on CT scan were single (7 cases) or multiple (7 cases) and the shape of calcification were nodular (10 cases), soap babble of ring (8 cases), and stippled (6 cases). The pattern of contrast enhancement were ring (5 cases) or nodular (1 case), and along the basal cistern (1 case with arachnoiditis). 4. 12 out of 13 cases, had long clinical symptoms over 3 years with calcifications, could be analyzed according to Valentine's vascular territory; 6 cases in PCA territory, 3 in MCA and 3 in ACA. 5. CT findings were noted according to the duration of symptoms; 5 cases, had symptoms less than 1 year, showed abscess (5 cases) and arachnoiditis (1 case) with brain edema, mass effect, hydrocephalus and contrast enhancement but no calcification in all. One case, had symptom of 1 year and 2 months, showed partially calcified granulomatous lesion with perifocal edema and contrast enhancement, 13 cases, had symptoms over 3 years, showed multiple calcification with brain atrophy (10 cases), but no contrast enhancement in all cases.

  9. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  10. Cerebral infarctions due to CNS infection with Enterobacter sakazakii

    International Nuclear Information System (INIS)

    Gallagher, P.G.; Ball, W.S.

    1991-01-01

    Recent reports have implicated Enterobacter sakazakii, a gram-negative enteric bacillus, in neonatal sepsis and meningitis. Cases of severe central nervous system involvement, including ventriculitis, brain abscess, infarction, and cyst formation, have been described. We present serial head CT findings in a case of neonatal E. sakazakii meningitis complicated by a ring enhancing cerebral infarction which mimicked abscess formation. In meningitis secondary to this agent, a recognized pattern of cerebral hypodensity with or without cystic degeneration late in the course of the infection is likely to represent cerebral infarction rather than an abscess especially if there is a lack of culture evidence of a bacterial infection. (orig.)

  11. Acidente vascular cerebral hemorrágico associado à acidente ofídico por serpente do gênero bothrops: relato de caso Hemorrhagic stroke related to snakebite by bothrops genus: a case report

    Directory of Open Access Journals (Sweden)

    Amanda Silva Machado

    2010-10-01

    Full Text Available Este trabalho tem como objetivo relatar um caso de acidente vascular cerebral hemorrágico, associado à acidente ofídico por serpente do gênero bothrops e hipertensão arterial sistêmica grave. Apesar do ofidismo botrópico ser frequente no Estado do Pará, tais associações são incomuns, necessitando de uma abordagem especializada e precoce, visando menores complicações.This research reports a clinical case of hemorrhagic stroke due to envenomation by bothrops snakebite associated with severe hypertension. Although bothrops snakebites are frequent in the State of Pará, such associations are uncommon, requiring specialized and early management to avoid severe complications.

  12. The effect of botulinum toxin A (Botox) injections used to treat limb spasticity on speech patterns in children with dysarthria and cerebral palsy: A report of two cases.

    Science.gov (United States)

    Workinger, Marilyn Seif; Kent, Raymond D; Meilahn, Jill R

    2017-05-19

    Botulinum toxin A (Btx-A) injections are used to treat limb spasticity in children with cerebral palsy (CP) resulting in improved gross and fine motor control. This treatment has also been reported to have additional functional effects, but the effect of treatment on speech has not been reported. This report presents results of longitudinal speech evaluation of two children with CP given injections of Btx-A for treatment of limb spasticity. Speech evaluations were accomplished at baseline (date of injections) and 4- and 10-weeks post-injections. Improvements in production of consonants, loudness control, and syllables produced per breath were found. Parental survey also suggested improvements in subjects' speech production and willingness to speak outside the testing situation. Future larger studies are warranted to assess the nature of the changes observed related to Btx-A.

  13. Computerized tomographic evaluation of cerebral cysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Young; Lee, Mi Sook; Jeon, Doo Sung; Kim, Hong Soo; Rhee, Hak Song [Precbyterian Medical Center, Chonju (Korea, Republic of)

    1988-08-15

    Cerebral cysticercosis, unfortunately frequent in Korea, is a parastic disease in which man serve as the intermediate host of taenia solium. The larvae have a predilection for the central nervous system and can cause a variety of neurologic symptoms. The authors reviewed 19 cases of surgically proven cerebral cysticercosis and following results were obtained. 1. The most frequent age distribution was 5th and 6th decade and male to female ratio was 14:5. 2. The most frevalent involving site was cerebral parenchyme and following by ventricles. 3. Clinical manifestations were symtom and sign of increased ICP, seizure and focal neurological dificit. 4. It was assumed that computerized tomography was the procedure of choice for the diagnosis of these parasitic brain disease.

  14. Diagnosis of cerebral disorders using computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, K [Tokyo Women' s Medical Coll. (Japan)

    1980-01-01

    Computed tomography (CT), which makes differential diagnosis of cerebral disorders possible, was applied in the diagnosis of hypertensive intracerebral hemorrhage, cerebral thrombosis, subarachnoid hemorrhage, and cerebrovascular Moyamoya disease. CT findings of hypertensive intracerebral hemorrhage showed the localization, volume, and direction of hematoma, and the classification of hematoma according to CT findings was highly correlated to the clinical symptoms of the patients. CT findings of cerebral thrombosis showed the extension of the lesion to be a low density area, but there were many cases in which they did not show a low density area immediately after an attack. CT findings of subarachnoid hemorrhage were very useful in the diagnosis of intracerebral hematoma, ventricular hematoma, and intracranial hematoma secondary to this disease. However, it was very difficult to diagnose cerebrovascular Moyamoya disease by means of CT.

  15. Diagnosis of cerebral disorders using computed tomography

    International Nuclear Information System (INIS)

    Kitamura, Koichi

    1980-01-01

    Computed tomography (CT), which makes differential diagnosis of cerebral disorders possible, was applied in the diagnosis of hypertensive intracerebral hemorrhage, cerebral thrombosis, subarachnoid hemorrhage, and cerebrovascular Moyamoya disease. CT findings of hypertensive intracerebral hemorrhage showed the localization, volume, and direction of hematoma, and the classification of hematoma according to CT findings was highly correlated to the clinical symptoms of the patients. CT findings of cerebral thrombosis showed the extension of the lesion to be a low density area, but there were many cases in which they did not show a low density area immediately after an attack. CT findings of subarachnoid hemorrhage were very useful in the diagnosis of intracerebral hematoma, ventricular hematoma, and intracranial hematoma secondary to this disease. However, it was very difficult to diagnose cerebrovascular Moyamoya disease by means of CT. (Nishio, M.)

  16. Pathological review of late cerebral radionecrosis

    International Nuclear Information System (INIS)

    Yoshii, Yoshihiko

    2008-01-01

    Late cerebral radionecrosis may be considered to be a specific chronic inflammatory response, although it is unknown whether the initial damage by brain irradiation is to an endothelial cell or a glial cell. I discuss the pathological specificity of late cerebral radionecrosis by studying the published literature and a case that I experienced. In late cerebral radionecrosis, there are typical coagulation necrosis areas containing fibrinoid necrosis with occlusion of the lumina and poorly active inflammatory areas with many inflammatory ghost cells, focal perivascular lymphocytes, hyalinized vessels, and telangiectatic vascularization near and in the necrotic tissue, and more active inflammatory areas formed as a partial rim of the reactive zone by perivascular lymphocytes, much vascularization, and glial fibrillary acidic protein (GFAP)-positive astrocytes at the corticomedullary border adjacent to necrotic tissue in the white matter. It is difficult to believe that coagulation necrosis occurs without first disordering the vascular endothelial cells because fibrinoid necrosis is a main feature and a diffusely multiple lesion in late cerebral radionecrosis. Because various histological findings do develop, progress, and extend sporadically at different areas and times in the irradiated field of the brain for a long time after radiation, uncontrolled chronic inflammation containing various cytokine secretions may also play a key role in progression of this radionecrosis. Evaluation of the mechanism of the development/aggravation of late cerebral radionecrosis requires a further study for abnormal cytokine secretions and aberrant inflammatory reactions. (author)

  17. Computerized tomographic studies in cerebral palsy

    International Nuclear Information System (INIS)

    Sugie, Yoko

    1981-01-01

    Computed tomographic (CT) findings in 200 children with cerebral palsy (CP) were analysed from the viewpoint of clinical manifestations, disease complications and etiological factors. CT scans of 135 cases (67.5%) were found to be abnormal and there were 14 (7%) borderline cases. The major abnormality found on CT scans was cerebral atrophy. Other important changes included focal or diffuse low density area in the brain tissue, congenital malformation, and cerebellar atrophy. From the clinical point of view, a large number of patients with spastic tetraplegia and spastic diplegia showed highly abnormal CT scans. On the other hand, in patients with spastic monoplegia, spastic paraplegia, and athetotic type, CT findings were normal or revealed only minor cerebral atrophy. Most children showing asymmetric clinical symptoms had corresponding asymmetric CT abnormalities which included ventricular enlargement, low density area in the brain tissue, and hemispherical volume. There was a significant correlation between the severity of physical impairment and the extent of CT abnormalities. Severely affected children had grossly abnormal CT scans such as hydranencephaly, polycystic change, and extensive cerebral atrophy. In the patients complicated with epilepsy, the incidence and severity of abnormal CT were higher than those of non-epileptic patients. Mentally retarded patients had variable enlargement of the subarachnoidal space depending on the severity of their mental retardation. Patients with suspected postnatal etiology also had high incidence of severe CT abnormality. CT scan is a valuable tool for evaluating patients with CP and in some cases, possible etiology of the disease may be discovered. (author)

  18. Nanomedicine in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Balakrishnan B

    2013-11-01

    Full Text Available Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM

  19. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral haemod...

