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Sample records for intracranial electroencephalography reveals

  1. Intracranial electroencephalography power and phase synchronization changes during monaural and binaural beat stimulation.

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    Becher, Ann-Katrin; Höhne, Marlene; Axmacher, Nikolai; Chaieb, Leila; Elger, Christian E; Fell, Juergen

    2015-01-01

    Auditory stimulation with monaural or binaural auditory beats (i.e. sine waves with nearby frequencies presented either to both ears or to each ear separately) represents a non-invasive approach to influence electrical brain activity. It is still unclear exactly which brain sites are affected by beat stimulation. In particular, an impact of beat stimulation on mediotemporal brain areas could possibly provide new options for memory enhancement or seizure control. Therefore, we examined how electroencephalography (EEG) power and phase synchronization are modulated by auditory stimulation with beat frequencies corresponding to dominant EEG rhythms based on intracranial recordings in presurgical epilepsy patients. Monaural and binaural beat stimuli with beat frequencies of 5, 10, 40 and 80 Hz and non-superposed control signals were administered with low amplitudes (60 dB SPL) and for short durations (5 s). EEG power was intracranially recorded from mediotemporal, temporo-basal and temporo-lateral and surface sites. Evoked and total EEG power and phase synchronization during beat vs. control stimulation were compared by the use of Bonferroni-corrected non-parametric label-permutation tests. We found that power and phase synchronization were significantly modulated by beat stimulation not only at temporo-basal, temporo-lateral and surface sites, but also at mediotemporal sites. Generally, more significant decreases than increases were observed. The most prominent power increases were seen after stimulation with monaural 40-Hz beats. The most pronounced power and synchronization decreases resulted from stimulation with monaural 5-Hz and binaural 80-Hz beats. Our results suggest that beat stimulation offers a non-invasive approach for the modulation of intracranial EEG characteristics. © 2014 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  2. Revealing hidden states in visual working memory using electroencephalography

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    Michael J. Wolff

    2015-09-01

    Full Text Available It is often assumed that information in visual working memory (vWM is maintained via persistent activity. However, recent evidence indicates that information in vWM could be maintained in an effectively ‘activity-silent’ neural state. Silent vWM is consistent with recent cognitive and neural models, but poses an important experimental problem: how can we study these silent states using conventional measures of brain activity? We propose a novel approach that is analogous to echolocation: using a high-contrast visual stimulus, it may be possible to drive brain activity during vWM maintenance and measure the vWM-dependent impulse response. We recorded electroencephalography (EEG while participants performed a vWM task in which a randomly oriented grating was remembered. Crucially, a high-contrast, task-irrelevant stimulus was shown in the maintenance period in half of the trials. The electrophysiological response from posterior channels was used to decode the orientations of the gratings. While orientations could be decoded during and shortly after stimulus presentation, decoding accuracy dropped back close to baseline in the delay. However, the visual evoked response from the task-irrelevant stimulus resulted in a clear re-emergence in decodability. This result provides important proof-of-concept for a promising and relatively simple approach to decode ‘activity-silent’ vWM content using non-invasive EEG.

  3. Localization of epileptogenic zones in Lennox–Gastaut syndrome using frequency domain source imaging of intracranial electroencephalography: a preliminary investigation

    International Nuclear Information System (INIS)

    Cho, Jae-Hyun; Jung, Young-Jin; Kim, Jeong-Youn; Im, Chang-Hwan; Kang, Hoon-Chul; Kim, Heung Dong; Yoon, Dae Sung; Lee, Yong-Ho

    2013-01-01

    Although intracranial electroencephalography (iEEG) has been widely used to localize epileptogenic zones in epilepsy, visual inspection of iEEG recordings does not always result in a favorable surgical outcome, especially in secondary generalized epilepsy such as Lennox–Gastaut syndrome (LGS). Various computational iEEG analysis methods have recently been introduced to confirm the visual inspection results. Of these methods, high gamma oscillation in iEEG has attracted interest because a series of studies have reported a close relationship between epileptogenic zones and cortical areas with high gamma oscillation. Meanwhile, frequency domain source imaging of EEG and MEG oscillations has proven to be a useful auxiliary tool for identifying rough locations of epileptogenic zones. To the best of our knowledge, however, frequency domain source imaging of high gamma iEEG oscillations has not been studied. In this study, we investigated whether the iEEG-based frequency domain source imaging of high gamma oscillation (60–100 Hz) would be a useful supplementary tool for identifying epileptogenic zones in patients with secondary generalized epilepsy. The method was applied to three successfully operated on LGS patients, whose iEEG contained some ictal events with distinct high gamma oscillations before seizure onset. The resultant cortical source distributions were compared with surgical resection areas and with high gamma spectral power distributions on the intracranial sensor plane. While the results of the sensor-level analyses contained many spurious activities, the results of frequency domain source imaging coincided better with the surgical resection areas, suggesting that the frequency domain source imaging of iEEG high gamma oscillations might help enhance the accuracy of pre-surgical evaluations of patients with secondary generalized epilepsy. (paper)

  4. Exploring the alpha desynchronization hypothesis in resting state networks with intracranial electroencephalography and wiring cost estimates.

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    Gómez-Ramírez, Jaime; Freedman, Shelagh; Mateos, Diego; Pérez Velázquez, José Luis; Valiante, Taufik A

    2017-11-15

    This paper addresses a fundamental question, are eyes closed and eyes open resting states equivalent baseline conditions, or do they have consistently different electrophysiological signatures? We compare the functional connectivity patterns in an eyes closed resting state with an eyes open resting state to investigate the alpha desynchronization hypothesis. The change in functional connectivity from eyes closed to eyes open, is here, for the first time, studied with intracranial recordings. We perform network connectivity analysis in iEEG and we find that phase-based connectivity is sensitive to the transition from eyes closed to eyes open only in interhemispheral and frontal electrodes. Power based connectivity, on the other hand, consistently discriminates between the two conditions in temporal and interhemispheral electrodes. Additionally, we provide a calculation for the wiring cost, defined in terms of the connectivity between electrodes weighted by distance. We find that the wiring cost variation from eyes closed to eyes open is sensitive to the eyes closed and eyes open conditions. We extend the standard network-based approach using the filtration method from algebraic topology which does not rely on the threshold selection problem. Both the wiring cost measure defined here and this novel methodology provide a new avenue for understanding the electrophysiology of resting state.

  5. A method for the topographical identification and quantification of high frequency oscillations in intracranial electroencephalography recordings.

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    Waldman, Zachary J; Shimamoto, Shoichi; Song, Inkyung; Orosz, Iren; Bragin, Anatol; Fried, Itzhak; Engel, Jerome; Staba, Richard; Sperling, Michael R; Weiss, Shennan A

    2018-01-01

    To develop a reliable software method using a topographic analysis of time-frequency plots to distinguish ripple (80-200 Hz) oscillations that are often associated with EEG sharp waves or spikes (RonS) from sinusoid-like waveforms that appear as ripples but correspond with digital filtering of sharp transients contained in the wide bandwidth EEG. A custom algorithm distinguished true from false ripples in one second intracranial EEG (iEEG) recordings using wavelet convolution, identifying contours of isopower, and categorizing these contours into sets of open or closed loop groups. The spectral and temporal features of candidate groups were used to classify the ripple, and determine its duration, frequency, and power. Verification of detector accuracy was performed on the basis of simulations, and visual inspection of the original and band-pass filtered signals. The detector could distinguish simulated true from false ripple on spikes (RonS). Among 2934 visually verified trials of iEEG recordings and spectrograms exhibiting RonS the accuracy of the detector was 88.5% with a sensitivity of 81.8% and a specificity of 95.2%. The precision was 94.5% and the negative predictive value was 84.0% (N = 12). Among, 1,370 trials of iEEG recording exhibiting RonS that were reviewed blindly without spectrograms the accuracy of the detector was 68.0%, with kappa equal to 0.01 ± 0.03. The detector successfully distinguished ripple from high spectral frequency 'fast ripple' oscillations (200-600 Hz), and characterize ripple duration and spectral frequency and power. The detector was confounded by brief bursts of gamma (30-80 Hz) activity in 7.31 ± 6.09% of trials, and in 30.2 ± 14.4% of the true RonS detections ripple duration was underestimated. Characterizing the topographic features of a time-frequency plot generated by wavelet convolution is useful for distinguishing true oscillations from false oscillations generated by filter ringing. Categorizing

  6. Adipsic diabetes insipidus revealing a bifocal intracranial germinoma.

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    Kreutz, Julie; Potorac, Iulia; Lutteri, Laurence; Gennigens, Christine; Martin, Didier; Daly, Adrian F; Bonneville, Jean-Francois; Tshibanda, Luaba; Beckers, Albert

    2017-07-01

    Adipsic diabetes insipidus is a rare complication of intracranial tumors in which impaired antidiuretic hormone secretion is associated with the loss of thirst sensation. Here, we present the case of a patient with bifocal intracranial germinoma, diagnosed due to symptoms mainly caused by adipsic diabetes insipidus. This is, to our knowledge, the first case of adipsic diabetes insipidus revealing an intracranial germinoma reported in the literature. We describe the diagnostic procedures and the three-year follow-up of this patient. Management of intracranial germ-cell tumors is made complex by the wide range of histological features. Although germinomas have a generally better prognosis than most nongerminomatous tumors, they can have severe or even life-threatening presentations. Adipsic diabetes insipidus is one such severe presentation and its rarity can make it difficult to recognize and manage. Awareness of this potential entity is therefore important for clinical practice. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  7. Circulating neutrophil transcriptome may reveal intracranial aneurysm signature.

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    Vincent M Tutino

    Full Text Available Unruptured intracranial aneurysms (IAs are typically asymptomatic and undetected except for incidental discovery on imaging. Blood-based diagnostic biomarkers could lead to improvements in IA management. This exploratory study examined circulating neutrophils to determine whether they carry RNA expression signatures of IAs.Blood samples were collected from patients receiving cerebral angiography. Eleven samples were collected from patients with IAs and 11 from patients without IAs as controls. Samples from the two groups were paired based on demographics and comorbidities. RNA was extracted from isolated neutrophils and subjected to next-generation RNA sequencing to obtain differential expressions for identification of an IA-associated signature. Bioinformatics analyses, including gene set enrichment analysis and Ingenuity Pathway Analysis, were used to investigate the biological function of all differentially expressed transcripts.Transcriptome profiling identified 258 differentially expressed transcripts in patients with and without IAs. Expression differences were consistent with peripheral neutrophil activation. An IA-associated RNA expression signature was identified in 82 transcripts (p<0.05, fold-change ≥2. This signature was able to separate patients with and without IAs on hierarchical clustering. Furthermore, in an independent, unpaired, replication cohort of patients with IAs (n = 5 and controls (n = 5, the 82 transcripts separated 9 of 10 patients into their respective groups.Preliminary findings show that RNA expression from circulating neutrophils carries an IA-associated signature. These findings highlight a potential to use predictive biomarkers from peripheral blood samples to identify patients with IAs.

  8. Electroencephalography Source Functional Connectivity Reveals Abnormal High-Frequency Communication Among Large-Scale Functional Networks in Depression.

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    Whitton, Alexis E; Deccy, Stephanie; Ironside, Manon L; Kumar, Poornima; Beltzer, Miranda; Pizzagalli, Diego A

    2018-01-01

    Functional magnetic resonance imaging studies of resting-state functional connectivity have shown that major depressive disorder (MDD) is characterized by increased connectivity within the default mode network (DMN) and between the DMN and the frontoparietal network (FPN). However, much remains unknown about abnormalities in higher frequency (>1 Hz) synchronization. Findings of abnormal synchronization in specific frequencies would contribute to a better understanding of the potential neurophysiological origins of disrupted functional connectivity in MDD. We used the high temporal resolution of electroencephalography to compare the spectral properties of resting-state functional connectivity in individuals with MDD (n = 65) with healthy control subjects (n = 79) and examined the extent to which connectivity disturbances were evident in a third sample of individuals in remission from depression (n = 30). Exact low resolution electromagnetic tomography was used to compute intracortical activity from regions within the DMN and FPN, and functional connectivity was computed using lagged phase synchronization. Compared to control subjects, the MDD group showed greater within-DMN beta 2 band (18.5-21 Hz) connectivity and greater beta 1 band (12.5-18 Hz) connectivity between the DMN and FPN. This hyperconnectivity was not observed in the remitted MDD group. However, greater beta 1 band DMN-FPN connectivity was associated with more frequent depressive episodes since first depression onset, even after controlling for current symptom severity. These findings extend our understanding of the neurophysiological basis of abnormal resting-state functional connectivity in MDD and indicate that elevations in high-frequency DMN-FPN connectivity may be a neural marker linked to a more recurrent illness course. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  9. RNA Sequencing Analysis of Intracranial Aneurysm Walls Reveals Involvement of Lysosomes and Immunoglobulins in Rupture

    NARCIS (Netherlands)

    Kleinloog, Rachel; Verweij, Bon H.; van der Vlies, Pieter; Deelen, Patrick; Swertz, Morris A.; de Muynck, Louis; Van Damme, Philip; Giuliani, Fabrizio; Regli, Luca; van der Zwan, Albert; van der Sprenkel, Jan W. Berkelbach; Han, K. Sen; Gosselaar, Peter; van Rijen, Peter C.; Korkmaz, Emine; Post, Jan A.; Rinkel, Gabriel J. E.; Veldink, Jan H.; Ruigrok, Ynte M.

