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Sample records for cerebral lesions shown

  1. Neonatal seizures associated with cerebral lesions shown by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Leth, H; Toft, P.B.; Herning, Gudrun Margrethe;

    1997-01-01

    AIM: To determine the diagnostic potential of magnetic resonance imaging (MRI) in neonatal seizures; to elucidate the aetiology, timing, and prognosis of the cerebral lesions detected. METHODS: Thirty one term neonates with clinical seizures underwent ultrasonography between days 1-7 (mean 2.5 days......) and a high field spin-echo MRI scan on days 1-30 (mean 8.1 days), both of which were repeated at 3 months of age. Routine investigation excluded, as far as possible, infection, haematological, and metabolic-toxic causes as causes of the neonatal seizures. RESULTS: Brain abnormality was demonstrated by MRI...... in 68% of infants and ultrasonographically in 10%. Diffuse brain lesions (present in 29%) were associated with high mortality (58%) and morbidity (42%), whatever the aetiology. In contrast to a better short term prognosis for neonates with focal lesions where no infants died, 33% had a handicap...

  2. Cerebral CT of ischaemic lesions

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    Aulich, A.

    1981-11-25

    The diagnosis of stroke must first be established by clinical examination. CT has proved useful for confirmation of the diagnosis and provides a global intracranial picture of morphological changes in cerebral vascular diseases. A hemorrhage can be recognized with certainty at the first CT examination as the cause of the stroke, but in the detection of a lesion due to ischemia an important role is played by the correct choice of the time of examination, and in some cases also of the check-up with contrast medium. The differential diagnosis between infarct in the acute stage and encephalitis or gliomas of low-grade malignity can be difficult. A decision can often only be made after a series of examinations. Postmalacial conditions are often difficult to differentiate from defects due to other causes, such as hemorrhage, head injury, postoperative states and after encephalitis. A knowledge of the anamnesis and the clinical findings is indispensable for CT evaluation. In assessing the prognosis before vascular surgery on the extracranial brain-supplying vessels the performance of a CT examination should be advised. A warning is given against the use of CT as a screening method.

  3. [Ischaemic lesions of cerebral after carotid stenting].

    Science.gov (United States)

    Medvedev, R B; Tanashian, M M; Kuntsevich, G I; Lagoda, O V; Skrylev, S I; Krotenkova, M V; Koshcheev, A Iu; Suslin, A S; Gemdzhian, É G

    2015-01-01

    Carotid angioplasty with stenting is a reliable method of primary and secondary prevention of ischaemic stroke in patients with stenosing lesions of the internal carotid artery. However, carrying out such operations is sometimes associated with risk for the development of intraoperative impairments of cerebral circulation due to arterioarterial embolism in cerebral arteries, as well as vasospasm. Presented herein are the results of following up a total of 64 patients with pronounced atherosclerotic lesions of internal carotid arteries (>70%) - "symptomatic" and "asymptomatic", undergoing carotid stenting. Acute foci of ischaemia in the brain after stenting according to the findings of diffusion-weighted magnetic resonance tomography were revealed in 40% of cases, and in only 6% of patients they manifested themselves by symptoms of acute cerebral circulatory impairment. We revealed a direct correlation between the number, size of infarctions in the brain, and the appearance of neurological symptomatology. Intraoperative monitoring of blood flow in the middle cerebral artery during stenting makes it possible to predict the appearance of acute foci of cerebral ischaemia, to specify the genesis of perioperative stroke, as well as to evaluate clinical significance of vasospasm and material microembolism. The obtained findings should concentrate neurologists' attention on active postoperative follow up of patients subjected to carotid angioplasty with stenting in order to perform adequate personified neuroprotective correction, including preventive one.

  4. Hyperdense lesions in CT of cerebral toxoplasmosis. Lesiones hiperdensas en TC en la toxoplamosis cerebral

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    Quiones 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[sub 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.

  5. Increased cerebral blood flow in MELAS shown by Tc-99m HMPAO brain SPECT

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    Peng, N.J.; Tsay, D.G. [Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung (Taiwan); Liu, R.S. [Department of Nuclear Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Taipei (Taiwan); Li, J.Y.; Kong, K.W. [Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung (Taiwan); Kwok, C.G.; Strauss, H.W. [Division of Nuclear Medicine, Department of Radiology, Stanford University Medical Center, CA (United States)

    2000-01-01

    We report cerebral SPECT studies on two siblings with the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). Tc-99m HMPAO brain SPECT was performed 8, 19 and 30 days after a stroke-like episode in one case and 10 days after a stroke-like episode, 6 h after a partial seizure and as a follow-up study in the other. Increased blood flow was seen in both these patients with stroke-like episodes due to MELAS. The cause of the increased blood flow is uncertain, but it may be related to the decreased pH created by local increase in lactic acid. (orig.)

  6. Effect of acupuncture therapy for postponing Wallerian degeneration of cerebral infarction as shown by diffusion tensor imaging.

    Science.gov (United States)

    Shen, Yunxia; Li, Ming; Wei, Ruipeng; Lou, Mingwu

    2012-12-01

    One aim of this study was to investigate the effects of acupuncture on cerebral function of patients with acute cerebral infarction. Another goal was to evaluate the relationship between acupuncture treatment and motor recovery patients with stroke and to provide a foundation for using acupuncture therapy for such patients. Twenty (20) patients with recent cerebral infarction were divided randomly to an acupuncture group and a control group. The infarction area in each patient was in the basal ganglia or included the basal ganglia with an area size of > 1 cm(2). Serial diffusion tensor imaging (DTI), fluid-attenuated inversion recovery (FLAIR), and T2-weighted imaging (T(2)WI) scans were performed on all patients and the results were evaluated using the National Institute of Health Stroke Scale and the Barthel Index each week. DTI images were postprocessed and analyzed. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of abnormal signals on DTI in the infarction areas and cerebral peduncles were calculated for both groups and compared with one another. (1) The ADC value of infarction lesions decreased at stroke onset; then, a significant elevation was observed after the acute stage, and a significant reduction in FA values was observed from stroke onset to the chronic stage. (2) The ADC of the bilateral cerebral peduncle was reduced on the infarction side. (3) There was a significant difference in ADC and FA values between the acupuncture and control groups. The FA value was higher in the acupuncture group than the control group. ADC and FA values might correlate to patient recovery and reveal the progress of secondary degeneration. Acupuncture treatment is effective for protecting neurons and facilitating recovery.

  7. Analysis with magnetic resonance imaging of lesions in cerebral achromatopsia

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    Tanaka, Yuichiro; Kitahara, Kenji; Kumegawa, Koichi [Jikei Univ., Tokyo (Japan). School of Medicine; Nakadomari, Satoshi [Kanagawa Rihabilitation Hospital, Atsugi (Japan); Umahara, Takahiko [Tokyo Medical Coll. (Japan)

    2002-03-01

    The purpose of this study was to localize the lesions associated with cerebral achromatopsia. We examined 20 patients with homonymous hemianopsia caused by cerebral infarction (17 men and 3 women aged 49 to 81 years; mean age, 65.1 years). Ishihara plates, standard pseudoiso-chromatic plates (part 2) and the panel D-15 test were used to examine color perception. Color matching tasks and color naming tasks were used to test color recognition. We tried to apply functional magnetic resonance imaging (fMRI) to lesion analysis in the brain. Cerebral achromatopsia was diagnosed in four patients. The analysis showed that lesions in the infracalcarine area (Brodmann's area 18 and 19) were associated with cerebral achromatopsia. Additionally, the lesions associated with failure of the panel D-15 (PD-15) test were located more anterior than the lesions associated with failure of Ishihara plates. We show evidence that lesions in the anterio-ventral temporo-occipital area are associated with cerebral achromatopsia. This result is in accord with past observations (autopsy, fMRI and positron emission tomography). (author)

  8. Praxial disorders in focal lesions of cerebral hemispheres

    Directory of Open Access Journals (Sweden)

    Jorge Murillo Duran

    2007-11-01

    Full Text Available The purpose of this work is to analyze paraxial difficulties i.e, functional disorders in movementresulting from cerebral tissue lesions. In accordance with the literature on the subject, the following definition, the following definition of apraxia has been accepted: “Apraxia is inability in properly executing kinetic tasks without impairment or loss of motor or sensory functions or ataxia with would condition such inability”. “Proper execution” used in this definition concerns not only the effect of the action but also means of its realization. “Kinetic tasks” signify all aspects of motor activity defined by instructions, irrespective of the type of instruction (verbal or gestures, and regardless of whether it required −in the final effect− imitating the movement of the investigator or whether they were performed independently. The methodology has been based in the principle on Luria’s works.Deliberations on praxial disorders were based on investigation results embracing 90 patients with focal cerebral lesions. In fifty cases, changes were localized in the left cerebral hemisphere, in forty cases−in the right hemisphere. The summing up the results concerning a global comparison between cerebral hemispheres, indicate the following regularities: Results achieved made it possible to form the opinion that not all of the generally accepted tests investigating praxia in persons with cerebral lesions are solved faultlessly by healthy individuals; thus, a faulty execution should not always be regarded as a sign of pathological functioning of the cerebral tissue as a result of lesion.

  9. Focal cerebral lesions and painting abilities.

    Science.gov (United States)

    Mazzucchi, Anna; Sinforiani, Elena; Boller, François

    2013-01-01

    Focal lesions such as strokes significantly affect painting production in the vast majority of artists. In particular, painters, when they resume painting, show changes in their painting style. In exceptional cases, there may be an apparent improvement in style, but in most cases, the changes represent nothing short of deterioration. This, however, varies according to the hemisphere affected. Painters with left-hemisphere lesions tend to show an inability to deal adequately with perspective and also tend to use simplified colors with fewer nuances. One often witnesses an evolution toward simpler, often "naïve" techniques, and at times rigid geometric repetitive features. Painters with right-hemisphere lesions also become unable to represent tridimensionality. In addition, their figures are often drawn in very summary fashion, with lack of coordination between volumes and space and a chromatic impoverishment; their main problem, however, is visuospatial, leading to neglect of the left side of the canvas.

  10. Brain Lesions in Children with Unilateral Spastic Cerebral Palsy.

    Science.gov (United States)

    Hadzagic-Catibusic, Feriha; Avdagic, Edin; Zubcevic, Smail; Uzicanin, Sajra

    2017-02-01

    Unilateral spastic cerebral palsy (US CP) is the second most common subtype of cerebral palsy. The aim of the study was to analyze neuroimaging findings in children with unilateral spastic cerebral palsy. The study was hospital based, which has included 106 patients with US CP (boys 72/girls 34, term 82/preterm 24). Neuroimaging findings were classified into 5 groups: Brain maldevelopment, predominant white matter injury, predominant gray matter injury, non specific findings and normal neuroimaging findings. Predominant white matter lesions where the most frequent (48/106,45.28%; term 35/preterm 13), without statistically significant difference between term and preterm born children (x2=0.4357; p=0.490517). Predominant gray matter lesions had 32/106 children, 30.19%; (term 25/preterm 7, without statistically significant difference between term and preterm born children (x2=0.902; p=0.9862). Brain malformations had 10/106 children, 9.43%, and all of them were term born. Other finding had 2/106 children, 1.89%, both of them were term born. Normal neuroimaging findings were present in14/106 patients (13.21%). Neuroimaging may help to understand morphological background of motor impairment in children with US CP. Periventricular white matter lesions were the most frequent, then gray matter lesions.

  11. Single photon emission computed tomography/computed tomography for malignant otitis externa: lesion not shown on planar image.

    Science.gov (United States)

    Chen, Yu-Hung; Hsieh, Hung-Jen

    2013-01-01

    Malignant otitis externa is a severe and rare infection of the external acoustic meatus. Triphasic bone and (67)Ga scintigraphies are used to initial detect and follow-up the response of therapy. With single photon emission computed tomography/computed tomography images, the diagnostic sensitivity is higher. We presented a case with malignant otitis externa with initial negative planar scintigraphic finding. The lesion was detected by photon emission computed tomography/computed tomography images. We concluded that the photon emission computed tomography/computed tomography should be performed routinely for patients with suspected malignant otitis externa, even without evidence of lesion on planar images.

  12. Paradoxical embolisation and cerebral white matter lesions in dementia.

    NARCIS (Netherlands)

    Purandare, N.; Oude Voshaar, R.C.; McCollum, C.; Jackson, A.; Burns, A.

    2008-01-01

    The study aimed to examine the relationship between spontaneous cerebral emboli (SCE), patent foramen ovale (PFO) and white matter hyperintensities (WMH) on cerebral MRI in patients with Alzheimer's disease (AD) and vascular dementia (VaD). SCE were identified by transcranial Doppler of the middle c

  13. Determinants of cerebral white matter lesions: A longitudinal population based MRI study

    NARCIS (Netherlands)

    H.F. de Leeuw (Frank)

    1999-01-01

    textabstractW hite matter lesions are frequently found on cerebral magnetic resonance imaging scans of elderly non-demented and demented people. l-4 The pathogenesis of white matter lesions is largely unknown. However age and high diastolic and systolic blood pressure levels and indicators of

  14. Can radiological characteristics of preoperative cerebral lesions predict postoperative intracranial haemorrhage in endocarditis patients?

    Science.gov (United States)

    Diab, Mahmoud; Guenther, Albrecht; Scheffel, Philipp; Sponholz, Christoph; Lehmann, Thomas; Hedderich, Johannes; Faerber, Gloria; Brunkhorst, Frank; Pletz, Mathias W; Doenst, Torsten

    2016-05-01

    Infective endocarditis (IE) is associated with high mortality (20-40%) and neurological complications (20-50%). Postoperative intracranial haemorrhage (ICH) is a feared complication especially in patients with preoperative cerebral infarcts. The aim of this study was to determine the radiological characteristics of cerebral lesions that could predict the occurrence of postoperative ICH in IE patients. We retrospectively reviewed all charts, brain imaging and follow-up data from patients operated for left-sided endocarditis between January 2007 and April 2013. A total of 308 patients (age 62.0 ± 13.9) underwent surgery for IE. Preoperative cerebrovascular complications were present in 122 patients (39.6%), representing stroke in 87, silent cerebral infarctions in 31 patients and transient ischaemic attacks in 4 patients. Among 118 patients with cerebral lesions, the aetiological classification of the lesions was ischaemic in 63.6%, ischaemic with haemorrhagic transformation (HT) in 17.8%, ischaemic with concomitant microbleeds in 16.1% and intracerebral bleeding in 2.5%. Postoperative ICH occurred in 17 patients and its incidence was slightly higher in patients with preoperative cerebral infarcts compared with those without preoperative cerebral infarcts [7.6 vs 4.2%, respectively, odds ratio (OR) 1.88, 95% confidence interval (CI) 0.70-5.02, P = 0.21]. However, the difference was not statistically significant. Similarly, the incidence of postoperative ICH was higher in cases of HT of ischaemic infarcts than in cases of ischaemic infarcts not complicated with HT (19.0 vs 5.3%). However, the difference was not statistically significant (P = 0.24). The radiological pattern of preoperative cerebral lesions was single in 35.6% and multiple in 60.0% of cases. Multiple cerebral lesions were associated with a non-significantly lower incidence of postoperative ICH than single lesions (5.6 vs 11.9%, respectively, OR: 0.44, CI: 0.11-1.73, P = 0.29). The results suggest that

  15. The impact of fMRI on multimodal navigation in surgery of cerebral lesions: four years clinical experience

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    Wurm, Gabriele [Landesnervenklinik Wagner Jauregg, Neurosurgical Department, Linz (Austria); Schnizer, Mathilde [Landesnervenklinik Wagner Jauregg, Neurological Department, Linz (Austria); Landesnervenklinik Wagner Jauregg, Neuroradiological Department, Linz (Austria); Fellner, Claudia [Landesnervenklinik Wagner Jauregg, Neuroradiological Department, Linz (Austria); University of Regensburg, Institute of Radiology, Regensburg (Germany)

    2008-09-15

    Neuronavigation with display of intraoperative structures, instrument locations, orientation and relationships to nearby structures can increase anatomic precision while enhancing the surgeon's confidence and his/her perception of safety. Combination of neuronavigation with functional imaging provides multimodal guidance for surgery of cerebral lesions. We evaluated the impact of functional MRI (fMRI) on surgical decision making and outcome. A neuronavigational device (StealthStation (tm), Medtronic Inc.) was used as platform to merge fMRI data with anatomic images, and to implement intraoperative multimodal guidance. In a 52-month period, where 977 surgical procedures were performed with the aid of neuronavigation, 88 patients underwent image-guided procedures using multimodal guidance. Patient, surgical and outcome data of this series was prospectively collected. Evaluation of 88 procedures on cerebral lesions in complex regions where fMRI data were integrated using the navigation system demonstrated that the additional information was presented in a user-friendly way. Computer assisted fMRI integration was found to be especially helpful in planning the best approach, in assessing alternative approaches, and in defining the extent of the surgical exposure. Furthermore, the surgeons found it more effective to interpret fMRI information when shown in a navigation system as compared to the traditional display on a light board or monitor. Multimodal navigation enhanced by fMRI was judged useful for optimization of surgery of cerebral lesions, especially in and around eloquent regions by experienced neurosurgeons. (orig.)

  16. Cerebral multicystic lesions in a child with neurofibromatosis

    OpenAIRE

    İsikay, Sedat; Yilmaz, Kutluhan

    2013-01-01

    Neurofibromatosis type 1 (NF-1) is an autosomal dominant neurocutaneous syndrome, with frequent involvement of the central nervous system (CNS). As well as abnormal cellular differentiation, disordered cell migration during development is the most common cause of the various brain lesions. Cystic lesions are rarely observed in neurocutaneous diseases, and the origin of the cysts is not known. This paper presents a rare case, a child at the age of 3, who was diagnosed as NF-1 and was observed ...

  17. Vascular risk factors, atherosclerosis, cerebral white matter lesions and cerebral perfusion in a population-based study

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    Claus, J.J. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Breteler, M.M.B. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Hasan, D. [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Krenning, E.P. [Dept. of Nuclear Medicine, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Bots, M.L. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Grobbee, D.E. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Swieten, J.C. van [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Harskamp, F. van [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Hofman, A. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands)

    1996-06-01

    We studied risk factors for cerebral vascular disease (blood pressure and hypertension, factor VIIc, factor VIIIc, fibrinogen), indicators of atherosclerosis (intima-media thickness and plaques in the carotid artery) and cerebral white matter lesions in relation to regional cerebral blood flow (rCBF) in 60 persons (aged 65-85 years) recruited from a population-based study. rCBF was assessed with single-photon emission tomography using technetium-99m d,l-hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO). Statistical analysis was performed with multiple linear regression with adjustment for age, sex and ventricle-to-brain ratio. A significant positive association was found between systolic and diastolic blood pressure and temporo-parietal rCBF. In analysis with quartiles of the distribution, we found a threshold effect for the relation of low diastolic blood pressure ({<=}60 mmHg) and low temporo-parietal rCBF. Levels of plasma fibrinogen were inversely related to parietal rCBF, with a threshold effect of high fibrinogen levels (>3.2 g/l) and low rCBF. Increased atherosclerosis was related to low rCBF in all cortical regions, but these associations were not significant. No consistent relation was observed between severity of cerebral white matter lesions and rCBF. Our results may have implications for blood pressure control in the elderly population. (orig.)

  18. A study of cerebral perfusion using single photon emission computed tomography in neonates with brain lesions

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    Haddad, J.; Contantinesco, A.; Brunot, B.; Messer, J. (Hospital Universitaire de Strasbourg (France))

    1994-03-01

    In this study the authors used a single photon emission computed tomography technique (SPECT) with radiolabelled [sup 99m]Tc HMPAO to assess cerebral perfusion in newborn infants with documented cerebral lesions and to determine to what extent brain SPECT might be useful in the neonatal period. A total of 15 newborn infants with the following cerebral pathologies were enrolled: severe parietal bilateral periventricular leucomalacia; moderate parietal bilateral PVL; intraventricular haemorrhage grade II with unilateral parietal parenchymal extension; cerebral infarction in the zone of middle cerebral artery; and post-haemorrhagic hydrocephalus. Follow-up was available in all infants. Alterations in cerebral perfusion were seen in only 12 of 15 infants and at the location of severe PVL, PE and CI. It was noted that the regions of diminished perfusion extended beyond the apparent extent of cerebral pathology delineated by ultrasound or magnetic resonance imaging. Markedly diminished perfusion was seen in one infant with hydrocephalus, which recovered following placement of ventriculo-peritoneal shunt. Regarding outcome, SPECT data failed to provide additional information than that of neuroradiological investigations. It is concluded that the use of SPECT, under these conditions, to assess alteration of cerebral perfusion in the neonatal period will not provide any additional information than that of neuroradiological investigations. 17 refs., 3 figs., 1 tab.

  19. Interaction between hypertension, apoE, and cerebral white matter lesions.

    NARCIS (Netherlands)

    Leeuw, H.F. de; Richard, F.; Groot, J.C. de; Duijn, C.M. van; Hofman, A.W.I.M.; Gijn, J. van; Breteler, M.M.B.

    2004-01-01

    BACKGROUND AND PURPOSE: Cerebral white matter lesions (WMLs) are frequently found on magnetic resonance imaging scans in both cognitively intact and demented elderly persons. Vascular risk factors, especially hypertension, are related to their presence. However, not every person with vascular risk

  20. Interaction between hypertension, apoE, and cerebral white matter lesions

    NARCIS (Netherlands)

    de Leeuw, FE; Richard, F; de Groot, JC; van Duijn, CM; Hofman, A; van Gijn, J; Breteler, MMB

    Background and Purpose - Cerebral white matter lesions (WMLs) are frequently found on magnetic resonance imaging scans in both cognitively intact and demented elderly persons. Vascular risk factors, especially hypertension, are related to their presence. However, not every person with vascular risk

  1. Behaviour after Cerebral Lesions in Children and Adults (1962)

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    Bishop, Dorothy

    2008-01-01

    It is generally believed that brain injuries vary in their effects according to the age at which they are sustained, but the nature and extent of these differences remain elusive. A full enquiry requires, ideally, the study of strictly comparable lesions in the young and the old, the opportunity for follow-up examinations extending over decades in…

  2. Experience of endovascular treatment of occlusion-stenotic lesions of cerebral arteries

    Directory of Open Access Journals (Sweden)

    Cherednichenko Yu.V.

    2016-03-01

    Full Text Available Objective — to evaluate the efficacy of endovascular techniques in the treatment of occlusion and stenotic lesions of the brachiocephalic and cerebral arteries, to define the ways of complications prevention. Materials and methods. 594 patients with occlusion and stenotic lesions of the brachiocephalic and cerebral arteries were operated by endovascular methods in endovascular center of Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov. 688 endovascular operations were carried out. Most part of the operations are carotid stenting (423 operations. All of these operations were carried out with the usage of different types of antiembolic protection systems: distal, proximal or their combination. Intracranial segments of cerebral arteries were operated in 43 cases. 169 operations of stenting of vertebral arteries in extracranial segments were performed. Subclavian arteries and brachiocephal truncus were operated in 53 cases. Results. Total removal of stenosis was achieved in 588 cases (98.99%. 509 patients (85.69% of cases had improvement in neurological status (on a scale NIHHS, Mrs., MoCA. 77 (12.96% patients had no deterioration of neurological status. Postoperative mortality was 1.01%. Common level of other complications was 4.3 %: cerebral complications - 2.7%. Discussion. The results of the endovascular treatment of occlusion and stenotic lesions of the cerebral arteries show high efficacy and low complication level. The ways of reduction complications level are identified. They are in a differentiated selection of antiembolic protection method, endovascular treatment planning, based on monitoring of changes in the brain hemoperfusion, the emphasis is on the use of the special neurologic deviсes. Conclusions. Endovascular treatment of occlusion and stenotic lesions of the cerebral arteries is effective with a small risk of complications. Risk can be reduced further by the differential choice of antiembolic protection

  3. Progesterone and nestorone promote myelin regeneration in chronic demyelinating lesions of corpus callosum and cerebral cortex.

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    El-Etr, Martine; Rame, Marion; Boucher, Celine; Ghoumari, Abdel M; Kumar, Narender; Liere, Philippe; Pianos, Antoine; Schumacher, Michael; Sitruk-Ware, Regine

    2015-01-01

    Multiple Sclerosis affects mainly women and consists in intermittent or chronic damages to the myelin sheaths, focal inflammation, and axonal degeneration. Current therapies are limited to immunomodulators and antiinflammatory drugs, but there is no efficient treatment for stimulating the endogenous capacity of myelin repair. Progesterone and synthetic progestins have been shown in animal models of demyelination to attenuate myelin loss, reduce clinical symptoms severity, modulate inflammatory responses and partially reverse the age-dependent decline in remyelination. Moreover, progesterone has been demonstrated to promote myelin formation in organotypic cultures of cerebellar slices. In the present study, we show that progesterone and the synthetic 19-nor-progesterone derivative Nestorone® promote the repair of severe chronic demyelinating lesions induced by feeding cuprizone to female mice for up to 12 weeks. Progesterone and Nestorone increase the density of NG2(+) oligodendrocyte progenitor cells and CA II(+) mature oligodendrocytes and enhance the formation of myelin basic protein (MBP)- and proteolipid protein (PLP)-immunoreactive myelin. However, while demyelination in response to cuprizone was less marked in corpus callosum than in cerebral cortex, remyelination appeared earlier in the former. The remyelinating effect of progesterone was progesterone receptor (PR)-dependent, as it was absent in PR-knockout mice. Progesterone and Nestorone also decreased (but did not suppress) neuroinflammatory responses, specifically astrocyte and microglial cell activation. Therefore, some progestogens are promising therapeutic candidates for promoting the regeneration of myelin.

  4. Relationship between brain lesion characteristics and communication in preschool children with cerebral palsy.

    Science.gov (United States)

    Coleman, Andrea; Fiori, Simona; Weir, Kelly A; Ware, Robert S; Boyd, Roslyn N

    2016-11-01

    MRI shows promise as a prognostic tool for clinical findings such as gross motor function in children with cerebral palsy(CP), however the relationship with communication skills requires exploration. To examine the relationship between the type and severity of brain lesion on MRI and communication skills in children with CP. 131 children with CP (73 males(56%)), mean corrected age(SD) 28(5) months, Gross Motor Functional Classification System distribution: I=57(44%), II=14(11%), III=19(14%), IV=17(13%), V=24(18%). Children were assessed on the Communication and Symbolic Behavioral Scales Developmental Profile (CSBS-DP) Infant-Toddler Checklist. Structural MRI was analysed with reference to type and semi-quantitative assessment of the severity of brain lesion. Children were classified for motor type, distribution and GMFCS. The relationships between type/severity of brain lesion and communication ability were analysed using multivariable tobit regression. Children with periventricular white matter lesions had better speech than children with cortical/deep grey matter lesions (β=-2.6, 95%CI=-5.0, -0.2, p=0.04). Brain lesion severity on the semi-quantitative scale was related to overall communication skills (β=-0.9, 95%CI=-1.4, -0.5, p1 SD below children with periventricular white matter lesions. Children with more severe brain lesions on MRI had poorer overall communication skills. Children with CP born at term had poorer communication than those born prematurely and were more likely to have cortical and deep grey matter lesions. Gross motor function better accounted for overall communication skills than the type of brain lesion or brain lesion severity. Copyright © 2016. Published by Elsevier Ltd.

  5. Neonatal cerebral lesions predict 2-year neurodevelopmental impairment in children treated with laser surgery for twin-twin transfusion syndrome.

    Science.gov (United States)

    Chmait, Ramen H; Chon, Andrew H; Schrager, Sheree M; Llanes, Arlyn; Hamilton, Anita H; Vanderbilt, Douglas L

    2017-09-06

    The objective of this study is to assess whether postnatally detected cerebral abnormalities are predictive of neurodevelopmental impairment (NDI) in survivors of twin-twin transfusion syndrome (TTTS) that underwent laser surgery. Ninety-nine children treated for TTTS had neurodevelopmental assessment at age 2-years (±6 weeks). 'High-risk survivors' had cerebral imaging in the neonatal period. 'High-risk survivors' were defined as (1) delivered at Battelle Developmental Inventory 2nd edition (BDI-2) score <70, cerebral palsy, blindness, and/or deafness. Multilevel logistic regression with robust standard errors was used to evaluate associations between cerebral lesions and NDI. Fifty-six children were 'high-risk survivors' and had neonatal cerebral imaging. Ten twins (18%) had at least one cerebral lesion, including grade 1-2 intraventricular hemorrhage (8), cystic periventricular leukomalacia (2), ventriculomegaly (1), and bilateral subependymal cyst (1). The risk of NDI in the 'high-risk survivors' was 7% (4/56) compared with 0% (0/43) in the remaining group. Among 'high-risk survivors', cerebral lesions were a significant risk factor for NDI (OR = 19.28, p < .001). Among 'high-risk survivors' of TTTS treated with laser surgery, cerebral lesions identified on neonatal imaging were associated with NDI at 2-years.

  6. Cerebral Alveolar Echinococcosis Concomitant with Liver and Lung Lesions in a Young Adult Patient: Case Report and Literature Review.

    Science.gov (United States)

    Batçık, Osman Ersegun; Öğrenci, Ahmet; Koban, Orkun; Ekşi, Murat Şakir; Bilge, Turgay

    2016-09-01

    We present the case of a 25-year-old male harboring multiple brain lesions mimicking tumor metastasis that were revealed to be caused by Echinococcus multilocularis. Cerebral echinococcosis with multiple lesions is rare and might be confused with a brain abscess, tuberculoma, or metastatic tumor disease. Brain magnetic resonance imaging and serological studies are helpful in the differential diagnosis. In case of E. multilocularis, cerebral invasion is the late stage of the disease that necessitates an aggressive treatment protocol.

  7. Impact of coexisting coronary artery disease on the occurrence of cerebral ischemic lesions after carotid stenting.

    Directory of Open Access Journals (Sweden)

    Kuo-Lun Huang

    Full Text Available BACKGROUND: Coronary artery disease (CAD may coexist with extracranial carotid artery stenosis (ECAS, but the influence of CAD on procedure-related complications after carotid artery stenting (CAS has not been well investigated. The study aimed to determine the impact of CAD on the occurrence of peri-CAS cerebral ischemic lesions on diffusion-weighted imaging (DWI scanning. METHODS: Coronary angiography was performed within six months before CAS. DWI scanning was repetitively done within 1 week before and after CAS. Clinical outcome measures were stroke, angina, myocardial infarction and death within 30 days. RESULTS: Among 126 patients (69.5±9.0 years recruited for unilateral protected CAS, 33 (26% patients had peri-CAS DWI-positive lesions. CAD was noted in 79% (26 in 33 and 48% (45 in 93 of patients with and without peri-CAS DWI-positive lesions (OR, 4.0; 95% CI, 1.6-10.0; P = .0018, and the number of concomitant CAD on coronary angiography was positively correlated with the risk for peri-CAS DWI-positive lesions (P = .0032. In patients with no CAD (n = 55, asymptomatic CAD (n = 41 and symptomatic CAD (n = 30, the occurrence rates of peri-CAS DWI-positive lesions were 13%, 41% and 30% (P = .0048, and the peri-CAS stroke rates were 2%, 7% and 0% (P = .2120. CONCLUSIONS: The severity of morphological CAD and the presence of either symptomatic or asymptomatic CAD are associated with the occurrence of peri-CAS cerebral ischemic lesions.

  8. Diffusion tensor imaging of early changes in corpus callosum after acute cerebral hemisphere lesions in newborns

    Energy Technology Data Exchange (ETDEWEB)

    Righini, Andrea; Doneda, Chiara; Parazzini, Cecilia; Arrigoni, Filippo; Triulzi, Fabio [Children' s Hospital V. Buzzi, ICP, Radiology and Neuroradiology Department, Milan (Italy); Matta, Ursula [University of Milan, Radiology Institute, Milan (Italy)

    2010-11-15

    The main purpose was to investigate any early diffusion tensor imaging (DTI) changes in corpus callosum (CC) associated with acute cerebral hemisphere lesions in term newborns. We retrospectively analysed 19 cases of term newborns acutely affected by focal or multi-focal lesions: hypoxic-ischemic encephalopathy, hypoglycaemic encephalopathy, focal ischemic stroke and deep medullary vein associated lesions. DTI was acquired at 1.5 Tesla with dedicated neonatal coil. DTI metrics (apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial {lambda} {sub parallel} and radial {lambda} diffusivity) were measured in the hemisphere lesions and in the CC. The control group included seven normal newborns. The following significant differences were found between patients and normal controls in the CC: mean ADC was lower in patients (0.88 SD 0.23 versus 1.18 SD 0.07 {mu}m{sup 2}/s) and so was mean FA (0.50 SD 0.1 versus 0.67 SD 0.05) and mean {lambda} {sub parallel} value (1.61 SD 0.52 versus 2.36 SD 0.14 {mu}m{sup 2}/s). In CC the percentage of ADC always diminished independently of lesion age (with one exception), whereas in hemisphere lesions, it was negative in earlier lesions, but exceeded normal values in the older lesions. CC may undergo early DTI changes in newborns with acute focal or multi-focal hemisphere lesions of different aetiology. Although a direct insult to CC cannot be totally ruled out, DTI changes in CC (in particular {lambda} {sub parallel}) may also be compatible with very early Wallerian degeneration or pre-Wallerian degeneration. (orig.)

  9. Cerebral Lesions at Fetal Magnetic Resonance Imaging and Neurologic Outcome After Single Fetal Death in Monochorionic Twins.

    Science.gov (United States)

    Jatzko, Birgit; Rittenschober-Böhm, Judith; Mailath-Pokorny, Mariella; Worda, Christof; Prayer, Daniela; Kasprian, Gregor; Worda, Katharina

    2015-10-01

    Single fetal death (sFD) in monochorionic twin pregnancies is associated with substantial morbidity and mortality in the survivor. The aim of our study was to evaluate the rate of cerebral lesions detected at fetal Magnetic Resonance Imaging (MRI) and to correlate the results with the neurologic outcome of the survivors of monochorionic twin pregnancies after sFD. Between 2005 and 2012, 11 monochorionic twin pregnancies with sFD and subsequent fetal MRI of the survivor were included. All neonates underwent neurologic assessment after birth and 56% of surviving infants underwent long-term neurologic assessment. MRI findings and neurologic outcome of the survivors were evaluated. Gestational age at sFD was 20.9 (±2.9) weeks; 55% (6/11) of survivors of monochorionic twin pregnancies after sFD showed cerebral lesions at fetal MRI; 72% (8/11) of all survivors had normal neonatal neurologic outcome: all survivors with normal fetal MRI and 50% of survivors with cerebral lesions at fetal MRI. Long-term neurologic assessment was normal in all tested patients with normal fetal MRI and in one of three tested patients with cerebral lesions at fetal MRI. Survivors of monochorionic twin pregnancies after sFD show a high rate of cerebral lesions at fetal MRI. The importance of cerebral lesions at fetal MRI in survivors after sFD in monochorionic twin pregnancies is uncertain. All tested survivors with normal fetal MRI showed normal neurologic outcome but only one of three survivors with cerebral lesions at fetal MRI showed normal long-term neurologic outcome.

  10. Cerebral lesions and event-related potential P300 using positron emission tomography (PET)

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Yasujiro; Okamoto, Kazuma; Tanaka, Makoto; Kondoh, Susumu; Hirai, Shunsaku (Gunma Univ., Maebashi (Japan). School of Medicine)

    1993-06-01

    To determine what lesions are involved in prolonging event-related potential P300 latency, regional cerebral blood flow (rCBF) and metabolism were investigated by positron emission tomography (PET) in a total of 40 patients with neurologic diseases (12 with chronic cerebrovascular disorder, 9 with spino-cerebellar degeneration, 4 with Alzheimer's type dementia, 4 with amyotrophic lateral sclerosis, and 11 with miscellaneous diseases). There was inverse correlation between rCBF and P300 latency in terms of any of the whole, left, and right hemispheres: P300 latency was associated with decreased rCBF. This was more noticeable in the cerebral cortex than white matter and in the right than left hemisphere, although there was no significant difference between them. In none of the regions, however, was there significant correlation between cerebral oxygen consumption and P300 latency. When the right and left frontal, temporal, parietal and occipital cortexes, thalamus, putamen, and caudatum were examined as regions of interest, there was significantly inverse correlation between rCBF and P300 latency in all regions except for the occipital cortex. This was more noticeable on the right than the left side, although no significant difference was observed. Cerebral oxygen consumption in these lesions did not correlate with P300 latency. In the study on bilateral rCBF difference, decreased rCBF confined to the right parietal lobe, bilateral thalamus and bilateral temporal lobes was found to be associated with a significantly prolonged P300 latency. Thus, rCBF in these regions seemed to be particularly responsible for P300 latency. (N.K.).

  11. CT and MRI findings of 144 patients with West syndrome. Characterization of the cerebral lesion and its topography

    Energy Technology Data Exchange (ETDEWEB)

    Hamano, Shin-ichiro; Tanaka, Manabu; Mochizuki, Mika; Sugiyama, Nobuyoshi; Nara, Takahiro; Oguma, Eiji [Saitama Children' s Medical Center, Iwatsuki (Japan); Eto, Yoshikatsu [Jikei Univ., Tokyo (Japan). School of Medicine

    2002-09-01

    In West syndrome, although classified as a generalized epilepsy, there are some patients reported to have became seizure-free and have good outcomes in the developmental aspect after resections of localized lesions. We reviewed computed tomography and magnetic resonance imaging of 144 patients with West syndrome and classified them into four categories depending on the distribution of lesion: normal group, diffuse group, disseminated group, localized group. Thirty-three patients belong to the normal group after having reviewed images from computed tomography and magnetic resonance imaging. The diffuse group consisted of 83 patients presenting morphologic abnormalities such as, diffuse cerebral atrophy, periventricular leukomalesia or polycystic encephalomalesia; the disseminated group included 17 patients having a diagnosis of tuberoius sclerosis, multiple cortical dysplasia or multiple cortical heterotopias. The lesions of all eleven patients with localized cerebral lesions involved the temporal and/or occipital lobes. Nine of the eleven patients with localized cerebral lesions had the lesions on the right side. These results suggest that the specificity of lesion topography of temporo-occipital regions and the right-side in West syndrome will have a close correlation with normal brain maturation, from the viewpoint of development of myelination and cerebral blood flow, and related with the genesis of West syndrome. (author)

  12. A case of spontaneous myocardial necrosis and cerebral ischemic lesions in a laboratory beagle dog.

    Science.gov (United States)

    Matsushita, Kohei; Kohara, Yukari; Ito, Yuko; Yoshikawa, Tsuyoshi; Sato, Makoto; Kitaura, Keisuke; Matsumoto, Satoshi

    2015-10-01

    A beagle dog treated with saline as a control animal in a preclinical study was euthanized due to sudden systemic deterioration. On histopathological examination, contraction band necrosis of myocardial cells was observed widely in the left ventricular wall, including the papillary muscle and apex, and observed slightly in the ventricular septum and left atrium. In the brain, necrosis was observed in neurons and glia of the cerebral cortex, hippocampal pyramidal cells, glial cells of the rostral commissure and Purkinje cells of the cerebellar vermis. It is highly probable that the marked systemic deterioration was caused by cardiac dysfunction due to the spontaneous contraction band necrosis of the myocardial cells, although the pathogenesis of the myocardial lesions remains unclear. Given the distribution of neuronal necrosis in the brain, it is likely that these lesions resulted from the ischemia responsible for acute cardiac failure.

  13. Blood Pressure Control in Aging Predicts Cerebral Atrophy Related to Small-Vessel White Matter Lesions

    Directory of Open Access Journals (Sweden)

    Kyle C. Kern

    2017-05-01

    Full Text Available Cerebral small-vessel damage manifests as white matter hyperintensities and cerebral atrophy on brain MRI and is associated with aging, cognitive decline and dementia. We sought to examine the interrelationship of these imaging biomarkers and the influence of hypertension in older individuals. We used a multivariate spatial covariance neuroimaging technique to localize the effects of white matter lesion load on regional gray matter volume and assessed the role of blood pressure control, age and education on this relationship. Using a case-control design matching for age, gender, and educational attainment we selected 64 participants with normal blood pressure, controlled hypertension or uncontrolled hypertension from the Northern Manhattan Study cohort. We applied gray matter voxel-based morphometry with the scaled subprofile model to (1 identify regional covariance patterns of gray matter volume differences associated with white matter lesion load, (2 compare this relationship across blood pressure groups, and (3 relate it to cognitive performance. In this group of participants aged 60–86 years, we identified a pattern of reduced gray matter volume associated with white matter lesion load in bilateral temporal-parietal regions with relative preservation of volume in the basal forebrain, thalami and cingulate cortex. This pattern was expressed most in the uncontrolled hypertension group and least in the normotensives, but was also more evident in older and more educated individuals. Expression of this pattern was associated with worse performance in executive function and memory. In summary, white matter lesions from small-vessel disease are associated with a regional pattern of gray matter atrophy that is mitigated by blood pressure control, exacerbated by aging, and associated with cognitive performance.

  14. Sex differences in spatial task performance of patients with and without unilateral cerebral lesions.

    Science.gov (United States)

    Lewis, R S; Kamptner, N L

    1987-04-01

    Two visuospatial tasks, the WAIS Block Design and the Street Gestalt Completion Test, were administered to men and women with and without unilateral cerebral lesions. These two tasks represent different categories of visuospatial functions. The Street test is a visual-perceptual gestalt task, requiring the closure of fragmented pictures, whereas Block Design is an analytical, manipulospatial task requiring rotation of spatial coordinates. For the non-brain-damaged group, the men showed a nonsignificant trend toward better Block Design performance relative to the women, whereas there was no sex-related difference in Street performance. For the brain-damaged groups, patients with right hemisphere lesions performed significantly worse than patients with left hemisphere lesions on both the Street test and Block Design, indicating that both tasks were more sensitive to right hemisphere functioning. There was, however, a significant sex X side of lesion interaction on Block Design only, with the men showing a more asymmetrical pattern of scores. These results suggest that sex differences in functional lateralization may underlie sex differences in visuospatial ability, and that sex differences in functional lateralization may be present for only certain visuospatial processes.

  15. Subdural intracranial pressure, cerebral perfusion pressure, and degree of cerebral swelling in supra- and infratentorial space-occupying lesions in children

    DEFF Research Database (Denmark)

    Stilling, M; Karatasi, E; Rasmussen, Mads

    2005-01-01

    UNLABELLED: To our knowledge comparative studies of intracranial pressure (ICP) and degree of cerebral swelling during craniotomy for supratentorial or infratentorial space occupying lesion in children are not available. In this prospective study subdural ICP, cerebral perfusion pressure (CPP......), dural tension, and the degree of cerebral swelling were analysed in supine and prone positioned children subjected to craniotomy for space occupying lesions. MATERIAL AND METHOD: 48 children with space occupying tumours were subjected to either isoflurane/nitrous oxide 50%/fentanyl (n = 22) or propofol....../fentanyl/air/oxygen (n = 26). 25 children were operated supratentorially in supine position, while 23 patients were operated infratentorially in the prone position. Subdural ICP, mean arterial blood pressure (MABP), and CPP were measured just before opening of the dura. Dural tension was estimated before opening of dura...

  16. ADVANCED MAGNETIC RESONANCE IMAGING OF CEREBRAL CAVERNOUS MALFORMATIONS: I. HIGH FIELD IMAGING OF EXCISED HUMAN LESIONS

    Science.gov (United States)

    Shenkar, Robert; Venkatasubramanian, Palamadai N.; Zhao, Jin-cheng; Batjer, H. Hunt; Wyrwicz, Alice M.; Awad, Issam A.

    2008-01-01

    Objectives We hypothesized that structural details would be revealed in cerebral cavernous malformations (CCMs) through the use of high field magnetic resonance (MR) and confocal microscopy, which have not been described previously. The structural details of CCMs excised from human patients were sought by examination with high field MR imaging, and correlated with confocal microscopy of the same specimens. Novel features of CCM structure are outlined, including methodological limitations, venues for future research and possible clinical implications. Methods CCM lesions excised from four patients were fixed in 2% paraformaldehyde and subjected to high resolution MR imaging at 9.4 or 14.1 Tesla by spin-echo and gradient recalled echo methods. Histological validation of angioarchitecture was conducted on thick sections of CCM lesions using fluorescent probes to endothelium under confocal microscopy. Results Images of excised human CCM lesions were acquired with proton density-weighted, T1-weighted, T2-weighted spin echo and T2*-weighted gradient-recalled echo MR. These images revealed large “bland” regions with thin walled caverns, and “honeycombed” regions with notable capillary proliferation and smaller caverns surrounding larger caverns. Proliferating capillaries and caverns of various sizes were also associated with the wall of apparent larger blood vessels in the lesions. Similar features were confirmed within thick sections of CCMs by confocal microscopy. MR relaxation times in different regions of interest suggested the presence of different states of blood breakdown products in areas with apparent angiogenic proliferative activity. Conclusions The high field MR imaging techniques demonstrate novel features of CCM angioarchitecture, visible at near histological resolution, including regions with apparently different biologic activity. These preliminary observations will motivate future research, correlating lesion biologic and clinical activity with

  17. Macrostructural and Microstructural Brain Lesions Relate to Gait Pathology in Children With Cerebral Palsy.

    Science.gov (United States)

    Meyns, Pieter; Van Gestel, Leen; Leunissen, Inge; De Cock, Paul; Sunaert, Stefan; Feys, Hilde; Duysens, Jacques; Desloovere, Kaat; Ortibus, Els

    2016-10-01

    Background Even though lower-limb motor disorders are core features of spastic cerebral palsy (sCP), the relationship with brain lesions remains unclear. Unraveling the relation between gait pathology, lower-limb function, and brain lesions in sCP is complex for several reasons; wide heterogeneity in brain lesions, ongoing brain maturation, and gait depends on a number of primary motor functions/deficits (eg, muscle strength, spasticity). Objective To use a comprehensive approach combining conventional MRI and diffusion tensor imaging (DTI) in children with sCP above 3 years old to relate quantitative parameters of brain lesions in multiple brain areas to gait performance. Methods A total of 50 children with sCP (25 bilateral, 25 unilateral involvement) were enrolled. The investigated neuroradiological parameters included the following: (1) volumetric measures of the corpus callosum (CC) and lateral ventricles (LVs), and (2) DTI parameters of the corticospinal tract (CST). Gait pathology and primary motor deficits, including muscle strength and spasticity, were evaluated by 3D gait analysis and clinical examination. Results In bilateral sCP (n = 25), volume of the LV and the subparts of the CC connecting frontal, (pre)motor, and sensory areas were most related to lower-limb functioning and gait pathology. DTI measures of the CST revealed additional relations with the primary motor deficits (n = 13). In contrast, in unilateral sCP, volumetric (n = 25) and diffusion measures (n = 14) were only correlated to lower-limb strength. Conclusions These results indicate that the combined influence of multiple brain lesions and their impact on the primary motor deficits might explain a large part of the gait pathology in sCP.

  18. Computed tomographic studies of the basis pedunculi in chronic hemiplegic patients: Topographic correlation between cerebral lesion and midbrain shrinkage

    Energy Technology Data Exchange (ETDEWEB)

    Warabi, T.; Miyasaka, K.; Inoue, K.; Nakamura, N.

    1987-09-01

    A computed tomographic method for analyzing the shrinkage of the basis pedunculi (BP) due to the secondary degeneration of the descending fibers was applied in correlation to the site of cerebral lesions in 89 chronic hemiplegic patients. Cerebral lesions in the anterior corona radiata or the anterior limb of the capsula interna caused shrinkage of the medial BP. Lesions in the central corona radiata or the genu and posterior limb of the capsula interna caused shrinkage of the central BP, while lesions of the posterior corona radiata or the posterior limb of the capsula interna caused shrinkage of the lateral BP. These results suggested that CT images are able to reveal the principle sites of atrophy of the descending fiber tracts in chronic hemiplegia.

  19. MRI phenotypes based on cerebral lesions and atrophy in patients with multiple sclerosis.

    Science.gov (United States)

    Tauhid, Shahamat; Neema, Mohit; Healy, Brian C; Weiner, Howard L; Bakshi, Rohit

    2014-11-15

    While disease categories (i.e. clinical phenotypes) of multiple sclerosis (MS) are established, there remains MRI heterogeneity among patients within those definitions. MRI-defined lesions and atrophy show only moderate inter-correlations, suggesting that they represent partly different processes in MS. We assessed the ability of MRI-based categorization of cerebral lesions and atrophy in individual patients to identify distinct phenotypes. We studied 175 patients with MS [age (mean ± SD) 42.7 ± 9.1 years, 124 (71%) women, Expanded Disability Status (EDSS) score 2.5 ± 2.3, n = 18 (10%) clinically isolated demyelinating syndrome (CIS), n=115 (66%) relapsing-remitting (RR), and n = 42 (24%) secondary progressive (SP)]. Brain MRI measures included T2 hyperintense lesion volume (T2LV) and brain parenchymal fraction (to assess whole brain atrophy). Medians were used to create bins for each parameter, with patients assigned a low or high severity score. Four MRI phenotype categories emerged: Type I = low T2LV/mild atrophy [n = 67 (38%); CIS = 14, RR = 47, SP = 6]; Type II = high T2LV/mild atrophy [n = 21 (12%); RR = 19, SP = 2]; Type III = low T2LV/high atrophy [n = 21 (12%); CIS = 4, RR = 16, SP = 1]; and Type IV = high T2LV/high atrophy [n = 66 (38%); RR = 33, S P = 33]. Type IV was the most disabled and was the only group showing a correlation between T2LV vs. BPF and MRI vs. EDSS score (all p atrophy in individual patients to identify four phenotypes in MS. Most patients have congruent extremes related to the degree of lesions and atrophy. However, many have a dissociation. Longitudinal studies will help define the stability of these patterns and their role in risk stratification. Copyright © 2014. Published by Elsevier B.V.

  20. Hand Function in Relation to Brain Lesions and Corticomotor-Projection Pattern in Children with Unilateral Cerebral Palsy

    Science.gov (United States)

    Holmstrom, Linda; Vollmer, Brigitte; Tedroff, Kristina; Islam, Mominul; Persson, Jonas Ke; Kits, Annika; Forssberg, Hans; Eliasson, Ann-Christin

    2010-01-01

    Aim: To investigate relationships between hand function, brain lesions, and corticomotor projections in children with unilateral cerebral palsy (CP). Method: The study included 17 children (nine males, eight females; mean age 11.4 [SD 2.4] range 7-16y), with unilateral CP at Gross Motor Function Classification System level I and Manual Ability…

  1. Biochemical indications of cerebral ischaemia and mitochondrial dysfunction in severe brain trauma analysed with regard to type of lesion

    DEFF Research Database (Denmark)

    Nordström, Carl-Henrik; Nielsen, Troels Halfeld; Schalén, Wilhelm

    2016-01-01

    ), cerebral haemorrhagic contusion (CHC) and no mass lesion (NML). Altogether about 150,000 biochemical analyses were performed during the initial 96 h after trauma. Compromised aerobic metabolism occurred during 38 % of the study period. The biochemical pattern indicating mitochondrial dysfunction was more...

  2. A case of pathology-proven neuromyelitis optica spectrum disorder with Sjögren syndrome manifesting aphasia and apraxia due to a localized cerebral white matter lesion.

    Science.gov (United States)

    Sawada, Jun; Orimoto, Ryosuke; Misu, Tatsuro; Katayama, Takayuki; Aizawa, Hitoshi; Asanome, Asuka; Takahashi, Kae; Saito, Tsukasa; Anei, Ryogo; Kamada, Kyousuke; Miyokawa, Naoyuki; Takahashi, Toshiyuki; Fujihara, Kazuo; Hasebe, Naoyuki

    2014-09-01

    A woman with Sjögren syndrome manifesting as aphasia with a left deep cerebral white matter lesion tested positive for anti-aquaporin 4 (AQP4) antibody. Open biopsy of the lesion revealed active demyelination with edematous changes and the preservation of most axons, indicating a non-necrotic demyelinating lesion. Immunostaining for AQP4 was diffusely lost, whereas the loss of glial fibrillary acidic protein immunostaining was limited but with highly degenerated astrocytic foot processes in perivascular areas. These results suggested neuromyelitis optica spectrum disorder (NMOSD) pathology rather than Sjögren-related vasculitis. Only cerebral cortical symptoms with a cerebral white matter lesion could be observed in NMOSDs.

  3. Adenosine A2A receptor deficiency up-regulates cystatin F expression in white matter lesions induced by chronic cerebral hypoperfusion.

    Directory of Open Access Journals (Sweden)

    Wei Duan

    Full Text Available In previous studies, we have shown that the inactivation of the adenosine A2A receptor exacerbates chronic cerebral hypoperfusion-induced white matter lesions (WMLs by enhancing neuroinflammatory responses. However, the molecular mechanism underlying the effect of the adenosine A2A receptor remains unknown. Recent studies have demonstrated that cystatin F, a potent endogenous cysteine protease inhibitor, is selectively expressed in immune cells in association with inflammatory demyelination in central nervous system diseases. To understand the expression of cystatin F and its potential role in the effect of A2A receptor on WMLs induced through chronic cerebral hypoperfusion, we investigated cystatin F expression in the WMLs of A2A receptor gene knockout mice, the littermate wild-type mice and wild-type mice treated daily with the A2A receptor agonist CGS21680 or both CGS21680 and A2A receptor antagonist SCH58261 after chronic cerebral hypoperfusion. The results of quantitative-PCR and western blot analysis revealed that cystatin F mRNA and protein expression were significantly up-regulated in the WMLs after chronic cerebral hypoperfusion. In addition, cystatin F expression in the corpus callosum was significantly increased in A2A receptor gene knockout mice and markedly decreased in mice treated with CGS21680 on both the mRNA and protein levels. Additionally, SCH58261 counteracted the attenuation of cystatin F expression produced by CGS21680 after chronic cerebral hypoperfusion. Moreover, double immunofluorescence staining revealed that cystatin F was co-localized with the activated microglia marker CD11b. In conclusion, the cystatin F expression in the activated microglia is closely associated with the effect of the A2A receptors, which may be related to the neuroinflammatory responses occurring during the pathological process.

  4. Adenosine A2A receptor deficiency up-regulates cystatin F expression in white matter lesions induced by chronic cerebral hypoperfusion.

    Science.gov (United States)

    Duan, Wei; Ran, Hong; Zhou, Zhujuan; He, Qifen; Zheng, Jian

    2012-01-01

    In previous studies, we have shown that the inactivation of the adenosine A2A receptor exacerbates chronic cerebral hypoperfusion-induced white matter lesions (WMLs) by enhancing neuroinflammatory responses. However, the molecular mechanism underlying the effect of the adenosine A2A receptor remains unknown. Recent studies have demonstrated that cystatin F, a potent endogenous cysteine protease inhibitor, is selectively expressed in immune cells in association with inflammatory demyelination in central nervous system diseases. To understand the expression of cystatin F and its potential role in the effect of A2A receptor on WMLs induced through chronic cerebral hypoperfusion, we investigated cystatin F expression in the WMLs of A2A receptor gene knockout mice, the littermate wild-type mice and wild-type mice treated daily with the A2A receptor agonist CGS21680 or both CGS21680 and A2A receptor antagonist SCH58261 after chronic cerebral hypoperfusion. The results of quantitative-PCR and western blot analysis revealed that cystatin F mRNA and protein expression were significantly up-regulated in the WMLs after chronic cerebral hypoperfusion. In addition, cystatin F expression in the corpus callosum was significantly increased in A2A receptor gene knockout mice and markedly decreased in mice treated with CGS21680 on both the mRNA and protein levels. Additionally, SCH58261 counteracted the attenuation of cystatin F expression produced by CGS21680 after chronic cerebral hypoperfusion. Moreover, double immunofluorescence staining revealed that cystatin F was co-localized with the activated microglia marker CD11b. In conclusion, the cystatin F expression in the activated microglia is closely associated with the effect of the A2A receptors, which may be related to the neuroinflammatory responses occurring during the pathological process.

  5. Severe cerebral white matter lesions in ischemic stroke patients are associated with less time spent at home and early institutionalization.

    Science.gov (United States)

    Sibolt, Gerli; Curtze, Sami; Melkas, Susanna; Pohjasvaara, Tarja; Kaste, Markku; Karhunen, Pekka J; Oksala, Niku K J; Erkinjuntti, Timo

    2015-12-01

    Cerebral white matter lesions are one imaging surrogate for cerebral small vessel disease. These white matter lesions are associated with increased morbidity and mortality in both the general population and ischemic stroke patients. To investigate whether severe white matter lesions in a cohort of ischemic stroke patients are associated with fewer days spent at home and earlier permanent institutionalization. We included 391 consecutive patients aged 55-85 years with ischemic stroke admitted to the Helsinki University Central Hospital (the Stroke Aging Memory cohort) with a 21-year follow-up. Hospitalization and nursing home admissions were reviewed from national registers.white matter lesions were rated using magnetic resonance imaging performed three-months poststroke, dichotomized as none-to-moderate and severe. Kaplan-Meier plots log-rank and binary logistic regression (odds ratio) and Cox multivariable proportional hazards model were used to study the association of white matter lesions with days spent at home and the time of permanent institutionalization. Hazards and odds ratio with their 95% confidence intervals are reported. Severe white matter lesions were associated with fewer days spent at home, and more frequent, and earlier permanent institutionalization (1487 vs. 2354 days; log-rank P lesions were associated with fewer days spent at home (odds ratio 1·62; confidence interval 1·16-2·25), permanent institutionalization within five-years (odds ratio 2·29; confidence interval 1·23-4·29), and increased hazards ratio of permanent institutionalization during 21 years of follow-up (1·64; confidence interval 1·119-2·26). After ischemic stroke, patients with severe white matter lesions spend fewer days at home and become permanently institutionalized earlier, especially within the first five-years. © 2015 World Stroke Organization.

  6. High blood pressure and cerebral white matter lesion progression in the general population.

    Science.gov (United States)

    Verhaaren, Benjamin F J; Vernooij, Meike W; de Boer, Renske; Hofman, Albert; Niessen, Wiro J; van der Lugt, Aad; Ikram, M Arfan

    2013-06-01

    High blood pressure is considered an important risk factor for cerebral white matter lesions (WMLs) in the aging population. In a longitudinal population-based study of 665 nondemented persons, we investigated the longitudinal relationship of systolic blood pressure, diastolic blood pressure, and pulse pressure with annual progression of WMLs. Means of blood pressure were calculated over a 5-year period before longitudinal MRI scanning. WML progression was subsequently measured on 2 scans 3.5 years apart. We performed analyses with linear regression models and evaluated adjustments for age, sex, cardiovascular risk factors, and baseline WML volume. In addition, we evaluated whether treatment of hypertension is related to less WML progression. Both systolic and diastolic blood pressures were significantly associated with annual WML progression (regression coefficient [95% confidence interval], 0.08 [0.03; 0.14] mL/y and 0.09 [0.03; 0.15] mL/y per SD increase in systolic and diastolic blood pressure, respectively). Pulse pressure was also significantly associated with WML progression, but not independent from hypertension. After adjustment for baseline WML volume, only systolic blood pressure remained significantly associated: 0.05 (0.00; 0.09) mL/y per SD increase. People with uncontrolled untreated hypertension had significantly more WML progression than people with uncontrolled treated hypertension (difference [95% confidence interval], 0.12 [0.00; 0.23] mL/y). The present study further establishes high blood pressure to precede WMLs and implies that hypertension treatment could reduce WML progression in the general population.

  7. Early transient presence of implanted bone marrow stem cells reduces lesion size after cerebral ischaemia in adult rats

    NARCIS (Netherlands)

    Keimpema, E.; Fokkens, M. R.; Nagy, Z.; Agoston, V.; Luiten, P. G. M.; Nyakas, C.; Boddeke, H. W. G. M.; Copray, J. C. V. M.

    Aims: Previous studies on the therapeutic time window for intravascular administration of bone marrow stem cells (BMSCs) after stroke have shown that early intervention (from 3 h after onset) in the middle cerebral artery occlusion (MCAO) rat model is the most effective approach to reduce ischaemic

  8. Effects of statins on the progression of cerebral white matter lesion: Post hoc analysis of the ROCAS (Regression of Cerebral Artery Stenosis) study.

    Science.gov (United States)

    Mok, Vincent C T; Lam, Wynnie W M; Fan, Yu Hua; Wong, Adrian; Ng, Ping Wing; Tsoi, Tak Hon; Yeung, Vincent; Wong, Ka Sing

    2009-05-01

    Arteriosclerotic related cerebral white matter lesion (WML) is associated with increased risk of death, stroke, dementia, depression, gait disturbance, and urinary incontinence. We investigated the effects of statins on WML progression by performing a post hoc analysis on the ROCAS (Regression of Cerebral Artery Stenosis) study, which is a randomized, double-blind, placebo-controlled study evaluating the effects of statins upon asymptomatic middle cerebral artery stenosis progression among stroke-free individuals. Two hundreds and eight randomized subjects were assigned to either placebo (n = 102) or simvastatin 20 mg daily (n = 106) for 2 years. Baseline severity of WML was graded visually into none, mild, and severe. Volume (cm3) of WML was determined quantitatively at baseline and at end of study using a semi-automated method based on MRI. Primary outcome was the change in WML volume over 2 years. After 2 years of follow-up, there was no significant change in WML volume between the active and the placebo group as a whole. However, stratified analysis showed that for those with severe WML at baseline, the median volume increase in the active group (1.9 cm3) was less compared with that in the placebo group (3.0 cm3; P = 0.047). Linear multivariate regression analysis identified that baseline WML volume (beta = 0.63, P < 0.001) and simvastatin treatment (beta = -0.214, P = 0.043) independently predicted change in WML volume. Our findings suggest that statins may delay the progression of cerebral WML only among those who already have severe WML at baseline.

  9. Unusual presentation of neurobrucellosis: a solitary intracranial mass lesion mimicking a cerebral tumor : a case of encephalitis caused by Brucella melitensis.

    Science.gov (United States)

    Erdem, Mehtap; Namiduru, Mustafa; Karaoglan, Ilkay; Kecik, Vuslat Bosnak; Aydin, Abdullah; Tanriverdi, Mustafa

    2012-10-01

    Among the diverse presentations of neurobrucellosis, solitary intracranial mass lesions are extremely rare. To the best of our knowledge, we describe here the second case of neurobrucellosis mimicking a cerebral tumor caused by Brucella melitensis. The mass lesion was clinically and radiologically indistinguishable from a brain tumor. The diagnosis was established by isolating Brucella melitensis in a blood culture and a positive Wright's agglutination test on the cerebrospinal fluid at 1:320 titers. Paraffin sections of the cerebral mass showed nongranulomatous encephalitis. We suggest that patients with an isolated intraparenchymal mass lesion with nongranulomatous encephalitis should also be studied for brucellosis in endemic areas.

  10. Clinical features in patients with simultaneous cerebral arterial and venous lesions (with literature survey

    Directory of Open Access Journals (Sweden)

    Lee Peng Chew

    2014-01-01

    Full Text Available Nowadays, only few cases of simultaneous cerebral arterial and venous thrombosis were reported. However, there might be high probability of coexisted cerebral arterial and venous changes. It is worthy to study the reasons and frequency of these coexisted vascular changes contributing to the development of clinical pictures. We analyzed 12 cases of simultaneous cerebral and/or neck vascular changes based on vascular images and ultrasonography which were divided into 4 groups: coexistence of simultaneous arterial and venous thrombosis; venous thrombosis with arterial hypoplasia; arterial thrombosis, arteritis or dissections with venous sinus hypoplasia; coexistence of arterial and venous hypoplasia.

  11. Spatial contrast sensitivity in unilateral cerebral ischaemic lesions involving the posterior visual pathway.

    Science.gov (United States)

    Bulens, C; Meerwaldt, J D; van der Wildt, G J; Keemink, C J

    1989-04-01

    Contrast sensitivity function was studied in 16 patients with unilateral ischaemic lesions involving the posterior visual pathway. Sixty-two percent of the patients showed contrast sensitivity loss in at least one eye for horizontal or vertical stimulus orientation. Visual perception was distorted in a qualitatively different way according to the anteroposterior site of the lesion. Patients with occipital or occipitotemporal lesions showed high spatial frequency selective losses and patients with temporal or parietal lesions low frequency selective losses. Stimulus orientation selectivity was observed in patients with lesions of the primary visual cortex as well as in patients with lesions anterior to the striate cortex. Contrast sensitivity orientation-selective losses were demonstrated in 14 of the 17 'affected' eyes.

  12. [The relationship between placental lesions and early hemorrhagic-ischemic cerebral injury in very low birth weight infants].

    Science.gov (United States)

    Vaihinger, Mara; Mazzitelli, Nancy; Balanian, Nora; Grandi, Carlos

    2013-01-01

    Introducción: El examen histopatológico de la placenta es trascendente para evidenciar desordenes relacionados con el embarazo que se asocian a lesiones isquémico hemorrágicas cerebrales (LIHC) en recién nacidos prematuros (RNPT). Objetivo: Estudiar la asociación entre lesiones placentarias y LIHC precoces detectadas con ecografía en RNPT ≤ 1500 g y 32 semanas. Material y Métodos: diseño caso – control. Criterios de inclusión: RNPT ≥ 24 y ≤ 32 semanas, ≥ 500 y ≤ 1500 g, nacidos en la Maternidad Sardá entre años 2006 y 2012. Criterios de exclusión: RNPT gemelares, con malformaciones o infecciones intrauterinas específicas y los fallecidos antes de las 24 horas de vida. Resultados: fueron incluidos 198 RNPT, 49 con LIHC (casos) y 149 sin LIHC (controles). No se encontraron diferencias en las lesiones histopatológicas placentarias entre los dos grupos, aunque se apreció una clara tendencia de lesiones inflamatorias en los casos (67.3%) en comparación con los controles (48 %, p = 0.018). La ruptura prematura de las membranas (p = 0.027) y la corioamnionitis clínica fueron más frecuentes en los casos. Complicaciones fuertemente asociadas a prematurez fueron estadísticamente más evidentes entre los casos. La hemorragia intraventricular fue la lesión cerebral más hallada. El 50% de los casos persistieron con LIHC a las 36-40 semanas, mientras que a mayor edad gestacional el riesgo de LIHC fue menor . Conclusiones: las lesiones histopatológicas placentarias no estuvieron asociadas independientemente a mayor riesgo de LIHC, aunque se observó un predominio de lesiones inflamatorias en los casos.