  20. A schizophrenic patient with cerebral infarctions after hemorrhagic shock

    Directory of Open Access Journals (Sweden)

    Youichi Yanagawa

    2013-01-01

    Full Text Available We herein report the fourth case of cerebral infarction, concomitant with hemorrhagic shock, in English literature. A 33-year-old male, who had been diagnosed with schizophrenia and given a prescription for Olanzapine, was discovered with multiple self-inflicted bleeding cuts on his wrist. On arrival, he was in hemorrhagic shock without verbal responsiveness, but his vital signs were normalized following infusion of Lactate Ringer′s solution. The neuroradiological studies revealed multiple cerebral ischemic lesions without any vascular abnormality. He was diagnosed with speech apraxia, motor aphasia, and dysgraphia, due to multiple cerebral infarctions. As there was no obvious causative factor with regard to the occurrence of cerebral infarction in the patient, the hypoperfusion due to hemorrhagic shock, and the thromboembolic tendency due to Olanzapine, might have acted together to lead to the patient′s cerebral ischemia.

  1. Diagnostic techniques in cerebral artery occlusions

    Energy Technology Data Exchange (ETDEWEB)

    Huber, P

    1972-01-01

    In two-thrids of the cases of cerebral artery occlusions ophthalmodynamotry, thermography, and the fluorescein test are sufficient. In cases where these give insufficient data, scintigraphy is the preferred screening method. For determination of the regional blood flow /sup 133/Xe is used. Angiographic investigation, however, is the method that gives the most clinically valuable data. The techniques used and the risks inherent in the method are described. (JSR)

  2. CT scan findings in cerebral paragonimiasis

    International Nuclear Information System (INIS)

    Udaka, Fukashi; Okuda, Bungo; Okada, Masako; Okae, Shunji; Kameyama, Masakuni

    1982-01-01

    Computed tomography was performed on 5 patients with chronic cerebral paragonimiasis. CT showed solitary or multiple, amorphous, round, or oval calcifications, and ventricular enlargement in all 5 cases. A large low-density area is also found in 4 of the 5 cases. These CT findings are compatible with previously reported findings of simple X-ray films of the skull, pneumoencephalography, and pathological studies. (author)

  3. Decreased cerebral blood flow after administration of sodium bicarbonate in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Fris-Hansen, B

    1978-01-01

    In the course of our studies on cerebral blood flow in newborn infants, we have observed a striking depressing effect of sodium bicarbonate infusion on cerebral blood flow which in some cases may severely aggravate cerebral ischemia. We measured cerebral blood flow before and after the treatment...... with 1 to 8 meqs of sodium bicarbonate in seven distressed newborn infants. The 133 Xe clearance technique was used. The results showed in six of the seven cases a decrease in cerebral blood flow, which in most cases was reduced to 14 to 22 ml/100 g/min, which is about half the value prior...... to the bicarbonate infusion. In one case an extreme reduction occurred: cerebral blood flow was reduced to 3 ml/100 g/min, well below the level compatible with tissue survival. The results are discussed with regard to the optimal treatment of the acidotic newborn....

  4. A population-based nested case control study on recurrent pneumonias in children with severe generalized cerebral palsy: ethical considerations of the design and representativeness of the study sample

    Directory of Open Access Journals (Sweden)

    Benninga Marc A

    2005-07-01

    Full Text Available Abstract Background In children with severe generalized cerebral palsy, pneumonias are a major health issue. Malnutrition, dysphagia, gastro-oesophageal reflux, impaired respiratory function and constipation are hypothesized risk factors. Still, no data are available on the relative contribution of these possible risk factors in the described population. This paper describes the initiation of a study in 194 children with severe generalized cerebral palsy, on the prevalence and on the impact of these hypothesized risk factors of recurrent pneumonias. Methods/Design A nested case-control design with 18 months follow-up was chosen. Dysphagia, respiratory function and constipation will be assessed at baseline, malnutrition and gastro-oesophageal reflux at the end of the follow-up. The study population consists of a representative population sample of children with severe generalized cerebral palsy. Inclusion was done through care-centres in a predefined geographical area and not through hospitals. All measurements will be done on-site which sets high demands on all measurements. If these demands were not met in "gold standard" methods, other methods were chosen. Although the inclusion period was prolonged, the desired sample size of 300 children was not met. With a consent rate of 33%, nearly 10% of all eligible children in the Netherlands are included (n = 194. The study population is subtly different from the non-participants with regard to severity of dysphagia and prevalence rates of pneumonias and gastro-oesophageal reflux. Discussion Ethical issues complicated the study design. Assessment of malnutrition and gastro-oesophageal reflux at baseline was considered unethical, since these conditions can be easily treated. Therefore, we postponed these diagnostics until the end of the follow-up. In order to include a representative sample, all eligible children in a predefined geographical area had to be contacted. To increase the consent rate, on

  5. Analysis of cranial CT-scan findings in cerebral palsy

    International Nuclear Information System (INIS)

    Wada, Fumio; Andoh, Tadashi; Une, Koji; Takamatsu, Tsurukichi

    1981-01-01

    CT-scan findings of 87 cerebral palsied children were studied. They consist of 23 cases of spastic quadriplegia, 9 cases of diplegia, 12 cases of paraplegia, 24 cases of athetosis and mixed type, and 19 cases of hemiplegia. In the former four types, ventricular dilatation and cortical atrophy were measured and abnormal changes in cerebral substance and cerebellar atrophy were observed. Spastic quadriplegia showed most intense changes in every aspect of the abnormalities, while paraplegia had almost normal appearance. Athetosis and mixed type had moderate changes. Hemiplegia always showed asymmetrical view on CT-scan, dilatation of lateral ventricle or atrophy of hemisphere in contralateral side being observed. (author)

  6. Analysis of cranial CT-scan findings in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Wada, F.; Andoh, T.; Une, K.; Takamatsu, T. (Kitakyushu Municipal Sogo-Ryoiku Center (Japan))

    1981-06-01

    CT-scan findings of 87 cerebral palsied children were studied. They consist of 23 cases of spastic quadriplegia, 9 cases of diplegia, 12 cases of paraplegia, 24 cases of athetosis and mixed type, and 19 cases of hemiplegia. In the former four types, ventricular dilatation and cortical atrophy were measured and abnormal changes in cerebral substance and cerebellar atrophy were observed. Spastic quadriplegia showed most intense changes in every aspect of the abnormalities, while paraplegia had almost normal appearance. Athetosis and mixed type had moderate changes. Hemiplegia always showed asymmetrical view on CT-scan, dilatation of lateral ventricle or atrophy of hemisphere in contralateral side being observed.

  7. Diffusion weighted EPI in early cerebral infarction and intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Susumu; Cho, Keiichi; Hosaka, Sumio; Ito, Koichiro; Tajima, Natsuki; Kobayashi, Shiro [Nippon Medical School (Japan). Chiba-Hokuso Hospital; Kumazaki, Tatsuo; Takahashi, Yoshiyuki

    1997-11-01

    Fifteen cases of early cerebral infarction and 14 cases of cerebral hemorrhage underwent diffusion weighted echo planar imaging. Increased intensity area was detected only 2 in 5 cases less than 3 hours from ictus, whereas infarction was correctly diagnosed in all cases over 3 hours. Infarcted area was increased on the follow-up study in 2 cases. Hematoma showed mixed intensity in hyper acute phase, very hypo in acute, mixed in subacute and very hyper in the chronic stage. High intensity area surrounded the hematoma. (author)

  8. Neuroimaging of cerebral vasculitis

    International Nuclear Information System (INIS)

    Wengenroth, M.; Saam, T.; Haehnel, S.

    2016-01-01

    Cerebral vasculitis can have a variety of origins. Furthermore, there are no vasculitis-specific symptoms or imaging signs and vasculitis of the CNS can mimic many other neurological diseases, which require different treatment approaches. Thus, the clinical and radiological diagnosis of cerebral vasculitis is challenging. Magnetic resonance imaging (MRI) and MR angiography (MRA) should be the radiological imaging methods of choice to assess the degree of parenchymal damage and to detect vessel wall changes. If the results are unclear digital subtraction angiography (DSA) should be pursued in order to also detect changes in medium sized vessels. Vasculitis of small vessels cannot be detected by vascular imaging and requires brain or leptomeningeal biopsy. In this review we present the current diagnostic approach and a variety of imaging findings in cerebral vasculitis and discuss the main radiological differential diagnoses. (orig.) [de

  9. Diaschisis with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Slater, R.; Reivich, M.; Goldberg, H.; Banka, R.; Greenberg, J.