    Background and Purpose-Analyzing genes involved in development and rupture of intracranial aneurysms can enhance knowledge about the pathogenesis of aneurysms, and identify new treatment strategies. We compared gene expression between ruptured and unruptured aneurysms and control intracranial

  10. High risk population isolate reveals low frequency variants predisposing to intracranial aneurysms

    NARCIS (Netherlands)

    Kurki, M.I.; Gaal, E.I.; Kettunen, J.; Lappalainen, T.; Menelaou, A.; Anttila, V.; Hof, F.N. van 't; Fraunberg, M. von Und Zu; Helisalmi, S.; Hiltunen, M.; Lehto, H.; Laakso, A.; Kivisaari, R.; Koivisto, T.; Ronkainen, A.; Rinne, J.; Kiemeney, B.; Vermeulen, S.; Kaunisto, M.A.; Eriksson, J.G.; Aromaa, A.; Perola, M.; Lehtimaki, T.; Raitakari, O.T.; Salomaa, V.; Gunel, M.; Dermitzakis, E.T.; Ruigrok, Y.M.; Rinkel, G.J.; Niemela, M.; Hernesniemi, J.; Ripatti, S.; Bakker, P.I. de; Palotie, A.; Jaaskelainen, J.E.

    2014-01-01

    3% of the population develops saccular intracranial aneurysms (sIAs), a complex trait, with a sporadic and a familial form. Subarachnoid hemorrhage from sIA (sIA-SAH) is a devastating form of stroke. Certain rare genetic variants are enriched in the Finns, a population isolate with a small founder

  11. Electroencephalography in eating disorders

    OpenAIRE

    J?uregui-Lobera, Ignacio

    2011-01-01

    Ignacio Jáuregui-Lobera1,21Behavioral Sciences Institute, 2Pablo de Olavide University, Seville, SpainAbstract: Clinical applications of electroencephalography (EEG) are used with different objectives, EEG being a noninvasive and painless procedure. In respect of eating disorders, in the 1950s a new line of study about the neurological bases of anorexia nervosa was started and has since been developed. The purpose of this review is to update the existing literature data on the main...

  12. Data mining and electroencephalography.

    Science.gov (United States)

    Flexer, A

    2000-08-01

    An overview of data mining (DM) and its application to the analysis of DM and electroencephalography (EEG) is given by: (i) presenting a working definition of DM, (ii) motivating why EEG analysis is a challenging field of application for DM technology and (iii) by reviewing exemplary work on DM applied to EEG analysis. The current status of work on DM and EEG is discussed and some general conclusions are drawn.

  13. Electroencephalography in eating disorders

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    Jáuregui-Lobera I

    2011-12-01

    Full Text Available Ignacio Jáuregui-Lobera1,21Behavioral Sciences Institute, 2Pablo de Olavide University, Seville, SpainAbstract: Clinical applications of electroencephalography (EEG are used with different objectives, EEG being a noninvasive and painless procedure. In respect of eating disorders, in the 1950s a new line of study about the neurological bases of anorexia nervosa was started and has since been developed. The purpose of this review is to update the existing literature data on the main findings in respect of EEG in eating disorders by means of a search conducted in PubMed. Despite the fact that weight gain tends to normalize some brain dysfunctions assessed by means of EEG, the specific effect of gaining weight remains controversial. Different studies have reported that cortical dysfunctions can be found in patients with anorexia nervosa even after weight gain, whereas others have reported a normalization of EEG in respect of the initial reduced alpha/increased beta power in those patients with refeeding. Findings of studies that have analyzed the possible relationship between eating disorders and depression, based on sleep EEG disturbances, do not support the idea of eating disorders as a variant of depression or affective disorders. Some EEG findings are very consistent with previous neuroimaging results on patients with anorexia nervosa, reporting neural disturbances in response to stimuli that are relevant to the pathology (eg, stimuli like food exposure, different emotional situations, or body images.Keywords: electroencephalography, event-related potentials, sleep, depression, refeeding, weight gain

  14. Clinically unsuspected intracranial hemorrhage as revealed by MR imaging in patients with multiple lacunar infarcts

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    Hashimoto, Shuji; Kawamura, Junichiro; Nakamura, Michikazu; Yamamoto, Toru; Miki, Yukio (Tenri Hospital, Nara (Japan))

    1990-07-01

    Between April 1987 and March 1989, high-field MR imaging was performed in 33 consecutive patients with multiple lacunar infarctions. Although they had no history of hemorrhagic stroke, 17 patients had low-signal intensity areas on T2-weighted images. The low-signal intensity areas were divided into two types: (I) areas more than 1 cm in the maximum diameter (9 patients) and (II) areas measuring as small as 2-3 mm in diameter (8 patients). Three patients had both types of low-signal intensity. For type I, the putamen, thalamus, and right temporal white matter were shown as low-signal intensities in 6, 2, and one patient, respectively. Low-signal intensity for type II was restricted to areas in or near the infarct lesions. Lesions of the putamen or thalamus, as shown in the group of type I, were considered to represent chronic hematoma probably due to previously undiagnosed cerebral hemorrhage. The group of type II seemed to have hemorrhagic infarction. A mean age of the onset of initial symptoms was 55.9 years in the group of type I and 58.6 years in the group of type II. Regarding blood pressure, there was no significant difference between the groups. T2-weighted imaging showed a tendency for low-signal intensity areas in younger patients with hypertension. Thus, MRI imaging may be useful in clinically diagnosing unsuspected intracranial hemorrhage in patients with multiple lacunar infarctions. (N.K.).

  15. Electroencephalography in dogs with epilepsy

    DEFF Research Database (Denmark)

    Berendt, Martin Ole; Høgenhaven, H; Flagstad, Annette Borgbjerg

    1999-01-01

    To investigate the diagnostic value of electroencephalography (EEG) in dogs with epilepsy, applying human criteria for EEG abnormalities observed with this disorder.......To investigate the diagnostic value of electroencephalography (EEG) in dogs with epilepsy, applying human criteria for EEG abnormalities observed with this disorder....

  16. Intracranial 4D flow magnetic resonance imaging reveals altered haemodynamics in sickle cell disease.

    Science.gov (United States)

    Václavů, Lena; Baldew, Zelonna A V; Gevers, Sanna; Mutsaerts, Henri J M M; Fijnvandraat, Karin; Cnossen, Marjon H; Majoie, Charles B; Wood, John C; VanBavel, Ed; Biemond, Bart J; van Ooij, Pim; Nederveen, Aart J

    2018-02-01

    Stroke risk in children with sickle cell disease (SCD) is currently assessed with routine transcranial Doppler ultrasound (TCD) measurements of blood velocity in the Circle of Willis (CoW). However, there is currently no biomarker with proven prognostic value in adult patients. Four-dimensional (4D) flow magnetic resonance imaging (MRI) may improve risk profiling based on intracranial haemodynamics. We conducted neurovascular 4D flow MRI and blood sampling in 69 SCD patients [median age 15 years (interquartile range, IQR: 12-50)] and 14 healthy controls [median age 21 years (IQR: 18-43)]. We measured velocity, flow, lumen area and endothelial shear stress (ESS) in the CoW. SCD patients had lower haematocrit and viscosity, and higher velocity, flow and lumen area, with lower ESS compared to healthy controls. We observed significant age-related decline in haemodynamic 4D flow parameters; velocity (Spearman's ρ = -0·36 to -0·61), flow (ρ = -0·26 to -0·52) and ESS (ρ = -0·14 to -0·54) in SCD patients. Further analysis in only adults showed that velocity values were similar in SCD patients compared to healthy controls, but that the additional 4D flow parameters, flow and lumen area, were higher, and ESS lower, in the SCD group. Our data suggest that 4D flow MRI may identify adult patients with an increased stroke risk more accurately than current TCD-based velocity. © 2017 John Wiley & Sons Ltd.

  17. High risk population isolate reveals low frequency variants predisposing to intracranial aneurysms.

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    Mitja I Kurki

    2014-01-01

    Full Text Available 3% of the population develops saccular intracranial aneurysms (sIAs, a complex trait, with a sporadic and a familial form. Subarachnoid hemorrhage from sIA (sIA-SAH is a devastating form of stroke. Certain rare genetic variants are enriched in the Finns, a population isolate with a small founder population and bottleneck events. As the sIA-SAH incidence in Finland is >2× increased, such variants may associate with sIA in the Finnish population. We tested 9.4 million variants for association in 760 Finnish sIA patients (enriched for familial sIA, and in 2,513 matched controls with case-control status and with the number of sIAs. The most promising loci (p<5E-6 were replicated in 858 Finnish sIA patients and 4,048 controls. The frequencies and effect sizes of the replicated variants were compared to a continental European population using 717 Dutch cases and 3,004 controls. We discovered four new high-risk loci with low frequency lead variants. Three were associated with the case-control status: 2q23.3 (MAF 2.1%, OR 1.89, p 1.42×10-9; 5q31.3 (MAF 2.7%, OR 1.66, p 3.17×10-8; 6q24.2 (MAF 2.6%, OR 1.87, p 1.87×10-11 and one with the number of sIAs: 7p22.1 (MAF 3.3%, RR 1.59, p 6.08×-9. Two of the associations (5q31.3, 6q24.2 replicated in the Dutch sample. The 7p22.1 locus was strongly differentiated; the lead variant was more frequent in Finland (4.6% than in the Netherlands (0.3%. Additionally, we replicated a previously inconclusive locus on 2q33.1 in all samples tested (OR 1.27, p 1.87×10-12. The five loci explain 2.1% of the sIA heritability in Finland, and may relate to, but not explain, the increased incidence of sIA-SAH in Finland. This study illustrates the utility of population isolates, familial enrichment, dense genotype imputation and alternate phenotyping in search for variants associated with complex diseases.

  18. Automatic detection of periods of slow wave sleep based on intracranial depth electrode recordings.

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    Reed, Chrystal M; Birch, Kurtis G; Kamiński, Jan; Sullivan, Shannon; Chung, Jeffrey M; Mamelak, Adam N; Rutishauser, Ueli

    2017-04-15

    An automated process for sleep staging based on intracranial EEG data alone is needed to facilitate research into the neural processes occurring during slow wave sleep (SWS). Current manual methods for sleep scoring require a full polysomnography (PSG) set-up, including electrooculography (EOG), electromyography (EMG), and scalp electroencephalography (EEG). This set-up can be technically difficult to place in the presence of intracranial EEG electrodes. There is thus a need for a method for sleep staging based on intracranial recordings alone. Here we show a reliable automated method for the detection of periods of SWS solely based on intracranial EEG recordings. The method utilizes the ratio of spectral power in delta, theta, and spindle frequencies relative to alpha and beta frequencies to classify 30-s segments as SWS or not. We evaluated this new method by comparing its performance against visually scored patients (n=9), in which we also recorded EOG and EMG simultaneously. Our method had a mean positive predictive value of 64% across all nights. Also, an ROC analysis of the performance of our algorithm compared to manually labeled nights revealed a mean average area under the curve of 0.91 across all nights. Our method had an average kappa score of 0.72 when compared to visual sleep scoring by an independent blinded sleep scorer. This shows that this simple method is capable of differentiating between SWS and non-SWS epochs reliably based solely on intracranial EEG recordings. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Intracranial Pressure

    DEFF Research Database (Denmark)

    Hvedstrup, Jeppe; Radojicic, Aleksandra; Moudrous, Walid

    2018-01-01

    OBJECTIVE: To compare a new method of noninvasive intracranial pressure (nICP) measurement with conventional lumbar puncture (LP) opening pressure. METHODS: In a prospective multicenter study, patients undergoing LP for diagnostic purposes underwent intracranial pressure measurements with HeadSen...

  20. Inferior frontal oscillations reveal visuo-motor matching for actions and speech: evidence from human intracranial recordings.

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    Halje, Pär; Seeck, Margitta; Blanke, Olaf; Ionta, Silvio

    2015-12-01

    The neural correspondence between the systems responsible for the execution and recognition of actions has been suggested both in humans and non-human primates. Apart from being a key region of this visuo-motor observation-execution matching (OEM) system, the human inferior frontal gyrus (IFG) is also important for speech production. The functional overlap of visuo-motor OEM and speech, together with the phylogenetic history of the IFG as a motor area, has led to the idea that speech function has evolved from pre-existing motor systems and to the hypothesis that an OEM system may exist also for speech. However, visuo-motor OEM and speech OEM have never been compared directly. We used electrocorticography to analyze oscillations recorded from intracranial electrodes in human fronto-parieto-temporal cortex during visuo-motor (executing or visually observing an action) and speech OEM tasks (verbally describing an action using the first or third person pronoun). The results show that neural activity related to visuo-motor OEM is widespread in the frontal, parietal, and temporal regions. Speech OEM also elicited widespread responses partly overlapping with visuo-motor OEM sites (bilaterally), including frontal, parietal, and temporal regions. Interestingly a more focal region, the inferior frontal gyrus (bilaterally), showed both visuo-motor OEM and speech OEM properties independent of orolingual speech-unrelated movements. Building on the methodological advantages in human invasive electrocorticography, the present findings provide highly precise spatial and temporal information to support the existence of a modality-independent action representation system in the human brain that is shared between systems for performing, interpreting and describing actions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Intracranial haemorrhage

    African Journals Online (AJOL)

    Consultant Neurosurgeon, Division of Neurosurgery, University of Cape Town and Groote Schuur Hospital, Cape Town. David Le Feuvre .... evacuation. This, together with criticism of various limitations of the STICH trial, has led to the initiation of STICH II.[19]. Intracranial haematomas may also be dealt with during another ...