  13. Assessment of the structural brain network reveals altered connectivity in children with unilateral cerebral palsy due to periventricular white matter lesions.

    Science.gov (United States)

    Pannek, Kerstin; Boyd, Roslyn N; Fiori, Simona; Guzzetta, Andrea; Rose, Stephen E

    2014-01-01

    Cerebral palsy (CP) is a term to describe the spectrum of disorders of impaired motor and sensory function caused by a brain lesion occurring early during development. Diffusion MRI and tractography have been shown to be useful in the study of white matter (WM) microstructure in tracts likely to be impacted by the static brain lesion. The purpose of this study was to identify WM pathways with altered connectivity in children with unilateral CP caused by periventricular white matter lesions using a whole-brain connectivity approach. Data of 50 children with unilateral CP caused by periventricular white matter lesions (5-17 years; manual ability classification system [MACS] I = 25/II = 25) and 17 children with typical development (CTD; 7-16 years) were analysed. Structural and High Angular Resolution Diffusion weighted Images (HARDI; 64 directions, b = 3000 s/mm(2)) were acquired at 3 T. Connectomes were calculated using whole-brain probabilistic tractography in combination with structural parcellation of the cortex and subcortical structures. Connections with altered fractional anisotropy (FA) in children with unilateral CP compared to CTD were identified using network-based statistics (NBS). The relationship between FA and performance of the impaired hand in bimanual tasks (Assisting Hand Assessment-AHA) was assessed in connections that showed significant differences in FA compared to CTD. FA was reduced in children with unilateral CP compared to CTD. Seven pathways, including the corticospinal, thalamocortical, and fronto-parietal association pathways were identified simultaneously in children with left and right unilateral CP. There was a positive relationship between performance of the impaired hand in bimanual tasks and FA within the cortico-spinal and thalamo-cortical pathways (r(2) = 0.16-0.44; p treatment may elucidate the neurological correlates of improved functioning due to intervention.

  14. Efficacy of T2*-Weighted Gradient-Echo MRI in Early Diagnosis of Cerebral Venous Thrombosis with Unilateral Thalamic Lesion

    Directory of Open Access Journals (Sweden)

    Shingo Mitaki

    2013-01-01

    Full Text Available Cerebral venous thrombosis (CVT is an uncommon cause of stroke with diverse etiologies and varied clinical presentations. Because of variability in clinical presentation and neuroimaging, CVT remains a diagnostic challenge. Recently, some studies have highlighted the value of T2*-weighted gradient-echo MRI (T2*WI in the diagnosis of CVT. We report the case of a 79-year-old woman with CVT due to a hypercoagulable state associated with cancer. On the initial T2-weighted image (T2WI, there was a diffuse high-intensity lesion in the right thalamus, extending into the posterior limb of the internal capsule and midbrain. T2*WI showed diminished signal and enlargement of the right basilar vein and the vein of Galen. Even though there is a wide range of differential diagnoses in unilateral thalamic lesions, and a single thalamus lesion is a rare entity of CVT, based on T2*WI findings we could make an early diagnosis and perform treatment. Our case report suggests that T2*WI could detect thrombosed veins and be a useful method of early diagnosis in CVT.

  15. Atrophy of the corpus callosum correlates with white matter lesions in patients with cerebral ischaemia

    Energy Technology Data Exchange (ETDEWEB)

    Meguro, K.; Yamadori, A. [Section of Neuropsychology, Division of Disability Science, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, 980-8575 Sendai (Japan); Constans, J.M.; Courtheoux, P.; Theron, J. [MR Unit, University of Caen School of Medicine, Caen (France); Viader, F. [Department of Neuroradiology, University of Caen School of Medicine, Caen (France)

    2000-06-01

    Many studies of white matter high signal (WMHS) on T2-weighted MRI have disclosed that it is related to cerebral ischaemia and to brain atrophy. Atrophy of the corpus callosum (CC) has also been studied in relation to ischaemia. Our objective was to test the hypothesis that CC atrophy could be due to ischaemia. We therefore assessed CC, WMHS and brain atrophy in patients with risk factors without strokes (the risk factor group) and in those with infarcts (the infarct group), to investigate the relationships between these factors. We studied 30 patients in the infarct group, 14 in the risk factor group, and 29 normal subjects. Using axial T1-weighted MRI, cortical atrophy and ventricular enlargement (brain atrophy) were visually rated. Using axial T2-weighted MRI, WMHS was assessed in three categories: periventricular symmetrical, periventricular asymmetrical and subcortical. Using the mid-sagittal T1-weighted image, the CC was measured in its anterior, posterior, midanterior and midposterior portions. In the normal group, no correlations were noted between parameters. In the infarct group, there were significant correlations between CC and brain atrophy, and between CC atrophy and WMHS. After removing the effects of age, gender and brain atrophy, significant correlations were noted between some CC measures and subcortical WMHS. In the risk factor group, there were significant correlations between CC and brain atrophy and between CC atrophy and WMHS. After allowance for age, gender and brain atrophy, significant correlations between some CC measures and periventricular WMHS remained. The hypothesis that CC atrophy could be due to cerebral ischaemia was supported by other analyses. Namely, for correlations between the extent of infarcts and partial CC atrophy in patients with anterior middle cerebral artery (MCA) and with posterior MCA infarcts, there were significant correlations between the extent of infarct and midanterior CC atrophy in the former, and posterior

  16. Intraarterial route increases the risk of cerebral lesions after mesenchymal cell administration in animal model of ischemia

    Science.gov (United States)

    Argibay, Bárbara; Trekker, Jesse; Himmelreich, Uwe; Beiras, Andrés; Topete, Antonio; Taboada, Pablo; Pérez-Mato, María; Vieites-Prado, Alba; Iglesias-Rey, Ramón; Rivas, José; Planas, Anna M.; Sobrino, Tomás; Castillo, José; Campos, Francisco

    2017-01-01

    Mesenchymal stem cells (MSCs) are a promising clinical therapy for ischemic stroke. However, critical parameters, such as the most effective administration route, remain unclear. Intravenous (i.v.) and intraarterial (i.a.) delivery routes have yielded varied outcomes across studies, potentially due to the unknown MSCs distribution. We investigated whether MSCs reached the brain following i.a. or i.v. administration after transient cerebral ischemia in rats, and evaluated the therapeutic effects of both routes. MSCs were labeled with dextran-coated superparamagnetic nanoparticles for magnetic resonance imaging (MRI) cell tracking, transmission electron microscopy and immunohistological analysis. MSCs were found in the brain following i.a. but not i.v. administration. However, the i.a. route increased the risk of cerebral lesions and did not improve functional recovery. The i.v. delivery is safe but MCS do not reach the brain tissue, implying that treatment benefits observed for this route are not attributable to brain MCS engrafting after stroke.

  17. [Semiotics of lesions of the cerebral venous collectors on application of noninvasive techniques of x-ray diagnosis].

    Science.gov (United States)

    Semenov, S; Abalmasov, V

    2001-01-01

    The study included application of a complex of the noninvasive diagnostic techniques such as MR tomography, MR venography, duplex scanning of the internal jugular veins, and transcranial Doppler sonography. The authors provide a detailed description of the semiotics of the MR signs of cerebral venous collector lesion in patients with thrombosis, extravasal compression, aneurysms, and developmental anomalies. Present the quantitative ultrasound parameters of hemodynamics in the efferent vessels of the brain accessible to inspections describe the effect of spontaneous echo-opacification in the internal jugular veins, which is assumed to be a predictor of thrombosis. Intravenous injection of magnevist resulted in an appreciable refinement of visualization of small dural sinuses at MR venography thereby allowing for the diagnosis of their thrombosis. It is suggested that the use of the entire complex of the x-ray modalities under consideration may lead to a more complete and noninvasive evaluation of the nature of cerebral venous insufficiency and of the degree of hemodynamic significance. Moreover, this will make it possible to outline approaches to therapeutic or surgical correction of the disease.

  18. The correlation of the thalamic lesions on MRI with cerebral cortical blood flow in patients with lacunar infarction

    Energy Technology Data Exchange (ETDEWEB)

    Nabatame, Hidehiko; Nakamura, Kazuo; Matsuda, Minoru; Fujimoto, Naoki [Shiga Medical Center, Moriyama (Japan); Fukuyama, Hidenao

    1995-07-01

    We performed MRI and measured cerebral blood flow (CBF) using {sup 123}I-IMP SPECT microsphere model in twenty three right-handed patients with lacunar infarction. Twelve of 23 patients showed chronic deterioration of dysarthria and gait disturbance. The mental function of the patients was evaluated by the Mini-Mental State (MMS) examination. The area of high intensity on T2-weighted images was quantitatively analyzed in the cerebral white matter (WM), lenticular nucleus (LN) and thalamus (THA). The score of MMS was positively correlated with the local CBF in the bilateral frontal, parietal, temporal and occipital cortices (p<0.05). Also, the area of high intensity in the left THA showed a significant negative correlation with local CBF of the bilateral frontal, parietal, temporal and occipital cortices (p<0.001). The high intensity areas of the bilateral LN, right WM and right THA had a significant but weaker negative correlation with local CBF of some cortices. These findings suggest that thalamic lesions on the dominant side play an important role in the reduction of cortical blood flow and the deterioration of mental functions in patients with lacunar infarction. (author).

  19. Inner speech in anarthria: neuropsychological evidence of differential effects of cerebral lesions on subvocal articulation.

    Science.gov (United States)

    Cubelli, R; Nichelli, P

    1992-07-01

    The role of articulation in verbal short-term memory was investigated in two anarthric patients, C.M. and F.C., both showing normal comprehension for written and spoken language, above average intelligence and visuo-spatial abilities. Based on experimental results, we propose that subvocal articulation might be impaired in anarthric patients in different ways, according to the site of lesion: in 'locked-in' patients only the articulatory rehearsal processes necessary to enhance memory performances is involved, while in cortical anarthric patients the lesion affects the articulatory recoding processes involved in transferring visually presented material into an articulatory form for better retention.

  20. The correlation between cognitive function and cerebral white matter lesions/insulin resistance in patients with lacunar infarction:a clinical study of 184 cases

    Institute of Scientific and Technical Information of China (English)

    张琼予

    2013-01-01

    Objective To investigate the correlation between cognitive function and cerebral white matter lesions(WML)/insulin resistance(IR) in patients with stroke.Methods Between May 2011 and October 2011,the clin-ical data of 184 in-patients with lacunar infarction were

  1. Serum carotenoids and cerebral white matter lesions : The Rotterdam Scan Study

    NARCIS (Netherlands)

    den Heijer, T; Launer, LJ; de Groot, JG; de Leeuw, FE; Oudkerk, M; van Gijn, J; Hofman, A; Breteler, MMB

    OBJECTIVES: To study the relation between serum levels of carotenoids and white matter lesions (WMLs) on magnetic resonance imaging (MRI). DESIGN: Evaluation of cross-sectional data from a cohort study. SETTING: The Rotterdam Scan Study. PARTICIPANTS: Two hundred and three nondemented older persons,

  2. CT and MRI findings of cerebral ischemic lesions in the cortical and perforating arterial system

    Energy Technology Data Exchange (ETDEWEB)

    Kameyama, Masakuni; Udaka, Fukashi; Nishinaka, Kazuto; Kodama, Mitsuo; Urushidani, Makoto; Kawamura, Kazuyuki; Inoue, Haruhisa; Kageyama, Taku [Sumitomo Hospital, Osaka (Japan)

    1995-07-01

    It is clinically useful to divide the location of infarction into the cortical and perforating arterial system. Computerized tomography (CT) and magnetic resonance imaging (MRI) now make the point of infarction a simple and useful task in daily practice. The diagnostic modality has also demonstrated that risk factors and clinical manifestations are different for infarction in the cortical as opposed to the perforating system. In this paper, we present various aspects of images of cerebral ischemia according to CT and/or MRI findings. With the advance of imaging mechanics, diagnostic capability of CT or/and MRI for cerebral infarction has markedly been improved. We must consider these points on evaluating the previously reported results. In addition, we always consider the pathological background of these image-findings for the precise interpretation of their clinical significance. In some instances, dynamic study such as PET or SPECT is needed for real interpretations of CT and/or MRI images. We paid special reference to lacunar stroke and striatocapsular infarct. In addition, `branch atheromatous disease (Caplan)` was considered, in particular, for their specific clinical significances. Large striatocapsular infarcts frequently show cortical signs and symptoms such as aphasia or agnosia in spite of their subcortical localization. These facts, although have previously been known, should be re-considered for their pathoanatomical mechanism. (author).

  3. HMG-CoA Reductase Inhibition Promotes Neurological Recovery, Peri-Lesional Tissue Remodeling, and Contralesional Pyramidal Tract Plasticity after Focal Cerebral Ischemia

    Science.gov (United States)

    Kilic, Ertugrul; Reitmeir, Raluca; Kilic, Ülkan; Caglayan, Ahmet Burak; Beker, Mustafa Caglar; Kelestemur, Taha; Ethemoglu, Muhsine Sinem; Ozturk, Gurkan; Hermann, Dirk M.

    2014-01-01

    3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors are widely used for secondary stroke prevention. Besides their lipid-lowering activity, pleiotropic effects on neuronal survival, angiogenesis, and neurogenesis have been described. In view of these observations, we were interested whether HMG-CoA reductase inhibition in the post-acute stroke phase promotes neurological recovery, peri-lesional, and contralesional neuronal plasticity. We examined effects of the HMG-CoA reductase inhibitor rosuvastatin (0.2 or 2.0 mg/kg/day i.c.v.), administered starting 3 days after 30 min of middle cerebral artery occlusion for 30 days. Here, we show that rosuvastatin treatment significantly increased the grip strength and motor coordination of animals, promoted exploration behavior, and reduced anxiety. It was associated with structural remodeling of peri-lesional brain tissue, reflected by increased neuronal survival, enhanced capillary density, and reduced striatal and corpus callosum atrophy. Increased sprouting of contralesional pyramidal tract fibers crossing the midline in order to innervate the ipsilesional red nucleus was noticed in rosuvastatin compared with vehicle-treated mice, as shown by anterograde tract tracing experiments. Western blot analysis revealed that the abundance of HMG-CoA reductase was increased in the contralesional hemisphere at 14 and 28 days post-ischemia. Our data support the idea that HMG-CoA reductase inhibition promotes brain remodeling and plasticity far beyond the acute stroke phase, resulting in neurological recovery. PMID:25565957

  4. Association of White Matter Lesions, Cerebral Atrophy, Intracranial Extravascular Calcifications, and Ventricular-Communicating Hydrocephalus with Delirium Among Veterans.

    Science.gov (United States)

    Detweiler, Mark B; Sherigar, Rathnakara M; Bader, Geoffrey; Sullivan, Kelly; Kenneth, Arline; Kalafat, Naciye; Reddy, Pavan; Lutgens, Brian

    2017-06-01

    The literature regarding the underlying neuropathogenesis of delirium on head computed tomography (CT) is limited. The aim of this research was to investigate, using case-control retrospective chart review, the association of white matter lesions (WML), cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus in older adult military veterans with and without delirium hospitalized in a Veterans Affairs Medical Center. Head CT scans were examined for WML, atrophy, and intracranial extravascular calcifications globally in the cortex, subcortex (frontal, temporal, parietal, occipital lobes), basal ganglia (globus pallidus, caudate, putamen), and internal capsule, in addition to the presence of ventricular-communicating hydrocephalus. WML were graded as not present, 2 cm. Atrophy, cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus were graded as present or not present. There was a significant association of WML in the temporal lobe periventricular cortical and subcortical brain and a significant association of atrophy in the parietal lobes and the cerebellum in hospitalized older adult military veterans with delirium compared with hospitalized older adult military veterans without delirium. There were no differences between the delirium and nondelirium groups for intracranial extravascular calcifications and ventricular-communicating hydrocephalus. The results suggest that atrophy in the parietal lobes and the cerebellum of hospitalized older adult military veterans may be associated with an elevated risk of delirium when compared with age, race, and sex-matched control veterans. Continuing efforts are needed to clarify the role of atrophy during delirium in the veteran and nonveteran older adult population to reduce progressive frailty and decreased quality of life secondary to hospital and posthospital-discharge delirium.

  5. Fisiopatoligia de las tormentas electricas en el encefalo del paciente con una lesion cerebral aguda. Resultados preliminares de un estudio piloto

    DEFF Research Database (Denmark)

    Sahuquillo, J; Sueiras, M; Garcia-Lopez, B;

    2011-01-01

    The phenomena of cortical spreading depolarization (CSD and CSD-like phenomena) are cellular depolarization waves involved in the progression of lesions in patients with stroke and traumatic brain injury (TBI). Which are detected by an electrocorticographic (ECoG) recording. Experimentally, CSD...... induces cerebral hypoxia and increases the permeability of the blood-brain barrier. Objectives: To determine the frequency and duration of CSD episodes in patients with TBI and malignant middle cerebral artery infarction (MMCAI) requiring craniectomy. Material and methods: 20 patients were included....... Conclusions: Episodes of CSD and CSD-like phenomena are frequently detected in patients with MMCAI and TBI....

  6. Automated, quantitative measures of grey and white matter lesion burden correlates with motor and cognitive function in children with unilateral cerebral palsy

    Directory of Open Access Journals (Sweden)

    Alex M. Pagnozzi

    2016-01-01

    Full Text Available White and grey matter lesions are the most prevalent type of injury observable in the Magnetic Resonance Images (MRIs of children with cerebral palsy (CP. Previous studies investigating the impact of lesions in children with CP have been qualitative, limited by the lack of automated segmentation approaches in this setting. As a result, the quantitative relationship between lesion burden has yet to be established. In this study, we perform automatic lesion segmentation on a large cohort of data (107 children with unilateral CP and 18 healthy children with a new, validated method for segmenting both white matter (WM and grey matter (GM lesions. The method has better accuracy (94% than the best current methods (73%, and only requires standard structural MRI sequences. Anatomical lesion burdens most predictive of clinical scores of motor, cognitive, visual and communicative function were identified using the Least Absolute Shrinkage and Selection operator (LASSO. The improved segmentations enabled identification of significant correlations between regional lesion burden and clinical performance, which conform to known structure-function relationships. Model performance was validated in an independent test set, with significant correlations observed for both WM and GM regional lesion burden with motor function (p < 0.008, and between WM and GM lesions alone with cognitive and visual function respectively (p < 0.008. The significant correlation of GM lesions with functional outcome highlights the serious implications GM lesions, in addition to WM lesions, have for prognosis, and the utility of structural MRI alone for quantifying lesion burden and planning therapy interventions.

  7. Preclinical cerebral network connectivity evidence of deficits in mild white matter lesions

    Directory of Open Access Journals (Sweden)

    Ying eLiang

    2016-02-01

    Full Text Available White matter lesions (WMLs are notable for their high prevalence and have been demonstrated to be a potential neuroimaging biomarker of early diagnosis of Alzheimer’s disease. This study aimed to identify the brain functional and structural mechanisms underlying cognitive decline observed in mild WMLs. Multi-domain cognitive tests, as well as resting-state, diffusion tensor and structural images were obtained on 42 mild WMLs and 42 age/sex-matched healthy controls. For each participant, we examined the functional connectivity of three resting-state networks related to the changed cognitive domains: the default mode network (DMN and the bilateral fronto-parietal network (FPN. We also performed voxel-based morphometry analysis to compare whole-brain gray matter volume, atlas-based quantification of the white matter tracts interconnecting the RSNs, and the relationship between functional connectivity and structural connectivity. We observed functional connectivity alterations in the DMN and the right FPN combined with related white matter integrity disruption in mild WMLs. However, no significant gray matter atrophy difference was found. Furthermore, the right precuneus functional connectivity in the DMN exhibited a significantly negative correlation with the memory test scores. Our study suggests that in mild WMLs, dysfunction of RSNs might be a consequence of decreased white matter structural connectivity, which further affects cognitive performance.

  8. Investigation of techniques to quantify in vivo lesion volume based on comparison of water apparent diffusion coefficient (ADC) maps with histology in focal cerebral ischemia of rats.

    Science.gov (United States)

    Kazemi, Mark; Silva, Matthew D; Li, Fuhai; Fisher, Marc; Sotak, Christopher H

    2004-06-01

    Stroke lesion-volume estimates derived from calculated water apparent diffusion coefficient (ADC) maps provide a quantitative surrogate end-point for investigating the efficacy of drug treatment or studying the temporal evolution of cerebral ischemia. Methodology is described for estimating ischemic lesion volumes in a rat model of permanent middle cerebral artery occlusion (MCAO) based on absolute and percent-reduction threshold values of the water ADC at 3 h post-MCAO. Volume estimates derived from average ADC (ADC(av)) maps were compared with those derived from post-mortem histological sections. Optimum ADC thresholds were established as those that provided the best correlation and one-to-one correspondence between ADC- and histologically derived lesion-volume estimates. At 3 h post-MCAO, an absolute-ADC(av) threshold of 47 x 10(-5) mm(2)/s (corresponding to a 33% reduction in ADC(av) based on a contralateral hemisphere comparison) provided the most accurate estimate of percent hemispheric lesion volume (%HLV). Experimental and data analysis issues for improving and validating the usefulness of DWI as a surrogate endpoint for the quantification of ischemic lesion volume are discussed.

  9. Effects of isoflurane, fentanyl, or thiopental anesthesia on regional cerebral blood flow and brain surface PO2 in the presence of a focal lesion in rabbits.

    Science.gov (United States)

    Murr, R; Schürer, L; Berger, S; Enzenbach, R; Peter, K; Baethmann, A

    1993-11-01

    These studies were conducted to determine the effect of anesthetic drugs on tissue perfusion and O2 supply in the brain with focal cerebral edema. Using an open cranium preparation, we studied the effects of isoflurane (I; 1 minimum alveolar anesthetic concentration), of fentanyl (F; 0.5-1 microgram.kg-1 x min-1), or of thiopental (T; 32.5 mg.kg-1 x h-1) on regional cerebral blood flow (rCBF) and regional brain tissue PO2 in albino rabbits (n = 6 per group) with a focal brain lesion (cold injury). The doses of anesthetics were sufficient to suppress nociception. rCBF (H2 clearance) and tissue PO2 (multiwire surface electrode) were studied adjacent to and distant from the lesion. Cerebral hyperemia developed immediately after trauma in all groups, although the flow increase did not attain statistical significance. rCBF was subsequently reduced by about 25% in the vicinity of the lesion. Distant from the trauma, a continuing hyperemia (+30%) was later observed in animals with isoflurane, whereas rCBF was decreased then by 10%-20% in animals with fentanyl, or was unchanged with thiopental. Brain tissue PO2 was increased with isoflurane in areas distant from the lesion, but decreased with fentanyl. However, with thiopental, the PO2 level had already been lowered before trauma with a subsequent tendency toward normalization. The heterogeneity of the tissue PO2 in fentanyl anesthesia, as well as the increased frequency of hypoxic PO2 values with thiopental, might have resulted from microcirculatory disturbances. Thus, although isoflurane seemed to facilitate hyperemia with an increased O2 supply to the brain, fentanyl tended to induce the opposite response. Although these properties suggest the potential to manipulate perfusion and O2 supply in cerebral ischemia or hyperemia after head injury, the effects of such measures on intracranial pressure, neurologic status, and outcome have yet to be proven.

  10. How does the interaction of presumed timing, location and extent of the underlying brain lesion relate to upper limb function in children with unilateral cerebral palsy?

    Science.gov (United States)

    Mailleux, Lisa; Klingels, Katrijn; Fiori, Simona; Simon-Martinez, Cristina; Demaerel, Philippe; Locus, Marlies; Fosseprez, Eva; Boyd, Roslyn N; Guzzetta, Andrea; Ortibus, Els; Feys, Hilde

    2017-09-01

    Upper limb (UL) function in children with unilateral cerebral palsy (CP) vary largely depending on presumed timing, location and extent of brain lesions. These factors might exhibit a complex interaction and the combined prognostic value warrants further investigation. This study aimed to map lesion location and extent and assessed whether these differ according to presumed lesion timing and to determine the impact of structural brain damage on UL function within different lesion timing groups. Seventy-three children with unilateral CP (mean age 10 years 2 months) were classified according to lesion timing: malformations (N = 2), periventricular white matter (PWM, N = 42) and cortical and deep grey matter (CDGM, N = 29) lesions. Neuroanatomical damage was scored using a semi-quantitative MRI scale. UL function was assessed at body function and activity level. CDGM lesions were more pronounced compared to PWM lesions (p = 0.0003). Neuroanatomical scores were correlated with a higher degree to UL function in the CDGM group (rs = -0.39 to rs = -0.84) compared to the PWM group (rrb = -0.42 to rs = -0.61). Regression analysis found lesion location and extent to explain 75% and 65% (p < 0.02) respectively, of the variance in AHA performance in the CDGM group, but only 24% and 12% (p < 0.03) in the PWM group. In the CDGM group, lesion location and extent seems to impact more on UL function compared to the PWM group. In children with PWM lesions, other factors like corticospinal tract (re)organization and structural connectivity may play an additional role. Copyright © 2017 European Paediatric Neurology Society. All rights reserved.

  11. Impact of acute cerebral ischemic lesions and their volume on the revascularization outcome of symptomatic carotid stenosis.

    Science.gov (United States)

    Pini, Rodolfo; Faggioli, Gianluca; Longhi, Matteo; Ferrante, Liborio; Vacirca, Andrea; Gallitto, Enrico; Gargiulo, Mauro; Stella, Andrea

    2017-02-01

    The influence of acute cerebral ischemic lesions (CILs) on the revascularization outcome of symptomatic carotid stenosis has been scarcely investigated in the literature. This study evaluated the effect of CILs and their volume on the results of carotid revascularization in symptomatic patients. All patients with symptomatic carotid artery stenosis who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS) between 2005 and 2014 were considered. CILs ipsilateral to the stenosis were identified in the preoperative cerebral computed tomography. The volume was quantified in mm(3) and correlated with 30-day rates of stroke and stroke/death by χ(2), multivariate analysis, Pearson correlation, and receiver operating characteristic curves. A total of 489 symptomatic patients were treated by CEA (327 [67%]) or CAS (162 [33%]), 186 (38%) ≤2 weeks and 303 (62%) >2 weeks from symptom onset. CEA and CAS patients had statistically similar rates of stroke (3.3% vs 5.5%; P = .27) and stroke/death (3.8% vs 5.9%; P = .22). CILs were identified in 251 patients (53%) and were associated with similar stroke and stroke/death rate compared with patients without CIL (12 [4.8%] vs 8 [3.5%], P = .46; and 14 [5.6%] vs 8 [3.5%]; P = .26, respectively). The median CIL volume was 1000 mm(3) (interquartile range [IQR], 7000 mm(3)). Patients with postoperative stroke and stroke/death had a significantly higher preoperative CIL volume of 5100 mm(3) (IQR, 31,000 mm(3)) vs 1000 mm(3) (IQR, 7000 mm(3); P = .01) and 4500 mm(3) (IQR, 17,450 mm(3)) vs 1000 mm(3) (IQR, 7000 mm(3); P = .03), respectively. The receiver operating characteristic curve analysis showed a volume of 4000 mm(3) was predictive of postoperative stroke with 75% sensitivity and 63% specificity. A CIL volume ≥4000 mm(3) was an independent risk factor for postoperative stroke, with a stroke rate of 9.3% (n = 9) vs 1.9% (n = 3) for a CIL volume of CIL volume in symptomatic carotid stenosis

  12. Preoperative cerebrovascular reactivity to acetazolamide measured by brain perfusion SPECT predicts development of cerebral ischemic lesions caused by microemboli during carotid endarterectomy

    Energy Technology Data Exchange (ETDEWEB)

    Aso, Kenta; Ogasawara, Kuniaki; Kobayashi, Masakazu; Suga, Yasunori; Chida, Kohei; Otawara, Yasunari; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan)]|[Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Sasaki, Makoto [Iwate Medical University, Advanced Medical Research Center, Morioka (Japan)

    2009-02-15

    The aim of the present study was to determine whether preoperative cerebrovascular reactivity (CVR) to acetazolamide measured by quantitative brain perfusion single-photon emission computed tomography (SPECT) predicts development of cerebral ischemic lesions on postoperative diffusion-weighted magnetic resonance imaging (DWI) that are caused by microemboli during carotid endarterectomy (CEA). One hundred and fifty patients with ipsilateral internal carotid artery stenosis (>70%) underwent CEA under transcranial Doppler monitoring of microembolic signals (MES) in the ipsilateral middle cerebral artery (MCA). Preoperative CVR to acetazolamide was measured using [{sup 123}I]N-isopropyl-p-iodoamphetamine SPECT, and region of interest (ROI) analysis in the ipsilateral MCA territory was performed using a three-dimensional stereotaxic ROI template. DWI was performed within 3 days before and 24 h after surgery. Twenty-six patients (17.3%) developed new postoperative ischemic lesions on DWI. Logistic regression analysis demonstrated that, among the variables tested, a high number of MES during carotid dissection (95% CIs, 1.179 to 1.486; P < 0.0001) and preoperative reduced CVR to acetazolamide (95% CIs, 0.902 to 0.974; P = 0.0008), which were significantly associated with the development of new postoperative ischemic lesions on DWI. In 47 patients with MES during carotid dissection, the combination of number of MES during carotid dissection and CVR to acetazolamide identified development of new postoperative ischemic lesions on DWI with a positive predictive value of 100% or zero. Preoperative CVR to acetazolamide measured by quantitative brain perfusion SPECT predicts development of cerebral ischemic lesions on postoperative DWI that are caused by microemboli during CEA. (orig.)

  13. Accuracy of CT cerebral perfusion in predicting infarct in the emergency department: lesion characterization on CT perfusion based on commercially available software.

    Science.gov (United States)

    Ho, Chang Y; Hussain, Sajjad; Alam, Tariq; Ahmad, Iftikhar; Wu, Isaac C; O'Neill, Darren P

    2013-06-01

    This study aims to assess the diagnostic accuracy of a single vendor commercially available CT perfusion (CTP) software in predicting stroke. A retrospective analysis on patients presenting with stroke-like symptoms within 6 h with CTP and diffusion-weighted imaging (DWI) was performed. Lesion maps, which overlays areas of computer-detected abnormally elevated mean transit time (MTT) and decreased cerebral blood volume (CBV), were assessed from a commercially available software package and compared to qualitative interpretation of color maps. Using DWI as the gold standard, parameters of diagnostic accuracy were calculated. Point biserial correlation was performed to assess for relationship of lesion size to a true positive result. Sixty-five patients (41 females and 24 males, age range 22-92 years, mean 57) were included in the study. Twenty-two (34 %) had infarcts on DWI. Sensitivity (83 vs. 70 %), specificity (21 vs. 69 %), negative predictive value (77 vs. 84 %), and positive predictive value (29 vs. 50 %) for lesion maps were contrasted to qualitative interpretation of perfusion color maps, respectively. By using the lesion maps to exclude lesions detected qualitatively on color maps, specificity improved (80 %). Point biserial correlation for computer-generated lesions (R pb = 0.46, p perfusion color map assessment, the lesion maps can help improve specificity.

  14. Lesions from patients with sporadic cerebral cavernous malformations harbor somatic mutations in the CCM genes: evidence for a common biochemical pathway for CCM pathogenesis.

    Science.gov (United States)

    McDonald, David A; Shi, Changbin; Shenkar, Robert; Gallione, Carol J; Akers, Amy L; Li, Stephanie; De Castro, Nicholas; Berg, Michel J; Corcoran, David L; Awad, Issam A; Marchuk, Douglas A

    2014-08-15

    Cerebral cavernous malformations (CCMs) are vascular lesions affecting the central nervous system. CCM occurs either sporadically or in an inherited, autosomal dominant manner. Constitutional (germline) mutations in any of three genes, KRIT1, CCM2 and PDCD10, can cause the inherited form. Analysis of CCM lesions from inherited cases revealed biallelic somatic mutations, indicating that CCM follows a Knudsonian two-hit mutation mechanism. It is still unknown, however, if the sporadic cases of CCM also follow this genetic mechanism. We extracted DNA from 11 surgically excised lesions from sporadic CCM patients, and sequenced the three CCM genes in each specimen using a next-generation sequencing approach. Four sporadic CCM lesion samples (36%) were found to contain novel somatic mutations. Three of the lesions contained a single somatic mutation, and one lesion contained two biallelic somatic mutations. Herein, we also describe evidence of somatic mosaicism in a patient presenting with over 130 CCM lesions localized to one hemisphere of the brain. Finally, in a lesion regrowth sample, we found that the regrown CCM lesion contained the same somatic mutation as the original lesion. Together, these data bolster the idea that all forms of CCM have a genetic underpinning of the two-hit mutation mechanism in the known CCM genes. Recent studies have found aberrant Rho kinase activation in inherited CCM pathogenesis, and we present evidence that this pathway is activated in sporadic CCM patients. These results suggest that all CCM patients, including those with the more common sporadic form, are potentially amenable to the same therapy.

  15. Long-term sensory stimulation therapy improves hand function and restores cortical responsiveness in patients with chronic cerebral lesions. Three single case studies.

    Directory of Open Access Journals (Sweden)

    Jan-Christoph eKattenstroth

    2012-08-01

    Full Text Available Rehabilitation of sensorimotor impairment resulting from cerebral lesion (CL utilizes task specific training and massed practice to drive reorganization and sensorimotor improvement due to induction of neuroplasticity mechanisms. Loss of sensory abilities often complicates recovery, and thus the individual’s ability to use the affected body part for functional tasks. Therefore, the development of additional and alternative approaches that supplement, enhance, or even replace conventional training procedures would be advantageous. Repetitive sensory stimulation protocols (rSS have been shown to evoke sensorimotor improvements of the affected limb in patients with chronic stroke. However, the possible impact of long-term rSS on sensorimotor performance of patients with CL, where the incident dated back many years remains unclear. The particular advantage of rSS is its passive nature, which does not require active participation of the subjects. Therefore, rSS can be applied parallel to other occupations, making the intervention easier to implement and more acceptable to the individual. Here we report the effects of applying rSS for 8, 36 and 76 weeks on the paretic hand of 3 long-term patients with different types of CL. Different behavioral tests were used to assess sensory and/or sensorimotor performance of the upper extremities prior, after, and during the intervention. In one patient, the impact of long-term rSS on restoration of cortical activation was investigated by recording somatosensory evoked potentials. After long-term rSS all three patients showed considerable improvements of their sensory and motor abilities. In addition, almost normal evoked potentials could be recorded after rSS in one patient. Our data show that long-term rSS applied to patients with chronic CL can improve tactile and sensorimotor functions, which, however, developed in some cases only after many weeks of stimulation, and continued to further improve on a time

  16. Cerebral Lesions in Patients Undergoing Coronary Artery Bypass Grafting in Relation to Asymptomatic Carotid and Vertebral Artery Stenosis

    DEFF Research Database (Denmark)

    Wiberg, Sebastian; Schoos, Mikkel; Sillesen, Henrik

    2015-01-01

    OBJECTIVES: Carotid artery stenosis (CAS) and vertebral artery stenosis (VAS) are associated with cerebral infarction after coronary artery bypass graft surgery (CABG). It remains unclear whether this association is causal. We investigated the associations between neurologically asymptomatic CAS ...

  17. Study of West syndrome manifesting periventricular leukomalacia by MRI. Correlation between West syndrome and cerebral white matter lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hamano, Shinichiro; Nara, Takahiro; Shimizu, Masaki; Arita, Jiro; Sakamoto, Masafumi; Eda, Naruyuki; Ogawara, Yoshikazu [Saitama Children`s Medical Center, Iwatsuki (Japan); Maekawa, Kihei

    1995-09-01

    Clinical features of West syndrome manifesting periventricular leukomalacia (PVL) were studied by MRI. The subjects were 10 patients with West syndrome associated with PVL. Occipital spike on electroencephalograms was considered an important characteristic finding of West syndrome. Patients with West syndrome associated with PVL had a lower cerebral blood flow volume at the early phase than those with cryptogenic West syndrome, suggesting a difference of pathophysiology between West syndrome with PVL and cryptogenic West syndrome. Abnormal findings on electroencephalograms and MRI, which are considered to affect the disease course, suggest the presence of cerebral cortical abnormalities, therefore, it is proved to be difficult to study the pathophysiology of West syndrome solely focusing on the findings of the cerebral cortical basal ganglia and the related parts. (Y.S.).

  18. The transfer from survey (map-like to route representations into Virtual Reality Mazes: effect of age and cerebral lesion

    Directory of Open Access Journals (Sweden)

    Stampatori Chiara

    2011-01-01

    Full Text Available Abstract Background To go from one place to another, we routinely generate internal representations of surrounding spaces, which can include egocentric (body-centred and allocentric (world-centred coordinates, combined into route and survey representations. Recent studies have shown how both egocentric and allocentric representations exist in parallel and are joined to support behaviour according to the task. Our study investigated the transfer from survey (map-like to route representations in healthy and brain-damaged subjects. The aim was two-fold: first, to understand how this ability could change with age in a sample of healthy participants, aged from 40 to 71 years old; second, to investigate how it is affected after a brain lesion in a 8 patients' sample, with reference to specific neuropsychological frames. Methods Participants were first required to perform the paper and pencil version of eight mazes, then to translate the map-like paths into egocentric routes, in order to find the right way into equivalent Virtual Reality (VR mazes. Patients also underwent a comprehensive neuropsychological evaluation, including a specific investigation of some topographical orientation components. Results As regards the healthy sample, we found age-related deterioration in VR task performance. While education level and gender were not found to be related to performance, global cognitive level (Mini Mental State Examination, previous experience with computer and fluidity of navigation into the VR appeared to influence VR task results. Considering the clinical sample, there was a difficulty in performing the VR Maze task; executive functions and visuo-spatial abilities deficits appeared to be more relevant for predicting patients' results. Conclusions Our study suggests the importance of developing tools aimed at investigating the survey to route transfer ability in both healthy elderly and clinical samples, since this skill seems high cognitive

  19. Utility of FDG-PETCT and magnetic resonance spectroscopy in differentiating between cerebral lymphoma and non-malignant CNS lesions in HIV-infected patients

    Energy Technology Data Exchange (ETDEWEB)

    Westwood, Thomas D., E-mail: tdwestwood@googlemail.com [Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Hogan, Celia, E-mail: celiahogan@hotmail.com [Monsall Unit, Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, Pennine Acute Hospitals NHS Trust (United Kingdom); Julyan, Peter J., E-mail: Peter.Julyan@christie.nhs.uk [Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Coutts, Glyn, E-mail: Glyn.Coutts@christie.nhs.uk [Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Bonington, Suzie, E-mail: suzi.bonington@christie.nhs.uk [Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Carrington, Bernadette, E-mail: Bernadette.Carrington@christie.nhs.uk [Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Taylor, Ben, E-mail: Ben.taylor@christie.nhs.uk [Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester (United Kingdom); Khoo, Saye, E-mail: S.H.Khoo@liverpool.ac.uk [Department of Infectious Diseases and Tropical Medicine, Royal Liverpool Hospital, Liverpool (United Kingdom); Bonington, Alec, E-mail: Alec.Bonington@pat.nhs.uk [Monsall Unit, Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, Pennine Acute Hospitals NHS Trust (United Kingdom)

    2013-08-15

    Background and purpose: In HIV infected patients, MRI cannot reliably differentiate between central nervous system (CNS) lymphoma and non-malignant CNS lesions, particularly cerebral toxoplasmosis (CTOX). This study prospectively investigates the utility of FDG PET-CT and magnetic resonance spectroscopy (MRS) in discriminating CNS lymphoma from non-malignant CNS lesions in HIV infected patients, and assesses the ability of FDG PET-CT to guide the use of early brain biopsy. Methods: 10 HIV patients with neurological symptoms and contrast enhancing lesions on MRI were commenced on anti-toxoplasmosis therapy before undergoing FDG PET-CT and MRS. Brain biopsies were sought in those with FDG PET-CT suggestive of CNS lymphoma, and in those with a negative FDG PET-CT scan who failed to respond to therapy. Final diagnosis was based on histology or treatment response. Results: Two patients were confirmed to have CNS lymphoma and FDG PET-CT was consistent with this diagnosis in both. Six patients had cerebral toxoplasmosis in all of whom FDG PET-CT was consistent with non-malignant disease. One patient had progressive multifocal leukoencephalopathy (PML), FDG PET-CT was equivocal. One patient had a haemorrhagic brain metastasis and FDG PET-CT wrongly suggested non-malignant disease. MRS was performed successfully in eight subjects: three results were suggestive of CNS lymphoma (one true positive, two false positive), four suggested CTOX (two false negative, two true negative), one scan was equivocal. Conclusion: FDG PET-CT correctly identified all cases of CNS lymphoma and CTOX, supporting its use in this situation. MRS was unhelpful in our cohort.

  20. 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

  1. 患侧大脑半球多脑叶离断术治疗难治性癫痫%Multi-lobar disconnection of cerebral hemisphere for refractory epilepsy caused by cerebral hemispheric lesions

    Institute of Scientific and Technical Information of China (English)

    常鹏飞; 蔡立新; 苏崇德

    2011-01-01

    Objective It is a great challenge to treat the epileptic patients with extensive cerebral lesions with primary functions partly remained in the pathological side. Here we introduce a new surgical approach, multi-lobe disconnection of cerebral hemisphere in order to control the epileptic seizures and remain the primary functions of the pathological cerebral hemisphere. Methods A) Surgical procedures:①Anatomical disconnect the link from frontal lobe to the basal ganglia and inner capsule. ②Exposing the frontal horn of lateral ventricle, and disconnect the frontal part of corpus callosum. ③Dissecting the lateral fissure, completely cut off the temporal stem and removing the cortex of insula, then get into the temporal horn of the ventricle, resect the hippocampus and amygdala . ④Along the superior temporal gyrus, cut off the links between the temporal and parietal lobes. ⑤ Disconnect the links from parieto-occipital lobes to the thalamus, basal ganglia and inner capsule. At the parietal horn, disconnect the posterior part of the corpus collasum. B) Clinical application, 5 patients with refractory epilepsy caused by extensive cerebral hemispheric lesions underwent the new operation. Presurgical evaluation demonstrated the exist of the primary functions of the pathological hemisphere. Results The new surgical procedure was successfully applied to five patients without any worsening of neurological deficit , remaining the primary functions of the pathological brain. Five patients were followed up for 13~20 months. 3 cases got Engel I, and 2 case, II respectively. Conclusion Multi-lobe disconnection of cerebral hemisphere is a liable and effective choice of treatment for the refractory epilepsy caused by extensive lesions of cerebral hemisphere.%目的 应用患侧大脑半球多脑叶离断术治疗该侧半球性病变导致的难治性癫痫,目的是对保留病变半球基本功能的癫痫患者提出一个有效而实用的术式.方法 ①大脑半球

  2. Constraints on grip selection in hemiparetic cerebral palsy: Effects of lesional side, end-point accuracy and context.

    NARCIS (Netherlands)

    Steenbergen, B.; Meulenbroek, R.G.J.; Rosenbaum, D.A.

    2004-01-01

    This study was concerned with the selection criteria used for grip planning in adolescents with left or right hemiparetic cerebral palsy. In the first experiment participants picked up a pencil and placed the tip in a pre-defined target region. We varied the size of the target to test the hypothesis

  3. Mesio-temporal ictal semiology as an indicator for surgical treatment of epilepsies with large multilobar cerebral lesions.

    Science.gov (United States)

    Catenoix, Hélène; Montavont, Alexandra; Isnard, Jean; Guénot, Marc; Chatillon, Claude-Edouard; Streichenberger, Nathalie; Ryvlin, Philippe; Mauguière, François

    2013-06-01

    Mesio-temporal ictal semiology is sometimes observed in patients with large multilobar lesion. In this situation, surgery is often discarded because of the lesion size and/or suspicion of extended or multifocal epileptogenic areas. In this retrospective study we evaluated the surgical outcome of such patients in order to assess whether the electro-clinical presentation of seizures could be a prognostic marker of surgical outcome. Among the temporal lobe epilepsy population explored in our department between 2000 and 2011 (240 patients), we identified 7 patients who presented an extensive lesion on brain Magnetic Resonance Imaging (MRI) (multilobar in four, hemispheric in two, and bilateral in one). All patients underwent (18)Fluorodeoxyglucose Positron Emission Tomography, which showed large, hemispheric or multilobar, areas of glucose hypometabolism. Because of the large lesion size, all patients were explored by stereoelectroencephalography (SEEG) before taking a decision regarding surgical indication. SEEG confirmed the temporal origin of the seizures and discarded the possibility of multiple epileptogenic zones. A temporal lobectomy, tailored on the basis of SEEG data, was proposed to the seven patients. The seven patients are classified Engel class I after the surgery (mean follow-up: 37.4±22.1 months). Our data thus suggest that, even in the absence of hippocampal MRI abnormality, ictal symptoms compatible with a temporal origin of seizures should be considered as a reliable indicator for surgery eligibility regardless of MRI lesion size. On the basis of our findings, the mesio-temporal semiology of seizures appears as one of the most reliable markers of operability in patients with large MRI lesions. These patients should not be excluded a priori from invasive exploration and surgical treatment, even if a large portion of their lesion is likely to be left in place after surgery. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All

  4. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  5. A Rare Case of Isolated Cerebral Sarcoidosis Presenting as Suprasellar Mass Lesion with Salt-Wasting Hypopituitarism.

    Science.gov (United States)

    Krenzlin, H; Jussen, D; Musahl, C; Scheil-Bertram, S; Wernecke, K; Horn, P

    2015-07-01

    Background Sarcoidosis is a systemic disorder of unknown origin characterized by noncaseating granulomas. Clinical symptoms due to central nervous system (CNS) involvement occur in 5 to 7% of all cases; subclinical involvement is more frequent. Sole CNS involvement is very rare. Case Report A 25-year-old man presented with increasing polyuria and polydipsia over 8 weeks. Magnetic resonance imaging (MRI) revealed a supra- and infra-chiasmatic pre-thalamic mass lesion 1.0 × 1.4 × 1.4cm in diameter. Microsurgical biopsy verified a necrotizing noncaseating epithelioid cell tumor indicative for neurosarcoidosis. All symptoms dissolved within 3 months under stringent corticoid therapy. Conclusion Intracranial mass lesions as the primary and only manifestation of neuronal sarcoidosis are rare. Because conservative treatment is safe and effective, surgery is limited to biopsy and the alleviation of pressure-related symptoms to preserve neurologic function.

  6. Intra-lesional spatial correlation of static and dynamic FET-PET parameters with MRI-based cerebral blood volume in patients with untreated glioma

    Energy Technology Data Exchange (ETDEWEB)

    Goettler, Jens; Preibisch, Christine [TU Muenchen, Department of Neuroradiology, Klinikum rechts der Isar, Munich (Germany); TU Muenchen, TUM Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Munich (Germany); Lukas, Mathias; Mustafa, Mona; Schwaiger, Markus; Pyka, Thomas [TU Muenchen, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Kluge, Anne; Kaczmarz, Stephan; Zimmer, Claus [TU Muenchen, Department of Neuroradiology, Klinikum rechts der Isar, Munich (Germany); Gempt, Jens; Ringel, Florian; Meyer, Bernhard [TU Muenchen, Department of Neurosurgery, Klinikum rechts der Isar, Munich (Germany); Foerster, Stefan [TU Muenchen, TUM Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Munich (Germany); TU Muenchen, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Klinikum Bayreuth, Department of Nuclear Medicine, Bayreuth (Germany)

    2017-03-15

    {sup 18}F-fluorethyltyrosine-(FET)-PET and MRI-based relative cerebral blood volume (rCBV) have both been used to characterize gliomas. Recently, inter-individual correlations between peak static FET-uptake and rCBV have been reported. Herein, we assess the local intra-lesional relation between FET-PET parameters and rCBV. Thirty untreated glioma patients (27 high-grade) underwent simultaneous PET/MRI on a 3 T hybrid scanner obtaining structural and dynamic susceptibility contrast sequences. Static FET-uptake and dynamic FET-slope were correlated with rCBV within tumour hotspots across patients and intra-lesionally using a mixed-effects model to account for inter-individual variation. Furthermore, maximal congruency of tumour volumes defined by FET-uptake and rCBV was determined. While the inter-individual relationship between peak static FET-uptake and rCBV could be confirmed, our intra-lesional, voxel-wise analysis revealed significant positive correlations (median r = 0.374, p < 0.0001). Similarly, significant inter- and intra-individual correlations were observed between FET-slope and rCBV. However, rCBV explained only 12% of the static and 5% of the dynamic FET-PET variance and maximal overlap of respective tumour volumes was 37% on average. Our results show that the relation between peak values of MR-based rCBV and static FET-uptake can also be observed intra-individually on a voxel basis and also applies to a dynamic FET parameter, possibly determining hotspots of higher biological malignancy. However, just a small part of the FET-PET signal variance is explained by rCBV and tumour volumes determined by the two modalities showed only moderate overlap. These findings indicate that FET-PET and MR-based rCBV provide both congruent and complimentary information on glioma biology. (orig.)

  7. Intra-cerebral injection of neuromyelitis optica immunoglobulin G and human complement produces neuromyelitis optica lesions in mice

    Science.gov (United States)

    Saadoun, Samira; Waters, Patrick; Bell, B. Anthony; Vincent, Angela; Verkman, A. S.

    2010-01-01

    Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system associated with autoantibodies against the glial water channel protein aquaporin-4. It has recently been reported that immunoglobulin from neuromyelitis optica patients injected peripherally does not cause lesions in naive rats, but only when pre-existing central nervous system inflammation is present. Here, we investigated whether immunoglobulin G from aquaporin-4-autoantibody-positive neuromyelitis optica patients has the potential to damage the central nervous system either alone or in the presence of human complement. Immunoglobulin G from neuromyelitis optica patients did not activate mouse complement and was not pathogenic when injected into mouse brain. However, co-injection of immunoglobulin G from neuromyelitis optica patients with human complement produced neuromyelitis optica-like lesions in mice. Within 12 h of co-injecting immunoglobulin G from neuromyelitis optica patients and human complement, there was a striking loss of aquaporin-4 expression, glial cell oedema, myelin breakdown and axonal injury, but little intra-parenchymal inflammation. At 7 days, there was extensive inflammatory cell infiltration, perivascular deposition of activated complement components, extensive demyelination, loss of aquaporin-4 expression, loss of reactive astrocytes and neuronal cell death. In behavioural studies, mice injected with immunoglobulin G from neuromyelitis optica patients and human complement into the right hemisphere preferentially turned to the right at 7 days. No brain inflammation, demyelination or right-turning behaviour was seen in wild-type mice that received immunoglobulin G from non-neuromyelitis optica patients with human complement, or in aquaporin-4-null mice that received immunoglobulin G from neuromyelitis optica patients with human complement. We conclude that co-injection of immunoglobulin G from neuromyelitis optica patients with human complement

  8. A Patient with Fragile X-Associated Tremor/Ataxia Syndrome Presenting with Executive Cognitive Deficits and Cerebral White Matter Lesions

    Directory of Open Access Journals (Sweden)

    Kensaku Kasuga

    2011-05-01

    Full Text Available Fragile X-associated tremor/ataxia syndrome (FXTAS is a late-onset neurodegenerative disorder that primarily affects males who are carriers of a premutation of a CGG expansion in the FMR1 gene. In Asian populations, FXTAS has rarely been reported. Here, we report the case of a Japanese FXTAS patient who showed predominant executive cognitive deficits as the main feature of his disease. In contrast, the patient exhibited only very mild symptoms of intention tremor and ataxia, which did not interfere with daily activities. A gene analysis revealed that the patient carried a premutation of a CGG expansion (111 CGG repeats in the FMR1 gene. The mRNA expression level of FMR1 in the patient was 1.5-fold higher than in controls. On brain MRI scans, fluid-attenuated inversion recovery images showed high-intensity lesions in the middle cerebellar peduncles and the cerebral white matter, with a frontal predominance. The present case extends previous notions regarding the cognitive impairment in FXTAS patients. Recognizing FXTAS patients with predominant cognitive impairment from various ethnic backgrounds would contribute to our understanding of the phenotypic variation of this disease.

  9. Supplementary motor complex and disturbed motor control – a retrospective clinical and lesion analysis of patients after anterior cerebral artery stroke

    Directory of Open Access Journals (Sweden)

    Florian eBrugger

    2015-10-01

    Full Text Available Background: Both the supplementary motor complex (SMC, consisting of the supplementary motor area (SMA-proper, the pre-SMA and the supplementary eye field, and the rostral cingulate cortex (ACC are supplied by the anterior cerebral artery (ACA and are involved in higher motor control. The Bereitschaftspotential (BP originates from the SMC and reflects cognitive preparation processes before volitional movements. ACA strokes may lead to impaired motor control in the absence of limb weakness and evoke an alien-hand syndrome (AHS in its extreme form.Aim: To characterize the clinical spectrum of disturbed motor control after ACA strokes including signs attributable to AHS and to identify the underlying neuroanatomical correlates.Methods: A clinical assessment focusing on signs of disturbed motor control including intermanual conflict (i.e. bilateral hand movements directed at opposite purposes, lack of self-initiated movements, exaggerated grasping, motor perseverations, mirror movements and gait apraxia was performed. Symptoms were grouped into A AHS specific and B non-AHS specific signs of upper limbs and C gait apraxia. Lesion summation mapping was applied to the patients’ MRI or CT scans to reveal associated lesion patterns. The BP was recorded in two patients.Results: Ten patients with ACA strokes (9 unilateral, 1 bilateral; mean age: 74.2 years; median NIH-SS at admission: 13.0 were included in this case series. In the acute stage, all cases had marked difficulties to perform volitional hand movements, while movements in response to external stimuli were preserved. In the chronic stage (median follow-up: 83.5 days initiation of voluntary movements improved, although all patients showed persistent signs of disturbed motor control. Impaired motor control is predominantly associated with damaged voxels within the SMC and the anterior and medial cingulate cortex, while lesions within the pre-SMA are specifically related to AHS. No BP was detected

  10. [A patient with meningeal carcinomatosis accompanied by a small pituitary metastatic lesion from gastric cancer who developed cerebral salt wasting syndrome].

    Science.gov (United States)

    Izumi, Y; Sakaguchi, K; Udaka, F; Tsujimura, T; Kameyama, M

    1999-09-01

    A 68-year-old man with disturbed consciousness had repeatedly developed light-headedness and dizziness since the summer of 1996 and was admitted to a hospital for detailed examinations on October 8, 1996. On admission, he weighed 49 kg and showed subclinical hypothyroidism with low T3 syndrome. The adrenal function and serum electrolytes were normal. Since the stool samples were positive for occult blood, gastroscopy was performed. Examination of the biopsy specimens demonstrated gastric cancer. On October 21, blood examination showed hyponatremia (127 mEq/l). On October 22, marked disturbance of consciousness developed. On October 24, the serum Na level further decreased to 116 mEq/l. On November 8, he was referred to our hospital. On admission, his skin and tongue showed marked dehydration, and severe disturbance of consciousness and neck stiffness were observed. The central venous pressure was 4 cmH2O. In the cerebrospinal fluid, atypical cells were observed, and a diagnosis of meningeal carcinomatosis was made. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was excluded because of marked dehydration, a normal blood ADH level, and because plasma osmotic pressure was greater than urinary osmotic pressure. Considering the possibility of cerebral salt wasting syndrome (CSWS) or hypoadrenocorticism, Na supplementation and drip infusion of prednisolone (20 mg/day) were performed. The serum Na has normalized (140.1 mEq/l), and his consciousness improved. He died of aggravation of the general condition on December 16. Pathological examination demonstrated a small metastatic lesion in the infundibular part of the pituitary gland and a small metastatic lesion in the parenchyma of the bilateral adrenal glands. However, since neither hypotension nor hypoglycemia was observed before treatment, and the blood cortisol level and the serum K level were normal, hypoadrenocorticism was excluded. Hypoaldosteronism was also excluded because of a normal serum K

  11. Demonstration of cerebral vessels by multiplane computed cerebral angiotomography

    Energy Technology Data Exchange (ETDEWEB)

    Asari S.; Satch, T.; Sakurai, M.; Yamamoto, Y. (Matsuyama Shimin Hospital, Matsuyama (Japan)); Sadamoto, K.

    1981-06-01

    1. Cerebral arteries and veins were demonstrated by multiplane computed cerebral angiotomography (combination of axial, modified coronal, half axial (Towne), and semisagittal planes). The vessels which were demonstrated by various planes were as follows: Axial plane: Willis ring, middle cerebral arteries (horizontal and insular portions), anterior cerebral arteries (Horizontal and ascending portions), posterior cerebral arteries, basal vein of Rosenthal, internal cerebral veins (and the subependymal veins which join the ICV), and vein of Galen. Coronal plane: intermal carotid arteries (supraclinoid portion), anterior cerebral arteries (horizontal portion), middle cerebral arteries (horizontal and insular portions), lenticulostriate arteries, basal vein of Rosenthal (and the subependymal veins which join this vessel), internal cerebral veins, and vein of Galen. Half axial plane (Towne projection): basilar artery, vertebral arteries, posterior cerebral arteries, superior cerebellar arteries, middle cerebral arteries (horizontal portion), and anterior cerebral arteries (horizontal and ascending portions). Semisagittal plane: internal carotid artery (supraclinoid portion), posterior communicating artery, posterior carebral artery, superior cerebellar artery, internal cerebral vein, basal vein of Rosenthal, vein of Galen, and straight shinus. 2. A detailed knowledge of normal cerebrovascular structures acquired by computed tomography (CT) is essential in detecting and more precisely localizing lesions such as cerebrovascular disease, neoplasm or abscess, in differentiating these lesions from the normal contrast-enhanced structures, and in understanding the spatial relationship between the mass lesion and the neighboring vessels. In addition, it will be possible to discover such asymptomatic cerebrovascular diseases as non-ruptured aneurysms, arteriovenous malformations, and Moyamoya disease by means of computed cerebral angiotomography.

  12. Gray matter involvement in patients with multiple sclerosis as shown by magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Reshiana Rumzan; CHEN Xuan; LI Yong-mei

    2012-01-01

    Objective To summarize the main findings seen on conventional and advanced magnetic resonance imaging (MRI)used to assess gray matter (GM) involvement in patients with multiple sclerosis (MS).Data sources The data used in this review were obtained mainly from studies reported in the PubMed database using the terms of multiple sclerosis,gray matter,magnetic resonance imaging.Study selection Relevant literatures on studies of GM involvement in MS patients were identified,retrieved and reviewed.Results MS is the most common chronic,disabling central nervous system disease in young adults.Although traditional thinking has considered MS to be a chronic inflammatory demyelinating condition affecting solely the white matter (WM) of the central nervous system,over the last few years it has been shown that GM pathology is also common and extensive.GM demyelinating lesions can not only be found in the cerebral cortex but also in the deep gray nuclei.Apart from focal demyelinatad lesions,diffuse neuronal loss and atrophy is also present in the GM of MS patients.Conclusions The widespread use of conventional and quantitative MRI based techniques in MS has led to an improved understanding of the mechanisms underlying the inflammatory and neurodegenerative processes of the disease.However,more researches are needed to unravel GM pathology in MS patients,which at present remains enigmatic.

  13. MR序列对脑实质型脑囊虫病不同时期病灶的显示%Conventional MR sequences in detecting lesions of cerebral neurocysticercosis in different periods

    Institute of Scientific and Technical Information of China (English)

    邱麟; 沈思; 胡锦波; 张承志; 刘斯润

    2012-01-01

    Objective To observe the sensitivity of several MR sequences (T1W, T2W, T2 FLAIR, DWI, EPI T2, CET1W sequence) in detecting lesions of cerebral neurocysticercosis in different periods. Methods MRI data of 40 patients with neurocysticercosis were reviewed. The number of lesions detected by the sequences was analyzed and statistically compared. Results Sixty-two lesions were detected by T1W (35 alive cysticercus lesions, 25 degeno-death stage lesions and 2 calcification stage lesions) , 78 were detected by T2W (33 alive cysticercus lesions, 36 degeno-death stage lesions and 9 calcification stage lesions), 115 lesions were detected by FLAIR (32 alive cysticercus lesions, 75 degeno-death stage lesions and 8 calcification stage lesions) , 33 were detected by DWI (12 alive cysticercuslesions, 16 degeno-death stage lesions and 5 calcification stage lesions), 69 lesions were detected by EPI T2 (31 alive cysticercus lesions, 29 degeno-death stage lesions and 9 calcification stage lesions), while 225 lesions were detected by CET1W sequence (23 alive cysticercus lesions, 200 degeno-death stage lesions and 2 calcification stage lesions). Conclusion CET1W and FLAIR sequence are both more sensitive than other sequences in detecting alive cysticercus lesions and degeno-death stage lesions. Compared with FLAIR or T1W sequence, combination of T2W and EPI T2 are better in detecting cysticercosis calcification within gray matter.%目的 探讨MR序列(T1W、T2W、T2 FLAIR、DWI、EPI T2、增强T1W)对不同时期脑囊虫病灶检出的敏感性.方法 回顾40例脑囊虫病患者的MR资料,分析各序列检出病灶的数目,并进行统计学处理.结果 T1W序列检出病灶62个(活虫期35个,变性坏死期25个,钙化期2个);T2W序列检出病灶78个(活虫期33个,变性坏死期36个,钙化期9个);FLAIR序列检出病灶115个(活虫期32个,变性坏死期75个,钙化期8个);DWI检出病灶33个(活虫期12个,变性坏死期16个,钙化期5个);EPI T2

  14. Brown Tumor Shown Flare Phenomenon On Bone Scan After Parathyroidectomy

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Kwang Ho; Park, Seol Hoon; Baek, So Ra; Chae, Sun Young; Koh, Jung Min; Kim, Jae Seung; Moon, Dae Hyuk; Ryu, Jin Sook [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2009-10-15

    Brown tumor is the benign bone lesion consists of woven bone and fibrous tissue without matrix, which develop due to chronic excessive osteoclastic activity such as hyperparathyroidism. Usually they appear with normal uptake or occasionally focally increased uptake on bone scan. We present a case with brown tumor shown more increased uptake and more number of lesions on bone scan after parathyroidectomy, and lesser increased uptake on serial bone scans without any other treatment through several months. This finding is thought to be similar to 'flare phenomenon' which is occasionally seen after treatment of metastatic bone lesions of malignant cancer, and may represent curative process of brown tumor with rapid normal bone formation.

  15. Percutaneous radiofrequency lesions adjacent to the dorsal root ganglion alleviate spasticity and pain in children with cerebral palsy: pilot study in 17 patients

    Directory of Open Access Journals (Sweden)

    van Rhijn Lodewijk W

    2010-06-01

    Full Text Available Abstract Background Cerebral palsy (CP may cause severe spasticity, requiring neurosurgical procedures. The most common neurosurgical procedures are continuous infusion of intrathecal baclofen and selective dorsal rhizotomy. Both are invasive and complex procedures. We hypothesized that a percutaneous radiofrequency lesion of the dorsal root ganglion (RF-DRG could be a simple and safe alternative treatment. We undertook a pilot study to test this hypothesis. Methods We performed an RF-DRG procedure in 17 consecutive CP patients with severe hip flexor/adductor spasms accompanied by pain or care-giving difficulties. Six children were systematically evaluated at baseline, and 1 month and 6 months after treatment by means of the Modified Ashworth Scale (MAS, Gross Motor Function Measure (GMFM and a self-made caregiver's questionnaire. Eleven subsequent children were evaluated using a Visual Analogue Scale (VAS for spasticity, pain and ease of care. Results A total of 19 RF-DRG treatments were performed in 17 patients. We found a small improvement in muscle tone measured by MAS, but no effect on the GMFM scale. Despite this, the caregivers of these six treated children unanimously stated that the quality of life of their children had indeed improved after the RF-DRG. In the subsequent 11 children we found improvements in all VAS scores, in a range comparable to the conventional treatment options. Conclusion RF-DRG is a promising new treatment option for severe spasticity in CP patients, and its definitive effectiveness remains to be defined in a randomised controlled trial.

  16. Comparative study of muscular tonus in spastic tetra paretic cerebral palsy in children with predominantly cortical and subcortical lesions in computerized tomography of the skull; Estudo comparativo do tono muscular na paralisia cerebral tetraparetica em criancas com lesoes predominantemente corticais ou subcorticais na tomografia computadorizada de cranio

    Energy Technology Data Exchange (ETDEWEB)

    Iwabe, Cristina [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Neurologia; Piovesana, Ana Maria Sedrez Gonzaga [Universidade Estadual de Campinas, SP (Brazil). Ambulatorio Multidisciplinar de Paralisia Cerebral e Neurologia Infantil

    2003-09-01

    The objective was to compare distribution and intensity of muscular tonus in spastic tetra paretic cerebral palsy (CP), correlating the clinical data with lesion location in the central nervous system. Twelve children aged two to four years old with predominantly cortical lesions (six children) and subcortical lesions (six children) were included. The tonus was analyzed in the upper (UULL) and lower limbs (LLLL) based on Durigon and Piemonte protocol. The result showed that there was no significant difference regarding tonus intensity and distribution in the UULL and LLLL in both groups. Comparing the upper and lower limbs of subjects in the same group, the LLLL presented more asymmetry and higher tonus intensity than the UULL. It was concluded that in this study children with CP as a result of predominantly cortical or subcortical lesions present a similar deficit in tonus modulation, causing a symmetric and homogeneous distribution of hypertonicity, which is predominant in the LLLL. (author)

  17. Evaluation of the "spasticity of conjugate gaze phenomenon" in unilateral cerebral lesions Avaliação do "fenômeno do desvio conjugado espástico ocular" em lesões cerebrais unilaterais

    Directory of Open Access Journals (Sweden)

    Eliana Teixeira Maranhão

    2007-06-01

    Full Text Available The spasticity of conjugate gaze phenomenon (SCG is a subtle motor ocular sign that usually indicates unilateral acute cerebral lesion. We analyzed the sensitivity of this sign in a prospective blinded study using 57 patients. All patients had monohemispheric brain lesions without resting deviation of the eyes and no motor complaints. Fourteen individuals without cerebral lesions were included as controls. Patients and controls were submitted to a brain magnetic resonance image. We observed SCG in just 1/57 (sensitivity of 1.7%, while all controls had a normal Bell's phenomenon. We speculate that SCG may disappear over time and is not useful to diagnose a long-lasting unilateral brain lesion.O fenômeno do "desvio conjugado espástico ocular" é um sinal motor ocular sutil que habitualmente indica lesões cerebrais mono-hemisféricas agudas. Avaliamos a sensibilidade deste sinal num estudo prospectivo cego em 57 pacientes. Todos os pacientes apresentavam lesões cerebrais mono-hemisféricas, ausência de queixas motoras ou de desvio conjugado dos olhos em repouso. Quatorze indivíduos sem lesão cerebral foram incluídos como controle. Pacientes e indivíduos controle foram submetidos a exame de ressonância magnética do crânio. Observamos o sinal do desvio conjugado espástico ocular em somente 1/57 pacientes (sensibilidade 1,7%, enquanto todos os controles apresentaram o fenômeno de Bell. Especulamos que este sinal desaparece com o tempo, e que o mesmo não é útil para o diagnóstico de pacientes com lesões cerebrais monohemisféricas de longa duração.