    1977-01-01

    Fifteen patients admitted to Philadelphia General Hospital with acute strokes had repeated measurements of cerebral blood flow measured by the /sup 133/X inhalation method. A progressive decline in cerebral blood flow in both hemispheres was observed during the first week after infarction in twelve of these patients. This decline could be partially explained by loss of autoregulation, but could not be correlated with level of consciousness, clinical status of PCO2. This progressive decline in flow in the non-ischemic hemisphere indicates a process more complex than a simple destruction of axonal afferants to neurons as implied by the term diaschisis. The flow changes in the non-ischemic hemisphere are likely caused by a combination of the immediate effects of decreased neuronal stimulation modified by loss of autoregulation, release of vasoactive substances, cerebral edema, and other factors.

  10. Pilates improves lower limbs strength and postural control during quite standing in a child with hemiparetic cerebral palsy: A case report study.

    Science.gov (United States)

    Dos Santos, Adriana Neves; Serikawa, Simoni Sayuri; Rocha, Nelci Adriana Cicuto Ferreira

    2016-08-01

    To verify the effect of Pilates exercises in a child with cerebral palsy (CP) with mild functional impairment. We evaluated average peak torque of ankle and knee extensors/flexors using a Biodex System, using concentric active-assisted test. We also evaluated amplitude of anterior-posterior and of medial-lateral displacement of the CoP and area of oscillation during quite standing with a BERTEC platform. We applied Pilates exercises for eight weeks. Peak torque/body weight of ankle and knee extensors/flexors of both affected and unaffected limbs increased after Pilates. Also, all kinetic variables decreased after Pilates' intervention. After one-month follow-up, isokinetic variable values were higher while kinetic variable values were lower than baseline values. Pilates may be an important rehabilitation technique for children with CP that present mild deficits in motor structures and high functional level, especially when the aims are to improve muscle strength and postural control during quite standing.

  11. Failure of tooth eruption in two patients with cerebral palsy and bruxism-a 10-year follow-up: a case report.

    Science.gov (United States)

    Staufer, Kirsten; Hamadeh, Sinan; Gesch, Dietmar

    2009-01-01

    The aim of this paper was to analyze delayed tooth eruption in two children with cerebral palsy who had severe bruxism and to determine whether treatment could influence tooth eruption and alignment. Extraction of primary teeth was carried out and orthodontic treatment was considered due to severe tooth wear of primary teeth, lack of space, and development of a class III malocclusion. Analysis was based on clinical examination, photographs, radiographs, and dental casts. In both patients, early mixed dentition was delayed for more than 5 years. Calcification and root development of posterior permanent teeth corresponded with the chronological age. Root resorption of the severely abraded primary teeth and eruption of their successors were delayed or failed. Eruption of permanent teeth occurred slowly after primary teeth were extracted. Orthodontic treatment succeeded in one patient, achieving a normal overjet in combination with a successful orofacial therapy. The disturbed exfoliation of abraded primary teeth and failure of tooth eruption of the posterior teeth could be linked to the systemic pathology and to bruxism. At age 20, eruption of the canines and premolars remained questionable.

  12. Unilateral traumatic hemorrhage of the basal ganglion and bihemisferic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2017-09-01

    Full Text Available Among the various injuries caused by the cerebral tramatic lesion are traumatic brain contusions. Hemorrhagic contusions of the basal ganglia are unusual. Different injuries such as cranial fractures, epidural hemorrhage, subdural hematoma, subarachnoid hemorrhage among others may be associated with brain contusions. In some cases traumatic brain injury arises. We present a case of a patient with unilateral cerebral contusion associated with bihemispheric cerebral infarction.

  13. Gammagraphy of cerebral perfusion

    International Nuclear Information System (INIS)

    Vazquez, Silvia

    2003-01-01

    Important aspects of the gammagraphy of cerebral perfusion and the diverse clinical applications in the neurological diseases are comment in this article. We focus in the usefulness of the photon emission cerebral tomography (SPECT) and its capacity to cross the hemato encephalic barrier through the use of radiopharmacons like 99 mTc-H M-PAO and 99mTc-EDC, thus managing to offer functional data on the captantes neurons of the radiopharmacon. The clinical applications of SPECT are studied; cerebrovascular disease, transient ischemic attacks, dementias, Alzheimer disease, as well as other neurological diseases are referred. (The author)

  14. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    Focal cerebral ischemia due to occlusion of a major cerebral artery is the cause of ischemic stroke which is a major reason of mortality, morbidity and disability in the populations of the developed countries. In the seven studies summarized in the thesis focal ischemia in rats induced by occlusion...... in the penumbra is recruited in the infarction process leading to a progressive growth of the infarct. The penumbra hence constitutes an important target for pharmacological treatment because of the existence of a therapeutic time window during which treatment with neuroprotective compounds may prevent...

  15. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Kino, Masao; Anno, Izumi; Yano, Yuhiko; Anno, Yasuro.

    1980-01-01

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  16. Hypoxic ischemia encephalopathy leading to external hydrocephalus and the cerebral atrophy: mechanism and differential diagnosis

    International Nuclear Information System (INIS)

    Huang Zhenglin; Mo Xiaorong

    2002-01-01

    Objective: It is a study of the mechanism and differential diagnosis of the infant external hydrocephalus and cerebral atrophy. Methods: In total 84 cases of neonatal hypoxic ischemia encephalopathy followed by infant external hydrocephalus were investigated, among which 26 patients gradually were found having developed cerebral atrophy in follow up. Results: Characteristic dilation of the frontal-parietal subarachnoid space and the adjacent cistern was noted on the CT images of the external hydrocephalus. CT revealed the enlarged ventricle besides the dilated subarachnoid space in the cases of cerebral atrophy, while these two entities were indistinguishable on CT in the early stage. Conclusion: Clinical manifestations make a major differential diagnosis of the external hydrocephalus and cerebral atrophy: tic and mild delayed development of locomotion over major presentation of external hydrocephalus, while cerebral atrophy is featured by remarkable dysnoesia and severe delayed development of locomotion. In addition, hemiplegia and increased muscular tension are presented in a few cases of cerebral atrophy

  17. Clinical study of interventional therapy for acute cerebral infarction

    International Nuclear Information System (INIS)

    Xiang Guangze; Xiao Yiming; Wen Zhilin

    2004-01-01

    Objective: To evaluate the clinical efficacy and safety of interventional therapy for acute cerebral infarction. Method: Using urokinase, 35 patients with acute cerebral infarction within 24 hours were treated by intra-artery thrombolytic therapy. Europe stroke scale (ESS), Barthel index (BI) were used to evaluate the recovery of neurological functions. Result: ESS score increase rapidly after thrombolytisis, and there were significant difference between the two teams. Thirteen of 13 cases treated within 6 hours from onset showed complete/partial recanalization in cerebral angiography and intraparenchymal hemorrhagic rate were 0%, twenty-six of 35 cases treated within 24 hours showed complete/partial recanalization and intraparenchymal hemorrhagic rate were 5.71%. Conclusion: Interventional therapy for acute cerebral infarction within 6h were safe and effective. (authors)

  18. [A clinical case of young, oral combined contraceptive using women, heterozygous carrier of the Factor V (Leiden) which revealed thrombosis of the left internal jugular vein and brain ischemia with cerebral infarction and ischemic stroke].

    Science.gov (United States)

    Kovachev, S; Ramshev, K; Ramsheva, Z; Ivanov, A; Ganovska, A

    2013-01-01

    Thrombophilia is associated with increased risks of venous thrombosis in women taking oral contraceptive preparations. Universal thrombophilia screening in women prior to prescribing oral contraceptive preparations is not supported by current evidence. The case is presented of a 23 year-old women with a personal history of interruption and on the same day started with oral contraceptive (0.03 microg ethynil estradiol - 0.075 microg gestodene), which due on a 18 pill/day to acute headache, increasing vomiting and speaking defects. Physical/neurologic/gynecologic examinations observed a normal status. The MRI and CT revealed thrombosis of the left internal jugular vein and brain ischemia with cerebral infarction and ischemic stroke. The acute therapy of thrombotic findings was accompanied with many tests. The thrombophilia PCR-Real time - test finds heterozygous carrier of the Factor V (Leiden). This case shows the need of large prospective studies that should be undertaken to refine the risks and establish the associations of thrombophilias with venous thrombosis among contraceptive users. The key to a prompt diagnosis is to know the risk factors. The relative value of a thrombophilia screening programme before contraceptive using needs to be established.

  19. Paralisia Facial Periférica por comprometimento do tronco cerebral: A propósito de um caso clínico Peripheral Facial Paralisys of brainstem origin: A clinical case description

    Directory of Open Access Journals (Sweden)

    Paulo R. Lazarini

    Full Text Available É apresentado um caso clínico de paciente portador de paralisia facial periférica com comprometimento de toda a hemiface direita. Durante a investigação clínica, esperava-se que o comprometimento topográfico do nervo facial se desse a partir de sua emergência na ponte. Após exames de imagem, evidenciou-se lesão expansiva no tronco cerebral. Deste modo, a classificação de paralisia facial como periférica ou central não atende a este caso. O uso de uma classificação utilizando os núcleos do nervo facial como referência pode ser mais adequado na investigação clínica da paralisia facial.It is presented a clinical case of a patient with a peripheral facial paralysis with hemifacial compromise. During the clinical investigation it was expected that the topographic compromise of the facial nerve would arise out of the emergence of the nerve from the pons. After some image examinations, an expansive brain trunk lesion was evidenced. Thus, the classification of facial paralysis - either peripheral or central - is not applicable to this case. The use of a classification having the facial nerve nucleus as reference could be more adequate in the clinical investigation of the paralysis.

