WorldWideScience

Sample records for encephalomalacia

  1. Manifestation of magnetic source imaging in patients with refractory epilepsy and encephalomalacia

    International Nuclear Information System (INIS)

    Sun Jilin; Wu Jie; Li Sumin; Liu Lianxiang; Wu Yujin; Liu Changlin

    2005-01-01

    Objective: To evaluate the epileptic focus localization value of MSI in patients with refractory epilepsy and encephalomalacia. Method: MSI examination was proceeded in 11 patients with refractory epilepsy and encephalomalacia. Five of them were treated with gamma-knife; the others were treated with surgery. Results: In the five patients treated with gamma-knife, the result was satisfied in 3 patients, one patient improved significantly, the other one useless. The distance between the encephalomalacia and the epileptic focus was 4cm in one patient; one patient's encephalomalacia was located in right frontal-parietal lobe but the epileptic focus mainly located in right temporal lobe, only a little located around the encephalomalacia. Overall agreement among VEEG, ECoG and MEG (presence of concordant spikes with the same localization shown by three techniques) was obtained in three patients, the areas localized by ECoG were larger than VEEG and MSI in two patients. The localization was different in VEEG, MSI and ECoG in one patient, then he was given a resection of bilateral occipital epileptic focus. The results of patients treated with surgery were satisfied. Conclusion: The MSI localization of epileptic focus in patients with refractory epilepsy and encephalomalacia is precise, and it can direct the advanced clinical treatment. (authors)

  2. Parieto-occipital encephalomalacia in children; clinical and electrophysiological features of twenty-seven cases.

    Science.gov (United States)

    Karaoğlu, Pakize; Polat, Ayşe İpek; Yiş, Uluç; Hız, Semra

    2015-01-01

    Brain injuries occurring at a particular time may cause damages in well-defined regions of brain. Perinatal hypoxic ischemic encephalopathy and hypoglycemia are some of the most common types of brain injuries. Neonatal hypoglycemia can cause abnormal myelination in parietal and occipital lobes resulting in parieto-occipital encephalomalacia. There is a small number of studies about clinical and electroencephalographic (EEG) features of children with parieto-occipital encephalomalacia. They might have important neurologic sequelae such as cortical visual loss, seizures, and psychomotor retardation. We aimed to evaluate the causes of parieto-occipital encephalomalacia and evaluate the clinical and electrophysiological features of children with parieto-occipital encephalomalacia. We evaluated clinical features and EEGs of 27 children with parieto-occipital encephalomalacia. Descriptive statistics were used. Hospitalization during the neonatal period was the most common cause (88.9%) of parieto-occipital brain injury. Eleven patients (40.7%) had a history of neonatal hypoglycemia. Twenty-three patients (85.2%) had epilepsy and nine of the epileptic patients (39%) had refractory seizures. Most of the patients had bilateral (50%) epileptic discharges originating from temporal, parietal, and occipital lobes (56.2%). However, some patients had frontal sharp waves and some had continuous spike and wave discharges during sleep. Visual abnormalities were evident in 15 (55.6%) patients. Twenty-two (81.5%) had psychomotor retardation. Fine motor skills, social contact and language development were impaired more than gross motor skills. In our study, most of the patients with parieto-occipital encephalomalacia had an eventful perinatal history. Epilepsy, psychomotor retardation, and visual problems were common neurologic complications.

  3. Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis

    Science.gov (United States)

    Love, Rozalyn; Lee, Amy; Matiasek, April; Carter, William; Ylagan, Marissa

    2014-01-01

    Introduction Encephalomalacia in a developing fetus is a rare and devastating neurological finding on radiologic imaging. Maternal diabetic ketoacidosis (DKA) can lead to metabolic and vascular derangements which can cause fetal encephalomalacia. Case We report the case of a 27-year-old pregnant woman with White's Class C diabetes mellitus who presented in the 25th week of gestation with DKA. Four weeks after her discharge, marked fetal cerebral ventriculomegaly was noted on ultrasound. A subsequent fetal magnetic resonance imaging (MRI) demonstrated extensive, symmetric cystic encephalomalacia, primarily involving both cerebral hemispheres. The pregnancy was continued with close fetal and maternal surveillance. The patient underwent a repeat cesarean delivery in her 37th week. The infant had a 1 month neonatal intensive care unit stay with care rendered by a multiple disciplinary team of pediatric subspecialists. The postnatal course was complicated by global hypotonia, poor feeding, delayed development and ultimately required anticonvulsants for recurrent seizures. He died at the age of 9 months from aspiration during a seizure. Discussion Although the maternal mortality from DKA has declined, DKA still confers significant neurological fetal morbidity to its survivors. PMID:25452892

  4. Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis

    Directory of Open Access Journals (Sweden)

    Rozalyn Love

    2014-11-01

    Full Text Available Introduction - Encephalomalacia in a developing fetus is a rare and devastating neurological finding on radiologic imaging. Maternal diabetic ketoacidosis (DKA can lead to metabolic and vascular derangements which can cause fetal encephalomalacia. Case - We report the case of a 27-year-old pregnant woman with White's Class C diabetes mellitus who presented in the 25th week of gestation with DKA. Four weeks after her discharge, marked fetal cerebral ventriculomegaly was noted on ultrasound. A subsequent fetal magnetic resonance imaging (MRI demonstrated extensive, symmetric cystic encephalomalacia, primarily involving both cerebral hemispheres. The pregnancy was continued with close fetal and maternal surveillance. The patient underwent a repeat cesarean delivery in her 37th week. The infant had a 1 month neonatal intensive care unit stay with care rendered by a multiple disciplinary team of pediatric subspecialists. The postnatal course was complicated by global hypotonia, poor feeding, delayed development and ultimately required anticonvulsants for recurrent seizures. He died at the age of 9 months from aspiration during a seizure. Discussion - Although the maternal mortality from DKA has declined, DKA still confers significant neurological fetal morbidity to its survivors.

  5. Prenatal diagnosis of fetal encephalomalacia after maternal diabetic ketoacidosis.

    Science.gov (United States)

    Love, Rozalyn; Lee, Amy; Matiasek, April; Carter, William; Ylagan, Marissa

    2014-11-01

    Introduction Encephalomalacia in a developing fetus is a rare and devastating neurological finding on radiologic imaging. Maternal diabetic ketoacidosis (DKA) can lead to metabolic and vascular derangements which can cause fetal encephalomalacia. Case We report the case of a 27-year-old pregnant woman with White's Class C diabetes mellitus who presented in the 25th week of gestation with DKA. Four weeks after her discharge, marked fetal cerebral ventriculomegaly was noted on ultrasound. A subsequent fetal magnetic resonance imaging (MRI) demonstrated extensive, symmetric cystic encephalomalacia, primarily involving both cerebral hemispheres. The pregnancy was continued with close fetal and maternal surveillance. The patient underwent a repeat cesarean delivery in her 37th week. The infant had a 1 month neonatal intensive care unit stay with care rendered by a multiple disciplinary team of pediatric subspecialists. The postnatal course was complicated by global hypotonia, poor feeding, delayed development and ultimately required anticonvulsants for recurrent seizures. He died at the age of 9 months from aspiration during a seizure. Discussion Although the maternal mortality from DKA has declined, DKA still confers significant neurological fetal morbidity to its survivors.

  6. Clinical observations of infants with multiple encephalomalacia on cranial computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Eda, I.; Yoshino, K.; Nakai, M.; Takashima, S. (Tottori Univ., Yonago (Japan). School of Medicine); Morita, M.

    1982-09-01

    Four cases whose CT scans showed multi-focal or diffuse low density in both cerebral hemisphere were reported and their clinical histories, roentogenographic and electroencephalographic findings were compared. Out of 2 cases with multi-focal low density, one fatal case (Case 1) was diagnosed neuropathologically as multicystic encephalomalacia (MCEM). He had asphyxia at delivery, convulsion and fever for a few days from the first day. Case 2 was one of twins with a clinical history of intrauterine onset. He had no trouble in delivery but poor feedings in the neonatal period. Two cases showed microcephaly, severe psychomotor retardation and tetraplegia later. Two cases with diffuse low density had the episode of respiratory arrest in early infancy. In one patient (Case 3), several cavities in CT and PEG at 2 months of age were demonstrated, and changed into diffuse low density of cerebral hemispheres at 8 months. Case 4 showed almost normal CT at the age of 16 days and developed diffuse low density at 5 months. They also showed microcephaly, severe psychomotor retardation and tetraplegia. EEG showed irregular slow wave activities in 2 cases with multicystic lesions, and almost flat activities in 2 cases with diffuse cystic lesions. The former was compatible with MCEM and the latter hydranencephaly of postnatal onset described by Friede. It was concluded that diffuse cystic lesion could be classified as an extreme type of MCEM, and both destructive lesions caused by pre-or postnatal hypoxia and circulatory disturbances of different severity. Serial CT scans might demonstrate the onset and progression of these pathological changes. EEG was also useful for monitoring the courses of these diseases.

  7. Clinical observations of infants with multiple encephalomalacia on cranial computerized tomography

    International Nuclear Information System (INIS)

    Eda, Isematsu; Yoshino, Kunio; Nakai, Minako; Takashima, Sachio; Morita, Motoaki.

    1982-01-01

    Four cases whose CT scans showed multi-focal or diffuse low density in both cerebral hemisphere were reported and their clinical histories, roentogenographic and electroencephalographic findings were compared. Out of 2 cases with multi-focal low density, one fatal case (Case 1) was diagnosed neuropathologically as multicystic encephalomalacia (MCEM). He had asphyxia at delivery, convulsion and fever for a few days from the first day. Case 2 was one of twins with a clinical history of intrauterine onset. He had no trouble in delivery but poor feedings in the neonatal period. Two cases showed microcephaly, severe psychomotor retardation and tetraplegia later. Two cases with diffuse low density had the episode of respiratory arrest in early infancy. In one patient (Case 3), several cavities in CT and PEG at 2 months of age were demonstrated, and changed into diffuse low density of cerebral hemispheres at 8 months. Case 4 showed almost normal CT at the ag e of 16 days and developed diffuse low density at 5 months. They also showed microcephaly, severe psychomotor retardation and tetraplegia. EEG showed irregular slow wave activities in 2 cases with multicystic lesions, and almost flat activities in 2 cases with diffuse cystic lesions. The former was compatible with MCEM and the latter hydranencephaly of postnatal onset described by Friede. It was concluded that diffuse cystic lesion could be classified as an extreme type of MCEM, and both destructive lesions caused by pre-or postnatal hypoxia and circulatory disturbances of different severity. Serial CT scans might demonstrate the onset and progression of these pathological changes. EEG was also useful for monitoring the courses of these diseases. (author)

  8. Focal symmetrical encephalomalacia in sheep Encefalomalacia focal simétrica em ovino

    Directory of Open Access Journals (Sweden)

    Luciano A. Pimentel

    2010-05-01

    Full Text Available Focal symmetrical encephalomalacia (FSE is the most prominent lesion seen in the chronic form of enterotoxemia by Clostridium perfringens type D. This paper reports FSE in sheep in Brazil. Six deaths occurred within a seven days period in a flock of 70, four to 30-month-old Santa Inês sheep in the state of Paraíba in the Brazilian semiarid. The flock was grazing a paddock of irrigated sprouting Cynodon dactylon (Tifton grass, and supplemented, ad libitum, with a concentrate of soybean, corn and wheat. Nervous signs included blindness and recumbence. A 19 month-old sheep was examined clinically and necropsied after a clinical course of three days. Gross lesions were herniation of the cerebellar vermis and multifocal, bilateral, symmetric brownish areas in the internal capsule, thalamus and cerebellar peduncles. Histologic lesions were multifocal, bilateral malacia with some neutrophils, swelling of blood vessels endothelium, perivascular edema, and hemorrhages. The flock was vaccinated, before the outbreak, with only one dose of Clostridium perfringens type D vaccine. Two factors are suggested to be important for the occurrence of the disease: insufficient immunity due to the incorrect vaccination; and high nutritional levels by the supplementation with highly fermentable carbohydrates.Encefalomalacia focal simétrica (EFS é a lesão mais proeminente vista nas formas subaguda ou crônica da enterotoxemia por Clostridium perfringens tipo D. Este trabalho relata EFS em ovinos no semiárido do estado da Paraíba. Seis ovinos morreram, em um período de sete dias, dentro de um rebanho de 70 animais, da raça Santa Inês, entre 4-30 meses de idade, que pastavam em piquete de Cynodon dactylon (capim Tifton, que estava rebrotando. Os ovinos eram suplementados com um concentrado de soja, trigo e milho. Os sinais nervosos incluíam cegueira e decúbito lateral. Um ovino de 19 meses de idade foi examinado clinicamente e necropsiado, depois de um curso

  9. Classification of brain compartments and head injury lesions by neural networks applied to MRI

    International Nuclear Information System (INIS)

    Kischell, E.R.; Kehtarnavaz, N.; Hillman, G.R.; Levin, H.; Lilly, M.; Kent, T.A.