  18. Monitoring ferumoxide-labelled neural progenitor cells and lesion evolution by magnetic resonance imaging in a model of cell transplantation in cerebral ischaemia [v1; ref status: indexed, http://f1000r.es/20l

    Directory of Open Access Journals (Sweden)

    Rachael A Panizzo

    2013-11-01

    Full Text Available Efficacy of neural stem/progenitor cell (NPC therapies after cerebral ischaemia could be better evaluated by monitoring in vivo migration and distribution of cells post-engraftment in parallel with analysis of lesion volume and functional recovery. Magnetic resonance imaging (MRI is ideally placed to achieve this, but still poses several challenges. We show that combining the ferumoxide MRI contrast agent Endorem with protamine sulphate (FePro improves iron oxide uptake in cells compared to Endorem alone and is non-toxic. Hence FePro complex is a better contrast agent than Endorem for monitoring NPCs. FePro complex-labelled NPCs proliferated and differentiated normally in vitro, and upon grafting into the brain 48 hours post-ischaemia they were detected in vivo by MRI. Imaging over four weeks showed the development of a confounding endogenous hypointense contrast evolution at later timepoints within the lesioned tissue. This was at least partly due to accumulation within the lesion of macrophages and endogenous iron. Neither significant NPC migration, assessed by MRI and histologically, nor a reduction in the ischaemic lesion volume was observed in NPC-grafted brains.  Crucially, while MRI provides reliable information on engrafted cell location early after an ischaemic insult, pathophysiological changes to ischaemic lesions can interfere with cellular imaging at later timepoints.

  19. Monitoring ferumoxide-labelled neural progenitor cells and lesion evolution by magnetic resonance imaging in a model of cell transplantation in cerebral ischaemia [v2; ref status: indexed, http://f1000r.es/30c

    Directory of Open Access Journals (Sweden)

    Rachael A Panizzo

    2014-03-01

    Full Text Available Efficacy of neural stem/progenitor cell (NPC therapies after cerebral ischaemia could be better evaluated by monitoring in vivo migration and distribution of cells post-engraftment in parallel with analysis of lesion volume and functional recovery. Magnetic resonance imaging (MRI is ideally placed to achieve this, but still poses several challenges. We show that combining the ferumoxide MRI contrast agent Endorem with protamine sulphate (FePro improves iron oxide uptake in cells compared to Endorem alone and is non-toxic. Hence FePro complex is a better contrast agent than Endorem for monitoring NPCs. FePro complex-labelled NPCs proliferated and differentiated normally in vitro, and upon grafting into the brain 48 hours post-ischaemia they were detected in vivo by MRI. Imaging over four weeks showed the development of a confounding endogenous hypointense contrast evolution at later timepoints within the lesioned tissue. This was at least partly due to accumulation within the lesion of macrophages and endogenous iron. Neither significant NPC migration, assessed by MRI and histologically, nor a reduction in the ischaemic lesion volume was observed in NPC-grafted brains.  Crucially, while MRI provides reliable information on engrafted cell location early after an ischaemic insult, pathophysiological changes to ischaemic lesions can interfere with cellular imaging at later timepoints.

  20. Extramedullary hematopoiesis presenting as a compressive cord and cerebral lesion in a patient without a significant hematologic disorder: a case report

    Directory of Open Access Journals (Sweden)

    Seddighi Amir

    2010-10-01

    Full Text Available Abstract Introduction Intracranial or spinal compressive lesions due to extramedullary hematopoiesis have been reported in the medical literature. Most of the reported cases are extradural lesions or, on rare occasions, foci within another neoplasm such as hemangioblastoma, meningioma or pilocytic astrocytoma. Often these cases occur in patients with an underlying hematological disorder such as acute myelogenic leukemia, myelofibrosis, or other myelodysplastic syndromes. Such lesions have also been reported in thalassemia major. Case presentation We report the case of a 43-year-old Iranian woman in whom extramedullary hematopoiesis presented as a compressive cord lesion and then later as an intracranial lesion. Conclusions To the best of our knowledge, we document the first reported case of sacral, lumbar, thoracic and cranial involvement in the same patient with extramedullary hematopoiesis, which seems both rare and remarkable.

  1. Tracking the Evolution of Cerebral Gadolinium-Enhancing Lesions to Persistent T1 Black Holes in Multiple Sclerosis: Validation of a Semiautomated Pipeline.

    Science.gov (United States)

    Andermatt, Simon; Papadopoulou, Athina; Radue, Ernst-Wilhelm; Sprenger, Till; Cattin, Philippe

    2017-09-01

    Some gadolinium-enhancing multiple sclerosis (MS) lesions remain T1-hypointense over months ("persistent black holes, BHs") and represent areas of pronounced tissue loss. A reduced conversion of enhancing lesions to persistent BHs could suggest a favorable effect of a medication on tissue repair. However, the individual tracking of enhancing lesions can be very time-consuming in large clinical trials. We created a semiautomated workflow for tracking the evolution of individual MS lesions, to calculate the proportion of enhancing lesions becoming persistent BHs at follow-up. Our workflow automatically coregisters, compares, and detects overlaps between lesion masks at different time points. We tested the algorithm in a data set of Magnetic Resonance images (1.5 and 3T; spin-echo T1-sequences) from a phase 3 clinical trial (n = 1,272), in which all enhancing lesions and all BHs had been previously segmented at baseline and year 2. The algorithm analyzed the segmentation masks in a longitudinal fashion to determine which enhancing lesions at baseline turned into BHs at year 2. Images of 50 patients (192 enhancing lesions) were also reviewed by an experienced MRI rater, blinded to the algorithm results. In this MRI data set, there were no cases that could not be processed by the algorithm. At year 2, 417 lesions were classified as persistent BHs (417/1,613 = 25.9%). The agreement between the rater and the algorithm was > 98%. Due to the semiautomated procedure, this algorithm can be of great value in the analysis of large clinical trials, when a rater-based analysis would be time-consuming. Copyright © 2017 by the American Society of Neuroimaging.

  2. The value of qualitative and quantitative assessment of lesion to cerebral cortex signal ratio on double inversion recovery sequence in the differentiation of demyelinating plaques from non-specific T2 hyperintensities

    Energy Technology Data Exchange (ETDEWEB)

    Hamcan, Salih; Battal, Bilal; Akgun, Veysel; Sari, Sebahattin; Tasar, Mustafa [Gulhane Military Medical School, Department of Radiology, Etlik, Ankara (Turkey); Oz, Oguzhan; Tasdemir, Serdar [Gulhane Military Medical School, Department of Neurology, Ankara (Turkey); Bozkurt, Yalcin [Golcuk Military Hospital, Department of Radiology, Kocaeli (Turkey)

    2017-02-15

    To assess the usefulness of the visual assessment and to determine diagnostic value of the lesion-to-cerebral cortex signal ratio (LCSR) measurement in the differentiation of demyelinating plaques and non-specific T2 hyperintensities on double inversion recovery (DIR) sequence. DIR and fluid-attenuated inversion recovery (FLAIR) sequences of 25 clinically diagnosed multiple sclerosis (MS) patients and 25 non-MS patients with non-specific T2-hyperintense lesions were evaluated visually and LCSRs were measured by two observers independently. On DIR sequence, the calculated mean LCSR ± SD for demyelinating plaques and non-specific T2-hyperintense lesions were 1.60 ± 0.26 and 0.75 ± 0.19 for observer1, and 1.61 ± 0.27 and 0.74 ± 0.19 for observer2. LCSRs of demyelinating plaques were significantly higher than other non-specific T2-hyperintense lesions on DIR sequence. By using the visual assessment demyelinating plaques were differentiated from non-specific T2-hyperintensities with 92.8 % sensitivity, 97.5 % specificity and 95.1 % accuracy for observer1 and 92.8 % sensitivity, 95 % specificity and 93.9 % accuracy for observer2. Visual assessment and LCSR measurement on DIR sequence seems to be useful for differentiating demyelinating MS plaques from supratentorial non-specific T2 hyperintensities. This feature can be used for diagnosis of MS particularly in patients with only supratentorial T2-hyperintense lesions who are categorized as radiologically possible MS. (orig.)

  3. Features to validate cerebral toxoplasmosis

    Directory of Open Access Journals (Sweden)

    Carolina da Cunha Correia

    2013-06-01

    Full Text Available Introduction Neurotoxoplasmosis (NT sometimes manifests unusual characteristics. Methods We analyzed 85 patients with NT and AIDS according to clinical, cerebrospinal fluid, cranial magnetic resonance, and polymerase chain reaction (PCR characteristics. Results In 8.5%, focal neurological deficits were absent and 16.4% had single cerebral lesions. Increased sensitivity of PCR for Toxoplasma gondii DNA in the central nervous system was associated with pleocytosis and presence of >4 encephalic lesions. Conclusions Patients with NT may present without focal neurological deficit and NT may occur with presence of a single cerebral lesion. Greater numbers of lesions and greater cellularity in cerebrospinal fluid improve the sensitivity of PCR to T gondii.

  4. Prospective study of p-[{sup 123}I]iodo-L-phenylalanine and SPECT for the evaluation of newly diagnosed cerebral lesions: specific confirmation of glioma

    Energy Technology Data Exchange (ETDEWEB)

    Hellwig, Dirk; Schaefer, Andrea; Farmakis, Georgios; Grgic, Aleksandar; Kirsch, Carl-Martin [Saarland University Medical Center, Department of Nuclear Medicine, Homburg/Saar (Germany); Ketter, Ralf; Moringlane, Jean R.; Steudel, Wolf-Ingo [Saarland University Medical Center, Department of Neurosurgery, Homburg (Germany); Romeike, Bernd F.M. [Saarland University Medical Center, Institute of Neuropathology, Homburg (Germany); Friedrich-Schiller-University, Department of Neuropathology, Jena (Germany); Samnick, Samuel [Saarland University Medical Center, Department of Nuclear Medicine, Homburg/Saar (Germany); University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany)

    2010-12-15

    The differentiation between gliomas, metastases and gliotic or inflammatory lesions by imaging techniques remains a challenge. Gliomas frequently exhibit increased uptake of radiolabelled amino acids and are thus amenable to PET or SPECT imaging. Recently, p-[{sup 123}I]iodo-L-phenylalanine (IPA) was validated for the visualization of glioma by SPECT and received orphan drug status. Here we investigated its diagnostic performance for differentiating indeterminate brain lesions. This prospective open study included 67 patients with newly diagnosed brain lesions suspicious for glioma (34 without and 33 with contrast enhancement in the MRI scan). Patients received 250 MBq IPA intravenously after overnight fasting. SPECT images at 30 min and 3 h post-injection were iteratively reconstructed and visually interpreted after image fusion with an MRI brain scan (fluid-attenuated inversion recovery sequence or T1-weighted contrast-enhanced image). Findings were correlated with results of stereotactic or open biopsies or serial imaging. Twenty-seven low-grade (2 WHO I, 25 WHO II) and 24 high-grade gliomas (1 WHO III, 23 WHO IV), 3 metastases originating from lung cancer as well as 13 non-neoplastic lesions were proven. All non-neoplastic lesions and all metastases were negative with IPA SPECT. Forty gliomas were true-positive (TP) and 11 false-negative (FN) findings (8 WHO II, 1 WHO III, 2 WHO IV) occurred. There were no false-positive (FP) findings. For the differentiation of primary brain tumours and non-neoplastic lesions, sensitivity and specificity were 78 and 100%. In 34 lesions without contrast enhancement in MRI, IPA SPECT resulted in 17 TP, 8 true-negative, 9 FN and no FP findings (sensitivity 65%, specificity 100%). In patients with suspected glioma, IPA SPECT shows a high specificity, but especially in low-grade gliomas FN findings may occur. Due to the high positive predictive value a positive finding allows a suspected glioma to be confirmed. (orig.)

  5. 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...

  6. Medidas do índice de resistência ao Doppler craniano em recém-nascidos pré-termo com lesão da substância branca cerebral Cranial Doppler resistance index measurement in preterm newborns with cerebral white matter lesion

    Directory of Open Access Journals (Sweden)

    Nayara Argollo

    2006-06-01

    Full Text Available OBJETIVO: Investigar se o índice de resistência (IR, nas primeiras 72 horas de vida de neonatos com lesão da substância branca (LSB cerebral, correlaciona-se com evolução desfavorável da LSB. MÉTODOS: Estudo retrospectivo. Identificaram-se os neonatos com LSB pelo laudo da ultra-sonografia craniana e foram selecionados aqueles com estudo do Doppler e medida do IR. Os neonatos foram divididos em três grupos: aqueles com IR baixo ( 0,85. A amostra foi analisada como um todo, e, posteriormente, estratificada por peso de nascimento. RESULTADOS: O fluxo sangüíneo cerebral medido pelo IR foi anormal em 46 (68,7%, sendo que em 42 (62,7% estava baixo, e em quatro (6%, alto. Dentre aqueles com baixo IR, 15 (35,7% tiveram evolução desfavorável, com sinais ultra-sonográficos de atrofia cerebral em 10 (23,8% e hemorragia intraventricular em cinco (11,9%. Os quatro neonatos com alto IR tiveram evolução desfavorável, sendo um (25% com sinais de atrofia cerebral e três (75% com hemorragia intraventricular. Não houve diferenças estatisticamente significantes entre os grupos de IR em relação à evolução para o óbito. CONCLUSÃO: O estudo demonstrou que, entre neonatos com LSB cerebral, o IR alterado nas primeiras 72 horas esteve associado com complicações na evolução dessa lesão. A alteração do IR não se associou à evolução para o óbito. Portanto, a medida do IR é importante parâmetro a ser avaliado em neonatos.OBJECTIVE: To investigate whether the resistance index (RI within the first 72 hours of life of newborn infants with cerebral white matter lesion (WML is correlated with the adverse outcome of WML. METHODS: Retrospective study. Newborn infants with WML were identified based on cranial ultrasound results, and those with Doppler imaging and RI measurement were selected. The newborn infants were placed in three groups: low ( 0.85 RI. The sample was analyzed as a whole at first and then stratified according to birth

  7. Focal parenchymal lesions in community-acquired bacterial meningitis in adults: a clinico-radiological study

    Energy Technology Data Exchange (ETDEWEB)

    Katchanov, Juri [Campus Charite Mitte, Charite, Department of Neurology, Berlin (Germany); University Hospital Charite, Campus Benjamin Franklin, Department of Neurology, Berlin (Germany); Siebert, Eberhard; Klingebiel, Randolf [Campus Charite Mitte, Charite, Department of Neuroradiology, Berlin (Germany); Endres, Matthias [Campus Charite Mitte, Charite, Department of Neurology, Berlin (Germany); Charite-Universitaetsmedizin Berlin, Center for Stroke Research Berlin, Berlin (Germany)

    2009-11-15

    Here, we analyzed the frequency, morphological pattern, and imaging characteristics of focal lesions as a consequence of community-acquired bacterial meningitis. We hypothesized that diffusion-weighted imaging combined with contrast-enhanced imaging, serial scanning, and multimodal vascular studies would provide further insight into the pathological basis of such parenchymal lesions in bacterial meningitis. We reviewed clinical and imaging data (i.e., magnetic resonance tomography, magnetic resonance angiography, computed tomography angiography, digital subtraction angiography) of 68 adult patients admitted to our neurological intensive care unit between March 1998 and February 2009 with the diagnosis of community-acquired bacterial meningitis. We identified seven patients with parenchymal lesions. These lesions could be attributed to four morphological patterns: (1) territorial cerebral ischemia, (2) perforating vessels ischemia, (3) ischemia of presumed cardiac origin, and (4) isolated cortical lesions. Whereas the patterns (1) and (2) were associated with vasculopathy of large- and medium-sized vessels (as shown by cerebral vascular imaging), vessel imaging in (3) and (4) did not show abnormal findings. Our study implies that parenchymal lesions in acute bacterial meningitis are mainly ischemic and due to involvement of large-, medium-, and small-sized arteries of the brain. Diffusion-weighted imaging combined with conventional, CT-, or MR-based cerebral angiography revealed the underlying pathophysiological mechanisms in the majority of patients. Furthermore, we detected two patients with isolated bilateral cortical involvement and normal vessel imaging. These lesions might represent ischemia due to the involvement of small pial and intracortical arteries. (orig.)

  8. 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...

  9. Validity of semi-quantitative scale for brain MRI in unilateral cerebral palsy due to periventricular white matter lesions: Relationship with hand sensorimotor function and structural connectivity

    Directory of Open Access Journals (Sweden)

    Simona Fiori

    2015-01-01

    Conclusion: The sqMRI scale demonstrates first evidence of construct validity against impaired motor and sensory function measures and brain structural connectivity in a cohort of children with UCP due to PWM lesions. More severe lesions correlated with poorer paretic hand sensorimotor function and impaired structural connectivity in the hemisphere contralateral to the clinical side of hemiplegia. The quantitative structural MRI scoring may be a useful clinical tool for studying brain structure–function relationships but requires further validation in other populations of CP.

  10. Cerebral lymphoma presenting as a leukoencephalopathy

    Science.gov (United States)

    Ayuso-Peralta, L; Orti-Pareja, M; Zurdo-Hernandez, M; Jimenez-Jimenez, F; Tejeiro-Martinez, J; Ricoy, J; de la Lama, A; Bernardo, A

    2001-01-01

    Cerebral lymphoma is infrequent in immunocompetent patients. This tumour usually appears on CT and MRI as a single lesion or as multiple lesions with mass effect and homogeneous enhancement after contrast administration. A patient is described with a cerebral lymphoma, confirmed by histopathological examination, who presented as a progressive leukoencephalopathy.

 PMID:11459903

  11. [Ischemic stroke and the ways of compensation of cerebral circulation in patients with nonspecific aorto-arteritis with lesions of the brachiocephalic arteries].

    Science.gov (United States)

    Kazanchian, P O; Varava, B N; Todua, F I; Kuntsevich, G I; Zotikov, A E; Iudin, V I; Kon, M V; Volokina, O I; Buklina, S B

    1991-01-01

    In patients suffering from nonspecific aortoarteritis associated with impairment of the common carotid arteries, cerebral blood flow is compensated for at the expense of an increase of the volumetric blood flow in the vertebral arteries. During the first three years since the onset of the first disease symptoms, the blood content in the basin of the internal carotid arteries is reduced. Brain strokes occur most frequently within that period. They mostly develop without any preceding transitory ischemic attacks. The origin of neurological symptomatology depends to a considerable measure on the condition of the anterior and posterior communicating arteries.

  12. Evaluation of cerebral hemodynamics with perfusion CT

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Yuzo; Furuichi, Masahiro; Nokura, Hiroaki [Inuyama Central Hospital, Aichi (Japan); Sakai, Noboru [Gifu Univ. (Japan). School of Medicine

    2002-07-01

    We report on the evaluation of cerebral ischemic lesions with perfusion CT. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of 52 patients mostly with ischemic cerebrovascular disease were analysed using the box-modulation transfer function method with 30 ml of contrast medium intravenously injected at 5 ml/sec. CBF, CBV and MTT of the middle cerebral artery (MCA) territory were 43.5{+-}4.6 ml/100 g/min, 1.9{+-}0.2 ml/100 g and 2.9{+-}0.6 seconds at the unaffected side, and 37.7{+-}7.3 ml/100 g /min, 2.1{+-}0.3 ml/100 g, 3.7{+-}0.9 seconds at the lesion side with stenosis or occlusion in the main MCA trunks or internal carotid artery, respectively. A statistically significant difference was shown in CBF and MTT values. Furthermore, there was a close correlation in CBF values of MCA territories between Xe-CT and perfusion CT (r=0.645, n=76, p<0.0001). MTT showed a positive correlation with CBV in those subjects when MTT was below 4.1 seconds (r=0.526, p<0.0001, n=83). MTT also showed a negative correlation with CBF in those patients when MTT indicated more than 4.1 seconds (r=0.818, p<0.001, n=21). These results suggest that the progression of cerebral ischemia may be classified in 4 stages using perfusion CT. The stages are as follows: stage 0; normal CBF without prolonged MTT and increased CBV, stage 1; relatively increased CBV, stage 2; significantly prolonged MTT, and stage 3; significantly deceased CBF with prolonged MTT. (author)

  13. Pharmacologic modulation of cerebral metabolic derangement and excitotoxicity in a porcine model of traumatic brain injury and hemorrhagic shock

    DEFF Research Database (Denmark)

    Hwabejire, John O; Jin, Guang; Imam, Ayesha M;

    2013-01-01

    Cerebral metabolic derangement and excitotoxicity play critical roles in the evolution of traumatic brain injury (TBI). We have shown previously that treatment with large doses of valproic acid (VPA) decreases the size of brain lesion. The goal of this experiment was to determine whether this eff...

  14. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    of the middle cerebral artery (MCAO) was used as an experimental model of ischemic stroke. MCAO produces an acute lesion consisting of an ischemic core or focus with severely reduced blood flow surrounded by a borderzone or ischemic penumbra with less pronounced blood flow reduction. Cells in the ischemic focus...

  15. Síndrome CLIPPERS con distribución atípica de las lesiones en la resonancia magnética cerebral

    OpenAIRE

    Canneti Heredia, Beatrice; Mosqueira, Antonio J.; Gilo, Francisco; Carreras, Teresa; Barbosa, Antonio; Meca-Lallana, Virginia; Vivancos, José

    2013-01-01

    Introducción. El síndrome CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) es un proceso inflamatorio del sistema nervioso central cuyo rasgo distintivo son las lesiones puntiformes en el troncoencéfalo captantes en los estudios de resonancia magnética. Clínicamente, cursa con disartria, ataxia y diplopía, y suele responder a corticoides. Anatomopatológicamente, aparecen infiltrados de linfocitos T en los espacios perivasculares...

  16. Cerebrovascular hemodynamics in patients with cerebral arteriosclerosis

    Institute of Scientific and Technical Information of China (English)

    Jianbo Yang; Changcong Cui; Chengbin Wu

    2011-01-01

    The present study observed hemodynamic changes in 26 patients with cerebral arteriosclerosis using a cerebral circulation dynamics detector and transcranial Doppler.In patients with cerebral arteriosclerosis the blood supply and flow rate in the bilateral carotid arteries and the blood flow rate in the anterior cerebral and middle cerebral arteries were similar to normal controls, but the cerebral vascular resistance, critical pressure and pulsatility index were increased, and cerebral arterial elasticity and cerebral blood flow autoregulation were decreased.Compared with the lesioned hemisphere of patients with cerebral infarction, the total blood supply and blood flow rate of patients with cerebral arteriosclerosis were higher.Compared with normal subjects, patients with cerebral arteriosclerosis exhibited cognitive disturbances, mainly in short-term memory, attention, abstract capability, and spatial and executive dysfunction.Results showed that cerebral arteriosclerosis does not directly affect the blood supply of a cerebral hemisphere, but affects cognitive function.The increased cerebral vascular resistance and reduced autoregulation of cerebral blood vessels may be important hemodynamic mechanisms of arteriosclerosis-induced cerebral infarction.

  17. The Association between Cerebral White Matter Lesions and Plasma Omega-3 to Omega-6 Polyunsaturated Fatty Acids Ratio to Cognitive Impairment Development

    Directory of Open Access Journals (Sweden)

    Michihiro Suwa

    2015-01-01

    Full Text Available Objective. Cerebral white matter hyperintensity (WMH with magnetic resonance imaging (MRI has a potential for predicting cognitive impairment. Serum polyunsaturated fatty acid (PUFA levels are important for evaluating the extent of atherosclerosis. We investigated whether abnormal PUFA levels affected WMH grading and cognitive function in patients without significant cognitive impairment. Methods. Atherosclerotic risk factors, the internal carotid artery (ICA plaque, and serum ratios of eicosapentaenoic to arachidonic acids (EPA/AA and docosahexaenoic to arachidonic acids (DHA/AA were assessed in 286 patients. The relationship among these risk factors, WMH, and cognitive function was evaluated using WMH grading and the Mini-Mental State Examination (MMSE. Results. The development of WMH was associated with aging, hypertension, ICA plaques, and a low serum EPA/AA ratio (<0.38, obtained as the median value but was not related to dyslipidemia, diabetes, smoking, and a low serum DHA/AA ratio (<0.84, obtained as the median value. In addition, the MMSE score deteriorated slightly with the progression of WMH (29.7 ± 1.0 compared to 28.4 ± 2.1, P<0.0001. Conclusions. The progression of WMH was associated with a low serum EPA/AA ratio and accompanied minimal deterioration in cognitive function. Sufficient omega-3 PUFA intake may be effective in preventing the development of cognitive impairment.

  18. A case of chronic cerebral paragonimiasis westermani.

    Science.gov (United States)

    Kang, S Y; Kim, T K; Kim, T Y; Ha, Y I; Choi, S W; Hong, S J

    2000-09-01

    We report a chronic cerebral paragonimiasis from a 41-year-old Korean man who complains a headache and weakness of left motor neuron components. Magnetic resonance images of the brain revealed conglomerates of multiple ring-like enhancements in temporo-occipital and frontal lobes of the right hemisphere. An intradermal test for paragonimiasis westermani was positive. The patient was born near an endemic area of paragonimiasis and used to eat boiled or grilled freshwater crayfish in his childhood. Nodules in the brain were resected through craniotomies. The eggs of P. westermani were identified pathologically and parasitologically in the calcified necrotic lesions. Examinations on sputum and fecal specimens for the eggs of P. westermani were shown to be negative and a chest radiograph was normal. It is presumed that the brain lesions were formed by P. westermani approximately 30 years ago.

  19. Malaria cerebral Cerebral malaria

    OpenAIRE

    Carlos Hugo Zapata Zapata; Silvia Blair Trujillo

    2003-01-01

    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 citoqu...

  20. Psychological distress is associated with vision-related but not with generic quality of life in patients with visual field defects after cerebral lesions

    Directory of Open Access Journals (Sweden)

    Bernhard A. Sabel

    2012-07-01

    Full Text Available Considerably diminished quality of life (QoL is observed in patients with visual field defects after lesions affecting the visual pathway. But little is known to what extent vision- and health-related QoL impairments are associated with psychological distress. In 24 patients with chronic visual field defects (mean age=56.17±12.36 the National Eye Institute-visual functioning questionnaire (NEI-VFQ for vision-related QoL, the Short Form Health Survey-36 (SF-36 for generic QoL and the revised Symptom-Checklist (SCL- 90-R were administered. Cases with clinically relevant SCL-90-R symptoms were defined. Demographic, QoL and visual field parameters were correlated with SCL-90-R scales. About 40% of the investigated patients met the crite- ria for the definition of psychiatric caseness. 8/12 NEI-VFQ scales correlated significantly with SCL-90-R phobic anxiety (r-range -0.41 to -0.64, P<0.05, 5/12 NEI-VFQ scales correlated with SCL-90-R interpersonal sensitivity (-0.43 to -0.50, and 3/12 with SCL-90-R depression (-0.51 to -0.57 and obsessive-compulsiveness (-0.41 to -0.43. In contrast, only 1/8 SF-36 scales correlated significantly with SCL-90-R depression, phobic anxiety and interpersonal sensitivity (-0.41 to -0.54. No substantial correlations were observed between visual field parameters and SCL-90-R scales. Significant correlations of SCL-90-R with NEI-VFQ but not with SF-36 suggest that self-rated psychological distress is the result of diminished vision- related QoL as a consequence of visual field loss. The extent of visual field loss itself did not influence the rating of psychological distress directly, since SCL-90-R symptoms were only reported when diminished vision-related QoL was present. Patients with reduced vision-related QoL due to persisting visual field defects should therefore be offered additional neuropsychological rehabilitation and supportive psychotherapeutic interventions even years after the lesion.

  1. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  2. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  3. Attempt to identify the functional areas of the cerebral cortex on CT slices parallel to the orbito-meatal line

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, Hirotaka; Okuda, Junichiro; Nishikawa, Takashi; Nishimura, Tsuyoshi (Osaka Univ. (Japan). Faculty of Medicine); Shiraishi, Junzo

    1982-06-01

    In order to identify the functional brain areas, such as Broca's area, on computed tomography slices parallel to the orbito-meatal line, the numbers of Brodmann's cortical mapping were shown on a diagram of representative brain sections parallel to the orbito-meatal line. Also, we described a method, using cerebral sulci as anatomical landmarks, for projecting lesions shown by CT scan onto the lateral brain diagram. The procedures were as follows. The distribution of lesions on CT slices was determined by the identification of major cerebral sulci and fissures, such as the Sylvian fissure, the central sulcus, and the superior frontal sulcus. Those lesions were then projected onto the lateral diagram by comparing each CT slice with the horizontal diagrams of brain sections. The method was demonstrated in three cases developing neuropsychological symptoms.

  4. 应用单光子发射断层显像评价合并大脑后动脉病变的烟雾病患者脑血流灌注%Evaluation of cerebral perfusion in moyamoya diseased patients with posterior cerebral artery lesions by single photon emission tomography examination

    Institute of Scientific and Technical Information of China (English)

    王莉; 段炼; 杨伟中; 龙亚红; 暴向阳; 赵峰; 咸鹏

    2013-01-01

    目的 分析合并大脑后动脉(PCA)病变的烟雾病患者脑血流异常灌注情况.方法 共纳入27例合并PCA病变的烟雾病患者,根据DSA检查结果,判定27例患者54侧的半球的铃木分期,及54支PCA的病变程度.27例患者均接受单光子发射断层显像术(SPECT)检查,记录额叶、顶叶、颞叶、枕叶、基底核区3~4个感兴趣区的平均局部脑血流量(rCBF),用各个脑区rCBF与小脑的rCBF的比值作为各个脑区rCBF的相对值.判定PCA病变程度、不同铃木分期对各脑叶rCBF相对值的影响. 结果 ①随着PCA病变程度的加重,额叶、顶叶、颞叶、枕叶、基底核区的rCBF相对值均逐渐下降,差异具有统计学意义,均P<0.05;其中顶叶轻度PCA病变的rCBF相对值(74±6)高于中度(63±9)、重度病变(60±17) PCA的rCBF相对值,差异有统计学意义;枕叶轻度PCA病变的rCBF相对值(72±7)高于中度(65±9)、重度病变(60±15) PCA的rCBF相对值,差异有统计学意义.②不同铃木分期的额叶、顶叶、颞叶、枕叶、基底核区rCBF相对值比较,差异均无统计学意义,P>0.05. 结论 各脑叶的rCBF相对值随着PCA病变程度加重而下降,但与铃木分期的病变程度无关.脑血管后循环病变可能是影响烟雾病患者脑血流灌注水平的重要因素.%Objective To analyze the abnormal cerebral blood flow perfusion in moyamoya diseased patients with posterior cerebral artery ( PCA) lesions. Methods A total of 27 moyamoya diseased patients with posterior cerebral artery lesions were enrolled in the study. According to the digital subtract an-giography (DSA) results, the Suzuki s stages of 27 patients ( 54 hemispheres) were determined and the PCA grading in all the 27 patients were identified. All the patients accepted single photon emission tomography ( SPECT) examination, and the mean value of three or four regions of interest was calculated in five regions ( frontal, parietal, temporal, and occipital

  5. Brain white matter lesions correlated to newborns death and lethality Fatores correlacionados ao óbito e à letalidade hospitalar em neonatos com lesão da substância branca cerebral

    Directory of Open Access Journals (Sweden)

    Nayara Argollo

    2006-06-01

    Full Text Available OBJECTIVES: to describe hospital lethality rates and factors correlated to death in neonates with brain white matter lesions. METHODS: a retrospective study was performed from January 1994 to December 2001. Neonates with white brain matter lesions were divided into survival and death groups and their medical files reviewed through the single blind method to determine evolution. Death certificates provided the cause of death. The groups were compared through correlation coefficients. Hospital lethality rate was calculated. RESULTS: ninety three cases of white brain matter lesions and seven deaths were determined. Hospital lethality rate was of 8.2.% (95%CI: 2.4-14.0 independently from lesion occurrence time, and of 10.3% (95%CI: 3.3-17.3 for deaths occurred during prenatal and perinatal periods. Death was correlated to: Apgar score, non-cephalic presentation, gestational age, hyperglicemia, hypercalcemia, convulsion, respiratory insufficiency and atelectasy. CONCLUSIONS: hospital lethality was of 10.3% generating the following hypothesis: perinatal asphyxia must be the principal direct and indirect etiologic factor (aggravating the expression of prematurity and infection diseases, of prenatal and perinatal mortality among newborns with white brain matter lesions; and OBJETIVOS: descrever a taxa de letalidade hospitalar e fatores correlacionados com o óbito em crianças com lesão da substância branca cerebral (LSB. MÉTODOS: estudo retrospectivo realizado de janeiro de 1994 a dezembro de 2001. Os neonatos com LSB foram divididos em sobreviventes ou óbito, e seus prontuários revisados de forma cega para a evolução. Dos atestados de óbito, a causa de morte. Os grupos foram comparados por coeficientes de correlação. Calculada a taxa de letalidade hospitalar. RESULTADOS: foram encontrados 93 casos de LSB e sete óbitos. A taxa de letalidade hospitalar foi de 8,2%, (IC95%: 2,4-14,0, independentemente da época de instalação da lesão, e de

  6. Cerebral candidiasis. Computed tomography appearance

    Energy Technology Data Exchange (ETDEWEB)

    Chaabane, M.; Ladeb, M.F.; Bouhaouala, M.H.; Ben Hammouda, M.; Ataalah, R.; Gannouni, A.; Krifa, H.

    1989-07-01

    A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodefinciency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature. (orig.).

  7. 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 ...

  8. Cerebral malaria Malaria cerebral

    OpenAIRE

    Silvia Blair Trujillo; Carlos Hugo Zapata Zapata

    2003-01-01

    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...

  9. [Acute tetraparesis of cerebral origin].

    Science.gov (United States)

    Feuillet, L; Milandre, L; Kaphan, E; Ali Cherif, A

    2005-09-01

    Thrombolytic treatment in the early stage of ischemic cerebral attacks requires rapid confirmation of the diagnosis and topographic localization. Unusual clinical features can lead to misdiagnosis with the risk of delaying optimal therapeutic management. We report the cases of two patients who experienced acute tetraparesis without any associated encephalic sign, consistent with the diagnosis of spinal cord injury. Cervical magnetic resonance imaging (MRI) was normal. Conversely, cerebral MRI displayed in both cases bilateral hemispheric infarction. Two ischemic lesions were revealed in the territory of both anterior cerebral arteries in the first patient, while the second patient had a bilateral infarction in the posterior arms of both internal capsules. In case of tetraparesis, emergency spinal cord MRI should be performed to rule out neurosurgical etiologies and ischemia. If negative, cerebral MRI should be performed at the same time to look for early cerebral infarction in both hemispheres and determine the indication for thrombolysis.

  10. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available 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. 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.

  11. Autopsy case of acute multiple sclerosis with multifocal low density areas in the cerebral white matter on CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Kamikura, Isao; Mizutani, Tomohiko; Sakamaki, Shuji; Takasu, Toshiaki; Kawamura, Toshiaki

    1988-01-01

    A 34-year-old woman presented with urination difficulty and consciousness disturbance, followed by persistent neurologic findings, such as semicomatose mental status and bilateral optic neuritis, and monophasic clinical course. Cranial CT showed multifocal low density areas in cerebral white matter. The patient was clinically diagnosed as having acute disseminated encephalomyelitis. She died of sepsis four months later. Autopsy revealed multifocal large demyelinating lesions confined to the cerebral white matter, shown as low density areas on CT scans, and demyelinating plaques scattered in the optic nerves and chiasm, and cerebral peduncle. The final diagnosis was acute multiple sclerosis. The CT appearance of multifocal low density areas was most likely due to demyelinating lesions causing edema and tissue necrosis. (Namekawa, K.).

  12. Elevated serum MFG-E8 level is possibly associated with the presence of high-intensity cerebral lesions on magnetic resonance imaging in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Kishi, Chikako; Motegi, Sei-Ichiro; Ishikawa, Osamu

    2017-07-01

    Human milk fat globule-EGF factor 8 (MFG-E8), also known as lactadherin, is a secreted glycoprotein that plays essential roles in the clearance of apoptotic cells and angiogenesis. It has been reported that serum MFG-E8 levels are higher in systemic lupus erythematosus (SLE) patients compared with in healthy controls; however, a previous study reported no correlation between serum MFG-E8 levels and SLE disease activity. The objective of this study was to assess serum MFG-E8 levels and their clinical associations in patients with SLE. Serum MFG-E8 levels in 49 Japanese patients with SLE, eight with cutaneous LE, and 28 healthy controls were examined. Serum MFG-E8 levels in SLE patients were significantly higher than those in cutaneous LE patients and healthy individuals. In addition, serum MFG-E8 levels were positively correlated with the SLE Disease Activity Index score, which reflects the disease activity of SLE. Notably, the frequency of the presence of high-intensity cerebral lesions on MRI in the SLE patients with elevated serum MFG-E8 levels was significantly higher than that in SLE patients with normal serum MFG-E8 levels. These findings suggest that elevated serum MFG-E8 levels may be associated with cerebrovascular diseases or neuropsychiatric SLE in patients with SLE, and that the measurement of serum MFG-E8 levels in SLE patients is useful for risk stratification of cerebrovascular disease or cerebrovascular disease-related neuropsychiatric SLE. © 2017 Japanese Dermatological Association.

  13. Detection of tumoral lesions in the posterior fossa, in brain computerized tomography scans for various conditions of acquiring a preliminary approach; Deteccion de lesiones tumorales en fosa posterior en imagenes de Tomografia Computarizada cerebral para diversas condiciones de adquisicion: un enfoque preliminar

    Energy Technology Data Exchange (ETDEWEB)

    Perez, M.; Carvalho-Filho, A. E.; Khoury, H. J.; Casas, M. C.; Andrade, M. E.; Paz, J. E.

    2010-07-01

    The present work performs a study over 13 tomographic images, using an anthropomorphic head phantom. It contains small lesions in the posterior fossa. Tube current (I [mA]), slice thickness (E [mm]), were the parameters changed among studies, looking for the best acquisition conditions, which permit good lesion detectability, and applying the lowest dose. Air Kerma in air [mGy] was calculated. Image quality was analyzed by both expert criterion and some merit figures. Two of them were global: contrasts to noise ratio (RCR [dB]) and signal to noise ratio (RSR). The rest of the measures used were relatives to the maximum dose condition: The gain in signal to noise ratio (SNR [dB]) and the maximum signal to noise ratio (PSNR [dB]), the normalized mean squared error (NMSE) and the structural similarity index (SSIM). Objective and subjective results were correlated. It is shown that it is possible to reduce the dose using lower values of mAs without affecting lesion detectability and keeping good image quality for the scanner used. An optimized protocol is also proposed for the technology used. (Author) 27 refs.

  14. Cerebritis due to Listeria monocytogeneses: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Aladro, Y. [Dept. of Neurology, Hospital Nuestra Senora del Pino, Las Palmas de Gran Canaria (Spain); Ponce, P. [Dept. of Diagnostic Radiology, Hospital Nuestra Senora del Pino, Las Palmas de Gran Canaria (Spain); Santullano, V. [Dept. of Diagnostic Radiology, Hospital Nuestra Senora del Pino, Las Palmas de Gran Canaria (Spain); Angel-Moreno, A. [Dept. of Internal Medicine, Hospital Insular, Univ. of Las Palmas de Gran Canaria (Spain); Angel Santana, M. [Dept. of Diagnostic Radiology, Hospital Nuestra Senora del Pino, Las Palmas de Gran Canaria (Spain)

    1996-04-01

    Infections by Listeria monocytogenes are uncommon, with cerebritis being even rarer. We present three cases of cerebritis which occurred during an outbreak of listeriosis. The CT and MR findings at diagnosis and during follow-up are described. Predominant deep white matter lesions with nodular and ring enhancement were seen. The MR yielded a higher resolution of the lesions than CT. (orig.)

  15. Detection, risk factors, and functional consequences of cerebral microinfarcts

    NARCIS (Netherlands)

    van Veluw, Susanne J; Shih, Andy Y; Smith, Eric E.; Chen, Christopher; Schneider, Julie A.; Wardlaw, Joanna M.; Greenberg, Steven M.; Biessels, Geert Jan|info:eu-repo/dai/nl/165576367

    Cerebral microinfarcts are small lesions that are presumed to be ischaemic. Despite the small size of these lesions, affected individuals can have hundreds to thousands of cerebral microinfarcts, which cause measurable disruption to structural brain connections, and are associated with dementia that

  16. Pure Gerstmann's syndrome from a focal lesion.

    Science.gov (United States)

    Roeltgen, D P; Sevush, S; Heilman, K M

    1983-01-01

    It is controversial whether a focal lesion can specifically induce Gerstmann's syndrome (dyscalculia, left-right disorientation, finger agnosia, and agraphia). Also, Gerstmann's tetrad has been attributed to other cerebral symptoms, particularly aphasia. We examined a patient who had all four symptoms of Gerstmann's syndrome, without other symptoms or signs, and who had a discrete left parietal lesion.

  17. Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging

    Science.gov (United States)

    Meier, Madeline H.; Shalev, Idan; Moffitt, Terrie E.; Kapur, Shitij; Keefe, Richard S.E.; Wong, Tien; Belsky, Daniel W.; Harrington, HonaLee; Hogan, Sean; Houts, Renate; Caspi, Avshalom; Poulton, Richie

    2013-01-01

    Objective Retinal and cerebral microvessels are structurally and functionally homologous, but, unlike cerebral microvessels, retinal microvessels can be noninvasively measured in vivo via retinal imaging. Here we test the hypothesis that individuals with schizophrenia show microvascular abnormality and evaluate the utility of retinal imaging as a tool for future schizophrenia research. Methods Participants were members of the Dunedin Study, a population-representative cohort followed from birth with 95% retention. Study members underwent retinal imaging at age 38 years. We assessed retinal arteriolar and venular caliber for all members of the cohort, including individuals who developed schizophrenia. Results Study members who developed schizophrenia were distinguished by wider retinal venules, suggesting microvascular abnormality reflective of insufficient brain oxygen supply. Analyses that controlled for confounding health conditions suggested that wider retinal venules are not simply an artifact of co-occurring health problems in schizophrenia patients. Wider venules were also associated with a dimensional measure of adult psychosis symptoms and with psychosis symptoms reported in childhood. Conclusions Findings provide initial support for the hypothesis that individuals with schizophrenia show microvascular abnormality. Moreover, results suggest that the same vascular mechanisms underlie subthreshold symptoms and clinical disorder and that these associations may begin early in life. These findings highlight the promise of retinal imaging as a tool for understanding the pathogenesis of schizophrenia. PMID:24030514

  18. Remote multiple intracranial hemorrhage in multiple metastatic lung adenocarcinoma following decompression of posterior fossa lesion: Unknown cause

    Directory of Open Access Journals (Sweden)

    Subhas Konar

    2015-01-01

    Full Text Available Cerebral metastasis can present with hemorrhage. However, multiple hemorrhages in metastatic lesions following surgical decompression of a single lesion are never reported. We report a case of cerebral metastasis from lung cancer that developed multiple hemorrhages in supratentorial metastatic lesions following surgical resection of an infratentorial lesion.

  19. Tumefação cerebral congestiva em vítimas fatais de acidente de trânsito: frequência e associação com outras lesões cranioencefálicas Congestive brain swelling in victims of fatal road traffic accidents: frequency and association with other head injury lesions

    Directory of Open Access Journals (Sweden)

    SEBASTIÃO SILVA GUSMÃO

    1999-12-01

    Full Text Available Realizou-se estudo anatomopatológico macro e microscópico do encéfalo de 120 vítimas fatais de acidente de trânsito. A tumefação cerebral congestiva (TCC ocorreu em 21 (17,5% pacientes. Consoante com a tumefação cerebral, que determina aumento volumétrico do encéfalo, foi encontrado aumento do peso médio do encéfalo. A contusão cerebral foi a lesão mais frequentemente associada com a TCC (76,2%, enquanto os hematomas intracranianos foram observados em quase metade dos casos.A morphological study, macro and microscopical, was made of brain lesions in 120 victims of fatal road traffic accidents. Congestive brain swelling occurred in 21 (17.5% patients. Owing to the brain swelling that increases the brain volume, an increase of brain weight was also observed. Brain contusion was the most frequent lesion associated with congestive brain swelling (76.2%, while the intracranial haematomas were observed in almost half of the cases.

  20. 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.

  1. Therapeutic implications of melatonin in cerebral edema.

    Science.gov (United States)

    Rathnasamy, Gurugirijha; Ling, Eng-Ang; Kaur, Charanjit

    2014-12-01

    Cerebral edema/brain edema refers to the accumulation of fluid in the brain and is one of the fatal conditions that require immediate medical attention. Cerebral edema develops as a consequence of cerebral trauma, cerebral infarction, hemorrhages, abscess, tumor, hypoxia, and other toxic or metabolic factors. Based on the causative factors cerebral edema is differentiated into cytotoxic cerebral edema, vasogenic cerebral edema, osmotic and interstitial cerebral edema. Treatment of cerebral edema depends on timely diagnosis and medical assistance. Pragmatic treatment strategies such as antihypertensive medications, nonsteroidal anti-inflammatory drugs, barbiturates, steroids, glutamate and N-methyl-D-aspartate receptor antagonists and trometamol are used in clinical practice. Although the above mentioned treatment approaches are being used, owing to the complexity of the mechanisms involved in cerebral edema, a single therapeutic strategy which could ameliorate cerebral edema is yet to be identified. However, recent experimental studies have suggested that melatonin, a neurohormone produced by the pineal gland, could be an effective alternative for treating cerebral edema. In animal models of stroke, melatonin was not only shown to reduce cerebral edema but also preserved the blood brain barrier. Melatonin's beneficial effects were attributed to its properties, such as being a potent anti-oxidant, and its ability to cross the blood brain barrier within minutes after its administration. This review summarizes the beneficial effects of melatonin when used for treating cerebral edema.

  2. MRI in human immunodeficiency virus-associated cerebral vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Berkefeld, J.; Lanfermann, H. [Frankfurt Univ. (Germany). Abt. fuer Neuroradiologie; Enzensberger, W. [Klinik fuer Neurologie, Klinikum der Johann Wolfgang Goethe-Univ. Frankfurt am Main (Germany)

    2000-07-01

    Cerebral ischaemia caused by inflammatory vasculopathies has been described as complication of human immunodeficiency virus (HIV) infection. Imaging studies have shown ischaemic lesions and changes of the vascular lumen, but did not allow demonstration of abnormalities within the vessel wall itself. Two HIV-infected men presented with symptoms of a transient ischaemic attack. Initial MRI of the first showed no infarct; in the second two small lacunar lesions were detected. In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed aneurysmal dilatation, with thickening and contrast enhancement of the wall of the internal carotid and middle cerebral (MCA) arteries. These findings were interpreted as indicating cerebral vasculitis. In the first patient the vasculopathy progressed to carotid artery occlusion, and he developed an infarct in the MCA territory, but then remained neurologically stable. In the second patient varicella zoster virus (VZV) infection was the probable cause of vasculitis. The clinical deficits and vasculitic MRI changes regressed with antiviral and immunosuppressive therapy. (orig.)

  3. Relationship Between HbAlc Levels and Cerebral Arterial Lesions in Patients With Ischemic Stroke With Different Glucose Metabolism%不同糖代谢状况缺血性脑卒中患者HbAlc水平与脑动脉病变程度的关系

    Institute of Scientific and Technical Information of China (English)

    詹红艳; 杨红英; 袁莉; 牛春华; 王丽英; 陈丽丽

    2015-01-01

    ObjectiveTo study the relationship between the level of glycosylated hemoglobin and cerebral arterial lesions in patients with ischemic stroke with different glucose metabolism.Methods 120 cases of ischemic stroke patients were chosen from June 2013 to June 2015 in Tangshan workers hospital, according to glucose metabolism is divided into normal group (n=20) and abnormal group (n=65), diabetes group (n=35). To analysis of HbA1c level, risk factors for cerebral artery disease, cerebral artery lesion sites and count of the three groups were compared. ResultsThere were no significant differences in gender, hypertension, smoking, TG, Hcy among the three groups (P>0.05), the differences were statistically signiifcant with alcohol, coronary heart disease, TC, HDL-C, HbAlc, LDL-C In the three groups of patients (P<0.05). In the patients with abnormal glucose metabolism and diabetes mellitus, cerebral blood vessel stenosis was dominated by moderate and severe cerebral artery stenosis, and the main was the main and the most affected (P<0.05).Conclusion Different levels of glucose metabolism affect cerebral vascular lesions and HbAlc level of cerebral artery stenosis, the location of the lesion and lesion count is affect brain artery disease are important risk factors.%目的研究不同糖代谢状况缺血性脑卒中患者的糖化血红蛋白水平与脑动脉病变程度的关系。方法选取2013年6月~2015年6月唐山市工人医院收治的缺血性脑卒中患者120例,根据糖代谢情况分为正常组(n=20)、异常组(n=65)、糖尿病组(n=35),比较三组的一般资料、分析HbAlc水平、脑动脉病变危险因素、脑动脉病变部位及支数。结果三组患者性别、高血压、吸烟、TG、Hcy等方面比较,差异无统计学意义(P>0.05),三组患者中饮酒、冠心病、HbAlc、TC、HDL-C、LDL-C比较,差异有统计学意义(P<0.05);三组患者中,正常组脑血管狭窄以轻度为主,

  4. Cerebral hemodynamics: concepts of clinical importance

    Directory of Open Access Journals (Sweden)

    Edson Bor-Seng-Shu

    2012-05-01

    Full Text Available Cerebral hemodynamics and metabolism are frequently impaired in a wide range of neurological diseases, including traumatic brain injury and stroke, with several pathophysiological mechanisms of injury. The resultant uncoupling of cerebral blood flow and metabolism can trigger secondary brain lesions, particularly in early phases, consequently worsening the patient's outcome. Cerebral blood flow regulation is influenced by blood gas content, blood viscosity, body temperature, cardiac output, altitude, cerebrovascular autoregulation, and neurovascular coupling, mediated by chemical agents such as nitric oxide (NO, carbon monoxide (CO, eicosanoid products, oxygen-derived free radicals, endothelins, K+, H+, and adenosine. A better understanding of these factors is valuable for the management of neurocritical care patients. The assessment of both cerebral hemodynamics and metabolism in the acute phase of neurocritical care conditions may contribute to a more effective planning of therapeutic strategies for reducing secondary brain lesions. In this review, the authors have discussed concepts of cerebral hemodynamics, considering aspects of clinical importance.

  5. Amelioration of cerebral ischemia-reperfusion injury based on liposomal drug delivery system with asialo-erythropoietin.

    Science.gov (United States)

    Ishii, Takayuki; Asai, Tomohiro; Oyama, Dai; Fukuta, Tatsuya; Yasuda, Nodoka; Shimizu, Kosuke; Minamino, Tetsuo; Oku, Naoto

    2012-05-30

    Cerebral ischemia-reperfusion (I/R) injury induces secondary cerebral damage. As drugs for treating this type of injury have shown poor efficacy and adverse side effects in clinical trials, a novel therapeutic strategy has been long awaited. In this study, we focused on the disruption of the blood-brain barrier after stroke, and applied a liposomal drug delivery system (DDS) designed to enhance the pharmacological effect of the neuroprotectant and to avoid side effects. PEGylated liposomes were injected at varying time after the start of reperfusion in transient middle cerebral artery occlusion (t-MCAO) model rats. The results showed PEGylated liposomes accumulated in the ischemic hemisphere at an early stage after reperfusion and were retained in the lesion for at least 24h after injection. We also investigated the effectiveness of asialo-erythropoietin (AEPO)-modified PEGylated liposomes (AEPO-liposomes) in treating the cerebral I/R injury. AEPO-liposome treatment significantly reduced TTC-defined cerebral legion following cerebral I/R injury, and ameliorated motor function compared with vehicle and AEPO treatment. In conclusion, these results indicate that AEPO-liposomes are a promising liposomal formulation for protecting the brain from I/R injury, and that this liposomal DDS has potential as a novel strategy for the treatment of cerebral I/R injury.

  6. The relation between white matter lesions of different parts of brain after acute cerebral infarction and depressive disorder%急性脑梗死后不同部位脑白质病变与抑郁的关系

    Institute of Scientific and Technical Information of China (English)

    姜丽杰; 于敏; 周莹; 侯宇; 娄伟

    2015-01-01

    目的 探讨急性脑梗死后不同部位的脑白质病变(WML)对抑郁发生的影响.方法 纳入大连市第三人民医院神经内科2012年3月至2013年4月住院的急性脑梗死患者97例,根据有无脑白质病变分为2组,比较2组间汉密尔顿焦虑量表(HAMA)评分及汉密尔顿抑郁量表(HAMD)评分有无差异.对有WML组行改良Scheltens评分,并将改良Scheltens评分与HAMD评分进行直线相关分析,了解额叶、颞叶、顶叶、枕叶、基底节、侧脑室旁及小脑、脑干等不同部位的白质损害程度与抑郁严重程度的相关性.结果 有WML组HAMD评分(10±6)分,HAMA评分(11±4)分,无WML组HAMD评分(6±4)分,HAMA评分(9±3)分,2组之间HAMD及HAMA评分比较差异均有统计学意义(均P<0.05);有WML组59例患者HAMD评分(10±6)分与改良Scheltens评分总分(4.39±0.49)分及额叶(2.76±0.43)分、枕叶白质(1.61±0.49)分、额部脑室旁白质(2.85±0.36)分,病变呈明显正相关(r=0.395,P=0.002;r=0.438,P =0.001;r =0.247,P=0.005;r =0.385,P=0.003).结论 急性脑梗死后不同部位的WML与抑郁障碍相关,主要以额部白质病变为主,额部白质病变越严重,抑郁程度越重.%Objective To evaluate the relationship between white matter lesions(WML) of different parts of brain after acute cerebral infarction and depressive disorder.Methods The clinical data of 97 patients with acute cerebral infarction were analyzed.All patients were divided into 2 groups according to with or without WML.The differences of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) between 2 groups were analyzed.The WML group was scored using the semiquatitative rating scale of Scheltens Rating Scale(Scheltens).The correlation between the scheltens of lateral ventricle,frontal lobe,parietal lobe,temporal lobe,occipital lobe,basal ganglia,cerebella,brainstem and HAMD were observed.Results In WML group,the scale of HAMD was 10 ±6 and HAMA was 11 ±4.In without WML group

  7. 创伤性脑损伤后脑白质损伤与认知功能障碍的相关性研究%Correlation study of cerebral white matter lesion with cognitive dysfunction after traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    朱永山; 张玉龙; 程海云; 李晓光; 熊坤林

    2016-01-01

    Objective To analyze the correlation between white matter injury and cognitive dysfunction using diffusion tensor imaging (DTI).Methods Seventeen subjects with TBI hospitalized from October 2012 to September 2013 had Glasgow coma scale (GCS) score of ≥ 13 (mild injury group, 10 cases) and ≤ 12 (moderate-severe injury group, 7 cases).Another 17 healthy subjects were used as controls.All were submitted to DTI examination.Fractional anisotropy (FA) and apparent diffusion coefficient(ADC) values in genu corpus callosum, splenium corpus callosum, posterior internal capsule, anterior internal capsule, and cerebral peduncle were calculated using the Neuro 3D software.Correlations between FA and ADC with the mini-mental state examination (MMSE) score were evaluated.Results Moderate-severe injury group demonstrated significantly reduced FA values in genu corpus callosum and splenium corpus callosum, and significantly increased ADC values of genu corpus callosum, splenium corpus callosum, posterior internal capsule and cerebral peduncle when compared to control group (P <0.05 or 0.01).FA and ADC values in the regions of interest did not differ significantly between mild injury group and control group (P > 0.05).In the genu corpus callosum and splenium corpus callosum, FA values were positively correlated with MMSE score (r =0.636, 0.601), while ADC values were negatively correlated with MMSE score (r =0.552, 0.660).Conclusions DTI reveals the cerebral white matter lesion that is undetectable using CT and conventional MRI.DTI is a helpful tool to evaluate the degree of cognitive function in patients with TBI, which provides the basic reference for the clinical treatment and prognosis.%目的 利用磁共振张量成像(DTI)分析创伤性颅脑损伤(TBI)后脑白质各个参数值的变化与认知功能障碍有无相关性. 方法 选取2012年10月-2013年9月收治的TBI患者17例,按照格拉斯哥昏迷评分(GCS)分为≥13分组(轻度组,10例)和≤12

  8. [Cerebral ischemia and histamine].

    Science.gov (United States)

    Adachi, Naoto

    2002-10-01

    Cerebral ischemia induces excess release of glutamate and an increase in the intracellular Ca2+ concentration, which provoke catastrophic enzymatic processes leading to irreversible neuronal injury. Histamine plays the role of neurotransmitter in the central nervous system, and histaminergic fibers are widely distributed in the brain. In cerebral ischemia, release of histamine from nerve endings has been shown to be enhanced by facilitation of its activity. An inhibition of the histaminergic activity in ischemia aggravates the histologic outcome. In contrast, intracerebroventricular administration of histamine improves the aggravation, whereas blockade of histamine H2 receptors aggravates ischemic injury. Furthermore, H2 blockade enhances ischemic release of glutamate and dopamine. These findings suggest that central histamine provides beneficial effects against ischemic neuronal damage by suppressing release of excitatory neurotransmitters. However, histaminergic H2 action facilitates the permeability of the blood-brain barrier and shows deleterious effects on cerebral edema.

  9. Memòria, reorganització cerebral evidenciada amb fMRI i hipocamp

    OpenAIRE

    Pinillos Blanco, Montserrat

    2013-01-01

    Aquesta pretén ser una revisió general dels processos cognitius normals i de la capacitat de reorganització cerebral en cas de dany cerebral adquirit (lesions i malalties neurodegeneratives). Esta pretende ser una revisión general de los procesos cognitivos normales y de la capacidad de reorganización cerebral en caso de daño cerebral adquirido (lesiones y enfermedades neurodegenerativas). Bachelor thesis for the Psychology program.

  10. Large cerebral vessel occlusive disease in Lyme neuroborreliosis.

    Science.gov (United States)

    Klingebiel, R; Benndorf, G; Schmitt, M; von Moers, A; Lehmann, R

    2002-02-01

    We report on a 12-year-old, previously healthy girl with an acute hemiparesis as the predominant clinical manifestation of Lyme neuroborreliosis (LNB). The diagnosis of LNB was based on cerebrospinal fluid (CSF) studies, laboratory findings and the clinical course whereas the patient's history and the lack of characteristic skin lesions obscured the diagnosis in the beginning. After four weeks of antibiotic and physiotherapeutic treatment, the hemiparetic symptoms had completely resolved. Although evidence of vasculitic and perivascular inflammation in LNB has been described in the literature, large cerebral vessel occlusive disease represents a rare finding. Appropriate treatment strategies can lead to good clinical rehabilitation, as shown in this case, making the timely diagnosis a crucial issue. We conclude that LNB should be considered in every stroke-like episode of unknown origin in children, even in the absence of a history of a tick bite or typical skin lesions.

  11. White Matter Development during Adolescence as Shown by Diffusion MRI

    Science.gov (United States)

    Schmithorst, Vincent J.; Yuan, Weihong

    2010-01-01

    Previous volumetric developmental MRI studies of the brain have shown white matter development continuing through adolescence and into adulthood. This review presents current findings regarding white matter development and organization from diffusion MRI studies. The general trend during adolescence (age 12-18 years) is towards increasing…

  12. Cerebral Venous Thrombosis.

    Science.gov (United States)

    Sassi, Samia Ben; Touati, Nahla; Baccouche, Hela; Drissi, Cyrine; Romdhane, Neila Ben; Hentati, Fayçal

    2016-01-01

    Data regarding cerebral venous thrombosis in North Africa are scarce. This study aims to identify the clinical features, risk factors, outcome, and prognosis of cerebral venous thrombosis in Tunisia. Data of 160 patients with radiologically confirmed cerebral venous thrombosis, hospitalized in Mongi Ben Hmida National Institute of Neurology (Tunis, Tunisia), were retrospectively collected and analyzed. The mean age was 37.3 years with a female predominance (83.1%). The mode of onset was subacute in most cases (56.2%). Headache was the most common symptom (71.3%), and focal neurologic symptoms were the main clinical presentation (41.8%). The most common sites of thrombosis were the superior sagittal sinus (65%) and the lateral sinus (60.6%). More than 1 sinus was involved in 114 (71.2%) patients. Parenchymal lesions observed in 85 (53.1%) patients did not correlate with cerebral venous thrombosis extent. Major risk factors were obstetric causes (pregnancy and puerperium) found in 46 (38.6% of women aged <50 years) patients, followed by anemia (28.1%) and congenital or acquired thrombophilia (16.2%). Mortality rate was of 6.6%. Good outcome at 6 months (modified Rankin Scale ≤2) was observed in 105 (87.5%)of 120 patients available for follow-up. Predictors of poor outcome were altered consciousness and elevated plasma C-reactive protein levels. Clinical and radiologic presentation of cerebral venous thrombosis in Tunisia was quite similar to other parts of the world with, however, a particularly high frequency of obstetric causes. Plasma C-reactive protein level should be considered as a prognostic factor in CVT.

  13. Atividade elétrica cerebral do rato com lesões da formação reticular mesencefálica Electrocorticographic study of the rats's bram after lesioning of the midbrain reticular formation

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1970-09-01

    Full Text Available No presente estudo foram utilizados 73 ratos em preparações agudas e crônicas, nas quais lesamos a formação reticular mesencefálica com corrente contínua (3,5 a 4,0 mA durante 5 a 10 segundos. O eletródio ativo era implantado estereotàxicamente segundo as coordenadas de König e Klippel. As lesões eram feitas parcial ou totalmente, uni ou bilateralmente, e em todos os animais procedeu-se ao controle histológico das áreas lesadas, usando-se o método de Weil. O registro da atividade elétrica cortical foi feito com polígrafo Beckman de 4 canais, utilizando-se derivações bipolares curtas (1mm com eletródios esféricos de platina. As experiências permitiram as seguintes conclusões: 1 — As características eletrofisiológicas dos fusos que ocorrem após lesões da formação reticular mesencefálica são muito semelhantes às dos fusos espontâneos e barbitúricos, inclusive quanto à projeção cortical. Quanto à duração dos potenciais que os constituem, contudo, notamos que a faixa de variação era mais centuada (20 a 80 ms, o que pode ser atribuído à maior complexidade dos potenciais do cérebro isolado, possivelmente pela falta de ação cronadora da formação reticular sobre o sistema sincronizador talâmico. 2 — Os mecanismos envolvidos na gênese dos fusos do sono barbitúrico ou espontâneo e os do cérebro isolado são, pelo menos em parte, dependentes do bloqueio da formação reticular mesencefálica. 3 — A formação reticular mesencefálica ativa preferencialmente o hemisfério cerebral homolateral; o contingente cruzado talvez seja mobilizado somente quando estímulos alertantes intensos atingem o tegmento mesencefálico. 4 — Além da formação reticular mesencefálica deve haver outros mecanismos ativadores corticais, visto que, em preparações agudas de cérebro isolado, observamos: a surtos de curta duração de atividade dessincronizada; b oscilações freqüentes do ECoG durante o registro

  14. Vasoespasmo cerebral

    Directory of Open Access Journals (Sweden)

    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  15. Imaging cerebral small vessel disease at 7 Tesla MRI

    NARCIS (Netherlands)

    Conijn, M.M.A.

    2011-01-01

    Cerebral small vessel disease is a term often used to refer to lacunar infarcts, white matter lesions (WML) and microbleeds; lesions that are thought to be caused by changes in the small vessels of the brain. These lesions are commonly found in the general elderly population. However, it is hard to

  16. Imaging cerebral small vessel disease at 7 Tesla MRI

    NARCIS (Netherlands)

    Conijn, M.M.A.

    2011-01-01

    Cerebral small vessel disease is a term often used to refer to lacunar infarcts, white matter lesions (WML) and microbleeds; lesions that are thought to be caused by changes in the small vessels of the brain. These lesions are commonly found in the general elderly population. However, it is hard to

  17. Spaceflight-induced alterations in cerebral artery vasoconstrictor, mechanical, and structural properties: implications for elevated cerebral perfusion and intracranial pressure

    National Research Council Canada - National Science Library

    Taylor, Curtis R; Hanna, Mina; Behnke, Bradley J; Stabley, John N; McCullough, Danielle J; Davis, 3rd, Robert T; Ghosh, Payal; Papadopoulos, Anthony; Muller-Delp, Judy M; Delp, Michael D

    2013-01-01

    .... Data from ground-based animal models simulating the effects of microgravity have shown that decrements in cerebral perfusion are associated with enhanced vasoconstriction and structural remodeling of cerebral arteries...