  20. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

    Immink, R V; Pott, F C; Secher, N H

    2014-01-01

    dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2...... the contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced...... cardiac output brain perfusion becomes jeopardized. Whether, in patients with cardiovascular disease and/or defect, cerebral blood flow cerebral control HV-induced hypocapnia elicits cerebral hypoperfusion, leading to TLOC, remains to be established....

  1. Recurrent cerebral thrombosis

    International Nuclear Information System (INIS)

    Iwamoto, Toshihiko; Abe, Shin-e; Kubo, Hideki; Hanyu, Haruo; Takasaki, Masaru

    1992-01-01

    Neuroradiological techniques were used to elucidate pathophysiology of recurrent cerebral thrombosis. Twenty-two patients with cerebral thrombosis who suffered a second attack under stable conditions more than 22 days after the initial stroke were studied. Hypertension, diabetes mellitus, and hypercholesterolemia were also seen in 20, 8, and 12 patients, respectively. The patients were divided into three groups according to their symptoms: (I) symptoms differed between the first and second strokes (n=12); (II) initial symptoms were suddenly deteriorated (n=6); and (III) symptoms occurring in groups I and II were seen (n=4). In group I, contralateral hemiparesis or suprabulbar palsy was often associated with the initial hemiparesis. The time of recurrent stroke varied from 4 months to 9 years. CT and MRI showed not only lacunae in both hemispheres, but also deep white-matter ischemia of the centrum semi-ovale. In group II, hemiparesis or visual field defect was deteriorated early after the initial stroke. In addition, neuroimaging revealed that infarction in the posterior cerebral artery was progressed on the contralateral side, or that white matter lesion in the middle artery was enlarged in spite of small lesion in the left cerebral hemisphere. All patients in group III had deterioration of right hemiparesis associated with aphasia. CT, MRI, SPECT, and angiography indicated deep white-matter ischemia caused by main trunk lesions in the left hemisphere. Group III seemed to be equivalent to group II, except for laterality of the lesion. Neuroradiological assessment of the initial stroke may help to predict the mode of recurrence, although pathophysiology of cerebral thrombosis is complicated and varies from patient to patient. (N.K.)

  2. Transbrachial artery approach for selective cerebral angiography

    International Nuclear Information System (INIS)

    Touho, Hajime; Karasawa, Jun; Shishido, Hisashi; Morisako, Toshitaka; Numazawa, Shinichi; Yamada, Keisuke; Nagai, Shigeki; Shibamoto, Kenji

    1990-01-01

    Transaxillary or transbrachial approaches to the cerebral vessels have been reported, but selective angiography of all four vessels has not been possible through one route. In this report, a new technique for selective cerebral angiography with transbrachial approach is described. One hundred and twenty three patients with cerebral infarction, vertebrobasilar insufficiency, intracerebral hemorrhage, epilepsy, or cerebral tumor were examined. Those patients consisted of 85 outpatients and 38 inpatients whose age ranged from 15 years old to 82 years old. The patients were examined via the transbrachial approach (97 cases via the right brachial, 29 cases via the left). Materials included a DSA system (Digital Fluorikon 5000, General Electric Co.), a 4 French tight J-curved Simmons 80-cm catheter, a 19-gauge extra-thin-wall Seldinger needle, and a J/Straight floppy 125-cm guide-wire. Generally, the volume of the contrast agent (300 mgI/ml iopamidol) used in the common carotid artery angiogram was 6 ml, while that used in the vertebral artery angiogram was 4 ml. If catheterization of the vertebral artery or right common carotid artery was unsuccessful, about 8 ml of the contrast agent was injected into the subclavian or branchiocephalic artery. Definitive diagnosis and a decision on proper treatment of the patients can be easily obtained, and the results were clinically satisfactory. Moreover, no complications were encountered in this study. This new technique making a transbrachial approach to the cerebral vessels using the DSA system is introduced here. Neurosurgeons can use this technique easily, and they will find that it provides them with all the information they need about the patient. (author)

  3. Left Atrium Papillary Fibroelastomas: A Cause of Cerebral Emboli

    Directory of Open Access Journals (Sweden)

    A. G. Ciss

    2012-01-01

    Full Text Available Papillary fibroelastomas are cardiac benign tumours. Among the benign cardiac tumor, papillary fibroelastomas are reported second after myxomas. Most often diagnosed incidentally, papillary fibroelastomas may embolize to cerebral circulation. Valvular locations are predominant; location in left atrium is rare. In this paper, we present a case of papillary fibroelastoma located in left atrium with symptoms of cerebral embolization. Transoesophageal echocardiography diagnosed a mobile mass. The patient was treated with surgical resection without further embolic complication.

  4. Posterior Cerebral Infarction following Loss of Guide Wire

    Directory of Open Access Journals (Sweden)

    Jean-Marc Bugnicourt

    2013-01-01

    Full Text Available Stroke after internal jugular venous cannulation typically leads to acute carotid or vertebral arteries injury and cerebral ischemia. We report the first case of delayed posterior cerebral infarction following loss of guide wire after left internal jugular venous cannulation in a 46-year-old woman with a history of inflammatory bowel disease. Our observation highlights that loss of an intravascular guide wire can be a cause of ischemic stroke in patients undergoing central venous catheterization.

  5. Posterior Cerebral Infarction following Loss of Guide Wire

    OpenAIRE

    Bugnicourt, Jean-Marc; Belhomme, Denis; Bonnaire, Bruno; Constans, Jean-Marc; Manaouil, Cécile

    2013-01-01

    Stroke after internal jugular venous cannulation typically leads to acute carotid or vertebral arteries injury and cerebral ischemia. We report the first case of delayed posterior cerebral infarction following loss of guide wire after left internal jugular venous cannulation in a 46-year-old woman with a history of inflammatory bowel disease. Our observation highlights that loss of an intravascular guide wire can be a cause of ischemic stroke in patients undergoing central venous catheterizat...

  6. No detectable nephrotoxic side effect using a dimer, non-ionic contrast media in cerebral perfusion computed tomography in case of suspected brain ischemia

    International Nuclear Information System (INIS)

    Petrik, M.; Weigel, C.; Kirsch, M.; Hosten, N.

    2005-01-01

    Purpose: In suspected brain ischemia, the perfusion cerebral computed tomography (cCT) should be performed with the lowest amount of contrast media to avoid a contrast media induced nephropathy (CIN) even if the patient already is in renal failure. We were interested to find the best parameters for this examination. Material and methods: From February 2000 to March 2003, 138 patients (58 females, 80 males, mean age 66.8 years) underwent cCT-perfusion immediately after the admission to our stroke unit. Of these patients, 62% (n=86) had normal renal function and 38% (n=52) renal failure (up to 381 μmol/l basic serum creatinine). We varied volume (20-80 ml), flow (5 vs. 7.2. ml/s) and concentration (270 vs. 320 ml/mg iodine) of a dimer, non-ionic contrast media (Visipaque registered ) to establish 5 groups. So we got patients receiving 6 g, 12 g, 16 g, 19 g and 25 g of iodine. After generating the perfusion maps, two radiologists reviewed the quality of the maps and scored it (1-5). We measured the serum creatinine before contrast application and at follow up cCt (days 3 and 7). Results: The quality of the maps increases with increasing amount of iodine. However, the diagnostic result was not significantly better using more than about 16 g of iodine (e.g., 60 ml-7.2 ml/s - 270 mg/ml) in cCT-perfusion studies. Only one patient had a pathologic increase in serum creatinine (day 1: 93; day 4: 146 μmol/l) but died at day 5 because of massive co-morbidity and septic pneumonia. No CIN occurred even in the patient group with pre-existent renal failure. Conclusions: About 60 ml contrast media and a moderate flow rate of about 7 ml/s ensure good results in perfusion-cCT, even if the patients have poor blood circulation or arteriosclerosis. The use of a dimer, non-ionic contrast media (range of 6-25 g iodine) seems to minimize the risk of CIN in the daily routine. (orig.)

  7. Postoperative Cerebral Vasospasm Following Transsphenoidal Pituitary Adenoma Surgery.

    Science.gov (United States)

    Eseonu, Chikezie I; ReFaey, Karim; Geocadin, Romergryko G; Quinones-Hinojosa, Alfredo

    2016-08-01

    Cerebral vasospasm following a transsphenoidal resection of a pituitary adenoma is a devastating occurrence that can lead to delayed cerebral ischemia and poor neurologic outcome if not diagnosed and treated in a timely manner. The etiology of this condition is not well understood but can lead to significant arterial vasospasm that causes severe ischemic insults. In this paper, we identify common presenting symptoms and essential management strategies to treat this harmful disease. A retrospective case report and literature review of presentation, treatment, and outcome of cerebral vasospasm following transsphenoidal surgery. We present 1 case and review 12 known cases in the literature on vasospasm following transsphenoidal surgery. Mean age was 48 (±13.8) years. There were 46.2% male patients. Factors associated with vasospasm, such as cerebral spinal fluid leaks following surgery, were seen in 38.5% of cases, and postoperative subarachnoid hemorrhage (SAH) was seen in 84.6% of cases. Hemiparesis was the presenting symptom of delayed cerebral ischemia in 61.5% of cases. For management, maintaining at least a euvolemic volume status was used in 76.9%, induced hypertension was used in 61.5%, and nimodipine was administered in 46.2% of cases. Patients returned to their neurologic baseline in 61.5% of cases, had new permanent deficits in 7.7% of cases, and died in 30.8% of cases. Cerebral vasospasm following transsphenoidal surgery is a dangerous disease that can lead to a high likelihood of mortality if not identified and treated. Early postoperative events, such as peritumoral subarachnoid hemorrhage and hemiparesis, may be factors associated with post-transsphenoidal surgery vasospasm. Effective treatment options used in patients that regained complete neurologic recovery were by inducing hypertension, maintaining euvolemia, and administering nimodipine. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Familial occurrence of cerebral gigantism, Sotos' syndrome.