  2. Intracranial Hemorrhage

    Science.gov (United States)

    2011-01-01

    Intracranial hemorrhage is a life-threatening condition, the outcome of which can be improved by intensive care. Intracranial hemorrhage may be spontaneous, precipitated by an underlying vascular malformation, induced by trauma, or related to therapeutic anticoagulation. The goals of critical care are to assess the proximate cause, minimize the risks of hemorrhage expansion through blood pressure control and correction of coagulopathy, and obliterate vascular lesions with a high risk of acute rebleeding. Simple bedside scales and interpretation of computed tomography scans assess the severity of neurological injury. Myocardial stunning and pulmonary edema related to neurological injury should be anticipated, and can usually be managed. Fever (often not from infection) is common and can be effectively treated, although therapeutic cooling has not been shown to improve outcomes after intracranial hemorrhage. Most functional and cognitive recovery takes place weeks to months after discharge; expected levels of functional independence (no disability, disability but independence with a device, dependence) may guide conversations with patient representatives. Goals of care impact mortality, with do-not-resuscitate status increasing the predicted mortality for any level of severity of intraparenchymal hemorrhage. Future directions include refining the use of bedside neuromonitoring (electroencephalogram, invasive monitors), novel approaches to reduce intracranial hemorrhage expansion, minimizing vasospasm, and refining the assessment of quality of life to guide rehabilitation and therapy. PMID:22167847

  3. Predictive Values of Electroencephalography (EEG) in Epilepsy ...

    African Journals Online (AJOL)

    Predictive Values of Electroencephalography (EEG) in Epilepsy Patients with Abnormal Behavioural Symptoms. OR Obiako, SO Adeyemi, TL Sheikh, LF Owolabi, MA Majebi, MO Gomina, F Adebayo, EU Iwuozo ...

  4. Intracranial lipomas

    International Nuclear Information System (INIS)

    Hayashi, Takashi; Shojima, Kazuhito; Moritaka, Kazuhiko; Utsunomiya, Hidetsuna; Konishi, Jun

    1984-01-01

    Intracranial lipomas are very rare and reports of infantile lipomas are scarce. Nine cases of intracranial lipomas, five in infants and four in adults are described and characteristic findings of the CT are presented. Two of the six cases involved lipomas at the corpus callosum that were associated with frontal dysraphism and cranium bifidum at the midline of frontal region. Five of the nine cases involved lipomas at the quadrigeminal cistern. In one case with an advanced enlargement in circumference of the head in the perinatal period, a V-P shunt was conducted for obstructive hydrocephalus. Another case had widely ranging agenesis of the corpus callosum associated with an interhemispheric cyst showing the right sided parietal and occipital lobes through the callosal agenesis. One of the nine cases had a lipoma in the left sylvian fissure and in the adult was in the interpeduncular cistern. Four of the nine cases were associated with agenesis of the corpus callosum. Based on these cases and published reports, the CT features of intracranial lipoma are discussed. (author)

  5. Intracranial Hypertension Research Foundation

    Science.gov (United States)

    ... PARTNERSHIPS Meet our Fundraising Partners Tweet Welcome Intracranial hypertension (IH) is the general term for the neurological ... high. (Old names for IH include Benign Intracranial Hypertension and Pseudotumor Cerebri). The Intracranial Hypertension Research Foundation ...

  6. Electroencephalography reveals lower regional blood perfusion and atrophy of the temporoparietal network associated with memory deficits and hippocampal volume reduction in mild cognitive impairment due to Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Moretti DV

    2015-02-01

    Full Text Available Davide Vito MorettiNational Institute for the research and cure of Alzheimer’s disease, S. John of God, Fatebenefratelli, Brescia, Italy Background: An increased electroencephalographic (EEG upper/lower alpha power ratio has been associated with less regional blood perfusion, atrophy of the temporoparietal region of the brain, and reduction of hippocampal volume in subjects affected by mild cognitive impairment due to Alzheimer’s disease as compared with subjects who do not develop the disease. Moreover, EEG theta frequency activity is quite different in these groups. This study investigated the correlation between biomarkers and memory performance.Methods: EEG α3/α2 power ratio and cortical thickness were computed in 74 adult subjects with prodromal Alzheimer’s disease. Twenty of these subjects also underwent assessment of blood perfusion by single-photon emission computed tomography (SPECT. Pearson’s r was used to assess the correlation between cortical thinning, brain perfusion, and memory impairment.Results: In the higher α3/α2 frequency power ratio group, greater cortical atrophy and lower regional perfusion in the temporoparietal cortex was correlated with an increase in EEG theta frequency. Memory impairment was more pronounced in the magnetic resonance imaging group and SPECT groups.Conclusion: A high EEG upper/low alpha power ratio was associated with cortical thinning and less perfusion in the temporoparietal area. Moreover, atrophy and less regional perfusion were significantly correlated with memory impairment in subjects with prodromal Alzheimer’s disease. The EEG upper/lower alpha frequency power ratio could be useful for identifying individuals at risk for progression to Alzheimer’s dementia and may be of value in the clinical context.Keywords: electroencephalography, perfusion, atrophy, temporoparietal network, memory deficits, hippocampal volume, mild cognitive impairment, Alzheimer’s disease

  7. Nephrogenic Diabetes Insipidus with Intracranial Calcifications in a ...

    African Journals Online (AJOL)

    Introduction: There are numerous causes for intracranial calcification in children. We describe an unusual cause of intracranial calcifications in a child, namely, nephrogenic diabetes insipidus (NDI). Case Report: A 12-year-old boy presented with seizures and developmental delay. MRI of the brain revealed intracranial ...

  8. Selective mutism and abnormal electroencephalography (EEG) tracings.

    Science.gov (United States)

    Politi, Keren; Kivity, Sara; Goldberg-Stern, Hadassa; Halevi, Ayelet; Shuper, Avinoam

    2011-11-01

    Epileptic discharges are not considered a part of the clinical picture of selective mutism, and electroencephalography is generally not recommended in its work-up. This report describes 6 children with selective mutism who were found to have a history of epilepsy and abnormal interictal or subclinical electroencephalography recordings. Two of them had benign epilepsy of childhood with centro-temporal spikes. The mutism was not related in time to the presence of active seizures. While seizures could be controlled in all children by medications, the mutism resolved only in 1. Although the discharges could be coincidental, they might represent a co-morbidity of selective mutism or even play a role in its pathogenesis. Selective mutism should be listed among the psychiatric disorders that may be associated with electroencephalographic abnormalities. It can probably be regarded as a symptom of a more complicated organic brain disorder.

  9. Understanding idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Markey, Keira A; Mollan, Susan P; Jensen, Rigmor H

    2016-01-01

    Idiopathic intracranial hypertension is a disorder characterised by raised intracranial pressure that predominantly affects young, obese women. Pathogenesis has not been fully elucidated, but several causal factors have been proposed. Symptoms can include headaches, visual loss, pulsatile tinnitus...

  10. Intracranial pressure monitoring (image)

    Science.gov (United States)

    Intracranial pressure monitoring is performed by inserting a catheter into the head with a sensing device to monitor the pressure around the brain. An increase in intracranial pressure can cause a decrease in blood flow to ...

  11. Monitoring of Intracranial Pressure During Intracranial Endoscopy

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-08-01

    Full Text Available Background: Intracranial endoscopy is a minimum invasive procedure, which reduces trauma to the brain, is cost-effective, and carries a shortened hospital stay with an improved postoperative outcome. Objective: To monitor intracranial pressure changes during intracranial endoscopy among children and adults under general anesthesia/sedation, and to compare the intracranial pressure changes between children and adults receiving general anesthesia and among adults receiving general anesthesia and sedation. Methods: The present cross-sectional study was conducted in one of the tertiary care hospitals of Lucknow. This was carried out in the department of neurosurgery from January 2008 to December 2008. Patients who were not fit for general anesthesia received local anesthesia under sedation. Patients participating in the study were divided into three groups. Intracranial pressure was recorded at specific intervals. Parametric data were subjected to statistical analysis using a student\\s t test. Result: A total of 70 patients were undergoing intracranial endoscopy under general anesthesia during the study period. In both groups A and B, intracranial pressure increases the maximum during inflation of the balloon. In group C, all the variations in ICP were found to be statistically significant. In the comparison of intracranial pressure changes between groups A and B, no significant difference was found. All correlations in the comparison of groups B and C were found to be statistically significant (p< 0.001. Conclusion: There is a need for continuous intraoperative monitoring of ICP intracranial endoscopy, because ICP increases in various stages of the procedure, which can be detrimental to the perfusion of the brain. [Arch Clin Exp Surg 2013; 2(4.000: 240-245

  12. Probabilistic forward model for electroencephalography source analysis

    International Nuclear Information System (INIS)

    Plis, Sergey M; George, John S; Jun, Sung C; Ranken, Doug M; Volegov, Petr L; Schmidt, David M

    2007-01-01

    Source localization by electroencephalography (EEG) requires an accurate model of head geometry and tissue conductivity. The estimation of source time courses from EEG or from EEG in conjunction with magnetoencephalography (MEG) requires a forward model consistent with true activity for the best outcome. Although MRI provides an excellent description of soft tissue anatomy, a high resolution model of the skull (the dominant resistive component of the head) requires CT, which is not justified for routine physiological studies. Although a number of techniques have been employed to estimate tissue conductivity, no present techniques provide the noninvasive 3D tomographic mapping of conductivity that would be desirable. We introduce a formalism for probabilistic forward modeling that allows the propagation of uncertainties in model parameters into possible errors in source localization. We consider uncertainties in the conductivity profile of the skull, but the approach is general and can be extended to other kinds of uncertainties in the forward model. We and others have previously suggested the possibility of extracting conductivity of the skull from measured electroencephalography data by simultaneously optimizing over dipole parameters and the conductivity values required by the forward model. Using Cramer-Rao bounds, we demonstrate that this approach does not improve localization results nor does it produce reliable conductivity estimates. We conclude that the conductivity of the skull has to be either accurately measured by an independent technique, or that the uncertainties in the conductivity values should be reflected in uncertainty in the source location estimates

  13. Canine Intracranial Meningioma: Case report

    Directory of Open Access Journals (Sweden)

    José Ricardo Gomes de Carvalho

    2016-11-01

    Full Text Available ABSTRACT. Carvalho J.R.G., Vasconcellos C.H.C., Bastos I. P.B., Trajano F.L.C., Costa T.S. & Fernandes J.I [Canine Intracranial Meningioma: Case report.] Meningioma intracraniano canino: Relato de caso. Revista Brasileira de Medicina Veterinária, 38(supl. 3:1- 7, 2016. Programa de Pós-Graduação em Ciências Veterinária, Universidade Federal Rural do Rio de Janeiro, BR 465 Km 7, Seropédica, RJ 23.897-000, Brasil, E-mail: vetjulio@yahoo.com.br Intracranial neoplasms usually show their signals in a moderate way, revealing a long background of nonspecific signs, making the diagnosis more difficult. The meningioma is the most common intracranial neoplasm in dogs and cats. Along the years, the Veterinary Medicine has experienced important technological improvements, making it possible the diagnosis of a lot of diseases. Therefore, diseases considered not common in the past, started being diagnosed more frequently, for instance, brain lesions. The objective of this research is to report a case of intracranial meningioma in a Boxer dog that arrived at the Veterinary Hospital of the Federal Rural University of Rio de Janeiro, highlighting its clinical improvement, diagnosis and treatment.

  14. The Intracranial Volume Pressure Response in Increased Intracranial Pressure Patients: Clinical Significance of the Volume Pressure Indicator.

    Science.gov (United States)

    Lai, Hung-Yi; Lee, Ching-Hsin; Lee, Ching-Yi

    2016-01-01

    For patients suffering from primary brain injury, monitoring intracranial pressure alone is not enough to reflect the dynamic intracranial condition. In our previous study, a segment of the pressure-volume curve can be expressed by the parabolic regression model with single indicator "a". The aim of this study is to evaluate if the indicator "a" can reflect intracranial conditions. Patients with traumatic brain injury, spontaneous intracranial hemorrhage, and/or hydrocephalus who had external ventricular drainage from January 2009 to February 2010 were included. The successive volume pressure response values were obtained by successive drainage of cerebral spinal fluid from intracranial pressure 20-25 mm Hg to 10 mm Hg. The relationship between withdrawn cerebral spinal fluid volume and intracranial pressure was analyzed by the parabolic regression model with single parameter "a". The overall mean for indicator "a" was 0.422 ± 0.046. The mean of "a" in hydrocephalus was 0.173 ± 0.024 and in severe intracranial mass with slender ventricle, it was 0.663 ± 0.062. The two extreme intracranial conditions had a statistical significant difference (ppressure-volume curve can reflect the dynamic intracranial condition and is comparable in different situations. A significantly larger indicator "a" with increased intracranial pressure is always observed in severe intracranial mass lesions with cerebral edema. A significantly smaller indicator "a" with increased intracranial pressure is observed in hydrocephalus. Brain computed tomography should be performed early if a rapid elevation of indicator "a" is detected, as it can reveal some ongoing intracranial pathology prior to clinical deterioration. Increased intracranial pressure was frequently observed in patients with intracranial pathology. The progression can be differentiated using the pattern of the volume pressure indicator.

  15. Ultra-high-resolution C-arm flat-detector CT angiography evaluation reveals 3-fold higher association rate for sporadic intracranial cavernous malformations and developmental venous anomalies: a retrospective study in consecutive 58 patients with 60 cavernous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Kocak, Burak [Aksaray State Hospital, Department of Radiology, Aksaray (Turkey); Kizilkilic, Osman; Kocer, Naci; Islak, Civan [Istanbul University, Department of Radiology, Cerrahpasa Medical Faculty, Istanbul (Turkey); Oz, Buge; Bakkaloglu, Dogu Vuralli [Istanbul University, Department of Pathology, Cerrahpasa Medical Faculty, Istanbul (Turkey); Isler, Cihan [Istanbul University, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul (Turkey)

    2017-06-15

    The imaging and surgical literature has confusing association rates for the association between sporadic intracranial cavernous malformations (CMs) and developmental venous anomalies (DVAs). In this study, our purpose was to determine the association rate using ultra-high-resolution C-arm flat-detector CT angiography (FDCTA) and compare it with literature. Fifty-eight patients with 60 sporadic intracranial CMs that underwent an FDCTA study were included in our retrospective study. Re-evaluation of radiological data was performed based on the criteria defined by authors. Isotropic volumetric reconstructions with ultra-high resolution (voxel size of 102 μm{sup 3} for initial; 67 μm{sup 3} and 32 μm{sup 3} for further evaluation) were used for assessment. Sixteen patients underwent surgery for excision of their CMs. Fifty-one of all patients (87.9 %) were associated with a DVA. Undefined local venous structures (UD-LVSs) were observed in the remaining 7 patients (12.1 %). The strength of interobserver agreement was excellent [kappa(k) coefficient = 0.923]. Ultra-high-resolution FDCTA evaluation of CMs and DVAs reveals 3-fold higher association rate compared to the literature. FDCTA for patients with sporadic CMs could help identify the associated DVAs that remained undetected or unclear with other imaging modalities, which can be useful in decision-making processes, planning surgery, and during operation. (orig.)