  18. Lesiones laborales

    OpenAIRE

    2015-01-01

    Las lesiones laborales se producen por un esfuerzo repetitivo, cuando un exceso de presión se ejerce sobre una parte del cuerpo provocando lesiones óseas, articulares, musculares y daños en los tejidos. Los accidentes laborales también pueden producir una lesión en el organismo y esto sumado a diversos factores es un problema para la reinserción laboral de los trabajadores de la energía eléctrica. Objetivo: Establecer cuáles son las lesiones más frecuentes que afectan a los ...

  19. Computed tomography of sellar and parasellar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hatano, Mitsunori; Aoki, Hideo (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1982-06-01

    Neuroradiological modalities, particularly CT, for sellar and parasellar lesions were reviewed. Although accurate preoperative diagnosis is sometimes difficult, CT diagnosed 83% as far as pituitary adenoma, craniopharyngioma and meningioma were concerned and demonstrated abnormal findings in 95% of parasellar tumors. At the authors' department, CT visualized abnormalities in all cases, with the exception of suprasellar arachnoid cyst, but a histological diagnosis was possible only in 84%. Since lesions including tumors cannot be completely denied even if CT shows normal images, findings by modalities such as plain craniography, cerebral tomography, cerebral angiography and cisternography should be judged comprehensively.

  20. Cerebral toxoplasmosis in AIDS - computerized tomography evaluation; Toxoplasmose cerebral na SIDA - avaliacao por tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Regina Coeli Fonseca [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Hospital Universitario Antonio Pedro. Servico de Radiologia; Narchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia

    1999-06-01

    Cerebral toxoplasmosis is a disease that affects many AIDS's patients. FOr this paper 46 patients with confirmed cases of cerebral toxoplasmosis who did a CT scan between March, 1994 and September, 1997 were examined. Single lesions were found in 28.3% of the patients. The lesions were more frequently detected in the basal ganglia and the frontal lobes. No lesion was larger than 4 cm. As regards the contrast enhancing of the lesions on a CT scan we observed that 54.5% of the lesions had a ring-like contrast enhancing, 36.4% had a nodular contrast enhancing and 6% had a heterogeneous form. After the 21st day of treatment we noticed an improvement in the aspect of the patients'lesions. The improvement of the lesions could be seen through a reduction of the edematous halo, a reduction of the lesion size and a modification in the contrast enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility with cerebral toxoplasmosis, as well as to monitor these patients during treatment. (author)

  1. [Advances in genetic research of cerebral palsy].

    Science.gov (United States)

    Wang, Fang-Fang; Luo, Rong; Qu, Yi; Mu, De-Zhi

    2017-09-01

    Cerebral palsy is a group of syndromes caused by non-progressive brain injury in the fetus or infant and can cause disabilities in childhood. Etiology of cerebral palsy has always been a hot topic for clinical scientists. More and more studies have shown that genetic factors are closely associated with the development of cerebral palsy. With the development and application of various molecular and biological techniques such as chromosome microarray analysis, genome-wide association study, and whole exome sequencing, new achievements have been made in the genetic research of cerebral palsy. Chromosome abnormalities, copy number variations, susceptibility genes, and single gene mutation associated with the development of cerebral palsy have been identified, which provides new opportunities for the research on the pathogenesis of cerebral palsy. This article reviews the advances in the genetic research on cerebral palsy in recent years.

  2. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Right Sport for You Healthy School Lunch Planner Cerebral Palsy KidsHealth > For Teens > Cerebral Palsy Print A A ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  3. Regional cerebral blood flow in various types of brain tumor. Effect of the space-occupying lesion on blood flow in brain tissue close to and remote from tumor site

    DEFF Research Database (Denmark)

    Kuroda, K; Skyhøj Olsen, T; Lassen, N A

    1982-01-01

    Regional cerebral blood flow (rCBF) was measured in 23 patients with brain tumors using the 133Xe intra-carotid injection method and a 254 channel gamma camera. The glioblastomas (4) and astrocytomas (4) all showed hyperemia in the tumor and tumor-near region. This was also seen in several mening...

  4. [Intraoperative monitoring of cerebral blood-flow and condition of cerebral at open and endovascular interventions in carotid system].

    Science.gov (United States)

    Kuntsevich, G I; Tanashian, M M; Skrylev, S I; Krotenkova, M V; Shchipakin, V L; Koshcheev, A Iu; Lagoda, O V; Gemdzhian, E G; Medvedev, R B; Kulikova, S N

    2011-01-01

    The aim of our research is to study hemodynamic and embolic situation during the carotid endarterectomy (CEA), carotid angioplastic and stenting (CAS), and to reveal the prognostic significance of the data provided by intraoperative monitoring of the brain blood flow in exposing acute ischemic lesions in brain. Intraoperative monitoring of blood flow in artery ophthalmic vas carried out with 60% of patients, in the middle cerebral artery-with 40% during the main stages of CEA, and with 64 patients in the middle cerebral artery during CAS. The comparison of the data of intraoperative monitoring of blood flow in middle cerebral artery with the result of brain diffusion-weighted magnetic resonance imaging (DW-MRI) 24 hours after the operation shows, that solid microembolic signals and vasospasm are prognostic signals (sensibility and specifics make up 95%) in the development of acute ischemic cerebral lesions. The monitoring of blood flow in artery ophthalmic is of the greatest diagnostic value in estimation of the hemodynamic situation, but it is of the lowest practical value in detecting microembolic signals. According to the data of the intraoperative blood flow monitoring in middle cerebral artery in group CEA the development of acute ischemic cerebral lesions were predicted with 11,1% of patients and the cause of postoperative stroke, developed by 2,9% of the patients, was specified. According to the result of DW-MRI, acute ischemic cerebral lesions were diagnosed with 21% of patients, that is, 18% of ischemic cerebral lesions were asymptomatic. In group CAS ischemic cerebral lesions were prognosed with 30% of patients, actually they were later detected with 40,6% of cases by means of DW-MRI. According to the data of intraoperative of blood flow monitoring the cause of the development of postoperative stroke was specified in 6,2% of cause; in 34,4% of cause the acute ischemic cerebral lesions were asymptomatic.

  5. Clinical experience with L-lysine escinate for acute and chronic cerebral circulatory disorders

    Directory of Open Access Journals (Sweden)

    N. V. Pizova

    2015-01-01

    Full Text Available Cerebrovascular diseases (CVD are major causes of disability and death in Russia. Stroke is the third significant cause of higher death rates after cardiovascular disease and cancer. The prevalence of circulatory diseases, such as atherosclerosis and hypertension, is on the rise. Therapy for CVD must be aimed at the underlying disease in which vascular catastrophe (atherosclerosis, hypertension, heart disease, etc. develops, at the regression of neurological and psychopathological syndromes, and at the improvement of cerebral blood flow and metabolic processes. Neuroprotective agents, whose efficacy has been established in uncontrolled and small placebo-controlled trials, are widely used in our country. The prescription of these medications is substantiated by the important role of the pathogenetic mechanisms underlying cerebral ischemia. This paper gives data on the clinical use of L-lysine escinate for ischemic stroke (IS, hypertensive crisis, and chronic cerebral circulatory disorders and discusses the mechanism of this drug's action and the pathogenetic mechanisms of cerebrovascular lesions. A number of investigations have shown it expedient to incorporate L-lysine escinate in the combined neuroprotective therapy of patients with IS, cerebral hypertensive crisis, and hypertensive encephalopathy, which is associated with its antiedematous effect, particularly in preventing vasogenic brain edema, in enhancing the tone of cerebral veins, and in improving venous outflow. It is stated that there is a need for an individualized approach to treating CVD, by taking into consideration the existing risk factors and somatic and neurological diseases. 

  6. Gear Durability Shown To Be Improved by Superfinishing

    Science.gov (United States)

    Krautz, Timothy L.

    2000-01-01

    Gears, bearings, and similar mechanical elements transmit loads through contacting surfaces. At the NASA Glenn Research Center at Lewis Field, we postulated that the fatigue lives of gears could be improved by providing smoother tooth surfaces. A superfinishing process was applied to a set of conventionally ground, aerospace-quality gears. This process produced a highly polished, mirrorlike surface as shown in the preceding photograph. The surface fatigue lives of both superfinished and conventionally ground gears were measured by experiments. The superfinished gears survived about four times longer than the conventionally ground gears. These superfinished gears were produced from conventionally ground, aerospace-quality gears whose geometry had been inspected. The gears were superfinished by placing them in a vibrating bath consisting of water, detergent, abrasive powder, and small pieces of zinc. Upon removal from the bath, the surfaces were highly polished, as depicted in the preceding photograph. The gears were again inspected, and dimensional measurements made before and after the superfinishing operation were compared. Superfinishing removed the peaks of the grinding marks and left a much smoother surface. Profile and spacing checks proved that the overall gear tooth shape was not affected in any harmful way. Superfinishing uniformly removed approximately 2.5 microns from each surface.

  7. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

    Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológi...

  8. Pink lesions.

    Science.gov (United States)

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  9. Radiologic findings of cerebral septic embolism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jee Young; Kim, Sang Joon; Kim Tae Hoon; Kim, Seung Chul; Kim, Jae Seung; Pai, Hyun Joo [Dankook Univ., Seoul (Korea, Republic of). Coll. of Medicine; Kim, Dong Ik [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine; Chang, Kee Hyun [Seoul National Univ. (Korea, Republic of). Coll. of Medicine; Choi, Woo Suk [Kyung Hee Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-01-01

    To determine the MR and CT findings which differentiate cerebral septic embolism from thrombotic infarction. Cerebral septic embolism was confirmed by blood culture in six patients and autopsy in two. The number, size, distribution, contrast enhancement, and hemorrhage of the lesions, as seen on MR and CT, were retrospectively analyzed, and four patients were followed up for between one week and seven months. In a total of eight patients, infective endocarditis (n=5) and sepsis (n=3) caused cerebral septic embolism. The number, of lesions was 3 {approx} 7 in six patients, over 10 in one, and innumerable in one: these varied in size from punctate to 6 cm and were distributed in various areas of the brain. Gyral infarction was noted in five patients: non-enhancing patchy lesions involving the basal ganglia or white matter were found in five, tiny isolated nodular or ring-enhancing small lesions involving the cortex and white matter in three, peripheral rim-enhancing large lesions in one, and numerous enhancing nodules disseminated in the cortex in one. Hemorrhage had occurred in six. follow-up studies in four patients showed that initial lesions had enlarged in two and regressed in two: new lesions had appeared in two. Multiple lesions of different sizes and various patterns which include gyral infarction, patchy or nodular lesion in the cortex, white mater of basal ganglia, and isolated small ring-like or nodular enhancement or frequent hemorrhage are findings which could be helpful in the radiologic diagnosis of cerebral septic embolism. (author). 8 refs., 5 figs.

  10. Could autologous cord blood stem cell transplantation treat cerebral palsy?

    National Research Council Canada - National Science Library

    Chen, Aiqing; Clowry, Gavin J

    2011-01-01

    .... This is why initially in cerebral palsy only subtle changes in spontaneous movements are seen after the time of lesion, followed by a progressive evolution of a movement disorder over many months and years...

  11. Neuroprotective effects of female sex steroids in cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Drača Sanja

    2013-03-01

    Full Text Available The central and peripheral nervous system are important targets of sex steroids. Sex steroids affect the brain development and differentiation, and influence neuronal functions. Recent evidence emphasizes a striking sex-linked difference in brain damage after experimental stroke, as well as the efficacy of hormones in treating cerebral stroke injury. Several different models of cerebral ischemia have been utilized for hormone neuroprotection studies, including transient or permanent middle cerebral artery occlusion, transient global ischemia, and transient forebrain ischemia. Extensive experimental studies have shown that female sex steroids such as progesterone and 176-estradiol exert neuroprotective effects in the experimental models of stroke, although deleterious effects have also been reported. Also, a significance of numerous factors, including gender and age of experimental animals, localization of brain lesion, duration of ischemia and precise dose of steroids has been pointed out. There are multiple potential mechanisms that might be invoked to explain the beneficial effects of female sex steroids in brain injury, involving neuroprotection, anti-inflammatory properties, effects on vasculature and altered transcriptional regulation. A several clinical trials on the effects of sex hormones to traumatic brain injury have been performed, suggesting that hormone therapy may represent a new therapeutic tool to combat certain diseases, such as traumatic brain injury. Further basic science studies and randomized clinical trials are necessary to reveal a potential application of these molecules as a new therapeutic strategy.

  12. Cerebral computed tomography in men with acquired immunodeficiency syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Brun, B.; Boesen, F.; Gerstoft, J.; Nielsen, J.O.; Praestholm, J.

    Cerebral CT scannings were performed in 19 homosexual men with the acquired immunodeficiency syndrome (AIDS). Nearly half of them (9 patients) had cortical atrophy. Three patients with toxoplasmosis had cerebral pathology, in two of them with ring enhancement while the third had an ill-defined nonspecific lesion with slight heterogeneous enhancement without ring formation. Two patients with multifocal leucoencephalopathy and non-Hodgkin's lymphoma, respectively, presented non-enhancing, low attenuating lesions at CT.

  13. Detection of cerebral microbleeds with quantitative susceptibility mapping in the ArcAbeta mouse model of cerebral amyloidosis

    Science.gov (United States)

    Klohs, Jan; Deistung, Andreas; Schweser, Ferdinand; Grandjean, Joanes; Dominietto, Marco; Waschkies, Conny; Nitsch, Roger M; Knuesel, Irene; Reichenbach, Jürgen R; Rudin, Markus

    2011-01-01

    Cerebral microbleeds (CMBs) are findings in patients with neurological disorders such as cerebral amyloid angiopathy and Alzheimer's disease, and are indicative of an underlying vascular pathology. A diagnosis of CMBs requires an imaging method that is capable of detecting iron-containing lesions with high sensitivity and spatial accuracy in the presence of potentially confounding tissue abnormalities. In this study, we investigated the feasibility of quantitative magnetic susceptibility mapping (QSM), a novel technique based on gradient-recalled echo (GRE) phase data, for the detection of CMBs in the arcAβ mouse, a mouse model of cerebral amyloidosis. Quantitative susceptibility maps were generated from phase data acquired with a high-resolution T2*-weighted GRE sequence at 9.4 T. We examined the influence of different regularization parameters on susceptibility computation; a proper adjustment of the regularization parameter minimizes streaking artifacts and preserves fine structures. In the present study, it is shown that QSM provides increased detection sensitivity of CMBs and improved contrast when compared with GRE magnitude imaging. Furthermore, QSM corrects for the blooming effect observed in magnitude and phase images and depicts both the localization and spatial extent of CMBs with high accuracy. Therefore, QSM may become an important tool for diagnosing CMBs in neurological diseases. PMID:21847134

  14. A functional lesion in developmental dyslexia: left angular gyral blood flow predicts severity.

    Science.gov (United States)

    Rumsey, J M; Horwitz, B; Donohue, B C; Nace, K L; Maisog, J M; Andreason, P

    1999-11-01

    Functional imaging studies have shown reduced regional cerebral blood flow (rCBF) in temporal and inferior parietal regions in dyslexia. To relate such abnormalities to the severity of dyslexia, correlations between reading skill and rCBF during a series of reading tasks and visual fixation were mapped for 17 right-handed dyslexic men, ages 18-40, and 14 matched controls. These correlations uniquely identified the left angular gyrus as the most probable site of a functional lesion in dyslexia: Here, higher rCBF was associated with better reading skill in controls (p alexia. Copyright 1999 Academic Press.

  15. Cerebral palsy update.

    Science.gov (United States)

    Krägeloh-Mann, Ingeborg; Cans, Christine

    2009-08-01

    A common language on CP has been developed for the European registers by the SCPE (Surveillance of Cerebral Palsy in Europe) working group and the common database allows prevalence analyses on a larger basis. CP prevalence increases with lower birthweight and higher immaturity. Increase of survival after preterm birth has first also increased CP rates. But already in the 80s this trend was reversed for LBW infants, and in the 90 s also for VLBW or very immature infants. The outcome with respect to CP in the group of extremely LBW or immature infants remains a matter of specific concern, as prevalence seems to be rather stable on a high level. CP is caused in more than 80% by brain lesions or maldevelopments which can be attributed to different timing periods of the developing brain. Extent and topography determine the clinical subtype of CP and are related also to the presence and severity of associated disabilities. CP, thus, offers a model to study plasticity of the developing brain. Reorganisation following unilateral lesions is mainly interhemispheric and homotopic. In the motor system, it involves the recruitment of ipsilateral tracts; functionality seems to be limited and decreases already towards the end of gestation. There is no clear evidence for substantial reorganisation in the sensory system. The best compensatory potential is described concerning language function following left hemispheric lesions. Language function reorganized to the right hemisphere eventually seems not to be impaired, this occurs, however, on the expense of primary right hemispheric functions.

  16. Cerebral Small Vessel Disease in Dementia and Depression: a prospective population-based MRI study

    NARCIS (Netherlands)

    N.D. Prins (Niels)

    2004-01-01

    markdownabstract__Abstract__ Cerebral white matter lesions and asymptomatic brain infarcts are common in elderly people. These brain lesions are thought to result from cerebral small vessel disease, and their presence and severity increase with age and the presence of arterial hypertension. There i

  17. A novel mouse model of cerebral cavernous malformations based on the two-hit mutation hypothesis recapitulates the human disease.

    Science.gov (United States)

    McDonald, David A; Shenkar, Robert; Shi, Changbin; Stockton, Rebecca A; Akers, Amy L; Kucherlapati, Melanie H; Kucherlapati, Raju; Brainer, James; Ginsberg, Mark H; Awad, Issam A; Marchuk, Douglas A

    2011-01-15

    Cerebral cavernous malformations (CCMs) are vascular lesions of the central nervous system appearing as multicavernous, blood-filled capillaries, leading to headache, seizure and hemorrhagic stroke. CCM occurs either sporadically or as an autosomal dominant disorder caused by germline mutation of one of the three genes: CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10. Surgically resected human CCM lesions have provided molecular and immunohistochemical evidence for a two-hit (germline plus somatic) mutation mechanism. In contrast to the equivalent human genotype, mice heterozygous for a Ccm1- or Ccm2-null allele do not develop CCM lesions. Based on the two-hit hypothesis, we attempted to improve the penetrance of the model by crossing Ccm1 and Ccm2 heterozygotes into a mismatch repair-deficient Msh2(-/-) background. Ccm1(+/-)Msh2(-/-) mice exhibit CCM lesions with high penetrance as shown by magnetic resonance imaging and histology. Significantly, the CCM lesions range in size from early-stage, isolated caverns to large, multicavernous lesions. A subset of endothelial cells within the CCM lesions revealed somatic loss of CCM protein staining, supporting the two-hit mutation mechanism. The late-stage CCM lesions displayed many of the characteristics of human CCM lesions, including hemosiderin deposits, immune cell infiltration, increased endothelial cell proliferation and increased Rho-kinase activity. Some of these characteristics were also seen, but to a lesser extent, in early-stage lesions. Tight junctions were maintained between CCM lesion endothelial cells, but gaps were evident between endothelial cells and basement membrane was defective. In contrast, the Ccm2(+/-)Msh2(-/-) mice lacked cerebrovascular lesions. The CCM1 mouse model provides an in vivo tool to investigate CCM pathogenesis and new therapies.

  18. Parasellar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ruscalleda, J. [Hospital Sant Pau, Radiology Department, Neuroradiology, Barcelona (Spain)

    2005-03-01

    The sellar and parasellar region is an anatomically complex area that represents a crucial crossroad of important adjacent structures, e.g. orbits, cavernous sinus and its content, polygon of Willis, hypothalamus through the pituitary stalk and dural reflections forming the diaphragm sellae and the walls of the cavernous sinuses. Although the cavernous sinus represents the most relevant parasellar structure, from the practical and clinical point of view all the structures that surround the sella turcica can be included in the parasellar region. CT and, mainly, MRI are the imaging modalities to study and characterise the normal anatomy and the majority of processes in this region. We present a practical short review of the most relevant CT and MRI characteristics, such as location, nature of contrast enhancement and presence of cystic components, together with clinical findings, which permit differentiation of the most frequent and less common lesions found in the parasellar region. Learning objectives: A short review of the anatomy and clinical symptoms related to the parasellar region. Radiological characterisation, mainly by MRI, of the many lesions that alter the structure and function of sellar and parasellar anatomy. Description of the MRI features that permit differentiation among less common lesions. (orig.)

  19. The anatomy of cerebral achromatopsia: a reappraisal and comparison of two case reports.

    Science.gov (United States)

    Bartolomeo, Paolo; Bachoud-Lévi, Anne-Catherine; Thiebaut de Schotten, Michel

    2014-07-01

    Brain damage can produce acquired deficits of color perception, or cerebral achromatopsia. In these patients, lesions tend to overlap on a restricted region in the ventral occipitotemporal cortex, close to the reported locations of the putative V4 complex and to foci of increased blood-oxygen-level-dependent (BOLD) activity related to color perception in normal participants. Unilateral lesions give rise to achromatopsia in the contralateral visual field (hemiachromatopsia). Here we present a partial English translation of the first case report of a hemiachromatopsic patient with detailed anatomical evidence (Madame R., Verrey, 1888), and discuss these results in relation to a more recent case report (Madame D., Bartolomeo et al., 1997) of a patient with two consecutive hemorrhagic lesions in the occipitotemporal regions of the two hemispheres. Strikingly, Madame D. developed full-field achromatopsia after the second lesion in the right hemisphere, without having shown any signs of hemiachromatopsia after the first lesion in the left hemisphere. Thanks to the comparison of the reconstructed lesion patterns between the two patients and with the putative location of color-related areas in the human brain, we offer a possible, if speculative, account of this puzzling pattern of anatomo-clinical correlations, based on intra- and inter-hemispheric connectivity. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Stochastic model of Tsc1 lesions in mouse brain.

    Directory of Open Access Journals (Sweden)

    Shilpa Prabhakar

    Full Text Available Tuberous sclerosis complex (TSC is an autosomal dominant disorder due to mutations in either TSC1 or TSC2 that affects many organs with hamartomas and tumors. TSC-associated brain lesions include subependymal nodules, subependymal giant cell astrocytomas and tubers. Neurologic manifestations in TSC comprise a high frequency of mental retardation and developmental disorders including autism, as well as epilepsy. Here, we describe a new mouse model of TSC brain lesions in which complete loss of Tsc1 is achieved in multiple brain cell types in a stochastic pattern. Injection of an adeno-associated virus vector encoding Cre recombinase into the cerebral ventricles of mice homozygous for a Tsc1 conditional allele on the day of birth led to reduced survival, and pathologic findings of enlarged neurons, cortical heterotopias, subependymal nodules, and hydrocephalus. The severity of clinical and pathologic findings as well as survival was shown to be dependent upon the dose and serotype of Cre virus injected. Although several other models of TSC brain disease exist, this model is unique in that the pathology reflects a variety of TSC-associated lesions involving different numbers and types of cells. This model provides a valuable and unique addition for therapeutic assessment.

  1. Cerebral neoplastic enhancing lesions: Multicenter, randomized, crossover intraindividual comparison between gadobutrol (1.0 M) and gadoterate meglumine (0.5 M) at 0.1 mmol Gd/kg body weight in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Anzalone, Nicoletta, E-mail: anzalone.nicoletta@hsr.it [Department of Neuroradiology, Scientific Institute H.S. Raffaele, Via Olgettina 60, 20132 Milan (Italy); Scarabino, Tommaso, E-mail: tscarabino@hotmail.com [“L. Bonomo” Hospital Center, Viale Istria 1, 70031 Andria (Italy); Venturi, Carlo, E-mail: c.venturi@ao-siena.toscana.it [U.O.C. Neuroimaging and Neurointerventional, “Santa Maria alle Scotte” Polyclinic, Viale Bracci 16, 53100 Siena (Italy); Cristaudo, Concetto, E-mail: concetto.cristaudo@tiscali.it [Cannizzaro Hospital, Via Messina, 829, 98125 Catania (Italy); Tartaro, Armando, E-mail: a.tartaro@radiol.unich.it [Institute for Advanced Biomedical Techniques, Clinical Sciences and Bioimaging Dept., G.D’Annunzio University, Via dei Vestini, 66100 Chieti (Italy); Scotti, Giuseppe, E-mail: scotti.giuseppe@hsr.it [University Scientific Institute, San Raffaele Hospital, Via Olgettina 60, 20090 Milano (Italy); Zimatore, Domenico, E-mail: dszimatore@hotmail.it [Maggiore Borgo Trento City Hospital, Piazzale Stefani 1, 37126 Verona (Italy); Floris, Roberto, E-mail: roberto.floris@uniroma2.it [Dept. of Diagnostic and Molecular Imaging, UOC of Neuroradiology, Tor Vergata Polyclinics, Viale Oxford 81, 00133 Roma (Italy); Carriero, Alessandro, E-mail: profcarriero@virgilio.it [“Maggiore della Carità” University Hospital, Corso Mazzini, 18, 28100 Novara (Italy); Longo, Marcello, E-mail: longomar@tin.it [“G. Martino” University Polyclinic, Via Consolare Valeria, 1, 98125 Messina (Italy); Cirillo, Mario, E-mail: emmecirillo@libero.it [Second University Hospital c/o CTO, Viale Colli Aminei, 21, 80131 Napoli (Italy); and others

    2013-01-15

    Objective: Two macrocyclic extracellular contrast agents, one-molar neutral gadobutrol and ionic gadoterate meglumine, were compared to determine the overall preference for one or the other in a clinical setting. Materials and methods: Multicenter, randomized, single-blind, intra-individually controlled, comparison study with a corresponding blinded read. Efficacy analysis was based on 136 patients who underwent identical MRI examinations: group A first received 1.0 M gadobutrol followed by 0.5 M gadoterate meglumine 48 h to 7 days later; group B had a reversed administration order. Three independent blinded readers assessed off-site their overall diagnostic preference (primary efficacy parameter) based on a matched pairs approach. Results: Superiority of gadobutrol over gadoterate meglumine was demonstrated for the qualitative assessment of overall preference across all readers by a statistically significant difference between both contrast agents for this primary endpoint. Preferences in lesion enhancement (secondary endpoint) were also found significantly in favor of gadobutrol. For preference in lesion delineation from surrounding tissue/edema and for internal structure only a trend towards a higher proportion for gadobutrol was found (except for internal structure reported by one reader, which showed a result of statistical significance). Lesion contrast and relative lesion enhancement (quantitative parameters) were statistically significantly higher for gadobutrol compared to gadoterate meglumine. Conclusion: Contrast-enhanced MRI of neoplastic brain lesions at a dose of 0.1 mmol Gd/kg body weight, assessed in a standardized off-site blinded reading, results in a significantly higher qualitative and quantitative preference for gadobutrol compared to gadoterate meglumine.

  2. Inter-individual Relationships between Sympathetic Arterial Baroreflex Function and Cerebral Perfusion Control in Healthy Males

    OpenAIRE

    Trevor Witter; Yu-Chieh Tzeng; Terry O'Donnell; Jessica Kusel; Bridget Walker; Mary Berry; Chloe E. Taylor

    2017-01-01

    Maintenance of adequate cerebral perfusion during normal physiological challenges requires integration between cerebral blood flow (CBF) and systemic blood pressure control mechanisms. Previous studies have shown that cardiac baroreflex sensitivity (BRS) is inversely related to some measures of cerebral autoregulation. However, interactions between the sympathetic arterial baroreflex and cerebral perfusion control mechanisms have not been explored. To determine the nature and magnitude of the...

  3. Parallel and serial processing of haptic information in man: effects of parietal lesions on sensorimotor hand function.

    Science.gov (United States)

    Knecht, S; Kunesch, E; Schnitzler, A

    1996-07-01

    Recent animal studies have shown that there is an evolutionary shift within the order of primates from parallel to serial processing of haptic information. In an attempt to determine whether there is also evidence of serial processing in humans 10 patients with parietal cortical lesions, three patients with subcortical lesions and one patient after hemispherectomy, were examined. Case-by-case and across subject analysis of lesion type, sensorimotor profile and electrophysiological findings showed that in unihemispheric lesions: (a) there is little impairment of thermesthesia, nociception and vibration sense: (b) two-point discrimination and integrity of the N20 somatosensory component are highly correlated; (c) a loss of the N20 component is accompanied by a severe impairment of stereognosis; (d) conversely, in more posterior lesions astereognosis can occur with an intact N20 component; and (e) if the lesion is in the right hemisphere there is frequently impairment of graphesthesia in both hands. These data are taken to indicate serial processing from SI (as evidenced by an intact N20 component) to posterior parietal cortex allowing progressive spatial and temporal integration. In graphesthesia our data suggest an integrative function of the right parietal cortex for both sides of the body. Other sensory qualities like vibration nociception and thermesthesia are apparently processed in a non-serial, probably parallel way involving both hemispheres. The effects of cerebral lesions in our series suggest parallel as well as serial processing of somesthetic information in man underlying the perception of different haptic features.

  4. Multiple cerebral hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Banzo, J.; Pina, J.I.; Abos, M.D.; Rios, G.; Garcia, D.; Marin, F.; Diaz, F.J.

    1984-12-01

    A 39-year-old woman was admitted to hospital with headaches, vomiting, psychic impairment and diplopia. Three hydatid cysts of the lung had been previously removed. An avascular mass in the left hemisphere with left-to-right displacement of the anterior cerebral arteries was noted during a brain angioscintigraphy. A cerebralthrombosis (CT) brain scan showed two cystic lesions situated in the left-frontal and occipital regions. A CT abdominal scan showed multiple cysts in the liver, spleen and both kidneys. At operation, two brain cysts were totally extirpated without rupture. The definite pathological diagnosis was secondry hydatid cysts. The headaches, vomiting and diplopia were persistent in the post-operative period. Seven days after the operation, a CT brain scan showed an infratenrorial cyst. The patient rejected any surgical intervention.

  5. Hyponatraemia secondary to cerebral salt wasting syndrome following routine pituitary surgery.

    Science.gov (United States)

    Atkin, S L; Coady, A M; White, M C; Mathew, B

    1996-08-01

    A female aged 53 years was found to have a suprasellar lesion, which was shown to be a Rathke's cyst after removal by transsphenoidal surgery. She presented 16 days postoperatively, and following two grand mal seizures was found to be profoundly hyponatraemic (sodium 101 nmol/l). She was initially thought to have the syndrome of inappropriate antidiuretic hormone and was treated accordingly, but central venous pressure measurement revealed the hypovolaemia of cerebral salt wasting syndrome. The patient subsequently developed severe neurological sequelae after the correction of her hyponatraemia, following the development of extrapontine myelinolysis. Cerebral salt wasting syndrome is a rare cause of hyponatraemia following pituitary transsphenoidal surgery, which may mimic the syndrome of inappropriate antidiuretic hormone secretion. This case emphasizes the poor prognosis that may result from the rapid correction of profound hyponatraemia.

  6. 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 ...

  7. Clinical practice: swallowing problems in cerebral palsy.

    NARCIS (Netherlands)

    Erasmus, C.E.; Hulst, K. van; Rotteveel, J.J.; Willemsen, M.A.A.P.; Jongerius, P.H.

    2012-01-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the

  8. Clinical practice: swallowing problems in cerebral palsy.

    NARCIS (Netherlands)

    Erasmus, C.E.; Hulst, K. van; Rotteveel, J.J.; Willemsen, M.A.A.P.; Jongerius, P.H.

    2012-01-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the

  9. Tachyzoites of Toxoplasma gondii irradiated with 255 Gy induces decrease of cysts and cerebral lesions in mice challenged with cysts of ME-49; Taquizoitos de Toxoplasma gondii irradiados com 255 Gy induzem diminuicao de cistos e lesoes cerebrais em camundongos desafiados com cistos da cepa ME-49

    Energy Technology Data Exchange (ETDEWEB)

    Hiramoto, Roberto Mitsuyoshi; Galisteo Juniorm Andres Jimenez; Nascimento, Nanci do; Andrade Junior, Heitor Franco de [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil). Lab. de Biologia Molecular]. E-mail: rmhiramoto@bol.com.br; hfandrad@usp.br

    2002-07-01

    Toxoplasmosis can cause ocular lesions in normal individuals and several diseases in foetus, HIV infection and transplants. Toxoplasma gondii has a complex life cycle, involving cats, as the definitive host, and warm blood species, as intermediated hosts. The infection occurs by ingestion of food and water contaminated with infected cat faeces, contaminated milk and cheese or raw and undercook meat of the intermediated hosts. To date, there is no commercial vaccine of use in humans. In this work, tachyzoites of T. gondii RH strain were irradiated with 255 Gy and inoculated in C57Bl/6j mice (3 doses, biweekly), after mice were challenged with 1, 5, 10, 20 and 25 cysts of ME-49 by oral gavage. The lesions and cysts in the brain were analyzed in all mice, after 4-week post infection. The mortality was 20% in control mice (ME-49 cysts only) and not one in immunized mice. The number of cysts was high in the control group, but low in immunized 255 Gy mice (n<100). Immunized mice showed less cerebral pathology and necrosis foci. Ionizing radiation is an important tool in the study toxoplasmosis and vaccine development. (author)

  10. Primary Cerebral Hydatid Cyst: Two Cases Report

    Directory of Open Access Journals (Sweden)

    Farideh Nejat

    2008-04-01

    Full Text Available Objective: Cerebral hydatid disease (CHD is a rare manifestation of echinococcosis but it constitutes a significant fraction of all intracranial mass lesions. In this paper we have reported two children with primary CHD without associated extracranial lesions.Case Presentation: Two cases of isolated cerebral hydatid disease are described. They were 7- and 10-year old children referred with focal neurological deficits and intracranial hypertension. Extensive extracranial investigations were negative. The literature concerning isolated cerebral hydatid disease is reviewed, and possible mechanisms by which the disease can be limited to brain, are discussed.Conclusion: Isolated CHD can occur with different mechanisms. Lack of effective immune system in the brain, the special architecture of brain tissue permitting rapid growth of cyst, patent ductus arteriosus, and patent foramen ovale, have been the proposed factors, but none of them has been proved yet.

  11. Differential diagnosis of bilateral thalamic lesions; Differenzialdiagnose bilateral Thalamuslaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Linn, J.; Brueckmann, H. [Universitaetsklinikum Muenchen (Germany). Abt. fuer Neuroradiologie; Hoffmann, L.A. [Universitaetsklinikum Muenchen (Germany). Inst. fuer Klinische Neuroimmunologie; Danek, A. [Universitaetsklinikum Muenchen (Germany). Klinik und Poliklinik fuer Neurologie

    2007-03-15

    A multitude of different diseases can result in bilateral thalamic lesions. These include vascular pathologies requiring prompt therapeutic intervention, such as basilar thrombosis or thrombosis of the internal cerebral veins, as well as tumors, infectious or demyelinating diseases, and toxic-metabolic lesions. Therefore, detailed knowledge of the typical radiological findings for the various diseases is essential for determining the correct diagnosis. This review provides a synopsis of the radiological findings for the most important bithalamic lesions and an overview of the literature.

  12. Acute cerebral vasculopathy in systemic sclerosis.

    Science.gov (United States)

    Faucher, Benoit; Granel, Brigitte; Nicoli, Francois

    2013-12-01

    Systemic sclerosis is an autoimmune disease characterized by skin and deep organ fibrosis and obliterative microvasculopathy. Cerebral involvement is currently not recognized as a manifestation of the disease, although several morphologic and functional studies suggested a frequent cerebral involvement in systemic sclerosis. We report a new case of acute cerebral vasculopathy in a patient suffering from systemic sclerosis together with five historical cases identified through a literature review. Cerebral acute vasculopathy most often revealed the disease. Affected patients suffered often from limited or diffuse cutaneous systemic sclerosis. Reversibility of arterial lesions, absence of specific histologic findings, and association with severe peripheral vascular involvement plead for a major role of vasospasm. However, the apparent efficacy of immunosuppressive treatments suggests an association with inflammatory or immune mechanisms. Awareness should be raised because of the severity of the disease, the risk of relapse, and the possible occurrence early in the course of systemic sclerosis.

  13. MRI of patients with cerebral palsy and normal CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Bogaert, P. van; Szliwowski, H.B. (Hopital Erasme, Brussels (Belgium). Dept. of Neurology); Baleriaux, D.; Christophe, C. (Hopital Erasme, Brussels (Belgium). Dept. of Radiology (Neuroradiology))

    1992-02-01

    Three children with clinical evidence of cerebral palsy (CP) and normal cerebral computed tomography (CT) scans were evaluated by magnetic resonance imaging (MRI) to identify CT-undetectable white matter lesions in the watershed zones of arterial territories. The two patients with spastic diplegia showed bilateral lesions either in the subcortical regions or in the occipital periventricular regions. The patient with congenital hemiplegia exhibited unilateral lesions in the periventricular region. We conclude that MRI is more informative than CT for the evaluation of patients with CP. (orig.).

  14. Pseudotumoral delayed cerebral radionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Ciaudo-Lacroix, C.; Lapresle, J. (Centre Hospitalier de Bicetre, 94 - Le Kremlin-Bicetre (France))

    1985-01-01

    A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. ..gamma..EG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed.

  15. 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.

  16. Cerebral Tissue Oxygenation during Immediate Neonatal Transition and Resuscitation

    Science.gov (United States)

    Pichler, Gerhard; Schmölzer, Georg M.; Urlesberger, Berndt

    2017-01-01

    This article provides a review of cerebral tissue oxygenation during immediate transition after birth in human neonates. Recommended routine monitoring, especially if resuscitation is needed, during this period includes arterial oxygen saturation and heart rate measured by pulse oximetry and electrocardiogram. However, there is increasing interest to monitor in addition with near-infrared spectroscopy (NIRS) the oxygenation of the brain. There is a different pattern of increase between cerebral tissue oxygenation and arterial oxygen saturation during the immediate transition, with cerebral tissue oxygenation reaching a plateau faster than arterial oxygen saturation. Differences can be explained, since cerebral tissue oxygenation is not only affected by arterial oxygen saturation but also by cerebral blood flow, hemoglobin content, and cerebral oxygen consumption. Normal values have already been established for different devices, gestational ages, and modes of delivery in neonates without any medical support. Cerebral hypoxia during immediate transition might cause brain damage. In preterm neonates with cerebral hemorrhage evolving in the first week after birth, the cerebral tissue oxygenation is already lower in the first minutes after birth compared to preterm neonates without cerebral hemorrhage. Using cerebral NIRS in combination with intervention guidelines has been shown to reduce the burden of cerebral hypoxia in preterm neonates. Cerebral tissue oxygenation during immediate transition seems to have an impact on outcome, whereby NIRS monitoring is feasible and has the advantage of continuous, non-invasive recording. The impact of NIRS monitoring and interventions on short- and long-term outcomes still need to be evaluated. PMID:28280719

  17. Reorganization of the Cerebro-Cerebellar Network of Language Production in Patients with Congenital Left-Hemispheric Brain Lesions

    Science.gov (United States)

    Lidzba, K.; Wilke, M.; Staudt, M.; Krageloh-Mann, I.; Grodd, W.

    2008-01-01

    Patients with congenital lesions of the left cerebral hemisphere may reorganize language functions into the right hemisphere. In these patients, language production is represented homotopically to the left-hemispheric language areas. We studied cerebellar activation in five patients with congenital lesions of the left cerebral hemisphere to assess…

  18. Reorganization of the Cerebro-Cerebellar Network of Language Production in Patients with Congenital Left-Hemispheric Brain Lesions

    Science.gov (United States)

    Lidzba, K.; Wilke, M.; Staudt, M.; Krageloh-Mann, I.; Grodd, W.

    2008-01-01

    Patients with congenital lesions of the left cerebral hemisphere may reorganize language functions into the right hemisphere. In these patients, language production is represented homotopically to the left-hemispheric language areas. We studied cerebellar activation in five patients with congenital lesions of the left cerebral hemisphere to assess…

  19. Cerebral lesions in acute arterial hypertension: the characteristic MRI in hypertensive encephalopathy; Zerebrale Veraenderungen bei krisenhafter arterieller Hypertonie: MRT-Befunde der hypertensiven Enzephalopathie sind wegweisend fuer Diagnose und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, J.P.; Krohmer, S. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Abt. Neuroradiologie, Universitaetsklinikum Leipzig AoeR (Germany); Guenther, A. [Klinik und Poliklinik fuer Neurologie, Universitaetsklinikum Leipzig AoeR (Germany); Zimmer, C. [Abt. fuer Neuroradiologie, Klinikum rechts der Isar der TU Muenchen (Germany)

    2006-06-15

    Purpose: in the nine years since the posterior reversible (leuc) encephalopathy syndrome (PRES) was first described, a number of causes have been under discussion. These not only include arterial hypertension, i. e. hypertensive crises, but also various toxic substances, i. e. immunosuppressive or chemotherapeutic agents, that are responsible for the formation of the symptoms and characteristic MR tomographic brain findings. Materials and methods: initial and follow-up MRI examinations of 8 patients were analyzed. All patients had acute neurological symptoms (headaches, seizures, visual disorders and vigilance disturbances) together with a detectable hypertensive crisis. Results: MRI disclosed increased signal intensity in subcortical and some cortical lesions in all patient FLAIR sequences. These changes were particularly extensive in the posterior circulation (occipital, cerebellum and brain stem) although they were also detected in brain areas supplied by the carotid artery. However, a cytotoxic genesis of the changes was ruled out in each patient by means of a normal DWI. Furthermore, when the blood pressure was normalized, reversibility of the lesions as proof of the diagnosis was detectable. (orig.)

  20. Cerebral tuberculoma in a patient receiving anti-TNF alpha (adalimumab) treatment.

    LENUS (Irish Health Repository)

    Lynch, Karen

    2010-10-01

    We report a case of a cerebral tuberculoma in a 60-year-old woman with rheumatoid arthritis while receiving the anti-tumor necrosis factor alpha monoclonal antibody, adalimumab (Humira), for active disease. MR brain imaging for dyspraxia revealed a left parietal ring-enhancing lesion, which on resection was shown to be a necrotizing granuloma. There were no associated pulmonary lesions, and the patient was systemically well. Sputum and urine cultures were negative for tuberculosis. The patient was treated with anti-tuberculous medications and made an excellent recovery. We consider this to be the first documented case of tuberculosis involving the central nervous system occurring in the setting of adalimumab treatment.

  1. Gaze Behaviour during Interception in Children with Spastic Unilateral Cerebral Palsy

    Science.gov (United States)

    van Kampen, P. M.; Ledebt, A.; Smorenburg, A. R. P.; Vermeulen, R. J.; Kelder, M. E.; van der Kamp, J.; Savelsbergh, G. J. P.

    2012-01-01

    Anticipatory gaze behaviour during interceptive movements was investigated in children with Spastic Unilateral Cerebral Palsy (SUCP), and related to the side of the intracerebral lesion. Five children with lesions of the right hemisphere (RHL) and five children with lesions of the left hemisphere (LHL) had to walk towards and intercept a ball that…

  2. Gaze Behaviour during Interception in Children with Spastic Unilateral Cerebral Palsy

    Science.gov (United States)

    van Kampen, P. M.; Ledebt, A.; Smorenburg, A. R. P.; Vermeulen, R. J.; Kelder, M. E.; van der Kamp, J.; Savelsbergh, G. J. P.

    2012-01-01

    Anticipatory gaze behaviour during interceptive movements was investigated in children with Spastic Unilateral Cerebral Palsy (SUCP), and related to the side of the intracerebral lesion. Five children with lesions of the right hemisphere (RHL) and five children with lesions of the left hemisphere (LHL) had to walk towards and intercept a ball that…

  3. 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.

  4. Cerebral astroblastoma: A radiopathological diagnosis

    Directory of Open Access Journals (Sweden)

    Deepak Kumar Singh

    2014-01-01

    Full Text Available Astroblastoma is a rare glial neoplasm whose histogenesis has been clarified recently. It primarily occurs in children and young adults. We are reporting a case of 12-year-old girl child who presented with features of raised intracranial tension and generalized tonic-clonic seizures. Brain magnetic resonance imaging revealed a large well-circumscribed, cystic lesion without perifocal edema, and enhancing mural nodule in right parietal region. A radiological differential diagnosis of pilocytic astrocytoma and cerebral astroblastoma was made. A complete excision was done and histologically the lesion turned out to be an astroblastoma. We review the histology, immunohistochemistry, and imaging features of astroblastoma and survey the current literature, treatment strategies, and prognostic aspects for the management of this rare neoplasm.

  5. Clinical applications of MR digital subtraction angiography for the evaluation of intracranial vascular and tumorous lesions

    Energy Technology Data Exchange (ETDEWEB)

    Katase, Shichiro; Tsuchiya, Kazuhiro; Hachiya, Junichi [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    2001-07-01

    MR digital subtraction angiography (MR DSA), which is performed by a rapid two-dimensional T1-weighted sequence in combination with bolus injection of gadolinium-based contrast agent was applied to the evaluation of cerebral arteriovenous malformations (AVMs), brain tumors (intraaxial and extraaxial tumors), and other vascular lesions. This study was performed to evaluate the clinical usefulness of the method in the diagnosis of these lesions. We studied 19 cases of cerebral AVM, 36 cases of intraaxial tumor (metastatic brain tumors in 14, glioblastomas in five, astrocytomas in eight, malignant lymphomas in four, pineal tumors in two, and other tumors, in three), 34 cases of extraaxial tumor (meningiomas in 29, and pituitary adenomas in five), and 10 cases of other vascular lesions (cerebral aneurysms in five, venous thrombosis in two, and other lesion in three). For cerebral AVMs, the feeder, nidus, and drainer were evaluated on a 4 - point grading scale (0=poor, 1=fair, 2=good, 3=excellent), and the results obtained were compared with those of conventional cerebral angiography or MR angiography using the postcontrast three-dimensional time-of-flight method. Brain tumors were classified into six enhancement patterns, and were compared with the findings of conventional cerebral angiography. Other vascular lesions were assessed visually. All cases were evaluated independently by two radiologists, and inter-observer agreement was assessed using the {kappa}-test. In all cerebral AVM cases, the hemodynamics of the feeder, nidus, and drainer could be observed. In all but five brain tumor cases, tumor stain could be confirmed in MR DSA images. The findings of tumor stain corresponded to those of cerebral angiographic images. For other vascular lesions, results of lesion detection and lesion morphology were almost in congruence with other methods. MR DSA provides information on the hemodynamics of vascular and tumorous lesions. When used in conjunction with routine MR

  6. Severe Cerebral Vasospasm in Patients with Hyperthyroidism

    Science.gov (United States)

    Oh, Hyuk-Jin; Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun

    2016-01-01

    Cerebral vasospasm associated with hyperthyroidism has not been reported to cause cerebral infarction. The case reported here is therefore the first of cerebral infarction co-existing with severe vasospasm and hyperthyroidism. A 30-year-old woman was transferred to our hospital in a stuporous state with right hemiparesis. At first, she complained of headache and dizziness. However, she had no neurological deficits or radiological abnormalities. She was diagnosed with hyperthyroidism 2 months ago, but she had discontinued the antithyroid medication herself three days ago. Magnetic resonance imaging and angiography showed cerebral infarction with severe vasospasm. Thus, chemical angioplasty using verapamil was performed two times, and antithyroid medication was administered. Follow-up angiography performed at 6 weeks demonstrated complete recovery of the vasospasm. At the 2-year clinical follow-up, she was alert with mild weakness and cortical blindness. Hyperthyroidism may influence cerebral vascular hemodynamics. Therefore, a sudden increase in the thyroid hormone levels in the clinical setting should be avoided to prevent cerebrovascular accidents. When neurological deterioration is noticed without primary cerebral parenchyma lesions, evaluation of thyroid function may be required before the symptoms occur. PMID:28184350

  7. Severe Cerebral Vasospasm in Patients with Hyperthyroidism.

    Science.gov (United States)

    Oh, Hyuk-Jin; Yoon, Seok-Mann; Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun

    2016-12-01

    Cerebral vasospasm associated with hyperthyroidism has not been reported to cause cerebral infarction. The case reported here is therefore the first of cerebral infarction co-existing with severe vasospasm and hyperthyroidism. A 30-year-old woman was transferred to our hospital in a stuporous state with right hemiparesis. At first, she complained of headache and dizziness. However, she had no neurological deficits or radiological abnormalities. She was diagnosed with hyperthyroidism 2 months ago, but she had discontinued the antithyroid medication herself three days ago. Magnetic resonance imaging and angiography showed cerebral infarction with severe vasospasm. Thus, chemical angioplasty using verapamil was performed two times, and antithyroid medication was administered. Follow-up angiography performed at 6 weeks demonstrated complete recovery of the vasospasm. At the 2-year clinical follow-up, she was alert with mild weakness and cortical blindness. Hyperthyroidism may influence cerebral vascular hemodynamics. Therefore, a sudden increase in the thyroid hormone levels in the clinical setting should be avoided to prevent cerebrovascular accidents. When neurological deterioration is noticed without primary cerebral parenchyma lesions, evaluation of thyroid function may be required before the symptoms occur.

  8. CT Analysis of 27 Neonatal Cases with Cerebral Infarction%新生儿脑梗死27例CT分析

    Institute of Scientific and Technical Information of China (English)

    汪兴龙; 胡必富; 罗洪云; 刘长华; 夏玉明; 严君

    2015-01-01

    目的:分析新生儿脑梗死的临床和CT表现,提高其诊断与鉴别诊断水平。方法回顾性分析27例新生儿脑梗死的临床和CT资料。结果左侧脑梗死15例,占55.6%,右侧6例,占22.2%,双侧6例,占22.2%;发生于顶枕叶20例,占74.1%;大脑中动脉供血区受累25例,占92.6%;CT表现呈底朝外的楔形或扇形低密度,灰白质同时受累,病灶边缘部分清楚,病变区脑沟变浅或消失,周围水肿较轻,中线结构轻度移位。结论新生儿脑梗死临床表现无特异性, CT检查是诊断新生儿脑梗死的重要手段。%Objective To analyze the clinical and CT manifestations of neonatal cerebral infarction, and to improve the level of diagnosis and differential diagnosis of neonatal cerebral infarction.Methods Retrospective analyze the clinical and CT data of 27 cases with neonatal cerebral infarction.Results There were 15 cases of cerebral infarction located on the left hemicerebrum (55.6%); 6 cases located on the right hemicerebrum (22.2%); 6 cases located on bilateral hemicerebrum (22.2%). 20 lesions were in occipital lobe (74.1%); Middle cerebral arteries were involved in 25 lesions (92.6%). In the CT images, the lesions were shown as low density wedge or sector shapes with bottom outlying, with gray matter affected at the same time. The edges of the lesions were clear, with the brain ditch shoaled or disappeared. The peripheral edema was lighter. The midline structures were slightly shifted.Conclusion The clinical manifestations of neonatal cerebral infarction were lack of speciifcity, and CT examination is an important method for diagnosis of neonatal cerebral infarction.

  9. Cerebral perfusion SPECT in transient ischemic attack

    Energy Technology Data Exchange (ETDEWEB)

    You, D.-L. E-mail: dlyou@mail.kfcc.org.tw; Shieh, F.-Y.; Tzen, K.-Y.; Tsai, M.-F.; Kao, P.-F

    2000-04-01

    Purpose: The purpose of our study is to evaluate the efficacy of cerebral perfusion single photon emission computerized tomography (SPECT) in patients with transient ischemic attack (TIA). Methods: Thirty-seven patients with TIA were collected for study. All patients had transient focal neurological symptoms or signs with complete recovery within 24 h after onset. The patients underwent cerebral perfusion SPECT between 6 h and 11 days after onset, with 10 cases performed within 24 h (group A), nine cases performed between 1 and 3 days (group B), 11 cases performed between 3 and 5 days (group C), and seven cases performed after more than 5 days (group D). A semi-quantitative method was used for analyzing the SPECT data, and the difference ratios between lesion side and contralateral normal side were calculated on each pair of regions of interest. Results: In total, 78.4% (29/37) of patients had reduced perfusion in the cerebral cortical regions or deep nuclei, and the regions with reduced perfusion corresponded with clinical presentations of the patients. The abnormal rate with reduced perfusion was 90.0% in group A, 77.8% in group B, 72.7% in group C and 71.4% in group D. Cross cerebellar diaschisis (CCD) was present in seven patients, and all of the primary cerebral perfusion defects of these patients were located at the territory of left or right middle cerebral artery. Conclusion: Cerebral perfusion SPECT is a potential tool to detect cerebral perfusion defects and CCD in patients with TIA. Although the perfusion defect may persist more than 5 days after onset, we suggest cerebral perfusion SPECT should be performed as soon as possible.

  10. Paraplegia caused by cerebral contusions in the bilateral precentral gyri

    Directory of Open Access Journals (Sweden)

    Hideaki Matsumura

    2016-01-01

    Conclusion: We must emphasize that cerebral contusion can be a differential diagnosis for paraplegia. In the acute phase, fluid-attenuated inversion recovery (FLAIR MRI coronal and sagittal images are useful for identifying precentral gyri contusions. Paraplegia caused by a cerebral contusion may be misdiagnosed as a spinal concussion due to the disappearance of the precentral gyrus lesion on FLAIR MRI in the subacute phase.

  11. The wide spectrum of hyperechoic lesions of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Linda, A., E-mail: annalinda33@gmail.co [Institute of Diagnostic Radiology, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine (Italy); Zuiani, C.; Lorenzon, M.; Furlan, A.; Londero, V. [Institute of Diagnostic Radiology, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine (Italy); Machin, P. [Institute of Pathology, Ospedale De Gironcoli, Conegliano (Italy); Bazzocchi, M. [Institute of Diagnostic Radiology, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine (Italy)

    2011-06-15

    Although breast lesions are commonly detected because of their hypoechogenicity, some lesions may present with hyperechogenicity due to their histological components. Hyperechogenicity has been shown to be highly predictive of benignity; however, hyperechoic lesions can occasionally be malignant. This article reviews hyperechoic lesions of the breast, describes the underlying histological causes associated with hyperechogenicity, and the sonographic features useful for the differential diagnosis between benign and malignant hyperechoic lesions.

  12. United Cerebral Palsy

    Science.gov (United States)

    ... be sure to follow us on Twitter . United Cerebral Palsy UCP educates, advocates and provides support services to ... Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 Washington, DC ...

  13. Employees with Cerebral Palsy

    Science.gov (United States)

    ... problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture (United Cerebral Palsy, 2010). "Cerebral" refers to the ...

  14. Assessment of the hand in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Praveen Bhardwaj

    2011-01-01

    Full Text Available Cerebral palsy is the musculoskeletal manifestation of a nonprogressive central nervous system lesion that usually occurs due to a perinatal insult to the brain. Though the cerebral insult is static the musculoskeletal pathology is progressive. Some patients with cerebral palsy whose hands are affected can be made better by surgery. The surgical procedures as such are not very technically demanding but the assessment, decision-making, and selecting the procedures for the given patient make this field challenging. When done well, the results are rewarding not only in terms of improvement in hand function but also in appearance and personal hygiene, which leads to better self-image and permits better acceptance in the society. This article focuses on the clinical examination, patient selection, and decision-making while managing these patients.

  15. Sirt1 in cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Kevin B Koronowski

    2015-01-01

    Full Text Available Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD +-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer′s Disease, Parkinson′s Disease, and Huntington′s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance.

  16. Sirt1 in cerebral ischemia

    Science.gov (United States)

    Koronowski, Kevin B.; Perez-Pinzon, Miguel A.

    2015-01-01

    Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD+)-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer’s Disease, Parkinson’s Disease, and Huntington’s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance. PMID:26819971

  17. Cerebral Palsy (For Kids)

    Science.gov (United States)

    ... CPR: A Real Lifesaver Kids Talk About: Coaches Cerebral Palsy KidsHealth > For Kids > Cerebral Palsy Print A A A What's in this article? ... the first word you spoke? For kids with cerebral palsy, called CP for short, taking a first step ...

  18. 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.

  19. Gamma Knife treatment for cerebral arteriovenous malformations.

    Science.gov (United States)

    Kemeny, Andras A; Radatz, Matthias W R; Rowe, Jeremy G; Walton, Lee; Vaughan, Paul

    2007-01-01

    One of the earliest indications for Gamma Knife treatment, radiosurgery for cerebral arteriovenous malformations, has stood the test of time. While initially only the ideal cases (small, compact nidus in a non-eloquent site) were chosen, increasingly larger, more complex AVMs were treated. Combination treatment with embolisation and surgery enables most lesions to be treated with success and remarkably low complication rate. This paper is a brief overview of the experience gained in Sheffield.

  20. Pericallosal lipoma and middle cerebral artery aneurysm: a coincidence?

    Energy Technology Data Exchange (ETDEWEB)

    Sommet, Julie; Schiff, Manuel; Evrard, Philippe [Hopital Robert Debre, APHP, Department of Paediatric Neurology and Metabolic Diseases, Paris Cedex 19 (France); Blanc, Raphael [Fondation Rothschild, Department of Interventional Radiology, Paris (France); Elmaleh-Berges, Monique [Hopital Robert Debre, Department of Paediatric Radiology, Paris (France)

    2010-08-15

    Intracranial lipomas are rare congenital malformations that can often be seen in association with other brain malformations; agenesis or dysgenesis of the corpus callosum is the most frequently associated brain anomaly. They are usually pericallosal asymptomatic midline lesions. Intracranial lipomas associated with a non-contiguous cerebral aneurysm are extremely rare. We report an infant with partial agenesis of the corpus callosum and pericallosal lipoma associated with cerebral haemorrhage due to a distal middle cerebral artery aneurysm. Such an association is probably not fortuitous and could suggest a pathogenic relationship. (orig.)

  1. Fate of diffusion restricted lesions in acute intracerebral hemorrhage.

    Directory of Open Access Journals (Sweden)

    Yuan-Hsiung Tsai

    Full Text Available Diffusion-restricted lesions on diffusion-weighted imaging (DWI are detected in patients with intracerebral hemorrhage (ICH. In this study, we aimed to determine the fate of DWI lesions in ICH patients and whether the presence of DWI lesions is associated with functional outcome in patients with ICH.This prospective study enrolled 153 patients with acute ICH. Baseline MRI scans were performed within 2 weeks after ICH to detect DWI lesions and imaging markers for small vessel disease (SVD. Follow-up MRI scans were performed at 3 months after ICH to assess the fate of the DWI lesions. We analyzed the associations between the characteristics of DWI lesions with clinical features and functional outcome.Seventeen of the 153 patients (11.1% had a total of 25 DWI lesions. Factors associated with DWI lesions were high initial systolic and mean arterial blood pressure (MAP at the emergency room, additional lowering of MAP within 24 hours, and the presence of white matter hyperintensity and cerebral microbleeds. Thirteen of the 25 DWI lesions (52% were not visible on follow-up T2-weighted or fluid-attenuated inversion recovery images and were associated with high apparent diffusion coefficient value and a sharper decease in MAP. The regression of DWI lesions was associated with good functional outcome.More than half of the DWI lesions in the ICH patients did not transition to visible, long-term infarction. Only if the DWI lesion finally transitioned to final infarction was a poor functional outcome predicted. A DWI lesion may be regarded as an ischemic change of SVD and does not always indicate certain cerebral infarction or permanent tissue injury.

  2. Effects of Milrinone continuous intravenous infusion on global cerebral oxygenation and cerebral vasospasm after cerebral aneurysm surgical clipping

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    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.

  3. Effect of cerebral lymphatic block on cerebral morphology and cortical evoked potential in rats

    Institute of Scientific and Technical Information of China (English)

    Zuoli Xia; Baoling Sun; Mingfeng Yang; Dongmei Hu; Tong Zhao; Jingzhong Niu

    2006-01-01

    BACKGROUND: It has been shown that although brain does not contain lining endothelial lymphatic vessel,it has lymphatic drain.Anterior lymphatic vessel in brain tissue plays a key role in introducing brain interstitial fluid to lymphatic system;however,the significance of lymphatic drain and the affect on cerebral edema remains unclear.OBJECTIVE: To investigate the effect of cerebral lymphatic block on cerebral morphology and cortical evoked potential in rats.DESIGN: Randomized controlled animal study.SETTING: Institute of Cerebral Microcirulation of Taishan Medical College and Department of Neurology of Affiliated Hospital.MATERIALS:A total of 63 healthy adult male Wistar rats weighing 300-350 g were selected in this study.Forty-seven rats were used for the morphological observation induced by lymphatic drain and randomly divided into three groups:general observation group(n=12),light microscopic observation group(n=21)and electronic microscopic observation group(n=14).The rats in each group were divided into cerebral lymphatic block subgroup and sham-operation control subgroup.Sixteen rats were divided into cerebral the effect of cerebral lymphatic block on cortical evoked potential,in which the animals were randomly divided into sham-operation group(n=6)and cerebral lymphatic block group(n=10).METHODS:The experiment was carried out in the Institute of Cerebral Microcirculation of Taishan Medical College from January to August 2003.Rats in cerebral lymphatic block group were anesthetized and separated bilateral superficial and deep cervical lymph nodes under sterile condition. Superior and inferior boarders of lymph nodes were ligated the inputting and outputting channels, respectively, and then lymph node was removed so as to establish cerebral lymphatic drain disorder models. Rats in sham-operation control group were not ligated the lymphatic vessel and removed lymph nodes.and other operations were as the same as those in cerebral lymphatic block group

  4. Cerebral venous thrombosis presenting with cerebellar ataxia and cortical blindness.

    Science.gov (United States)

    Ben Sassi, Samia; Mizouni, Habiba; Nabli, Fatma; Kallel, Lamia; Kefi, Mounir; Hentati, Fayçal

    2010-01-01

    Venous infarction in the cerebellum has been reported only rarely, probably because of the abundant venous collateral drainage in this region. Bilateral occipital infarction is a rare cause of visual loss in cerebral venous thrombosis. We describe a 50-year-old woman with a history of ulcerative colitis who developed acute cerebellar ataxia and cortical blindness. She had bilateral cerebellar and occipital lesions related to sigmoid venous thrombosis and achieved complete recovery with anticoagulation therapy. Cerebral venous thrombosis should be considered in cases of simultaneous cerebellar and occipital vascular lesions.

  5. Perioperative management of patients with lung carcinoma and cerebral metastases

    Science.gov (United States)

    Gheorghita, Eva; Pruna, Viorel Mihai; Neagoe, Luminita; Bucur, Cristina; Cristescu, Catioara; Gorgan, Mircea Radu

    2010-01-01

    ABSTRACT Objective: The present study proposes to present the importance of perioperative therapeutic management in survival prolongation and the quality of life for patients that have undergone surgery for cerebral metastases secondary to pulmonary tumors. Method: During 2001-2009, 40 patients with ages between 43-74 years have been diagnosed in our clinic with pulmonary tumor and cerebral metastases. The patients presented single cerebral lesion (excepting one patient with 2 cerebral metastases) and pulmonary tumor. Intracranial pressure (ICP) was high in all cases. All patients have undergone operation with general anesthesia. Results:For all patients the reduction of ICP and keeping an optimal CPP (cerebral perfusion pressure) was pursued. In 38 cases, general anesthesia was performed with Sevoflurane and opioids (fentanyl, remifentanyl, sufentanyl) and in 2 cases the TIVA (total intravenous anesthesia) technique was used with propofol and remifentanyl. 14 of the patients required intraoperative depletive treatment through administering mannitol 20%. 37 patients (92%) have been discharged with improved neurological condition without showing signs of intracranial hypertension, convulsive seizures and with partially or totally remitted hemiparesis and one patient had worse postoperative neurological status. Conclusion:Pulmonary tumor with cerebral metastases represent an important cause for death rate. To solve secondary cerebral lesions, the perioperative management must include assesment and choosing an anesthesia technique with a proper intraoperative management. PMID:21977115

  6. Globus pallidus high-signal lesions: A predominant MRI finding in children with neurofibromatosis type 1

    Directory of Open Access Journals (Sweden)

    Arif Khan

    2013-01-01

    Full Text Available Introduction: Lesions of the brain, recognized as unidentified bright objects (UBOs, are commonly observed as areas of increased T2-weighted signal intensity on magnetic resonance imaging (MRI in children with neurofibromatosis type 1 (NF1. Identification of these lesions is not currently encompassed in the National Institute of Health (NIH diagnostic criteria for NF1. Objective: We aimed to determine the prevalence of UBOs in children with NF1 and identify areas of the brain that are commonly affected by these lesions, allowing us to evaluate whether UBOs should be included in the diagnostic criteria for the diagnosis of NF1. Materials and Methods: We reviewed the cranial MRI scans of 22 children who had been diagnosed with sporadic or familial NF1 in accordance with the criteria established by NIH. UBOs were present in 81% of the children with NF1. Results: These lesions have a predilection for specific areas of the brain, including the globus pallidus (72%, cerebellum (66%, brainstem (27% and cerebral hemispheres (16%. The prevalence of UBOs identified varied significantly with age and sex; they were infrequent in children less than 4 years of age but were common in those aged between 4 and 12 years of age. UBOs were more commonly seen in males (66.6% compared with females (33.3%. Repeat MRI scan on a subset of these patients with UBOs did not show any significant changes despite a worsening in clinical symptoms. Conclusion and Discussion: We have shown that UBOs are a common finding in children with NF1, and are most prevalent between the ages of 4 and 12 years. Many sites of the brain are affected by these lesions, most notably the globus pallidus and the cerebellum. Further research must be conducted to elucidate the significance of UBOs in patients with NF1 and whether these lesions have any utility in the clinical detection of NF1.