    Science.gov (United States)

    Hansen, F J; Friis, B

    1976-05-01

    Since the original description of cerebral gigantism, about 85 cases have been reported. Four papers comment on familial occurrence but never in parents and their children. This paper describes the syndrome in a mother and her child, which, together with facts pointing towards prenatal etiology, such as excessive birthweight, striking mutual resemblance and abnormal dermatoglyphics, points to a genetic defect. Previous endocrine studies are enlarged by the findings of normal serum somatomedin and serum prolactin.

  9. Cerebellar and cerebral atrophy in trichothiodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye-Kyung; Sargent, Michael A.; Poskitt, Kenneth J. [British Columbia Children' s Hospital, Department of Radiology, Vancouver, BC (Canada); Prendiville, Julie S. [British Columbia Children' s Hospital, Division of Paediatric Dermatology, Department of Paediatrics, Vancouver, BC (Canada)

    2005-10-01

    Trichothiodystrophy is a rare neuroectodermal disorder of autosomal recessive inheritance that is characterized by brittle hair, nail dysplasia, ichthyosis, mental retardation, and gonadal failure. We describe a female patient whose cranial MRI revealed almost total lack of myelination in the supratentorial white matter, which is similar to the previously described cases. In addition, there was progressive cerebellar and cerebral atrophy, which has not been well documented in association with trichothiodystrophy. (orig.)

  10. Cerebral sino-venous thrombosis

    International Nuclear Information System (INIS)

    Sayama, Ichiro; Kobayashi, Tsunesaburo; Nakajima, Kenji

    1982-01-01

    Three cases of cerebral sino-venous thrombosis were reported. Repeated CT findings were studied and discussed on account of the treatments for those pathologic conditions. Those of studied cases are; a 22-year-old postpartum woman, a 42-year-old woman with irregular vaginal bleeding, and a 26-year-old man with severe reactive emesis after drinking alcohol. They were treated conservatively. Case 1 died in its acute stage. In the remaining ones, each had an uneventful recovery. CT scan findings of them manifested their exact clinical conditions. These findings were devided into two categories, one was direct signs expressed sino-venous occlusion, the other was indirect signs which appeared as a result of these occlusion. Direct signs cannot always get in every cases with sino-venous occlusion, but as for indirect signs, we can get various changes corresponding to the time taken CT photoes, and they are useful to decide appropriate treatments at that time. Considering suitable treatments for this disease, it is necessary to select most suitable ones according to their pathologic conditions, which may be precisely drawn with CT scans. (J.P.N.)

  11. Aphasia following anterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    Shimosaka, Shinichi; Waga, Shiro; Kojima, Tadashi; Shimizu, Takeo; Morikawa, Atsunori

    1982-01-01

    We have report two cases of aphasia that had infarcts in the distribution of the left or right anterior cerebral artery, as confirmed by computed tomography. Case 1 is a right-handed, 65-year-old man in whom computerized tomographic scanning revealed an infarction of the territory of the left anterior cerebral artery after the clipping of the anterior communicating artery aneurysm. The standard language test of aphasia (SLTA) revealed non-fluent aphasia with dysarthria, good comprehension, almost normal repetition with good articulation, and a defectiveness in writing. This syndrome was considered an instance of transcortical motor aphasia. Although three years had passed from the onset, his aphasia did not show any improvement. Case 2 is a 37-year-old man who is right-handed but who can use his left hand as well. He was admitted because of subarachnoid hemorrhage from an anterior communicating aneurysm. Because of postoperative spasm, an infarction in the distribution of the right anterior cerebral artery developed. He was totally unable to express himself vocally, but he could use written language quite well to express his ideas and had a good comprehension of spoken language. This clinical picture was considered that of an aphemia. After several weeks, his vocalization returned, but the initial output was still hypophonic. (J.P.N.)

  12. MR findings of cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Myung Kwan; Chang, Kee Hyun; Han, Moon Hee; Choi, Choong Gom [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1994-10-15

    To describe MR findings of cerebral venous sinus thrombosis. We reviewed 11 MR images of six patients with cerebral venous sinus thrombosis. The MR images were retrospectively analyzed in terms of location and signal intensity of the thrombi, parenchymal lesions such as hemorrhage and edema, and changes in follow up study obtained in 4 patients. The thrombus in venous sinus was visualized on MRI in all six patients. The most frequently involved sites were superior sagittal sinus(n=4) and left transverse sinus(n=4). Signal intensity of the thrombus was isointense or hyperintense on both T1- and T2-weighted images with loss of normal signal void of the sinus on all sequences in all patients. Parenchymal lesion was patients in five of six cases, manifested as local hemorrhage in three and edema in three cases(one case overlapped). Local edema seen in three patients was completely resolved on follow up study of seven to 29 days intervals. It is concluded that iso- or high signal intensity with loss of signal void in venous sinus is virtually diagnostic of venous sinus thrombosis. If there are local parenchymal lesions such as hemorrhage and/or edema of unknown causes, cerebral venous sinus thrombosis should be included in differential diagnosis.

  13. Cerebral blood flow and oxygen metabolism after subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Ito, Hidemichi; Sakurai, Takashi; Hayashi, Tatsuo; Hashimoto, Takuo

    2004-01-01

    The mechanism of reduction of cerebral circulation in the early phase of aneurysmal subarachnoid hemorrhage (SAH) has not yet been clarified. Previous studies have variously indicated that cerebral blood flow (CBF) reduction may be due to cerebral vasospasm, an elevation in intracranial pressure (ICP), constriction of intraparenchymal arterioles, or metabolic reduction. The aim of this study is to investigate the relationship between cerebral circulation and oxygen metabolism. In 36 patients with aneurysmal SAH, the values of mean cerebral blood flow (mCBF), cerebral metabolic rate of oxygen (GMRO 2 ) and oxygen extraction fraction (OEF) were measured by using single photon emission computed tomography (SPECT) with arterial blood drawing and oxygen saturation of internal jugular bulb blood (SjO 2 ) in the acute stage (1-3 days after onset) and the spasm stage (7-10 days after onset). The patients in our study were selected by using the following criteria: no history of cerebrovascular or cardiopulmonary diseases; under the age of 70; the ruptured aneurysm was treated by clipping or coil embolization within 72 hours after onset; no symptoms of cerebral vasospasm; no signs of cerebral ischemic change on CT scans. These patients were divided into 2 groups according to the World Federation of Neurological Surgeons (WFNS) grading classification; the mild group (Grades I and II) consisted of 27 cases and the severe group (Grade IV) consisted of 9 cases. We studied differences in mCBF CMRO 2 , and OEF between the mild group and severe group. In the mild group, mCBF, CMRO 2 , and OEF were significantly higher than in the severe group during both the acute and the spasm stage. Also mCBF showed a direct correlation with CMRO 2 . All the patients were kept under the following conditions: the bed was positioned so that the upper body was raised at an angle at 30 deg; blood pressure was maintained at 130-150 mmHg and PaCO 2 of arterial blood was maintained at 35-40 mmHg; ICP

  14. Cerebral localization in antiquity.

    Science.gov (United States)

    Rose, F Clifford

    2009-07-01

    Fragments of neurology can be found in the oldest medical writings in antiquity. Recognizable cerebral localization is seen in Egyptian medical papyri. Most notably, the Edwin Smith papyrus describes hemiplegia after a head injury. Similar echoes can be seen in Homer, the Bible, and the pre-Hippocratic writer Alcmaeon of Croton. While Biblical writers thought that the heart was the seat of the soul, Hippocratic writers located it in the head. Alexandrian anatomists described the nerves, and Galen developed the ventricular theory of cognition whereby mental functions are classified and localized in one of the cerebral ventricles. Medieval scholars, including the early Church Fathers, modified Galenic ventricular theory so as to make it a dynamic model of cognition. Physicians in antiquity subdivided the brain into separate areas and attributed to them different functions, a phenomenon that connects them with modern neurologists.