  16. Intracranial Vasospasm without Intracranial Hemorrhage due to Acute Spontaneous Spinal Subdural Hematoma.

    Science.gov (United States)

    Oh, Jung-Hwan; Jwa, Seung-Joo; Yang, Tae Ki; Lee, Chang Sub; Oh, Kyungmi; Kang, Ji-Hoon

    2015-12-01

    Spontaneous spinal subdural hematoma (SDH) is very rare. Furthermore, intracranial vasospasm (ICVS) associated with spinal hemorrhage has been very rarely reported. We present an ICVS case without intracranial hemorrhage following SDH. A 41-year-old woman was admitted to our hospital with a complaint of severe headache. Multiple intracranial vasospasms were noted on a brain CT angiogram and transfemoral cerebral angiography. However, intracranial hemorrhage was not revealed by brain MRI or CT. On day 3 after admission, weakness of both legs and urinary incontinence developed. Spine MRI showed C7~T6 spinal cord compression due to hyperacute stage of SDH. After hematoma evacuation, her symptoms gradually improved. We suggest that spinal cord evaluation should be considered in patients with headache who have ICVS, although intracranial hemorrhage would not be visible in brain images.

  17. Decomposition and classification of electroencephalography data

    DEFF Research Database (Denmark)

    Frølich, Laura

    _MARC was also used to inspect effects of artefacts on motor imagery based Brain-Computer Interfaces (BCIs) in two studies, where removing artefactual ICs had little performance impact. Finally, we investigated multi-linear classification on single trials of EEG data, proposing a rigorous optimisation approach......This thesis is about linear and multi-linear analyses of electroencephalography (EEG) data and classification of estimated EEG sources. One contribution consists of an automatic classification method for independent components (ICs) of EEG data and a freely available implementation as an EEGLab...... of six linear decomposition methods. This study showed that high-pass filtering data at high cut-off frequencies improved artefact removal performances in an Event-Related Desynchronisation setting, providing similar performances of the three included Independent Component Analysis variants. IC...

  18. Electroencephalography after a single unprovoked seizure.

    Science.gov (United States)

    Debicki, Derek B

    2017-07-01

    Electroencephalography (EEG) is an essential diagnostic tool in the evaluation of seizure disorders. In particular, EEG is used as an additional investigation for a single unprovoked seizure. Epileptiform abnormalities are related to seizure disorders and have been shown to predict recurrent unprovoked seizures (i.e., a clinical definition of epilepsy). Thus, the identification of epileptiform abnormalities after a single unprovoked seizure can inform treatment options. The current review addresses the relationship between EEG abnormalities and seizure recurrence. This review also addresses factors that are found to improve the yield of recording epileptiform abnormalities including timing of EEG relative to the new-onset seizure, use of repeat studies, use of sleep deprivation and prolonged recordings. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  19. Spontaneous intracranial hypotension.

    LENUS (Irish Health Repository)

    Fullam, L

    2012-01-31

    INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.

  20. Unruptured intracranial aneurysms

    NARCIS (Netherlands)

    Backes, D

    2016-01-01

    Rupture of an intracranial aneurysm results in aneurysmal subarachnoid hemorrhage (SAH), a subtype of stroke with an incidence of 9 per 100,000 person-years and a case-fatality around 35%. In order to prevent SAH, patients with unruptured intracranial aneurysms can be treated by neurosurgical or

  1. INCREASED TISSUE TRANSGLUTAMINASE LEVELS ARE ASSOCIATED WITH INCREASED EPILEPTIFORM ACTIVITY IN ELECTROENCEPHALOGRAPHY AMONG PATIENTS WITH CELIAC DISEASE

    Directory of Open Access Journals (Sweden)

    Sedat IŞIKAY

    2015-12-01

    Full Text Available Background - Celiac disease is an autoimmune systemic disorder in genetically predisposed individuals precipitated by gluten ingestion. Objective - In this study, we aimed to determine asymptomatic spike-and-wave findings on electroencephalography in children with celiac disease. Methods - A total of 175 children with the diagnosis of celiac disease (study group and 99 age- and sex-matched healthy children as controls (control group were included in the study. In order to determine the effects of gluten free diet on laboratory and electroencephalography findings, the celiac group is further subdivided into two as newly-diagnosed and formerly-diagnosed patients. Medical histories of all children and laboratory findings were all recorded and neurologic statuses were evaluated. All patients underwent a sleep and awake electroencephalography. Results - Among 175 celiac disease patients included in the study, 43 were newly diagnosed while 132 were formerly-diagnosed patients. In electroencephalography evaluation of patients the epileptiform activity was determined in 4 (9.3% of newly diagnosed and in 2 (1.5% of formerly diagnosed patients; on the other hand the epileptiform activity was present in only 1 (1.0% of control cases. There was a statistically significant difference between groups in regards to the presence of epileptiform activity in electroencephalography. Pearson correlation analysis revealed that epileptiform activity in both sleep and awake electroencephalography were positively correlated with tissue transglutaminase levels (P=0.014 and P=0.019, respectively. Conclusion - We have determined an increased epileptiform activity frequency among newly-diagnosed celiac disease patients compared with formerly-diagnosed celiac disease patients and control cases. Moreover the tissue transglutaminase levels were also correlated with the presence of epileptiform activity in electroencephalography. Among newly diagnosed celiac disease patients

  2. Intracranial pressure monitoring

    Science.gov (United States)

    ICP monitoring; CSF pressure monitoring ... There are 3 ways to monitor pressure in the skull (intracranial pressure). INTRAVENTRICULAR CATHETER The intraventricular catheter is the most accurate monitoring method. To insert an intraventricular catheter, a ...

  3. Clonidine Sedation Effects in Children During Electroencephalography

    Directory of Open Access Journals (Sweden)

    Mohammad Barzegar

    2017-10-01

    Full Text Available It is very important to have proper management in children with Seizure. Electroencephalography (EEG as a diagnostic instrument has a key role in determining the management method of seizure in children. Because of poor cooperation of some children (especially children with attention deficit hyperactivity disorders and developmental disorders in performing EEG, it is the best choice to sedate children before EEG. The aim of present study is to evaluate the sedation efficacy of clonidine in children before EEG. In a randomized clinical trial, 45 children age 2 to 12 with seizure, who referred to Children Hospital of Tabriz University of Medical Sciences and candidate for EEG, were studied. Sedation before EEG induced by 0.5 to 2.0 mg clonidine orally. Sedation score (0 to 5 measured by using eyes condition, response to voice, and response to touch. Successful sedation, EEG performing, and hemodynamic stability were evaluated during sedation. Of all patients, 40 patients (88.88% were sedated successfully, and EEG was performed for all of the children. Mean onset time of clonidine effect was 35.47±13.56 minutes and mean time of that the patients’ level of consciousness back to the level before administrating of clonidine was 77.55±26.87 minutes. Hemodynamic states of all patients were stable during the study, and there were no significant changes in vital sign of patients. In conclusion, clonidine can be considered as a safe alternative medication for sedation for EEG, which is fortunately associated with no significant change in vital signs, which may complicate overall status of patients.

  4. Intracranial Hypertension: Medication and Surgery

    Science.gov (United States)

    ... have little effect on headaches caused by intracranial hypertension, they may temporarily affect the intensity of a ... study in which 26 patients with idiopathic intracranial hypertension (IIH) were treated with octreotide, a synthetic hormone ...

  5. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected but u...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  6. Intracranial pressure after subarachnoid hemorrhage.

    Science.gov (United States)

    Zoerle, Tommaso; Lombardo, Alessandra; Colombo, Angelo; Longhi, Luca; Zanier, Elisa R; Rampini, Paolo; Stocchetti, Nino

    2015-01-01

    To describe mean intracranial pressure after aneurysmal subarachnoid hemorrhage, to identify clinical factors associated with increased mean intracranial pressure, and to explore the relationship between mean intracranial pressure and outcome. Analysis of a prospectively collected observational database. Neuroscience ICU of an academic hospital. One hundred sixteen patients with subarachnoid hemorrhage and intracranial pressure monitoring. None. Episodes of intracranial pressure greater than 20 mm Hg lasting at least 5 minutes and the mean intracranial pressure for every 12-hour interval were analyzed. The highest mean intracranial pressure was analyzed in relation to demographic characteristics, acute neurologic status, initial radiological findings, aneurysm treatment, clinical vasospasm, and ischemic lesion. Mortality and 6-month outcome (evaluated using a dichotomized Glasgow Outcome Scale) were also introduced in multivariable logistic models. Eighty-one percent of patients had at least one episode of high intracranial pressure and 36% had a highest mean intracranial pressure more than 20 mm Hg. The number of patients with high intracranial pressure peaked 3 days after subarachnoid hemorrhage and declined after day 7. Highest mean intracranial pressure greater than 20 mm Hg was significantly associated with initial neurologic status, aneurysmal rebleeding, amount of blood on CT scan, and ischemic lesion within 72 hours from subarachnoid hemorrhage. Patients with highest mean intracranial pressure greater than 20 mm Hg had significantly higher mortality. When death, vegetative state, and severe disability at 6 months were pooled, however, intracranial pressure was not an independent predictor of unfavorable outcome. High intracranial pressure is a common complication in the first week after subarachnoid hemorrhage in severe cases admitted to ICU. Mean intracranial pressure is associated with the severity of early brain injury and with mortality.

  7. A case of intracranial teratoma

    International Nuclear Information System (INIS)

    Shiota, Madoka; Ando, Yukinori; Takashima, Sachio; Hori, Tomokatsu; Hiramoto, Shinsuke.

    1985-01-01

    A case of neonatal intracranial teratoma was examined on ultrasonography (US), computed tomography (CT) and tumor markers in serum, CSF and tumor tissue. This 27-day-old male infant was pointed out a head enlargement by prenatal sonography at 39 weeks' gestation. He admitted to our hospital at the age of one day after cesarean section. His birth weight was 4430 g and head circumstance 47.5 cm. On admission, physical and neurological examinations reveled big head, weak crying, twiching and sun set phenomenon. The optic fundi were normal. The CT scan at 1 day demonstrated the marked enlargement of lateral ventricles and the supratentorial large polycystic mass with calcifications at midline area. Transfontanelle sonography also delineated the polycystic mass and enlarged ventricle. Ventricular tap showed bloody CSF. Alpha-Fetoprotein and carcinoembryonic antigen level in CSF was higher than those in serum. Postmortam tumor necropsy revealed a teratoma including mature squamous epithelium, muscle, cartilage, bone, lymphoid and nervous tissue. There were immature mesenchymal cells in some parts. The immune histochemical method showed positive staining to AFP in intestinal and respiratory epithelium, and to CEA in intestinal epithelium and immature mesenchymal cells. In summary, these characteristic findings of US, CT and tumor marker in CSF have a diagnostic value of intracranial teratoma. (author)

  8. Raised intracranial pressure

    African Journals Online (AJOL)

    is article presents an approach to raised intracranial pressure (ICP) constructed in a question-answer fashion. ..... Given that raised ICP is a serious and potentially life-threatening emergency, fast and reliable referral and transfer mechanisms should be established to ensure patients with this condition are effectively treated.

  9. Intracranial atherosclerosis following radiotherapy

    International Nuclear Information System (INIS)

    Werner, M.H.; Burger, P.C.; Heinz, E.R.; Friedman, A.H.; Halperin, E.C.; Schold, S.C. Jr.

    1988-01-01

    We describe a case of severe intracranial atherosclerosis in a young man who had received therapeutic radiation for a presumed brain neoplasm. Since there was no evidence of vascular disease outside the radiation ports, we speculate that accelerated atherosclerosis was induced by radiation and that hyperlipidemia may have predisposed him to this effect

  10. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  11. Intracranial tuberculoma: MR imaging

    International Nuclear Information System (INIS)

    Salgado, P.; Zenteno, M.A.; Rodriguez-Carbajal, J.; Brutto, O.H. del; Talamas, O.

    1989-01-01

    MR studies of 6 patients with intracranial tuberculoma are reviewed. All patients also underwent CT scans which showed hypo- or isodense lesions with abnormal enhancement following contrast administration. MR showed lesions with prolongation of the T1 relaxation time in every case. On the T2-weighted sequences, the signal properties of the tuberculoma varied according to the stage of evolution of the lesion. Incipient tuberculomas appeared as scattered areas of hypointensity surrounded by edema. Mature tuberculomas were composed of a dark necrotic center surrounded by an isointense capsule which was, in turn, surrounded by edema. In one patient, the center of the lesion was hyperintense probably because of liquefaction and pus formation (tuberculous abscess). While both, CT and MR, were equally sensitive in visualizing the intracranial tuberculoma in every patient, MR was slightly superior in demonstrating the extent of the lesion, especially for brainstem tuberculomas. Nevertheless, the potential role for MR diagnosis of intracranial tuberculoma is limited by the fact that other infectious or neoplasic diseases may present similar findings. The diagnosis of intracranial tuberculoma should rest on a proper integration of data from clinical manifestations, cerebrospinal fluid analysis, and neuroimaging studies. (orig.)

  12. Intracranial tuberculoma: MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Salgado, P.; Zenteno, M.A.; Rodriguez-Carbajal, J.; Brutto, O.H. del; Talamas, O.