  7. Cramped synchronized general movements in preterm infants as an early marker for cerebral palsy

    NARCIS (Netherlands)

    Ferrari, F; Cioni, G; Einspieler, C; Roversi, MF; Bos, AF; Paolicelli, PB; Ranzi, A; Prechtl, HFR

    2002-01-01

    Objective: To ascertain whether specific abnormalities (ie, cramped synchronized general movements [GMs]) can predict cerebral palsy and the severity of later motor impairment in preterm infants affected by brain lesions. Design: Traditional neurological examination was performed, and GMs were seria

  8. FAM222B Is Not a Likely Novel Candidate Gene for Cerebral Cavernous Malformations

    NARCIS (Netherlands)

    Spiegler, Stefanie; Kirchmaier, Bettina; Rath, Matthias; Korenke, G. Christoph; Tetzlaff, Fabian; Van De Vorst, Maartje; Neveling, Kornelia; Acker-Palmer, Amparo; Kuss, Andreas W.; Gilissen, Christian; Fischer, Andreas; Schulte-Merker, Stefan; Felbor, Ute

    2016-01-01

    Cerebral cavernous malformations (CCMs) are prevalent slow-flow vascular lesions which harbour the risk to develop intracranial haemorrhages, focal neurological deficits, and epileptic seizures. Autosomal dominantly inherited CCMs were found to be associated with heterozygous inactivating mutations

  9. Mitochondrial Targeted Antioxidant in Cerebral Ischemia.

    Science.gov (United States)

    Ahmed, Ejaz; Donovan, Tucker; Yujiao, Lu; Zhang, Quanguang

    There has been much evidence suggesting that reactive oxygen species (ROS) generated in mitochondria during cerebral ischemia play a major role in programming the senescence of organism. Antioxidants dealing with mitochondria slow down the appearance and progression of symptoms in cerebral ischemia and increase the life span of organisms. The mechanisms of mitochondrial targeted antioxidants, such as SKQ1, Coenzyme Q10, MitoQ, and Methylene blue, include increasing adenosine triphosphate (ATP) production, decreasing production of ROS and increasing antioxidant defenses, providing benefits in neuroprotection following cerebral ischemia. A number of studies have shown the neuroprotective role of these mitochondrial targeted antioxidants in cerebral ischemia. Here in this short review we have compiled the literature supporting consequences of mitochondrial dysfunction, and the protective role of mitochondrial targeted antioxidants.

  10. Functional MRI in Patients with Intracranial Lesions near Language Areas.

    Science.gov (United States)

    Hakyemez, B; Erdogan, C; Yildirim, N; Bora, I; Bekar, A; Parlak, M

    2006-06-30

    We aimed to depict Broca's area and Wernicke's area by word generation and sentence formation paradigms in patients with various intracranial lesions adjacent to language areas using functional MRI technique and to evaluate the ability of functional MRI to lateralize the hemispheric dominance for language. Twenty-three right-handed patients were included in this study. Lesions were classified as low-grade glioma (n=8), high-grade glioma (n=9), metastasis (n=1), meningioma (n=1), arteriovenous malformation (n=2) and mesial temporal sclerosis (n=2). We performed blood-oxygenated-level-dependant functional MRI using a 1.5-T unit. Word generation and sentence formation tasks were used to activate language areas. Language areas were defined as Brodmann 44, 45 (Broca's area) and Brodmann 22 area (Wernicke's area). Laterality index was used to show the dominant hemisphere. Two poorly cooperative patients showed no activation and were excluded from the study. Broca's area was localized in 21 patients (100 %). Wernicke's area, on the other hand, could only be localized in eight of the 21 patients (38 %).The left hemisphere was dominant in 86% of patients while atypical language lateralization (right or bilateral) was demonstrated in 14% of the patients. Bilateral activation areas were shown in 10% of those patients while right cerebral hemisphere was dominant in 4% of the patients. Word generation and sentence formation tasks are especially helpful in localizing Broca's area. Wernicke's area could also be demonstrated in some of the cases. Functional MRI can be used as an important and useful means of demonstrating language areas in patients with lesions adjacent to those areas and depicting the hemispheric dominance.

  11. Hemicorea asociada a toxoplasmosis cerebral y SIDA

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    N.S. garretto

    1995-03-01

    Full Text Available Se observan complicaciones neurológicas en 40% de enfermos con SIDA. De estos, en 10% puede ser la manifestation inicial de la enfermedad. En otro 11% pueden aparecer trastornos del movimiento. Comunicamos el primer caso de hemicorea asociada a toxoplasmosis cerebral y SIDA en nuestro pais. Hombre de 26 anos, con diagnostico de SIDA y toxoplasmosis cerebral. Habia comenzado con crisis motoras simples de hemicuerpo izquierdo, con generalization secundaria y luego perdida de fuerza progresiva en dicho hemicuerpo. La RMN de cérebro mostro una lesion frontal derecha y otra temporo-occipital izquierda, con gran edema perilesional y efecto de masa. Las serologias para HIV y toxoplasmosis fueron positivas. Comenzo tratamiento con sulfadiazina y pirimetamina. Al duodecimo dia aparecieron movimientos involuntários dei pie izquierdo, coreicos, que se extendieron mas tarde a todo ese miembro inferior y luego al hemicuerpo. Nueva RMN de cérebro mostro disminucion dei edema y efecto de masa de las lesiones. Sin embargo, se observo una nueva lesion a nivel peduncular derecho. Movimientos involuntarios en pacientes con toxoplasmosis cerebral comenzaron a describirse recientemente solo en pacientes con SIDA. El presente seria el decimotercer caso de la literatura mundial y el primero en nuestro pais de hemicorea asociada a toxoplasmosis y SIDA.

  12. Putaminal alteration in multiple sclerosis patients with spinal cord lesions.

    Science.gov (United States)

    Zimmermann, Hilga; Rolfsnes, Hans O; Montag, Swantje; Wilting, Janine; Droby, Amgad; Reuter, Eva; Gawehn, Joachim; Zipp, Frauke; Gröger, Adriane

    2015-10-01

    Typical multiple sclerosis (MS) lesions occur in the brain as well as in the spinal cord. However, two extreme magnetic resonance imaging phenotypes appear occasionally: those with predominantly spinal cord lesions (MS + SL) and those with cerebral lesions and no detectable spinal lesions (MS + CL). We assessed whether morphological differences can be found between these two extreme phenotypes. We examined 19 patients with MS + SL, 18 with MS + CL and 20 controls. All subjects were examined using magnetic resonance imaging, including anatomical and diffusion tensor imaging sequences. Voxel-based morphologic and regions of interest-based analyses and tract-based spatial statistics were performed. Patients also underwent neuropsychological testing. Demographic, clinical and neuropsychological characteristics did not differ between MS + SL and MS + CL patients. Patients with MS + SL showed significantly larger putamen volumes than those with MS + CL which correlated negatively with disability. Compared to controls, only MS + CL revealed clear cortical and deep gray matter atrophy, which correlated with cerebral lesion volume. Additionally, extensive white matter microstructural damage was found only in MS + CL compared to MS + SL and controls in the tract-based spatial statistics. Higher putamen volumes in MS + SL could suggest compensatory mechanisms in this area responsible for motor control. Widely reduced fractional anisotropy values in MS + CL were caused by higher cerebral lesion volume and thus presumably stronger demyelination, which subsequently leads to higher global gray matter atrophy.

  13. The choroid plexus is a key cerebral invasion route for T cells after stroke.

    Science.gov (United States)

    Llovera, Gemma; Benakis, Corinne; Enzmann, Gaby; Cai, Ruiyao; Arzberger, Thomas; Ghasemigharagoz, Alireza; Mao, Xiang; Malik, Rainer; Lazarevic, Ivana; Liebscher, Sabine; Ertürk, Ali; Meissner, Lilja; Vivien, Denis; Haffner, Christof; Plesnila, Nikolaus; Montaner, Joan; Engelhardt, Britta; Liesz, Arthur

    2017-07-31

    Neuroinflammation contributes substantially to stroke pathophysiology. Cerebral invasion of peripheral leukocytes-particularly T cells-has been shown to be a key event promoting inflammatory tissue damage after stroke. While previous research has focused on the vascular invasion of T cells into the ischemic brain, the choroid plexus (ChP) as an alternative cerebral T-cell invasion route after stroke has not been investigated. We here report specific accumulation of T cells in the peri-infarct cortex and detection of T cells as the predominant population in the ipsilateral ChP in mice as well as in human post-stroke autopsy samples. T-cell migration from the ChP to the peri-infarct cortex was confirmed by in vivo cell tracking of photoactivated T cells. In turn, significantly less T cells invaded the ischemic brain after photothrombotic lesion of the ipsilateral ChP and in a stroke model encompassing ChP ischemia. We detected a gradient of CCR2 ligands as the potential driving force and characterized the neuroanatomical pathway for the intracerebral migration. In summary, our study demonstrates that the ChP is a key invasion route for post-stroke cerebral T-cell invasion and describes a CCR2-ligand gradient between cortex and ChP as the potential driving mechanism for this invasion route.

  14. Cerebral microangiopathies; Zerebrale Mikroangiopathien

    Energy Technology Data Exchange (ETDEWEB)

    Linn, Jennifer [Klinikum der Universitaet Muenchen (Germany). Abt. fuer Neuroradiologie

    2011-03-15

    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.)

  15. Cerebral magnetic resonance imaging in a patient with ankylosing spondylitis and multiple sclerosis-like syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Cellerini, M.; Gabbrielli, S. [Neuroradiology Unit, Trauma Center (CTO), Careggi Hospital, Florence (Italy); Bongi, S.M. [Section of Rheumatology, Univ. of Florence (Italy)

    2001-12-01

    Clinical and cerebral magnetic resonance imaging (MRI) findings in a patient with ankylosing spondylitis (AS) and multiple sclerosis-like (MS-like) syndrome are reported. Cerebral MRI demonstrated multiple, MS-like, scattered foci of signal abnormality, one of which showed contrast enhancement. Lesion dissemination in ''space and time'' is a hallmark for diagnosis of MS, and its demonstration by enhanced cerebral MRI prompted suspicion of coexistence of MS and AS in our patient. (orig.)

  16. TANG's Scalp Acupuncture and Infantile Cerebral Palsy:Case Reports of 34 Cases

    Institute of Scientific and Technical Information of China (English)

    秦秀娣; 韩丑萍

    2008-01-01

    @@ Cerebral palsy (CP) refers to non-progressive motor disorder resulting from a group of cerebral lesions. It can occur as a result of motor center injuries before, during or after birth and subsequently non-progressive central motor dysfunction, followed by mental retardation and motor impairment of the four limbs. The author treated 34 cases of cerebral palsy with the scalp acupuncture of Doctor TANG Song-yan. The report is now as follows.

  17. Protective effect of extract of Cordyceps sinensis in middle cerebral artery occlusion-induced focal cerebral ischemia in rats

    Directory of Open Access Journals (Sweden)

    Tang Huiling

    2010-10-01

    Full Text Available Abstract Background Ischemic hypoxic brain injury often causes irreversible brain damage. The lack of effective and widely applicable pharmacological treatments for ischemic stroke patients may explain a growing interest in traditional medicines. From the point of view of "self-medication" or "preventive medicine," Cordyceps sinensis was used in the prevention of cerebral ischemia in this paper. Methods The right middle cerebral artery occlusion model was used in the study. The effects of Cordyceps sinensis (Caterpillar fungus extract on mortality rate, neurobehavior, grip strength, lactate dehydrogenase, glutathione content, Lipid Peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na+K+ATPase activity and glutathione S transferase activity in a rat model were studied respectively. Results Cordyceps sinensis extract significantly improved the outcome in rats after cerebral ischemia and reperfusion in terms of neurobehavioral function. At the same time, supplementation of Cordyceps sinensis extract significantly boosted the defense mechanism against cerebral ischemia by increasing antioxidants activity related to lesion pathogenesis. Restoration of the antioxidant homeostasis in the brain after reperfusion may have helped the brain recover from ischemic injury. Conclusions These experimental results suggest that complement Cordyceps sinensis extract is protective after cerebral ischemia in specific way. The administration of Cordyceps sinensis extract significantly reduced focal cerebral ischemic/reperfusion injury. The defense mechanism against cerebral ischemia was by increasing antioxidants activity related to lesion pathogenesis.

  18. Protective effect of extract of Cordyceps sinensis in middle cerebral artery occlusion-induced focal cerebral ischemia in rats

    Science.gov (United States)

    2010-01-01

    Background Ischemic hypoxic brain injury often causes irreversible brain damage. The lack of effective and widely applicable pharmacological treatments for ischemic stroke patients may explain a growing interest in traditional medicines. From the point of view of "self-medication" or "preventive medicine," Cordyceps sinensis was used in the prevention of cerebral ischemia in this paper. Methods The right middle cerebral artery occlusion model was used in the study. The effects of Cordyceps sinensis (Caterpillar fungus) extract on mortality rate, neurobehavior, grip strength, lactate dehydrogenase, glutathione content, Lipid Peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na+K+ATPase activity and glutathione S transferase activity in a rat model were studied respectively. Results Cordyceps sinensis extract significantly improved the outcome in rats after cerebral ischemia and reperfusion in terms of neurobehavioral function. At the same time, supplementation of Cordyceps sinensis extract significantly boosted the defense mechanism against cerebral ischemia by increasing antioxidants activity related to lesion pathogenesis. Restoration of the antioxidant homeostasis in the brain after reperfusion may have helped the brain recover from ischemic injury. Conclusions These experimental results suggest that complement Cordyceps sinensis extract is protective after cerebral ischemia in specific way. The administration of Cordyceps sinensis extract significantly reduced focal cerebral ischemic/reperfusion injury. The defense mechanism against cerebral ischemia was by increasing antioxidants activity related to lesion pathogenesis. PMID:20955613

  19. Acute Paraplegia with Cognitive Alterations After Bilateral Infarcts in Cerebral Small Vessel Disease

    Directory of Open Access Journals (Sweden)

    Francisco Javier Ros Forteza

    2017-08-01

    Full Text Available Cerebral small vessel disease (SVD affects the small arteries, arterioles, venules and capillaries in the brain and can be identified clinically and/or radiologically. We describe the case of a 71-year-old man with sporadic cerebral SVD who presented with acute paraplegia with urinary incontinence and recent cognitive impairment that developed after the occurrence of ischaemic lesions.

  20. Requirement for Tumor Necrosis Factor Receptor 2 Expression on Vascular Cells To Induce Experimental Cerebral Malaria

    OpenAIRE

    Stoelcker, Benjamin; Hehlgans, Thomas; Weigl, Karin; Bluethmann, Horst; Grau, Georges E.; Männel, Daniela N

    2002-01-01

    Using tumor necrosis factor receptor type 2 (TNFR2)-deficient mice and generating bone marrow chimeras which express TNFR2 on either hematopoietic or nonhematopoietic cells, we demonstrated the requirement for TNFR2 expression on tissue cells to induce lethal cerebral malaria. Thus, TNFR2 on the brain vasculature mediates tumor necrosis factor-induced neurovascular lesions in experimental cerebral malaria.

  1. Cerebral Air Embolism from Angioinvasive Cavitary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Chen Lin

    2014-01-01

    Full Text Available Background. Nontraumatic cerebral air embolism cases are rare. We report a case of an air embolism resulting in cerebral infarction related to angioinvasive cavitary aspergillosis. To our knowledge, there have been no previous reports associating these two conditions together. Case Presentation. A 32-year-old female was admitted for treatment of acute lymphoblastic leukemia (ALL. Her hospital course was complicated by pulmonary aspergillosis. On hospital day 55, she acutely developed severe global aphasia with right hemiplegia. A CT and CT-angiogram of her head and neck were obtained demonstrating intravascular air emboli within the left middle cerebral artery (MCA branches. She was emergently taken for hyperbaric oxygen therapy (HBOT. Evaluation for origin of the air embolus revealed an air focus along the left lower pulmonary vein. Over the course of 48 hours, her symptoms significantly improved. Conclusion. This unique case details an immunocompromised patient with pulmonary aspergillosis cavitary lesions that invaded into a pulmonary vein and caused a cerebral air embolism. With cerebral air embolisms, the acute treatment option differs from the typical ischemic stroke pathway and the provider should consider emergent HBOT. This case highlights the importance of considering atypical causes of acute ischemic stroke.

  2. Efeitos do pentobarbital sódico sobre a atividade elétrica cerebral do rato com lesões da formação reticular mesencefálica Action of sodium pentobarbital on the cortical electrical activity of the rat after lesion of the midbrain reticular formation

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1970-12-01

    Full Text Available Para êste estudo foram empregados 35 ratos da raça Wistar em preparação aguda (24 com lesão bilateral e 11 com lesão unilateral da formação reticular mesencefálica e 18 preparações crônicas. O método empregado na obtenção das preparações foi descrito em trabalho anterior12. O objetivo desta série de experiências foi o de verificar de que maneira o pentobarbital interfere sobre as características da atividade elétrica cortical após lesão da formação reticular mesencefálica. Para tal, em animais preparados agudamente, foram feitas lesões progressivamente mais extensas e o barbitúrico injetado por via intravenosa em doses crescentes. A fim de testar a integridade do sistema reticular ativador ascendente, além de estímulos dolorosos intensos, aplicávamos pulsos de 5 a 10 V, 100 Hz, e 0,1 ms à formação reticular mesencefálica situada abaixo da região lesada. A ausência de reação de alerta cortical (dessincronização nos assegurava que tal sistema havia sido lesado completamente. Nas preparações crônicas o pentobarbital era injetado por via intraperitoneal. Dessas experiências concluimos o seguinte: 1. Aumento da sincronização do eletrocorticograma nos animais com lesões parciais ou totais da formação reticular mesencefálica. 2. Depressão acentuada e precoce da atividade elétrica cerebral nos ratos com lesão muito extensa (comprometendo também a porção ventrobasal do tálamo. 3. Isocronismo da atividade elétrica cortical nos dois hemisférios cerebrais. 4. O pentobarbital parece agir tanto sobre os sistemas ativadores como sobre o sincronizador do eletrocorticograma. As doses pequenas deprimem os primeiros, liberando o segundo, enquanto que as maiores bloqueiam também este último. Sòmente doses muito mais altas é que fazem desaparecer totalmente a atividade do córtex cerebral, que se mostra, portanto, mais resistente à ação da droga.This study was performed on 35 albino rats prepared for

  3. Modulation of cerebral blood flow with transcutaneous electrical neurostimulation (TENS) in patients with cerebral vasospasm after subarachnoid hemorrhage

    NARCIS (Netherlands)

    ter Laan, Mark; van Dijk, J.M.C.; Stewart, Roy; Staal, Michiel J; Elting, Jan-Willem J

    2014-01-01

    ObjectivesTranscutaneous electrical neurostimulation (TENS) and spinal cord stimulation have been shown to increase peripheral and cerebral blood flow. We postulate that certain pathological conditions attenuate cerebral autoregulation, which may result in a relative increase of the importance of ne

  4. Chinese semantic processing cerebral areas

    Institute of Scientific and Technical Information of China (English)

    SHAN Baoci; ZHANG Wutian; MA Lin; LI Dejun; CAO Bingli; TANG Yiyuan; WU Yigen; TANG Xiaowei

    2003-01-01

    This study has identified the active cerebral areas of normal Chinese that are associated with Chinese semantic processing using functional brain imaging. According to the traditional cognitive theory, semantic processing is not particularly associated with or affected by input modality. The functional brain imaging experiments were conducted to identify the common active areas of two modalities when subjects perform Chinese semantic tasks through reading and listening respectively. The result has shown that the common active areas include left inferior frontal gyrus (BA 44/45), left posterior inferior temporal gyrus (BA37); the joint area of inferior parietal lobules (BA40) and superior temporal gyrus, the ventral occipital areas and cerebella of both hemispheres. It gives important clue to further discerning the roles of different cerebral areas in Chinese semantic processing.

  5. Neurological manifestations and PET studies of the thalamic vascular lesions

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Shinji; Kawamura, Mitsuru; Hirayama, Keizo [Chiba Univ. (Japan). School of Medicine

    1995-02-01

    We divided 38 patients with cerebrovascular disease of the thalamus into 5 groups according to the site of the thalamic lesions as confirmed by X-ray CT and/or MRI. In 16 patients, we examined the cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO{sub 2}) by positron emission tomography (PET). In the anteromedial thalamic lesion group, patients displayed disturbances of spontaneity, memory, reading and writing. CBF and CMRO{sub 2} were decreased in the frontal, parietal and temporal lobes on the side of the lesion. In the dorsolateral thalamic lesion group, ataxic hemiparesis was a characteristic symptom. CBF and CMRO{sub 2} were decreased in frontoparietal lobes on the side of the lesion. In the group with lesions confined to the nucleus ventralis posterioris thalami, the main symptoms were sensory disturbance, with cheiro-oral sensory syndrome being particularly evident. CBF and CMRO{sub 2} were decreased in the parietal lobe on the side of the lesion. In the group with posterolateral thalamic lesions without pulvinar involvement, patients exhibited thalamic syndrome without thalamic pain. CBF and CMRO{sub 2} were decreased in the frontoparietal and temporal lobes on the side of the lesion. In contrast, in the group with posterolateral thalamic lesions with pulvinar involvement, all patients showed thalamic pain. The decrease in CBF and CMRO{sub 2} extended to the inferomedial region of the temporal lobe in addition to the area of decreased CBF and CMRO{sub 2} observed in the group with posterolateral thalamic lesions without pulvinar involvement. Based on these results, we speculate that the neurological manifestations of thalamic vascular disease are associated with a decrease in cortical CBF and CMRO{sub 2} secondary to the thalamic lesions. (author).

  6. Alexia without agraphia associated with right occipital lesion.

    Science.gov (United States)

    Hirose, G; Kin, T; Murakami, E

    1977-01-01

    A 78 year old, right handed man developed the syndrome of alexia without agraphia due to a right occipital thrombotic stroke. The cerebral dominance test strongly suggests that his right hemisphere is dominant. This is believed to be the first case of alexia without agraphia secondary to a right occipital lesion in a right handed person. PMID:886349

  7. 脑梗死急性期梗死部位及白质病变与认知功能关系的临床分析%Clinical Analysis of the Relationship between Vascular Cognitive Impairment and Infarction Locations and White Matter Lesions at Early Stages of Acute Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    张娟; 李见; 陈文瑞; 孟香玉; 胡文立

    2013-01-01

      目的研究急性脑梗死患者梗死部位及是否合并脑白质病变对患者早期认知功能的影响。  方法采用临床痴呆评定量表、简易精神状态检查量表和中文版蒙特利尔认知评估量表对连续入组的急性脑梗死患者进行认知心理学评估,分析患者不同梗死部位包括皮层梗死、皮层下关键部位梗死和皮层下非关键部位梗死及是否合并白质病变对患者认知功能的影响。  结果急性脑梗死患者血管性认知功能障碍组的平均年龄显著高于无认知功能障碍组(67.3110.88 vs 57.099.91,P=0.015),神经功能缺损评分显著高于无认知功能障碍组[3.0(2.0~4.0) vs 1.0(1.0~2.0),P=0.012]。认知功能障碍组的日常生活能力评分显著低于无认知功能障碍组(81.6723.55 vs 95.9112.00,P=0.029)。两组患者梗死部位有显著差异(P=0.042),皮层梗死更多见于血管性认知功能障碍组,皮层梗死患者的视空间与执行功能显著低于皮层下非关键位置梗死患者[1.5(0.0~3.0) vs 3.0(2.0~4.0),P=0.016]。白质病变与认知障碍的发生无明显相关性。  结论急性脑梗死患者早期认知障碍与年龄、严重的神经功能缺损、皮层梗死、日常生活能力下降密切相关。%Objective To analyze the influences of infarction locations and white matter lesions on vascular cognitive impairment (VCI) of acute cerebral infarction patients at their early stages. Methods Consecutive acute cerebral infarction patients underwent Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Analyses were performed to study the association between cognitive impairment and infarction locations including cortical infarction, subcortical critical site infarction, subcortical non-critical site infarction and white matter lesions including leukoaraiosis and non

  8. Perioperative cerebral ischaemia in cardiac surgery and BIS.

    Science.gov (United States)

    Villacorta, J; Kerbaul, F; Collart, F; Guidon, C; Bonnet, M; Guillen, J C; Gouin, F

    2005-08-01

    A 46-year-old woman was monitored by bispectral index monitoring (BIS) during redo aortic and mitral valve replacement. On release of the aortic cross clamp there was a sudden, severe, unexplained, and sustained fall in the BIS value. Postoperatively, a CT scan was consistent with multiple ischaemic lesions. The lesions were presumed to be due to air embolism. This case suggests that a sudden unexplained and persistent fall in BIS may indicate cerebral ischaemia.

  9. Cerebral infarction presenting pure motor mono-paresis. Diagnosis by diffusion-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Masaya; Udaka, Fukashi; Nishinaka, Kazuto; Kubori, Tamotsu; Kameyama, Masakuni [Sumitomo Hospital, Osaka (Japan)

    2001-02-01

    We studied 10 patients with acute ischemic cerebrovascular disorders presenting paralysis confined to one limb, unaccompanied by sensory signs (pure motor monoparesis, PMM) on diffusion-weighted MR imaging (DWI). DWI revealed fresh ischemic lesions in all patients, except for 2 cases of transient ischemic attack. On DWI, acute infarction in multiple lesions was identified, and small superficial lesions were clearly described. Superficial lesions were seen in 4 patients, and deep lesions were also seen in 4 patients. DWI is useful for lesion analysis in cerebral infarction with PMM. (author)

  10. Long-term functional outcome after stroke: the impact of MRI-detected lesion characteristics

    NARCIS (Netherlands)

    Schiemanck, S.K.

    2007-01-01

    The objective of this thesis was to gain a better understanding of the relationship between ischemic lesion characteristics and long-term functional outcome of stroke survivors. The relationship between volume and localization of the ischemic cerebral lesion and the long-term functional outcome of

  11. Evaluation of murine models of permanent focal cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    席刚明; 汪华侨; 何国厚; 黄朝芬; 魏国耀

    2004-01-01

    Background To date murine models of permanent focal cerebral ischemia have not been well characterized. The purposes of this paper were to compare three different permanent middle cerebral artery occlusion (MCAo) models with or without craniectomy, and to identify an ideal mouse model of permanent focal cerebral ischemia.Methods Experiments were performed on 45 healthy adult male Kunming mice, weighing 28 to 42 g. The animals were randomly assigned to three groups (n=15 in every group) based on surgical procedure: MCAo via the external carotid artery (ECA), MCAo via the common carotid artery (CCA), and direct ligation of the middle cerebral artery (MCA). Each day post-ischemia, the animals were scored using an eight-grade neurological function scale, and mortality was also recorded. Seven days post-ischemia, the brains were removed for lesion size determination using triphenyltetrazolium chloride staining. Correlation analysis of lesion volume and neurological score was carried out. Results Mortality in the group receiving direct MCA ligation was lowest among the three groups, and there was a significant difference between the direct MCA ligation group and the two intraluminal occlusion groups (P0.7, P<0.05), suggesting good reproducibility of lesion volume in the three groups, but the infarct volume was more constant in the direct MCA ligation group. Conclusion The direct ligation model of MCAo provides an optimal means of studying permanent focal cerebral ischemia, and is preferable to the models using intraluminal sutures.

  12. Unique psoriatic lesion versus multiple lesions

    Directory of Open Access Journals (Sweden)

    Anca Chiriac

    2014-10-01

    Full Text Available Aim: To evaluate the number of lesions of psoriasis and to find risk factors for multiple lesions. Material and Methods: 1,236 patients (male 54.13%, female 45.87% with psoriasis were seen over a period of 8 years in an Outpatient Clinic. Patients filled out questionnaires containing age at onset, number of lesions and location at the beginning of the disease, gender, type and localization of psoriasis at the time of clinical examination, psoriasis family history, previous treatment, comorbidities, and social status. Results: The number of psoriasis lesions correlates with: onset age of psoriasis (F=8.902, p=0.0029; age at the moment of clinical examination (F=8.902, p=0.0029; residence in rural area (χ2=8.589, p=0.00338, 95%CI; alcohol intake (χ2=16.47, p=0.00005, 95%CI; smoking (χ2=8.408, p=0.00373, 95%CI; occupation: workers/pupils/students (χ2=14.11, p=0.0069, 95%CI. Conclusions: There is a correlation between number of psoriatic lesions and some factors. Multiple lesions were observed in older patients, smokers and drinkers, coming from rural area and social active (workers and pupils/students. No correlation was statistically proved between number of lesions and gender, comorbidities and family history of psoriasis.

  13. Cerebral aterial spasm. I. Adrenergic mechanism in experimental cerebral vasospasm.

    Directory of Open Access Journals (Sweden)

    Morooka,Hiroshi

    1978-04-01

    Full Text Available This study demonstrates that an adrenergic mechanism plays an important role in producing the delayed cerebral vasospasm which follows subarachnoid hemorrhage. Results were as follows: 1. Experimental subarachnoid hemorrhage (SAH was produced by injection of fresh arterial blood into the cisterna magna in cats. The cerebral vasospasm was shown angiographically to be biphasic in nature: immediate constriction lasting 1 h and marked prolonged spasm occurring between the 3rd and 5th day after SAH. The amount of noradrenaline (NA and dopamine-beta-hydroxylase (DBH activity decreased over a period of 24 h both within the wall of the basilar artery and in the locus ceruleus and then gradually increased, reaching a maximum on the 3rd day after SAH. 2. Topical application of spasmogenic substances (NA and blood produced a marked constriction of the hypersensitive basilar artery on the 3rd day after SAH. 3. 6-Hydroxydopamine (6-OHDA injection into the cisterna magna produced prolonged vasocilatation. The dilated vessel responded with mild transient constriction after the topical application of NA or fresh blood. DBH activity and NA concentration in the vessels, locus ceruleus and medial hypothalamus decreased markedly on the 3rd day after the cisternal injection of 6-OHDA. 4. Various spasmogenic substances (i.e. serotonin, NA, prostaglandins and methemoglobin were measured in a mixture of equal volume of CSF and blood in cats. ONly the serotonin in the mixed fluid produced vasoconstriction. Spasmogenic substances decreased markedly in the mixed fluid incubated for 3 days at 37 degrees C, and none of these substances apart from methemoglobin was present in a concentration sufficient to produce constriction of vessels. 5. These results suggest that early spasm is induced by serotonin around the arteries of the cranial base, and delayed spasm might be caused by hyperreaction of cerebral vessels to spasmogenic substances such as methemoglobin, during the

  14. Challenges in understanding the impact of blood pressure management on cerebral oxygenation in the preterm brain

    Directory of Open Access Journals (Sweden)

    Aminath eAzhan

    2012-12-01

    Full Text Available Systemic hypotension in preterm infants has been related to increased mortality, cerebrovascular lesions and neurodevelopmental morbidity. Treatment of hypotension with inotropic medications aims at preservation of end organ perfusion and oxygen delivery, especially the brain. The common inotropic medications in preterm infants include dopamine, dobutamine, adrenalin, with adjunctive use of corticosteroids in cases of refractory hypotension. Whether maintenance of mean arterial blood pressure (MAP by use of inotropic medication is neuroprotective or not remains unclear. This review explores the different inotropic agents and their effects on perfusion and oxygenation in the preterm brain, in clinical studies as well as in animal models. Dopamine and adrenalin, because of their -adrenergic vasoconstrictor actions, have raised concerns of reduction in cerebral blood flow (CBF. Several studies in hypotensive preterm infants have shown that dopamine elevates CBF together with increased MAP, in keeping with limited cerebro-autoregulation. Adrenaline is also effective in raising cerebral perfusion together with MAP in preterm infants. Experimental studies in immature animals show no cerebro-vasoconstrictive effects of dopamine or adrenaline, but demonstrate the consistent findings of increased cerebral perfusion and oxygenation with the use of dopamine, dobutamine and adrenaline, alongside with raised MAP. Both clinical and animal studies report the transitory effects of adrenaline in increasing plasma lactate, and blood glucose, which might render its use as a 2nd line therapy. To investigate the cerebral effects of inotropic agents in long-term outcome in hypotensive preterm infants, carefully designed prospective research possibly including preterm infants with permissive hypotension is required. Preterm animal models would be useful in investigating the relationship between the physiological effects of inotropes and histopathology outcomes in

  15. CEREBRAL HYDATID DISEASE: CT AND MR IMAGING FINDINGS

    Directory of Open Access Journals (Sweden)

    Ajay

    2014-10-01

    Full Text Available OBJECTIVE: Cerebral hydatid disease is very rare, representing only 2% of all cerebral space occupying lesions even in the countries where the disease is endemic. The aim of this paper is to describe the characteristic features of cerebral hydatid disease in computed tomography (CT and magnetic resonance imaging (MRI. METHODS: Here is a case 25yr/m who presented to neurosurgery OPD with complaints of headache, vomiting, right sided weakness and seizures for 2 weeks. CT and MRI were the imaging modalities to reach the diagnosis which was pathologically confirmed postoperatively as hydatid disease. RESULTS: CT and MR imaging findings of E. granulosus lesions were well defined, smooth thin-walled, spherical, homogeneous cystic lesions with no contrast enhancement, no calcification, and no surrounding oedema. CONCLUSION: Although cystic cerebral hydatid disease is well demonstrated by CT and MR examinations, CT is superior in detecting calcification in the cyst, when present, MR is better in demonstrating cyst capsule, detecting multiplicity and defining the anatomic relationship of the lesion with the adjacent structures, and it is more helpful in surgical planning.

  16. Compensatory cerebral motor control following presumed perinatal ischemic stroke

    NARCIS (Netherlands)

    van der Hoorn, Anouk; Potgieser, Adriaan R E; Brouwer, Oebele F; de Jong, Bauke M

    2014-01-01

    Case: A fifteen year-old left-handed girl presented with right-sided focal motor seizures. Neuroimaging showed a large left hemisphere lesion compatible with a middle cerebral artery stroke of presumed perinatal origin. She was not previously diagnosed with a motor deficit, although neurological exa

  17. Low cerebral blood flow in hypotensive perinatal distress

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1977-01-01

    Hypoxic brain injury is the most important neurological problem in the neonatal period and accounts for more neurological deficits in children than any other lesion. The neurological deficits are notably mental retardation, epilepsy and cerebral palsy. The pathogenesis has hitherto been poorly...

  18. Vascular permeability in cerebral cavernous malformations.

    Science.gov (United States)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik B W; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-10-01

    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 observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy.

  19. Magnetic Resonance Imaging of Cerebral Aspergillosis: Imaging and Pathological Correlations

    Science.gov (United States)

    Sabou, Marcela; Lannes, Béatrice; Cotton, François; Meyronet, David; Galanaud, Damien; Cottier, Jean-Philippe; Grand, Sylvie; Desal, Hubert; Kreutz, Julie; Schenck, Maleka; Meyer, Nicolas; Schneider, Francis; Dietemann, Jean-Louis; Koob, Meriam

    2016-01-01

    Cerebral aspergillosis is associated with a significant morbidity and mortality rate. The imaging data present different patterns and no full consensus exists on typical imaging characteristics of the cerebral lesions. We reviewed MRI findings in 21 patients with cerebral aspergillosis and correlated them to the immune status of the patients and to neuropathological findings when tissue was available. The lesions were characterized by their number, topography, and MRI signal. Dissemination to the brain resulted from direct spread from paranasal sinuses in 8 patients, 6 of them being immunocompetent. Hematogenous dissemination was observed in 13 patients, all were immunosuppressed. In this later group we identified a total of 329 parenchymal abscesses involving the whole brain with a predilection for the corticomedullary junction. More than half the patients had a corpus callosum lesion. Hemorrhagic lesions accounted for 13% and contrast enhancement was observed in 61% of the lesions. Patients with hematogenous dissemination were younger (p = 0.003), had more intracranial lesions (p = 0.0004) and had a higher 12-week mortality rate (p = 0.046) than patients with direct spread from paranasal sinuses. Analysis of 12 aneurysms allowed us to highlight two distinct situations. In case of direct spread from the paranasal sinuses, aneurysms are saccular and located on the proximal artery portions, while the hematogenous dissemination in immunocompromised patients is more frequently associated with distal and fusiform aneurysms. MRI is the exam of choice for cerebral aspergillosis. Number and type of lesions are different according to the mode of dissemination of the infection. PMID:27097323

  20. Angiographic findings in 2 children with cerebral paragonimiasis with hemorrhage.

    Science.gov (United States)

    Chen, Zhi; Chen, Jingyu; Miao, Hongpin; Li, Fei; Feng, Hua; Zhu, Gang

    2013-05-01

    Hemorrhagic events associated with cerebral paragonimiasis are not rare, especially in children and adolescents; however, angiographic evidence of cerebrovascular involvement has not been reported. The authors describe angiographic abnormalities of the cerebral arteries seen in 2 children in whom cerebral paragonimiasis was associated with hemorrhagic stroke. The patients presented with acute intracerebral and subarachnoid hemorrhage. Angiography revealed a beaded appearance and long segmental narrowing of arteries, consistent with arteritis. In both patients, involved vessels were seen in the area of the hemorrhage. The vascular changes and the hemorrhage, together with new lesions that developed close to the hemorrhage and improved after praziquantel treatment, were attributed to paragonimiasis. Further study of the frequency and mechanism of hemorrhagic cerebrovascular complications associated with cerebral paragonimiasis is needed.

  1. 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.

  2. 视网膜血管异常与脑小血管病%Retinal vascular abnormalities and cerebral small vessel disease

    Institute of Scientific and Technical Information of China (English)

    李華; 吴丹紅

    2014-01-01

    Cerebral small vessel disease is common and is gradually being understood,but it is difficult to visualize directly in the body.The retinal vessels share the similar anatomic,physiological,and embryological characteristics with the cerebral small vessels.Their changes may reflect the changes of cerebral small vessels in a certain extent.Studies in recent years have shown that retinal vascular abnormalities are associated with lacunar infarction and white matter lesions.This article summarizes the research evidence of the correlation of between retinal vascular abnormalities and cerebral small vessel disease.%脑小血管病很常见并逐渐被认识,但在体内很难直接观察.视网膜血管与脑小血管具有相似的解剖学、生理学和胚胎学特征,其改变可能在一定程度上能反映脑小血管改变.近年来的研究显示,视网膜血管异常与腔隙性梗死和脑白质病变相关.文章对视网膜血管异常与脑小血管病相关性的研究证据进行了总结.

  3. Acute Headache at Emergency Department: Reversible Cerebral Vasoconstriction Syndrome Complicated by Subarachnoid Haemorrhage and Cerebral Infarction

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    M. Yger

    2015-01-01

    Full Text Available Introduction. Reversible cerebral vasoconstriction syndrome is becoming widely accepted as a rare cause of both ischemic and haemorrhagic stroke and should be evocated in case of thunderclap headaches associated with stroke. We present the case of a patient with ischemic stroke associated with cortical subarachnoid haemorrhage (cSAH and reversible diffuse arteries narrowing, leading to the diagnosis of reversible vasoconstriction syndrome. Case Report. A 48-year-old woman came to the emergency department because of an unusual thunderclap headache. The computed tomography of the brain completed by CT-angiography was unremarkable. Eleven days later, she was readmitted because of a left hemianopsia. One day after her admission, she developed a sudden left hemiparesis. The brain MRI showed ischemic lesions in the right frontal and occipital lobe and diffuse cSAH. The angiography showed vasoconstriction of the right anterior cerebral artery and stenosis of both middle cerebral arteries. Nimodipine treatment was initiated and vasoconstriction completely regressed on day 16 after the first headache. Conclusion. Our case shows a severe reversible cerebral vasoconstriction syndrome where both haemorrhagic and ischemic complications were present at the same time. The history we reported shows that reversible cerebral vasoconstriction syndrome is still underrecognized, in particular in general emergency departments.

  4. Long Term Neuropsychological Follow-Up in Patients With Herpes Simplex Encephalitis and Predominantly Left-Sided Lesions

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    B. Laurent

    1991-01-01

    Full Text Available Five patients with predominantly dominant cerebral hemisphere lesions due to herpes simplex encephalitis are described. Verbal amnesia was the main deficit but amnesic aphasia sometimes associated with impairment of remote memory also occurred. Semantic and episodic memory deficits were also explored in one case and the role of the right cerebral hemisphere in facilitating recovery of learning is discussed.

  5. Cerebral Palsy (CP) Quiz

    Science.gov (United States)

    ... SSI file Error processing SSI file Pop Quiz: Cerebral Palsy Language: English Español (Spanish) Recommend on Facebook Tweet ... Sandy is the parent of a child with cerebral palsy and the Board President of Gio’s Garden , a ...

  6. Reversible cerebral vasoconstriction syndrome

    Directory of Open Access Journals (Sweden)

    Saini Monica

    2009-01-01

    Full Text Available Reversible cerebral vasoconstriction syndromes (RCVS are a group of disorders that have in common an acute presentation with headache, reversible vasoconstriction of cerebral arteries, with or without neurological signs and symptoms. In contrast to primary central nervous system vasculitis, they have a relatively benign course. We describe here a patient who was diagnosed with RCVS.

  7. CT diagnosis of sellar and juxtasellar lesions, 3. Non-tumorous lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Tatsuya (Nagoya Univ. (Japan). Faculty of Medicine)

    1982-08-01

    A study is made of the usefulness and limitations of the CT diagnosis of sellar and juxtasellar lesions other than tumors. This study is based on 112 verified cases at Nagoya University Hospital from October, 1976, to December, 1981. The lesions included in this study are classified into four groups: vascular, inflammatory, traumatic lesion, and congenital anomaly. Although cerebral angiography is the cardinal method for the diagnosis of vascular lesions, CT is useful for the evaluation of a giant aneurysm, the localization of bleeding, or infarction by a ruptured aneurysm. Radiation brain necrosis, a special form of vascular lesion, can also be diagnosed if the critical analysis is made after previous irradiation. CT findings are helpful for the local diagnosis of acute inflammatory lesions, such as basal meningitis or abscess, but specific diagnosis is made on the basis of clinical signs and CSF study. Abnormal CT findings are obtained from a chronic inflammatory process, such as arachnoiditis adhesiva, glanuloma, or mucocele. Differential diagnosis is necessary with brain tumors. The CT findings of an arachnoid cyst are often diagnostic. Metrizamide or air cisternography, either combined with CT or without it, is important for the diagnosis of basal meningoencephalocele and hypothalamic hamaroma. Pneumocephalus and an intracranial foreign body resulting from a head injury can be diagnosed by plain skull and CT. The diagnosis of CSF leakage or prolapse cerebri associated with a skull-base fracture has been most difficult, but even it is possible by a combination of polytomography and high-resolution CT with metrizamide cisternography.

  8. Clinical Features of Liver Cancer with Cerebral Hemorrhage

    Science.gov (United States)

    Lu, Qiuhong; Chen, Li; Zeng, Jinsheng; Huang, Gelun; Qin, Chao; Cheng, Daobin; Yu, Lixia; Liang, Zhijian

    2016-01-01

    Background Cerebral hemorrhage is common in patients with cancer, but the clinical features and pathogenesis of liver cancer patients with cerebral hemorrhage are not well known. Material/Methods Liver cancer patients who developed cerebral hemorrhage were recruited from the First Affiliated Hospital of Guangxi Medical University between January 2003 and December 2014. We retrospectively analyzed clinical presentations, results of laboratory tests, and imaging examinations. The clinical features and pathogenesis were summarized. Results Among 11133 patients with liver cancer, 9 patients (0.08%), including 3 females and 6 males met the inclusion criteria. The age range was 48–73 years and the average age was 61.67±8.97 years. Five patients did not have traditional hemorrhage risk factors and 4s had the risk factors; however, all had developed hepatocellular carcinoma, and 3 had developed metastasis. All 9 patients showed elevated tumor markers: an increased AFP level was detected in 6 patients, coagulation dysfunctions in 8 patients, and abnormal liver functions in 6 patients. Five patients had developed cerebral hemorrhagic lesions in the lobes of their brains, while hemorrhagic lesions in the basal ganglia occurred in 3 patients and in the brainstem in only 1 patient. Four patients had clear consciousness, while 5 patients were in coma and showed poor prognosis. Conclusions Patients who have liver cancer complicated with cerebral hemorrhage usually lack traditional risk factors of cerebral hemorrhage. The site of cerebral hemorrhage is often detected in the lobes of the brain. Coagulation dysfunctions might be the main pathogenesis of liver cancer complicated with cerebral hemorrhage. PMID:27209058

  9. Perfusion-CT for early assessment of traumatic cerebral contusions

    Energy Technology Data Exchange (ETDEWEB)

    Soustiel, Jean F.; Mahamid, Eugenia; Goldsher, Dorith; Zaaroor, Menashe [Faculty of Medicine, Technion - Israel Institute of Technology, Department of Neurosurgery, Rambam Medical Center, P.O. Box 9602, Haifa (Israel)

    2008-02-15

    To investigate the value of perfusion-CT (PCT) for assessment of traumatic cerebral contusions (TCC) and to compare the abilities of early noncontrast CT and PCT modalities to evaluate tissue viability. PCT studies performed in 30 patients suffering from TCC during the acute phase of their illness were retrospectively reviewed. Cerebral blood flow (CBF), volume (CBV) and mean transit time (MTT) were measured in three different areas: the hemorrhagic core of the TCC, the surrounding hypodense area and the perilesional normal-appearing parenchyma. TCC area was measured on CBF-, CBV- and MTT-derived maps and compared with the areas measured using the same slice obtained with CT scans performed on admission, at the time of PCT (follow-up CT) and at 1 week. TCC were characterized by low CBF and CBV values (9.2{+-}6.6 ml/100 g per min and 0.9{+-}0.7 ml/100 g, respectively) and a significant prolongation of MTT (11.9{+-}10.7 s) in the hemorrhagic core whereas PCT parameters were more variable in the hypodense area. The TCC whole area showed a noticeable growth of the lesions during the first week of admission. In comparison with early noncontrast CT, CBV and CBF maps proved to be more congruent with the findings of noncontrast CT scans at 1 week. PCT confirmed the results of xenon-CT studies and was shown to allow better evaluation of tissue viability than noncontrast CT. These findings suggest that PCT could be implemented in the future for the early assessment of patients with traumatic brain injury. (orig.)

  10. MRI features of pediatric cerebral paragonimiasis in the active stage.

    Science.gov (United States)

    Zhang, Jin Song; Huan, Yi; Sun, Li Jun; Zhang, Guang Yun; Ge, Ya Li; Zhao, Hai Tao

    2006-04-01

    We retrospectively reviewed the MR images of the brains of six children (age = 5-13 years) who had cerebral paragonimiasis in the early active stage. Diagnosis was based on a positive antibody test enzyme-linked immunosorbent assay (ELISA) for paragonimiasis in serum. The most common finding (in five patients) was irregular hemorrhage of various degrees. Moreover, in three cases some multiple irregular lesions with surrounding edema appeared to be conglomerated and aggregated. The rare appearance (in one patient) was a "tunnel sign," which showed the migrating track of the adult worm. In one patient with abscess and minimal hemorrhage, diffusion-weighted imaging (DWI) showed a heterogeneous high signal of lesions. Other findings included slight (one patient) or marked (one patient) irregular contrast enhancement, and large edematous areas surrounding small centers of hemorrhage (two patients). MR findings of conglomerated lesions with hemorrhage or tunnel sign may help to establish the diagnosis of active-stage cerebral paragonimiasis.

  11. Cerebral oximetry and cerebral blood flow monitoring in 2 pediatric survivors with out-of-hospital cardiac arrest.

    Science.gov (United States)

    Abramo, Thomas; Aggarwal, Nitin; Kane, Ian; Crossman, Kristen; Meredith, Mark

    2014-04-01

    In pediatric out-of-hospital cardiac arrest (POHCA), cardiovascular monitoring tools have improved resuscitative endeavors and cardiovascular outcomes but with still poor neurologic outcomes. Regarding cardiac arrest in patients with congenital heart disease during surgery, the application of cerebral oximetry with blood volume index (BVI) during the resuscitation has shown significant results and prognostic significance. We present 2 POHCA patients who had cerebral oximetry with BVI monitoring during their arrest and postarrest phase in the emergency department and its potential prognostic aspect.Basic procedures include left and right cerebral oximetry with BVI monitoring at every 5-second interval during cardiac arrest, resuscitation, and postarrest in 2 POHCA patients in the pediatric emergency department.Regional cerebral tissue oxygen saturation (rSo2) with BVI readings in these 2 POHCA survivors demonstrated interesting cerebral physiology, blood flow, and potential prognostic outcome. In 1 patient, the reference range of cerebral rSo2 with positive blood flow during arrest and postarrest phases consistently occurred. This neurologic monitoring had its significance when the resuscitation effectiveness was used and end-tidal CO2 changes were lost. The other patient's cerebral rSo2 with simultaneous BVI readings and trending showed the effectiveness of the emergency medical services (EMS) resuscitation.Cerebral oximetry with cerebral blood flow index monitoring in these POHCA survivors demonstrates compelling periarrest and postarrest cerebral physiology information and prognostication. Cerebral oximetry with cerebral BVI monitoring during these arrest phases has potential as a neurologic monitor for the resuscitative intervention's effectiveness and its possible neurologic prognostic application in the pediatric OCHA patients.

  12. 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......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 observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability...... correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive...

  13. Pediatric neuroradiology: Cerebral and cranial diseases

    Energy Technology Data Exchange (ETDEWEB)

    Diebler, C.; Dulac, O.

    1987-01-01

    In this book, a neuroradiologist and a neuropediatrician have combined forces to provide the widest possible knowledge in investigating cranial and cerebral disorders in infancy and childhood. Based on more than 20,000 pediatric CT examinations, with a follow-up time often exceeding ten years, the book aims to bridge interdisciplinary gaps and help radiologists, pediatricians and neurosurgeons solve the various problems of pediatric neuroradiology that frequently confront them. For each disease, the etiology, clinical manifestation, pathological lesions and radiological presentations are discussed, supported by extensive illustrations. Malformative, vascular, traumatic, tumoral, infectious and metabolic diseases are reviewed. Miscellaneous conditions presenting particular symptoms or syndromes are also studied, such as hydrocephalus and neurological complications of leukemia. Contents: Cerebral and cranial malformations; neurocutaneous syndromes; inherited metabolic diseases; infectious diseases - vascular disorders; intracranial tumors; cranial trauma - miscellaneous and subject index.

  14. Clinical practice: swallowing problems in cerebral palsy.

    Science.gov (United States)

    Erasmus, Corrie E; van Hulst, Karen; Rotteveel, Jan J; Willemsen, Michel A A P; Jongerius, Peter H

    2012-03-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Early attention should be given to dysphagia and excessive drooling and their substantial contribution to the burden of a child with CP and his/her family. This review displays the important functional and anatomical issues related to swallowing problems in children with CP based on relevant literature and expert opinion. Furthermore, based on our experience, we describe a plan for approach of investigation and treatment of swallowing problems in cerebral palsy.

  15. Stenting for Atherosclerotic Stenosis of the Intracranial or Skull Base Cerebral Arteries: Effectiveness and Problems

    OpenAIRE

    Harakuni, T.; Hyodo, A.; Shingaki, T.; Kugai, M.; Kinjyo, T.; Tsuchida, H.; Sugimoto, K.; Yoshii, Y.; Matsumaru, Y.

    2004-01-01

    Since May 1992, we have performed percutaneous transluminal angioplasty (PTA) or stenting 70 times for 65 lesions in 62 patients with atherosclerotic stenosis of the intracranial or skull base cerebral arteries. Stenting was carried out nine times for nine lesions in nine cases. Stenting was performed on patients with an average age of 62. The patients were eight men and one woman. The stenotic lesions involved the internal carotid artery (petrous portion) in four cases, the internal carotid ...

  16. Clinical study on the efficacy of Rajayapana Basti and Baladi Yoga in motor disabilities of cerebral palsy in children

    OpenAIRE

    Shailaja, U.; Prasanna N Rao; Girish, K. J.; Arun Raj, G.R.

    2014-01-01

    Background: Cerebral palsy is a static encephalopathy that may be defined as a non-progressive disorder of posture and movement often associated with epilepsy and abnormalities in speech, vision and intellect resulting from a defect or lesion of the developing brain. There are 25 lakhs cerebral palsy affected children in India. Aim: To assess the efficacy of Rajayapana Basti (RB) and Baladi Yoga in motor disabilities of cerebral palsy in children. Materials and Methods: Total 98 children sati...

  17. Cerebral hypoxia and ischemia in preterm infants

    Directory of Open Access Journals (Sweden)

    Alberto Ravarino

    2014-06-01

    Full Text Available Premature birth is a major public health issue internationally affecting 13 million babies worldwide. Hypoxia and ischemia is probably the commonest type of acquired brain damage in preterm infants. The clinical manifestations of hypoxic-ischemic injury in survivors of premature birth include a spectrum of cerebral palsy and intellectual disabilities. Until recently, the extensive brain abnormalities in preterm neonates appeared to be related mostly to destructive processes that lead to substantial deletion of neurons, axons, and glia from necrotic lesions in the developing brain. Advances in neonatal care coincide with a growing body of evidence that the preterm gray and white matter frequently sustain less severe insults, where tissue destruction is the minor component. Periventricular leukomalacia (PVL is the major form of white matter injury and consists classically of focal necrotic lesions, with subsequent cyst formation, and a less severe but more diffuse injury to cerebral white mater, with prominent astrogliosis and microgliosis but without overt necrosis. With PVL a concomitant injury occurs to subplate neurons, located in the subcortical white matter. Severe hypoxic-ischemic insults that trigger significant white matter necrosis are accompanied by neuronal degeneration in cerebral gray and white matter. This review aims to illustrate signs of cerebral embryology of the second half of fetal life and correlate hypoxic-ischemic brain injury in the premature infant. This should help us better understand the symptoms early and late and facilitate new therapeutic strategies. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  18. Ghost cell lesions

    Directory of Open Access Journals (Sweden)

    E Rajesh

    2015-01-01

    Full Text Available Ghost cells have been a controversy for a long time. Ghost cell is a swollen/enlarged epithelial cell with eosnophilic cytoplasm, but without a nucleus. In routine H and E staining these cells give a shadowy appearance. Hence these cells are also called as shadow cells or translucent cells. The appearance of these cells varies from lesion to lesion involving odontogenic and nonodontogenic lesions. This article review about the origin, nature and significance of ghost cells in different neoplasms.

  19. 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)

  20. Strategic Role of Frontal White Matter Tracts in Vascular Cognitive Impairment: A Voxel-Based Lesion-Symptom Mapping Study in CADASIL

    Science.gov (United States)

    Duering, Marco; Zieren, Nikola; Herve, Dominique; Jouvent, Eric; Reyes, Sonia; Peters, Nils; Pachai, Chahin; Opherk, Christian; Chabriat, Hugues; Dichgans, Martin

    2011-01-01

    Cerebral small vessel disease is the most common cause of vascular cognitive impairment. It typically manifests with lacunar infarcts and ischaemic white matter lesions. However, little is known about how these lesions relate to the cognitive symptoms. Previous studies have found a poor correlation between the burden of ischaemic lesions and…

  1. Altered electroencephalogram complexity in autistic children shown by the multiscale entropy approach

    Science.gov (United States)

    Liu, Tian; Chen, Yanni; Chen, Desheng; Li, Chenxi; Qiu, Yusheng

    2017-01-01

    Autism spectrum disorder (ASD) is a severe neurodevelopment disorder. This study tests the hypothesis that children with ASD show atypical intrinsic complexity of brain activity. Electroencephalogram data were collected from boys with ASD and matching normal typically developing children while performing an observation and an imitation task. The multiscale entropy was estimated within the 0.5–30 Hz frequency band over 30 time scales using a coarse-grained procedure. A decreased electroencephalogram complexity was observed in the ASD children both during the observation and during the imitation tasks. On comparing the two tasks, significant differences were observed between groups in the right hemisphere, and also the central cortex for the observation task. Multiscale entropy could provide further evidence of the relationship between ASD and cerebral dysfunction. PMID:27984543

  2. Lesion activity assessment

    DEFF Research Database (Denmark)

    Ekstrand, K R; Zero, D T; Martignon, S

    2009-01-01

    in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee...... the activity of primary coronal and root lesions reliably and accurately at one examination by using the combined information obtained from a range of indicators--such as visual appearance, location of the lesion, tactile sensation during probing and gingival health....

  3. 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.)

  4. Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA

    Directory of Open Access Journals (Sweden)

    Kim Yong-Won

    2012-08-01

    Full Text Available Abstract Background The diagnosis of transient ischemic attack (TIA based on clinical history and objective findings, even including multiparametric MRI, can be misleading. We report two patients who presented with TIA-like deficits with isolated perfusion lesions in corresponding areas but were finally diagnosed as transient neurological symptoms associated with dural arteriovenous fistula (dAVF. Case presentation Two patients presented with transient focal neurological symptoms lasting less than one hour. An isolated perfusion deficit with no diffusion change in the clinically relevant area was shown on brain MRI, indicating transient ischemia as the most plausible cause of neurological symptoms. However, cerebral angiography let to diagnosis of dAVF in both cases. Intracerebral hemorrhage occurred after the initial diagnosis of TIA in one patient, and the small area of perfusion abnormality accompanied by the enlarged cortical vein in the other case helped to identify the dAVF through the further investigation. The pattern of perfusion-weighted imaging in both cases revealed increase of mean transit time and relative cerebral blood volume denoting the venous congestion in a clinically corresponding area. Conclusion Reported cases are uncommon clinical presentation of a dAVF, which can be misdiagnosed as TIA on clinical grounds. In rare cases, the isolated perfusion deficits could be attributable to venous congestion, despite the similar pattern of clinical presentation, such as with TIA.

  5. MRI of fetal acquired brain lesions

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: daniela.prayer@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Kasprian, Gregor [Department of Radiodiagnostics, Medical University of Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna (Austria); Helmer, Hanns [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Dietrich, Wolfgang [Department of Neurosurgery, Medical University of Vienna (Austria); Eppel, Wolfgang [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Langer, Martin [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria)

    2006-02-15

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.

  6. MRI of fetal acquired brain lesions.

    Science.gov (United States)

    Prayer, Daniela; Brugger, Peter C; Kasprian, Gregor; Witzani, Linde; Helmer, Hanns; Dietrich, Wolfgang; Eppel, Wolfgang; Langer, Martin

    2006-02-01

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.

  7. Anestesia e paralisia cerebral

    OpenAIRE

    Március Vinícius M Maranhão

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC) é uma doença não progressiva decorrente de lesão no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC freqüentemente é submetido a procedimentos cirúrgicos devido a doenças usuais e situações particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pré, intra e pós-operatório n...

  8. 21 CFR 610.63 - Divided manufacturing responsibility to be shown.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Divided manufacturing responsibility to be shown. 610.63 Section 610.63 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... manufacturing responsibility to be shown. If two or more licensed manufacturers participate in the...

  9. Unilateral Pseudotumoral Presentation of Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Leonardo Halley Carvalho Pimentel

    2014-09-01

    Full Text Available Cerebral venous thrombosis (CVT is an unusual cause of stroke. It is more common in middle-aged women and deep CVT lesions are usually bilateral. CVT can have very diverse clinical presentations and mimic other conditions. We report two women with CVT initially diagnosed as tumors (unilateral pseudotumoral presentation of CVT successfully treated with intravenous heparin. Early diagnosis was important and completely reversed the symptoms. The diagnosis of CVT should be remembered when clinical picture is compatible even if brain imaging suggests unilateral tumor.

  10. EVALUATION OF NEUROIMAGING IN CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    S.H. Hasanpour avanji

    2008-11-01

    Full Text Available ObjectiveCerebral palsy (CP, a common static motor neurological disorder of childhood with wide spectrum of underlying etiologies, can be demonstrated with different neuro imaging techniques. We undertook this study to investigate the diagnosis of intracranial lesions in children with CP and its correlation between clinical deficits and neuroradiological findings.Materials and methodsIn this prospective hospital-based study, the data of 120 patients with CP, aged below 18 years, referring to the neurology clinic of the Ali Asghar Pediatric hospital in Tehran was studied; data on their cranial neuroimaging findings was analyzed any possible association(s between the gestational ages, prenatal history and neurological deficits were investigated.ResultsOf the 120 patients, 72 (60% were male; 75% were aged below 7 years.Common predisposing factors were prenatal asphyxia, LBW, prematurity and toxemia of pregnancy. Of the 120 cases, 90%(107 had spastic CP, with the quadriplegic type being the most common (54%, followed by spastic paraplegia (21%; twenty-four patients (20% had significant Preventricular Leucomalacia (PVL, a finding more common among those born pre-term.Sixteen patients had hemiplegic CP, 14 of whom showed unilateral lesions on brain MRI imaging. Ten (8% had extra pyramidal CP, a condition more common among term born infants, while six of the 10(72% showed significant abnormalities on the basal ganglia. Cerebral atrophy was seen in 60 (50% of patients and PVL in 20%; encephalomalacia, gliosis, middle cerebral artery infarcts, PVL and gliosis indicated hypoxia as a risk factor for CP. Extent of MRI lesions correlated with the severity of neurological deficits in CP lesions, which were more extensive in Quadriplegics and double hemiplegics rather than paraplegics, and among those delivered preterm as compared to those born at term.ConclusionRadiological findings were found to be closely related to the type of CP and the neurological

  11. Mechanism and treatment principle for cerebral vessel spasm caused by concussion

    Institute of Scientific and Technical Information of China (English)

    肖兴义; 郭新红; 王德文; 薛关生

    2002-01-01

    Objective: To discuss the mechanism of cerebral vessel spasm caused by concussion and the effect of Nimodipine on concussion. Methods: A total of 224 patients who were treated from March 1995 to October 1999 were divided into two groups randomly, ie, Nimodipine group (113 cases) and control group (111 cases). Middle cerebral artery (MCA), basilar artery (BA) and the average peak forward velocity of cerebral blood flow were observed by color three-dimensional transcranial Doppler (3D-TCD) within 24 hours after admission and at the end of 3-6 days of treatment. Cerebral blood flow changes, characteristics and treatment effect were analyzed and determined by clinical main symptom disappearance rate. Results: In concussion, cerebral blood flow was divided into 3 phases: cerebral blood flow low infusion dilation phase, cerebral blood vessel spasm phase and cerebral blood flow recovery phase. In the Nimodipine group, clinical main symptom disappearance rate was higher than that in the control group in the cerebral spasm and recovery phases with a significant difference (P<0.01).  Conclusions: Cerebral vessel spasm, hypoxia and ischemia lesion are the main pathological changes. Whether cerebral dysfunction is reversible or not is mainly determined by spasm time of cerebral blood vessel. Nimodipine has a good effect on releasing spasm and diminishing the cerebral blood flow velocity. It not only improves curative effect on concussion, but also reduces and prevents concussion sequelae. Hence, concussion patients who have cerebral spasm confirmed by 3D-TCD should be given Nimodipine routinely and early.

  12. Recurrent cerebral thrombosis; With special reference to the neuroradiological study

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, Toshihiko; Abe, Shin-e; Kubo, Hideki; Hanyu, Haruo; Takasaki, Masaru (Tokyo Medical Coll. (Japan))

    1992-10-01

    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.).

  13. Cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Renowden, Shelley [Frenchay Hospital, Bristol BS16 1LE (United Kingdom)

    2004-02-01

    A comprehensive synopsis on cerebral venous thrombosis is presented. It emphasizes the various aetiologies, the wide clinical spectrum and the unpredictable outcome. Imaging techniques and pitfalls are reported and the therapeutic options are discussed. (orig.)

  14. The continuum of spreading depolarizations in acute cortical lesion development

    DEFF Research Database (Denmark)

    Hartings, Jed A; Shuttleworth, C William; Kirov, Sergei A;

    2017-01-01

    A modern understanding of how cerebral cortical lesions develop after acute brain injury is based on Aristides Leão's historic discoveries of spreading depression and asphyxial/anoxic depolarization. Treated as separate entities for decades, we now appreciate that these events define a continuum...... of spreading mass depolarizations, a concept that is central to understanding their pathologic effects. Within minutes of acute severe ischemia, the onset of persistent depolarization triggers the breakdown of ion homeostasis and development of cytotoxic edema. These persistent changes are diagnosed....... The causal role of these waves in lesion development has been proven by real-time monitoring of electrophysiology, blood flow, and cytotoxic edema. The spreading depolarization continuum further applies to other models of acute cortical lesions, suggesting that it is a universal principle of cortical lesion...

  15. Neuropsiquiatría y daño cerebral

    OpenAIRE

    Legascue de Larrañaga, Iván

    2007-01-01

    En países occidentales, los accidentes constituyen la primera causa de muerte en adultos jóvenes. Mundialmente, las lesiones por accidentes de tráfico en particular están aumentando su incidencia y se prevé que constituyan la tercer causa de muerte y discapacidad mundial en el 2020. Los accidentes de coche son la causa más frecuente de daño cerebral traumático, mientras que las caídas constituyen la segunda. El daño cerebral se asocia a más de la mitad del total de las muertes por traumatismo...

  16. Tuberculous cerebritis and tuberculoma in a patient with AIDS: Literature review and case report.

    Directory of Open Access Journals (Sweden)

    Saeed Abrishamkar

    2006-11-01

    Full Text Available Tuberculous brain cerebritis, abscess and tuberculoma in AIDS patients are considered as rare conditions and only few cases have been reported in the literature. The present case is a 28-year-old man with AIDS and previous systemic tuberculosis, denied by him and his family. He was admitted to our department due to headache, hemiparesis and seizures. A brain computed tomography (CT scan disclosed a frontal hypodense lesion with a non-homogenous contrast enhancement that was reported as a high grade glioma. Magnetic resonance imaging (MRI showed a diffuse hypointense lesion in right frontal area on T1-weighted, and hyperintense on T2-weighted and flair view, but there was a small paraventricular region with hypointensity on both T1, T2 and flair series, which was also reported to be a high grade glioma. Because of clinical course and imaging findings, the patient was a candidate for operation. After operation, the results of pathology and laboratory examination confirmed the diagnosis of tuberculous brain cerebritis and tuberculoma with positive Acquired Immune Virus (HIV serology. Thus, tuberculous cerebritis, tuberculoma and abscesses should be considered in the differential diagnosis of focal brain lesions in AIDS patients, but AIDS should also be considered in every patient with an uncommon cerebral lesion who is not cooperative with medical healthcare providers. Surgical excision or biopsy and anti-tuberculous treatment are the mainstay in management of these lesions in patients with AIDS. KEY WORDS: AIDS, tuberculoma, tuberculosis cerebritis.