  15. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  16. Value of three-dimensional computed tomography in screening cerebral aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Tamaki; Sugiura, Yusuke; Suzuki, Atsushi; Yamagata, Yoshitaka [Hyogo Medical Coll. (Japan)

    1997-10-01

    We performed three-dimensional computed tomography (3D-CT) in 6 patients of cerebral aneurysm. Prior cerebral angiography showed a total of 17 aneurysms. 3D-CT alone detected 10 cerebral aneurysm (59%). It was possible to identify aneurysms larger than 10 mm even when located near the circle of Willis. It was difficult to identify aneurysms when smaller than 7 mm regardless of their location. 3D-CT was of limited value in detecting cerebral aneurysms, particularly when located near the circle of Willis with complex vascular network. As cases of oculomotor palsy may be caused by lesions other than cerebral aneurysm, we advocate that 3D-CT be performed after magnetic resonance imaging (MRI) in screening cases of suspected cerebral aneurysm. (author)

  17. Cerebral ketone body metabolism.

    Science.gov (United States)

    Morris, A A M

    2005-01-01

    Ketone bodies (KBs) are an important source of energy for the brain. During the neonatal period, they are also precursors for the synthesis of lipids (especially cholesterol) and amino acids. The rate of cerebral KB metabolism depends primarily on the concentration in blood; high concentrations occur during fasting and on a high-fat diet. Cerebral KB metabolism is also regulated by the permeability of the blood-brain barrier (BBB), which depends on the abundance of monocarboxylic acid transporters (MCT1). The BBB's permeability to KBs increases with fasting in humans. In rats, permeability increases during the suckling period, but human neonates have not been studied. Monocarboxylic acid transporters are also present in the plasma membranes of neurons and glia but their role in regulating KB metabolism is uncertain. Finally, the rate of cerebral KB metabolism depends on the activities of the relevant enzymes in brain. The activities vary with age in rats, but reliable results are not available for humans. Cerebral KB metabolism in humans differs from that in the rat in several respects. During fasting, for example, KBs supply more of the brain's energy in humans than in the rat. Conversely, KBs are probably used more extensively in the brain of suckling rats than in human neonates. These differences complicate the interpretation of rodent studies. Most patients with inborn errors of ketogenesis develop normally, suggesting that the only essential role for KBs is as an alternative fuel during illness or prolonged fasting. On the other hand, in HMG-CoA lyase deficiency, imaging generally shows asymptomatic white-matter abnormalities. The ability of KBs to act as an alternative fuel explains the effectiveness of the ketogenic diet in GLUT1 deficiency, but its effectiveness in epilepsy remains unexplained.

  18. Radiopharmaceuticals for cerebral studies

    International Nuclear Information System (INIS)

    Leon Cabana, Alba

    1994-01-01

    For obtain good brain scintillation images in nuclear medicine must be used several radiopharmaceuticals. Cerebral studies give a tumors visual image as well as brain anomalities detection and are helpful in the diagnostic diseases . Are described in this work: a cerebrum radiopharmaceuticals classification,labelled compounds proceeding and Tc 99m good properties in for your fast caption, post administration and blood purification for renal way

  19. Significance of non-specific complaints in asymptomatic cerebral infarction. Approach based on the cerebral circulation

    Energy Technology Data Exchange (ETDEWEB)

    Sakayori, Osamu; Kitamura, Shin; Nagazumi, Atsushi; Terashi, Akirou [Nippon Medical School, Tokyo (Japan)

    1997-10-01

    Seventy-three cases with asymptomatic cerebral infarction detected by MR scanning and 80 cases of past stroke patients were evaluated. The regional cerebral blood flow (CBF) using the SPECT, idoine-123-IMP autoradiography (ARG) method was measured. Twenty-two patients with non-specific complaints (dizziness, numbness of the extremities, headache, etc.) without cerebrovascular risk factors were also examined as controls. Fifty-two percent of the asymptomatic infarction cases had non-specific complaints. The regional CBF in all cerebral non-specific complaints showed significantly lower values as compared to the controls. There was no difference in CBF values between the asymptomatic infarction cases with non-specific complaints and the past stroke patients. Among the asymptomatic infarction patients, cases with both non-specific complaints and hypertension displayed significantly lower CBF values, especially in the frontal and temporal cortical regions, than did cases without non-specific complaints or hypertension. These findings suggest that the patient`s complaints should be taken into consideration when determining the clinical treatment of asymptomatic infarction. (author)

  20. Utility of the cerebral SPECT in schizophrenia

    International Nuclear Information System (INIS)

    Heuguerot, C.H.; Lopez-Lerena, J.J.; Quagliata, A.; Hermida, J.C.; Oliveira, M.C.; Anastasia, H.

    2002-01-01

    Objective: To compare cortical and subcortical cerebral perfusion in schizophrenics patients with normal controls, and analyze the relation to clinical patterns and neuroleptic treatment. Method: 18 patients meeting DSM-IV criteria for schizophrenia under neuroleptic treatment (except 3 cases), evaluated with clinical scales (BPRS and PANSS). The control group included 5 subjects in good health. All subjects were studied with single photon emission computed tomography (SPECT) using technetium-99 etilencisteinato (99mTc-ECD) as a tracer. Region of interest (ROI) were defined in cerebral cortex and thalamus-basal ganglia areas. The cortical cerebral blood flow was measured with a quantitative analysis, expressed as a ratio of regional tracer uptake to occipital cortex uptake. In basal ganglia and thalamus, regional blood flow was evaluated with a semiquantitative methodology, defining categories. Results: Schizophrenics patients showed a significant reduction of perfusion on a left anterior frontal cortex ('hipofrontality') and global decrease of perfusion on left hemisphere. The interhemispheric (left/right) ratio of perfusion was incremented respect control group. In thalamic-basal ganglia complex, a significant hypoperfusion was found in neuroleptic-free patients and control group. On the other hand, neuroleptic-treated patients revealed normal or increased regional blood flow in thalamus and basal ganglia. Only the clinical item 'thought disorder' had significant high correlation with perfusion on left structures (left anterior frontal, left lateral frontal, left temporo-parietal); the other items correlated with right structures. Conclusions: The findings suggest a pattern o left cerebral hypoperfusion in patients with an incremented interhemispheric ratio of cerebral blood flow. The pivotal role of thalamic and basal ganglia areas in the pathophysiology of schizophrenia and neuroleptic action was reaffirmed; apparently, perfusion in thalamic-basal ganglia

  1. Magnetic Resonance Features of Cerebral Malaria

    Energy Technology Data Exchange (ETDEWEB)

    Yadav, P.; Sharma, R.; Kumar, S.; Kumar, U. (Dept. of Radiodiagnosis and Dept. of Medicine, All India Institute of Medical Sciences, New Delhi (India))

    2008-06-15

    Background: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome. Purpose: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium. Material and Methods: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm2, and apparent diffusion coefficient (ADC) maps were obtained. Results: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map. Conclusion: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients

  2. Magnetic Resonance Features of Cerebral Malaria

    International Nuclear Information System (INIS)

    Yadav, P.; Sharma, R.; Kumar, S.; Kumar, U.

    2008-01-01

    Background: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome. Purpose: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium. Material and Methods: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm 2 , and apparent diffusion coefficient (ADC) maps were obtained. Results: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map. Conclusion: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients

  3. Cerebral blood flow in progressive aphasia without dementia. Case report, using 133xenon inhalation, technetium 99m hexamethylpropyleneamine oxime and single photon emission computerized tomography

    DEFF Research Database (Denmark)

    Delecluse, F; Andersen, A R; Waldemar, G

    1990-01-01

    We report a case of progressive aphasia without clinical signs of intellectual or behavioral impairment, satisfying Mesulam's clinical criteria of primary progressive aphasia, as 4 yrs of extensive psychometric testing and radiological imaging, comprising CT and MRI, failed to detect evidence...

  4. Cerebral Oximetry in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    A. N. Shepelyuk

    2012-01-01

    Full Text Available Based on the data of numerous current references, the review describes different neuromonitoring methods during cardiac surgery under extracorporeal circulation. It shows that it is important and necessary to make neuromonitoring for the early diagnosis and prevention of neurological complications after cardiac surgery. Particular attention is given to cerebral oximetry; the possibilities and advantages of this technique are described. Correction of cerebral oximetric values is shown to improve survival rates and to reduce the incidence of postoperative complications. Lack of cerebral oximetry monitoring denudes a clinician of important information and possibilities to optimize patient status and to prevent potentially menacing complications, which allows one to conclude that it is necessary to use cerebral oximetry procedures within neu-romonitoring in cardiac surgery. Key words: extracorporeal circulation, cerebral oximetry, neurological dysfunction, cerebral oxygenation.

  5. Diagnosis of cerebral abscesses by angiography, gammaencephalography and scintigraphy of the brain

    International Nuclear Information System (INIS)

    Freitag, J.; Otto, H.J.; Freitag, G.; Abraham, K.; Koch, R.D.; Fendel, K.; Krumbholz, S.; Burger, P.; Remmert, S.

    1981-01-01

    40 patients suspected of suffering from a cerebral abscess were examined by cerebral angiography and in 14 cases moreover by gammaencephalography and cerebral scintigraphy, resp. Angiographically the abcesses appeared mostly as avascular tumors, in radioisotope examination, however the localized increase of the activity concentration suggested pathological findings. The uncharacteristic symptoms could only be attributed to a process of abscess-formation in connection with clinical and paraclinical findings

  6. Stroke from Vasospasm due to Marijuana Use: Can Cannabis Synergistically with Other Medications Trigger Cerebral Vasospasm?

    Science.gov (United States)

    Jamil, Marium; Zafar, Atif; Adeel Faizi, Syed; Zawar, Ifrah

    2016-01-01

    We present a case of imaging proven cerebral vasospasm causing ischemic stroke in a young patient chronically on buprenorphine-naloxone for heroin remission who started smoking cannabis on a daily basis. With cannabis legalization spreading across the states in the USA, it is important for physicians not only to be aware of cannabis reported association with cerebral vasospasm in some patients but also to be on the lookout for possible interacting medications that can synergistically affect cerebral vessels causing debilitating strokes.