    1989-09-01

    MR studies of 6 patients with intracranial tuberculoma are reviewed. All patients also underwent CT scans which showed hypo- or isodense lesions with abnormal enhancement following contrast administration. MR showed lesions with prolongation of the T1 relaxation time in every case. On the T2-weighted sequences, the signal properties of the tuberculoma varied according to the stage of evolution of the lesion. Incipient tuberculomas appeared as scattered areas of hypointensity surrounded by edema. Mature tuberculomas were composed of a dark necrotic center surrounded by an isointense capsule which was, in turn, surrounded by edema. In one patient, the center of the lesion was hyperintense probably because of liquefaction and pus formation (tuberculous abscess). While both, CT and MR, were equally sensitive in visualizing the intracranial tuberculoma in every patient, MR was slightly superior in demonstrating the extent of the lesion, especially for brainstem tuberculomas. Nevertheless, the potential role for MR diagnosis of intracranial tuberculoma is limited by the fact that other infectious or neoplasic diseases may present similar findings. The diagnosis of intracranial tuberculoma should rest on a proper integration of data from clinical manifestations, cerebrospinal fluid analysis, and neuroimaging studies. (orig.).

  13. Electroencephalography as a tool for evidence-based diagnosis and ...

    African Journals Online (AJOL)

    Introduction: Electroencephalography (EEG) remains the most important investigative modality in the diagnostic evaluation of individuals with epilepsy. Children living with epilepsy in the developing world are faced with challenges of lack of access to appropriate diagnostic evaluation and a high risk of misdiagnosis and ...

  14. Clinico-Electroencephalography Pattern and Determinant of 2-year ...

    African Journals Online (AJOL)

    Clinico-Electroencephalography Pattern and Determinant of 2-year Seizure Control in Patients with Complex Partial Seizure Disorder in Kano, Northwestern ... Ability to predict seizure control on first diagnosis can be very useful in the management of patients with CPS. ... Data were analyzed using STATA version 10.

  15. Spontaneous Intracranial Hypotension

    International Nuclear Information System (INIS)

    Joash, Dr.

    2015-01-01

    Epidemiology is not only rare but an important cause of new daily persistent headaches among young & middle age individuals. The Etiology & Pathogenesis is generally caused by spinal CSF leak. Precise cause remains largely unknown, underlying structural weakness of spinal meninges is suspected. There are several MR Signs of Intracranial Hypotension that include:- diffuse pachymeningeal (dural) enhancement; bilateral subdural, effusion/hematomas; Downward displacement of brain; enlargement of pituitary gland; Engorgement of dural venous sinuses; prominence of spinal epidural venous plexus and Venous sinus thrombosis & isolated cortical vein thrombosis. The sum of volumes of intracranial blood, CSF & cerebral tissue must remain constant in an intact cranium. Treatment in Many cases can be resolved spontaneously or by use Conservative approach that include bed rest, oral hydration, caffeine intake and use of abdominal binder. Imaging Modalities for Detection of CSF leakage include CT myelography, Radioisotope cisternography, MR myelography, MR imaging and Intrathecal Gd-enhanced MR

  16. Intracranial Atherosclerotic Disease

    Directory of Open Access Journals (Sweden)

    Maria Khan

    2011-01-01

    Full Text Available Intracranial atherosclerotic disease (ICAD is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%–99% stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. Among Asians, cilostazol has shown a favorable effect on symptomatic stenosis and is of benefit in terms of fewer bleeds. Moreover, aggressive risk factor management alone and in combination with dual antiplatelets been shown to be most effective in this group of patients. Interventional trials on intracranial atherosclerotic stenosis have so far only been carried out among Caucasians and have not yielded consistent results. Since the Asian population is known to be preferentially effected, focused trials need to be performed to establish treatment modalities that are most effective in this population.

  17. Intracranial chondroma: a rare entity.

    Science.gov (United States)

    Maheshwari, Veena; Mehdi, Ghazala; Varshney, Manoranjan; Jain, Anshu; Vashishtha, Sonal; Gaur, Kavita; Srivastava, Vinod Kumar

    2011-05-12

    Intracranial chondroma is a rare benign cartilaginous tumour with an incidence of less than 1% of all primary intracranial tumours. The authors are reporting here a case of intracranial chondroma in a 40-year-old man who presented with 5-month history of headache and gradual diminution of vision. A tentative diagnosis of chondroma was made on imprint cytology which was confirmed on histopathological examination.

  18. Imaging of Intracranial Pressure Disorders.

    Science.gov (United States)

    Holbrook, John; Saindane, Amit M

    2017-03-01

    Intracranial pressure (ICP) is the pressure inside the bony calvarium and can be affected by a variety of processes, such as intracranial masses and edema, obstruction or leakage of cerebrospinal fluid, and obstruction of venous outflow. This review focuses on the imaging of 2 important but less well understood ICP disorders: idiopathic intracranial hypertension and spontaneous intracranial hypotension. Both of these ICP disorders have salient imaging findings that are important to recognize to help prevent their misdiagnosis from other common neurological disorders. Copyright © 2017 by the Congress of Neurological Surgeons.

  19. Design of a Holter for Electroencephalography and Polysomnography

    International Nuclear Information System (INIS)

    Martin Gonzalez, Francisco; Velarde Reyes, Ernesto

    2009-01-01

    This paper presents the design of a 40 digital channels Holter for ambulatory studies of electroencephalography(EEG) and polisomnography (PSG), specially for epilepsy and sleep disorders. It includes a revision of the market and technologies used in such equipment. The requirements of design are established, and solutions are presented. It shows a functional diagram of the system including technologies like wireless communication, reading and writing in USB flash devices and a new amplifier design with dynamic compensation of direct current polarization

  20. A Customizable and Expandable Electroencephalography (EEG) Data Collection System

    Science.gov (United States)

    2016-03-01

    monitoring the brain’s electrical activity, known as electroencephalography (EEG). Studies have shown encouraging results in the areas of medicine and...devices, including Emotiv Systems3 and Advanced Brain Monitoring,4 as well as open source alternatives such as OpenBCI.5 These products generally...channels were tested and the results were the same. (a) Gain = 1 (b) Gain = 2 Fig. 5 Measured output with gain = a) 1, b) 2, c) 12, and d

  1. Primary brain tumor presenting as intracranial hemorrhage

    International Nuclear Information System (INIS)

    Tsunoda, Shigeru; Sakaki, Toshisuke; Miyamoto, Seiji; Kyoi, Kikuo; Utsumi, Shozaburo; Kamada, Kitaro; Inui, Shoji; Masuda, Akio.

    1989-01-01

    Ten cases of primary brain tumor presenting as intracranial hemorrhage were studied in terms of the radiological and histological findings. The cases having hemorrhage in the tumor, as established through CT or histologically, were excluded if their onsets were not sudden due to intracranial hemorrhages. The results obtained may be summarized as follows: 1) From an anatomical point of view, cerebral subcortical hemorrhages account for 80%; hemorrhages in the cerebellopontine angle, 10%, and hemorrhages in the basal ganglia, 10%. 2) Plain CT findings showed perifocal low-density areas within 24 hours after onset in all 10 cases. 3) Enhanced CT findings showed enhanced areas in 4 or 6 cases. 4) Angiographic findings revealed abnormalities besides the mass effect in 5 of the 10 cases. 4) Angiographic findings revealed abnormalities besides the mass effect in 5 of the 10 cases. 5) From a histological point of view, glioblastomas account for 30%; malignant astrocytomas, 20%; astrocytomas, 20%; malignant ependymomas, 10%; hemangioblastoma, 10%, and transitional meningiomas, 10%. In conclusion, a perifocal low-density area on CT within 24 hours after onset is the most meaningful indication of intracranial hemorrhage originating from a brain tumor. A histological 'perinuclear halo' in an astrocytoma as an artifact due to hemorrhage may often be misleading in diagnosing mixed oligo-astrocytomas. (author)

  2. INTRACRANIAL PRESSURE MONITORING

    Directory of Open Access Journals (Sweden)

    Retno Widiyanthi

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Intracranial pressure is total of pressure that is produced by brain, blood, and cerebrospinal fluid/CSF in the tight cranial space. As a respon to intracranial pressure increasing, compensation begin by movement of CSF from ventricle to cerebral subarachnoidal space, and increase the absorption of CSF. Increasing of ICP usually caused by increasing of brain volume (cerebral oedem, blood (intracranial bleeding, space occupying lesion, or CSF (hidrocephalus. Indication in ICP monitoring can be seen from : neurological criteria, abnormal CT-scan result when admission, normal CT-scan result, but had more two risk factors. According to the procedure that must be done, there are two methods in ICP monitoring: invasive ICP monitoring methodes and non-invasive measuring method. Increasing of ICP will decrease the compliance of brain, pulsation of artery more clearly, and the component of vein is lost. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  3. Sinogenic intracranial complications

    DEFF Research Database (Denmark)

    Kofoed, Mikkel Seremet; Fisker, Niels; Christensen, Anne Estmann

    2018-01-01

    We present two 11-year-old girls with chronic recurrent multifocal osteomyelitis, treated with adalimumab. Both developed severe intracranial complications to sinusitis. Patient 1 had been treated with adalimumab for 15 months when she developed acute sinusitis complicated by an orbital abscess...... and subcortical abscesses in combination with sinusitis. She was treated with endoscopic sinus surgery and intravenous antibiotics. Both patients had developed psoriasis and episodes of infection during treatment. They were non-septic and had low fever on presentation. None of the patients suffered any long...

  4. Intracranial Pressure Monitoring

    DEFF Research Database (Denmark)

    Raboel, P H; Bartek, J; Andresen, M

    2012-01-01

    Monitoring of intracranial pressure (ICP) has been used for decades in the fields of neurosurgery and neurology. There are multiple techniques: invasive as well as noninvasive. This paper aims to provide an overview of the advantages and disadvantages of the most common and well-known methods...... standard in terms of accurate measurement of pressure, although microtransducers generally are just as accurate. Both invasive techniques are associated with a minor risk of complications such as hemorrhage and infection. Furthermore, zero drift is a problem with selected microtransducers. The non...

  5. Intracranial Hemorrhage in Pregnancy

    Directory of Open Access Journals (Sweden)

    Afshan B. Hameed

    2012-11-01

    Full Text Available A pregnant woman with a mechanical prosthetic mitral valve was anticoagulated with low-molecular-weight heparin in the first trimester followed by warfarin until 36 weeks' gestation. She was then switched to intravenous unfractionated heparin infusion to allow for regional anesthesia in anticipation of vaginal delivery. She developed severe headache on hospital day 2 that was refractory to pain medications. Cranial imaging demonstrated a large subdural hematoma with midline shift. She delivered a healthy baby girl by cesarean section. Eventually, symptoms and intracranial abnormalities resolved over time. In conclusion, subdural hematoma is a relatively rare complication that requires multidisciplinary management plan.

  6. Meningiomas among intracranial neoplasms in Johannesburg ...

    African Journals Online (AJOL)

    Background: Worldwide there are varying reports on the prevalence of meningiomas among intracranial neoplasms. Different reports state intracranial meningiomas, gliomas or metastatic tumours as the most common tumour among intracranial neoplasms. We present our institutions' experience of patients with intracranial ...

  7. Eleven cases of neonatal intracranial hemorrhage

    International Nuclear Information System (INIS)

    Matsuda, Tadashi; Asao, Toyohiko; Shibata, Takeo

    1981-01-01

    Eleven cases of neonatal intracranial hemorrhage were diagnosed and followed up by CT scanning. By CT, hemorrhagic lesions were shown as high density areas in an acute stage and imaged as low density areas after the hemorrhage was absorbed. The time of absorption varies depending upon the site and the severity of hemorrhage. Intraventricular hemorrhage, petechial hemorrhage and subdural hematoma were absorbed rapidly in more than 70% of the exanimed cases, CT scanning 1 - 2 weeks after the onset revealed absorption of hemorrhage. However, the absorption delayed in intracerebral hematoma; CT scan taken after one month showed hemorrhagic lesions remaining in 75% of the cases. In nine cases who survived, following the absorption of the hemorrhagic lesions, cerebral atrophy was observed in 4 cases (44%), ventricular enlargement in 3 cases (33%), and complete recovery in 2 cases (22%). From these results, CT scanning for diagnosis of neonatal intracranial hemorrhage should be done before the hemorrhagic lesion is absorbed (within 7 days of the onset). Follow-up study by CT is important for observing changes and predicting prognosis of intracranial hemorrhage. (Ueda, J.)

  8. The value of electroencephalography in differential diagnosis of altered mental status in emergency departments

    International Nuclear Information System (INIS)

    Duran, L.; Yardan, T.; Kati, C.; Akdemir, H. U.; Altuntas, M.; Balci, K.; Karadas, S.

    2014-01-01

    Objective: To evaluate the value of electroencephalography in patients with altered mental status in emergency departments. Methods: Demographical characteristics, types and aetiologies of seizures, and clinical outcomes of the patients were recorded. Patients were divided into 4 groups according to the complaints of admission: findings and symptoms of seizure; stroke and symptoms of stroke-related seizures; syncope; and metabolic abnormalities and other causes of altered mental status. The electroencephalography findings were classified into 3 groups: epileptiform discharges; paroxysmal electroencephalography abnormalities; and background slowing. Electroencephalography abnormalities in each subgroup were evaluated. SPSS 21 was used for statistical analysis. Results: Of the total 190 patients in the study, 117(61.6%) had pathological electroencephalography findings. The main reason for electroencephalography in the emergency department was the presence of seizure findings and symptoms in 98(51.6%) patients. The ratio of electroencephalography abnormality was higher in patients who were admitted with complaints of metabolic abnormality-related consciousness disturbances (p<0.001). A total of 124(65.3%) patients had neuroimagings. Electroencephalography abnormalities were found to be significantly higher in patients with neuroimagings compared to those without neuroimagings (p<0.003). Conclusion: Despite advanced neuroimaging techniques, electroencephalography is still an important tool in the differential diagnosis of altered mental status such as epileptic seizures, metabolic abnormalities, pseudo-seizures and syncope. (author)

  9. Unruptured Intracranial Aneurysms

    Science.gov (United States)

    Raymond, J.; Guillemin, F.; Proust, F.; Molyneux, A.J.; Fox, A.J.; Claiborne, J.S.; Meder, J.-F.; Rouleau, I.