    1995-01-01

    An automatic, neural network-based approach was applied to segment normal brain compartments and lesions on MR images. Two supervised networks, backpropagation (BPN) and counterpropagation, and two unsupervised networks, Kohonen learning vector quantizer and analog adaptive resonance theory, were trained on registered T2-weighted and proton density images. The classes of interest were background, gray matter, white matter, cerebrospinal fluid, macrocystic encephalomalacia, gliosis, and 'unknown'. A comprehensive feature vector was chosen to discriminate these classes. The BPN combined with feature conditioning, multiple discriminant analysis followed by Hotelling transform, produced the most accurate and consistent classification results. Classifications of normal brain compartments were generally in agreement with expert interpretation of the images. Macrocystic encephalomalacia and gliosis were recognized and, except around the periphery, classified in agreement with the clinician's report used to train the neural network. (orig.)

  10. Classification of brain compartments and head injury lesions by neural networks applied to MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kischell, E R [Dept. of Electrical Engineering, Texas A and M Univ., College Station, TX (United States); Kehtarnavaz, N [Dept. of Electrical Engineering, Texas A and M Univ., College Station, TX (United States); Hillman, G R [Dept. of Pharmacology, Univ. of Texas Medical Branch, Galveston, TX (United States); Levin, H [Dept. of Neurosurgery, Univ. of Texas Medical Branch, Galveston, TX (United States); Lilly, M [Dept. of Neurosurgery, Univ. of Texas Medical Branch, Galveston, TX (United States); Kent, T A [Dept. of Neurology and Psychiatry, Univ. of Texas Medical Branch, Galveston, TX (United States)

    1995-10-01

    An automatic, neural network-based approach was applied to segment normal brain compartments and lesions on MR images. Two supervised networks, backpropagation (BPN) and counterpropagation, and two unsupervised networks, Kohonen learning vector quantizer and analog adaptive resonance theory, were trained on registered T2-weighted and proton density images. The classes of interest were background, gray matter, white matter, cerebrospinal fluid, macrocystic encephalomalacia, gliosis, and `unknown`. A comprehensive feature vector was chosen to discriminate these classes. The BPN combined with feature conditioning, multiple discriminant analysis followed by Hotelling transform, produced the most accurate and consistent classification results. Classifications of normal brain compartments were generally in agreement with expert interpretation of the images. Macrocystic encephalomalacia and gliosis were recognized and, except around the periphery, classified in agreement with the clinician`s report used to train the neural network. (orig.)

  11. Immunosuppressive effects of fumonisin B1 in the Trichinella spiralis model

    NARCIS (Netherlands)

    Nijs M de; Egmond HP van; Jong WH de; Loveren H van; LPI; ARO; MGB

    Fumonisin B1 is a mycotoxin produced by Fusarium moniliforme and is found mainly in maize. Fumonisin B1 has been associated with human esophageal cancer, lung edema in pigs and leuko-encephalomalacia in equine species. Adverse effects of this mycotoxin on the immune system can be expected but were

  12. Author Details

    African Journals Online (AJOL)

    A case of extensive synovial involvement by tophaceous gout. Abstract PDF · Vol 15, No 2 (2011) - Articles A severe case of astrogliosis and encephalomalacia in a neonate with a massive vein of Galen malformation (VGM) Abstract PDF · Vol 15, No 2 (2011) - Articles Radiological chest manifestations in diffuse infiltrative ...

  13. Computerized transverse tomography of vascular lesions of the brain. II. Aneurysms

    International Nuclear Information System (INIS)

    Pressman, B.D.; Gilbert, G.E.; Davis, D.O.

    1975-01-01

    Computerized transverse tomography (CTT) is an excellent screening examination for intracerebral disease. Unfortunately, the detection rate of small aneurysms by this procedure is not high. Nevertheless, CTT may be useful in aneurysm cases since it may indicate the need for further evaluation in patients with associated hematomas, encephalomalacia, or ventricular dilatation, even if the aneurysm itself is not delineated. (U.S.)

  14. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su Mi; Chai, Jee Won [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The aim of this study was to characterize the brain ultrasonographic findings of late-onset circulatory dysfunction (LCD) due to adrenal insufficiency (AI) in preterm infants. Among the 257 preterm infants born at <33 weeks of gestation between December 2009 and February 2014 at our institution, 35 preterm infants were diagnosed with AI. Brain ultrasonographic findings were retrospectively analyzed before and after LCD in 14 preterm infants, after exclusion of the other 21 infants with AI due to the following causes: death (n=2), early AI (n=5), sepsis (n=1), and patent ductus arteriosus (n=13). Fourteen of 257 infants (5.4%) were diagnosed with LCD due to AI. The age at LCD was a median of 18.5 days (range, 9 to 32 days). The last ultrasonographic findings before LCD occurred showed grade 1 periventricular echogenicity (PVE) in all 14 patients and germinal matrix hemorrhage (GMH) with focal cystic change in one patient. Ultrasonographic findings after LCD demonstrated no significant change in grade 1 PVE and no new lesions in eight (57%), grade 1 PVE with newly appearing GMH in three (21%), and increased PVE in three (21%) infants. Five infants (36%) showed new development (n=4) or increased size (n=1) of GMH. Two of three infants (14%) with increased PVE developed cystic periventricular leukomalacia (PVL) and rapid progression to macrocystic encephalomalacia. LCD due to AI may be associated with the late development of GMH, increased PVE after LCD, and cystic PVL with rapid progression to macrocystic encephalomalacia.

  15. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine

    Energy Technology Data Exchange (ETDEWEB)

    Xiao Lianxiang [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Lin Xiangtao, E-mail: yishui1982@126.com [Shandong University School of Medicine, Shandong Medical Imaging Research Institute, No. 44 West Wenhua Road, Jinan 250012 (China); Cao Jinfeng [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Wang Xueyu [Division of Pediatrics, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan 250021 (China); Wu Lebin [Shandong Medical Imaging Research Institute, No. 324 Jingwu Road, Jinan 250021 (China)

    2011-09-15

    Purpose: Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Methods: Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5 mg and atropine 0.025 mg. These patients were referred to our hospital within 24 h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. Results: These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. Conclusion: In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment.

  16. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine

    International Nuclear Information System (INIS)

    Xiao Lianxiang; Lin Xiangtao; Cao Jinfeng; Wang Xueyu; Wu Lebin

    2011-01-01

    Purpose: Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Methods: Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5 mg and atropine 0.025 mg. These patients were referred to our hospital within 24 h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. Results: These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. Conclusion: In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment.

  17. Herpes simplex encephalitis: MRI findings in two cases confirmed by polymerase chain reaction assay

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J.W.; Kim, I.O.; Kim, W.S.; Yeon, K.M. [Dept. of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital, Seoul (Korea); Lee, H.-J.; Hwang, Y.S. [Dept. of Paediatrics, Seoul National University College of Medicine, Seoul (Korea)

    2001-09-01

    Herpes simplex virus (HSV) type I causes a fulminant necrotising meningoencephalitis distinguished from other encephalitides by its focal and often haemorrhagic nature. Specific antiviral therapy with acyclovir can significantly improve the prognosis. We present MRI findings of two cases of herpes simplex encephalitis (HSE) confirmed by PCR analysis, focusing on the serial changes after acyclovir therapy: gyral swelling, high signal intensity on T2-weighted images in the subfrontal region, temporal lobe and insula in the initial stage, then regional extension with enhancement and haemorrhage despite appropriate acyclovir therapy, and finally encephalomalacia and brain atrophy. (orig.)

  18. Herpes simplex encephalitis: MRI findings in two cases confirmed by polymerase chain reaction assay

    International Nuclear Information System (INIS)

    Lee, J.W.; Kim, I.O.; Kim, W.S.; Yeon, K.M.; Lee, H.-J.; Hwang, Y.S.

    2001-01-01

    Herpes simplex virus (HSV) type I causes a fulminant necrotising meningoencephalitis distinguished from other encephalitides by its focal and often haemorrhagic nature. Specific antiviral therapy with acyclovir can significantly improve the prognosis. We present MRI findings of two cases of herpes simplex encephalitis (HSE) confirmed by PCR analysis, focusing on the serial changes after acyclovir therapy: gyral swelling, high signal intensity on T2-weighted images in the subfrontal region, temporal lobe and insula in the initial stage, then regional extension with enhancement and haemorrhage despite appropriate acyclovir therapy, and finally encephalomalacia and brain atrophy. (orig.)

  19. Central nervous system pathology in pediatric AIDS: an autopsy study.

    Science.gov (United States)

    Dickson, D W; Belman, A L; Park, Y D; Wiley, C; Horoupian, D S; Llena, J; Kure, K; Lyman, W D; Morecki, R; Mitsudo, S

    1989-01-01

    The neuropathologic findings of brains and spinal cords removed at autopsy from 26 infants and children with AIDS is described; in two cases, only the spinal cords were available. The most common finding in the brains was dystrophic calcification of blood vessels of all calibers in the basal ganglia and deep cerebral white matter (21 og 24 cases). The next most frequent finding was subacute encephalitis (SE) (15 of 24 cases) with microglial nodules and multinulceated giant cells. Immunocytochemical and in situ hybridization studies showed HIV antigen or genetic sequences only in the brains of cases with SE. Multinucleated giants cells (MGC) were the most frequent cells with reaction products. MGC were labeled with ricinus lectin (RCA), but not with leukocyte common antigen (LCA) or glial fibrillary acidic protein. Many cells in microglial nodules were labeled with RCA, but not LCA; cells in the perivascular compartment were labeled with LCA, but not RCA. Corticospinal tract degeneration was noted in 15 of 20 spinal cords. In six cases tract degeneration was consistent with delayed myelination, and the remaining cases had axonal injury consistent with Wallerian degeneration. Opportunistic infections were rare (three cases). Central nervous system lymphoma occurred in three children and was the most common mass lesion. In two cases lymphoma occurred in the setting of a systemic polyclonal immunoproliferation possibly related to Epstein-Barr virus infection. Cerebrovascular accidents were noted in seven cases. Two cases had hemorrhage associated with immune thrombocytopenia; one hemorrhage was catastrophic. Two children had large vessel arteriopathy with multiple encephalomalacias. Two children had a necrotizing encephalopathy with encephalomalacia and vascular changes suggestive of a mitochondrial cytopathy.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine.

    Science.gov (United States)

    Xiao, Lianxiang; Lin, Xiangtao; Cao, Jinfeng; Wang, Xueyu; Wu, Lebin

    2011-09-01

    Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5mg and atropine 0.025 mg. These patients were referred to our hospital within 24h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Neurological impairment in a surviving twin following intrauterine fetal demise of the co-twin: a case study.

    Science.gov (United States)

    Forrester, K R; Keegan, K M; Schmidt, J W

    2013-01-01

    It has been established that twin pregnancies are at an increased risk for complications, including the risk of morbidity or mortality for one or both of the infants. Cerebral palsy and other associated neurological deficits also occur at higher rates in twin pregnancies. This report examines two cases of intrauterine demise of one twin with subsequent survival of the co-twin. In both cases, the surviving infant suffered significant neurological sequelae. Impairments observed in these two cases include multicystic encephalomalacia and periventricular leukomalacia as well as the subsequent development of cerebral palsy. This case study explores the predisposing factors, incidence, pathophysiology, consequences, and future research implications of these findings.

  2. First report of Angiostrongylus vasorum in a wild red fox (Vulpes vulpes) from Apulia (Italy).

    Science.gov (United States)

    Passantino, Giuseppe; Marino, Fabio; Gaglio, Gabriella; Patruno, Rosa; Lanteri, Giovanni; Zizzo, Nicola

    2017-04-05

    Severe lung strongylosis was detected in a wild red fox (Vulpes vulpes) (1/12) from Apulia (Italy). We performed routine diagnostics on 12 foxes found dead in Apulia. Eleven of them showed lesions consistent with a vehicle collision. However, the remaining fox appeared to have died from other causes. At necropsy we observed, catarrhal enteritis, fatty liver, lung congestion with some areas rm in consistence and brain haemorrhages and malacia. Histopathology revealed lung brosis with mononucleate cells in ltration, thrombosis a several larval nematodes spread in the parenchyma, interstitial nephritis, interstitial myocarditis, encephalitis, encephalomalacia, and a brain granuloma. The larvae recovered from the lung parenchyma were identi ed as the rst stage larvae of Angiostrongylus vasorum. This is the rst documented report of angiostrongylosis in a fox in Southern Italy.