  17. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  18. Cerebral microbleeds and asymptomatic cerebral infarctions in patients with atrial fibrillation.

    Science.gov (United States)

    Saito, Tsukasa; Kawamura, Yuichiro; Tanabe, Yasuko; Asanome, Asuka; Takahashi, Kae; Sawada, Jun; Katayama, Takayuki; Sato, Nobuyuki; Aizawa, Hitoshi; Hasebe, Naoyuki

    2014-07-01

    Atrial fibrillation (AF) is a cardiac arrhythmia that does not infrequently induce ischemic strokes; however, little research has been reported on focal cerebral microangiopathic lesions in patients with AF. Recently cerebral microbleeds (CMBs) have been noticed for their potential implication in cerebral small vessel disease. Therefore, we had 2 goals in the present study: (1) to compare the prevalence of CMBs in patients with AF with that in patients without AF, and (2) to prove that CMBs could be a clinical predictive factor for the development of future cerebral microangiopathy in patients with AF without a history of symptomatic cerebral infarction in a prospective manner. We performed yearly brain magnetic resonance imaging (MRI) assessments for a maximum of 5 years in 131 patients with AF and 112 control patients. Seventy-seven patients with AF underwent more than 3 yearly MRI scans. The Kaplan-Meier curve showed that the development of an asymptomatic cerebral infarction (ACI) was associated with the baseline presence of a CMB (P=.004). A multivariate Cox regression analysis revealed that the CMBs at baseline were significantly associated with an increment in not only the occurrence of ACIs (hazard ratio [HR], 5.414; 95% confidence interval [CI], 1.03-28.43; P=.046) but also in the consecutive development of CMBs (HR, 6.274; 95% CI, 1.43-27.56; P=.015). Patients with AF had a significantly higher prevalence of CMBs. The presence of CMBs in the baseline MRI may predict the consequent onset of an ACI and increase in CMBs in patients with AF. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  19. The role of SDF-1/CXCR4 in the vasculogenesis and remodeling of cerebral arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Wang L

    2015-09-01

    Full Text Available Lingyan Wang,1 Shaolei Guo,2 Nu Zhang,2 Yuqian Tao,3 Heng Zhang,1 Tiewei Qi,2 Feng Liang,2 Zhengsong Huang2 1Department of Neurosurgery ICU, 2Department of Neurosurgery, 3Department of Neurology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China Background: Cerebral arteriovenous malformation (AVM involves the vasculogenesis of cerebral blood vessels and can cause severe intracranial hemorrhage. Stromal cell-derived factor-1 (SDF-1 and its receptor, CXCR4, are believed to exert multiple physiological functions including angiogenesis. Thus, we investigated the role of SDF-1/CXCR4 in the vasculogenesis of cerebral AVM.Methods: Brain AVM lesions from surgical resections were analyzed for the expression of SDF-1, CXCR4, VEGF-A, and HIF-1 by using immunohistochemical staining. Flow cytometry was used to quantify the level of circulating endothelial progenitor cells (EPCs. Further, in an animal study, chronic cerebral hypoperfusion model rats were analyzed for the expression of SDF-1 and HIF-1. CXCR4 antagonist, AMD3100, was also used to detect its effects on cerebral vasculogenesis and SDF-1 expression.Results: Large amounts of CXCR4-positive CD45+ cells were found in brain AVM lesion blood vessel walls, which also have higher SDF-1 expression. Cerebral AVM patients also had higher level of EPCs and SDF-1. In chronic cerebral hypoperfusion rats, SDF-1, HIF-1, and CD45 expressions were elevated. The application of AMD3100 effectively suppressed angiogenesis and infiltration of CXCR4-positive CD45+ cells in hypoperfusion rats compared to controls.Conclusion: The SDF-1/CXCR4 axis plays an important role in the vasculogenesis and migration of inflammatory cells in cerebral AVM lesions, possibly via the recruitment of bone marrow EPCs. Keywords: cerebral arteriovenous malformation, SDF-1/CXCR4, chronic cerebral hypoperfusion, endothelial progenitor cells

  20. Estradiol reduces activity of the blood-brain barrier Na-K-Cl cotransporter and decreases edema formation in permanent middle cerebral artery occlusion.

    Science.gov (United States)

    O'Donnell, Martha E; Lam, Tina I; Tran, Lien Q; Foroutan, Shahin; Anderson, Steven E

    2006-10-01

    Estrogen has been shown to protect against stroke-induced brain damage, yet the mechanism is unknown. During the early hours of stroke, cerebral edema forms as increased transport of Na and Cl from blood into brain occurs across an intact blood-brain barrier (BBB). We showed previously that a luminal BBB Na-K-Cl cotransporter is stimulated by hypoxia and arginine vasopressin (AVP), factors present during cerebral ischemia, and that inhibition of the cotransporter by intravenous bumetanide greatly reduces edema in rats subjected to permanent middle cerebral artery occlusion (MCAO). The present study was conducted to determine whether estrogen protects in stroke at least in part by reducing activity of the BBB cotransporter, thereby decreasing edema formation. Ovariectomized rats were subjected to 210 mins of permanent MCAO after 7-day or 30-min pretreatment with 17beta-estradiol and then brain swelling and 2,3,5-triphenyltetrazolium chloride staining were assessed as measures of brain edema and lesion volume, respectively. Diffusion-weighed imaging was used to monitor permanent MCAO-induced decreases in apparent diffusion coefficient (ADC) values, an index of changes in brain water distribution and mobility. Na-K-Cl cotransporter activity of cerebral microvascular endothelial cells (CMECs) was assessed as bumetanide-sensitive K influx and cotransporter abundance by Western blot analysis after estradiol treatment. Estradiol significantly decreased brain swelling and lesion volume and attenuated the decrease in ADC values during permanent MCAO. Estradiol also abolished CMEC cotransporter stimulation by chemical hypoxia or AVP and decreased cotransporter abundance. These findings support the hypothesis that estrogen attenuates stimulation of BBB Na-K-Cl cotransporter activity, reducing edema formation during stroke.

  1. Cerebral microbleeds (CMBs) - relevance for mechanisms of cerebral hemorrhage--analysis of 24 MRI evaluated patients.

    Science.gov (United States)

    Ghelmez, D; Sorin Tuţă, S; Popa, C

    2013-01-01

    The new MRI techniques introduced in the last decade allowed the detection of cerebral microbleeds (CMBs) in different groups of diseases: stroke, Alzheimer disease, vascular dementia or healthy people of advanced age. CMBs are radiologically defined as small, rounded, homogeneous, hypointense lesions on T2*-weighed gradient-recalled echo (T2*-GRE) sequences. We evaluated the prevalence, number and location of CBMs in a cohort of 26 consecutive cerebral hemorrhage patients admitted in the National Institute of Neurology and Neurovascular Diseases. We also assessed the association between CMB, classical vascular risk factors and small vessel disease. From the 26 patients, 2 patients had secondary intracerebral hemorrhage (ICH) (hemorrhage in metastasis, respectively a cavernoma). From the 24 ICH patients 12 have had at least 1 CMB lesion. The average volume of the cerebral hemorrhage was larger in patients with CMBs, with a relative increase of 42%. Small vessel disease was associated with a significant increase in the presence of CMBs (relative increase of 86%). In both cases, however, since the number of patients enrolled was small, the correlations did not reach statistical significance.

  2. [Cerebral paragonimiasis with peculiar calcified foci: a case report].

    Science.gov (United States)

    Kinoshita, K; Koga, T

    1986-04-01

    In Japan more than 400 cases of intracranial invasion of Paragonimus westermani have been reported. In recent years, however, because of the decrease of incidence of parasitic disease, erroneous diagnosis is apt to be made. Peculiar but characteristic calcified cystic lesions in chronic stage of cerebral paragonimiasis were described as "soap bubble appearance" in x-rays by Oh in 1968. We report such a case with calcified lesions of soap bubble appearance in plain x-ray films in the right parieto-occipital region. The patient was a 30-year-old man who had generalized convulsive seizures since childhood. CT scan revealed these lesions to have high density in the margin and relatively low density in the center. Recently some cases of cerebral involvement by Paragonimus miyazakii were reported in Japan. The immunoserological tests are most useful for the diagnosis of paragonimiasis. Bithionol administration is the treatment of choice in acute stage. Calcified lesions with positive serological tests in two years after the onset of cerebral signs should be removed surgically, if possible.

  3. Ring enhancing intracranial lesion responding to antituberculous treatment in an HIV-infected patient

    OpenAIRE

    Daniela Pellegrino; Juliana Gerhardt; Porfírio,Fátima M.V.; Edgar Bortholi Santos; Dauar,Rafi F.; Augusto C. Penalva de Oliveira; José E. Vidal

    2010-01-01

    Cerebral tuberculomas constitute a major differential diagnosis of cerebral toxoplasmosis in human immunodeficiency virus (HIV)-infected patients in developing countries. We report the case of a 34-year old woman co-infected with HIV and possible disseminated tuberculosis (hepatitis, lymphadenopathy, and pleural effusion) who presented a large and solitary intracranial mass lesion. Despite extensive diagnostic efforts, including brain, ganglionar, and liver biopsies, no definitive diagnosis w...

  4. Cerebral Aneurysm in the Evolution of Cardiac Myxoma: Clinical and Physiopathological Interpretations; El aneurisma cerebral en la evolucion del mixoma cardiaco: planteamientos clinicos y fisopatologicos

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, R.; Garcia, M. L. [Hospital General Universitario Morales Meseguer. Murcia (Spain)

    2003-07-01

    We present the case of a patient with stroke, cerebral aneurysms (small distal and large proximal) who had been treated for cardiac myxoma 18 years earlier. We compared the imaging findings (localization, size, density and associated cerebral lesions) with those of other publications. The data obtained from other works and those that we could derive from our patient suggest that the cerebral aneurysms are responsible for neurological symptoms observed some time after removal of the tumor. On the other hand, such aneurysms tend to grow larger and more proximal with increasing time after surgery. (Author) 15 refs.

  5. Exploring the role of MKK7 in excitotoxicity and cerebral ischemia: a novel pharmacological strategy against brain injury

    Science.gov (United States)

    Vercelli, A; Biggi, S; Sclip, A; Repetto, I E; Cimini, S; Falleroni, F; Tomasi, S; Monti, R; Tonna, N; Morelli, F; Grande, V; Stravalaci, M; Biasini, E; Marin, O; Bianco, F; di Marino, D; Borsello, T

    2015-01-01

    Excitotoxicity following cerebral ischemia elicits a molecular cascade, which leads to neuronal death. c-Jun-N-terminal kinase (JNK) has a key role in excitotoxic cell death. We have previously shown that JNK inhibition by a specific cell-permeable peptide significantly reduces infarct size and neuronal death in an in vivo model of cerebral ischemia. However, systemic inhibition of JNK may have detrimental side effects, owing to blockade of its physiological function. Here we designed a new inhibitor peptide (growth arrest and DNA damage-inducible 45β (GADD45β-I)) targeting mitogen-activated protein kinase kinase 7 (MKK7), an upstream activator of JNK, which exclusively mediates JNK's pathological activation. GADD45β-I was engineered by optimizing the domain of the GADD45β, able to bind to MKK7, and by linking it to the TAT peptide sequence, to allow penetration of biological membranes. Our data clearly indicate that GADD45β-I significantly reduces neuronal death in excitotoxicity induced by either N-methyl-D-aspartate exposure or by oxygen–glucose deprivation in vitro. Moreover, GADD45β-I exerted neuroprotection in vivo in two models of ischemia, obtained by electrocoagulation and by thromboembolic occlusion of the middle cerebral artery (MCAo). Indeed, GADD45β-I reduced the infarct size when injected 30 min before the lesion in both models. The peptide was also effective when administrated 6 h after lesion, as demonstrated in the electrocoagulation model. The neuroprotective effect of GADD45β-I is long lasting; in fact, 1 week after MCAo the infarct volume was still reduced by 49%. Targeting MKK7 could represent a new therapeutic strategy for the treatment of ischemia and other pathologies involving MKK7/JNK activation. Moreover, this new inhibitor can be useful to further dissect the physiological and pathological role of the JNK pathway in the brain. PMID:26270349

  6. 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...

  7. Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jia; Duan, Yun You; Liu, Xi; Wang, Yu; Gao, Guo Dong; Qin, Huai Zhou; Wang, Liang [Tangdu Hospital of the Fourth Military Medicine University, Xi an (China)

    2011-10-15

    We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. All the lesions were located in the cortex and their mean size was 1.3 {+-} 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

  8. White matter reorganization and functional response after focal cerebral ischemia in the rat.

    Directory of Open Access Journals (Sweden)

    Chrystelle Po

    Full Text Available After stroke, the brain has shown to be able to achieve spontaneous functional recovery despite severe cerebral damage. This phenomenon is poorly understood. To address this issue, focal transient ischemia was induced by 60 min middle cerebral artery occlusion in Wistar rats. The evolution of stroke was followed using two magnetic resonance imaging modalities: diffusion spectrum imaging (acquired before, one and four weeks after stroke and functional magnetic resonance imaging (acquired before and five weeks after stroke. To confirm the imaging observations, immunohistochemical staining for myelin, astrocytes and macrophages/microglia was added. At four weeks after stroke, a focal alteration of the diffusion anisotropy was observed between the ipsilesional ventricle and the lesion area. Using tractography this perturbation was identified as reorganization of the ipsilesional internal capsule. Functional imaging at five weeks after ischemia demonstrated activation of the primary sensorimotor cortex in both hemispheres in all rats except one animal lacking a functional response in the ipsilesional cortex. Furthermore, fiber tracking showed a transhemispheric fiber connection through the corpus callosum, which-in the rat without functional recovery-was lost. Our study shows the influence of the internal capsule reorganization, combined with inter-hemispheric connections though the corpus callosum, on the functional activation of the brain from stroke. In conclusion, tractography opens a new door to non-invasively investigate the structural correlates of lack of functional recovery after stroke.

  9. Pharmacologic approaches to cerebral aging and neuroplasticity: insights from the stroke model.

    Science.gov (United States)

    Chollet, François

    2013-03-01

    Brain plasticity is an intrinsic characteristic of the nervous system that allows continuous remodeling of brain functions in pathophysiological conditions. Although normal aging is associated with morphological modifications and decline of cerebral functions, brain plasticity is at least partially preserved in elderly individuals. A growing body of evidence supports the notion that cognitive enrichment and aerobic training induce a dynamic reorganization of higher cerebral functions, thereby helping to maintain operational skills in the elderly and reducing the incidence of dementia. The stroke model clearly shows that spontaneous brain plasticity exists after a lesion, even in old patients, and that it can be modulated through external factors like rehabilitation and drugs. Whether drugs can be used with the aim of modulating the effects of physical training or cognitive stimulation in healthy aged people has not been addressed until now. The risk:benefit ratio will be the key question with regard to the ethical aspect of this challenge. We review in this article the main aspects of human brain plasticity as shown in patients with stroke, the drug modulation of brain plasticity and its consequences on recovery, and finally we address the question of the influence of aging on brain plasticity.

  10. The role of preoperative cerebral magnetic resonance angiography in the prevention of cerebral complications following cardiovascular surgery

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Masakazu; Sakai, Akira; Kodera, Koujirou; Sudo, Kyouichi; Oosawa, Mikio [Seirei Hamamatsu General Hospital, Shizuoka (Japan)

    1997-11-01

    Screening of carotid and intracranial artery diseases by magnetic resonance angiography (MRA) was performed in forty-one adult patients prior to elective cardiovascular surgery. In twenty patients (48.8%), MRA demonstrated significant cerebrovascular lesions: carotid or main cerebral artery stenosis in 7, diffuse cerebral arteriosclerotic change in 6, vertebral artery lesion in 5 and berry aneurysm in 2. Advanced age (over 70 years) and previous cerebrovascular events increased the incidence of cerebrovascular lesions on MRA. Forty patients underwent scheduled surgery under cardiopulmonary bypass, and pulsatile flow perfusion was used in patients in whom significant cerebrovascular lesions were demonstrated on MRA. One patient with aortic arch aneurysm was judged to be an unacceptable candidate for surgery in light of his marked diffuse arteriosclerotic lesions on MRA. In five patients, staged operation was performed from 10 to 30 days after cerebrovascular surgery (bypass surgery for internal carotid occlusion in 2, aneurysm clipping in 2, carotid endarterectomy in 1). Postoperative neurological complications occurred in one patient (2.5%). In conclusion, screening of carotid and intracranial artery diseases by MRA is a safe and useful method for evaluation of cerebrovascular lesions in patients with advanced age, previous cerebrovascular events and/or arteriosclerotic diseases. (author)

  11. CYSTIC LESIONS OF THE BRAIN - A CLASSIFICATION BASED ON PATHOGENESIS, WITH CONSIDERATION OF HISTOLOGICAL AND RADIOLOGICAL FEATURES

    NARCIS (Netherlands)

    GO, KG; HEW, JM; KAMMAN, RL; MOLENAAR, WM; PRUIM, J; BLAAUW, EH

    1993-01-01

    A classification of the existing multitude of cystic lesions of the brain is proposed, which allows an understanding of their genesis and consequent therapeutic implications, as well as their diagnostic characteristics. Essentially, cerebral cystic lesions may be classified into the following catego

  12. Coexistence of intracranial epidermoid tumor and multiple cerebral aneurysms

    Science.gov (United States)

    Yao, Pei-Sen; Lin, Zhang-Ya; Zheng, Shu-Fa; Lin, Yuan-Xiang; Yu, Liang-Hong; Jiang, Chang-Zhen; Kang, De-Zhi

    2017-01-01

    Abstract Rationale: There were a few case reports concerning epidermoid tumor coexisted with multiple cerebral aneurysms. Here, we present one case of coexistence of intracranial epidermoid tumor and multiple cerebral aneurysms and performed a literature review. Patient concerns: A 42 years old male patient was admitted to our institution with complaints of headache and dizziness. Interventions: The radiological examinations showed a hypointense lesion in the right parasellar and petrous apex region and an ipsilateral saccular aneurysm originated from the M2–M3 junction of the right middle cerebral artery (MCA) and a saccular aneurysm of the clinoid segment of right internal carotid artery (ICA). Interventions: The patients underwent a right frontotemporal approach for removal of the epidermoid tumor and clipping of the MCA aneurysm in one stage. The aneurysm located at the clinoid segment of ICA was invisible and untreated during operation. Outcomes: No postoperative complications were found in the patient. The patient's follow up after 5 years of surgical treatment was uneventful, and the untreated aneurysm remains stable. Lessons: The coexistence of intracranial epidermoid tumor and cerebral aneurysm is a rare event. The secondly inflammation in cerebral arterial wall may be responsible for the aneurysm formation. Surgical treatment of the intracranial epidermoid tumor and cerebral aneurysm repair may be an optimal scheme in one stage. PMID:28151901

  13. Vasopressin serum levels in patients with severe brain lesions and in brain-dead patients Níveis séricos de arginina vasopressina em pacientes com lesão cerebral grave e em pacientes com morte encefálica

    Directory of Open Access Journals (Sweden)

    Eliane de Araújo Cintra

    2004-06-01

    Full Text Available INTRODUCTION: Patients with severe brain lesions (SBL and brain-dead patients (BD frequently present with vasopressin (AVP secretion disorders. OBJECTIVE: To evaluate AVP serum levels in SBL and BD patients. DESIGN: Prospective, open label, observational trial. SETTING: A general teaching hospital. METHOD: Three groups of adult subjects (age> 18y of both sexes were included in this study: control group: 29 healthy volunteers; SBL group: 17 patients with Glasgow Coma Scale (GCSINTRODUÇÃO: Pacientes com lesão cerebral grave (LCG ou com morte encefálica (ME freqüentemente apresentam alterações na secreção de vasopressina (AVP. OBJETIVO: Avaliar os níveis séricos de AVP em pacientes com LCG e ME. DESENHO: Estudo prospectivo, aberto, observacional. LOCAL: Um hospital geral universitário. MÉTODO: Sujeitos adultos (idade >18 anos, de ambos os sexos, foram divididos em três grupos: grupo controle: 29 voluntários sadios; grupo LCG: 17 pacientes com pontuação na Escala de Coma de Glasgow (ECG<8; grupo ME: 11 pacientes com diagnóstico de ME. Amostras de sangue venoso foram colhidas pela manhã, em repouso, nos pacientes do grupo controle, e de 8/8h, por 24h, nos pacientes dos grupos LCG e ME, para dosagens de AVP. Variáveis clínicas e laboratoriais de interesse foram anotadas concomitantemente. RESULTADOS: Os valores da AVP (pg/ml foram [média (DP; mediana]: grupo controle [2,2(1,1; 2,0]; grupo LCG [5,7(6,3; 2,9] e grupo ME [2,6(1,0; 2,8]. Observou-se maior variação dos níveis séricos de AVP no grupo LCG, mas sem diferença estatisticamente significativa em relação aos demais (p=0,06. Hipotensão (p=0,02, hipernatremia (p=0,0001, hiperosmolaridade sérica (p=0,0001 e hiposmolaridade urinária (p=0,003 foram proeminentes no grupo ME em relação ao grupo LCG. CONCLUSÃO: Não foram encontradas diferenças estatisticamente significativas nos níveis de AVP entre os grupos, notando-se apenas uma maior variação de seus níveis s

  14. Acute ischaemic brain lesions in intracerebral haemorrhage: multicentre cross-sectional magnetic resonance imaging study.

    Science.gov (United States)

    Gregoire, Simone M; Charidimou, Andreas; Gadapa, Naveen; Dolan, Eamon; Antoun, Nagui; Peeters, Andre; Vandermeeren, Yves; Laloux, Patrice; Baron, Jean-Claude; Jäger, Hans R; Werring, David J

    2011-08-01

    Subclinical acute ischaemic lesions on brain magnetic resonance imaging have recently been described in spontaneous intracerebral haemorrhage, and may be important to understand pathophysiology and guide treatment. The underlying mechanisms are uncertain. We tested the hypothesis that ischaemic lesions are related to magnetic resonance imaging markers of the severity and type of small-vessel disease (hypertensive arteriopathy or cerebral amyloid angiopathy) in a multicentre, cross-sectional study. We studied consecutive patients with intracerebral haemorrhage from four specialist stroke centres, and age-matched stroke service referrals without intracerebral haemorrhage. Acute ischaemic lesions were assessed on magnetic resonance imaging (imaging. White matter changes and cerebral microbleeds were rated with validated scales. We investigated associations between diffusion-weighted imaging lesions, clinical and radiological characteristics. We included 114 patients with intracerebral haemorrhage (39 with clinically probable cerebral amyloid angiopathy) and 47 age-matched controls. The prevalence of diffusion-weighted imaging lesions was 9/39 (23%) in probable cerebral amyloid angiopathy-related intracerebral haemorrhage versus 6/75 (8%) in the remaining patients with intracerebral haemorrhage (P = 0.024); no diffusion-weighted imaging lesions were found in controls. Diffusion-weighted imaging lesions were mainly cortical and were associated with mean white matter change score (odds ratio 1.14 per unit increase, 95% confidence interval 1.02-1.28, P = 0.024) and the presence of strictly lobar cerebral microbleeds (odds ratio 3.85, 95% confidence interval 1.15-12.93, P = 0.029). Acute, subclinical ischaemic brain lesions are frequent but previously underestimated after intracerebral haemorrhage, and are three times more common in cerebral amyloid angiopathy-related intracerebral haemorrhage than in other intracerebral haemorrhage types. Ischaemic brain lesions are

  15. Neonatal deep white matter venous infarction and liquefaction: a pseudo-abscess lesion

    Energy Technology Data Exchange (ETDEWEB)

    Ruess, Lynne; Rusin, Jerome A. [Nationwide Children' s Hospital, Department of Radiology, Columbus, OH (United States); The Ohio State University College of Medicine and Public Health, Columbus, OH (United States); Dent, Carly M.; Tiarks, Hailey J.; Yoshida, Michelle A. [Nationwide Children' s Hospital, Department of Radiology, Columbus, OH (United States)

    2014-11-15

    Deep white matter hemorrhagic venous infarction with subsequent cavitation due to necrosis and liquefaction has been described in neonates and may be associated with infection and meningitis. In our experience, the MRI pattern of these lesions is confused with the pattern seen with cerebral abscesses. The purpose of our study was to characterize the MRI findings of post infarction necrosis and liquefaction after hemorrhagic deep white matter venous infarction in infants and to distinguish these lesions from cerebral abscesses. An institutional review board approved a retrospective review of imaging records to identify all patients with cerebral venous infarction at a children's hospital during a 10-year period. Nine infants had deep white matter hemorrhagic venous infarction with white matter fluid signal cavitary lesions. A diagnosis of cerebral abscess was considered in all. The imaging and laboratory findings in these patients are reviewed and compared to descriptions of abscesses found in the literature. There were six female and three male infants. The mean age at presentation was 20 days (range: 0-90 days), while the corrected age at presentation was less than 30 days for all patients. Seven patients presented with seizures and signs of infection; one infant presented with lethargy and later proved to have protein C deficiency. MRI was performed 0-12 days from presentation in these eight patients. Another patient with known protein C deficiency underwent MRI at 30 days for follow-up of screening US abnormalities. There were a total of 38 deep cerebral white matter fluid signal cavitary lesions: 25 frontal, 9 parietal, 2 temporal, 2 occipital. Larger lesions had dependent debris. All lesions had associated hemorrhage and many lesions had evidence of adjacent small vessel venous thrombosis. Lesions imaged after gadolinium showed peripheral enhancement. Three lesions increased in size on follow-up imaging. Three patients, two with meningitis confirmed via

  16. Intraosseous osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Adler, C.P.; Wenz, W.

    1981-10-01

    Any pathological damage occurring in a bone will produce either an osteolytic or osteosclerotic lesion which can be seen in the macroscopic specimen as well as in the roentgenogram. Various bone lesions may lead to local destructions of the bone. An osteoma or osteoplastic osteosarcoma produces an osteosclerotic lesion showing a dense mass in the roentgenogram; a chondroblastoma or an osteoclastoma, on the other hand, induces an osteolytic focal lesion. This paper presents examples of different osteolytic lesions of the humerus. An osteolytic lesion seen in the roentgenogram may be either produced by an underlying non-ossifying fibroma of the bone, by fibrous dysplasia, osteomyelitis or Ewing's sarcoma. Differential diagnostic considerations based on the radiological picture include eosinophilic bone granuloma, juvenile or aneurysmal bone cyst, multiple myeloma or bone metastases. Serious differential diagnostic problems may be involved in case of osteolytic lesions occurring in the humerus. Cases of this type involving complications have been reported and include the presence of an teleangiectatic osteosarcoma as well as that of a hemangiosarcoma of the bone.

  17. 阻塞性睡眠呼吸暂停低通气综合征患者海马及脑白质病变与认知功能的相关性%Correlation between cognitive function and hippocampal atrophy and cerebral white matter lesions in patients with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    彭万达; 陈锐; 蒋震; 徐孝秋; 王婧; 李洁; 刘春风

    2014-01-01

    Objective To explore the relationship between cognitive impairment and the changes of hippocampal structure and cerebral white matter on brain magnetic resonance imaging (MRI) in subjects with obstructive sleep apnea hypopnea (OSAHS).Methods A total of 81 snoring patients were monitored by overnight polysomnography (PSG) at Sleep Center,Second Affiliated Hospital,Soochow University from March 2012 to August 2013.Based on the results of apnea-hypopnea index (AHI),they were divided into mild (n =23),moderate (n =18),severe OSAHS (n =23) and primary snoring (n =17) groups.Periventricular hyperintensity (PVH) related to the severity of cerebral white matter lesions and hippocampal atrophy on brain MRI were evaluated according to the Fukudas method and Scheltens standard.The sequences of regular and perpendicular to bilateral hippocampal fluid attenuated inversion recovery (FIAIR) were used.Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) were performed to evaluate the changes of cognitive function in all subjects.Results The cognitive function scores,especially MoCA,progressively decreased and the scores of hippocampal atrophy and PVH increased as the severity of OSAHS aggravated among these groups.Compared to primary snoring group,MoCA and MMSE scores decreased (24.5 ± 2.7 vs 28.0 ± 1.9,P =0.000 ; 27.5 ± 1.4 vs 28.7 ± 1.3,P =0.013) and hippocampal atrophy and PVH scores increased (2.4 ± 1.2 vs 1.5 ± 1.2,P =0.007 ; 3.6 ± 1.0 vs 1.6 ± 1.5,P =0.000) in the severe OSAHS group.The evaluations of MoCA subdomains further revealed selective reduction in visual space,execution function and delayed memory.PVH scores and hippocampal atrophy scores were negatively correlated with MoCA scores (r =-0.30,P =0.010 ; r =-0.30,P =0.006).Multiple linear regression analysis indicated that the degrees of AHI and hippocampal atrophy were the major risk factors for MoCA scores (standardized regression coefficient:-0.386,-0.247; P =0.000,0.020).The scores

  18. Activation-induced resetting of cerebral oxygen and glucose uptake in the rat

    DEFF Research Database (Denmark)

    Madsen, P L; Linde, R; Hasselbalch, S G

    1998-01-01

    In the clinical setting it has been shown that activation will increase cerebral glucose uptake in excess of cerebral oxygen uptake. To study this phenomenon further, this study presents an experimental setup that enables precise determination of the ratio between cerebral uptake of glucose...... and oxygen in the awake rat. Global CBF was measured by the Kety-Schmidt technique, and the ratio between cerebral uptake rates for oxygen, glucose, and lactate was calculated from cerebral arterial-venous differences. During baseline conditions, rats were kept in a closed box designed to minimize...... interference. During baseline conditions CBF was 1.08 +/- 0.25 mL x g(-1) x minute(-1), and the cerebral oxygen to glucose uptake ratio was 5.5. Activation was induced by opening the sheltering box for 6 minutes. Activation increased CBF to 1.81 mL x g(-1) x minute(-1). During activation cerebral glucose...

  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...

  20. Clinical study on the efficacy of Rajayapana Basti and Baladi Yoga in motor disabilities of cerebral palsy in children.

    Science.gov (United States)

    Shailaja, U; Rao, Prasanna N; Girish, K J; Arun Raj, G R

    2014-01-01

    Cerebral palsy is a static encephalopathy that may be defined as a non-progressive disorder of posture and movement often associated with epilepsy and abnormalities in speech, vision and intellect resulting from a defect or lesion of the developing brain. There are 25 lakhs cerebral palsy affected children in India. To assess the efficacy of Rajayapana Basti (RB) and Baladi Yoga in motor disabilities of cerebral palsy in children. Total 98 children satisfying diagnostic criteria and between the age group of 2-10 years were included and randomly divided into two groups. In RB with Baladi group (n = 40) patients were treated with Mustadi Rajayapana Basti for 8 days, followed by oral administration of Baladi Yoga with honey and ghee for 60 days. Before administering Basti, patients were subjected to Sarvanga Abhyanga and Sastikashali Pinda Sveda. In the control group (n = 40), patients were given tablets of Godhuma Choorna for 60 days. Before administering the placebo tablet, the patients of the control group were given Sarvanga Abhyanga and Sastikashali Pinda Sveda for 8 days. The patients of the control group were given Basti with lukewarm water for 8 days. RB group has shown improvements in understanding ability (13.43%), speech (10%) and performance skill (11.11%), in fine motor functions such as putting small object in to a container (14.3%), throws the ball in all direction (21.8%), use of thumb and index finger (10.93%), retaining 2 inch cube in fist (19.04%), folds paper and inserts into envelope (10.30%), in gross motor functions such as in crawling (26.7%), sitting (31.7%), standing (13.75%), walking (9.5%) and claps hands (13.9%) respectively. Mustadi RB along with Baladi Yoga provided a significant improvement in all the parameters and has promising result in managing motor disabilities of cerebral palsy in children.

  1. Transcranial laser stimulation improves human cerebral oxygenation

    OpenAIRE

    2016-01-01

    Background and Objective Transcranial laser stimulation of the brain with near‐infrared light is a novel form of non‐invasive photobiomodulation or low‐level laser therapy (LLLT) that has shown therapeutic potential in a variety of neurological and psychological conditions. Understanding of its neurophysiological effects is essential for mechanistic study and treatment evaluation. This study investigated how transcranial laser stimulation influences cerebral hemodynamics and oxygenation in th...

  2. 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

  3. [CT findings in "fresh" cerebral paragonimiasis].

    Science.gov (United States)

    Li, H Z; Xie, F W; Sun, S C

    1992-01-01

    There are few reports on CT findings in "fresh" cerebral paragonimiasis. We have experienced four cases of "fresh" cerebral paragonimiasis examined by CT scan. Three patients were children aged 7, 9, and 14 years, and one was an adult aged 25 years. Three patients were examined by CT scan 2 to 6 months after the onset of high grade fever, convulsion and focal deficit signs, and a patient was examined one month after his progressive visual disturbance. The unique CT findings are multilocular cystic lesions in temporo-occipital or in temporo-parietal lobes with extensive brain edema. Two cases were also associated with "soap-bubble" calcifications. The cysts were more dense than CSF and enhanced by contrast media. The histopathological specimen showed that the eggs of paragonimus were in the abscess cavity, of which the wall was composed with highly vascular gliomesenchymal capsule and numerous cell infiltration. Three patients underwent craniotomy for removal of abscess and decompression. Bitionol were administered and all patients recovered well. We also discussed the differential diagnosis of cerebral parasitic granulomas.

  4. A cerebral abscess at first internist glance.

    Science.gov (United States)

    Ribeiro, Rita; Patrício, Catarina; Valejo Coelho, Margarida Moura; Brotas, Vítor

    2015-11-27

    A 73-year-old man was transferred to the neurosurgery ward, with a presumptive diagnosis of cerebral abscess. The case was also discussed with the internists as internal medicine consultants. The neurosurgeons pointed out a right temporal lobe abscedated lesion on CT, but we noticed that the hypodense attenuation that usually surrounds the abscess wall (vasogenic oedema) extended to a broader, well-delimitated area, suggesting medium cerebral artery territory. The patient had left-sided hemiplegia with a confusional state and low-grade fever. Considering possible haematogenous dissemination, an echocardiography was performed, confirming mitral endocarditis. Blood cultures and aspirated pus isolated Escherichia coli. Investigating the patient's medical history, we learned he had been submitted to bladder catheterisation 7 weeks before for acute urinary retention due to benign prostatic hyperplasia, and empirically medicated for urinary tract infection. E. coli had also been isolated in a urine specimen at the time. The clinical history of the patient cancelled the pathogenesis of cerebral abscess. 2015 BMJ Publishing Group Ltd.

  5. Energy requirements of children with cerebral palsy.

    Science.gov (United States)

    Hogan, S Eileen

    2004-01-01

    Energy requirements of children and adolescents with cerebral palsy appear to be disease-specific and different from the current recommendations for healthy children, varying depending upon functional capacity, degree of mobility, severity of disease, and level of altered metabolism. Feeding problems are prevalent in many of these children, and can result in inadequate energy intake. Wasting of voluntary muscles, a common symptom of cerebral palsy, contributes to reduced resting energy needs; nevertheless, the location of the central nervous system lesion may also influence energy requirements. To guarantee individualized, accurate, and optimal energy recommendations for this population, resting energy expenditure should preferentially be measured by indirect calorimetry. Equations and formulae to predict healthy people's resting energy expenditure are available, but tend to overestimate these children's energy needs. Future studies should address the role of the central nervous system in regulating energy metabolism in this population. When adequately nourished, children and adolescents with cerebral palsy appear more tranquil and require decreased feeding time, which gives caregivers time to develop the child's functional independence and character. Understanding energy requirements of this population will provide caregivers and health professionals with guidelines for providing optimal nutritional status.

  6. [Acute benign cerebral angiopathy. 6 cases].

    Science.gov (United States)

    Rousseaux, P; Scherpereel, B; Bernard, M H; Guyot, J F

    1983-10-08

    The 6 cases reported here constitute, with 5 previously published cases, a special nosological entity tentatively called "acute benign cerebral angiopathy" by the authors. These 11 cases have in common certain radiological and clinical features. Arteriography shows segmental, multifocal and assymetrical stenoses involving the cerebral arteries between Willis' circle and the terminal arterioles and looking like "strings of sausages". The lesions disappear within one month and present the radiological characteristics of arteritis of medium caliber vessels. The clinical symptoms are suggestive of meningeal haemorrhage or acute cerebromeningeal oedema, with acute repetitive attacks of severe headache and agitation with obnubilation; epileptic seizures and transient neurological deficit may occur. True meningeal haemorrhage confirmed by lumbar puncture is seen in nearly one half of the cases; it seems to be due to alterations in the blood-brain barrier induced by the angiopathy. Intracerebral haematoma may develop, but the disease is usually benign and regresses spontaneously in a few days. None of the usual causes of cerebral arteritis (intra-cranial infection, collagen disease, allergic or toxic angitis) has been found. Pseudo-arteritis (notably spasm of ruptured arterial aneurysms) has been excluded. No aetiological factor common to the 11 cases reported has been elicited, although 6 of the patients had recently given birth and our 6 patients had benign virus infection before or during the clinical manifestations of the disease. In the authors' opinion, the most rewarding line of research would be the role of short acute attacks of arterial hypertension.

  7. Gd-DTPA-enhanced lesions in the brain of patients with acute optic neuritis

    DEFF Research Database (Denmark)

    Christiansen, P; Frederiksen, J L; Henriksen, O

    1992-01-01

    The cerebral hemispheres of 19 patients with acute monosymptomatic optic neuritis (AMON) were investigated using magnetic resonance imaging (MRI) and Gadolinium-DTPA (Gd-DTPA). Using T1-weighted and T2-weighted imaging sequences it was disclosed that 14 of 19 patients had lesions and that enhance......The cerebral hemispheres of 19 patients with acute monosymptomatic optic neuritis (AMON) were investigated using magnetic resonance imaging (MRI) and Gadolinium-DTPA (Gd-DTPA). Using T1-weighted and T2-weighted imaging sequences it was disclosed that 14 of 19 patients had lesions...... and that enhancement was seen in seven patients. It is known that patients with AMON and silent lesions in the CNS have a highly increased risk of developing multiple sclerosis (MS) later on. If it is accepted that a silent lesion in patients with AMON does represent a multiple sclerosis (MS) plaque......, and that an enhancing silent lesion represents an acute MS lesion, we may hypothesize that the disease process ultimately leading to MS starts long before the first symptom or sign ever appears. It would seem that at least half of the silent lesions in the cerebral hemispheres of patients with AMON had existed before...

  8. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  9. Common conjunctival lesions

    African Journals Online (AJOL)

    ocular appearance. is discussion does not attempt to classify lesions, but only highlights ... magnifying glass. Examine what you can see and evert the upper ... look at the cornea and feel for pre-auricular and submandibular lymph nodes.

  10. Oropharynx lesion biopsy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003850.htm Oropharynx lesion biopsy To use the sharing features on this ... Department of Otolaryngology - Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. ...

  11. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Schwendicke, F; Frencken, J E; Bjørndal, L

    2016-01-01

    caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal...... or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal...... health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health...

  12. Gene expression profiling in the human middle cerebral artery after cerebral ischemia

    DEFF Research Database (Denmark)

    Vikman, P; Edvinsson, L

    2006-01-01

    MCA samples distributing to the ischemic area, 7-10 days post-stroke. The gene expression was examined with real-time polymerase chain reaction (PCR) and microarray, proteins were studied with immunohistochemistry. We investigated genes previously shown to be upregulated in animal models of cerebral...... with microarray and seven genes chosen for further investigation with real-time PCR; ELK3, LY64, Metallothionin IG, POU3F4, Actin alpha2, RhoA and smoothelin. Six of these were regulated the same way when confirming array expression with real-time PCR. Gene expression studies in the human MCA leading......We have investigated the gene expression in human middle cerebral artery (MCA) after ischemia. Ischemic stroke affects the perfusion in the affected area and experimental cerebral ischemia results in upregulation of vasopressor receptors in the MCA leading to the ischemic area. We obtained human...

  13. Unusual benign breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Porter, G.J.R. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom)]. E-mail: gporter@ncht.trent.nhs.uk; Evans, A.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); Lee, A.H.S. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); Hamilton, L.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); James, J.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom)

    2006-07-15

    The purpose of this article is to show examples of the radiological (mammography and/or ultrasound) and pathological appearances of unusual benign breast lesions. The conditions covered are granular cell tumours, fibromatosis, nodular fasciitis, myofibroblastomas, haemangiomas, neurofibromas, and leiomyomas. The article includes the first published description of the ultrasound appearance of a myofibroblastoma. Knowledge of these appearances may help confirm or refute radiological-pathological concordance of percutaneous biopsy results during multidisciplinary assessment of these lesions and aid patient management.

  14. Andersson Lesion in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Manimegalai N, KrishnanKutty K, Panchapakesa Rajendran C, Rukmangatharajan S, Rajeswari S

    2004-04-01

    Full Text Available Andersson lesions are destructive foci that appear at the discovertebral junction in ankylosingspondylitis. We report three cases of ankylosing spondylitis with such lesions. These lesions simulatean infection and in our country, mimic spinal tuberculosis.

  15. Giant pediatric aneurysm treated with ligation of the middle cerebral artery with the Drake tourniquet and extracranial-intracranial bypass.

    Science.gov (United States)

    Lansen, T A; Kasoff, S S; Arguelles, J H

    1989-07-01

    Saccular intracranial aneurysms occur infrequently in children, and the incidence of pediatric giant aneurysms is statistically in the same proportion as in adults. The management of these giant aneurysms can be treacherous. This paper presents a case of a 9-year-old boy with a giant aneurysm of the right middle cerebral artery that was successfully managed by ligation of the middle cerebral artery using a Drake tourniquet with the patient awake and by augmentation of the middle cerebral artery circulation with superficial temporal artery-middle cerebral artery anastomosis without excision of the lesion.

  16. A prospective, longitudinal study of growth, nutrition and sedentary behaviour in young children with cerebral palsy

    OpenAIRE

    Weir Kelly A; Tweedy Sean M; Boyd Roslyn N; Bell Kristie L; Stevenson Richard D; Davies Peter SW

    2010-01-01

    Abstract Background Cerebral palsy is the most common cause of physical disability in childhood, occurring in one in 500 children. It is caused by a static brain lesion in the neonatal period leading to a range of activity limitations. Oral motor and swallowing dysfunction, poor nutritional status and poor growth are reported frequently in young children with cerebral palsy and may impact detrimentally on physical and cognitive development, health care utilisation, participation and quality o...

  17. Tuberous sclerosis complex diagnosed from oral lesions

    Directory of Open Access Journals (Sweden)

    Leonardo de Jesus Araujo

    Full Text Available CONTEXT: Tuberous sclerosis complex (TSC is a genetic disease in the group known as neurocutaneous syndromes, with dominant autosomal inheritance. It is characterized by skin and adnexal lesions and central and peripheral nervous system tumors, with neurological and psychiatric findings. It may affect the heart, kidneys, eyes, face, bones, lungs, stomach and dentition. CASE REPORT: We present the case of a 66-year-old man with dermatological signs that included hypopigmented maculae, confetti-like lesions, shagreen plaque, angiofibromas on nasolabial folds, neck and back, nail dystrophy and periungual fibromas on fingers and toes. An electroencephalogram produced normal results, but magnetic resonance imaging showed a nodular image measuring 1.2 x 1.0 cm close to the Monro foramen, which was similar to cerebral parenchyma and compatible with a subependymal giant-cell astrocytoma. A conservative approach was taken, through control imaging examinations on the lesion for seven years, with absence of any expansive process or neurological symptoms. Abdominal ultrasonography revealed a solid, heterogenic and echogenic mass with a calcified focus, measuring 4.6 x 3.4 cm, in the rightkidney, compatible with angiomyolipoma. The patient was treated by means of complete nephrectomy because of malignant areas seen on histopathological examination and died one month after the procedure. This case report illustrates the importance of oral clinical findings such as dental enamel pits and angiofibromas in making an early diagnosis of TSC, with subsequent screening examinations, treatment and genetic counseling.

  18. Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Won; Won, Kyung Sook; Choi, Byung Wook; Zeon, Seok Kil [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2010-04-15

    The distinction between primary central nervous system (CNS) lymphoma and nonmalignant lesions due to opportunistic infections, in particular cerebral toxoplasmosis, is important because of the different treatments involved. A 32-year-old patient with AIDS was hospitalized for intermittent headaches. Brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion in the right frontal lobe. A fluorine-18 fluorodeoxyglucose (F-18 FDG) position emission tomography (PET)/ computed tomography (CT) scan showed moderate FDG uptake in the nodular lesion of the right frontal lobe. We present a case of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS) and the usefulness of F-18 FDG PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.

  19. Fast diffusion kurtosis imaging (DKI) with Inherent COrrelation-based Normalization (ICON) enhances automatic segmentation of heterogeneous diffusion MRI lesion in acute stroke.

    Science.gov (United States)

    Zhou, Iris Yuwen; Guo, Yingkun; Igarashi, Takahiro; Wang, Yu; Mandeville, Emiri; Chan, Suk-Tak; Wen, Lingyi; Vangel, Mark; Lo, Eng H; Ji, Xunming; Sun, Phillip Zhe

    2016-12-01

    Diffusion kurtosis imaging (DKI) has been shown to augment diffusion-weighted imaging (DWI) for the definition of irreversible ischemic injury. However, the complexity of cerebral structure/composition makes the kurtosis map heterogeneous, limiting the specificity of kurtosis hyperintensity to acute ischemia. We propose an Inherent COrrelation-based Normalization (ICON) analysis to suppress the intrinsic kurtosis heterogeneity for improved characterization of heterogeneous ischemic tissue injury. Fast DKI and relaxation measurements were performed on normal (n = 10) and stroke rats following middle cerebral artery occlusion (MCAO) (n = 20). We evaluated the correlations between mean kurtosis (MK), mean diffusivity (MD) and fractional anisotropy (FA) derived from the fast DKI sequence and relaxation rates R1 and R2 , and found a highly significant correlation between MK and R1 (p segmentation in an animal stroke model. We found significantly different kurtosis and diffusivity lesion volumes: 147 ± 59 and 180 ± 66 mm(3) , respectively (p = 0.003, paired t-test). The ratio of kurtosis to diffusivity lesion volume was 84% ± 19% (p < 0.001, one-sample t-test). We found that relaxation-normalized MK (RNMK), but not MD, values were significantly different between kurtosis and diffusivity lesions (p < 0.001, analysis of variance). Our study showed that fast DKI with ICON analysis provides a promising means of demarcation of heterogeneous DWI stroke lesions.

  20. Cerebellar and cerebral autoregulation in migraine.

    Science.gov (United States)

    Reinhard, Matthias; Schork, Joscha; Allignol, Arthur; Weiller, Cornelius; Kaube, Holger

    2012-04-01

    Silent ischemic brain lesions frequently occur in migraine with aura and are most often located in cerebellar border zones. This may imply an impairment of cerebellar blood flow autoregulation. This study investigated the characteristics of interictal cerebellar autoregulation in migraine with and without aura. Thirty-four patients (n=17, migraine without aura; n=17, migraine with aura) and 35 age- and sex-matched controls were studied. Triple simultaneous transcranial Doppler monitoring of one posterior inferior cerebellar artery, right posterior cerebral artery, and left middle cerebral artery was performed. Autoregulation dynamics were assessed from spontaneous blood pressure fluctuations (correlation coefficient index Dx) and from respiratory-induced 0.1-Hz blood pressure oscillations (phase and gain). Compared with controls, the autoregulatory index Dx was higher (indicating less autoregulation) in the posterior inferior cerebellar artery (P=0.0062) and middle cerebral artery (P=0.0078) in migraine with aura, but not in migraine without aura. Phase and gain did not significantly differ between migraine patients and controls. No significant associations of autoregulation with clinical factors were found, including frequency of migraine attacks and orthostatic intolerance. This first-time analysis of cerebellar autoregulation in migraine did not show a specific cerebellar dysautoregulation in the interictal period. More static autoregulatory properties (index Dx) are, however, impaired in persons with migraine with aura both in the cerebellar and anterior circulation. The cerebellar predilection of ischemic lesions in migraine with aura might be a combination of altered autoregulation and additional factors, such as the end artery cerebellar angioarchitecture.

  1. Cerebral phaeohyphomycosis by Exophiala dermatitidis

    Directory of Open Access Journals (Sweden)

    S Sood

    2014-01-01

    Full Text Available Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  2. Cerebral phaeohyphomycosis by Exophiala dermatitidis.

    Science.gov (United States)

    Sood, S; Vaid, V K; Sharma, M; Bhartiya, H

    2014-01-01

    Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  3. Parietal lesion effects on cued recall following pair associate learning.

    Science.gov (United States)

    Ben-Zvi, Shir; Soroker, Nachum; Levy, Daniel A

    2015-07-01

    We investigated the involvement of the posterior parietal cortex in episodic memory in a lesion-effects study of cued recall following pair-associate learning. Groups of patients who had experienced first-incident stroke, generally in middle cerebral artery territory, and exhibited damage that included lateral posterior parietal regions, were tested within an early post-stroke time window. In three experiments, patients and matched healthy comparison groups executed repeated study and cued recall test blocks of pairs of words (Experiment 1), pairs of object pictures (Experiment 2), or pairs of object pictures and environmental sounds (Experiment 3). Patients' brain CT scans were subjected to quantitative analysis of lesion volumes. Behavioral and lesion data were used to compute correlations between area lesion extent and memory deficits, and to conduct voxel-based lesion-symptom mapping. These analyses implicated lateral ventral parietal cortex, especially the angular gyrus, in cued recall deficits, most pronouncedly in the cross-modal picture-sound pairs task, though significant parietal lesion effects were also found in the unimodal word pairs and picture pairs tasks. In contrast to an earlier study in which comparable parietal lesions did not cause deficits in item recognition, these results indicate that lateral posterior parietal areas make a substantive contribution to demanding forms of recollective retrieval as represented by cued recall, especially for complex associative representations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Computed tomographic (CT) scans in cerebral palsy (CP)

    Energy Technology Data Exchange (ETDEWEB)

    Kolawole, T.M.; Patel, P.J. (King Saud Univ., Riyadh (Saudi Arabia). Dept. of Radiology); Mahdi, A.H. (King Saud Univ., Riyadh (Saudi Arabia). Dept. of Paediatrics)

    1989-11-01

    The CT findings in 120 cerebral palsied children are analysed. The 72.5% positive findings are correlated with the clinical types, as well as the aetiological basis for the cerebral palsy. The spastic type, 83.3% of the total number of children, had the highest positive findings. The yield was increased in children with seizures (91.3%) and those in the postnatal group (90%), as well as those with birth trauma and neonatal asphyxia (94%). The findings were those of atrophy in 30.8%, hydrocephalus, in 10%, infarct in 11.6%, porencephaly in 8.3% and others. The atropic changes and their patterns are explained. Treatable lesions, such as tumour, hydrocephalus, subdural haematoma, porencephaly and hygroma were identified in 22.5% of cases. It is concluded that CT scan is definitely efficacious in the management of cerebral palsied children. (orig.).

  5. Pathogenesis, diagnosis and treatment of cerebral fat embolism

    Institute of Scientific and Technical Information of China (English)

    Yihua Zhou; Ying Yuan; Chahua Huang; Lihua Hu; Xiaoshu Cheng

    2015-01-01

    In this study, we analyzed two cases of pure cerebral fat embolism and reviewed related literatures to explore the pathogenesis, clinical manifestations, diagnosis and treatment of cerebral fat embolism, improve the treatment efficiency and reduce the misdiagnosis rate.In our cases, patients fully returned to consciousness at the different times with good prognosis, normal vital signs and without obvious sequelae.For patients with the limb fractures, who developed coma without chest distress, dyspnea or other pulmonary symptoms 12 or 24 h post injury, cerebral fat embolism should be highly suspected, except for those with intracranial lesions, such as delayed traumatic intracerebral hemorrhage, etc.The early diagnosis and comprehensive treatment can improve prognosis.

  6. The cerebral perivascular cells.

    Science.gov (United States)

    Angelov, D N; Walther, M; Streppel, M; Guntinas-Lichius, O; Neiss, W F

    1998-01-01

    This monograph reviews the literature and presents experimental data on the intracerebral presentation of antigen(s) to the immune system as a consequence of neuronal cell death. "Which cells are the antigen presenting cells (APC) of the brain?" is the main question of this book. The immune surveillance of the CNS occurs through specialized resident cells, which present (auto)antigen(s) to the immune system and thus initiate an (auto)immune response. There are four established prerequisites necessary to identify resident APC of the brain. First, the APC must be capable to phagocytose dead neurons. Second, in order to be recognized by T lymphocytes, these neuronophages must express Major Histocompatibility Complex (MHC) cells II glycoproteins on their surface. Third, in order to present (auto)antigen, the MHC class II-positive neuronophages must also be able to contact T lymphocytes. Fourth, in order to exert a stimulatory effect on T lymphocytes, the APC should be able to produce the cytokine interleukin-1 beta (IL-128 Mb). Three main tools were used to identify and characterize the APC of the brain. First, a lesion model was employed that yields a slowly progressing neuronal cell loss without disruption of the blood-brain barrier. This model consisted of resection of 10 mm of the facial nerve, which caused a slowly occurring neuronal death so that one year after resection the amount of facial neurons was about 44% of the control value. Second, neuronophages were labeled in vivo in situ via phagocytosis of the permanent fluorescent marker Fluoro-Gold (FG) from decaying pre-loaded facial motoneurons. Third, the FG-labeled neuronophages were immunocytochemically characterized with the new method "immunoquenching of fluorescence". Sections of the brainstem containing FG-labeled, i.e. fluorescent, neuronophages were incubated with a variety of primary antibodies, followed by avidin-HRP and DAB-nickel as a dark brown reaction product for bright-field microscopy. In the

  7. Venocentric lesions: an MRI marker of MS?

    Directory of Open Access Journals (Sweden)

    Matthew P. Quinn

    2013-07-01

    Full Text Available From the earliest descriptions of MS, the venocentric characteristic of plaques was noted. Recently, numerous MRI studies have proposed this finding as a prospective biomarker for MS, which might aid in differentiating MS from other diseases with similar MRI findings. High field MRI studies have shown that penetrating veins can be detected in most MS lesions using T2* weighted or susceptibility weighted imaging. Future studies must address the feasibility of imaging such veins in a clinically practical context. The specificity of this biomarker has been studied only in a limited capacity. Results in microangiopathic lesions are conflicting, whereas asymptomatic white matter hyperintensities as well as lesions of NMO are less frequently venocentric compared to MS plaques. Prospective studies have shown that the presence of venocentric lesions at an early clinical presentation is highly predictive of future MS diagnosis. This is very promising, but work remains to be done to confirm or exclude lesions of common MS mimics, such as ADEM, as venocentric. A number of technical challenges must be addressed before the introduction of this technique as a complementary tool in current diagnostic procedures.

  8. Image-guided resection of cerebral cavernous malformations

    Institute of Scientific and Technical Information of China (English)

    毛颖; 周良辅; 杜固宏; 陈亮

    2003-01-01

    Objective To evaluate retrospectively the effectiveness of image-guided navigation techniques in the management of cerebral CMs.Methods Between July 1997 and January 2001, 44 patients underwent image-guided resection of cerebral CMs. To counteract brain shift, a small silicon catheter was implanted as a guide in the case of deep-seated lesions (except in the case of brain stem CMs) and before excision of multiple lesions. Results A total of 27 men and 17 women with a mean age of 35 years underwent surgical procedures (5 patients had multiple lesions). The lesions were located in the frontal (n=14), lobe temporal lobe (n=12), parietal lobe (n=6), cerebellum (n=6), thalamus (n=5), pons (n=5), and orbital region (n=1). Under the guidance of a StealthStation navigator, total removal of the lesions was achieved in all patients. Follow-up revealed marked improvement of preoperative symptoms in 26 patients and no additional deficits in 13 patients. Five patients suffered from additional neurological deficits, but two of them gradually improved during the follow-up period. Conclusions With the assistance of an image-guided surgical system, functional areas can be effectively avoided and surgical injury can be decreased. This system is well suited for accurate localization and safe resection of small, deep-seated CMs.

  9. Interventions shown to aid executive function development in children 4 to 12 years old.

    Science.gov (United States)

    Diamond, Adele; Lee, Kathleen

    2011-08-19

    To be successful takes creativity, flexibility, self-control, and discipline. Central to all those are executive functions, including mentally playing with ideas, giving a considered rather than an impulsive response, and staying focused. Diverse activities have been shown to improve children's executive functions: computerized training, noncomputerized games, aerobics, martial arts, yoga, mindfulness, and school curricula. All successful programs involve repeated practice and progressively increase the challenge to executive functions. Children with worse executive functions benefit most from these activities; thus, early executive-function training may avert widening achievement gaps later. To improve executive functions, focusing narrowly on them may not be as effective as also addressing emotional and social development (as do curricula that improve executive functions) and physical development (shown by positive effects of aerobics, martial arts, and yoga).

  10. Reversible white matter lesions during ketogenic diet therapy in glucose transporter 1 deficiency syndrome.

    Science.gov (United States)

    Shiohama, Tadashi; Fujii, Katsunori; Takahashi, Satoru; Nakamura, Fumito; Kohno, Yoichi

    2013-12-01

    Glucose transporter type 1 deficiency syndrome is caused by brain energy failure resulting from a disturbance in glucose transport. We describe a 4-year-old boy with classical type glucose transporter type 1 deficiency syndrome with a heterozygous splice acceptor site mutation (c.517-2A>G) in the SLCA2A1 gene. We initiated a ketogenic diet at 4 months of age. However, even though his condition was good during ketogenic diet therapy, multiple cerebral white matter and right cerebellum lesions appeared at 9 months of age. The lesions in the cerebral white matter subsequently disappeared, indicating that white matter lesions during diet therapy may be reversible and independent of the ketogenic diet. This is the first report of reversible white matter lesions during ketogenic diet therapy in glucose transporter type 1 deficiency syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Focal cerebral hyperemia in postconcussive amnesia.

    Science.gov (United States)

    Nariai, T; Suzuki, R; Ohta, Y; Ohno, K; Hirakawa, K

    2001-12-01

    Transient amnesia caused by minor head injury is commonly encountered in daily neurosurgical practice, but the mechanism of such amnesia has not been extensively studied. We measured the regional cerebral blood flow (rCBF) of patients with postconcussive amnesia with Xe/CT CBF to examine whether a focal disturbance of CBF exists. The Xe/CT CBF study was performed in eight patients with closed head injury without organic cerebral lesion while they were suffering from posttraumatic amnesia (concussion group). The time interval between accident and CBF measurement was less than 2 h in three patients, 5-6 h in two, 8-9 h in two, and 18 in one. The results were compared with those of nine normal volunteers and eight other age-matched patients who recovered without any neurological deficit despite the presence of hemorrhagic regions (mild hemorrhage group). The rCBF of the concussion group was significantly elevated in the bilateral mesial temporal cortex in comparison to the normal group. The rCBF in the mild hemorrhage group was lower than that of normal controls in all regions. The analysis of right-left difference in CBF indicated that there was significant asymmetry (right > left) in the frontal and temporal cortex in the concussion group, but not in the normal and mild hemorrhage group. This Xe/CT CBF study in acute stages of cerebral concussion, in which patients were amnestic, detected focal cerebral hyperemia. Such hyperemia in regions closely related to human memory function may be the result of vasoparalysis or the compensatory activation of memory circuits after denervation injury.

  12. Cavernous sinus syndrome due to rhino-orbital-cerebral mucormycosis

    Directory of Open Access Journals (Sweden)

    Vagner Moyses Vilela

    2013-06-01

    Full Text Available The present report describes the case of a 43-year-old diabetic patient with facial pain, protruding eyes, nasal congestion and decreased right vision (involvement of the ipsilateral cranial nerves III, IV and V. Computed tomography showed diffuse sinusitis at right, cribriform plate erosion and presence of a hypodense collection in the frontal lobe with peripheral enhancement. Magnetic resonance imaging confirmed the presence of a cerebral abscess. Samples were collected from the lesion, confirming hyphae compatible with mucormycosis.

  13. Miliary tuberculosis with cerebral, liver, prostate and retroesophageal involvement

    Directory of Open Access Journals (Sweden)

    Raquel Goncalves

    2017-01-01

    The authors describe the case of an adult man from Guinea-Bissau that has been residing in Portugal for the last few months, admitted with complaints of headache. He was submitted to a computerized tomography (CT scan of the brain which showed multiple lesions. This led to further study and the diagnosis of a disseminated tuberculosis with cerebral, liver, prostate and retroesophageal involvement. He was started on anti-tuberculosis therapy, achieving good results.

  14. Cerebral Microbleeds: Their Associated Factors, Radiologic Findings, and Clinical Implications

    OpenAIRE

    Kim, Beom Joon; Lee, Seung-Hoon

    2013-01-01

    Cerebral microbleeds (CMBs) are tiny, round dark-signal lesions that are most often detected on gradient-echo MR images. CMBs consist of extravasations of blood components through fragile microvascular walls characterized by lipohyalinosis and surrounding macrophages. The prevalence of CMBs in elderly subjects with no history of cerebrovascular disease is around 5%, but is much higher in patients with ischemic or hemorrhagic stroke. Development of CMBs is closely related to various vascular r...

  15. Brainstem involvement as a cause of central sleep apnea: pattern of microstructural cerebral damage in patients with cerebral microangiopathy.

    Directory of Open Access Journals (Sweden)

    Thomas Duning

    Full Text Available BACKGROUND: The exact underlying pathomechanism of central sleep apnea with Cheyne-Stokes respiration (CSA-CSR is still unclear. Recent studies have demonstrated an association between cerebral white matter changes and CSA. A dysfunction of central respiratory control centers in the brainstem was suggested by some authors. Novel MR-imaging analysis tools now allow far more subtle assessment of microstructural cerebral changes. The aim of this study was to investigate whether and what severity of subtle structural cerebral changes could lead to CSA-CSR, and whether there is a specific pattern of neurodegenerative changes that cause CSR. Therefore, we examined patients with Fabry disease (FD, an inherited, lysosomal storage disease. White matter lesions are early and frequent findings in FD. Thus, FD can serve as a "model disease" of cerebral microangiopathy to study in more detail the impact of cerebral lesions on central sleep apnea. PATIENTS AND METHODS: Genetically proven FD patients (n = 23 and age-matched healthy controls (n = 44 underwent a cardio-respiratory polysomnography and brain MRI at 3.0 Tesla. We applied different MR-imaging techniques, ranging from semiquantitative measurement of white matter lesion (WML volumes and automated calculation of brain tissue volumes to VBM of gray matter and voxel-based diffusion tensor imaging (DTI analysis. RESULTS: In 5 of 23 Fabry patients (22% CSA-CSR was detected. Voxel-based DTI analysis revealed widespread structural changes in FD patients when compared to the healthy controls. When calculated as a separate group, DTI changes of CSA-CSR patients were most prominent in the brainstem. Voxel-based regression analysis revealed a significant association between CSR severity and microstructural DTI changes within the brainstem. CONCLUSION: Subtle microstructural changes in the brainstem might be a neuroanatomical correlate of CSA-CSR in patients at risk of WML. DTI is more sensitive and specific than

  16. Meniscal Ramp Lesions

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LaPrade, Robert F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol. PMID:27504467

  17. In vivo assessment of experimental neonatal excitotoxic brain lesion with USPIO-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Alison, Marianne; Azoulay, Robin; Chalard, Francois [INSERM U676,Hopital Robert Debre, AP-HP, Paris (France); Universite Paris 7, Faculte de Medecine Denis Diderot, IFR02 et IFR25, Paris (France); Hopital Robert Debre, AP-HP, Service d' Imagerie Pediatrique, Paris (France); Gressens, Pierre [INSERM U676,Hopital Robert Debre, AP-HP, Paris (France); Universite Paris 7, Faculte de Medecine Denis Diderot, IFR02 et IFR25, Paris (France); Hopital Robert Debre, AP-HP, Service de Neurologie Pediatrique, Paris (France); PremUP, Paris (France); Sebag, Guy [INSERM U676,Hopital Robert Debre, AP-HP, Paris (France); Universite Paris 7, Faculte de Medecine Denis Diderot, IFR02 et IFR25, Paris (France); Hopital Robert Debre, AP-HP, Service d' Imagerie Pediatrique, Paris (France); PremUP, Paris (France)

    2010-09-15

    To assess the feasibility of magnetic resonance imaging (MRI) enhanced with ultrasmall superparamagnetic particles of iron oxide (USPIO) for assessing excitotoxic brain lesions in an experimental model of neonatal periventricular white matter (PWM) lesions. Brain lesions were induced by intracerebral injection of ibotenate in 14 newborn rats. Pre- and post-USPIO T2-weighted MRI was performed in seven of them (group A) and in five control newborns (group C). In seven newborns with induced cerebral lesions, USPIO-enhanced MRI was not performed (group B). We compared the signal intensity of the lesion to the contralateral unaffected brain (lesion-to-brain contrast, LBC) and the lesion signal-to-noise ratio (SNR) before and after USPIO injection. MR imaging was correlated with histology. USPIO injection significantly (P < 0.05) decreased LBC and SNR of brain lesion but induced no changes in normal controls. The densities of macrophages and iron-laden cells were higher on the lesion side than on the contralateral side (P < 0.05). Neither lesion size nor the surrounding macrophage infiltrate was significantly different between groups A and B. Post-USPIO T2-weighted MRI demonstrated negative enhancement of neonatal excitotoxic brain lesion. USPIO injection does not appear to exacerbate brain lesions. (orig.)

  18. Ancient Grandeur of the Vertebrate Neuropeptide Y System Shown by the Coelacanth Latimeria chalumnae

    OpenAIRE

    Larhammar, Dan; Bergqvist, Christina A

    2013-01-01

    The neuropeptide Y (NPY) family receptors and peptides have previously been characterized in several tetrapods, teleost fishes, and in a holocephalan cartilaginous fish. This has shown that the ancestral NPY system in the jawed vertebrates consisted of the peptides NPY and peptide YY (PYY) and seven G-protein-coupled receptors named Y1–Y8 (Y3 does not exist). The different vertebrate lineages have subsequently lost or gained a few receptor genes. For instance, the human genome has lost three ...