    2008-01-01

    Summary The preventive treatment of unruptured aneur­ysms has been performed for decades despite the lack of evidence of a clinical benefit. Reports of observational studies such as the International Study of Unruptured Intracranial Aneurysms (ISUIA) suggest that preventive treatments are rarely justified. Are these reports compelling enough to guide clinical practice? The ISUIA methods and data are reviewed and analysed in a more conventional manner. The design of the appropriate clinical research program is approached by steps, reviewing potential problems, from the formulation of the precise research question to the interpretation of subgroup analyses, including sample size, representativity, duration of observation period, blin­ding, definition of outcome events, analysis of cross-overs, losses to follow-up, and data reporting. Unruptured intracranial aneurysms observed in ISUIA ruptured at a minimal annual rate of 0.8% (0.5-1%), despite multiple methodological difficulties biased in favour of a benign natural history. Available registries do not have the power or the design capable of providing normative guidelines for clinical decisions. The appropriate method to solve the clinical dilemma is a multicentric trial comparing the incidence of a hard clinical outcome events in approximately 2000 patients randomly allocated to a treatment group and a deferred treatment group, all followed for ten years or more. Observational studies have failed to provide reliable evidence in favour or against the preventive treatment of unruptured aneurysms. A randomized trial is in order to clarify what is the role of prevention in this common clinical problem. PMID:20557790

  10. Pediatric Idiopathic Intracranial Hypertension Presenting With Sensorineural Hearing Loss.

    Science.gov (United States)

    Reitsma, Sietze; Stokroos, Robert; Weber, Jacobiene W; van Tongeren, Joost

    2015-12-01

    To present the rare case of a young boy with idiopathic intracranial hypertension presenting with bilateral sensorineural hearing loss developing over several months. This was accompanied by headaches, otalgia, tinnitus, and vertigo. Furthermore, we aim to provide a concise review on this matter, as this report represents the second case in literature of pediatric idiopathic intracranial hypertension presenting with hearing loss. Workup of a 9-year-old boy with bilateral sensorineural hearing loss, including (among others) physical examination, audiometry, diagnostic imaging, and lumbar puncture. Physical examination including fundoscopy as well as imaging showed no abnormalities. At presentation, pure tone audiometry revealed bone conduction thresholds of about 30 dB HL in both ears. Two months later, this declined to about 35 dB HL in both ears. Lumbar puncture revealed an increased intracranial pressure. The boy was thus diagnosed with idiopathic intracranial hypertension. After the lumbar puncture, the otological complaints gradually resolved, and the hearing normalized (bone conduction thresholds of 0-5 dB HL). Although rare, sensorineural hearing loss in the pediatric population together with otalgia, tinnitus, and vertigo can be due to idiopathic intracranial hypertension and as such can be reversible. © The Author(s) 2015.

  11. IDIOPATHIC INTRACRANIAL HYPERTENSION IN A WOMAN WITH SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Ivan N. Dimitrov

    2012-02-01

    Full Text Available Idiopathic intracranial hypertension (IIH or benign intracranial hypertension is a neurological syndrome characterized by elevated intracranial pressure. This uncommon disorder occurs primarily in obese women aged 10 to 50 years, sometimes in association with endocrine and metabolic dysfunction, with systemic diseases or when treated with multiple medications. We describe a case of IIH in a 43-year-old woman with schizophrenia treated with risperidone, demonstrating a typical clinical picture of benign intracranial hypertension. For the 5 years of treatment with risperidone she put on 35 kg in total (BMI> 35; for the last 2-3 months she began to complain of visual obscurations, nausea with vomiting. Ophthalmoscopy revealed bilateral asymmetric papilledema (OD>OS. Magnetic resonance imaging was normal, intracranial pressure was elevated IIH was diagnosed. Risperidone was discontinued and replaced with Seroquel 200 mg daily. Treatment with furosemide and mannitol 10 % was initiated. Papilledema resolved completely over the next 2 months. The patient was followed-up for four years after risperidone withdrawal. Weight loss of 28 kg was noted for four years. There were no relapses of headache, nausea, visual obscuration. Ophthalmologic examination revealed no papilledema.We suggest that prolonged use of antipsychotics, such as risperidone, should require proper surveillance for possible development of IIH and routine ophthalmologic examinations should be performed.

  12. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

    Science.gov (United States)

    ... post pubescent teenagers, tends to fit the adult stereotype. How is pediatric idiopathic intracranial hypertension diagnosed? If ... Subscribe to AOJ Allied Health Resources for School Nurses About AAPOS Our Association Staff Contacts Medical Disclaimer ...

  13. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype or a...... antibiotic treatment, signs and symptoms of elevated intracranial pressure resolved completely. Syphilis is a rare, but very important, differential diagnosis that in this case was clinically indistinguishable from IIH....

  14. Intracranial Extramedullary Hematopoiesis in Beta-Thalassemia

    Energy Technology Data Exchange (ETDEWEB)

    Karki, Bivek; Xu, Yi Kai; Wu, Yuan Kui [Nan fang Hospital, Southern Medical University, Guangzhou (China); Tamrakar, Karuna [Zhujiang Hospital, Southern Medical University, Guangzhou (China)

    2012-03-15

    Extramedullary hematopoiesis (EMH) represents tumor-like proliferation of hemopoietic tissue which complicates chronic hemoglobinopathy. Intracranial EMH is an extremely rare occurrence. Magnetic resonance imaging (MRI) offers a precise diagnosis. It is essential to distinguish EMH from other extradural central nervous system tumors, because treatment and prognosis are totally different. Herein, we report the imaging findings of beta-thalassemia in a 13-year-old boy complaining of weakness of left side of the body and gait disturbance; CT and MRI revealed an extradural mass in the right temporoparietal region.

  15. Intracranial Extramedullary Hematopoiesis in Beta-Thalassemia

    International Nuclear Information System (INIS)

    Karki, Bivek; Xu, Yi Kai; Wu, Yuan Kui; Tamrakar, Karuna

    2012-01-01

    Extramedullary hematopoiesis (EMH) represents tumor-like proliferation of hemopoietic tissue which complicates chronic hemoglobinopathy. Intracranial EMH is an extremely rare occurrence. Magnetic resonance imaging (MRI) offers a precise diagnosis. It is essential to distinguish EMH from other extradural central nervous system tumors, because treatment and prognosis are totally different. Herein, we report the imaging findings of beta-thalassemia in a 13-year-old boy complaining of weakness of left side of the body and gait disturbance; CT and MRI revealed an extradural mass in the right temporoparietal region.

  16. A case of intracranial malignant fibrous histiocytoma

    Directory of Open Access Journals (Sweden)

    Amir Hossein Sarrami

    2011-01-01

    Full Text Available We describe a case of intracranial malignant fibrous histiocytoma which had infiltrated pons, cerebellum and basal surface of left temporal lobe without any visible mass. The patient presented with a sudden loss of consciousness and vomiting. Clinical findings, laboratory tests, imaging and examination of the cerebrospinal fluid tended to establish the diagnosis of an infectious condition than a malignancy. Without any response to the antibiotics and with a progressive deterioration of neurologic and mental condition, the patient died after 20 days. In the autopsy, histological and immunohistochemical study of the brain revealed the diagnosis of malignant fibrous histiocytoma (MFH.

  17. Idiopathic intracranial hypertension and transverse sinus stenoses

    DEFF Research Database (Denmark)

    Skyrman, Simon; Fytagoridis, Anders; Andresen, Morten

    2013-01-01

    An 18-year-old woman was diagnosed with idiopathic intracranial hypertension (IIH) and bilateral transverse sinus stenoses (TSS), after presenting with papilledema and decreased visual acuity. Lumbar puncture revealed an opening pressure of >60 cm H2O. MRI showed bilateral TSS believed to be asso...... was inserted since the patient had improved with CSF diversion. MRI verified reopening of the venous sinuses after shunt placement, and the patient remains asymptomatic with no signs of relapse after 3 years of follow-up....

  18. Intracranial extramedullary hematopoiesis in beta-thalassemia.

    Science.gov (United States)

    Karki, Bivek; Xu, Yi-Kai; Tamrakar, Karuna; Wu, Yuan-Kui

    2012-01-01

    Extramedullary hematopoiesis (EMH) represents tumor-like proliferation of hemopoietic tissue which complicates chronic hemoglobinopathy. Intracranial EMH is an extremely rare occurrence. Magnetic resonance imaging (MRI) offers a precise diagnosis. It is essential to distinguish EMH from other extradural central nervous system tumors, because treatment and prognosis are totally different. Herein, we report the imaging findings of beta-thalassemia in a 13-year-old boy complaining of weakness of left side of the body and gait disturbance; CT and MRI revealed an extradural mass in the right temporoparietal region.

  19. Visual findings as primary manifestations in patients with intracranial tumors

    Directory of Open Access Journals (Sweden)

    Nazife Sefi-Yurdakul

    2015-08-01

    Full Text Available AIM:To evaluate the visual findings as primary manifestations in patients with intracranial tumors.METHODS:The medical charts of the patients with intracranial tumors who initially admitted to the Neuro-ophthalmology and Strabismus Department with ocular complaints between August 1999 and December 2012 were reviewed retrospectively. The detailed clinical history and the findings of neuro-ophthalmologic examination were recorded. Ocular symptoms and signs, the types and locations of intracranial tumors, and the duration of symptoms before the diagnosis were evaluated.RESULTS:The mean age of 11 women (61.1% and 7 men (38.9% was 42.2±11.0 (range 20-66y at the time of intracranial tumor diagnosis. Initial symptoms were transient visual obscurations, visual loss or visual field defect in 16 cases (88.9%, and diplopia in 2 cases (11.1%. Neuro-ophthalmologic examination revealed normal optic discs in both eyes of 6 patients (33.3%, paleness, atrophy or edema of optic disc in 12 patients (66.7%, and sixth cranial nerve palsy in 2 patients (11.1%. Visual acuity ranged between normal vision and loss of light perception. Cranial imaging demonstrated craniopharyngioma (n=1, plasmacytoma (n=1, meningioma (n=6; olfactory groove and tuberculum sellae, pontocerebellar angle, anterior cranial fossa, frontal vertex, suprasellar region, and pituitary macroadenoma (n=10. The mean duration between the onset of visual disturbances and the diagnosis of intracranial tumor was 9.8±18mo (range 3d-6y.CONCLUSION:The ophthalmologist is frequently the first physician to encounter a patient with clinical manifestations of intracranial tumors that may cause neurological and ocular complications. Neuro-ophthalmologic findings should be carefully evaluated to avoid a delay in the diagnosis of intracranial tumors.

  20. Nonlocal Intracranial Cavity Extraction

    Science.gov (United States)

    Manjón, José V.; Eskildsen, Simon F.; Coupé, Pierrick; Romero, José E.; Collins, D. Louis; Robles, Montserrat

    2014-01-01

    Automatic and accurate methods to estimate normalized regional brain volumes from MRI data are valuable tools which may help to obtain an objective diagnosis and followup of many neurological diseases. To estimate such regional brain volumes, the intracranial cavity volume (ICV) is often used for normalization. However, the high variability of brain shape and size due to normal intersubject variability, normal changes occurring over the lifespan, and abnormal changes due to disease makes the ICV estimation problem challenging. In this paper, we present a new approach to perform ICV extraction based on the use of a library of prelabeled brain images to capture the large variability of brain shapes. To this end, an improved nonlocal label fusion scheme based on BEaST technique is proposed to increase the accuracy of the ICV estimation. The proposed method is compared with recent state-of-the-art methods and the results demonstrate an improved performance both in terms of accuracy and reproducibility while maintaining a reduced computational burden. PMID:25328511

  1. Spontaneous intracranial hypotension

    International Nuclear Information System (INIS)

    Haritanti, A.; Karacostas, D.; Drevelengas, A.; Kanellopoulos, V.; Paraskevopoulou, E.; Lefkopoulos, A.; Economou, I.; Dimitriadis, A.S.

    2009-01-01

    Spontaneous intracranial hypotension (SIH) is an uncommon but increasingly recognized syndrome. Orthostatic headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delayed diagnosis of this condition may subject patients to unnecessary procedures and prolong morbidity. We describe six patients with SIH and outline the important clinical and neuroimaging findings. They were all relatively young, 20-54 years old, with clearly orthostatic headache, minimal neurological signs (only abducent nerve paresis in two) and diffuse pachymeningeal gadolinium enhancement on brain MRI, while two of them presented subdural hygromas. Spinal MRI was helpful in detecting a cervical cerebrospinal fluid leak in three patients and dilatation of the vertebral venous plexus with extradural fluid collection in another. Conservative management resulted in rapid resolution of symptoms in five patients (10 days-3 weeks) and in one who developed cerebral venous sinus thrombosis, the condition resolved in 2 months. However, this rapid clinical improvement was not accompanied by an analogous regression of the brain MR findings that persisted on a longer follow-up. Along with recent literature data, our patients further point out that SIH, to be correctly diagnosed, necessitates increased alertness by the attending physician, in the evaluation of headaches

  2. Nonlocal Intracranial Cavity Extraction

    Directory of Open Access Journals (Sweden)

    José V. Manjón

    2014-01-01

    Full Text Available Automatic and accurate methods to estimate normalized regional brain volumes from MRI data are valuable tools which may help to obtain an objective diagnosis and followup of many neurological diseases. To estimate such regional brain volumes, the intracranial cavity volume (ICV is often used for normalization. However, the high variability of brain shape and size due to normal intersubject variability, normal changes occurring over the lifespan, and abnormal changes due to disease makes the ICV estimation problem challenging. In this paper, we present a new approach to perform ICV extraction based on the use of a library of prelabeled brain images to capture the large variability of brain shapes. To this end, an improved nonlocal label fusion scheme based on BEaST technique is proposed to increase the accuracy of the ICV estimation. The proposed method is compared with recent state-of-the-art methods and the results demonstrate an improved performance both in terms of accuracy and reproducibility while maintaining a reduced computational burden.