  3. Orbital roof encephalocele mimicking a destructive neoplasm.

    Science.gov (United States)

    Alsuhaibani, Adel H; Hitchon, Patrick W; Smoker, Wendy R K; Lee, Andrew G; Nerad, Jeffrey A

    2011-01-01

    The purpose of this case report is to report an orbital roof encephalocele mimicking a destructive orbital neoplasm. Orbital roof encephalocele is uncommon but can mimic neoplasm. One potential mechanism for the orbital roof destruction is a post-traumatic "growing orbital roof fracture." The growing fracture has been reported mostly in children but can occur in adults. Alternative potential etiologies for the encephalocele are discussed, including Gorham syndrome. Orbital roof encephalocele is uncommon in adults, and the findings can superficially resemble an orbital neoplasm. Radiographic and clinical features that might suggest the correct diagnosis include a prior history of trauma, overlying frontal lobe encephalomalacia without significant mass effect or edema, and an orbital roof defect. The "growing fracture" mechanism may be a potential explanation for the orbital roof destruction in some cases.

  4. USE OF DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING FOR REVEALING HYPOXIC-ISCHEMIC BRAIN LESIONS IN NEONATES

    Directory of Open Access Journals (Sweden)

    E. V. Shimchenko

    2014-01-01

    Full Text Available The article presents advantages of use of diffusion-weighted magnetic resonance imaging (DW MRI for revealing hypoxic-ischemic brain lesions in neonates. The trial included 97 neonates with perinatal brain lesion who had been undergoing treatment at a resuscitation department or neonatal pathology department in the first month of life. The article shows high information value of diffusion-weighted images (DWI for diagnostics of hypoxic-ischemic lesions in comparison with regular standard modes. In the event of no structural brain lesions of neonates, pronounced increase in signal characteristics revealed by DWI indicated considerable pathophysiological alterations. Subsequently, children developed structural alterations in the form of cystic encephalomalacia with expansion of cerebrospinal fluid spaces manifested with pronounced neurological deficit. DW MRI has been offered as a method of prognosticating further neurological development of children on early stages. 

  5. CT findings in neonatal hypothermia

    International Nuclear Information System (INIS)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y.; Hershkowitz, E.; Berenstein, T.; Sofer, S.; Maor, E.

    1998-01-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the 'reversal sign'. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The 'reversal sign' has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.)

  6. Fatal accidental inhalation of brake cleaner aerosols.

    Science.gov (United States)

    Veit, F; Martz, W; Birngruber, C G; Dettmeyer, R B

    2018-04-23

    Brake cleaner liquid is commonly used for cleaning of engines and motor parts. The commercially available products usually contain mainly volatile organic compounds. As a consequence brake cleaner evaporates fast and almost completely from the cleaned surface. This case report presents a fatal accidental inhalation of brake cleaner liquid aerosols due to the attempted cleaning of a boat engine. A 16year old boy was found lifeless in the engine compartment of a boat engine. In close proximity to the body, the police found cleanings wipes soaked with brake cleaner as well as a pump spray bottle filled with brake cleaner. Essentially the autopsy revealed a cerebral oedema with encephalomalacia, no coagulated blood as well as increased blood and tissue fluid content of the lung. Toxicological analysis revealed brake cleaner fluid in the lung, gastric content and heart blood. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Late radiation encephalopathy in the dog. A model for cerebral vascular disease

    International Nuclear Information System (INIS)

    Michaelson, S.M.; Kramer, M.W.

    The Research Group on Industrial and Environmental Neurology has suggested that assessment of cerebral atherosclerosis should be considered as part of its purview of problems of interest. Although the present study is not related to the ordinary environmental or industrial situation, it can apply to accidental over-exposure to external ionizing radiation or radiation therapy and describes an animal model that can be used for fundamental study of cerebral vascular conditions and encephalomalacia. Ionizing radiation damage to nervous tissue may be apparent early after irradiation or may become evident after a variable latent period. The concept of late ionizing radiation-induced neuropathy, the subject of this study, is characterized by a long latent period between exposure and initial clinical signs, an inverse relationship between radiation dose and latency of appearance of late radiation encephalopathy, and an apparent lack of demonstrable physiological, biochemical, and morphological alterations until necrosis becomes manifest. (U.S.)

  8. Computed tomographic findings in cerebral palsy: Analysis of hemisphere and lateral ventricular volume

    International Nuclear Information System (INIS)

    Cho, Seoung Hwan; Kim, Hak Jin; Sol, Chang Hyo; Kim, Byung Soo

    1989-01-01

    Authors analysed the CT findings of 28 cerebral palsy patients at Pusan National University Hospital from January, 1984 to December, 1987. Volumes of hemispheres, lateral ventricles and paranchymes were measured in patients who showed no remarkable abnormality on CT film, and compared with those of normal control group. 1. Among the 28 cerebral palsy patients, there were 6 cases of diffuse atrophy in CT findings, and unilateral atrophy in 2 cases and encephalomalacia and diffuse white matter low density in 1 case and generalized symmetrical white matter low density in 1 case, but remaining 18 cases had no specific abnormal finding on CT. 2. Difference in volumes of brain parenchyma and lateral ventricles of each hemisphere was greater than that of control group. 3. There were more enlarged lateral ventricles and prominent unilateral brain atrophy in 18 cases of cerebral palsy who showed no specific abnormality on CT as compared with normal control group

  9. Palilalia, echolalia, and echopraxia-palipraxia as ictal manifestations in a patient with left frontal lobe epilepsy.

    Science.gov (United States)

    Cho, Yang-Je; Han, Sang-Don; Song, Sook Keun; Lee, Byung In; Heo, Kyoung

    2009-06-01

    Palilalia is a relatively rare pathologic speech behavior and has been reported in various neurologic and psychiatric disorders. We encountered a case of palilalia, echolalia, and echopraxia-palipraxia as ictal phenomena of left frontal lobe epilepsy. A 55-year-old, right-handed man was admitted because of frequent episodes of rapid reiteration of syllables. Video-electroencephalography monitoring revealed stereotypical episodes of palilalia accompanied by rhythmic head nodding and right-arm posturing with ictal discharges over the left frontocentral area. He also displayed echolalia or echopraxia-palipraxia, partially responding to an examiner's stimulus. Magnetic resonance imaging revealed encephalomalacia on the left superior frontal gyrus and ictal single photon emission computed tomography showed hyperperfusion just above the lesion, corresponding to the left supplementary motor area (SMA), and subcortical nuclei. This result suggests that the neuroanatomic substrate involved in the generation of these behaviors as ictal phenomena might exist in the SMA of the left frontal lobe.

  10. Unusual case of recurrent SMART (stroke-like migraine attacks after radiation therapy syndrome

    Directory of Open Access Journals (Sweden)

    Ramnath Santosh Ramanathan

    2016-01-01

    Full Text Available Stroke-like migraine attacks after radiation therapy (SMART syndrome is a rare delayed complication of cerebral radiation therapy. A 53-year-old female initially presented with headache, confusion and left homonymous hemianopia. Her medical history was notable for cerebellar hemangioblastoma, which was treated with radiation in 1987. Her initial brain MRI (magnetic resonance imaging revealed cortical enhancement in the right temporo-parieto-occipital region. She improved spontaneously in 2 weeks and follow-up scan at 4 weeks revealed no residual enhancement or encephalomalacia. She presented 6 weeks later with aphasia. Her MRI brain revealed similar contrast-enhancing cortical lesion but on the left side. Repeat CSF studies was again negative other than elevated protein. She was treated conservatively and recovered completely within a week. Before diagnosing SMART syndrome, it is important to rule out tumor recurrence, encephalitis, posterior reversible encephalopathy syndrome (PRES and stroke. Typically the condition is self-limiting, and gradually resolves.

  11. Unusual case of recurrent SMART (stroke-like migraine attacks after radiation therapy) syndrome.

    Science.gov (United States)

    Ramanathan, Ramnath Santosh; Sreedher, Gayathri; Malhotra, Konark; Guduru, Zain; Agarwal, Deeksha; Flaherty, Mary; Leichliter, Timothy; Rana, Sandeep

    2016-01-01

    Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare delayed complication of cerebral radiation therapy. A 53-year-old female initially presented with headache, confusion and left homonymous hemianopia. Her medical history was notable for cerebellar hemangioblastoma, which was treated with radiation in 1987. Her initial brain MRI (magnetic resonance imaging) revealed cortical enhancement in the right temporo-parieto-occipital region. She improved spontaneously in 2 weeks and follow-up scan at 4 weeks revealed no residual enhancement or encephalomalacia. She presented 6 weeks later with aphasia. Her MRI brain revealed similar contrast-enhancing cortical lesion but on the left side. Repeat CSF studies was again negative other than elevated protein. She was treated conservatively and recovered completely within a week. Before diagnosing SMART syndrome, it is important to rule out tumor recurrence, encephalitis, posterior reversible encephalopathy syndrome (PRES) and stroke. Typically the condition is self-limiting, and gradually resolves.

  12. CT findings in neonatal hypothermia

    Energy Technology Data Exchange (ETDEWEB)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y. [Department of Radiology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P. O. Box 151, Beer-Sheva 84101 (Israel); Hershkowitz, E.; Berenstein, T.; Sofer, S. [Pediatric Intensive Care Unit, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel); Maor, E. [Department of Pathology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel)

    1998-06-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the `reversal sign`. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The `reversal sign` has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.) With 6 figs., 1 tab., 13 refs.

  13. Aleutian Disease: An Emerging Disease in Free-Ranging Striped Skunks (Mephitis mephitis) From California.

    Science.gov (United States)

    LaDouceur, E E B; Anderson, M; Ritchie, B W; Ciembor, P; Rimoldi, G; Piazza, M; Pesti, D; Clifford, D L; Giannitti, F

    2015-11-01

    Aleutian disease virus (ADV, Amdovirus, Parvoviridae) primarily infects farmed mustelids (mink and ferrets) but also other fur-bearing animals and humans. Three Aleutian disease (AD) cases have been described in captive striped skunks; however, little is known about the relevance of AD in free-ranging carnivores. This work describes the pathological findings and temporospatial distribution in 7 cases of AD in free-ranging striped skunks. All cases showed neurologic disease and were found in a 46-month period (2010-2013) within a localized geographical region in California. Lesions included multisystemic plasmacytic and lymphocytic inflammation (ie, interstitial nephritis, myocarditis, hepatitis, meningoencephalitis, pneumonia, and splenitis), glomerulonephritis, arteritis with or without fibrinoid necrosis in several organs (ie, kidney, heart, brain, and spleen), splenomegaly, ascites/hydrothorax, and/or encephalomalacia with cerebral microangiopathy. ADV infection was confirmed in all cases by specific polymerase chain reaction and/or in situ hybridization. The results suggest that AD is an emerging disease in free-ranging striped skunks in California. © The Author(s) 2014.

  14. Secondary Eating Disorder: A Reality? Case Report of Post Brain Injury Sequelae.

    Science.gov (United States)

    Das, Aparna; Elwadhi, Deeksha; Gupta, Manushree

    2017-01-01

    Traumatic brain injury (TBI) can lead to changes in eating behavior patterns. This report describes the case of a patient with alcohol dependence presenting with behavioral changes and eating disorder following frontal lobe trauma. A 42-year-old male, premorbidly well-adjusted presented with alcohol use in dependent pattern for years. He sustained a subdural hematoma in the frontal lobe following a road traffic accident 10 years back. Post-TBI, the patient, started having low frustration tolerance, aggressive outbursts, disinhibition, difficulty in persisting with tasks, apathy, amotivation, and craving for food with inability to control intake on the sight of food. On testing, a deficit in frontal lobe functions was seen. Magnetic resonance imaging scan showed large areas of gliosis and encephalomalacia involving both frontal lobes with parenchymal loss. Eating disorders have been reported after TBI. This case report underscores a major role of frontal-subcortical circuits in regulation of eating habits.