  19. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Innes, N P T; Frencken, J E; Bjørndal, L

    2016-01-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current...... managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical...... manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm...

  20. Global cerebral blood flow and metabolism during acute hyperketonemia in the awake and anesthetized rat

    DEFF Research Database (Denmark)

    Linde, Rasmus; Hasselbalch, Steen G.; Topp, Simon;

    2006-01-01

    In the human setting, it has been shown that acute increase in the concentration of ketone bodies by infusion of beta-hydroxybutyrate increased the cerebral blood flow (CBF) without affecting the overall cerebral metabolic activity. The mechanism by which this effect of ketone bodies was mediated...

  1. Mechanisms of Acupuncture Therapy for Cerebral Ischemia: an Evidence-Based Review of Clinical and Animal Studies on Cerebral Ischemia.

    Science.gov (United States)

    Zhu, Wen; Ye, Yang; Liu, Yi; Wang, Xue-Rui; Shi, Guang-Xia; Zhang, Shuai; Liu, Cun-Zhi

    2017-05-19

    Ischemic stroke is a major cause of mortality and disability worldwide. As a part of Traditional Chinese Medicine (TCM), acupuncture has been shown to be effective in promoting recovery after stroke. In this article, we review the clinical and experimental studies that demonstrated the mechanisms of acupuncture treatment for cerebral ischemia. Clinical studies indicated that acupuncture activated relevant brain regions, modulated cerebral blood flow and related molecules in stroke patients. Evidence from laboratory indicated that acupuncture regulates cerebral blood flow and metabolism after the interrupt of blood supply. Acupuncture regulates multiple molecules and signaling pathways that lead to excitoxicity, oxidative stress, inflammation, neurons death and survival. Acupuncture also promotes neurogenesis, angiogenesis as well as neuroplasticity after ischemic damage. The evidence provided from clinical and laboratory suggests that acupuncture induces multi-level regulation via complex mechanisms and a single factor may not be enough to explain the beneficial effects against cerebral ischemia.

  2. Lesiones deportivas Sports injuries

    OpenAIRE

    2007-01-01

    El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participa...

  3. Achieving Control of Lesion Growth in CNS with Minimal Damage

    CERN Document Server

    Raja, Mathankumar

    2012-01-01

    Lesions in central nervous system (CNS) and their growth leads to debilitating diseases like Multiple Sclerosis (MS), Alzheimer's etc. We developed a model earlier which shows how the lesion growth can be arrested through a beneficial auto-immune mechanism. The success of the approach depends on a set of control parameters and their phase space was shown to have a smooth manifold separating the uncontrolled lesion growth region from the controlled. Here we show that an optimal set of parameter values exist which minimizes system damage while achieving control of lesion growth.

  4. Does the risk of cerebral palsy increase or decrease with increasing gestational age?

    Directory of Open Access Journals (Sweden)

    Murphy-Kaulbeck Lynn

    2003-12-01

    Full Text Available Abstract Background It is generally accepted that the risk of cerebral palsy decreases with increasing gestational age of live born infants. However, recent studies have shown that cerebral palsy often has prenatal antecedents including congenital malformations, vascular insults and maternal infection. Cerebral palsy is therefore better viewed as occurring among fetuses, rather than among infants. We explored the epidemiologic implications of this change in perspective. Methods We used recently published data from Shiga Prefecture, Japan and from North-East England to examine the pattern of gestational age-specific rates of cerebral palsy under these alternative perspectives. We first calculated gestational age-specific rates of cerebral palsy as per convention, by dividing the number of cases of cerebral palsy identified among live births within any gestational age category by the number of live births in that gestational age category. Under the alternative formulation, we calculated gestational age-specific rates of cerebral palsy by dividing the number of cases of cerebral palsy identified among live births within any gestational age category by the number of fetuses who were at risk of being born at that gestation and being afflicted with cerebral palsy. Results Under the conventional formulation, cerebral palsy rates decreased with increasing gestational age from 63.9 per 1,000 live births at Conclusions The fetuses-at-risk approach is the appropriate epidemiologic formulation for calculating the gestational age-specific rate of cerebral palsy from a causal perspective. It shows that the risk of cerebral palsy increases as gestational duration increases. This compelling view of cerebral palsy risk may help refocus research aimed at understanding and preventing cerebral palsy.

  5. Category-specific visual agnosia: lesion to semantic memory versus extra-lesional variables in a case study and a connectionist model.

    Science.gov (United States)

    Barbeau, E; Giusiano, B

    2003-12-01

    There is a current debate on the causes of category-specific agnosia. The aim of this study was to examine the effects of lesional and extra-lesional variables on object recognition. Extra-lesional variables, such as visual complexity or familiarity, are factors that influence recognition. Using a connectionist model based on study, we provide evidence that extra-lesional variables can yield dissociations in the recognition rate of different categories. Furthermore, it is shown that lesional and extra-lesional variables can interact (p agnosia might thus result from complex interactions.

  6. ADVANCED MAGNETIC RESONANCE IMAGING OF CEREBRAL CAVERNOUS MALFORMATIONS

    Science.gov (United States)

    Shenkar, Robert; Venkatasubramanian, Palamadai N.; Wyrwicz, Alice M.; Zhao, Jin-cheng; Shi, Changbin; Akers, Amy; Marchuk, Douglas A.; Awad, Issam A.

    2008-01-01

    Objective We sought to assess the appearance of cerebral cavernous malformations (CCMs) on magnetic resonance (MR) imaging in murine Ccm1 and Ccm2 gene knockout models, and to develop a technique of lesion localization for correlative pathobiologic studies Methods Brains from eighteen CCM mutant mice (Ccm1+/-Trp53-/- and Ccm2+/-Trp53-/-) and 28 controls were imaged by gradient recalled echo (T2*)-weighted MR at 4.7 T and 14.1 T in vivo and/or ex vivo. After MR imaging, the brains were removed and stained with hematoxylin and eosin and cells were laser microdissected for molecular biologic studies. Results T2*-weighted MR imaging of brains in vivo and ex vivo revealed lesions similar to human CCMs in mutant mice, but not in control animals. Stereotactic localization and hematoxylin and eosin-staining of correlative tissue sections confirmed lesion histology, and revealed other areas of dilated capillaries in the same brains. Some lesions were identified by MR imaging at 14.1 T, but not at 4.7 T. PCR amplification from Ccm1 and β-actin genes was demonstrated from nucleic acids extracted from laser microdissected lesional and perilesional cells. Conclusions The high field MR imaging techniques offer new opportunities for further investigation of disease pathogenesis in vivo, and the localization, staging and histobiologic dissection of lesions, including the presumed earliest stages of CCM lesion development. PMID:18981891

  7. Activities of daily living and lesion position among multiple sclerosis patients by Bayes network

    Institute of Scientific and Technical Information of China (English)

    Zhifang Pan; Hongtao Lu; Qi Cheng

    2013-01-01

    Magnetic resonance imaging is a highly sensitive approach for diagnosis of multiple sclerosis, and T2-weighted images can reveal lesions in the cerebral white matter, gray matter, and spinal cord. However, the lesions have a poor correlation with measurable clinical disability. In this study, we performed a large-scale epidemiological survey of 238 patients with multiple sclerosis in eleven districts by network member hospitals in Shanghai, China within 1 year. The involved patients were scanned for position and size of lesions by MRI. Results showed that lesions in the cerebrum, spinal cord, or supratentorial position had an impact on the activities of daily living in multiple sclerosis patients, as assessed by the Bayes network. On the other hand, brainstem lesions were very unlikely to influence the activities of daily living, and were not associated with the position of lesion, patient's gender, and patient's living place.

  8. The influence on perceptions of truthfulness of the emotional expressions shown when talking about failure

    Directory of Open Access Journals (Sweden)

    Shlomo David

    2015-02-01

    Full Text Available The study aimed to assess whether showing emotion in an organizational inquiry into failure affects perceptions of truthfulness as a function of the match between the explanation of what caused the failure and the emotion expressed. Two web-based studies were conducted. Participants with work experience saw videos of an inquiry and rated the protagonist’s truthfulness. In both studies protagonists who expressed an emotion (anger or shame were rated as less truthful than protagonists who expressed no emotion, regardless of what the failure was attributed to. In order to not confound effects of emotions with occupational stereotype effects only male protagonists were shown. Showing emotions when questioned is normal. Managers have to be aware of a tendency to count this against the employee. This is the only research focusing on the effects of showing emotions on perceptions of truthfulness in an organizational context.

  9. The influence on perceptions of truthfulness of the emotional expressions shown when talking about failure.

    Science.gov (United States)

    David, Shlomo; Hareli, Shlomo; Hess, Ursula

    2015-02-01

    The study aimed to assess whether showing emotion in an organizational inquiry into failure affects perceptions of truthfulness as a function of the match between the explanation of what caused the failure and the emotion expressed. Two web-based studies were conducted. Participants with work experience saw videos of an inquiry and rated the protagonist's truthfulness. In both studies protagonists who expressed an emotion (anger or shame) were rated as less truthful than protagonists who expressed no emotion, regardless of what the failure was attributed to. In order to not confound effects of emotions with occupational stereotype effects only male protagonists were shown. Showing emotions when questioned is normal. Managers have to be aware of a tendency to count this against the employee. This is the only research focusing on the effects of showing emotions on perceptions of truthfulness in an organizational context.

  10. Case of subacute cerebellar degeneration associated with pleocytosis and cerebellar swelling shown in computed tomography scanning

    Energy Technology Data Exchange (ETDEWEB)

    Yoshino, Hiide; Anezaki, Toshiharu; Takashima, Noriko; Inuzuka, Takashi; Miyatake, Tadashi

    1988-02-01

    A 44 year old woman was healthy until January 3, 1986, when she had headache. On January 9, she developed gait ataxia and dysarthria. Cerebellar ataxia worsened rapidly. Aftar a week she could not sit without support and her consciousness was disturbed. Corticosteroid was administrated and consciousness proved alert, but cerebellar ataxia and dysarthria remained unchanged. The patient was found carcinoma of the lung in August 1986. Characteristic features of clinical and laboratory findings of this patient are acute progression, cerebrospinal fluid pleocytosis of 1,064/3 cells (860 mononuclear cell, 204 polymorphonuclear cell), and cerebellar swelling shown in computed tomography scanning. Though the mechanism of acute cerebellar degeneration is still uncertained, inflammatory process was supported to exist in cerebellum of this case.

  11. No evidence of ischemia in stroke-like lesions of mitochondrial POLG encephalopathy.

    Science.gov (United States)

    Tzoulis, Charalampos; Henriksen, Eilen; Miletic, Hrvoje; Bindoff, Laurence A

    2017-01-01

    Stroke-like lesions are characteristically associated with mitochondrial encephalopathies such as those caused by mutations of polymerase gamma (POLG) and the m.3243A>G mitochondrial DNA (mtDNA) mutation. The combination of acute clinical onset, MRI and pathological abnormalities, have led to the suggestion that these lesions are ischemic. Here, we sought to determine the role of ischemia in the pathogenesis of mitochondrial stroke-like lesions. We performed a systematic study of cerebral blood vessel morphology, density and distribution in post mortem brain tissue from nine patients with POLG-encephalopathy and seven neurologically healthy controls. We found that patients had significantly higher cerebral vascular density than controls: this was more pronounced in areas of chronic neurodegeneration, where vascular density correlated with the severity of neuronal loss, but was also seen in acute lesions. Further, blood vessels were patent and, in acute lesions, dilated suggesting increased perfusion. In contrast to what would be expected in ischemia, stroke-like lesions were not pan-necrotic and were highly vascularized. Our results suggest that ischemia does not contribute to the pathogenesis of either the chronic neurodegeneration or acute lesions in POLG encephalopathy. Neovascularization and vascular dilatation does occur and suggests a compensatory response. We suggested the acute lesions are more likely to reflect energy insufficiency and our earlier studies suggest that this is driven in large part by seizure activity. Copyright © 2016 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

  12. Cranio-cerebral gunshot wounds

    Directory of Open Access Journals (Sweden)

    C. Majer1, G. Iacob2

    2010-11-01

    Full Text Available Cranio-cerebral gunshots wounds(CCGW are the most devastating injuriesto the central nervous system, especiallymade by high velocity bullets, the mostdevastating, severe and usually fatal type ofmissile injury to the head.Objective: To investigate and compare,using a retrospective study on five cases theclinical outcomes of CCGW. Predictors ofpoor outcome were: older age, delayedmode of transportation, low admissionCGS score with haemodynamic instability,CT visualization of diffuse brain damage,bihemispheric, multilobar injuries withlateral and midline sagittal planestrajectories made by penetrating highvelocity bullets fired from a very closerange, brain stem and ventricular injurywith intraventricular and/or subarachnoidhemorrhage, mass effect and midline shift,evidence of herniation and/or hematomas,high ICP and/or hypotension, abnormalcoagulation states on admission ordisseminated intravascular coagulation. Lessharmful effects were generated by retainedmissiles, bone fragments with CNSinfection, DAI lesions and neuronaldamages associated to cavitation, seizures.Material and methods: 5 patients (4 maleand 1 female, age ranged 22-65 years, withCCGW, during the period 2004-2009,caused by military conflict and accidentalfiring. After initial resuscitation all patientswere assessed on admission by the GlasgowComa Scale (GCS. After investigations: Xrayskull, brain CT, Angio-CT, cerebralMRI, SPECT; baseline investigations,neurological, haemodynamic andcoagulability status all patients underwentsurgical treatment following emergencyintervention. The survival, mortality andfunctional outcome were evaluated byGlasgow Outcome Scale (GOS score.Results: Referring on five cases weevaluate on a retrospective study the clinicaloutcome, imagistics, microscopic studies onneuronal and axonal damage generated bytemporary cavitation along the cerebralbullet’s track, therapeutics, as the review ofthe literature. Two patients with anadmission CGS 9 and 10

  13. Traumatic plexus lesion.

    NARCIS (Netherlands)

    Dongen, R.T.M. van; Cohen, S.P.; Kleef, M. van; Mekhail, N.; Huygen, F.

    2011-01-01

    Pain, motor, and sensory deficits characterize patients with a traumatic lesion of the brachial plexus. Frequently, more severe injuries co-exist that require immediate surgical attention. Early rehabilitation and physical therapy are the cornerstones of treatment. Pharmacological management can be

  14. Immunopathology of skin lesions

    Directory of Open Access Journals (Sweden)

    Khan Nazoora

    2001-09-01

    Full Text Available A study was conducted on 130 patients suffering from skin lesions which included psoriasis, lichen planus, DLE, pemphigus, vitiligo and alopecia areata. Forty age-and-sex-matched healthy individuals served as control. Serum IgG, IgM, and circulating immune complexes (CIC were estimated. Significant increase in serum IgG (1937.2 ± 1030.43 mg% and IgM (232.12 ± 136.98 mg% was observed in all the skin lesions when compared with controls except in lichen planus where they were significantly lowered, values being 580.61± 77.35 mg% and 66.88 ± 6.59mg% respectively. CIC levels were significantly raised (P<0.00 1 in various skin lesions (40.49±23.29 when compared with controls (17.68± 3.21, but no significance was observed in lichen planus( 17.72 ± 4.28. Serum IgG, IgM and CIC were statistically significantly altered depending on the extent of the lesion and lowered significantly to almost normal values following treatment, thereby confirming the role of immunity in the pathogenesis of these skin disorders.

  15. Genital lesions following bestiality

    Directory of Open Access Journals (Sweden)

    Mittal A

    2000-01-01

    Full Text Available A 48-year-old man presented with painful genital lesions with history of bestiality and abnor-mal sexual behaviour. Examination revealed multiple irregular tender ulcers and erosions, with phimosis and left sided tender inguinal adenopathy. VDRL, TPHA, HIV-ELISA were negative. He was treated with ciprofloxacin 500mg b.d. along with saline compresses with complete resolution.

  16. White matter lesion progression

    DEFF Research Database (Denmark)

    Hofer, Edith; Cavalieri, Margherita; Bis, Joshua C;

    2015-01-01

    BACKGROUND AND PURPOSE: White matter lesion (WML) progression on magnetic resonance imaging is related to cognitive decline and stroke, but its determinants besides baseline WML burden are largely unknown. Here, we estimated heritability of WML progression, and sought common genetic variants...

  17. Parálisis cerebral Cerebral palsy

    OpenAIRE

    Jorge Malagon Valdez

    2007-01-01

    El término parálisis cerebral (PC) engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia me...

  18. Parálisis cerebral Cerebral palsy

    Directory of Open Access Journals (Sweden)

    Jorge Malagon Valdez

    2007-01-01

    Full Text Available El término parálisis cerebral (PC engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia mental, trastornos del lenguaje, audición, visión, déficit de la atención que mejoran el pronóstico de manera significativa. El pronóstico también depende de la gravedad del padecimiento y de las manifestaciones asociadas.The term cerebral palsy (CP, is used for a great number of clinical neurological syndromes. The syndromes are characterized by having a common cause, motor defects. It is important, because they can cause a brain damage by presenting motor defects and some associated deficiencies, such as mental deficiency, epilepsy, language and visual defects and pseudobulbar paralysis, with the nonevolving fact. Some authors prefer using terms such as "non-evolving encephalopathies". In the treatment the utility of prevention programs of early stimulation and special rehabilitation methods, and treatment of associated deficiencies such as epilepsy, mental deficiency, language, audition and visual problems, and the attention deficit improve the prognosis in an important way. The prognosis depends on the severity of the disease and the associated manifestations.

  19. Morel-Lavallee lesion

    Institute of Scientific and Technical Information of China (English)

    Li Hui; Zhang Fangjie; Lei Guanghua

    2014-01-01

    Objective To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity.Familiarization may decrease missed diagnoses and misdiagnoses.It could also help steer the clinician to the proper treatment choice.Data sources A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords:Morel-Lavallee lesion,closed degloving injury,concealed degloving injury,Morel-Lavallee effusion,Morel-Lavallee hematoma,posttraumatic pseudocyst,posttraumatic soft tissue cyst.Study selection Chinese and English language literatures relevant to the subject were collected.Their references were also reviewed.Results Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury.It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia.Apart from the classic location over the region of the greater trochanter,MLLs have been described in other parts of the body.The natural history of MLL has not yet been established.The lesion may decrease in volume,remain stable,enlarge progressively or show a recurrent pattern.Diagnosis of MLL was often missed or delayed.Ultrasonography,computed tomography,and magnetic resonance imaging have great value in the diagnosis of MLL.Treatment of MLL has included compression,local aspiration,open debridement,and sclerodesis.No standard treatment has been established.Conclusions A diagnosis of MLL should be suspected when a soft,fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury.Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis.Treatment decisions should base on association with fractures,the condition of the lesion,symptom and desire of the patient.

  20. Gd-DTPA-enhanced lesions in the brain of patients with acute optic neuritis

    DEFF Research Database (Denmark)

    Christiansen, P; Frederiksen, J L; Henriksen, O

    1992-01-01

    The cerebral hemispheres of 19 patients with acute monosymptomatic optic neuritis (AMON) were investigated using magnetic resonance imaging (MRI) and Gadolinium-DTPA (Gd-DTPA). Using T1-weighted and T2-weighted imaging sequences it was disclosed that 14 of 19 patients had lesions...

  1. Citicoline Protects Against Cognitive Impairment in a Rat Model of Chronic Cerebral Hypoperfusion

    OpenAIRE

    Lee, Hyun Joon; Kang, Ji Seung; Kim, Yeong In

    2008-01-01

    Background and purpose Cerebral white matter (WM) lesions are frequently observed in human cerebrovascular diseases, and are believed to be responsible for cognitive impairment. Various neuroprotective agents can suppress this type of WM or neuronal damage. In this study, we investigated whether citicoline, a drug used to treat acute ischemic stroke, can attenuate WM lesions and cognitive decline caused by chronic hypoperfusion in the rat. Methods Animals were divided into immediate- and dela...

  2. Ancient Grandeur of the Vertebrate Neuropeptide Y System Shown by the Coelacanth Latimeria chalumnae.

    Science.gov (United States)

    Larhammar, Dan; Bergqvist, Christina A

    2013-01-01

    The neuropeptide Y (NPY) family receptors and peptides have previously been characterized in several tetrapods, teleost fishes, and in a holocephalan cartilaginous fish. This has shown that the ancestral NPY system in the jawed vertebrates consisted of the peptides NPY and peptide YY (PYY) and seven G-protein-coupled receptors named Y1-Y8 (Y3 does not exist). The different vertebrate lineages have subsequently lost or gained a few receptor genes. For instance, the human genome has lost three of the seven receptors while the zebrafish has lost two and gained two receptor genes. Here we describe the NPY system of a representative of an early diverging lineage among the sarcopterygians, the West Indian Ocean coelacanth Latimeria chalumnae. The coelacanth was found to have retained all seven receptors from the ancestral jawed vertebrate. The receptors display the typical characteristics found in other vertebrates. Interestingly, the coelacanth was found to have the local duplicate of the PYY gene, called pancreatic polypeptide, previously only identified in tetrapods. Thus, this duplication took place very early in the sarcopterygian lineage, before the origin of tetrapods. These findings confirm the ancient complexity of the NPY system and show that mammals have lost more NPY receptors than any other vertebrate lineage. The coelacanth has all three peptides found in tetrapods and has retained the ancestral jawed vertebrate receptor repertoire with neither gains or losses.

  3. Ancient grandeur of the vertebrate neuropeptide Y system shown by the coelacanth Latimeria chalumnae

    Directory of Open Access Journals (Sweden)

    Dan eLarhammar

    2013-03-01

    Full Text Available The neuropeptide Y (NPY family receptors and peptides have previously been characterized in several tetrapods, teleost fishes and in a holocephalan cartilaginous fish. This has shown that the ancestral NPY system in the jawed vertebrates consisted of the peptides NPY and PYY and seven G-protein-coupled receptors named Y1-Y8 (Y3 does not exist. The different vertebrate lineages have subsequently lost or gained a few receptor genes. For instance, the human genome has lost three of the seven receptors while the zebrafish has lost two and gained two receptor genes. Here we describe the NPY system of a representative of an early diverging lineage among the sarcopterygians, the West Indian Ocean coelacanth Latimeria chalumnae. The coelacanth was found to have retained all seven receptors from the ancestral jawed vertebrate. The receptors display the typical characteristics found in other vertebrates. Interestingly, the coelacanth was found to have the local duplicate of the PYY gene, called pancreatic polypeptide, previously only identified in tetrapods. Thus, this duplication took place very early in the sarcopterygian lineage, before the origin of tetrapods. These findings confirm the ancient complexity of the NPY system and show that mammals have lost more NPY receptors than any other vertebrate lineage. The coelacanth has all three peptides found in tetrapods and has retained the ancestral jawed vertebrate receptor repertoire with neither gains or losses.

  4. A novel phytoremediation technology shown to remediate petroleum hydrocarbons from soils in situ

    Energy Technology Data Exchange (ETDEWEB)

    Huang, X.D.; Yu, X.M.; Gerhardt, K.; Glick, B.; Greenberg, B [Waterloo Environmental Biotechnology Inc., Hamilton, ON (Canada); Waterloo Univ., ON (Canada). Dept. of Biology

    2009-04-01

    This article described a newly developed, advanced microbe-enhanced phytoremediation system that can be used to remediate lands polluted by hydrocarbons, salts and metals. The technology uses 3 complementary processes to achieve effective remediation of strongly bound persistent organic pollutants (POPs) from soil. The remediation process involves physical soil treatment, photochemical photooxidation, microbial remediation and growth of plants treated with plant growth promoting rhizobacteria (PGPR). The PGPR-enhanced phytoremediation system (PEPS) alleviates plant stress and increases biodegradation activities, thereby accelerating plant growth in the presence of POPs or poor soils. The PEPS has been used successfully to remove petroleum hydrocarbons (PHCs) from impacted soils in situ at several sites across Canada. Studies have shown that the PHCs are degraded in the rhizosphere. This article also presented a summary of the work conducted at 3 sites in Alberta. It took only 2 years to remediate the 3 sites to levels required for site closure under Alberta Tier 1 guidelines. It was concluded that PEPS is equally effective for total PHC and Fraction 3 CCME hydrocarbons. 1 tab., 3 figs.

  5. Cerebral Infarction Arising from Takotsubo Cardiomyopathy: Case Report and Literature Review.

    Science.gov (United States)

    Otani, Yoshihiro; Tokunaga, Koji; Kawauchi, Satoshi; Inoue, Satoshi; Watanabe, Kyoichi; Kiriyama, Hideki; Sakane, Kosuke; Maekawa, Kiyoaki; Date, Isao; Matsumoto, Kengo

    2016-10-01

    Although most patients with takotsubo cardiomyopathy have a favorable outcome, complications are not uncommon. Recent studies have reported an increase in incidence of cardioembolic complications; however, the association between takotsubo cardiomyopathy and stroke, in particular thromboembolic cerebral infarction, remains unclear. We reported a 44-year-old woman who had a cerebral infarction resulting from takotsubo cardiomyopathy. She had felt chest discomfort a few days prior to infarction, and later developed left hemiparesis. Head magnetic resonance imaging (MRI) revealed acute infarction in the right insular cortex and occlusion of the right middle cerebral artery at the M2 segment. Echocardiogram revealed a takotsubo-like shape in the motion of the left ventricular wall, and coronary angiography showed neither coronary stenosis nor occlusion. Cerebral infarction resulting from takotsubo cardiomyopathy was diagnosed and treatment with anticoagulant was started. MRI on the eighth day after hospitalization showed recanalization of the right middle cerebral artery and no new ischemic lesions. The findings of the 19 previously published cases who had cerebral infarction resulting from takotsubo cardiomyopathy were also reviewed and showed the median interval between takotsubo cardiomyopathy and cerebral infarction was approximately 1 week and cardiac thrombus was detected in 9 of 19 patients. We revealed that thromboembolic events occurred later than other complications of takotsubo cardiomyopathy and longer observation might be required due to possible cardiogenic cerebral infarction. Anticoagulant therapy is recommended for patients with takotsubo cardiomyopathy with cardiac thrombus or a large area of akinetic left ventricle.

  6. The influence of transcutaneous electrical neurostimulation (TENS) on human cerebral blood flow velocities

    NARCIS (Netherlands)

    ter Laan, Mark; van Dijk, J. Marc C.; Elting, Jan-Willem J.; Fidler, Vaclav; Staal, Michiel J.

    It has been shown that transcutaneous electrical neurostimulation (TENS) reduces sympathetic tone. Spinal cord stimulation (SCS) has proven qualities to improve coronary, peripheral, and cerebral blood circulation. Therefore, we postulate that TENS and SCS affect the autonomic nervous system in

  7. Cerebral cavernous malformations arise from endothelial gain of MEKK3-KLF2/4 signalling.

    Science.gov (United States)

    Zhou, Zinan; Tang, Alan T; Wong, Weng-Yew; Bamezai, Sharika; Goddard, Lauren M; Shenkar, Robert; Zhou, Su; Yang, Jisheng; Wright, Alexander C; Foley, Matthew; Arthur, J Simon C; Whitehead, Kevin J; Awad, Issam A; Li, Dean Y; Zheng, Xiangjian; Kahn, Mark L

    2016-04-07

    Cerebral cavernous malformations (CCMs) are common inherited and sporadic vascular malformations that cause strokes and seizures in younger individuals. CCMs arise from endothelial cell loss of KRIT1, CCM2 or PDCD10, non-homologous proteins that form an adaptor complex. How disruption of the CCM complex results in disease remains controversial, with numerous signalling pathways (including Rho, SMAD and Wnt/β-catenin) and processes such as endothelial-mesenchymal transition (EndMT) proposed to have causal roles. CCM2 binds to MEKK3 (refs 7, 8, 9, 10, 11), and we have recently shown that CCM complex regulation of MEKK3 is essential during vertebrate heart development. Here we investigate this mechanism in CCM disease pathogenesis. Using a neonatal mouse model of CCM disease, we show that expression of the MEKK3 target genes Klf2 and Klf4, as well as Rho and ADAMTS protease activity, are increased in the endothelial cells of early CCM lesions. By contrast, we find no evidence of EndMT or increased SMAD or Wnt signalling during early CCM formation. Endothelial-specific loss of Map3k3 (also known as Mekk3), Klf2 or Klf4 markedly prevents lesion formation, reverses the increase in Rho activity, and rescues lethality. Consistent with these findings in mice, we show that endothelial expression of KLF2 and KLF4 is increased in human familial and sporadic CCM lesions, and that a disease-causing human CCM2 mutation abrogates the MEKK3 interaction without affecting CCM complex formation. These studies identify gain of MEKK3 signalling and KLF2/4 function as causal mechanisms for CCM pathogenesis that may be targeted to develop new CCM therapeutics.

  8. 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.

  9. [Managing focal incidental renal lesions].

    Science.gov (United States)

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

  10. Neuroprotective effects of rutaecarpine on cerebral ischemia reperfusion injury**

    Institute of Scientific and Technical Information of China (English)

    Chunlin Yan; Ji Zhang; Shu Wang; Guiping Xue; Yong Hou

    2013-01-01

    Rutaecarpine, an active component of the traditional Chinese medicine Tetradium ruticarpum, has been shown to improve myocardial ischemia reperfusion injury. Because both cardiovascular and cerebrovascular diseases are forms of ischemic vascular disease, they are closely related. We hypothesized that rutaecarpine also has neuroprotective effects on cerebral ischemia reperfusion injury. A cerebral ischemia reperfusion model was established after 84, 252 and 504 µg/kg carpine were given to mice via intraperitoneal injection, daily for 7 days. Results of the step through test, 2,3,5-triphenyl tetrazolium chloride dyeing and oxidative stress indicators showed that rutae-carpine could improve learning and memory ability, neurological symptoms and reduce infarction volume and cerebral water content in mice with cerebral ischemia reperfusion injury. Rutaecarpine could significantly decrease the malondialdehyde content and increase the activities of superoxide dismutase and glutathione peroxidase in mouse brain. Therefore, rutaecarpine could improve neu-rological function fol owing injury induced by cerebral ischemia reperfusion, and the mechanism of this improvement may be associated with oxidative stress. These results verify that rutaecarpine has neuroprotective effects on cerebral ischemia reperfusion in mice.

  11. Age dependent white matter lesions and brain volume changes in healthy volunteers

    DEFF Research Database (Denmark)

    Christiansen, P; Larsson, H B; Thomsen, C

    1994-01-01

    The brain of 142 healthy volunteers aged 21 to 80 years were investigated using MR imaging. The number and size of the white matter hyperintensity lesions (WMHL) in the cerebral hemispheres were determined. Furthermore, the volume of the cerebral hemispheres and of the lateral ventricles...... was measured. An almost linear increase in the number of volunteers with WMHL was seen with aging for males and females. With aging a significant decrease in the volume of the cerebral hemispheres was found for males, and a significant increase in the volume of the lateral ventricles was seen for both males...... and females. Our results suggest that with aging central atrophy increases more (relatively) than cortical atrophy. No correlation was found between the decreasing volume of the cerebral hemispheres and the increasing number and size of WMHL, nor between the increasing volume of the lateral ventricles...

  12. Phenylpropanolamine and cerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    McDowell, J.R.; LeBlanc, H.J.

    1985-05-01

    Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

  13. Lesiones en el deporte

    Directory of Open Access Journals (Sweden)

    Rubio Gimeno, Silvio

    2000-02-01

    Full Text Available Not available

    El incremento de la actividad física y del deporte, en las sociedades llamadas desarrolladas, ha traído consigo beneficios claros para la salud, reflejados en diferentes indicadores de salud. Simultáneamente, el deporte de competición obliga a una dedicación diaria a intensidad de entrenamiento, con objeto de obtener los elevados requerimientos físicos que exige la competición. Todo ello ha traído consigo la aparición de numerosas lesiones, fundamentalmente del sistema músculo- esquelético.
    Se exponen en este trabajo consideraciones históricas, la epidemiología de la lesión deportiva y se describen, concisamente, algunas de las lesiones más habituales y significativas que afectan a músculos, tendones y sistema esquelético.

  14. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    Anthony Richard Bain

    2014-03-01

    Full Text Available Hyperthermia is associated with marked reductions in cerebral blood flow (CBF. Increased distribution of cardiac output to the periphery, increases in alveolar ventilation and resultant hypocapnia each contribute to the fall in CBF during passive hyperthermia; however, their relative contribution remains a point of contention, and probably depends on the experimental condition (e.g. posture and degree of hyperthermia. The hyperthermia-induced hyperventilatory response reduces arterial CO2 pressure (PaCO2 causing cerebral vasoconstriction and subsequent reductions in flow. During supine passive hyperthermia, the majority of recent data indicate that reductions in PaCO2 may be the primary, if not sole, culprit for reduced CBF. On the other hand, during more dynamic conditions (e.g. hemorrhage or orthostatic challenges, an inability to appropriately decrease peripheral vascular conductance presents a condition whereby adequate cerebral perfusion pressure may be compromised secondary to reductions in systemic blood pressure. Although studies have reported maintenance of pre-frontal cortex oxygenation (assessed by near-infrared spectroscopy during exercise and severe heat stress, the influence of cutaneous blood flow is known to contaminate this measure. This review discusses the governing mechanisms associated with changes in CBF and oxygenation during moderate to severe (i.e. 1.0°C to 2.0°C increase in body core temperature levels of hyperthermia. Future research directions are provided.

  15. Cerebral salt wasting syndrome

    Directory of Open Access Journals (Sweden)

    Harshal Dholke

    2016-01-01

    Full Text Available Traumatic brain injury (TBI is on the rise, especially in today′s fast-paced world. TBI requires not only neurosurgical expertise but also neurointensivist involvement for a better outcome. Disturbances of sodium balance are common in patients with brain injury, as the central nervous system plays a major role in sodium regulation. Hyponatraemia, defined as serum sodium <135 meq/L is commonly seen and is especially deleterious as it can contribute to cerebral oedema in these patients. Syndrome of inappropriate antidiuretic hormone secretion (SIADH, is the most well-known cause of hyponatraemia in this subset of patients. Cerebral Salt Wasting Syndrome (CSWS, leading to renal sodium loss is an important cause of hyponatraemia in patients with TBI. Although incompletely studied, decreased renal sympathetic responses and cerebral natriuretic factors play a role in the pathogenesis of CSWS. Maintaining a positive sodium balance and adequate hydration can help in the treatment. It is important to differentiate between SIADH and CSWS when trying to ascertain a case for patients with acute brain injury, as the treatment of the two are diametrically opposite.

  16. Transient cerebral arteriopathy: a disorder recognized by serial angiograms in children with stroke.

    Science.gov (United States)

    Chabrier, S; Rodesch, G; Lasjaunias, P; Tardieu, M; Landrieu, P; Sébire, G

    1998-01-01

    Repeated clinical evaluation and cerebral arteriography during the evolution of ischemic strokes of idiopathic origin allowed us to characterize a transient cerebral arteriopathy. We retrospectively studied the clinical characteristics, course, and neuroimaging features of this disorder in nine children. Of 34 children with ischemic strokes seen consecutively between 1984 and 1995, 9 (26%) were diagnosed as having transient attack of the cerebral arterial wall, termed transient cerebral arteriopathy. All of these patients had previously been in good health. The mean age at the time of the first stroke was 6 years (range, 2 9/12 years to 13 4/12 years). All children presented with acute hemiplegia. A recurrence of the stroke took place 3 months at the latest after the initial infarct in three children (mean clinical follow-up 2 7/12 years). Cerebral imaging in all the patients showed small subcortical infarcts located in basal ganglia or internal capsule. Arteriography revealed multifocal lesions of the arterial wall (focal stenosis or segmental narrowing), mostly located in the initial parts of basal arteries of the carotid system. Longitudinal arteriographic follow-up showed initial worsening of these arterial lesions (n = 5) for a maximum duration of 7 months followed by complete regression (n = 2), improvement (n = 5), or stabilization of the lesions (n = 2). Five patients had a complete clinical recovery. Further studies are necessary to confirm a presumed inflammatory cause of this arteriopathy.

  17. Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

    Directory of Open Access Journals (Sweden)

    Nikolaos Mouchtouris

    2015-01-01

    Full Text Available Cerebral cavernous malformations are the most common vascular malformations and can be found in many locations in the brain. If left untreated, cavernomas may lead to intracerebral hemorrhage, seizures, focal neurological deficits, or headaches. As they are angiographically occult, their diagnosis relies on various MR imaging techniques, which detect different characteristics of the lesions as well as aiding in planning the surgical treatment. The clinical presentation and the location of the lesion are the most important factors involved in determining the optimal course of treatment of cavernomas. We concisely review the literature and discuss the advantages and limitations of each of the three available methods of treatment—microsurgical resection, stereotactic radiosurgery, and conservative management—depending on the lesion characteristics.

  18. Seismic subduction of the Nazca Ridge as shown by the 1996-97 Peru earthquakes

    Science.gov (United States)

    Spence, W.; Mendoza, C.; Engdahl, E.R.; Choy, G.L.; Norabuena, E.

    1999-01-01

    By rupturing more than half of the shallow subduction interface of the Nazca Ridge, the great November 12, 1996 Peruvian earthquake contradicts the hypothesis that oceanic ridges subduct aseismically. The mainshock's rupture has a length of about 200 km and has an average slip of about 1.4 m. Its moment is 1.5 x 1028 dyne-cm and the corresponding M(w) is 8.0. The mainshock registered three major episodes of moment release as shown by a finite fault inversion of teleseismically recorded broadband body waves. About 55% of the mainshock's total moment release occurred south of the Nazca Ridge, and the remaining moment release occurred at the southern half of the subduction interface of the Nazca Ridge. The rupture south of the Nazca Ridge was elongated parallel to the ridge axis and extended from a shallow depth to about 65 km depth. Because the axis of the Nazca Ridge is at a high angle to the plate convergence direction, the subducting Nazca Ridge has a large southwards component of motion, 5 cm/yr parallel to the coast. The 900-1200 m relief of the southwards sweeping Nazca Ridge is interpreted to act as a 'rigid indenter,' causing the greatest coupling south of the ridge's leading edge and leading to the large observed slip. The mainshock and aftershock hypocenters were relocated using a new procedure that simultaneously inverts local and teleseismic data. Most aftershocks were within the outline of the Nazca Ridge. A three-month delayed aftershock cluster' occurred at the northern part of the subducting Nazca Ridge. Aftershocks were notably lacking at the zone of greatest moment release, to the south of the Nazca Ridge. However, a lone foreshock at the southern end of this zone, some 140 km downstrike of the mainshock's epicenter, implies that conditions existed for rupture into that zone. The 1996 earthquake ruptured much of the inferred source zone of the M(w) 7.9-8.2 earthquake of 1942, although the latter was a slightly larger earthquake. The rupture zone of

  19. Reduced visual surround suppression in schizophrenia shown by measuring contrast detection thresholds

    Science.gov (United States)

    Serrano-Pedraza, Ignacio; Romero-Ferreiro, Verónica; Read, Jenny C. A.; Diéguez-Risco, Teresa; Bagney, Alexandra; Caballero-González, Montserrat; Rodríguez-Torresano, Javier; Rodriguez-Jimenez, Roberto

    2014-01-01

    Visual perception in schizophrenia is attracting a broad interest given the deep knowledge that we have about the visual system in healthy populations. One example is the class of effects known collectively as visual surround suppression. For example, the visibility of a grating located in the visual periphery is impaired by the presence of a surrounding grating of the same spatial frequency and orientation. Previous studies have suggested abnormal visual surround suppression in patients with schizophrenia. Given that schizophrenia patients have cortical alterations including hypofunction of NMDA receptors and reduced concentration of GABA neurotransmitter, which affect lateral inhibitory connections, then they should be relatively better than controls at detecting visual stimuli that are usually suppressed. We tested this hypothesis by measuring contrast detection thresholds using a new stimulus configuration. We tested two groups: 21 schizophrenia patients and 24 healthy subjects. Thresholds were obtained using Bayesian staircases in a four-alternative forced-choice detection task where the target was a grating within a 3∘ Butterworth window that appeared in one of four possible positions at 5∘ eccentricity. We compared three conditions, (a) target with no-surround, (b) target embedded within a surrounding grating of 20∘ diameter and 25% contrast with same spatial frequency and orthogonal orientation, and (c) target embedded within a surrounding grating with parallel (same) orientation. Previous results with healthy populations have shown that contrast thresholds are lower for orthogonal and no-surround (NS) conditions than for parallel surround (PS). The log-ratios between parallel and NS thresholds are used as an index quantifying visual surround suppression. Patients performed poorly compared to controls in the NS and orthogonal-surround conditions. However, they performed as well as controls when the surround was parallel, resulting in significantly

  20. Comparison of cerebral blood flow pattern by transcranial Doppler in patients with diffuse and focal causes of brain death

    Directory of Open Access Journals (Sweden)

    Alireza Vakilian

    2012-01-01

    Full Text Available Background: This study aims to assess the cerebral vessels flow in brain death patients with different causes, including focal and diffuse lesions and comparison of flows according to the underlying causes. Materials and Methods: Two groups of 15 brain-dead patients one with focal and the other with diffuse brain lesions were compared according to their cerebral blood flow pattern 48 h passed brain death certification. Results: Bilateral absence of flow in middle cerebral artery (MCA was found in 54.5% of brain-dead patients with diffuse lesion and 50.33% of those with focal lesions. Systolic spike pattern in MCA flow was found in 46.2% of patients with focal lesion and 16.65% of patients with diffuse lesion. Diastole-systole separation pattern in MCA was seen in 16.65% of patients with the diffuse lesions. This pattern in MCA was not seen in patients with the focal lesion group. In carotid arteries, we did not find the absence of flow in any cases. Thirty percent of all patients in both groups had a normal flow pattern (36.6% of patients with focal lesions and 23.3% of patients with diffuse lesion. Patients with focal lesion had 33.3% systolic spike pattern flow and had 23.35% diastole-systole separation flow pattern. In intra-cranial vessels, systolic spike pattern was more common among patients with focal lesions than patients with diffuse lesion, however, this difference was not statistically significant (46.2% of patients with focal lesion and 16.65% of patients with diffuse lesion (P value = 0.244-0.09. Diastole-systole separation flow was more common in patients with diffuse lesions than those with the focal lesions although this could not reach the significant level as the previous pattern (20% of patients with diffuse lesion versus no case in patients with focal lesion (P value = 0.181. Conclusion: Absence of flow was the most common brain flow pattern in the focal and diffuse group lesions. There was no difference in flow pattern

  1. Meniscal Ramp Lesions

    OpenAIRE

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, ...

  2. The relationship between cerebral infarction on MR and angiographic findings in moyamoya disease: significance of the posterior circulation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ja; Song, Soon Young [College of Medicine, Kwangdong Univ., Koyang (Korea, Republic of); Yu, Won Jong; Jung, So Lyung; Chung, Bong Gak; Kag, Si Won [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of); Kim, Man Deuk [College of Medicine, Pochon CHA Univ., Pochon (Korea, Republic of)

    2002-06-01

    To investigate the relationship between changes in the posterior and anterior circulation, as seen at angiography, and the frequency and extent of cerebral infarction revealed by MR imaging in moyamoya disease. This study involved 34 patients (22 females and 12 males, aged 2-52 years) in whom cerebral angiography revealed the presence of moyamoya disease (bilateral; unilateral= 24:10; total hemispheres=58) and who also underwent brain MR imaging. To evaluate the angiographic findings, we applied each angiographic staging system to the anterior and posterior circulation. Leptomeningeal collateral circulation from the cortical branches of the posterior cerebral artery (PCA) was also assigned one of four grades. At MR imaging, areas of cerebral cortical or subcortical infarction in the hemisphere were divided into six zones. White matter and basal ganglionic infarction, ventricular dilatation, cortical atrophy, and hemorrhagic lesions were also evaluated. To demonstrate the statistical significance of the relationship between the angiographic and the MR findings, both the Mantel-Haenszel chi-square test for trend and the chi-square test were used. The degree of steno-occlusive PCA change correlated significantly with the internal carotid artery (ICA) stage (p<0.0001). As PCA stages advanced, the degree of leptomeningeal collaterals from the PCA decreased significantly (P<0.0001), but ICA stages were not significant (p>0.05). The prevalence of infarction showed significant correlation with the degree of steno-occlusive change in both the ICA and PCA. The degree of cerebral ischemia in moyamoya patients increased proportionally with the severity of PCA stenosis rather than with that of steno-occlusive lesins of the anterior circulation. Infarctions tended to be distributed in the anterior part of the hemisphere at PCA state I or II, while in more advanced PCA lesions, they were also found posteriorly, especially in the territories of the posterior middle cerebral artery

  3. An unexpected lumbar lesion

    Directory of Open Access Journals (Sweden)

    Laura Beard

    2016-01-01

    Full Text Available This case report details an interesting case of suspected spinal bifida in an obstetric patient who presented for an elective cesarean section. A large scarred/dimpled area, surrounded by significant hair growth in the region of the lumbar spine had been missed in multiple antenatal and preoperative assessments and was recognized on the day of the surgery as the patient was being prepared for spinal anesthesia. The patient was uncertain regarding the pathology of the lesion, and all investigations relating to this had been undertaken in Pakistan where she lived as a child. General anesthesia was undertaken because magnetic resonance imaging had not been performed and tethering of the spinal cord could not be ruled out clinically. The patient suffered from significant blood loss intra and postoperatively, requiring a two unit blood transfusion. She was discharged after 5 days in the hospital. This case highlights the need for thorough examination in all obstetric patients presenting to the preoperative clinic, focusing on the airway, vascular access, and lumbar spine. Patients may not always disclose certain information due to a lack of understanding, embarrassment, forgetfulness, or language barriers. Significant aspects of their care may have been undertaken abroad and access to these notes is often limited. Preoperative detection of the lesion would have allowed further investigation and imaging of the lesion and enabled more comprehensive discussions with the patient regarding anesthetic options and risk.

  4. 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.)

  5. A practical grading system of ultrasonographic visibility for intracerebral lesions.

    Science.gov (United States)

    Mair, Richard; Heald, James; Poeata, Ion; Ivanov, Marcel

    2013-12-01

    Intraoperative ultrasound for intracranial neurosurgery was largely abandoned in the 1980s due to poor image resolution. Despite many technological advances in ultrasound since then, the use of this imaging modality in contemporary practice remains limited. Our aim was to evaluate the utility of modern intraoperative ultrasound in the resection of a wide variety of intracranial pathologies. A total of 105 patients who underwent intracranial lesion resection in a contiguous fashion were prospectively included in the study. Ultrasound images acquired intraoperatively were used to stratify lesions into one of four grades (grades 0-3) on the basis of their ultrasonic echogenicity and border visibility. Forty-two out of 105 lesions (40 %) were clearly identifiable and had a clear border with normal tissue (grade 3). Fifty-five of 105 lesions (52 %) were clearly identifiable but had no clear border with normal tissue (grade 2). Eight of 105 lesions (8 %) were difficult to identify and had no clear border with normal tissue (grade 1). None (0 %) of the lesions could not be identified (grade 0). High-grade gliomas, cerebral metastases, meningiomas, ependymomas, and haemangioblastomas all demonstrated a median ultrasonic visibility grade of 2 or greater. Low-grade astrocytomas and oligodendrogliomas demonstrated a median ultrasonic visibility grade of 2 or less. Intraoperative ultrasound can be of tremendous benefit in allowing the surgeon to appraise the location, extent, and local environment of their target lesion, as well as to reduce the risk of preventable complications. We believe that our grading system will provide a useful adjunct to the neurosurgeon when deciding for which lesions intraoperative ultrasound would be useful.

  6. Home Literacy Environment: Characteristics of Children with Cerebral Palsy

    Science.gov (United States)

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

    2009-01-01

    Background: Various aspects of the home literacy environment are considered to stimulate the emergent literacy development in children without disabilities. It is important to gain insight into the home literacy environment of children with cerebral palsy given that they have been shown to have difficulty acquiring literacy skills. Aims: The aims…

  7. Home literacy environment: characteristics of children with cerebral palsy

    NARCIS (Netherlands)

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

    2009-01-01

    Background: Various aspects of the home literacy environment are considered to stimulate the emergent literacy development in children without disabilities. It is important to gain insight into the home literacy environment of children with cerebral palsy given that they have been shown to have diff

  8. Intra-arterial nimodipine for cerebral vasospasm after subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Bashir, Asma; Andresen, Morten; Bartek, Jiri

    2016-01-01

    Intra-arterial nimodipine (IAN) has shown a promising effect on cerebral vasospasm (CV) after aneurysmal subarachnoid haemorrhage. At our institution, Rigshospitalet, IAN treatment has been used since 2009, but the short- and long-term clinical efficacy of IAN has not yet been assessed. The purpose...

  9. Home Literacy Environment: Characteristics of Children with Cerebral Palsy

    Science.gov (United States)

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

    2009-01-01

    Background: Various aspects of the home literacy environment are considered to stimulate the emergent literacy development in children without disabilities. It is important to gain insight into the home literacy environment of children with cerebral palsy given that they have been shown to have difficulty acquiring literacy skills. Aims: The aims…

  10. Home literacy environment: characteristics of children with cerebral palsy

    NARCIS (Netherlands)

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

    2009-01-01

    Background: Various aspects of the home literacy environment are considered to stimulate the emergent literacy development in children without disabilities. It is important to gain insight into the home literacy environment of children with cerebral palsy given that they have been shown to have diff

  11. Hyperlalia: A Right Cerebral Hemisphere Syndrome

    Directory of Open Access Journals (Sweden)

    Atsushi Yamadori

    1990-01-01

    Full Text Available We describe a new right hemispheric behavioural syndrome for which we propose the name “hyperlalia”. In a typical case an apparently unconcerned and expressionless patient is easily prompted to remarkable volubility with a content which is loose and incoherent. The voice is low and monotonous. All the lesions confirmed by computed tomography of the brain overlapped in the perisylvian area in the territory of the right middle cerebral artery. Loss of a subtle balance between the left hemispheric speech area and the corresponding area in the right hemisphere caused by acute damage of the right perisylvian area may have resulted in disinhibition of the speech function. Similarities and dissimilarities with the known pathology of talkativeness are also discussed.

  12. Cerebral metabolic adaptation and ketone metabolism after brain injury

    Science.gov (United States)

    Prins, Mayumi L

    2010-01-01

    The developing central nervous system has the capacity to metabolize ketone bodies. It was once accepted that on weaning, the ‘post-weaned/adult’ brain was limited solely to glucose metabolism. However, increasing evidence from conditions of inadequate glucose availability or increased energy demands has shown that the adult brain is not static in its fuel options. The objective of this review is to summarize the body of literature specifically regarding cerebral ketone metabolism at different ages, under conditions of starvation and after various pathologic conditions. The evidence presented supports the following findings: (1) there is an inverse relationship between age and the brain’s capacity for ketone metabolism that continues well after weaning; (2) neuroprotective potentials of ketone administration have been shown for neurodegenerative conditions, epilepsy, hypoxia/ischemia, and traumatic brain injury; and (3) there is an age-related therapeutic potential for ketone as an alternative substrate. The concept of cerebral metabolic adaptation under various physiologic and pathologic conditions is not new, but it has taken the contribution of numerous studies over many years to break the previously accepted dogma of cerebral metabolism. Our emerging understanding of cerebral metabolism is far more complex than could have been imagined. It is clear that in addition to glucose, other substrates must be considered along with fuel interactions, metabolic challenges, and cerebral maturation. PMID:17684514

  13. Cerebral Autoregulation in Normal Pregnancy and Preeclampsia

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Panerai, Ronney B.; Haeri, Sina; Griffioen, Annemiek C.; Zeeman, Gerda; Belfort, Michael A.

    2013-01-01

    OBJECTIVE: To test the hypothesis that preeclampsia is associated with impaired dynamic cerebral autoregulation. METHODS: In a prospective cohort analysis, cerebral blood flow velocity of the middle cerebral artery (determined by transcranial Doppler), blood pressure (determined by noninvasive arter

  14. Determining cerebral death with radiologic diagnostic procedures

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, R.M.

    1980-05-01

    Cerebral death determination has become a very important medicolegal question. The imaging modalities of computed tomographic scanning, nuclear medicine, and cerebral angiography are enabling the physician to better evaluate those conditions that may mimic cerebral death.

  15. Molecular pathophysiology of cerebral edema.

    Science.gov (United States)

    Stokum, Jesse A; Gerzanich, Volodymyr; Simard, J Marc

    2016-03-01

    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.

  16. 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

  17. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

    Immink, R V; Pott, F C; Secher, N H

    2014-01-01

    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......This review summarizes evidence in humans for an association between hyperventilation (HV)-induced hypocapnia and a reduction in cerebral perfusion leading to syncope defined as transient loss of consciousness (TLOC). The cerebral vasculature is sensitive to changes in both the arterial carbon...

  18. Disaster Impacts on Human Capital Accumulation Shown in the Typhoon Haiyan Case

    Science.gov (United States)

    Özceylan Aubrecht, Dilek; Aubrecht, Christoph

    2014-05-01

    School children and their school environment are increasingly exposed to all kinds of hazards. Many disaster events have shown the extent of disaster impacts on the education sector which this study also highlights in the Typhoon Haiyan Case. Disasters do not only cause loss of lives or damage to educational facilities, they also entail significant economic and social consequences on human capital development in the short and long-run. While the trend of short term disaster impact can easily be analyzed in rapid post disaster assessments taking destroyed assets as proxy, usually analyses of medium and long-term effects of disasters include large inherent uncertainties and are of less tangible nature, require more time and complex methods and can often not give comprehensive results. The consequences of disasters especially in developing countries are therefore to a certain extent often left unknown. Generally, economic and social effects of disasters on human capital seem to be ambiguous and to some degree these effects are related to economic, social and institutional well-being. Thus, clear understanding is crucial to interpret its complex effects on human capital accumulation. This essential nature of medium and long-term effects has not been reflected in many analyses. Focus has mostly been given on the extent of physical damage, displacements, lives and assets lost instead of targeting resilience of social and economic characteristics of communities in terms of preventing human capital accumulation disruption. Main objective of this study is to provide a conceptual framework illustrating the impacts of disasters on schooling which might help in assessing such effects, as one of the fundamental components of human capital accumulation (Ozceylan Aubrecht, 2013). The dimensions of human capital building and its relationship to disasters under the light of past disaster events are discussed with a special focus on the recent Typhoon Haiyan that struck the

  19. Multiple Factors Involved in the Pathogenesis of White Matter Lesions

    Science.gov (United States)

    Lin, Jing; Wang, Dilong; Lan, Linfang

    2017-01-01

    White matter lesions (WMLs), also known as leukoaraiosis (LA) or white matter hyperintensities (WMHs), are characterized mainly by hyperintensities on T2-weighted or fluid-attenuated inversion recovery (FLAIR) images. With the aging of the population and the development of imaging technology, the morbidity and diagnostic rates of WMLs are increasing annually. WMLs are not a benign process. They clinically manifest as cognitive decline and the subsequent development of dementia. Although WMLs are important, their pathogenesis is still unclear. This review elaborates on the advances in the understanding of the pathogenesis of WMLs, focusing on anatomy, cerebral blood flow autoregulation, venous collagenosis, blood brain barrier disruption, and genetic factors. In particular, the attribution of WMLs to chronic ischemia secondary to venous collagenosis and cerebral blood flow autoregulation disruption seems reasonable. With the development of gene technology, the effect of genetic factors on the pathogenesis of WMLs is gaining gradual attention. PMID:28316994

  20. Acute periodontal lesions.

    Science.gov (United States)

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  1. Atypical idiopathic inflammatory demyelinating lesions

    DEFF Research Database (Denmark)

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo;

    2013-01-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be class...

  2. Computed tomographic findings of cerebral paragonimiasis

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Weon Tae; Jung, Min Ki; Kang, Heoung Keun; Chung, Hyon De [Chonnam University Medicine School, Gwangju (Korea, Republic of)

    1988-10-15

    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.

  3. Causes of cerebral small vessel disease : a prospective population-based MRI study

    NARCIS (Netherlands)

    E.J. van Dijk (Ewoud)

    2004-01-01

    markdownabstract__Abstract__ In the 1970s, the introduction of computed tomography (CT) and magnetic resonance imaging (MRI) in medicine, made it possible to image the living brain. These images showed that cerebral white matter lesions and asymptomatic lacunar brain infarcts are extremely common i

  4. Microbleeds are independently related to gait disturbances in elderly individuals with cerebral small vessel disease

    NARCIS (Netherlands)

    Laat, Karlijn de; Berg, H.A. van den; Norden, Anouk van; Gons, R.A.R.; Olde Rikkert, M.G.M.; Leeuw, F.E. de

    2011-01-01

    BACKGROUND AND PURPOSE: Cerebral small vessel disease (SVD), including white matter lesions and lacunar infarcts, is related to gait disturbances. Microbleeds (MB) are another manifestation of SVD, but their clinical impact remains unclear. We therefore investigated the relation between the number

  5. Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

    Directory of Open Access Journals (Sweden)

    Gherasim Dorin Nicolae

    2017-03-01

    Full Text Available Objective: This study presents the experience of one neurosurgical center in the treatment of 18 consecutive patients with distal anterior cerebral artery (DACA aneurysms during a 10 years period. Our aim was to compare treatment outcomes of these lesions with intracranial aneurysms in general, and to present technical nuances in surgical treatment.

  6. Cerebral salt wasting syndrome in a patient with a pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Singh S

    2003-01-01

    Full Text Available Cerebral salt wasting syndrome (CSWS is often an unrecognized cause of hyponatremia that occurs in the setting of intracranial lesions. It is important to differentiate CSWS from the syndrome of inappropriate ADH secretion, as this would alter the management of hyponatremia. We describe a case of CSWS that occurred in association with a non­functioning pituitary adenoma.

  7. Cerebral salt wasting syndrome in a patient with a pituitary adenoma.

    Science.gov (United States)

    Singh, S K; Unnikrishnan, A G; Reddy, V S; Sahay, R K; Bhadada, S K; Agrawal, J K

    2003-03-01

    Cerebral salt wasting syndrome (CSWS) is often an unrecognized cause of hyponatremia that occurs in the setting of intracranial lesions. It is important to differentiate CSWS from the syndrome of inappropriate ADH secretion, as this would alter the management of hyponatremia. We describe a case of CSWS that occurred in association with a non-functioning pituitary adenoma.

  8. Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel dissease

    NARCIS (Netherlands)

    Laat, de K.F.; Norden, van A.G.W.; Oudheusden, van L.J.B.; Uden, van I.W.M.; Norris, D.G.; Zwiers, M.P.; Leeuw, de F.E.

    2012-01-01

    Although the role of cerebral small vessel disease (SVD), including white matter lesions (WMLs) and lacunar infarcts, in mild parkinsonian signs (MPS) is increasingly being recognized, not all individuals with SVD have MPS. Using diffusion tensor imaging (DTI), we investigated whether the presence o

  9. Retinal vessel diameters and cerebral small vessel disease: the Rotterdam Scan Study

    NARCIS (Netherlands)

    Ikram, M.K.; Jong, F.J. de; Dijk, E.J. van; Prins, N.D.; Hofman, A.; Breteler, M.M.B.; de Jong, P.T.V.M.

    2006-01-01

    The direct visualization of retinal vessels provides a unique opportunity to study cerebral small vessel disease, because these vessels share many features. It was reported that persons with smaller retinal arteriolar-to-venular ratio tended to have more white matter lesions on MRI. It is unclear wh

  10. Primary cerebral echinoccocosis in a child: Case report - Surgical technique, technical pitfalls, and video atlas

    Directory of Open Access Journals (Sweden)

    Ahmed M. A. Altibi

    2016-01-01

    Conclusion: Intracranial hydatid cyst is very rare. Nevertheless, it should always be considered as a differential diagnosis in cerebral cystic lesions, especially in children. The surgical technique used to remove the cyst appears to be safe. However, several precautions must be applied intraoperatively to avoid the catastrophe of cyst rupture.

  11. Microbleeds are independently related to gait disturbances in elderly individuals with cerebral small vessel disease

    NARCIS (Netherlands)

    Laat, Karlijn de; Berg, H.A. van den; Norden, Anouk van; Gons, R.A.R.; Olde Rikkert, M.G.M.; Leeuw, F.E. de

    2011-01-01

    BACKGROUND AND PURPOSE: Cerebral small vessel disease (SVD), including white matter lesions and lacunar infarcts, is related to gait disturbances. Microbleeds (MB) are another manifestation of SVD, but their clinical impact remains unclear. We therefore investigated the relation between the number a

  12. Role of dynamic CT perfusion study in evaluating various intracranial space-occupying lesions

    Directory of Open Access Journals (Sweden)

    Ravindra B Kamble

    2015-01-01

    Full Text Available Aims: Differentiating intracranial mass lesions on CT scan is challenging. The purpose of our study was to determine the perfusion parameters in various intracranial space-occupying lesions (ICSOL, differentiate benign and malignant lesions, and differentiate between grades of gliomas. Materials and Methods: We performed CT perfusion (CTP in 64 patients, with age ranging from 17 to 68 years, having space-occupying lesions in brain and calculated relative cerebral blood flow (rCBF and relative cerebral blood volume (rCBV. Results: We found significantly lower perfusion in low-grade gliomas as compared to high-grade tumors, lymphoma, and metastases. Similarly in infective lesions, TWT and abscesses showed significantly lower perfusion compared to TOT. In ring enhancing lesions, capsule of TWT showed significantly lower perfusion as compared to abscesses, TOT, and metastases. Conclusion: Thus, in conclusion, infective lesions can be differentiated from tumors like lymphomas, high-grade gliomas, or metastases based on perfusion parameters. The cut off value of rCBV 1.64 can be used to differentiate between low grade and high grade gliomas. However, depending only on perfusion parameters, differentiation between the tumors like lymphomas, high-grade gliomas, and metastases may not be possible.

  13. Asperger's syndrome with unusual cerebral pathology: Case report and literature review.

    Science.gov (United States)

    Liu, Liqiong; Vo, Van; Ware, Marcus; Xiong, Zhenggang

    2012-05-01

    A case of Asperger's syndrome with unusual cerebral pathological changes is reported. A 22-year-old male had been having diagnostic Asperger's syndrome since the age of eight and had epilepsy during the past two years. Radiological studies revealed a focal intra-axial cortical and subcortical cerebral lesion with hyper-intensity and non-enhancing contrast in the left frontal lobe. Histological and immunohistochemical studies demonstrated that the lesion consisted of cortical laminar disorganization, neuronal dysmorphism and increased heterotopic neurons in sub-cortical white matter. To our knowledge, this is the first case of Asperger's syndrome with focal cerebral pathological abnormalities rather than mini-columnar changes and the gyrial malformation reported in the literature.

  14. Magnetic Resonance Imaging in Breath-Hold Divers with Cerebral Decompression Sickness

    Directory of Open Access Journals (Sweden)

    Ryu Matsuo

    2014-01-01

    Full Text Available The mechanism of cerebral decompression sickness (DCS is still unclear. We report 2 cases of breath-hold divers with cerebral DCS in whom magnetic resonance imaging (MRI demonstrated distinctive characteristics. One case presented right hemiparesthesia, diplopia, and gait disturbance after breath-hold diving into the sea at a depth of 20 m. Brain MRI with fluid-attenuated inversion recovery (FLAIR sequence revealed multiple hyperintense lesions in the right frontal lobe, bilateral thalamus, pons, and right cerebellar hemisphere. The second case presented visual and gait disturbance after repetitive breath-hold diving into the sea. FLAIR imaging showed hyperintense areas in the bilateral occipito-parietal lobes. In both cases, diffusion-weighted imaging and apparent diffusion coefficient mapping revealed hyperintense areas in the lesions identified by FLAIR. Moreover, follow-up MRI showed attenuation of the FLAIR signal abnormalities. These findings are suggestive of transient hyperpermeability in the microvasculature as a possible cause of cerebral DCS.

  15. Co-localization of brain-derived neurotrophic factor (BDNF) and wild-type huntingtin in normal and quinolinic acid-lesioned rat brain.

    Science.gov (United States)

    Fusco, Francesca R; Zuccato, Chiara; Tartari, Marzia; Martorana, Alessandro; De March, Zena; Giampà, Carmela; Cattaneo, Elena; Bernardi, Giorgio

    2003-09-01

    Loss of huntingtin-mediated brain-derived neurotrophic factor (BDNF) gene transcription has been described in Huntington's disease (HD) [Zuccato et al. (2001) Science, 293, 493-498]. It has been shown that BDNF is synthesized in the pyramidal layer of cerebral cortex and released in the striatum [Altar et al. (1997) Nature, 389, 856-860; Conner et al. (1997) J. Neurosci., 17, 2295-2313]. Here we show the cellular localization of BDNF in huntingtin-containing neurons in normal rat brain; our double-label immunofluorescence study shows that huntingtin and BDNF are co-contained in approximately 99% of pyramidal neurons of motor cortex. In the striatum, huntingtin is expressed in 75% of neurons containing BDNF. In normal striatum we also show that BDNF is contained in cholinergic and in NOS-containing interneurons, which are relatively resistant to HD degeneration. Furthermore, we show a reduction in huntingtin and in BDNF immunoreactivity in cortical neurons after striatal excitotoxic lesion. Our data are confirmed by an ELISA study of BDNF and by a Western blot analysis of huntingtin in cortex of quinolic acid (QUIN)-lesioned hemispheres. In the lesioned striatum we describe that the striatal subpopulation of cholinergic neurons, surviving degeneration, contain BDNF. The finding that BDNF is contained in nearly all neurons that contain huntingtin in the normal cortex, along with the reduced expression of BDNF after QUIN injection of the striatum, shows that huntingtin may be required for BDNF production in cortex.

  16. Neuroimaging diagnosis for cerebral infarction An 8-year bibliometric analysis

    Institute of Scientific and Technical Information of China (English)

    Yan Du; Xiaoxia Yang; Hong Song; Bo Chen; Lin Li; Yue Pan; Qiong Wu; Jia Li

    2012-01-01

    imaging.Detection of clinical super-acute cerebral infarction remains controversial due to its changes on imaging,lack of specificity,and its similarity to a space-occupying lesion.Neuroimaging diagnosis for cerebral infarction remains a highly active area of research and development.