  7. Watershed Cerebral Infarction in a Patient with Acute Renal Failure

    Directory of Open Access Journals (Sweden)

    Ruya Ozelsancak

    2016-02-01

    Full Text Available Acute renal failure can cause neurologic manifestations such as mood swings, impaired concentration, tremor, stupor, coma, asterixis, dysarthria. Those findings can also be a sign of cerebral infarct. Here, we report a case of watershed cerebral infarction in a 70-year-old female patient with acute renal failure secondary to contrast administration and use of angiotensin converting enzyme inhibitor. Patient was evaluated with magnetic resonance imaging because of dysarthria. Magnetic resonance imaging revealed milimmetric acute ischemic lesion in the frontal and parietal deep white matter region of both cerebral hemisphere which clearly demonstrated watershed cerebral infarction affecting internal border zone. Her renal function returned to normal levels on fifth day of admission (BUN 32 mg/dl, creatinine 1.36 mg/dl and she was discharged. Dysarthria continued for 20 days.

  8. Cerebral malformations without antenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine J. [Diagnostic Neuroradiology, Hopital Timone, Marseille (France)

    2010-06-15

    Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms), or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital hemiparesis, epilepsy and mental or psychomotor retardation. MRI is the imaging method of choice to assess cerebral malformations. (orig.)

  9. Microsurgery Simulator of Cerebral Aneurysm Clipping with Interactive Cerebral Deformation Featuring a Virtual Arachnoid.

    Science.gov (United States)

    Shono, Naoyuki; Kin, Taichi; Nomura, Seiji; Miyawaki, Satoru; Saito, Toki; Imai, Hideaki; Nakatomi, Hirofumi; Oyama, Hiroshi; Saito, Nobuhito

    2018-05-01

    A virtual reality simulator for aneurysmal clipping surgery is an attractive research target for neurosurgeons. Brain deformation is one of the most important functionalities necessary for an accurate clipping simulator and is vastly affected by the status of the supporting tissue, such as the arachnoid membrane. However, no virtual reality simulator implementing the supporting tissue of the brain has yet been developed. To develop a virtual reality clipping simulator possessing interactive brain deforming capability closely dependent on arachnoid dissection and apply it to clinical cases. Three-dimensional computer graphics models of cerebral tissue and surrounding structures were extracted from medical images. We developed a new method for modifiable cerebral tissue complex deformation by incorporating a nonmedical image-derived virtual arachnoid/trabecula in a process called multitissue integrated interactive deformation (MTIID). MTIID made it possible for cerebral tissue complexes to selectively deform at the site of dissection. Simulations for 8 cases of actual clipping surgery were performed before surgery and evaluated for their usefulness in surgical approach planning. Preoperatively, each operative field was precisely reproduced and visualized with the virtual brain retraction defined by users. The clear visualization of the optimal approach to treating the aneurysm via an appropriate arachnoid incision was possible with MTIID. A virtual clipping simulator mainly focusing on supporting tissues and less on physical properties seemed to be useful in the surgical simulation of cerebral aneurysm clipping. To our knowledge, this article is the first to report brain deformation based on supporting tissues.

  10. Molecular pathophysiology of cerebral edema

    Science.gov (United States)

    Gerzanich, Volodymyr; Simard, J Marc

    2015-01-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema. PMID:26661240

  11. Cerebral vasculitis and lateral rectus palsy - two rare central nervous system complications of dengue fever: two case reports and review of the literature.

    Science.gov (United States)

    Herath, H M M; Hewavithana, J S; De Silva, C M; Kularathna, O A R; Weerasinghe, N P

    2018-04-19

    Dengue fever is a common mosquito-borne viral illness with a clinical spectrum ranging from a simple febrile illness to potentially life-threatening complications such as dengue hemorrhagic fever and dengue shock syndrome. Dengue infection can affect many organs, including the central nervous system. The neurological manifestations reported in dengue infections are meningitis, encephalitis, stroke, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. We report the cases of two interesting patients with confirmed dengue infection who presented with complications of possible central nervous system vasculitis and cranial nerve palsy. The first patient was a 53-year-old previously healthy Singhalese woman who developed acute-onset slurring of speech and ataxia with altered sensorium 1 day after recovery from a critical period of dengue hemorrhagic fever. Subsequent investigations revealed evidence of encephalopathy with brainstem ischemic infarctions. Her clinical picture was compatible with central nervous system vasculitis. She was treated successfully with intravenous steroids and had a full functional recovery. The second patient was a middle-aged Singhalese woman who had otherwise uncomplicated dengue infection. She developed binocular diplopia on day 4 of fever. An ocular examination revealed a convergent squint in the left eye with lateral rectus palsy but no other neurological manifestation. Central nervous system vasculitis due to dengue infection is a very rare phenomenon, and to the best of our knowledge, only one case of central nervous system vasculitis has been reported to date, in a patient of pediatric age. Cranial nerve palsy related to dengue infection is also rare, and only a few cases of isolated abducens nerve palsy have been reported to date. The two cases described in this report illustrate the rare but important central nervous system manifestations of dengue fever and support the fact that the central nervous system is one of the

  12. The result of surgical treatment in patients with cerebral aneurysms in Maharaj Nakorn Chiang Mai Hospital: a report of 225 cases.

    Science.gov (United States)

    Watcharasaksilp, Wanarak; Limpastan, Kriengsak; Norasathada, Tanya; Vaniyapong, Tanat

    2013-07-01

    Evaluate the result of intracranial aneurysm surgery in Maharaj Nakorn Chiang Mai Hospital. A retrospective study ofpatients who underwent surgery for intracranial aneurysms between 2003 and 2007. The patients'age, gender, signs and symptoms, CT brain findings, Subarachnoid hemorrhage (SAH), World Federation of Neurosurgical Society grading (WFNS), and aneurysm location were studied and correlated with outcome after surgery. Two hundred twenty five patients ofintracranial aneurysm were operated on between 2003 and 2007. Two hundred nine patients (92%) had anterior circulation aneurysms and 18 (8%) had posterior circulation aneurysms. The outcome, as evaluated by Glasgow Outcome Scale (GOS), showed good recovery and moderate disability patients (142, 62.9%) were classified as favorable outcome group whereas patients with severe disability, vegetative state, and dead (83, 36.9%) were classified as unfavorable outcome. According to WFNS grading, the patients with unruptured aneurysm and WFNS grade 1-2 had favorable outcome in 116 patients (78.37%) and unfavorable outcome in 32 patients (21.62%). Whereas the patients with WFNS grade 3-5 had favorable outcome in 32 patients (33.76%) and unfavorable outcome in 51 patients (66.23%). This study of 225 cases revealed 142 cases with favorable outcome and 83 cases with unfavorable outcome. Factors that affected the outcome were WFNS grading and age.

  13. A study on regional cerebral circulation in stroke patients with aphasia

    International Nuclear Information System (INIS)

    Kudo, Ryozo

    1985-01-01

    To study the pathophysiology of aphasia due to cerebral stroke, regional cerebral blood flow (rCBF) was measured by the 133 Xe clearance method and the volume of low density area (LDA) was estimated on the basis of computerized tomography in 43 thrombotic (24 aphasia and 19 non-aphasia), 30 hemorrhagic (16 aphasia and 14 non-aphasia) and 6 non-stroke cases. 1) In the healthy hemisphere, rCBF showed no significant difference between aphasia and non-aphasia in both thrombotic and hemorrhagic cases. In the affected hemisphere, thrombotic cases showed significantly decreased rCBF in aphasic cases as compared to non-aphasic, however, hemorrhagic cases revealed no difference. 2) LDA volume showed no significant difference between aphasia and non-aphasia in cerebral thrombosis, however, LDA volume in non-aphasia was smaller than that in aphasia in cerebral hemorrage. 3) Significant differences in the pathophysiology of aphasia due to cerebral stroke were recognized between cerebral thrombosis and cerebral hemorrhage. Such differences should be taken into consideration in the management and treatment of aphasia caused by cerebral stroke. (author)

  14. Computed tomographic findings of cerebral arterial ectasia

    International Nuclear Information System (INIS)

    Choi, Woo Suk; Ko, Young Ho; Lim, Jae Hoon

    1987-01-01

    The computed tomographic findings of cerebral arterial ectasia in 8 patients, of which 5 cases were angiographically documented, are reported. The ecstatic arteries, located predominantly in the suprasellar and interpeduncular cisterns, appeared as serpignous, tubular structures on the unenhanced scan. The enhanced CT scan demonstrated dense, sharply defined, homogeneous intraluminal enhancement. Until recently, the diagnosis of cerebral arterial ectasia was usually established by angiography. With introduction of CT it has become possible to noninvasively identify and characterize this vascular disorder and its associated intracranial complications. The vertebrobasilar dolichoectasia may be diagnosed by CT as an extra-axial lesion in the cerebellopontine angle. It enhances in a tubular fashion after intravenous injection of contrast.

  15. Cerebral hyperperfusion syndrome after carotid angioplasty

    International Nuclear Information System (INIS)

    Milosevic, Z.; Surlan, M.; Zvan, B.; Zaletel, M.