  15. MRI findings of the brain after gas explosion and its relationship with post-traumatic stress disorder

    International Nuclear Information System (INIS)

    Zhao Ruifeng; Jin Yilong; Li Huabing; Li Shufeng; Tian Shuwen; Li Haixue; Chen Yanhui; Wang Tianliang; Ma Lin; Ren Zijing; Ma Lin

    2008-01-01

    Objective: To investigate MR findings and dynamic changes of the brain after gas explosion, and to evaluate the relationship between MR findings and post-traumatic stress disorder (PTSD). Methods: Forty-nine survivors of a gas explosion (group A) were examined with brain MRI within 1 to 3 days, and serial MR follow-up examinations were also performed. Forty miners not under the ground that day were assigned as group B, and 40 staff working on the ground as group C. The signal intensity values of hippocampus and globus pallidus on T 2 WI were measured in the three groups and F test was performed by using SPSS 13.0. The relationship between signal intensity values of hippocampus/globus pallidus and PTSD was explored, and the relationship between ADC values of hippocampus and PTSD was also investigated. Results: In group A, slight low signal on T 1 WI and high signal on T 2 WI were detected on initial MRI in hippocarnpus (33 cases), globus pallidus (12 cases), cortex (10 cases), and midbrain (2 cases), respectively. On follow-up MRI at 2 months, lesions in hippocampus disappeared (25 cases) or remained slight high signal on T 2 WI (8 cases), lesions in globus pallidus disappeared (3 cases, 5 sides) or showed shrinkage and encephalomalacia (9 cases), cortical lesions resulted in encephalomalacia in 2 cases and returned normal in the others, and lesions in the midbrain showed encephalomalacia. For comparison of T 2 signal intensity values in hippocampus and globus pallidus, there was significant difference between group A and group B (P 0.05). In group A, the T 2 signal intensities of PTSD and non- PTSD were 455 ± 37 and 462 ± 53 in the left hippocampus, and 458 ± 36 and 460 ± 43 in the right hippocampus on 1 to 3 days, and the T 2 signal intensities of PTSD and non-PTSD were 438 ± 29 and 424 ± 37 in the left hippocampus, and 442 ± 31 and 430 ± 32 in the right hippocampus at 2 months. The T 2 signal intensities of PTSD and non-PTSD were 361 ± 35 and 366 ± 63

  16. Cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru; Achados tomograficos de pacientes submetidos a tomografia de cranio no pronto-socorro do Hospital Universitario Cajuru

    Energy Technology Data Exchange (ETDEWEB)

    Lara Filho, Lauro Aparecido; Omar, Samir Sari; Biguelini, Rodrigo Foletto; Santos, Rony Augusto de Oliveira, E-mail: samir176@gmail.com [Pontificia Universidade Catolica do Parana (PUCPR), Curitiba, PR (Brazil). Cuso de Medicina

    2013-05-15

    Objective: to identify and analyze the prevalence of cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru. Materials and methods: cross-sectional study analyzing 200 consecutive non contrast-enhanced cranial computed tomography reports of patients admitted to the emergency unit of Hospital Universitario Cajuru. Results: alterations were observed in 76.5% of the patients. Among them, the following findings were most frequently observed: extracranial soft tissue swelling (22%), bone fracture (16.5%), subarachnoid hemorrhage (15%), nonspecific hypodensity (14.5%), paranasal sinuses opacification (11.5%), diffuse cerebral edema (10.5%), subdural hematoma (9.5%), cerebral contusion (8.5%), hydrocephalus (8%), retractable hypodensity /gliosis/ encephalomalacia (8%). Conclusion: the authors recognize that the most common findings in emergency departments reported in the literature are similar to the ones described in the present study. This information is important for professionals to recognize the main changes to be identified at cranial computed tomography, and for future planning and hospital screening aiming at achieving efficiency and improvement in services. (author)

  17. [Severe late-onset group B streptococcal infection. A case report].

    Science.gov (United States)

    Haase, Roland; Nagel, Frank; Hirsch, Wolfgang; Sitka, Uwe

    2003-01-01

    Group B Streptococcus (GBS) is a well-known cause of neonatal pneumonia, sepsis and meningitis. Peripartal antibiotic prophylaxis for early-onset GBS infection is in routine use since the beginning of the last decade, but strategies for effective prevention of late-onset GBS infections are still lacking. Few hours after discharge from a non-local maternity ward a 3-week-old boy was admitted to our hospital because of GBS meningitis with necrotizing encephalomalacia. Maternal mastitis, not a disease of the baby, had led to the first admission. Case history and negative maternal swabs and cultures for GBS led to the hypothesis of nosocomial infection. Screening and risk based peripartal antibiotic prophylaxis, better monitoring and improved therapeutic modalities have reduced the incidence and mortality of early-onset GBS infections, but peripartal prophylaxis failed to influence late-onset GBS infections. Up to 40 % of infants with late-onset meningitis develop neurological sequelae. Maternal vaccination with multivalent conjugate vaccines against GBS is a new strategy which may lead to passive protection of the infant. Further studies to examine the efficacy of vaccines are in progress.

  18. CT analysis of missile head injury

    International Nuclear Information System (INIS)

    Besenski, N.; Jadro-Santel, D.; Jelavic-Koic, F.; Pavic, D.; Mikulic, D.; Glavina, K.; Maskovic, J.

    1995-01-01

    Between August 1991 and December 1992, CT was performed in 154 patients who had suffered missile head injury during the war in the Republic of Croatia. In 54% CT was performed 1-24 h after injury, and in 27% follow-up CT was also obtained. The wounds were penetrating, tangential or perforating (45%, 34% and 21%, respectively). Haemorrhage was the most frequent lesion in the brain (84%). Follow-up CT evolution of haemorrhage, oedema, cerebritis, abscess, secondary vascular lesions, necrosis, encephalomalacia and hydrocephalus. The most dynamic changes occurred 7-14 days after injury. In 14% of cases, deep cerebral lesions were found in the corpus callosum, septum pellucidum periventricular region and pons, although bone and shell fragments were in a different part of the brain parenchyma. Such lesions were found in penetrating injuries only. CT proved very useful for assessing the extent and type of lesions. Although different mechanisms of brain damage in missile head injury are known, here they are, to the best of our knowledge, shown for the first time by CT. (orig.)

  19. Computed tomography in young children with herpes simplex virus encephalitis

    International Nuclear Information System (INIS)

    Sugimoto, T.; Woo, M.; Okazaki, H.; Nishida, N.; Hara, T.; Yasuhara, A.; Kasahara, M.; Kobayashi, Y.

    1985-01-01

    Computed tomographic (CT) scans were obtained from eight infants and young children with herpes simplex virus encephalitis. In two cases the initial scan showed diffuse edematous changes as a mass effect without laterality. Unilateral localized low attenuation in the initial scan was evident 4 days after the onset in one patient, and high attenuation in the initial scan appeared on the 6th day in another patient, but in general, it was not possible to establish an early diagnosis of herpes simplex virus encephalitis from CT scan. In the longitudinal study the calcification with ventriculomegaly appeared in 3 of 5 survivors, and gyriform calcification in 2 of 3 patients, respectively. The appearance of multicystic encephalomalacia was evident in one patient 6 months after the onset of neonatal herpes simplex encephalitis. It is shown that the CT findings of neonates and young children with herpes simplex encephalitis are different from those of older children and adults, and the importance of longitudinal CT studies was stressed in clarifying the pathophysiology of the central nervous system involvement in survivors. (orig.)

  20. Hypoxic-Ischemic Encephalopathy With Clinical and Imaging Abnormalities Limited to Occipital Lobe.

    Science.gov (United States)

    Parmar, Hemant A; Trobe, Jonathan D

    2016-09-01

    The vulnerable brain areas in hypoxic-ischemic encephalopathy (HIE) following systemic hypotension are typically the neocortex, deep cerebral gray nuclei, hippocampus, cerebellum, and the parieto-occipital arterial border zone region. The visual cortex is not commonly recognized as a target in this setting. Single-institution review from 2007 to 2015 of patients who suffered cortical visual loss as an isolated clinical manifestation following systemic hypotension and whose brain imaging showed abnormalities limited to the occipital lobe. Nine patients met inclusion criteria. Visual loss at outset ranged from hand movements to 20/20, but all patients had homonymous field loss at best. In 1 patient, imaging was initially normal but 4 months later showed encephalomalacia. In 2 patients, imaging was initially subtle enough to be recognized as abnormal only when radiologists were advised that cortical visual loss was present. The occipital lobe may be an isolated target in HIE with cortical visual loss as the only clinical manifestation. Imaging performed in the acute period may appear normal or disclose abnormalities subtle enough to be overlooked. Radiologists informed of the clinical manifestations may be more attune to these abnormalities, which will become more apparent months later when occipital volume loss develops.

  1. A case of tacrolimus-induced encephalopathy after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Myoung Uk Kim

    2011-01-01

    Full Text Available We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI showed acute infarction of the middle cerebral artery (MCA territory in the right frontal lobe. Three days later, she had normal mental function and maintained normal blood pressure with left hemiparesis. Follow-up MRI was performed on D19, showing new infarct lesions at both cerebral hemispheres. Ten days later, MRI showed further improvement, but brain single photon emission computed tomography (SPECT showed mild reduction of uptake in both the anterior cingulate gyrus and the left thalamus. One month after onset of symptoms, angiography showed complete resolution of stenosis. However, presenting as a mild fine motor disability of both hands and mild dysarthria, what had been atrophy at both centrum semiovale at 4 months now showed progression to encephalomalacia. There are two points of interest in this case. First, encephalopathy occurred after administration of tacrolimus and improved after discontinuation of the drug. Second, the development of right-side hemiplegia could not be explained by conventional MRI; but through diffusion tensor imaging (DTI and diffusion tensor tractography (DTT of white matter tract, visualization was possible.

  2. Congenital orbital encephalocele, orbital dystopia, and exophthalmos.

    Science.gov (United States)

    Hwang, Kun; Kim, Han Joon

    2012-07-01

    We present here an exceedingly rare variant of a nonmidline basal encephalocele of the spheno-orbital type, and this was accompanied with orbital dystopia in a 56-year-old man. On examination, his left eye was located more inferolaterally than his right eye, and the patient said this had been this way since his birth. The protrusion of his left eye was aggravated when he is tired. His naked visual acuity was 0.7/0.3, and the ocular pressure was 14/12 mm Hg. The exophthalmometry was 10/14 to 16 mm. His eyeball motion was not restricted, yet diplopia was present in all directions. The distance from the midline to the medial canthus was 20/15 mm. The distance from the midline to the midpupillary line was 35/22 mm. The vertical dimension of the palpebral fissure was 12/9 mm. The height difference of the upper eyelid margin was 11 mm, and the height difference of the lower eyelid margin was 8 mm. Facial computed tomography and magnetic resonance imaging showed left sphenoid wing hypoplasia and herniation of the left anterior temporal pole and dura mater into the orbit, and this resulted into left exophthalmos and encephalomalacia in the left anterior temporal pole. To the best of our knowledge, our case is the second case of basal encephalocele and orbital dystopia.

  3. Late vascular effects in irradiated mice brain

    International Nuclear Information System (INIS)

    Yoshii, Yoshihiko; Maki, Yutaka; Phillips, T.L.

    1982-01-01

    The whole brains of mice were irradiated with 250 kVp X-ray at 120 rad min -1 (1.6 mm Cu HVL, TSD 50 cm) and a histological study was done. The dose range of X-irradiation was from 1300 to 2500 rads. i.e., 1300, 1500, 1750, 2000, and 2500 rads. In the microscopic examination, the mice were killed at the regular postirradiation intervals of between 15 and 20, 31 and 40, 41 and 50, 51 and 60, 61 and 70, 71 and 80, 81 and 90, 139 and 177 weeks. A histological examination was performed by a morphometric estimation of vascular lesion in which the degree of the damage to the arterial system was scored through whole serial brain sections. Necrosis (encephalomalacia), atrophy, cell infiltration, and telangiectatic vascular change of the brain, caused as a result of the fibrinoid necrosis of the large artery were observed. Incidence of the fibrinoid necrosis increased dose dependently between 41 and 87 weeks after irradiation. Mean score of fibrinoid necrosis increased dose dependently approximately 60 weeks after irradiation. It is suggested that scores of large vessel damage do relate to dose at 41 - 87 weeks and can be used to quantify the vessel injury and a fibrinoid necrosis of the large vessels may relate to the incidence of radionecrosis. (author)

  4. Late vascular effects in irradiated mice brain. In relation to experimental radionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Yoshii, Y; Maki, Y [Tsukuba Univ., Sakura, Ibaraki (Japan); Phillips, T L

    1982-03-01

    The whole brains of mice were irradiated with 250 kVp X-ray at 120 rad min/sup -1/ (1.6 mm Cu HVL, TSD 50 cm) and a histological study was done. The dose range of X-irradiation was from 1300 to 2500 rads. i.e., 1300, 1500, 1750, 2000, and 2500 rads. In the microscopic examination, the mice were killed at the regular postirradiation intervals of between 15 and 20, 31 and 40, 41 and 50, 51 and 60, 61 and 70, 71 and 80, 81 and 90, 139 and 177 weeks. A histological examination was performed by a morphometric estimation of vascular lesion in which the degree of the damage to the arterial system was scored through whole serial brain sections. Necrosis (encephalomalacia), atrophy, cell infiltration, and telangiectatic vascular change of the brain, caused as a result of the fibrinoid necrosis of the large artery were observed. Incidence of the fibrinoid necrosis increased dose dependently between 41 and 87 weeks after irradiation. Mean score of fibrinoid necrosis increased dose dependently approximately 60 weeks after irradiation. It is suggested that scores of large vessel damage do relate to dose at 41 - 87 weeks and can be used to quantify the vessel injury and a fibrinoid necrosis of the large vessels may relate to the incidence of radionecrosis.