  3. Deep Neural Architectures for Mapping Scalp to Intracranial EEG.

    Science.gov (United States)

    Antoniades, Andreas; Spyrou, Loukianos; Martin-Lopez, David; Valentin, Antonio; Alarcon, Gonzalo; Sanei, Saeid; Took, Clive Cheong

    2018-03-19

    Data is often plagued by noise which encumbers machine learning of clinically useful biomarkers and electroencephalogram (EEG) data is no exemption. Intracranial EEG (iEEG) data enhances the training of deep learning models of the human brain, yet is often prohibitive due to the invasive recording process. A more convenient alternative is to record brain activity using scalp electrodes. However, the inherent noise associated with scalp EEG data often impedes the learning process of neural models, achieving substandard performance. Here, an ensemble deep learning architecture for nonlinearly mapping scalp to iEEG data is proposed. The proposed architecture exploits the information from a limited number of joint scalp-intracranial recording to establish a novel methodology for detecting the epileptic discharges from the sEEG of a general population of subjects. Statistical tests and qualitative analysis have revealed that the generated pseudo-intracranial data are highly correlated with the true intracranial data. This facilitated the detection of IEDs from the scalp recordings where such waveforms are not often visible. As a real-world clinical application, these pseudo-iEEGs are then used by a convolutional neural network for the automated classification of intracranial epileptic discharges (IEDs) and non-IED of trials in the context of epilepsy analysis. Although the aim of this work was to circumvent the unavailability of iEEG and the limitations of sEEG, we have achieved a classification accuracy of 68% an increase of 6% over the previously proposed linear regression mapping.

  4. Ten self-inflicted intracranial penetrating nail gun injuries

    Science.gov (United States)

    Yuh, Sung-Joo; Alaqeel, Ahmed

    2015-01-01

    Penetrating craniocerebral injuries from nail gun use are rare. We describe a case of 10 self-inflicted nail gun injuries with intracranial penetrations. We also review the literature and discuss management strategies of such craniocerebral trauma. A 33-year-old male with a long-standing history of severe depression took a nail gun and sustained 10 penetrating intracranial injuries. Initial neuroimaging revealed 10 penetrating nails, all sparing the major cerebral vasculature. Immediate surgical removal was undertaken in the surgical suite using a combination of craniotomies, craniectomies, and blind removal. Intracranial injuries from self-inflicted nail gun misuse is becoming increasingly more frequent. Initial appropriate clinical decision-making are critical in preventing further cortical or vascular damage. PMID:26166596

  5. Intracranial extradural hematoma: Spontaneous rapid decompression – not resolution

    Science.gov (United States)

    Bhat, Abdul Rashid; Raswan, Uday Singh; Kirmani, Altaf Rehman

    2015-01-01

    The surgical option to evacuate an intracranial extradural hematoma (EDH) was postponed in a 2-year-old female child who appeared fully alert and active after a brief spell of unconsciousness following a fall from height. The child was received, with a swelling on and around the right parietal eminence, by the emergency staff just half an hour after the time of injury. The immediate X-ray skull and first computed tomography (CT) scan head showed a parietal bone fracture, EDH, and cephalhematoma. However, follow-up CT scan head after about 4½ h revealed the dramatic absence of EDH but increased size and bogginess of cephalhematoma. The EDH had transported into subgaleal space resulting in a decompression of intracranial compartment in intracranially. PMID:26557173

  6. Post-irradiation vasculopathy of intracranial major arteries in children

    International Nuclear Information System (INIS)

    Nishizawa, Shigeru; Ryu, Hiroshi; Yokoyama, Tetsuo; Ninchoji, Toshiaki; Shimoyama, Ichiro; Yamamoto, Seiji; Uemura, Kenichi

    1991-01-01

    We report two rare cases of post-irradiation vasculopathy of intracranial major arteries in children. A 13-year-old girl suffered from transient right hemiparesis 1 year after irradiation for suprasellar germinoma. Left carotid angiograms revealed marked stenoses of the intracranial internal carotid, middle cerebral, and anterior cerebral arteries, which were previously normal, and moyamoya vessels. A 2.5-year-old girl underwent internal irradiation with 198 Au colloid for cystic craniopharyngioma. At the age of 10 years, she suddenly became unconscious after vomiting. Computed tomographic scans showed a right frontal intracerebral hematoma. Right carotid angiograms disclosed complete obstruction of the intracranial internal carotid, middle cerebral, and anterior cerebral arteries and moyamoya vessels, previously not present. The danger of radiation therapy causing occlusive vasculopathy in small and major cerebral arteries in children is emphasized. To prevent permanent ischemic neurological deficits, vasculopathy should be treated either medically or surgically as early as possible. (author)

  7. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K

    2010-01-01

    . The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  8. Intracranial dural metastases.

    Science.gov (United States)

    Nayak, Lakshmi; Abrey, Lauren E; Iwamoto, Fabio M

    2009-05-01

    : Intracranial dural metastases (IDM) are found at autopsy in 9% of patients with advanced systemic cancer. However, to the authors' knowledge, IDM have not been studied systematically in the modern neuroimaging era. The objective of the current study was to evaluate the demographics, clinical presentation, imaging, treatment, and prognosis of patients with IDM. : The current study was a retrospective review of 122 patients with IDM diagnosed at Memorial Sloan-Kettering Cancer Center between 1999 and 2006. Patients with concurrent brain or leptomeningeal metastases were excluded. : Sixty-one percent of the patients were women; the median age at diagnosis was 59 years, the median Karnofsky performance scale (KPS) at diagnosis was 80, and the median time to IDM diagnosis from initial cancer diagnosis was 37 months. Breast (34%) and prostate (17%) cancers were the most frequent primary tumors associated with IDM. Fifty-six percent of patients had a single dural metastasis. On imaging, 70% had metastases of the overlying skull, 44% had dural tail metastases, 53% had vasogenic edema, and 34% had brain invasion. Direct extension from skull metastases was the most common mode of spread. Eighty-three percent of patients had active systemic disease at the time of IDM diagnosis. A lower KPS and lung cancer were associated with worse overall survival. Surgical resection and chemotherapy improved progression-free survival, but only resection was found to be associated with improved overall survival. : IDM affect a significant proportion of cancer patients. KPS and status of systemic cancer should guide treatment decisions. Cancer 2009. (c) 2009 American Cancer Society.

  9. Electroencephalography Predicts Poor and Good Outcomes After Cardiac Arrest: A Two-Center Study.

    Science.gov (United States)

    Rossetti, Andrea O; Tovar Quiroga, Diego F; Juan, Elsa; Novy, Jan; White, Roger D; Ben-Hamouda, Nawfel; Britton, Jeffrey W; Oddo, Mauro; Rabinstein, Alejandro A

    2017-07-01

    The prognostic role of electroencephalography during and after targeted temperature management in postcardiac arrest patients, relatively to other predictors, is incompletely known. We assessed performances of electroencephalography during and after targeted temperature management toward good and poor outcomes, along with other recognized predictors. Cohort study (April 2009 to March 2016). Two academic hospitals (Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Mayo Clinic, Rochester, MN). Consecutive comatose adults admitted after cardiac arrest, identified through prospective registries. All patients were managed with targeted temperature management, receiving prespecified standardized clinical, neurophysiologic (particularly, electroencephalography during and after targeted temperature management), and biochemical evaluations. We assessed electroencephalography variables (reactivity, continuity, epileptiform features, and prespecified "benign" or "highly malignant" patterns based on the American Clinical Neurophysiology Society nomenclature) and other clinical, neurophysiologic (somatosensory-evoked potential), and biochemical prognosticators. Good outcome (Cerebral Performance Categories 1 and 2) and mortality predictions at 3 months were calculated. Among 357 patients, early electroencephalography reactivity and continuity and flexor or better motor reaction had greater than 70% positive predictive value for good outcome; reactivity (80.4%; 95% CI, 75.9-84.4%) and motor response (80.1%; 95% CI, 75.6-84.1%) had highest accuracy. Early benign electroencephalography heralded good outcome in 86.2% (95% CI, 79.8-91.1%). False positive rates for mortality were less than 5% for epileptiform or nonreactive early electroencephalography, nonreactive late electroencephalography, absent somatosensory-evoked potential, absent pupillary or corneal reflexes, presence of myoclonus, and neuron-specific enolase greater than 75 µg/L; accuracy was highest for

  10. Intracranial arachnoid cysts treated surgically

    International Nuclear Information System (INIS)

    Okamoto, Junji; Matsumoto, Keizo

    1982-01-01

    Craniotomy and an examination of the maximal extent of extirpation of the cystic membrane were performed under an operative microscope in a series of 30 consecutive cases of intracranial arachnoid cysts. From these clinical features and a histological examination of the membrane, the etiologies of the arachnoid cysts may be divided into three fundamental categories: arachnoid cysts due to local brain atrophy or malformation (Category I), arachnoid cysts due to a malformation of the local arachnoid membrane itself (Category II), and arachnoid cysts due to acquired etiology (Category III). The postoperative reduction rates were investigated by means of a serial CT examination over a follow-up period of from 1 month to 6.5 years (average 2 years) in 27 cases. The postoperative reduction rates of 5 cases were less than 20% (Group A), 15 cases had rates from 30 to 80% (Group B), and 7 cases had rates of more than 90% (Group C). Cases of females, large cysts, round-shaped cysts, and cases with positive mass signs and poorly communicating cysts are revealed by metrizamide CT examination seemed to have a tendency for cystic cavity to be reduced well, judging from the postoperative analysis of the clinical findings. Furthermore, from the standpoint of our hypothesis concerning the etiology of the arachnoid cysts, Group A fit in almost all cases in Category I, though a few cases of Group A who had severe secondary local brain damage were in Category II. Group C fit in Category III in almost all cases, though a few cases of Group C who had minimal local brain damage were in Category II. Cases of Group B were considered to show some changes in the local cerebrum of various degrees in the cases of Categories II and III. (J.P.N.)

  11. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation. T....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  12. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...... or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant...... antibiotic treatment, signs and symptoms of elevated intracranial pressure resolved completely. Syphilis is a rare, but very important, differential diagnosis that in this case was clinically indistinguishable from IIH....

  13. Intracranial calcification in central diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Al-Kandari, Salwa R. [Al Razi Hospital, Department of Clinical Radiology, Kuwait (Kuwait); Pandey, Tarun [Al Razi Hospital, Department of Clinical Radiology, Kuwait (Kuwait); University of Arkansas for Medical Sciences, Radiology Department, Little Rock, AR (United States); Badawi, Mona H. [Al-Adan Hospital, Department of Paediatrics, Kuwait (Kuwait)

    2008-01-15

    Intracranial calcification is a known but extremely rare complication of diabetes insipidus. To date, only 16 patients have been reported and all had the peripheral (nephrogenic) type of diabetes insipidus. We report a child with intracranial calcification complicating central diabetes insipidus. We also report a child with nephrogenic diabetes insipidus, and compare the patterns of intracranial calcification. (orig.)

  14. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...... or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant...

  15. Management of Unruptured Intracranial Aneurysms.

    Science.gov (United States)

    Nasr, Deena M; Brown, Robert D

    2016-09-01

    Unruptured intracranial aneurysms (UIA) occur in approximately 2-3 % of the population. Most of these lesions are incidentally found, asymptomatic and typically carry a benign course. Although the risk of aneurysmal subarachnoid hemorrhage is low, this complication can result in significant morbidity and mortality, making assessment of this risk the cornerstone of UIA management. This article reviews important factors to consider when managing unruptured intracranial aneurysms including patient demographics, comorbidities, family history, symptom status, and aneurysm characteristics. It also addresses screening, monitoring, medical management and current surgical and endovascular therapies.

  16. Emotion Regulation of Neuroticism: Emotional Information Processing Related to Psychosomatic State Evaluated by Electroencephalography and Exact Low-Resolution Brain Electromagnetic Tomography

    OpenAIRE

    Ikeda, Shunichiro; Mizuno-Matsumoto, Yuko; Canuet, Leonides; Ishii, Ryouhei; Aoki, Yasunori; Hata, Masahiro; Katsimichas, Themistoklis; Pascual-Marqui, Roberto D; Hayashi, Takuto; Okamoto, Eika; Asakawa, Tetsuya; Iwase, Masao; Takeda, Masatoshi

    2015-01-01

    Emotion regulation is the process that adjusts the type or amount of emotion when we experience an emotional situation. The aim of this study was to reveal quantitative changes in brain activity during emotional information processing related to psychosomatic states and to determine electrophysiological features of neuroticism. Twenty-two healthy subjects (mean age 25 years, 14 males and 8 females) were registered. Electroencephalography (EEG) was measured during an emotional audiovisual memo...

  17. Topographic movie of intracranial ictal high-frequency oscillations with seizure semiology: epileptic network in Jacksonian seizures.