    2002-01-01

    Background. Cerebral hyperperfusion syndrome after carotid endarterectomy is an uncommon but well-defined entity. There are only few reports of ''hyperperfusion injury'' following carotid angioplasty. Case report. We report an unstable arterial hypertension and high-grade carotid stenosis in a 58-year-old, right-handed woman. After a stroke in the territory of middle cerebral artery carotid angioplasty was performed in the patient. Among risk factors, the long lasting arterial hypertension was the most pronounced. Immediately after the procedure, the patient was stable without any additional neurologic deficit. The second day, the patient had an epileptic seizure and CT revealed a small haemorrhage in the left frontal lobe. Conclusions. The combination of a high-grade carotid stenosis and unstable arterial pressure is probably an important prognostic factor in the pathogenesis of hyperperfusion syndrome. (author)

  16. Relation of plasma homocyst(e)ine to cerebral infarction and cerebral atherosclerosis.

    Science.gov (United States)

    Yoo, J H; Chung, C S; Kang, S S

    1998-12-01

    A number of investigations support the theory that the elevated plasma homocyst(e)ine is associated with occlusive vascular disease. The aim of this study is to examine whether moderate hyperhomocyst(e)inemia is an independent risk factor for cerebral infarction. In addition, we examined the association between plasma homocyst(e)ine and the severity of cerebral atherosclerosis. We conducted a hospital-based case-control study with 140 male controls and 78 male patients with nonfatal cerebral infarction, aged between 39 and 82 years. Plasma homocyst(e)ine levels were analyzed in 218 subjects. Fifty-five patients were evaluated for cerebral vascular stenosis by MR angiography. The mean plasma level of homocyst(e)ine was higher in cases than in controls (11.8+/-5.6 versus 9.6+/-4.1 micromol/L; P=0.002). The proportion of subjects with moderate hyperhomocyst(e)inemia was significantly higher in cases than in controls (16.7% versus 5.0%; P=0.004). Based on the logistic regression model, the odds ratio of the highest 5% of homocyst(e)ine levels in control group was 4.17 (95% confidence interval, 3.71 to 4. 71)(P=0.0001). After additional adjustment for total cholesterol, hypertension, smoking, diabetes, and age, the odds ratio was 1.70 (95% confidence interval, 1.48 to 1.95) (P=0.0001). The plasma homocyst(e)ine levels of patients having vessels with 3 or 2 stenosed sites were significantly higher than those of patients having vessels with 1 stenosed site or normal vessels (14.6+/-1.4, 11.0+/-1.4 versus 7.8+/-1.5, 8.9+/-1.4 micromol/L respectively; P<0. 02). Multiple logistic regression analysis revealed that moderate hyperhomocyst(e)ienemia was significantly associated with the number of stenosed vessels (P=0.001). These findings suggest that moderate hyperhomocyst(e)inemia is an independent risk factor for cerebral infarction and may predict the severity of cerebral atherosclerosis in patients with cerebral infarction.

  17. Abordagem anestésica de grávida com malformação arteriovenosa cerebral e hemorragia subaracnoidea durante a gravidez: relato de caso Abordaje anestésico de embarazada con malformación arteriovenosa cerebral y hemorragia subaracnoidea durante el embarazo: relato de caso Anesthetic approach of pregnant woman with cerebral arteriovenous malformation and subarachnoid hemorrhage during pregnancy: case report

    Directory of Open Access Journals (Sweden)

    Catarina Santos Carvalho

    2013-04-01

    de 39 semanas, sana antes del embarazo, con antecedentes de HSA a las 22 semanas de gestación que se manifestó por medio de cefaleas, vómitos y mareos, sin la pérdida de la consciencia u otros déficits a la hora de su entrada en el servicio de urgencia. La resonancia magnética (RM arrojó MAV frontal izquierda. Después de un breve período de ingreso para la estabilización y el diagnóstico, se decidió mantener el embarazo y el acompañamiento ambulatorio multidisciplinario por neurocirugía y obstetricia en consulta de alto riesgo. Se optó por realizar la cesárea electiva a las 39 semanas bajo anestesia epidural lumbar. En el intraoperatorio ocurrió un episodio de hipotensión que fue rápidamente revertido con fenilefrina. El Índice de Apgar del recién nacido fue de 10/10. El catéter epidural fue usado para la analgesia postoperatoria, que también cursó sin intercurrencias. CONCLUSIONES: Son muy raros los casos publicados de abordaje anestésico de embarazadas con MAV sintomáticas. Todas las decisiones tomadas por el equipo multidisciplinario, desde optar por continuar con el embarazo, hasta el momento ideal para intervenir la MAV, pasando por el tipo de anestesia y analgesia, fueron sopesadas en función del riesgo de daño cerebral. Desde el punto de vista anestésico, los autores enfatizan la necesidad de estabilidad hemodinámica.BACKGROUND AND OBJECTIVES: Subarachnoid hemorrhage (SAH during pregnancy is a rare event, and about half the cases are due to arteriovenous malformations (AVM. The authors describe the anesthetic approach of a 39 week pregnant patient scheduled for cesarean section, with a history of SAH due to AVM at 22 week gestation. CASE REPORT: 39 week pregnant patient, healthy prior to pregnancy, with a history of SAH at 22 week gestation, manifested by headache, vomiting, and dizziness without loss of consciousness or other deficits on admission to the emergency room. Magnetic resonance imaging (MRI revealed a left frontal AVM

  18. Cerebral Amyloid Angiopathy

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    Mahmut Edip Gürol

    2009-03-01

    Full Text Available Cerebral amyloid angiopathy (CAA is characterized by the accumulation of amyloid beta-peptides (Ab in the walls of leptomeningeal arteries, arterioles, and veins. Despite the fact that these pathological changes were first described in 1909, major advancement in our understanding of the clinicoradiological manifestations, neurobiology, and course of CAA has occurred only during the last 30 years. No significant associations have been shown between CAA and other systemic/visceral amyloidoses or vascular risk factors, including hypertension. CAA is well known as the most common cause of spontaneous and anticoagulant-related lobar parenchymal ICH in the elderly. It also causes lobar cerebral microbleeds (CMBs, small dot-like dark susceptibility artifacts visible with gradient recalled echo (GRE-magnetic resonance imaging (MRI. CMBs are important markers of disease severity and predictors of CAA progression. Amyloid angiopathy is also a common cause of ischemic microvascular white matter disease (WMD and deep cerebral infarctions. Such WMD is defined as subcortical and periventricular white matter changes without obvious infarction, as well as a dark appearance on computerized tomography (CT and a bright appearance on fluid attenuated inversion recovery (FLAIR-MRI. CAA-related vascular dysfunction, with its hemorrhagic and ischemic complications, is a recognized contributor to vascular cognitive impairment in the elderly, an independent effect that is synergistically increased by Alzheimer pathologies, such as plaques and tangles. A set of clinicoradiological criteria was established for the accurate diagnosis of CAA. According to the Boston Criteria, patients aged 55 years and older with multiple hemorrhages (on CT or GRE-MRI restricted to the lobar, cortical, or corticosubcortical regions (cerebellar hemorrhage allowed are diagnosed as probable CAA when no other etiology is found; a single hemorrhage in the same region is classified as possible

  19. Cerebral circulation and prognosis of the patients with hypoxic encephalopathy

    International Nuclear Information System (INIS)

    Nogami, Kenichiro; Fujii, Masami; Kashiwagi, Shiro; Sadamitsu Daikai; Maekawa, Tsuyoshi

    2000-01-01

    Recent progress in cardiopulmonary resuscitation techniques improved the survival rate of patients with acute cardiopulmonary disturbances. However, severe cerebral complications remained frequently in patients who survived the acute stage. Early prediction of cerebral prognosis is important to optimize the management of these patients. We examined the relations between radiological findings (Xe-CT and MRI) and cerebral prognosis. Patients included in this study were selected from all patients with hypoxic encephalopathy admitted to our hospital. There were 11 men and 10 women. Causes of hypoxic encephalopathy were heart disease (11 cases), suffocation (4 cases), CO intoxication (2 cases), asthma (1 case), pneumothorax (1 case), anaphyraxy shock (1 case) and electric shock (1 case). Xe-CT and MRI were carried out 3 weeks after the onset. Cerebral blood flow (CBF) of the patients was measured at rest and 15 minutes after intravenous administration of acetazolamide (1 g). The prognosis was evaluated 3 months after the onset in accordance with Glasgow Outcome Scale (GOS). Low hemispheric CBF (30 ml/100 g/min), poor reactivity of acetazolamide challenge test (10 ml/100 g/min), presence of hyperintensity areas in the basal ganglia in T1 weighted images (T1WI) and T2 weighted images (T2WI) are the factors associated with poor outcome in hypoxic encephalopathy. (author)

  20. Interfaces para control cerebral

    OpenAIRE

    Spinelli, Enrique Mario

    2000-01-01

    La función de una interfaz para control cerebral basada en señales de electroencefalograma (EEG), en forma general denominada BCI (Brain control Interface), es establecer un enlace directo entre el cerebro y una máquina, sin utilizar acciones motoras directas. Una BCI permite realizar operaciones simples a partir de la interpretación de las señales de EEG. Su desarrollo está principalmente orientado hacia la ayuda a personas con discapacidades motoras severas, que poseen deterioros en el sist...