  5. Diffusion and Perfusion Characteristics of MELAS (Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-Like Episode) in Thirteen Patients

    International Nuclear Information System (INIS)

    Kim, Ji Hye; Jeon, Tae Yeon; Eo, Hong; Yoo, So Young; Lim, Myung Kwan; Rha, Jung Ho; Shu, Chang Hae

    2011-01-01

    We analyzed the diffusion and perfusion characteristics of acute MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode) lesions in a large series to investigate the controversial changes of the apparent diffusion coefficient (ADC) that were reported in prior studies. We analyzed 44 newly appearing lesions during 28 stroke-like episodes in 13 patients with MELAS. We performed a visual assessment of the MR images including the ADC and perfusion maps, comparison of the ADC between the normal and abnormal areas, comparison of % ADC between the 44 MELAS lesions and the 30 acute ischemic infarcts. In addition, the patterns of evolution on follow-up MR images were analyzed. Decreased, increased, and normal ADCs were noted in 16 (36%), 16 (36%), and 12 (27%) lesions, respectively. The mean % ADC was 102 ± 40.9% in the MELAS and 64 ± 17.8% in the acute vascular infarcts (p < 0.001), while perfusion imaging demonstrated hyper-perfusion in six acute MELAS lesions. On follow-up images, resolution, progression, and tissue loss were noted in 10, 4, and 17 lesions, respectively. The cytotoxic edema gradually evolves following an acute stroke-like episode in patients with MELAS, and this may overlap with hyper-perfusion and vasogenic edema. The edematous swelling may be reversible or it may evolve to encephalomalacia, suggesting irreversible damage

  6. Diffusion and Perfusion Characteristics of MELAS (Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-Like Episode) in Thirteen Patients

    Science.gov (United States)

    Kim, Ji Hye; Jeon, Tae Yeon; Rha, Jung Ho; Eo, Hong; Yoo, So-Young; Shu, Chang Hae

    2011-01-01

    Objective We analyzed the diffusion and perfusion characteristics of acute MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode) lesions in a large series to investigate the controversial changes of the apparent diffusion coefficient (ADC) that were reported in prior studies. Materials and Methods We analyzed 44 newly appearing lesions during 28 stroke-like episodes in 13 patients with MELAS. We performed a visual assessment of the MR images including the ADC and perfusion maps, comparison of the ADC between the normal and abnormal areas, comparison of % ADC between the 44 MELAS lesions and the 30 acute ischemic infarcts. In addition, the patterns of evolution on follow-up MR images were analyzed. Results Decreased, increased, and normal ADCs were noted in 16 (36%), 16 (36%), and 12 (27%) lesions, respectively. The mean % ADC was 102 ± 40.9% in the MELAS and 64 ± 17.8% in the acute vascular infarcts (p MELAS lesions. On follow-up images, resolution, progression, and tissue loss were noted in 10, 4, and 17 lesions, respectively. Conclusion The cytotoxic edema gradually evolves following an acute stroke-like episode in patients with MELAS, and this may overlap with hyper-perfusion and vasogenic edema. The edematous swelling may be reversible or it may evolve to encephalomalacia, suggesting irreversible damage. PMID:21228936

  7. Survey on coenurosis in sheep and goats in Egypt

    Directory of Open Access Journals (Sweden)

    Enas A. Desouky

    2011-09-01

    Full Text Available A total of 75 sheep and goats from apparently healthy and from clinically affected flocks were examined for Coenurus cerebralis cysts from different localities in Egypt. Of 25 animals examined from clinically diseased sheep and goats, 25 (100% revealed the presence of infestation with one to four coenuri in the brain. The sites of predilection were the left hemisphere (48%, followed by the right hemisphere (40% and the cerebellum (12%. There was no apparent effect of the age of sheep and goats on susceptibility to infestation with C. cerebralis. Another 50 animals from apparently healthy sheep and goat herds presented no C. cerebralis cysts. The cysts from infested sheep could infest newborn puppies experimentally, with a prepatent period of 60 days post infestation. A total of 15 immature worms that were recovered from one puppy did not reach patency until 105 days post infestation with C. cerebralis cyst scolices. Pathological changes in C. cerebralis-infested sheep brain revealed parasitic elements, demyelinated nerve tracts, hyperaemic blood vessels with round cell infiltration, encephalomalacia with round cell infiltration and palisading macrophages and giant cells, as well as focal replacement of the brain parenchyma with caseated and calcified materials. The morphological characteristics of both the larval stage from sheep and goats and adult worms of Taenia multiceps from experimentally infested dogs are described. The results conclude that C. cerebralis is one of the principal causes of nervous manifestations of coenurosis in clinically diseased sheep and goats in Egypt.

  8. Serial MR observation of cortical laminar necrosis caused by brain infarction

    Energy Technology Data Exchange (ETDEWEB)

    Komiyama, M.; Nakajima, H.; Nishikawa, M.; Yasui, T. [Department of Neurosurgery, Osaka City General Hospital (Japan)

    1998-12-01

    To examine the chronological changes characteristic of cortical laminar necrosis caused by brain infarction, 16 patients were repeatedly examined using T1-, T2-weighted spin-echo, T2{sup *}-weighted gradient echo, fluid attenuated inversion recovery (FLAIR) images, and contrast enhanced T1-weighted images at 1.0 or 1.5 T. High intensity cortical lesions were visible on the T1-weighted images from 2 weeks after ictus and became prominent at 1 to 3 months, then became less apparent, but occasionally remained at high intensity for 2 years. High intensity cortical lesions on FLAIR images became prominent from 1 month, and then became less prominent from 1 year, but occasionally remained at high intensity for 2 years. Subcortical lesions did not display high intensity on T1-weighted images at any stage. On FLAIR images, subcortical lesions initially showed slightly high intensity and then low intensity from 6 months due to encephalomalacia. Cortical lesions showed prominent contrast enhancement from 2 weeks to 3 months, but subcortical lesions were prominent from 2 weeks only up to 1 month. T2*-weighted images disclosed haemosiderin in 3 of 7 patients, but there was no correlation with cortical short T1 lesions. Cortical laminar necrosis showed characteristic chronological signal changes on T1-weighted images and FLAIR images. Cortical short T1 lesions were found not to be caused by haemorrhagic infarction. (orig.) With 5 figs., 1 tab., 9 refs.

  9. Infartos cerebrales de repetición y anemia drepanocítica en un niño:: revisión de la literatura médica Repeated brain infarctions and sickle cell anemia in a child:: medical literature review

    Directory of Open Access Journals (Sweden)

    José Vargas Díaz

    2009-12-01

    Full Text Available Una de las complicaciones neurológicas más devastadoras de la anemia drepanocítica son los ictus, tanto isquémicos como hemorrágicos. El 11% de los pacientes con hemoglobina SS (HbSS tienen un ictus antes de los 20 años de edad. Se presenta el caso de un niño de 14 años, congolés, gravemente desnutrido, con anemia drepanocítica y antecedentes de ictus isquémicos de repetición, que fue atendido en la Clínica Internacional «Cira García». La resonancia magnética evidenció signos de infartos antiguos a diferentes niveles en ambos hemisferios y zonas de encefalomalacia. Este paciente muestra la evolución natural de las complicaciones cerebrovasculares de la anemia de células falciformes.Among the most devastating neurologic complications from sickle-cell anemia are the ischemic and hemorrhagic ictus. The 11% of patients with SS hemoglobin (HbSS has ictus before the twenties. This is the case of a child from the Congo aged 14 severely undernourished presenting with sickle-cell anemia and backgrounds of repeated ischemic ictus, seen in the "Cira García" International Clinic. Magnetic resonance showed signs of an old infarction at different levels of both hemispheres and encephalomalacia zones. This patient shows the natural course of the cerebrovascular complications of sickle-cell anemia.

  10. Late vascular effects of whole brain X-irradiation in the mouse

    Energy Technology Data Exchange (ETDEWEB)

    Yoshii, Y [Tsukuba Univ., Sakma, Ibaraki (Japan). Inst. of Clinical Medicine; Phillips, T L [California Univ., San Francisco (USA). Dept. of Radiation Oncology

    1982-01-01

    The whole brains of mice were irradiated with 250kVp X-rays at 120 rads min/sup -1/ (1.6 mm Cu HVL, TSD 50 cm), and a histological study was carried out. The dose range of X-irradiation was from 1,300 to 2,500 rads, i.e., 1,300, 1,500, 1,750, 2,000, and 2,500 rads. Eighty-six mice were used for histological examination. For microscopic examination, the mice were killed at regular postirradiation intervals between 15 and 20, 31 and 40, 41 and 50, 51 and 60, 61 and 70, 71 and 80, 81 and 90, 139 and 177 weeks. The brains were removed immediately thereafter, fixed in Bouin's solution, and embedded in paraffin. A histological examination was performed by a morphometric estimation of vascular lesions, in which the degree of the damage to the arterial system was scored in whole serial brain section. Necrosis (encephalomalacia), atrophy, cell infiltration, and telangiectactic vascular change of the brain, caused as a result of the fibrinoid necrosis of the large arteries, were observed. Dose-dependent incidence of the fibrinoid necrosis increased between 41 and 87 weeks after irradiation. Mean score of fibrinoid necrosis increased dose dependently approximately 60 weeks after irradiation. It is suggested that scores of large vessel damage do relate to dose at 41 to 87 weeks, and can be used to quantify the vessel injury, and that fibrinoid necrosis of the large vessels may relate to the incidence of radionecrosis.

  11. Late vascular effects of whole brain X-irradiation in the mouse

    International Nuclear Information System (INIS)

    Yoshii, Y.; Phillips, T.L.

    1982-01-01

    The whole brains of mice were irradiated with 250kVp X-rays at 120 rads min -1 (1.6 mm Cu HVL, TSD 50 cm), and a histological study was carried out. The dose range of X-irradiation was from 1,300 to 2,500 rads, i.e., 1,300, 1,500, 1,750, 2,000, and 2,500 rads. Eighty-six mice were used for histological examination. For microscopic examination, the mice were killed at regular postirradiation intervals between 15 and 20, 31 and 40, 41 and 50, 51 and 60, 61 and 70, 71 and 80, 81 and 90, 139 and 177 weeks. The brains were removed immediately thereafter, fixed in Bouin's solution, and embedded in paraffin. A histological examination was performed by a morphometric estimation of vascular lesions, in which the degree of the damage to the arterial system was scored in whole serial brain section. Necrosis (encephalomalacia), atrophy, cell infiltration, and telangiectactic vascular change of the brain, caused as a result of the fibrinoid necrosis of the large arteries, were observed. Dose-dependent incidence of the fibrinoid necrosis increased between 41 and 87 weeks after irradiation. Mean score of fibrinoid necrosis increased dose dependently approximately 60 weeks after irradiation. It is suggested that scores of large vessel damage do relate to dose at 41 to 87 weeks, and can be used to quantify the vessel injury, and that fibrinoid necrosis of the large vessels may relate to the incidence of radionecrosis. (Author)

  12. Hydrocephalus in a yellow-headed Amazon parrot (Amazona ochrocephala oratrix).

    Science.gov (United States)

    Keller, Krista A; Guzman, David Sanchez-Migallon; Muthuswamy, Anantharaman; Forrest, Lisa J; Steinberg, Howard; Sladky, Kurt; Petersen, Sophie

    2011-09-01

    A 37-year-old female yellow-headed Amazon parrot (Amazona ochrocephala oratrix) was presented after a 4-month-period behavior change and intermittent episodes of obtunded mentation. Clinical findings on physical examination included ataxia, a weak grasp, and reluctance to move. Results of magnetic resonance imaging were consistent with severe hydrocephalus without evidence of cerebrospinal fluid obstruction. The bird was treated with tapering dosages of prednisolone over a 4-month period, during which time the episodes did not occur. Discontinuation of treatment was attempted several times but resulted in relapse. After 3.5 years of maintenance treatment with prednisolone, the bird was presented subsequent to a 5-hour episode of obtunded mentation and worsening neurologic signs. Despite increasing the dose of prednisolone and providing additional supportive care, the bird's condition worsened, and euthanasia was elected. Necropsy findings included severe hydrocephalus with significant loss of right cerebral parenchyma and no evidence of cerebrospinal fluid obstruction. Histologic examination of the remaining cerebral parenchyma revealed a moderate, multifocal, cellular infiltrate; encephalomalacia; fibrosis; and hemosiderosis in tissue adjacent to the distended ventricles. Other findings included hepatic vacuolar degeneration. Diagnostic imaging and postmortem findings were consistent with a diagnosis of hydrocephalus ex vacuo. To our knowledge, this is the first report of hydrocephalus in an Amazon parrot as well as the first report of hydrocephalus in any avian species associated with long-term follow-up and prolonged corticosteroid treatment.