  17. Neuroimaging in Cerebral Palsy – Report from North India

    Directory of Open Access Journals (Sweden)

    Anju AGGARWAL

    2013-11-01

    Full Text Available How to Cite This Article: Aggarwal A, Mittal H, Debnath SKR, Rai A. Neuroimaging in Cerebral Palsy–Report from North India. Iran J Child Neurol. 2013 Autumn; 7(3:41- 46. ObjectiveOnly few Indian reports exist on neuroimaging abnormalities in children with cerebral palsy (CP from India. Materials & MethodsWe studied the clinico-radiological profile of 98 children diagnosed as CP at a tertiary centre in North India. Relevant investigations were carried out to determine the etiology. ResultsAmong the 98 children studied, 80.5% were males and 22.2% were premature. History of birth asphyxia was present in 41.9%. Quadriplegic CP was seen in 77.5%, hemiplegic in 11.5%, and diplegic in 10.5%. Other abnormalities were microcephaly (60.5%, epilepsy (42%, visual abnormality (37%, and hearing abnormality (20%. Neuroimaging was abnormal in 94/98 (95.91%.Abnormalities were periventricular white matter abnormalities (34%, deep grey matter abnormalities (47.8%, malformations (11.7%, and miscellaneous lesions (6.4%. Neuroimaging findings did not relate to the presence of birth asphyxia, sex, epilepsy, gestation, type of CP, or microcephaly. ConclusionsNeuroimaging is helpful for etiological diagnosis, especially malformations.  ReferencesSinghi PD, Ray M, Suri G. Clinical spectrum of cerebral palsy in north India-an analysis of 1000 cases. J Trop Pediatr 2002 48(3; 162-6.Sharma P, Sharma U, Kabra A. Cerebral Palsy-Clinical Profile and Predisposing Factors. Indian Pediatr 1999;36(10:1038-42.Nelson KB, Ellenberg JH. Antecedents of cerebral palsy. Multivariate analysis of risk. N Engl J Med 1986 315(2:81-6.Krägeloh-Mann I, Horber V. The role of magnetic resonance imaging in elucidating the pathogenesis of cerebral palsy: a systematic review. Dev Med Child Neurol 2007; 49(2:144-51.Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007

  18. A disappearing neonatal skin lesion.

    LENUS (Irish Health Repository)

    Hawkes, Colin Patrick

    2012-01-31

    A preterm baby girl was noted at birth to have a firm, raised, non-tender skin lesion located over her right hip. She developed three similar smaller lesions on her ear, buttock and right knee. All lesions had resolved by 2 months of age.

  19. Late cerebral ischaemia after subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Edvinsson, L; Povlsen, G K

    2011-01-01

    the MEK-ERK1/2 pathway. Inhibition of MEK-ERK1/2 signalling has been shown to prevent cerebrovascular receptor upregulation and normalize CBF and neurological function after SAH in rats. At the same time, in rat SAH, certain cytokines and BBB-regulating proteins are upregulated in cerebral artery smooth...... muscles and treatment with MEK-ERK1/2 inhibitors prevents the induction of these proteins. Thus, inhibitors of MEK-ERK1/2 signalling exert multimodal beneficial effects in SAH....

  20. Symmetrical central tegmental tract (CTT) hyperintense lesions on magnetic resonance imaging in children

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Shoko; Hayakawa, Katsumi; Yamamoto, Akira [Kyoto City Hospital, Department of Radiology, Kyoto (Japan); Aida, Noriko [Kanagawa Children' s Medical Center, Department of Radiology, Kyoto (Japan); Okano, Souzo; Matsushita, Hiroko [Kyoto City Hospital, Department of Pediatrics, Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko; Yoshida, Naoko; Hirota, Haruyo [St. Joseph Hospital for Handicapped Children, Department of Pediatric Neurology, Kyoto (Japan)

    2009-02-15

    The central tegmental tract (CTT) is mainly the extrapyramidal tract connecting between the red nucleus and the inferior olivary nucleus. There are only a few case reports describing CTT abnormalities on magnetic resonance imaging (MRI) in children. Our purpose was to evaluate the frequency of CTT lesions and their characteristics on MRI, and to correlate the MR imaging findings with clinical features. We reviewed retrospectively the MR images of 392 children (215 boys and 177 girls) ranging in age from 1 to 6 years. To evaluate symmetrical CTT hyperintense lesions, we defined a CTT lesion as an area of bilateral symmetrical hyperintensity in the tegmentum pontis on both T2-weighted images and diffusion-weighted images in more than two slices. We measured the ADC (apparent diffusion coefficient) values of symmetrical CTT hyperintensity, and compared them with those of children without CTT abnormality. CTT lesions were detected in 20 (5.1%) of the 392 children. The mean ADC value for these 20 children was significantly lower than that of the normal CTT (p<0.001). On MR imaging, other than CTT lesions, associated parenchymal lesion included: none (n=6); other abnormalities, including periventricular leukomalacia (n=3); thin corpus callosum (n=3); ventricular dilatation (n=2); encephalopathy (n=2). Clinically, cerebral palsy was the most frequent clinical diagnosis (n=6), accounting for 30%, which was significantly more frequent than the prevalence of cerebral palsy among children without CTT lesions (13%) (n<0.05). CTT lesions were detected in 5.1% of all the children examined. Cerebral palsy was the most frequent clinical diagnosis. (orig.)

  1. Brain injury in premature neonates: A primary cerebral dysmaturation disorder?

    Science.gov (United States)

    Back, Stephen A; Miller, Steven P

    2014-04-01

    With advances in neonatal care, preterm neonates are surviving with an evolving constellation of motor and cognitive disabilities that appear to be related to widespread cellular maturational disturbances that target cerebral gray and white matter. Whereas preterm infants were previously at high risk for destructive brain lesions that resulted in cystic white matter injury and secondary cortical and subcortical gray matter degeneration, contemporary cohorts of preterm survivors commonly display less severe injury that does not appear to involve pronounced glial or neuronal loss. Nevertheless, these milder forms of injury are also associated with reduced cerebral growth. Recent human and experimental studies support that impaired cerebral growth is related to disparate responses in gray and white matter. Myelination disturbances in cerebral white matter are related to aberrant regeneration and repair responses to acute death of premyelinating late oligodendrocyte progenitors (preOLs). In response to preOL death, early oligodendrocyte progenitors rapidly proliferate and differentiate, but the regenerated preOLs fail to normally mature to myelinating cells required for white matter growth. Although immature neurons appear to be more resistant to cell death from hypoxia-ischemia than glia, they display widespread disturbances in maturation of their dendritic arbors, which further contribute to impaired cerebral growth. These complex and disparate responses of neurons and preOLs thus result in large numbers of cells that fail to fully mature during a critical window in development of neural circuitry. These recently recognized forms of cerebral gray and white matter dysmaturation raise new diagnostic challenges and suggest new therapeutic directions centered on reversal of the processes that promote dysmaturation.

  2. [The left central gyral lesion and pure anarthria].

    Science.gov (United States)

    Tabuchi, M; Odashima, K; Fujii, T; Suzuki, K; Saitou, J; Yamadori, A

    2000-05-01

    We report a very rare case of pure anarthria with lesion analysis. A 44-year-old right-handed man suffered from a cerebral infarction with a mild right hemiparesis and speech disturbance. An MRI of the brain 1.5 months post onset revealed a lesion confined to the left central gyrus. One month after the onset, his spontaneous speech was dysprosodic and laborious. It was contaminated with dysarthria and phonological paraphasias. However, language comprehension, repetition and naming abilities were normal. Most remarkably he showed no impairment in writing with his left hand. Over the following months, his difficulties in verbal output showed general amelioration, but the isolated impairment in the domain of articulation characterized by dysprosody, dysarthria, and phonological paraphasia persisted. As for the symptomatology of pure anarthria resulting from precentral gyral lesions, there have been controversies about its pureness. Some argue that the so called pure anarthria always shows some degree of writing disturbances, albeit mild in degree. Others maintain there certainly exists the pure type without any signs of agraphia. In the present case lesions were limited to the central gyrus but spared the lowest opercular portion. The previous reports of pure anarthria that had mild agraphia all had lesions involving the opercular portion. We conclude the sparing of this area is most likely related with sparing of writing capacity in pure anarthria.

  3. EBV-positive B cell cerebral lymphoma 12 years after sex-mismatched kidney transplantation: post-transplant lymphoproliferative disorder or donor-derived lymphoma?

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2010-06-01

    We present a follow-up case report of possible transmission of lymphoma 12 years after deceased-donor renal transplantation from a male donor who was found at autopsy to have had an occult lymphoma. The female recipient underwent prompt transplant nephrectomy. However, 12 years later, she presented with cerebral B cell lymphoma. A donor origin for the cerebral lymphoma was supported by in situ hybridization demonstration of a Y chromosome in the lymphoma. There was a dramatic resolution of the cerebral lesions with tapering of immunosuppression and introduction of rituximab treatment. The finding of a Y chromosome in the cerebral lymphoma does not exclude a host contribution to lymphoma development.

  4. Evaluation of Patients with Cerebral Venous Sinus Thrombosis

    Directory of Open Access Journals (Sweden)

    Abdullah Yılgör

    2014-08-01

    Full Text Available OBJECTIVE: The aim of this article is to point out the etiology, risk factors, the rate of recanalization and mortality of cerebral venous sinus thrombosis patients. METHODS: The current study was planned as retrospectively and fifty patients were included. All the patients were analyzed according to the clinical presentation, etiologic causes, risk factors, presence of MR lesion, the involvement of anatomic localization, recanalization and mortality. RESULTS: The most frequent risk factors of the cases were prothrombotic conditions (34%, pregnancy (14% and puerperium (8%. The most frequent involvement was transverse sinus and secondly more than one sinüs thrombosis. As clinical application symptoms we detected headache (68% and then focal neurologic deficiency (30%. On the other hand, at least 3 month’s incidence rate of recanalization in the patients was 70.7%. Except for 2 cases that ended with death, the mortality of the cases was low. We could not find a significant association between risk factors and the presence of cerebral MR lesion or not (p=0.42 and also the presence of recanalization or not in the follow-up MR venography (p=0.625. CONCLUSION: We have concluded that, in the diagnosis and follow-up of cerebral venous sinus thrombosis, MR venography is the best method; through early diagnosis and proper treatment, the rate of recanalization will be fairly high and mortality will be low. In etiology, besides trombotic conditions, pregnancy and puerperium must be considered as one of the frequent risk factors.

  5. Successful Treatment of Cerebral Toxoplasmosis with Clindamycin: A Case Report

    Directory of Open Access Journals (Sweden)

    Deepak Madi

    2012-09-01

    Full Text Available Toxoplasmosis is caused by infection with the obligate intracellular parasite Toxoplasma gondii. Toxoplasmosis is generally a late complication of HIV infection and usually occurs in patients with CD4 + T-cell counts below 200/μl. Co-trimoxazole (trimethoprim plus sulfamethoxazole is the most common drug used in India for the treatment of AIDS-associated cerebral toxoplasmosis. Other alternative drugs used for the treatment of cerebral toxoplasmosis are clindamycin plus pyrimethamine and clarithromycin with pyrimethamine.A 30-year-old male known case of retroviral disease presented to Kasturba Medical College, India, with complaints of fever, headache and vomiting. Computed tomography scan of his brain showed irregular ring enhancing lesion in the right basal ganglia. Toxoplasma serology revealed raised IgG antibody levels. Based on the CT features and serology, diagnosis of cerebral toxoplasmosis was made. He was treated with clindamycin alone as he had historyof sulfonamide allergy. The patient was symptomatically better after 48 hours. After 21 days, repeat CT of brain was done which was normal. The patient showed good clinical improvement within 48 hours and the lesion resolved completely within 3 weeks. The authors recommend using clindamycin without pyrimethamine in resource poor settings and in patients who do not tolerate sulfa drugs.

  6. Neonatal cerebral infarction; Symptoms, CT findings and prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Fujimoto, Shinji; Togari, Hajime; Sobajima, Hisanori; Suzuki, Shigesumi; Wada, Yoshiro (Nagoya City Univ. (Japan). Faculty of Medicine); 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).

  7. An Up-to-Date Review on Cerebral Microbleeds.

    Science.gov (United States)

    Wu, Yan; Chen, Tao

    2016-06-01

    Cerebral microbleeds (CMBs) are small cerebrovascular lesions. More and more CMBs have been found in patients with ischemic stroke, dementia, and cerebral amyloid angiopathy, as well as some normal elderly populations. The objective of this study is to summarize the main risk factor, impairment, and therapy of CMBs. We searched and scanned all the literature with the keyword "cerebral microbleeds" or "CMBs" in the database of PubMed and Elsevier. The risks factors for CMBs are complicated, including those that cause large-vessel disease, such as hypertension and old age, and those that cause small-vessel disease, such as amyloid deposits, endothelial lesions, and atrial fibrillation. Moreover, drugs and therapies used to treat cerebrovascular diseases such as statin, intravenous thrombolysis, and coumarin may also increase risk of CMBs. The relationship between antiplatelet treatment and CMBs is now unclear. Gene polymorphisms have been considered to be associated with CMBs. Gene mutations involving collagen type IV alpha 1 and collagen type IV alpha 2, sortilin-related receptor gene, forkhead box C1, and paired-like homeodomain 2 were reported to affect CMBs with the modification of corresponding proteins and functions. The cognition impairment caused by CMBs draws great attention. White matter deterioration is the possible answer. However, different studies could not reach the same conclusion on the damage of cognition of CMBs. Further research is needed to provide effectual therapeutic proposals for CMBs, which differ from the treatment for large-artery disease and dementia. Copyright © 2016. Published by Elsevier Inc.

  8. A magnetic resonance imaging finding in children with cerebral palsy: Symmetrical central tegmental tract hyperintensity.

    Science.gov (United States)

    Derinkuyu, Betul Emine; Ozmen, Evrim; Akmaz-Unlu, Havva; Altinbas, Namik Kemal; Gurkas, Esra; Boyunaga, Oznur

    2017-03-01

    Central tegmental tract is an extrapyramidal tract between red nucleus and inferior olivary nucleus which is located in the tegmentum pontis bilaterally and symmetrically. The etiology of the presence of central tegmental tract hyperintensity on MRI is unclear. In this study our aim is to evaluate the frequency of central tegmental tract lesions in patients with cerebral palsy and control group, as well as to determine whether there is an association between central tegmental tract lesions and cerebral palsy types. Clinical and MRI data of 200 patients with cerebral palsy in study group (87 female, 113 male; mean age, 5.81years; range, 0-16years) and 258 patients in control group (114 female, 144 male; mean age, 6.28years; range, 0-16years) were independently evaluated by two reader for presence of central tegmental tract hyperintensity and other associated abnormalities. Central tegmental tract hyperintensities on T2WI were detected in 19% of the study group (38/200) and 3.5% of the control group (9/258) (pcerebral palsy and 35% (14/40) in dyskinetic cerebral palsy (p=0.0131). The prevalence of central tegmental tract hyperintensity is higher in patients with cerebral palsy particularly in dyskinetic type. We suggest that there is an increased association of the tegmental lesions with dyskinetic CP. Patients with cerebral palsy and ischemic changes were more likely to have central tegmental tract lesions. According to our results we advocate that an ischemic process may have a role in the etiopathogenesis. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  9. Cerebral glucose metabolism in neurofibromatosis type 1 assessed with [18F]-2-fluoro-2-deoxy-D-glucose and PET.

    OpenAIRE

    Balestri, P; Lucignani, G; Fois, A.; Magliani, L; Calistri, L; Grana, C.; Di Bartolo, R M; Perani, D; Fazio, F.

    1994-01-01

    Cerebral PET with [18F]-2-fluoro-2-deoxy-D-glucose has been performed in four patients with neurofibromatosis type 1 (NF1) to assess the relation between cerebral metabolic activity, MRI, and the presence of neurological symptoms, including seizures, as well as mental and language retardation. Widespread hypometabolism occurred in three of the patients. The lesions on MRI, which were localised in the subcortical white matter and grey structures, had normal rates of glucose metabolism. This fi...

  10. Lesiones deportivas Sports injuries

    Directory of Open Access Journals (Sweden)

    Isabel Cristina Gallego Ching

    2007-04-01

    Full Text Available El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participantes o tasas por horas de juego o por número de partidos jugados. Las tasas varían entre 1,7 y 53 lesiones por 1.000 horas de práctica deportiva, entre 0,8 y 90,9 por 1.000 horas de entrenamiento, entre 3,1 y 54,8 por 1.000 horas de competición y de 6,1 a 10,9 por 100 juegos. La gran variación entre las tasas de incidencia se explica por las diferencias existentes entre los deportes, los países, el nivel competitivo, las edades y la metodología empleada en los estudios. Se ha definido la lesión deportiva como la que ocurre cuando los atletas están expuestos a la práctica del deporte y se produce alteración o daño de un tejido, afectando el funcionamiento de la estructura. Los deportes de contacto generan mayor riesgo de presentar lesiones; se destacan al respecto los siguientes: fútbol, rugby, baloncesto, balonmano, artes marciales y jockey. Las lesiones ocurren con mayor probabilidad en las competencias que en el entrenamiento. Stress generated by sports practice has increased the probability that athletes suffer from acute and chronic injuries. Worldwide, there have been many different investigations concerning the incidence of sport injuries. The different ways in which results have been presented makes it difficult to compare among them. Rates of sports injuries vary between 1.7 and 53 per 1.000 hours of sports practice; 0.8 and 90.9 per 1.000 hours of training; 3.1 and 54.8 per 1.000 hours of competition, and 6.1 and 10.9 per 100

  11. Wernicke's encephalopathy induced by total parenteral nutrition in patient with acute leukaemia: unusual involvement of caudate nuclei and cerebral cortex on MRI

    Energy Technology Data Exchange (ETDEWEB)

    D' Aprile, P.; Tarantino, A.; Carella, A. [Division of Neuroradiology, Policlinico, Univ. of Bari (Italy); Santoro, N. [Inst. of Paediatric Clinic I, Policlinico, University of Bari, Bari (Italy)

    2000-10-01

    We report a 13-year-old girl with leukaemia and Wernicke's encephalopathy induced by total parenteral nutrition. MRI showed unusual bilateral lesions of the caudate nuclei and cerebral cortex, as well as typical lesions surrounding the third ventricle and aqueduct. After intravenous thiamine, the patient improved, and the abnormalities on MRI disappeared. (orig.)

  12. Intracranial lesions in the acquired immunodeficiency syndrome: radiological (computed tomographic) features

    Energy Technology Data Exchange (ETDEWEB)

    Elkin, C.M.; Leon, E.; Grenell, S.L.; Leeds, N.E.

    1985-01-18

    Computed tomography (CT) delineates the presence or absence of intracerebral focal lesions in most instances. The presence of contrast enhancement, cerebral atrophy, and an intracranial mass are important in consideration of the differential diagnosis and in establishing the diagnosis. Initially the authors utilized a double dose of contrast medium in all patients after single-dose study, but little additional information was obtained. A second dose of contrast medium is now administered only to evaluate further a suspected lesion. Angiography can confirm the location of the lesion(s) and the cortical veins before biopsy. Of one hundred patients with AIDS examined, 33% had neurological symptoms excluding headache and herpes zoster. All patients with neurological symptoms were studied with noncontrast and contrast CT scanning. Twenty-seven patients in the group had abnormal scans. In 13, the abnormality was limited to a diffuse atrophic appearance, while in 14, focal lesions were identified. Representative cases are discussed and illustrated.

  13. Splenial lesions of the corpus callosum: Disease Spectrum and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Eun; Choi, Dae Seob; Shin, Hwa Seon; Baek, Hye Jin; Choi, Ho Cheol; Kim, Ji Eun; Choi, Hye Young; Park, Min Jung [Dept. of Radiology, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of)

    2017-08-01

    The corpus callosum (CC) is the largest white matter structure in the brain, consisting of more than 200–250 million axons that provide a large connection mainly between homologous cerebral cortical areas in mirror image sites. The posterior end of the CC is the thickest part, which is called the slenium. Various diseases including congenital to acquired lesions including congenital anomalies, traumatic lesions, ischemic diseases, tumors, metabolic, toxic, degenerative, and demyelinating diseases, can involve the splenium of the CC and their clinical symptoms and signs are also variable. Therefore, knowledge of the disease entities and the imaging findings of lesions involving the splenium is valuable in clinical practice. MR imaging is useful for the detection and differential diagnosis of splenial lesions of the CC. In this study, we classify the disease entities and describe imaging findings of lesions involving the splenium of the CC based on our experiences and a review of the literature.

  14. Management of Traumatic Fibroma in a Patient with Cerebral Palsy Using 810nm Diode Laser

    Science.gov (United States)

    Sierra-Garcia, Gerardo Daniel; Nájera, Rosa Isela Sánchez; Perales-Perez, áRaúl Vicente

    2017-01-01

    There are several treatment options for hyperplastic gingival lesions. Among these, diode lasers have the advantages of less bleeding, which is an important characteristic in mucosal lesions, a shorter procedure time, better healing, and less complications. We present the case of a 48-year-old male patient with a history of cerebral palsy and a presumptive diagnosis of traumatic fibroma. The entire lesion was removed in one session with no complications. No recurrence was observed at 3 months follow up. This procedure can be considered a good modality especially for physically challenged patients. PMID:28384984

  15. Recurrent cerebral larva migrans: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    P M Jagannath

    2009-01-01

    Full Text Available Cerebral larva migrans (CLM is an uncommon and rarely diagnosed entity. We report here a histopathologically proven case of CLM in a 13 year-old girl, who presented with bilateral focal seizures, right hemiparesis, and lapsed into altered sensorium prior to admission. Her CT scan was suggestive of a granulomatous lesion which eventually turned out to be CLM (toxocariasis. Interestingly, the lesion recurred after excision, with a confusing clinical picture. Following the second surgery, the pathology was reconfirmed and cure was provided for the disease. There has been no further intracranial recurrence during the past ten years although she developed cutaneous lesions.

  16. Cerebral fat embolism syndrome after long bone fracture due to gunshot injury

    Directory of Open Access Journals (Sweden)

    Latif Duran

    2014-01-01

    Full Text Available Cerebral fat embolism syndrome is a lethal complication of long-bone fractures and clinically manifasted with respiratory distress, altered mental status, and petechial rash. We presented a 20-year-old male admitted with gun-shot wounds to his left leg. Twenty-four hours after the event, he had generalized tonic clonic seizures, decorticate posture and a Glascow Coma Scale of seven with localization of painful stimuli. Subsequent magnetic resonance imaging of the brain showed a star-field pattern defining multiple lesions of restricted diffusion. On a 4-week follow-up, he had returned to normal neurological function. Despite the severity of the neurological condition upon initial presentation, the case cerebral fat embolism illustrates that, cerebral dysfunction associated with cerebral fat embolism illustrates reversible.

  17. Klatskin-Like Lesions

    Directory of Open Access Journals (Sweden)

    M. P. Senthil Kumar

    2012-01-01

    Full Text Available Hilar cholangiocarcinoma, also known as Klatskin tumour, is the commonest type of cholangiocarcinoma. It poses unique problems in the diagnosis and management because of its anatomical location. Curative surgery in the form of major hepatic resection entails significant morbidity. About 5–15% of specimens resected for presumed Klatskin tumour prove not to be cholangiocarcinomas. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a Klatskin tumour, leading to misinterpretation. This paper aims to summarise the features of such Klatskin-like lesions that have been reported in surgical literature.

  18. Klatskin-like lesions.

    Science.gov (United States)

    Senthil Kumar, M P; Marudanayagam, R

    2012-01-01

    Hilar cholangiocarcinoma, also known as Klatskin tumour, is the commonest type of cholangiocarcinoma. It poses unique problems in the diagnosis and management because of its anatomical location. Curative surgery in the form of major hepatic resection entails significant morbidity. About 5-15% of specimens resected for presumed Klatskin tumour prove not to be cholangiocarcinomas. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a Klatskin tumour, leading to misinterpretation. This paper aims to summarise the features of such Klatskin-like lesions that have been reported in surgical literature.

  19. Lesiones en el deporte

    OpenAIRE

    2000-01-01

    Not available

    El incremento de la actividad física y del deporte, en las sociedades llamadas desarrolladas, ha traído consigo beneficios claros para la salud, reflejados en diferentes indicadores de salud. Simultáneamente, el deporte de competición obliga a una dedicación diaria a intensidad de entrenamiento, con objeto de obtener los elevados requerimientos físicos que exige la competición. Todo ello ha traído consigo la aparición de numerosas lesiones, fundamentalmen...

  20. Atrichia with Papular Lesions

    OpenAIRE

    Bansal, Manish; Manchanda, Kajal; Lamba, Sachin; Pandey, SS

    2011-01-01

    Atrichia with papular lesions (APL) is a rare autosomal recessive form of irreversible alopecia with onset at few months of age with papular keratin cysts over the body. It is associated with mutation in the Zinc finger domain of the human hairless gene on chromosome region 8p12. An eleven-year-old male presented with extensive alopecia starting at six months of age refractory to the treatment along with keratotic papules on the face and trunk. Biopsy from a papule showed mid-dermal keratin c...

  1. Lesiones en corredores amateurs

    OpenAIRE

    Natale, Vanesa

    2011-01-01

    Se realizó un estudio tomando como muestra a 100 corredores amateurs de la ciudad de Mar del Plata, en la cual el objetivo general fue determinar cuáles son las patologías más frecuentes en corredores. Correr no es solo un deporte en si mismo sino que tiene elementos de otras actividades deportivas, es decir, que las lesiones de los corredores también son comunes en otros tipos de deportes. El número de deportistas aumenta diariamente y al mismo tiempo aumentan el número de per...

  2. Cystic Lesions of the Mediastinum.

    Science.gov (United States)

    Vargas, Daniel; Suby-Long, Thomas; Restrepo, Carlos S

    2016-06-01

    Cystic lesions are commonly seen in the mediastinum, and they may arise from virtually any organ. The vast majority of these lesions are benign and result in no symptoms. When large, cysts may produce symptoms related to compression of adjacent structures. The most common mediastinal cysts are pericardial and foregut duplication cysts. Both computed tomography and magnetic resonance are routinely used to evaluate these lesions. Although computed tomography offers superior spatial resolution, magnetic resonance is useful in differentiating cysts that contain proteinaceous material from solid lesions. Occasionally, cysts arise from solid lesions, such as thymoma or teratoma. Although cysts are alike in appearance, location helps narrowing the differential diagnoses.

  3. Increase of cerebral blood flow at high altitude

    DEFF Research Database (Denmark)

    Lassen, N A

    1992-01-01

    CBF increases with acute hypoxia despite the opposing vasoconstrictor effects of the drop in pCO2 caused by hyperventilation. Maintaining normocapnia by adding CO2 the hypoxic CBF responsiveness about doubles. As we have shown recently by this test, the hypoxic CBF response is not blunted but rat...... vasodilatation cannot explain the usual (mild) form of AMS. But it may well be involved in the pathogenesis of the rare but severe cerebral form of AMS, as prolonged increased capillary pressure in vasodilated areas could lead to vasogenic cerebral edema....

  4. Feeding method and health outcomes of children with cerebral palsy.

    Science.gov (United States)

    Rogers, Brian

    2004-08-01

    Disorders of feeding and swallowing are common in children with cerebral palsy. Feeding and swallowing disorders have significant implications for development, growth and nutrition, respiratory health, gastrointestinal function, parent-child interaction, and overall family life. Assessments need to be comprehensive in scope and centered around the medical home. Oral feeding interventions for children with cerebral palsy may be effective in promoting oral motor function, but have not been shown to be effective in promoting feeding efficiency or weight gain. Feeding gastrostomy tubes are a reasonable alternative for children with severe feeding and swallowing problems who have had poor weight gain.

  5. A comparison of iopamidol and iohexol in cerebral angiography.

    Science.gov (United States)

    Pelz, D M; Fox, A J; Viñuela, F; Lylyk, P

    1988-01-01

    Iopamidol and iohexol, the new nonionic low-osmolality contrast agents, have both been shown to be safe, effective, and better tolerated than conventional ionic agents for cerebral angiography. In this randomized, double-blind study involving 40 patients, these two agents were compared for adverse effects, radiographic quality, and patient tolerance. No significant differences were observed in 220 injections. Because we found iopamidol and iohexol to be equally safe and effective for cerebral angiography, the choice of which contrast agent to use should be based on other considerations.

  6. Cerebral microbleeds (CMBs) – relevance for mechanisms of cerebral hemorrhage – analysis of 24 MRI evaluated patients

    Science.gov (United States)

    Ghelmez, D; Sorin Tuţă, S; Popa, C

    2013-01-01

    Abstract Introduction. The new MRI techniques introduced in the last decade allowed the detection of cerebral microbleeds (CMBs) in different groups of diseases: stroke, Alzheimer disease, vascular dementia or healthy people of advanced age. CMBs are radiologically defined as small, rounded, homogeneous, hypointense lesions on T2*-weighed gradient-recalled echo (T2*-GRE) sequences. Objective and Method. We evaluated the prevalence, number and location of CBMs in a cohort of 26 consecutive cerebral hemorrhage patients admitted in the National Institute of Neurology and Neurovascular Diseases. We also assessed the association between CMB, classical vascular risk factors and small vessel disease. Results and Conclusions. From the 26 patients, 2 patients had secondary intracerebral hemorrhage (ICH) (hemorrhage in metastasis, respectively a cavernoma). From the 24 ICH patients 12 have had at least 1 CMB lesion. The average volume of the cerebral hemorrhage was larger in patients with CMBs, with a relative increase of 42%. Small vessel disease was associated with a significant increase in the presence of CMBs (relative increase of 86%). In both cases, however, since the number of patients enrolled was small, the correlations did not reach statistical significance. PMID:24868257

  7. Oligodendrogenesis after Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ruilan eZhang

    2013-10-01

    Full Text Available AbstractNeural stem cells in the subventricular zone (SVZ of the lateral ventricle of adult rodent brain generate oligodendrocyte progenitor cells (OPCs that disperse throughout the corpus callosum and striatum where some of OPCs differentiate into mature oligodendrocytes. Studies in animal models of stroke demonstrate that cerebral ischemia induces oligodendrogenesis during brain repair processes. This article will review evidence of stroke-induced proliferation and differentiation of OPCs that are either resident in white matter or are derived from SVZ neural progenitor cells and of therapies that amplify endogenous oligodendrogenesis in ischemic brain.

  8. Cerebral oxygenation after birth

    DEFF Research Database (Denmark)

    Hessel, Trine W; Hyttel-Sorensen, Simon; Greisen, Gorm

    2014-01-01

    AIM: To compare absolute values of regional cerebral tissue oxygenation (cStO2 ) during haemodynamic transition after birth and repeatability during steady state for two commercial near-infrared spectroscopy (NIRS) devices. METHODS: In a prospective observational study, the INVOS 5100C and FORE......: The INVOS and FORE-SIGHT cStO2 estimates showed oxygenation-level-dependent difference during birth transition. The better repeatability of FORE-SIGHT could be due to the lower response to change in saturation....

  9. Resting cerebral blood flow

    Science.gov (United States)

    Ances, B M.; Sisti, D; Vaida, F; Liang, C L.; Leontiev, O; Perthen, J E.; Buxton, R B.; Benson, D; Smith, D M.; Little, S J.; Richman, D D.; Moore, D J.; Ellis, R J.

    2009-01-01

    Objective: HIV enters the brain soon after infection causing neuronal damage and microglial/astrocyte dysfunction leading to neuropsychological impairment. We examined the impact of HIV on resting cerebral blood flow (rCBF) within the lenticular nuclei (LN) and visual cortex (VC). Methods: This cross-sectional study used arterial spin labeling MRI (ASL-MRI) to measure rCBF within 33 HIV+ and 26 HIV− subjects. Nonparametric Wilcoxon rank sum test assessed rCBF differences due to HIV serostatus. Classification and regression tree (CART) analysis determined optimal rCBF cutoffs for differentiating HIV serostatus. The effects of neuropsychological impairment and infection duration on rCBF were evaluated. Results: rCBF within the LN and VC were significantly reduced for HIV+ compared to HIV− subjects. A 2-tiered CART approach using either LN rCBF ≤50.09 mL/100 mL/min or LN rCBF >50.09 mL/100 mL/min but VC rCBF ≤37.05 mL/100 mL/min yielded an 88% (29/33) sensitivity and an 88% (23/26) specificity for differentiating by HIV serostatus. HIV+ subjects, including neuropsychologically unimpaired, had reduced rCBF within the LN (p = 0.02) and VC (p = 0.001) compared to HIV− controls. A temporal progression of brain involvement occurred with LN rCBF significantly reduced for both acute/early (<1 year of seroconversion) and chronic HIV-infected subjects, whereas rCBF in the VC was diminished for only chronic HIV-infected subjects. Conclusion: Resting cerebral blood flow (rCBF) using arterial spin labeling MRI has the potential to be a noninvasive neuroimaging biomarker for assessing HIV in the brain. rCBF reductions that occur soon after seroconversion possibly reflect neuronal or vascular injury among HIV+ individuals not yet expressing neuropsychological impairment. GLOSSARY AEH = acute/early HIV infection; ANOVA = analysis of variance; ASL-MRI = arterial spin labeling MRI; CART = classification and regression tree; CBF = cerebral blood flow; CH = chronic HIV

  10. Thrombosis of the great cerebral vein in a hemodialysis patient.

    Science.gov (United States)

    Ratkovic, Marina; Basic-Jukic, Nikolina; Gledovic, Branka; Radunovic, Danilo

    2014-01-01

    Cerebral venous thrombosis is a rare condition with various clinical presentations which may delay diagnosis. It is frequently associated with severe consequences. We present the first documented case of thrombosis of the great cerebral vein in a hemodialysis patient. A 29-year-old female patient with end-stage renal disease of unknown etiology was admitted to a hospital with altered consciousness and nausea. Severe headache in the right parietal area had started 2 days before. On examination, she was in the poor overall condition, dysartric, with a severe nystagmus. Urgent brain multislice computerized tomography and magnetic resonance imaging revealed thrombosis of the great cerebral vein with hypodense zones in hypothalamus, thalamus and basal ganglia. She was treated with heparin bolus of 25000 IU with a favorable outcome. Detailed examination demonstrated increased lupus anticoagulant (LA) 1 and LA2 and increased LA1/LA2. Control magnetic resonance imaging performed 1 year later revealed multiple vascular lesions within the brain. Acetylsalicylate was introduced in therapy. Thrombosis of the cerebral veins should be suspected in patients with end-stage renal disease, altered neurological status and signs of increased intracranial pressure.

  11. Maduración cerebral y desarrollo cognoscitivo

    Directory of Open Access Journals (Sweden)

    Mónica Rosselli

    2003-01-01

    Full Text Available La maduración cerebral se correlaciona con muchos de los cambios cognoscitivos y de comportamiento observados durante la infancia y la adolescencia. En este artículo se revisa el concepto de maduración cerebral y su asociación con el desarrollo de la preferencia manual, del lenguaje verbal y de la función ejecutiva en el niño. Se describe el incremento de las arborizaciones dendríticas como el cambio cortical más importante asociado a la adquisición de funciones cognoscitivas complejas. Se asocia la maduración del hemisferio derecho con la conducta emocional y la maduración del hemisferio izquierdo con el lenguaje. La maduración de las áreas prefrontales se correlaciona con el desarrollo de las funciones ejecutivas. Se presentan ejemplos específicos sobre la existencia de asimetría cerebral motriz desde el nacimiento y sobre la lateralización posterior de funciones visuales, auditivas y táctiles. Se analiza la participación cualitativamente diferente de los hemisferios cerebrales en los procesos cognoscitivos durante las distintas etapas del desarrollo del niño. Finalmente, se presentan algunos ejemplos de las secuelas cognoscitivas secundarias a lesiones cerebrales tempranas como un método más para entender la ontogenia de la asimetría cerebral

  12. Maduración cerebral y desarrollo cognoscitivo

    Directory of Open Access Journals (Sweden)

    Mónica Roselli

    2003-05-01

    Full Text Available La maduración cerebral se correlaciona con muchos de los cambios cognoscitivos y de comportamiento observados durante la infancia y la adolescencia. En este artículo se revisa el concepto de maduración cerebral y su asociación con el desarrollo de la preferencia manual, del lenguaje verbal y de la función ejecutiva en el niño. Se describe el incremento de las arborizaciones dendríticas como el cambio cortical más importante asociado a la adquisición de funciones cognoscitivas complejas. Se asocia la maduración del hemisferio derecho con la conducta emocional y la maduración del hemisferio izquierdo con el lenguaje. La maduración de las áreas prefrontales se correlaciona con el desarrollo de las funciones ejecutivas. Se presentan ejemplos específicos sobre la existencia de asimetría cerebral motriz desde el nacimiento y sobre la lateralización posterior de funciones visuales, auditivas y táctiles. Se analiza la participación cualitativamente diferente de los hemisferios cerebrales en los procesos cognoscitivos durante las distintas etapas del desarrollo del niño. Finalmente, se presentan algunos ejemplos de las secuelas cognoscitivas secundarias a lesiones cerebrales tempranas como un método más para entender la ontogenia de la asimetría cerebral.

  13. Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis

    Science.gov (United States)

    Kim, Su-Hyun; Hyun, Jae-Won; Joung, AeRan; Lee, Sang Hyun; Kim, Ho Jin

    2016-01-01

    We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD. PMID:27936193

  14. Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis.

    Science.gov (United States)

    Kim, Su-Hyun; Hyun, Jae-Won; Joung, AeRan; Lee, Sang Hyun; Kim, Ho Jin

    2016-01-01

    We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD.

  15. [Bony Bankart lesions].

    Science.gov (United States)

    Spiegl, U J; Braun, S; Euler, S A; Warth, R J; Millett, P J

    2014-12-01

    Fractures of the anteroinferior glenoid rim, termed bony Bankart lesions, have been reported to occur in up to 22% of first time anterior shoulder dislocations. The primary goal of treatment is to create a stable glenohumeral joint and a good shoulder function. Options for therapeutic intervention are largely dependent on the chronicity of the lesion, the activity level of the patient and postreduction fracture characteristics, such as the size, location and number of fracture fragments. Non-operative treatment can be successful for small, acute fractures, which are anatomically reduced after shoulder reduction. However, in patients with a high risk profile for recurrent instability initial Bankart repair is recommended. Additionally, bony fixation is recommended for acute fractures that involve more than 15-20% of the inferior glenoid diameter. On the other hand chronic fractures are generally managed on a case-by-case basis depending on the amount of fragment resorption and bony erosion of the anterior glenoid with high recurrence rates under conservative therapy. When significant bone loss of the anterior glenoid is present, anatomical (e.g. iliac crest bone graft and osteoarticular allograft) or non-anatomical (e.g. Latarjet and Bristow) reconstruction of the anterior glenoid is often indicated.

  16. Uncommon Causes of Cerebral Microbleeds.

    Science.gov (United States)

    Noorbakhsh-Sabet, Nariman; Pulakanti, Varun Chandi; Zand, Ramin

    2017-10-01

    Cerebral microbleeds (CMBs) are small and round perivascular hemosiderin depositions detectable by gradient echo sequences or susceptibility-weighted imaging. Cerebral microbleeds are common among patients with hypertension, cerebral ischemia, or cerebral amyloid angiopathy. In this article, we describe uncommon causes of CMBs. We searched Pubmed with the keyword CMBs for relevant studies and looked for different uncommon causes of CMBs. CMBs have several uncommon etiologies including posterior reversible encephalopathy syndrome, infective endocarditis, brain radiation therapy, cocaine abuse, thrombotic thrombocytopenic purpura, traumatic brain injury, intravascular lymphomatosis or proliferating angio-endotheliomatosis, moyamoya disease, sickle cell anemia/β-thalassemia, cerebral autosomal dominant arteriopathy subcortical infarcts, and leukoencephalopathy (CADASIL), genetic syndromes, or obstructive sleep apnea. Understanding the uncommon causes of CMBs is not only helpful in diagnosis and prognosis of some of these rare diseases, but can also help in better understanding different pathophysiology involved in the development of CMBs. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. Distribution and natural course of intracranial vessel wall lesions in patients with ischemic stroke or TIA at 7.0 tesla MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kolk, Anja G. van der; Luijten, Peter R.; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); Zwanenburg, Jaco J.M. [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Brundel, Manon; Biessels, Geert Jan [University Medical Center Utrecht, Department of Neurology, Utrecht (Netherlands); Visser, Fredy [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); Philips Healthcare, Best (Netherlands)

    2015-06-01

    Previous studies using intracranial vessel wall MRI techniques showed that over 50 % of patients with ischemic stroke or TIA had one or more intracranial vessel wall lesions. In the current study, we assessed the preferential location of these lesions within the intracranial arterial tree and their potential changes over time in these patient groups. Forty-nine patients with ischemic stroke (n = 25) or TIA (n = 24) of the anterior cerebral circulation underwent 7.0 T MRI, including a T{sub 1}-weighted magnetization-preparation inversion recovery turbo-spin-echo (MPIR-TSE) sequence within one week and approximately one month after symptom onset. Intracranial vessel wall lesions were scored for multiple locations within the arterial tree and differences between one-week and one-month images. At baseline, 132 intracranial vessel wall lesions were found in 41 patients (84 %), located primarily in the anterior cerebral circulation (74 %), with a preferential location in the distal internal carotid artery and M1 and M2 segments of the middle cerebral artery. During follow-up, presence or enhancement patterns changed in 14 lesions (17 %). A large burden of intracranial vessel wall lesions was found in both the anterior and posterior cerebral circulation. Most lesions were found to be relatively stable, possibly indicating a more generalized atherosclerotic process. (orig.)

  18. Estimating total cerebral microinfarct burden from diffusion-weighted imaging

    Science.gov (United States)

    Auriel, Eitan; Westover, M. Brandon; Bianchi, Matt T; Reijmer, Yael; Martinez-Ramirez, Sergi; Ni, Jun; Van Etten, Ellis; Frosch, Matthew P; Fotiadis, Panagiotis; Schwab, Kris; Vashkevich, Anastasia; Boulouis, Grégoire; Younger, Alayna P; Johnson, Keith A; Sperling, Reisa A; Hedden, Trey; Gurol, M. Edip; Viswanathan, Anand; Greenberg, Steven M

    2015-01-01

    Background and Purpose Cerebral microinfarcts (CMI) are important contributors to vascular cognitive impairment. MRI diffusion-weighted imaging (DWI) hyperintensities have been suggested to represent acute CMI. We aim to describe a mathematical method for estimating total number of CMI based on the presence of incidental DWI lesions. Methods We reviewed MRI scans of subjects with cognitive decline, cognitively normal subjects and previously reported subjects with past intracerebral hemorrhage (ICH). Based on temporal and spatial characteristics of DWI lesions we estimated the annual rate of CMI needed to explain the observed rate of DWI lesion detection in each group. To confirm our estimates we performed extensive sampling for CMI in the brain of a deceased subject with past lobar ICH who found to have a DWI lesion during life. Results Clinically silent DWI lesions were present in 13 of 343 (3.8%) cognitively impaired, and 10 of 199 (5%) cognitively intact normal non-ICH patients, both lower than the incidence in the past ICH patients (23 of 178, 12.9%, p<0.0006). The predicted annual incidence of CMI ranges from 16 to 1566 for non-ICH and 50 to 5041 for ICH individuals. Histologic sampling revealed a total of 60 lesions in 32 sections. Based on previously reported methods, this density of CMI yields an estimated total brain burden MLE of 9321 CMIs (95% CI 7255–11990). Conclusions Detecting even a single DWI lesion suggests an annual incidence of hundreds of new CMI. The cumulative effects of these lesions may directly contribute to small-vessel-related vascular cognitive impairment PMID:26159796

  19. A longitudinal study of cerebral glucose metabolism, MRI, and disability in patients with MS

    DEFF Research Database (Denmark)

    Blinkenberg, M; Jensen, C.V.; Holm, S;

    1999-01-01

    in longitudinal studies of MS patients, but little is known about the associated changes in cerebral neural function. METHODS: The authors studied 10 patients with clinically definite MS who underwent serial measurements of CMRglc, MRI T2-weighted total lesion area (TLA), and clinical evaluation of disability...... (Expanded Disability Status Scale [EDSS]) over a period of approximately 2 years (three examinations). CMRglc was calculated using PET and 18-fluorodeoxyglucose (FDG). RESULTS: The global cortical CMRglc decreased with time (p...OBJECTIVE: To study the time-related changes in cerebral metabolic rate of glucose (CMRglc) in MS patients and to correlate these with changes in MRI lesion load and disability. BACKGROUND: Measurements of MRI lesion load and neurologic disability are used widely to monitor disease progression...

  20. Quantitative MRI analysis of dynamic enhancement of focal liver lesions

    Directory of Open Access Journals (Sweden)

    S. S. Bagnenko

    2012-01-01

    Full Text Available In our study 45 patients with different focal liver lesions (110 nodules were examined using high field MR-system (1,5 T. During this investigation quantitative MRI analysis of dynamic enhancement of various hepatic lesions and parenchymatous organs of abdomen were performed. It was shown that quantitative evaluation of enhanced MRI improves understanding of vascular transformation processes in pathologic hepatic focuses and in liver itself that is important for differential diagnoses of these diseases.

  1. Cerebral sinus venous thrombosis

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-01-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  2. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  3. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I. [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  4. Cerebral cartography and connectomics.

    Science.gov (United States)

    Sporns, Olaf

    2015-05-19

    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 dynamics of functional brain connectivity, the definition of areal parcellations and their hierarchical organization into large-scale networks, the extension of whole-brain connectivity to cellular-scale networks, and the mapping of structure/function relations in empirical recordings and computational models. Successfully addressing these challenges will require extensions of methods and tools from network science to the mapping and analysis of human brain connectivity data. The emerging view that the brain is more than a collection of areas, but is fundamentally operating as a complex networked system, will continue to drive the creation of ever more detailed and multi-modal network maps as tools for on-going exploration and discovery in human connectomics. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  5. Bruxism Control in a Child with Cerebral Palsy

    Science.gov (United States)

    Oliveira, Cristiana Aroeira G. R.; de Paula, Viviane Andrade Cancio; Portela, Maristela Barbosa; Primo, Laura Salignac Guimarães; Castro, Gloria Fernanda

    2011-01-01

    Cerebral palsy (CP) is one of the most severe childhood disabilities due to a lesion in the developing brain. Oral conditions often observed in this pathogenic are a tendency for the delayed eruption of permanent molars, higher percentages of malocclusion and parafunctional habits, including bruxism. The significance of oral conditions observed in CP patients demonstrates the need for intensive home and professional care for these individuals. This paper presents a 7-year-old boy, with cerebral palsy, severe mental retardation, who had high abrasion wear of the primary teeth related to bruxism. Dental care was carried out under oxide-induced sedation, and management of the bruxism was achieved after the use of a resin acrylic protective appliance fixed on both sides of the mandibula. The treatment performed offered efficiency advantages, was clinically viable, and should be a valuable option to practitioners considering appliance therapy to control parafunctional behavior. PMID:21991456

  6. Spatial characteristics of cerebral polyopia: a case study.

    Science.gov (United States)

    Cornblath, W T; Butter, C M; Barnes, L L; Hasselbach, M M

    1998-12-01

    A 41-year-old woman showed bilateral monocular polyopia and an incomplete, right-sided homonymous hemianopia following bilateral cerebral strokes confirmed by neuroimaging. She was tested with briefly-presented visual stimuli to determine whether her polyopic images varied with visual field position of stimuli which evoked them. Stimuli close to her scotoma elicited polyopic images at shorter latency and higher probability than did stimuli more distant from it. RS could maintain stable fixation on small stimuli, suggesting that eye movements were not responsible for her polyopia. We discuss the possibility that cerebral polyopia is due to recoding of visual receptive fields in primary visual cortex and that bilateral occipital lesions are a causative factor in the genesis of the disorder.

  7. Word and face recognition deficits following posterior cerebral artery stroke

    DEFF Research Database (Denmark)

    Kuhn, Christina D.; Asperud Thomsen, Johanne; Delfi, Tzvetelina

    2016-01-01

    Abstract Recent findings have challenged the existence of category specific brain areas for perceptual processing of words and faces, suggesting the existence of a common network supporting the recognition of both. We examined the performance of patients with focal lesions in posterior cortical...... areas to investigate whether deficits in recognition of words and faces systematically co-occur as would be expected if both functions rely on a common cerebral network. Seven right-handed patients with unilateral brain damage following stroke in areas supplied by the posterior cerebral artery were...... included (four with right hemisphere damage, three with left, tested at least 1 year post stroke). We examined word and face recognition using a delayed match-to-sample paradigm using four different categories of stimuli: cropped faces, full faces, words, and cars. Reading speed and word length effects...

  8. Mental Symptoms in Huntington's Disease and a Possible Primary Aminergic Neuron Lesion

    Science.gov (United States)

    Mann, J. John; Stanley, Michael; Gershon, Samuel; Rossor, M.

    1980-12-01

    Monoamine oxidase activity was higher in the cerebral cortex and basal ganglia of patients dying from Huntington's disease than in controls. Enzyme kinetics and multiple substrate studies indicated that the increased activity was due to elevated concentrations of monoamine oxidase type B. Concentrations of homovanillic acid were increased in the cerebral cortex but not in the basal ganglia of brains of patients with Huntington's disease. These changes may represent a primary aminergic lesion that could underlie some of the mental symptoms of this disease.

  9. Biomimetic Remineralization of Carious Lesions by Self-Assembling Peptide.

    Science.gov (United States)

    Kind, L; Stevanovic, S; Wuttig, S; Wimberger, S; Hofer, J; Müller, B; Pieles, U

    2017-07-01

    Caries is the most common disease in the world. Great efforts have been undertaken for prevention and to identify a regenerative treatment solution for dental caries. Self-assembling β-sheet forming peptides have previously shown to form 3-dimensional fiber networks supporting tissue regeneration. In particular, the self-assembling peptide P11-4 has shown potential in the treatment and prevention of dental caries. It has previously been shown that application of monomeric P11-4 solution to early carious lesions can increase net mineral gain by forming de novo hydroxyapatite crystals. The hypothesis for the mode of action was that monomeric self-assembling peptide P11-4 diffuses into the subsurface lesion body and assembles therein into higher order fibrils, facilitating mineralization of the subsurface volume by mimicking the natural biomineralization of the tooth enamel, and it remains within the lesion body as a scaffold built-in by the newly formed hydroxyapatite. The aim of the present study was to investigate the mechanism of action of the self-assembling peptide P11-4 supporting mineralization of carious enamel. By various analytical methods, it could be shown that the self-assembling peptide P11-4 diffuses into the subsurface lesion, assembles into higher formed aggregates throughout the whole volume of the lesion, and supports nucleation of de novo hydroxyapatite nanocrystals and consequently results in increased mineral density within the subsurface carious lesion. The results showed that the application of self-assembling peptide P11-4 can facilitate the subsurface regeneration of the enamel lesion by supporting de novo mineralization in a similar mode of action as has been shown for the natural formation of dental enamel.

  10. Endothelin Receptors, Mitochondria and Neurogenesis in Cerebral Ischemia

    Science.gov (United States)

    Gulati, Anil

    2016-01-01

    Background: Neurogenesis is most active during pre-natal development, however, it persists throughout the human lifespan. The putative role of mitochondria in neurogenesis and angiogenesis is gaining importance. Since, ETB receptor mediated neurogenesis and angiogenesis has been identified, the role of these receptors with relevance to mitochondrial functions is of interest. Methods: In addition to work from our laboratory, we undertook an extensive search of bibliographic databases for peer-reviewed research literature. Specific technical terms such as endothelin, mitochondria and neurogenesis were used to seek out and critically evaluate literature that was relevant. Results: The ET family consists of three isopeptides (ET-1, ET-2 and ET-3) that produce biological actions by acting on two types of receptors (ETA and ETB). In the central nervous system (CNS) ETA receptors are potent constrictors of the cerebral vasculature and appear to contribute in the causation of cerebral ischemia. ETA receptor antagonists have been found to be effective in animal model of cerebral ischemia; however, clinical studies have shown no efficacy. Mitochondrial functions are critically important for several neural development processes such as neurogenesis, axonal and dendritic growth, and synaptic formation. ET appears to impair mitochondrial functions through activation of ETA receptors. On the other hand, blocking ETB receptors has been shown to trigger apoptotic processes by activating intrinsic mitochondrial pathway. Mitochondria are important for their role in molecular regulation of neurogenesis and angiogenesis. Stimulation of ETB receptors in the adult ischemic brain has been found to promote angiogenesis and neurogenesis mediated through vascular endothelial growth factor and nerve growth factor. It will be interesting to investigate the effect of ETB receptor stimulation on mitochondrial functions in the CNS following cerebral ischemia. Conclusion: The findings of this

  11. HTLV-I associated myelopathy with multiple spotty areas in cerebral white matter and brain stem by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hara, Yasuo; Takahashi, Mitsuo; Yoshikawa, Hiroo; Yorifuji, Shirou; Tarui, Seiichiro

    1988-01-01

    A 48-year-old woman was admitted with complaints of urinary incontinence and gait disturbance, both of which had progressed slowly without any sign of remission. Family history was not contributory. Neurologically, extreme spasticity was recoginized in the lower limbs. Babinski sign was positive bilaterally. Flower-like atypical lymphocytes were seen in blood. Positive anti-HTLV-I antibody was confirmed in serum and spinal fluid by western blot. She was diagnosed as having HTLV-I associated myelopathy (HAM). CT reveald calcification in bilateral globus pallidus, and MRI revealed multiple spotty areas in cerebral white matter and brain stem, but no spinal cord lesion was detectable. Electrophysiologically, brain stem auditory evoked potential (BAEP) suggested the presence of bilateral brain stem lesions. Neither median nor posterior tibial nerve somatosensory evoked potentials were evoked, a finding suggesting the existence of spinal cord lesion. In this case, the lesion was not confined to spinal cord, it was also observed in brain stem and cerebral white matter. Such distinct lesions in cerebral white matter and brain stem have not been reported in patients with HAM. It is suggested that HTLV-I is probably associated with cerebral white matter and brain stem.

  12. HISTOMORPHOLOGICAL SPECTRUM OF BREAST LESIONS

    Directory of Open Access Journals (Sweden)

    Kiran H. S

    2016-07-01

    Full Text Available BACKGROUND Cancer of the breast is the second most common cause of cancer in women. Benign or malignant lesions presenting as mass in the breast causes anxiety to the patients and the family members. AIMS AND OBJECTIVES OF THE STUDY 1. To classify different types of lesions of breast, both benign and malignant. 2. Histomorphological study of various types of benign and malignant breast lesions. 3. To study spectrum of lesions associated with benign and malignant breast diseases. SETTING AND DESIGN All the breast biopsies, lumpectomies, and mastectomy specimens presenting to Department of Pathology of our institution between June 2012 to June 2014. MATERIALS AND METHODS A sample size of 100 cases are included in this study. Clinical details are taken from records. The specimens of breast sent to the Department of Pathology are processed by routine histopathological techniques. Histopathological features are studied on haematoxylin and eosin-stained sections. STATISTICAL ANALYSIS Statistically, the test of proportion is used to obtain the frequency of all lesions. Chi-square test, which is used to find the association between the spectrum of lesions showed a p value of 0.0438 and hence the study was considered significant. RESULTS In our study, out of 100 cases, malignant breast lesions constituted the majority of the lesions comprising of 49 cases (49%, followed by benign lesions comprising 46 cases (46% and the inflammatory lesions comprising 5 cases (5%. Among benign lesions, fibrocystic disease was the predominant lesion comprising of 39 cases (41%, followed by fibroadenoma comprising 26 cases (28%, which is followed by 13 cases (14% of fibrocystic disease with columnar cell change and 8 cases (9% of sclerosing adenosis. Among malignant lesions, invasive ductal carcinoma (NST type was the most common lesion comprising 31 cases (61% followed by 11 cases (21% of invasive lobular carcinoma. Invasive papillary carcinoma and medullary carcinoma

  13. Improved differentiation between MS and vascular brain lesions using FLAIR* at 7 Tesla

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    Kilsdonk, Iris D.; Wattjes, Mike P.; Lopez-Soriano, Alexandra; Jong, Marcus C. de; Graaf, Wolter L. de; Conijn, Mandy M.A.; Barkhof, Frederik [VU University Medical Center, Department of Radiology, De Boelelaan 1118, HZ, Amsterdam (Netherlands); Kuijer, Joost P.A. [VU University Medical Center, Department of Physics and Medical Technology, Amsterdam (Netherlands); Polman, Chris H. [VU University Medical Center, Department of Neurology, Amsterdam (Netherlands); Luijten, Peter R. [University Medical Center, Department of Radiology, Utrecht (Netherlands); Geurts, Jeroen J.G. [VU University, Department of Anatomy and Neurosciences, Amsterdam (Netherlands); Geerlings, Mirjam I. [University Medical Center, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands)

    2014-04-15

    To investigate whether a new magnetic resonance image (MRI) technique called T2*-weighted fluid attenuation inversion recovery (FLAIR*) can differentiate between multiple sclerosis (MS) and vascular brain lesions, at 7 Tesla (T). We examined 16 MS patients and 16 age-matched patients with (risk factors for) vascular disease. 3D-FLAIR and T2*-weighted images were combined into FLAIR* images. Lesion type and intensity, perivascular orientation and presence of a hypointense rim were analysed. In total, 433 cerebral lesions were detected in MS patients versus 86 lesions in vascular patients. Lesions in MS patients were significantly more often orientated in a perivascular manner: 74 % vs. 47 % (P < 0.001). Ten MS lesions (2.3 %) were surrounded by a hypointense rim on FLAIR*, and 24 MS lesions (5.5 %) were hypointense on T2*. No lesions in vascular patients showed any rim or hypointensity. Specificity of differentiating MS from vascular lesions on 7-T FLAIR* increased when the presence of a central vessel was taken into account (from 63 % to 88 %), most obviously for deep white matter lesions (from 69 % to 94 %). High sensitivity remained (81 %). 7-T FLAIR* improves differentiation between MS and vascular lesions based on lesion location, perivascular orientation and presence of hypointense (rims around) lesions. circle A new MRI technique T2*-weighted fluid attenuation inversion recovery (FLAIR*) was investigated. circle FLAIR* at 7-T MRI combines FLAIR and T2* images into a single image. circle FLAIR* at 7 T does not require enhancement with contrast agents. (orig.)

  14. Heart rate variability in patients with chronic cerebral ischemia

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    Smyshlaeva О.М.

    2010-12-01

    Full Text Available The purpose of the work is to estimate the status of autonomic nervous system in patients with chronic cerebral ischemia by means of the analysis of heart rate variability at various stages of disease. 120 patients with chronic cerebral ischemia aged from 45 to 65 took part in the research. The comparison group included 30 patients with an arterial hypertension and without chronic cerebral ischemia. Heart rate variability analisis included time-domain and frequency-domain methods of five-minute sequence of the electrocardiographic intervals registered in at rest and in or-thostatic probe. The results of research have shown, that autonomic disorders with prevalence of sympathetic nervous system accompany initial implications of chronic cerebral ischemia. The second stage of disease is characterized by depression of activity of both autonomic, and central regulation. The expressed depression of autonomic maintenance of regulation of heart rhythm of both from sympathetic, and from parasympathetic nervous system was observed at the third stage of chronic cerebral ischemia

  15. CEREBRAL PALSY AND MUSIC ACHIEVEMENT

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    Miodrag L. STOSHLJEVIKJ

    2008-12-01

    Full Text Available Pupils with cerebral palsy attend elementary education accordind to a regular and special teaching plan and program. Regular school curriculum was reformed in 1992, while special plan and program has not been changed and adapted according to pupil’s needs and capacities. Music is one of the best means of expressing oneself and plays a very important role in the development of every child, the child with cerebral palsy in particular.In order to test the possibility of pupils with cerebral palsy, with and without mental retardation, to apprehend the actual program content, we have conducted research on musical achievement of children with cerebral palsy. During 2007 a research was carried out, on the sample of 27 pupils with cerebral palsy and mild mental retardation who attended classes in the school “Miodrag Matikj”, and a sample of16 students with cerebral palsy without mental retardation who attended the school “Dr. Dragan Hercog” in Belgrade.Results of the research, as well as analysis of music curriculum content, indicated that the capacities of students with cerebral palsy to carry out the curriculum tasks require special approach and methodology. Therefore, we introduced some proposals to overcome the difficulties in fulfilling music curriculum demands of those pupils. We made special emphasis on the use of computer based Assistive technology which facilitates the whole process to a large extent.

  16. Thalamic Lesions: A Radiological Review

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    Dimitri Renard

    2014-01-01

    Full Text Available Background. Thalamic lesions are seen in a multitude of disorders including vascular diseases, metabolic disorders, inflammatory diseases, trauma, tumours, and infections. In some diseases, thalamic involvement is typical and sometimes isolated, while in other diseases thalamic lesions are observed only occasionally (often in the presence of other typical extrathalamic lesions. Summary. In this review, we will mainly discuss the MRI characteristics of thalamic lesions. Identification of the origin of the thalamic lesion depends on the exact localisation inside the thalamus, the presence of extrathalamic lesions, the signal changes on different MRI sequences, the evolution of the radiological abnormalities over time, the history and clinical state of the patient, and other radiological and nonradiological examinations.

  17. Characteristic analysis of secondary epileptic attack of senile arteriosclerotic cerebral infarction%老年人动脉硬化性脑梗死继发癫痫发作的特点分析

    Institute of Scientific and Technical Information of China (English)

    曹绪政; 兰杰; 徐建民; 邱朝晖

    2002-01-01

    Senile cerebral apoplexy is mainly caused by arteriosclerosis, which is also an important reason to epileptic attack. We analyzed clinical data of 1 383 in patient cerebral infarction cases from 211th Hospital of PLA from January 1996 to October 2001 in which there were 79 secondary epileptic attack of senile arteriosclerotic cerebral infarction.Results were shown followed.

  18. MEK inhibitor treatment is effective in a patient with metastatic carcinoma of the ampulla of Vater with BRAF and NRAS mutations shown by next-generation sequencing.

    Science.gov (United States)

    Tahover, Esther; Bar Shalom, Rachel; Bogot, Naama; Kelsen, David; Gabizon, Alberto

    2016-07-01

    Here, we present a case of an 84-year-old woman who developed obstructive jaundice and was diagnosed with nonoperable adenocarcinoma originating from the ampulla of Vater, a lethal disease with a median overall survival of less than a year. Her tumor was examined by next-generation sequencing, which showed BRAF and NRAS mutations. To target these mutations, a MEK inhibitor was chosen for treatment. The patient has been treated with a MEK inhibitor for the last 12 months since diagnosis, with clinical and laboratory improvement and manageable side effects. PET-computed tomography imaging has shown stable disease or improvement in the primary and metastatic lesions. This is the first case report of an ampulla of a Vater cancer patient with NRAS and BRAF mutations, identified in next-generation sequencing, and treated successfully with a MEK inhibitor.

  19. CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS

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    N. V. Pizova

    2014-01-01

    Full Text Available Objective: to determine the incidence of atherosclerotic lesions in the carotid and vertebral arteries of young patients from Doppler ultrasound data and to compare the quantitatively assessed traditional risk factors of coronary heart disease (CHD with severe extracranial artery atherosclerotic lesion.Subjects and methods. Doppler ultrasound was carried out evaluating structural changes in the aortic arch branches in 1563 railway transport workers less than 45 years of age. A separate sample consisted of 68 young people with carotid atherosclerotic changes, in whom traditional risk factors for CHD were studied, so were in a control group of individuals without atherosclerotic changes (n = 38.Results. Among the examinees, carotid atherosclerotic lesion was detected in 112 (7.1 % cases, the increase in the rate of atherosclerotic plaques in patients aged 35–45 years being 9.08 %; that in the rate of local intima-media thickness in those aged 31–40 years being 5.1 %. Smoking (particularly that along with hypercholesterolemia and a family history of cardiovascular diseases, obesity (along with low activity, and emotional overstrain were defined as important risk factors in the young patients. Moreover, factor analysis has shown that smoking,hypertension, and early cardiovascular pathology in the next of kin makes the greatest contribution to the development of carotid atherosclerotic lesion.Conclusion. Among the patients less than 45 years of age, carotid and vertebral artery atherosclerotic changes were found in 112 (7.1 % cases, which were more pronounced in male patients. Smoking, particularly along with hypercholesterolemia and genetic predisposition to cardiovascular diseases, was a risk factor that had the highest impact on the degree of atherosclerotic lesion in the aortic arch branches of the young patients.

  20. CEREBRAL PALSY : ANTENATAL RISK FACTORS

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    Srinivasa Rao

    2015-05-01

    Full Text Available INTRODUCTION: Cerebral palsy (CP is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. AIM: To study the different antenatal maternal risk factors associated with cerebral palsy in the study group. MATERIA LS AND METHODS: Retrospective study was done to assess possible associated antenatal risk factors for cerebral palsy. Mothers of 100 cerebral palsy children were selected who are treated in Rani Chandramani Devi Hospital, a Government hospital in Visakhapa tn am, Andhra Pradesh State, India , from 2012 to 2014 and 100 controls, mothers of normal children were studied. Detailed antenatal history was obtained from the mothers of the children in both affected and control group. RESULTS: From the data, we conclude that the association of maternal anaemia with cerebral palsy is 7.3 times higher; association of maternal hypertension with cerebral palsy is 6.6 time higher, association with Pre - eclampsia is 6 times higher; association with Eclampsia is 8.6 times higher ; with antepartum haemorrhage, the association is 8.6 times higher and association of multiple pregnancy with cerebral palsy is 4.8 times higher than with controls. CONCLUSION: From this study of the role of antenatal risk factors, in the occurrence of cer ebral palsy in children it is concluded that the most common risk factor associated with cerebral palsy is the maternal anaemia and the other important risk factors associated being hypertension, pre eclampsia, eclampsia, antepartum haemorrhage and multipl e births.