  13. Follow-up neurological evaluation in patients with small cell lung carcinoma treated with prophylactic cranial irradiation and chemotherapy

    International Nuclear Information System (INIS)

    Catane, R.; Schwade, J.G.; Yarr, I.; Licher, A.S.; Tepper, J.E.; Dunnick, N.R.; Brody, L.; Brereton, H.D.; Cohen, M.; Glatstein, E.

    1981-01-01

    The safety of prophylactic cranial irradiation (PCI) has recently been questioned, based on reports of computerized tomographic abnormalities mainly seen in children, who received PCI and chemotherapy, primarily for acute lymphocytic leukemia. In order to clarify the significance of these findings, we examined a series of adult patients who were long term survivors (18 to 48 months, median 26 months, after all treatment). These patients were treated with combination radiotherapy and chemotherapy for small cell lung carcinoma and received cranial irradiation in the absence of known brain involvement by tumor. Patients were divided into three groups: three patients who received PCI + intrathecal methotrexate (MTX) (Group 1), and ten who received only PCI (Group 2). An additional three patients (Group 3) were identified as long term survivors (41 to 70 months after all treatments) of a similar treatment program without any central nervous system (CNS) prophylaxis. All patients received an extensive evaluation of a variety of clinical parameters, EEG, and computer tomography (CT). Although CT abnormalities were detectable (mild cerebral atrophy in eight patients, encephalomalacia in one of the 13 patients with CNS prophylaxis, and mild atrophy in two of the three patients without CNS prophylaxis), no significant clinical abnormalities or EEG changes were detectable. While this group of patients is small, it is a unique cohort: adults who have received cranial irradiation in the absence of known brain tumor with long term follow-up. The precise role of CNS prophylaxis in the etiology of CT abnormalities is unclear, and the lack of clinically significant changes would suggest no contraindication to PCI when indicated

  14. 99mTc-HMPAO Brain SPECT in Patients with Post-Traumatic Organic Mental Disorder

    International Nuclear Information System (INIS)

    Lee, Kang Wook; Lee, Dong Jin; Shong, Min Ho; Kang, Min Hee; Ghi, Ick Sung; Shin, Young Tai; Ro, Heung Kyu

    1994-01-01

    It is well known that 99m Tc-HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of 99m Tc-HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD). We included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of 99m Tc-HMPAO SPECT with those of MRI, EEG and MINI mental status examination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on 99m Tc-HMPAO SPECT. 2) Most frequent lesion on brain 99m Tc-HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain 99m Tc-HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain 99m Tc-HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain 99m Tc-HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that 99m Tc-HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.

  15. High-resolution cranial ultrasound in the shaken-baby syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Chen, C.Y.; Chin, S.C.; Lee, C.C.; Lee, K.W. [Dept. of Radiology, Tri-Service General Hospital and National Defence Medical Centre, Taipei, Taiwan (Taiwan); Huang, C.C. [Dept. of Paediatrics, National Cheng Kung University Hospital, Tainan (Taiwan); Zimmerman, R.A. [Dept. of Radiology, Children' s Hospital of Philadelphia, PA (United States); Yuh, Y.S.; Chen, S.J. [Dept. of Paediatrics, Tri-Service General Hospital and National Defence Medical Centre, Neihu, Taipei (Taiwan)

    2001-08-01

    With limited near-field resolution and accessible acoustic windows, sonography has not been advocated for assessing central nervous system injuries in the shaken-baby syndrome. Our purpose was to correlate high-resolution ultrasonographic characteristics of central nervous system injuries in whiplash injuries and the shaken-baby-syndrome with MRI and CT. Ultrasonographic images of 13 infants, aged 2-12 months, with whiplash or shaking cranial trauma were reviewed and compared with MRI in 10 and CT in 10. Five patients had serial ultrasonography and MRI or CT follow-up from 1 to 4 months after the initial injury. With ultrasonography we identified 20 subdural haematomas. MRI and CT in 15 of these showed that four were hyperechoic in the acute stage, three were mildly echogenic in the subacute stage, and that one subacute and seven chronic lesions were echo-free. Five patients had acute focal or diffuse echogenic cortical oedema which evolved into subacute subcortical hyperechoic haemorrhage in four, and well-defined chronic sonolucent cystic or noncystic encephalomalacia was seen at follow-up in two. Using ultrasonography we were unable to detect two posterior cranial fossa subdural haematomas or subarachnoid haemorrhage in the basal cisterns in three cases, but did show blood in the interhemispheric cistern and convexity sulci in two. Ultrasonography has limitations in demonstrating abnormalities remote from the high cerebral convexities but may be a useful adjunct to CT and MRI in monitoring the progression of central nervous system injuries in infants receiving intensive care. (orig.)

  16. High-resolution cranial ultrasound in the shaken-baby syndrome

    International Nuclear Information System (INIS)

    Chen, C.Y.; Chin, S.C.; Lee, C.C.; Lee, K.W.; Huang, C.C.; Zimmerman, R.A.; Yuh, Y.S.; Chen, S.J.

    2001-01-01

    With limited near-field resolution and accessible acoustic windows, sonography has not been advocated for assessing central nervous system injuries in the shaken-baby syndrome. Our purpose was to correlate high-resolution ultrasonographic characteristics of central nervous system injuries in whiplash injuries and the shaken-baby-syndrome with MRI and CT. Ultrasonographic images of 13 infants, aged 2-12 months, with whiplash or shaking cranial trauma were reviewed and compared with MRI in 10 and CT in 10. Five patients had serial ultrasonography and MRI or CT follow-up from 1 to 4 months after the initial injury. With ultrasonography we identified 20 subdural haematomas. MRI and CT in 15 of these showed that four were hyperechoic in the acute stage, three were mildly echogenic in the subacute stage, and that one subacute and seven chronic lesions were echo-free. Five patients had acute focal or diffuse echogenic cortical oedema which evolved into subacute subcortical hyperechoic haemorrhage in four, and well-defined chronic sonolucent cystic or noncystic encephalomalacia was seen at follow-up in two. Using ultrasonography we were unable to detect two posterior cranial fossa subdural haematomas or subarachnoid haemorrhage in the basal cisterns in three cases, but did show blood in the interhemispheric cistern and convexity sulci in two. Ultrasonography has limitations in demonstrating abnormalities remote from the high cerebral convexities but may be a useful adjunct to CT and MRI in monitoring the progression of central nervous system injuries in infants receiving intensive care. (orig.)

  17. The preliminary study of 18F-FDG brain PET in diagnosis of alzheimer's disease

    International Nuclear Information System (INIS)

    Ma Yunchuan; Zhang Xinqing; Li Depeng; Shang Jianwen; Su Yusheng; Zhang Linying; Peng Cheng; Pan Zhongyun

    2000-01-01

    Objective: To investigate the imaging characteristics and diagnostic criteria of 18 F-FDG brain PET in diagnosis of Alzheimer's disease (AD). Methods: The sutdy included 12 normal subjects, 12 patients with AD and 11 patients with non-AD dementia. 40 min after intravenous administration of 18 F-FDG, brain scan was performed using Siemens ECAT47 scanner. The transaxial, coronal and sagittal images were then reconstructed by computer. At the same time, semiquantitative analysis was also applied to help evaluation using the ratio of mean radioactivity of cerebral lobe to cerebellum (R cl/cb ). Results: In normal subjects PET scan showed clear images of cerebral cortex, basal ganglia, thalamus and cerebellum with symmetrical distribution of radioactivity. PET images from Alzheimer's disease patients were classified into 3 patterns: bilateral parietal hypometabolism in 5 cases, bilateral temporo-parietal hypometabolism in 4 cases and unilateral temporo-parietal hypometabolism in 3 cases. The R cl/cb of AD patients in parietal and temporal lobe was significantly decreased than normal subjects (P cl/cb was also reflecting thedementia degree. Compared with MRI imaging , 12 patients with AD had cerebral hypometabolism but only 10 had hippocampus atrophy. 10 patients with non-AD dementia had local structural foci seen in MRI, including old hemorrhage, infarction and encephalomalacia, but these lesions were not found in AD. Conclusions: Based on excluding cerebral structural lesions which are better detected by MRI, bilateral or unilateral parietal or temporo-parietal hypometabolism found in FDG PET can be considered indicative of Alzheimer's disease. Semiquantitative analysis of the images yielded can help to evaluate the dementia degree

  18. Diagnostic and prognostic values of CT in neonate hypoxic and ischemic encephalopathy

    International Nuclear Information System (INIS)

    Yu Hongsheng; Ji Luzhou; Sun Guoyun

    2009-01-01

    Objective: To explore the relationship between the clinical grades, severity of asphyxia and CT grades, and to investigate the CT value in predicting the outcomes in neonates with hypoxia and ischemia encephalopathy (HIE). Methods: A total of 83 neonates that had obvious history of asphyxia and were diagnosed as HIE were studied. Their clinic and CT data were carefully analyzed. Results: Seventy-nine of 83 HIE neonates CT showed significant abnormalities in various extents. Main manifestations included cerebral edema, infarction, and intracranial hemorrhage. Pure subarachnoid hemorrhage (SAH) was detected most often (28 out of 42) among the intracranial hemorrhage, and followed by complex hemorrhage (14 out of 42). HIE clinic grades were consistent with CT grades (r=0.7989, t r =11.95. P<0.01); while severity of asphyxia and CT grades were significantly correlated (r=0.692, t r =8.63, P<0.01), i.e. more serious asphyxia resulted in higher CT grade indicating more severe brain damage. Follow-up CT showed that the brain parenchyma with mild or mediate abnormalities on initial CT, the hypodense lesions shrank or even disappeared, and SAH was absorbed completely. However, the severe complex intracranial hemorrhage and cerebral infarction resulted in local encephalomalacia, atrophy, hydrocephalus, parenchymal calcification, and porencephalia. Three patients died during the follow-up period (χ = 30.95, P< 0.01). Conclusion: Cerebral edema. infarction, and intracranial hemorrhage are key CT signs in diagnosis of HIE. SAH is the most frequent complication of HIE. CT can provide objective evidences in the diagnosis and prognosis assessment of HIE. (authors)

  19. MR findings of cerebral palsy and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Ho; Kim, In One; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-04-01

    To demonstrate MR findings of cerebral palsy (CP), correlation with clinical findings, and differences between the full-term and pre-term group. Brain MRI of 94 patients with cerebral palsy (CP) were reviewed. The frequency of each MR finding, statistical correlation with clinical findings including type, severity and extent of CP, and differences between the full-term and pre-term group were analyzed. Abnormal MR findings were found in 83 patients(88%), and were as follows : diffuse brain atrophy(30%); periventricular leukomalacia(PVL)(28%); infarction(11%), basal ganglia abnormality(11%); delayed myelination(10%); nonspecific tissue loss or encephalomalacia(9%); and cortical dysplasia(7%). Hemiplegia was the most common condition among patients with infarction, and was found in 80% of this group; diplegia was found in 50% of cases with diffuse brain atrophy, while paraplegia was found in 36% of those with normal MR findings (p < .05). Mild symptoms were dominant in patients with normal MR findings(82%) and in those with infarctions(90%)(p < .05). PVL was the dominant finding in the pre-term group (65%) whereas findings in the full-term group varied; in this group, 38% of MR findings suggested prenatal insults. Possible causative factors were found in 66% of the full-term and 80% of the pre-term group. Perinatal factors were dominant in the pre-term group(81%), whereas prenatal and postnatal factors showed relatively higher frequencies in the full-term group(30% and 24%, respectively). Diffuse brain atrophy and PVL were the most common MR findings. The extent of CP the pre-term correlated well with MR findings. PVL and perinatal factors were dominant in the pre-term group, whereas variable MR findings and relatively higher frequencies of pre- and postnatal factors were found in the full-term group.

  20. MR findings of cerebral palsy and clinical correlation

    International Nuclear Information System (INIS)

    Kim, Sun Ho; Kim, In One; Kim, Woo Sun; Yeon, Kyung Mo

    1997-01-01

    To demonstrate MR findings of cerebral palsy (CP), correlation with clinical findings, and differences between the full-term and pre-term group. Brain MRI of 94 patients with cerebral palsy (CP) were reviewed. The frequency of each MR finding, statistical correlation with clinical findings including type, severity and extent of CP, and differences between the full-term and pre-term group were analyzed. Abnormal MR findings were found in 83 patients(88%), and were as follows : diffuse brain atrophy(30%); periventricular leukomalacia(PVL)(28%); infarction(11%), basal ganglia abnormality(11%); delayed myelination(10%); nonspecific tissue loss or encephalomalacia(9%); and cortical dysplasia(7%). Hemiplegia was the most common condition among patients with infarction, and was found in 80% of this group; diplegia was found in 50% of cases with diffuse brain atrophy, while paraplegia was found in 36% of those with normal MR findings (p < .05). Mild symptoms were dominant in patients with normal MR findings(82%) and in those with infarctions(90%)(p < .05). PVL was the dominant finding in the pre-term group (65%) whereas findings in the full-term group varied; in this group, 38% of MR findings suggested prenatal insults. Possible causative factors were found in 66% of the full-term and 80% of the pre-term group. Perinatal factors were dominant in the pre-term group(81%), whereas prenatal and postnatal factors showed relatively higher frequencies in the full-term group(30% and 24%, respectively). Diffuse brain atrophy and PVL were the most common MR findings. The extent of CP the pre-term correlated well with MR findings. PVL and perinatal factors were dominant in the pre-term group, whereas variable MR findings and relatively higher frequencies of pre- and postnatal factors were found in the full-term group

  1. A distinct clinicopathological variant of focal cortical dysplasia IIId characterized by loss of layer 4 in the occipital lobe in 12 children with remote hypoxic-ischemic injury.

    Science.gov (United States)

    Wang, Dan-Dan; Piao, Yue-Shan; Blumcke, Ingmar; Coras, Roland; Zhou, Wen-Jing; Gui, Qiu-Ping; Liu, Cui-Cui; Hu, Jing-Xia; Cao, Li-Zhen; Zhang, Guo-Jun; Lu, De-Hong

    2017-10-01

    In 2011, the International League Against Epilepsy (ILAE) proposed a consensus classification system of focal cortical dysplasia (FCD) to distinguish clinicopathological subtypes, for example, "isolated" FCD type Ia-c and IIa-b, versus "associated" FCD type IIIa-d. The histopathological differentiation of FCD type I and III variants remains, however, a challenging issue in everyday practice. We present a unique histopathological pattern in patients with difficult-to-diagnose FCD, which highlights this dilemma, but also helps to refine the current ILAE classification scheme of FCD. We present a retrospective series of 11 male and one female patient with early onset pharmacoresistant epilepsy of the posterior quadrant (mean age at seizure onset = 4.6 years). All surgical specimens were reviewed. Clinical histories were retrieved and extracted from archival patient files. Microscopic inspection revealed abnormalities in cortical architecture with complete loss of layer 4 in all surgical samples of the occipital lobe, as confirmed by semiquantitative measurements (p occipital lobe in all patients, and signal changes suggestive of subcortical encephalomalacia were found in seven patients. Surgical treatment achieved favorable seizure control (Engel class I and II) in seven patients with an available follow-up period of 6.1 years. Prominent disorganization of cortical layering and lack of any other microscopically visible principle lesion in the surgical specimen would result in this neuropathological pattern hitherto being classified as FCD ILAE type Ib. However, perinatal hypoxia with distinctive MRI changes suggested primarily a hypoxemic lesion and acquired pathomechanism of neuronal cell loss in the occipital lobe of our patient series. We propose, therefore, classifying this distinctive clinicopathological pattern as a separate variant of FCD ILAE type IIId. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  2. Lesion-induced pseudo-dominance at functional magnetic resonance imaging: implications for preoperative assessments.

    Science.gov (United States)

    Ulmer, John L; Hacein-Bey, Lotfi; Mathews, Vincent P; Mueller, Wade M; DeYoe, Edgar A; Prost, Robert W; Meyer, Glenn A; Krouwer, Hendrikus G; Schmainda, Kathleen M

    2004-09-01

    To illustrate how lesion-induced neurovascular uncoupling at functional magnetic resonance imaging (fMRI) can mimic hemispheric dominance opposite the side of a lesion preoperatively. We retrospectively reviewed preoperative fMRI mapping data from 50 patients with focal brain abnormalities to establish patterns of hemispheric dominance of language, speech, visual, or motor system functions. Abnormalities included gliomas (31 patients), arteriovenous malformations (AVMs) (11 patients), other congenital lesions (4 patients), encephalomalacia (3 patients), and tumefactive encephalitis (1 patient). A laterality ratio of fMRI hemispheric dominance was compared with actual hemispheric dominance as verified by electrocortical stimulation, Wada testing, postoperative and posttreatment deficits, and/or lesion-induced deficits. fMRI activation maps were generated with cross-correlation (P frontal gyrus gliomas and in one patient with focal tumefactive meningoencephalitis, fMRI incorrectly suggested strong right hemispheric speech dominance. In two patients with lateral precentral gyrus region gliomas and one patient with a left central sulcus AVM, the fMRI pattern incorrectly suggested primary corticobulbar motor dominance contralateral to the side of the lesion. In a patient with a right superior frontal gyrus AVM, fMRI revealed pronounced left dominant supplementary motor area activity in response to a bilateral complex motor task, but right superior frontal gyrus perilesional hemorrhage and edema subsequently caused left upper-extremity plegia. Pathophysiological factors that might have caused neurovascular uncoupling and facilitated pseudo-dominance at fMRI in these patients included direct tumor infiltration, neovascularity, cerebrovascular inflammation, and AVM-induced hemodynamic effects. Sixteen patients had proven (1 patient), probable (2 patients), or possible (13 patients) but unproven lesion-induced homotopic cortical reorganization. Lesion-induced neurovascular

  3. Hemodynamic and metabolic correlates of perinatal white matter injury severity.

    Directory of Open Access Journals (Sweden)

    Art Riddle

    Full Text Available Although the spectrum of perinatal white matter injury (WMI in preterm infants is shifting from cystic encephalomalacia to milder forms of WMI, the factors that contribute to this changing spectrum are unclear. We hypothesized that the variability in WMI quantified by immunohistochemical markers of inflammation could be correlated with the severity of impaired blood oxygen, glucose and lactate.We employed a preterm fetal sheep model of in utero moderate hypoxemia and global severe but not complete cerebral ischemia that reproduces the spectrum of human WMI. Since there is small but measurable residual brain blood flow during occlusion, we sought to determine if the metabolic state of the residual arterial blood was associated with severity of WMI. Near the conclusion of hypoxia-ischemia, we recorded cephalic arterial blood pressure, blood oxygen, glucose and lactate levels. To define the spectrum of WMI, an ordinal WMI rating scale was compared against an unbiased quantitative image analysis protocol that provided continuous histo-pathological outcome measures for astrogliosis and microgliosis derived from the entire white matter.A spectrum of WMI was observed that ranged from diffuse non-necrotic lesions to more severe injury that comprised discrete foci of microscopic or macroscopic necrosis. Residual arterial pressure, oxygen content and blood glucose displayed a significant inverse association with WMI and lactate concentrations were directly related. Elevated glucose levels were the most significantly associated with less severe WMI.Our results suggest that under conditions of hypoxemia and severe cephalic hypotension, WMI severity measured using unbiased immunohistochemical measurements correlated with several physiologic parameters, including glucose, which may be a useful marker of fetal response to hypoxia or provide protection against energy failure and more severe WMI.

  4. Epilepsy surgery in the elderly: an unusual case of a 75-year-old man with recurrent status epilepticus.

    Science.gov (United States)

    Tellez-Zenteno, Jose F; Sadanand, Venkatraman; Riesberry, Martha; Robinson, Christopher A; Ogieglo, Lissa; Masiowski, Paul; Vrbancic, Mirna

    2009-06-01

    Epilepsy surgery is increasingly well-supported as an effective treatment for patients with intractable epilepsy. It is most often performed on younger patients and the safety and efficacy of epilepsy surgery in elderly patients are not frequently described. We report a case of a 75-year-old right-handed man who underwent a left fronto-temporal craniotomy for resection of a suprasellar meningioma in 2002. Immediately following hospital discharge, he began to experience complex partial seizures. He continued to have frequent seizures despite treatment with multiple combinations of antiepileptic medications. He presented with status epilepticus every two or three months, and required long periods of hospitalization on each occasion for post-ictal confusion and aphasia. Scalp EEG showed continuous spikes and polyspikes and persistent slowing in the left temporal area, as well as spikes in the left frontal area. EEG telemetry recorded multiple seizures, all with a clear focus in the left temporal area. MRI scan showed an area of encephalomalacia in the left temporal lobe, as well as post-surgical changes in the left frontal area. Neuropsychological testing showed bilateral memory impairment with no significant cognitive decline expected after unilateral temporal lobe resection. A left anteromesial temporal lobectomy was performed with intraoperative electrocorticography. Since surgery, the patient was not seizure-free (Engel class II-b), but had no further episodes of status epilepticus in one year and two months of follow-up. This is one of the oldest patients reported in the literature with epilepsy surgery and supports the possibility of epilepsy surgery in elderly patients for particular cases. In addition, few cases with such a malignant evolution of temporal lobe epilepsy have been described in this age group.

  5. Epilepsy secondary to Menkes' disease: five cases report and review of literature

    Directory of Open Access Journals (Sweden)

    Pei-yuan ZHANG

    2014-12-01

    Full Text Available Objective To study the clinical features of patients with Menkes' disease (MD that initiate from seizures, and to reinforce the knowledge of etiological diagnosis of secondary epilepsy.  Methods The clinical and laboratory features of 5 MD patients who were admitted from December 1992 to March 2014 were retrospectively analyzed.  Results All cases were male infants including two brothers, and the age of onset was 1-5 months after birth. Their clinical manifestations started from tonic (N = 3 and focal clonic (N = 2 seizures. The focal clonic seizures became more frequent and progressively worsened. Four cases showed abnormal background EEG rhythm; 3 cases revealed interictal focal or multifocal epileptiform discharges over occipital region predominantly; 2 cases revealed epileptic discharge in fit period EEG. All the cases manifested severe mental retardation accompanied with light complexion and curly hair. Low serum copper and ceruloplasmin levels were found in 4 cases and lead to the diagnosis of MD. The exceptional one was made clinical diagnosis of MD due to his typical manifestation and the diagnosis of his elder brother. Three cases received MRI examination, which showed extensive cerebral atrophy and symmetric encephalomalacia foci. One case revealed tortuosity of main artery and diminution of distal artery by MRA. One case was treated with phenobarbital, 2 cases with topiramate, one case with topiramate and levetiracetam and clonazepam. One case died of respiratory failure at 24 h after admission. The other 4 cases were followed up for 1-9 months after being discharged, 3 of whom died, and the left one converted to intractable infantile spasms and severe mental retardation, with interictal EEG changing to hypsarrhythmia.  Conclusions The onset of patients with epilepsy secondary to MD often occurs in early infancy, manifesting tonic and focal clonic seizures predominantly with interictal epileptiform discharges over the posterior

  6. Toxicity of inhaled 238PuO2 in beagle dogs. A. Monodisperse 1.5 μm 238PuO2. B. Monodisperse 3.0 μm 238PuO2 particles. III

    International Nuclear Information System (INIS)

    Lustgarten, C.S.; Mewhinney, J.A.; Hobbs, C.H.; Halliwell, W.H.; Jones, R.K.; Mauderly, J.L.; McClellan, R.O.; Mo, T.; Pickrell, J.A.

    1976-01-01

    To obtain essential information on the importance of the homogeneity or non-homogeneity of the radiation dose to lung (the hot particle question), Beagle dogs have been exposed to monodisperse aerosols (sigma/sub g/ 238 PuO 2 of either 1.5 μm or 3.0 μm aerodynamic diameter (AD). By using monodisperse particles of these two sizes, the average dose to lung is held constant for a given initial lung burden, but the local alpha dose around the two sizes of particles varies by a factor of about ten. All exposures have been completed with 72 days exposed to each of the two particle sizes of 238 PuO 2 (total of 144 dogs) resulting in graded initial lung burdens which range from .005 to 2.2 μCi/kg of body weight. Twenty-four dogs exposed to the diluent aerosol are serving as controls. The animals will be studied over their total life span. Two exposed dogs have died from pulmonary injury: Dog 710C (with an initial lung burden of 2.0 μCi/kg) died at 631 days after inhalation of 3.0 μm AD aerosol. The cause of death was radiation pneumonitis and pulmonary fibrosis, Dog 746B (with an initial lung burden of 1.3 μCi/kg) died at 791 days after inhalation of 1.5 μm AD aerosol. Death was attributed to intrapulmonic hemorrhage resulting from a degenerative vasculitis. One control dog (721A) was euthanized at 820 days after exposure due to a meningitis and encephalomalacia that caused a severe central nervous system disorder that made the dog difficult to handle.A leukopenia in exposed dogs to date has occurred earlier and to a greater degree in dogs exposed to 3.0 μm AD particles than in dogs that recevied 1.5 μm AD particles. One hundred forty-two exposed and 23 control dogs are surviving at 175 to 1024 days after exposure

  7. [Clinical analysis and follow-up of neonatal purulent meningitis caused by group B streptococcus].

    Science.gov (United States)

    Zhu, Minli; Zhu, Jianghu; Li, Haijing; Liu, Peining; Lin, Zhenlang

    2014-02-01

    To study the clinical characteristics, antibiotics sensitivity and outcome of group B streptococcus (GBS) meningitis in neonates in order to provide the guide for early diagnosis and appropriate treatment. A retrospective review was performed and a total of 13 cases of neonatal purulent meningitis caused by GBS were identified in the Neonatal Intensive Care Unit of Yuying Children's Hospital of Wenzhou Medical University from January 1, 2005 to May 31, 2013. The clinical characteristics, antibiotics sensitivity test results and outcome were analyzed. Fever, poor feeding, seizure and lethargy were common clinical signs of neonatal purulent meningitis caused by GBS. Three cases of early onset GBS meningitis received prepartum antibiotics. All 13 cases had abnormal C-reactive protein (CRP) level, and 11 cases had increased CRP within hours after admission. Of the 13 patients, 7 were cured, 4 discharged with improvement, 2 patients died during hospitalization after being given up because of serious complication. The average length of stay for recovered patients was (47 ± 21)d. Acute complications mainly included hyponatremia (5 cases), intracranial hemorrhage (3 cases) , ventriculomegaly (3 cases) , subdural collection (2 cases) , hydrocephalus (2 cases), septic shock (2 cases), cerebral hernia (1 case), encephalomalacia (1 case). One preterm patient with early onset GBS meningitis died 1 month after hospital discharge. Among 7 survivors with 10-24 months follow-up, 3 were early onset GBS meningitis, 2 with normal results of neurologic examination, 1 with delayed motor development, 4 were late onset GBS meningitis, 1 with normal results of neurologic examination, 3 were neurologically impaired with manifestations including delayed motor development (2 cases) and seizures (1 case). All the GBS strains were sensitive to penicillin and linezolid (13/13, 10/10), the susceptibility to levofloxacin, ampicillin and vancomycin were 11/12, 9/10, 8/13 respectively. The clinical

  8. MRI findings of brain damage due to neonatal hypoglycemia

    International Nuclear Information System (INIS)

    Wang Lu; Fan Guoguang; Ji Xu; Sun Baohai; Guo Qiyong

    2009-01-01

    Objective: To report the MRI findings of brain damage observed in neonatal patients who suffered from isolated hypoglycemia and to explore the value of diffusion-weighted imaging(DWI) in early detection of neonatal hypoglycemic brain injury. Methods: Twelve neonates with isolated hypoglycemia (10 of the 12 were diagnosed to suffer from hypoglycemic encephalopathy) were enrolled in this study. They were first scanned at age from 3 days to 10 days with T 1 WI, T 2 WI and DWI(b is 0 s/mm 2 , 1000 s/mm 2 ), and 4 of them were then scanned from 7 days to 10 days following the initial scan. All acquired MR images were retrospectively analysed. Results: First series of DWI images showed distinct hyperintense signal in 11 cases in several areas including bilateral occipital cortex (2 cases), right occipital cortex (1 case), left occipital cortex and subcortical white matter(1 case), bilateral occipital cortex and subcortical white matter (2 cases), bilateral parieto-occipital cortex (2 cases), bilateral parieto-occipital cortex and subcortical white matter(2 cases), the splenium of corpus callosum (4 cases), bilateral corona radiata( 2 cases), left caudate nucleus and globus pallidus (1 case), bilateral thalamus (1 case), bilaterally posterior limb of internal capsule (1 case). In the initial T 1 WI and T 2 WI images, there were subtle hypointensity in the damaged cortical areas (3 cases), hyperintensity in the bilaterally affected occipital cortex( 1 case) on T 1 weighted images, and hyperintensity in the affected cortex and subcortical white matter with poor differentiation on T 2 weighted images. The followed-up MRI of 4 cases showed regional encephalomalacia in the affected occipital lobes(4 cases), slightly hyperintensity on T 2 weighted images in the damaged occipital cortex (2 cases), extensive demyelination (1 case), disappearance of hyperintensity of the splenium of corpus callosum (1 case), and persistent hyperintensity in the splenium of corpus callosum (1 case

  9. The preliminary study of 18F-FDG PET in diagnosis of Alzheimer's disease

    International Nuclear Information System (INIS)

    Ma, Y.; Zhang, X.; Le, D.

    2000-01-01

    was. The Rcl/cb can also be indicated the dementia degree. Compared with MR imaging, 12 patients with AD had cerebral hypo metabolism but only 10 had hippocampus atrophy. 10 patients with non-AD dementia had local structural foci which were seen in MR, including old hemorrhage infarction and encephalomalacia, but these lesions were not found in AD. 1 patient with mild LBD was both negative PET and MR. Based on excluding cerebral structural lesions which are better detected by MR, bilateral or unilateral parietal or temporo-parietal hypo metabolism found in FDG PET are considered as indicative of Alxhemer's disease. Semiquantitative analysis can help to evaluate dementia degree

  10. The preliminary study of {sup 18}F-FDG PET in diagnosis of Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Y.; Zhang, X.; Le, D. [Capital Univ. of Medical Sciences, Beijing (Switzerland)] [and others

    2000-07-01

    hypometabloic region was. The Rcl/cb can also be indicated the dementia degree. Compared with MR imaging, 12 patients with AD had cerebral hypo metabolism but only 10 had hippocampus atrophy. 10 patients with non-AD dementia had local structural foci which were seen in MR, including old hemorrhage infarction and encephalomalacia, but these lesions were not found in AD. 1 patient with mild LBD was both negative PET and MR. Based on excluding cerebral structural lesions which are better detected by MR, bilateral or unilateral parietal or temporo-parietal hypo metabolism found in FDG PET are considered as indicative of Alxhemer's disease. Semiquantitative analysis can help to evaluate dementia degree.

  11. Doenças neurológicas de ovinos na região central do Rio Grande do Sul Neurological diseases in sheep from central Rio Grande do Sul state, southern Brazil

    Directory of Open Access Journals (Sweden)

    Daniel R. Rissi

    2010-03-01

    mailed in samples from practitioners. Out of these, 69 experimental cases were excluded from this study. The remaining 517 cases were composed of 361 (69.8% cases with conclusive diagnoses and 156 (30.2% cases with inconclusive diagnoses. In 58 (16% occasions, sheep died in consequence of neurological disease. Most important diseases included coenurosis (15 cases or 25.8%, listeriosis (9 cases or 15.5%, tetanus (8 cases or 13.7%, vertebral abscesses (4 cases or 6.8%, and cerebral abscesses (3 cases or 5.1%. Poisoning by Erytroxylum argentinum, post-caudectomy suppurative myelitis, fibrinosuppurative meningoencephalitis, polioencephalomalacia, rabies (2 cases or 3.4% each were occasionally diagnosed. Spinal cord demyelinization, encephalic white matter edema, focal symmetrical encephalomalacia, hydranencephalia, cerebellar hypoplasia, poisoning by organophosphate, poisoning by Solanum pseudocapsicum, fibrinosuppurative myelitis, and presumptive closantel toxicity (1 case or 1.7% each were rarely seen.

  12. Correlation of glucose metabolism in brain cells and brain morphological changes with clinical typing in children with cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    Qiongxiang Zhai; Huixian Qiao; Jiqing Liu

    2006-01-01

    palsy with PET image. RESULTS:All 31 children were involved in the final analysis.No one was dropped out in this study.①Analytic results of glucose metabolism in brain cells:Glucose metabolism of 28 children was abnormal,and the abnormal rate was 90%.The symptoms of glucose metabolism were as the same as those of hypometabolism.A total of 13 cases had multi-focal abnormality,8 mono-focal abnormality,7 glucose-diffused abnormality.and 3 normality.②Correlation between MRI examination and abnormal degree of PET imagling:Three cases had normal PET imagling but abnormal MRI examination. Among children with mono-focal abnormality of PET imagling,2 had brain atrophy,3 poor brain white matter,5 encephalomalacia focus, 1 hydrocephalus.and 1 normality.Among children with multi-focal abnormality of PET imagling,3 had brain atrophy,4 poor brain white matter,5 encephaiomalacia focus,and 1 hydrocephalus.Among children with glucose-diffused abnormality of PET imagling,3 had brain atrophy,2 poor brain white matter,1 hydrocephalus,and 1 nor mality.There were significant differences between various groups of MRI abnormality and abnormal degree of PET imagling(P<0.01),and brain atrophy was the main symptom.③Correlation between vanous types of cerebral palsy and abnormal degree of PET imagling:Among 10 children with cerebral palsy,one case had normal PET imagling,2 mono-focal abnormality,4 multi-focal abnormality,and 3 diffused abnormality.Among 13 children with cerebral palsy of mixed type.there wer 1,4,6 and 2 cases with normal and abnormal PEI imagling,respectively.Among 4 children with cerebral palsy of gradual-movement type,there were 0,1,2 and 1 cases with normal and abnormal PET imagling,respectively.Among 4 children with cerebrel palsy of ataxia,there was 1 and 1 case with normal and abnormal PET imaging,respectively.There were significant differences between various types of cerebral palsy and abnormal degree of PET imagling(P<0.01),and spasm and mixed types were obvious

  13. 中枢神经系统感染新生儿颅脑超声结果分析%Features of craniocerebral ultrasonography of neonates with central nervous system infections

    Institute of Scientific and Technical Information of China (English)

    周江英; 邓旦; 张溢

    2018-01-01

    to the types of the central nervous system infection.All of the neonates received the craniocerebral ultrasonography;the lateral ventricle dilatation,meningeal echo abnormalities,subdural effusion,encephalomalacia,encephalopyosis and changes of brain parenchyma were observed and compared among the three groups of neonates.RESULTS The craniocerebral ultrasonography showed that among the 56 neonates with central venous system infection,44 had abnormal meningeal echo,with the rate of abnormal meningeal echo 78.57%,the rate of abnormal meningeal echo was 94.44 % in the suppurative meningitis group,100.00% in the tuberculous meningitis group,significantly higher than 16.67 % in the viral meningitis group (P<0.05).The craniocerebral ultrasonography indicated that among the 56 neonates,50 had lateral ventricle dilatation,with the incidence rate 89.29 %,the incidence rate of lateral ventricle dilatation of both the suppurative meningitis group and the tuberculous meningitis group was 100.00%,significantly higher than 50.00% of the viral meningitis group (P<0.05).The neonates who had subdural effusion accounted for 52.78% in the suppurative meningitis group,75.00% in the tuberculous meningitis group,significantly higher than that in the viral meningitis group (P<0.05).The neonates who had changes of brain parenchyma accounted for 30.56% in the suppurative meningitis group,25.00% in the tuberculous meningitis group,significantly lower than that in the viral meningitis group (P < 0.05).CONCLUSION As a non-invasive examination approach,the craniocerebral ultrasonography may help clinicians differentiate the types of central nervous system infections and have very great clinical significance in diagnosis of the central nervous system infections.