    Science.gov (United States)

    Akiyama, Tomoyuki; Chan, Derrick W; Go, Cristina Y; Ochi, Ayako; Elliott, Irene M; Donner, Elizabeth J; Weiss, Shelly K; Snead, O Carter; Rutka, James T; Drake, James M; Otsubo, Hiroshi

    2011-01-01

    We developed a technique to produce images of dynamic changes in ictal high-frequency oscillations (HFOs) >40 Hz recorded on subdural electroencephalography (EEG) that are time-locked to the ictal EEG and ictal semiology video. We applied this technique to Jacksonian seizures to demonstrate ictal HFO propagation along the homunculus in the primary sensory-motor cortex to visualize the underlying epileptic network. We analyzed intracranial ictal EEGs from two patients with intractable Jacksonian seizures who underwent epilepsy surgery. We calculated the degrees of increase in amplitude within 40-80, 80-200, and 200-300 Hz frequency bands compared to the interictal period and converted them into topographic movies projected onto the brain surface picture. We combined these data with the ictal EEGs and video of the patient demonstrating ictal semiology. The ictal HFOs began in the sensory cortex and appeared concomitantly with the sensory aura. They then propagated to the motor cortex at the same time that focal motor symptoms evolved. As the seizure progressed, the ictal HFOs spread or reverberated in the rolandic region. However, even when the seizure became secondarily generalized, the ictal HFOs were confined to the rolandic region. In both cases, there was increased amplitude of higher frequency bands during seizure initiation compared to seizure progression. This combined movie showed the ictal HFO propagation corresponding to the ictal semiology in Jacksonian seizures and revealed the epileptic network involved in seizure initiation and progression. This method may advance understanding of neural network activities relating to clinical seizure generation and propagation. Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.

  18. [Effects of solcoseryl on the cerebral blood flow, intracranial pressure, systemic blood pressure and EEG in acute intracranial hypertensive cats (author's transl)].

    Science.gov (United States)

    Kubota, S; Asakura, T; Kitamura, K

    1976-02-01

    The experiment was performed on 86 cases under intraperitoneal pentobarbital anesthesia. One balloon was placed in the extradural space of right frontal region, and the other balloon was placed in the left extradural space and the intracranial pressure was measured. A needle was stereotaxically inserted into the subcortical area in order to measure the cerebral blood flow. Systemic blood pressure was recorded by inserting a catheter into the femoral artery, and electrocorticogram was also recorded. An expanding intracranial lesion was made by inflating the extradural balloon with physiological saline. The animals were arbitrarily divided into two groups.: 1) light or moderate groups which intracranial pressure before the injection of drug was below 400 mmH2O. 2) severe groups above 400 mmH2O. After the maintenance of the pressure, Solcoseryl was infused intravenously. The investigation was focused to observe whether Solcoseryl reveales any potent effect on cerebral blood flow, intracranial pressure, systemic blood pressure and on electroencephalogram in acute intracranial hypertension. Results 1) Intravenous injection of Solcoseryl had the effect of lowering intracranial pressure in the light or moderate and severe groups. Particularly, dose of 80 mg/kg showed the marked effect, though with a rebound phenomenon in the light or moderate groups. Furthermore, the effect was more marked and lasting by drip infusion of Solcoseryl and also by intravenous injection of Solcoseryl after pretreatment with hydrocortisone, and at this time no rebound phenomenon was recognized. 2) Solcoseryl had the effect of increasing the cerebral blood flow accompained with the lowering of intracranial pressure. 3) Systemic blood pressure was transiently lowered by the injection of Solcoseryl 20 mg/kg or 80 mg/kg and recovered immediately. 4) Solcoseryl had no effect on electroencephalogram in the severe groups. Conclusion On the basis of these results, it is rational to conclude that

  19. Intracranial hemorrhage: ultrasound, CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, Thierry A.G.M. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland)

    2005-03-01

    Intracranial hemorrhage is one of the most common causes of acute focal neurologic deficit in children and adults. Neuroimaging including ultrasonography (US), computer tomography (CT) and magnetic resonance imaging (MRI) is essential in the diagnosis of intracranial hemorrhage. Imaging findings should guide treatment. The highly variable appearance of an intracranial hemorrhage can be challenging. A thorough knowledge of hematoma evolution and US, CT and MR hematoma characteristics is mandatory for adequate interpretation of findings. The purpose of this review is (1) to summarize the imaging characteristics of intracranial hemorrhage on various imaging techniques and (2) to review the various types of intracranial hemorrhage, and their causes. (orig.)

  20. Concomitant Intracranial Chronic Subdural Hematoma and Spinal Subdural Hematoma: A Case Report and Literature Review.

    Science.gov (United States)

    Matsumoto, Hiroaki; Matsumoto, Shigeo; Yoshida, Yasuhisa

    2016-06-01

    Concomitant intracranial chronic subdural hematoma (CSDH) and spinal subdural hematoma (SDH) are rare, and the etiology has yet to be elucidated. However, migration of the hematoma intracranially to a spinal site or coincidence of both intracranial and spinal CSDHs have been proposed as etiologies. We report a case of concomitant intracranial CSDH and spinal SDH in which spinal hematoma might have migrated from the cranial lesion. A previously healthy 58-year-old man with previous trauma to the occiput and lumbar spine suffered from headache, lumbago, and left hemiparesis. Head computed tomography revealed right-sided intracranial CSDH, and he underwent single burr-hole craniotomy. Although clinical symptoms tended to improve, left lower-limb weakness and lumbago remained. Spinal magnetic resonance imaging (MRI) 3 days after craniotomy revealed SDH extending from T1-S1. Because conservative therapy had not improved clinical symptoms, hematoma evacuation was performed via a left L5 hemilaminectomy 1 week after craniotomy. The patient showed complete recovery immediately postoperatively. We reviewed the cases of 22 patients with concomitant intracranial CSDH and spinal SDH to discuss the features, etiology, and treatment strategy. Although surgical intervention was mainly selected for intracranial CSDH, conservative observation was mainly selected for spinal SDH. Outcomes were good in all patients. We created a new classification of spinal SDH shape using sagittal MRI. This classification indicates that cases with both ventral and dorsal SDH tend to require surgical intervention. This classification may help in deciding treatment strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. On seeing the trees and the forest: single-signal and multisignal analysis of periictal intracranial EEG.

    Science.gov (United States)

    Schindler, Kaspar; Gast, Heidemarie; Goodfellow, Marc; Rummel, Christian

    2012-09-01

    Epileptic seizures are associated with a dysregulation of electrical brain activity on many different spatial scales. To better understand the dynamics of epileptic seizures, that is, how the seizures initiate, propagate, and terminate, it is important to consider changes of electrical brain activity on different spatial scales. Herein we set out to analyze periictal electrical brain activity on comparatively small and large spatial scales by assessing changes in single intracranial electroencephalography (EEG) signals and of averaged interdependences of pairs of EEG signals. Single and multiple EEG signals are analyzed by combining methods from symbolic dynamics and information theory. This computationally efficient approach is chosen because at its core it consists of analyzing the occurrence of patterns and bears analogy to classical visual EEG reading. Symbolization is achieved by first mapping the EEG signals into bit strings, that is, long sequences of zeros and ones, depending solely on whether their amplitudes increase or decrease. Bit strings reflect relational aspects between consecutive values of the original EEG signals, but not the values themselves. For each bit string the relative frequencies of the different constituent short bit patterns are then determined and used to compute two information theoretical measures: (1) redundancy (R) of single bit strings characterizes electrical brain activity on a comparatively small spatial scale represented by a single EEG signal and (2) averaged pair-wise mutual information with all other bit strings (M), which allows tracking of larger-scale EEG dynamics. We analyzed 20 periictal intracranial EEG recordings from five patients with pharmacoresistant temporal lobe epilepsy. At seizure onset, R first strongly increased and then decreased toward seizure termination, whereas M gradually increased throughout the seizure. Bit strings with maximal R were always derived from EEG signals recorded from the visually

  2. Haemorrhage in intracranial tuber- culosis

    African Journals Online (AJOL)

    Introduction. Intracranial tuberculosis is an important cause of morbidity and mortality in developing countries where tuberculosis is endemic.1 In the central nervous system tuberculosis manifests as cerebritis, cerebral abscess, tuberculoma, and tubercu- lous meningitis (TBM).1-5 TBM is thought to arise from cerebrospinal.

  3. What Is IH (Intracranial Hypertension)?

    Science.gov (United States)

    ... Store What is IH? What is IH? Intracranial hypertension literally means that the pressure of cerebrospinal fluid ( ... is too high. “Intracranial” means “within the skull.” “Hypertension” means “high fluid pressure.” To understand how this ...

  4. Spaceflight-Induced Intracranial Hypertension.

    Science.gov (United States)

    Michael, Alex P; Marshall-Bowman, Karina

    2015-06-01

    Although once a widely speculated about and largely theoretical topic, spaceflight-induced intracranial hypertension has gained acceptance as a distinct clinical phenomenon, yet the underlying physiological mechanisms are still poorly understood. In the past, many terms were used to describe the symptoms of malaise, nausea, vomiting, and vertigo, though longer duration spaceflights have increased the prevalence of overlapping symptoms of headache and visual disturbance. Spaceflight-induced visual pathology is thought to be a manifestation of increased intracranial pressure (ICP) because of its similar presentation to cases of known intracranial hypertension on Earth as well as the documentation of increased ICP by lumbar puncture in symptomatic astronauts upon return to gravity. The most likely mechanisms of spaceflight-induced increased ICP include a cephalad shift of body fluids, venous outflow obstruction, blood-brain barrier breakdown, and disruption to CSF flow. The relative contribution of increased ICP to the symptoms experienced during spaceflight is currently unknown, though other factors recently posited to contribute include local effects on ocular structures, individual differences in metabolism, and the vasodilator effects of carbon dioxide. This review article attempts to consolidate the literature regarding spaceflight-induced intracranial hypertension and distinguish it from other pathologies with similar symptomatology. It discusses the proposed physiological causes and the pathological manifestations of increased ICP in the spaceflight environment and provides considerations for future long-term space travel. In the future, it will be critical to develop countermeasures so that astronauts can participate at their peak potential and return safely to Earth.

  5. Imaging intracranial tuberculosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Jamieson, D.H. [Dept. of Radiology, Red Cross War Memorial Children`s Hospital, Rondebosch (South Africa)

    1995-05-01

    A morphologically based imaging review of intracranial tuberculosis in childhood is presented. The computed tomography and magnetic resonance features of parenchymal tuberculoma, tuberculous meningitis and meningeal/meniningocerebral tuberculoma are illustrated. Recent insight into the nature of tuberculoma necrosis and its magnetic resonance correlation is reviewed. Pathogenesis, relevant clinical background and the role of modern imaging is discussed. (orig.)

  6. Resistive NMR of intracranial hematomas

    Energy Technology Data Exchange (ETDEWEB)

    Zimmerman, R.A.; Bilaniuk, L.T.; Grossman, R.I.; Levine, R.S.; Lynch, R.; Goldberg, H.I.; Samuel, L.; Edelstein, W.; Bottomley, P.; Redington, R.W.

    1985-01-01

    Comparison between computed tomography and nuclear magnetic resonance imaging in 17 patients with intracranial hematomas indicate a distinct role for NMR in evaluating the stable patient with hematoma. NMR is useful for delineating the extent of the hematoma, the relationship of the hematoma to brain anatomy, and the presence of hematoma at a time when the hematoma is isodense on CT.

  7. The correlation between pulsatile intracranial pressure and indices of intracranial pressure-volume reserve capacity: results from ventricular infusion testing.

    Science.gov (United States)

    Eide, Per Kristian

    2016-12-01

    OBJECTIVE The objective of this study was to examine how pulsatile and static intracranial pressure (ICP) scores correlate with indices of intracranial pressure-volume reserve capacity, i.e., intracranial elastance (ICE) and intracranial compliance (ICC), as determined during ventricular infusion testing. METHODS All patients undergoing ventricular infusion testing and overnight ICP monitoring during the 6-year period from 2007 to 2012 were included in the study. Clinical data were retrieved from a quality registry, and the ventricular infusion pressure data and ICP scores were retrieved from a pressure database. The ICE and ICC (= 1/ICE) were computed during the infusion phase of the infusion test. RESULTS During the period from 2007 to 2012, 82 patients with possible treatment-dependent hydrocephalus underwent ventricular infusion testing within the department of neurosurgery. The infusion tests revealed a highly significant positive correlation between ICE and the pulsatile ICP scores mean wave amplitude (MWA) and rise-time coefficient (RTC), and the static ICP score mean ICP. The ICE was negatively associated with linear measures of ventricular size. The overnight ICP recordings revealed significantly increased MWA (> 4 mm Hg) and RTC (> 20 mm Hg/sec) values in patients with impaired ICC ( 4 mm Hg, RTC > 20 mm Hg/sec), but not increased mean ICP (pressure-volume reserve capacity, i.e., ICE and ICC.

  8. Video electroencephalography monitoring differentiates between epileptic and non-epileptic seizures

    DEFF Research Database (Denmark)

    Nørmark, Mette Borch; Erdal, Jesper; Kjær, Troels Wesenberg

    2011-01-01

    Epilepsy is often misdiagnosed and approximately one in every four patients diagnosed with refractory epilepsy does not have epilepsy, but instead non-epileptic seizures. Video electroencephalography monitoring (VEM) is the gold standard for differentiation between epileptic and non...

  9. Characteristic CT and MRI findings of intracranial chondroma

    Energy Technology Data Exchange (ETDEWEB)

    Duan, Fuhong; Qiu, Shijun; Liu, Zhenyin; Lv, Xiaofei; Feng, Xia; Xiong, Wei; An, Jie; Chen, Jing; Yang, Weicong; Wen, Chuhong [Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong (China)], E-mail: qiushijun006@163.com; Jiang, Jianwei; Chang, Jun [Department of Radiology, The Third Affiliated Hospital of Nantong University, Wuxi, Jiangsu (China)

    2012-12-15

    Background. Intracranial chondromas are rare benign tumors. To date, few data are available on their neuroradiological features. Purpose. To describe a series of patients with intracranial chondroma and to analyze and discuss the computed tomography (CT) and magnetic resonance imaging (MRI) features that may distinguish chondromas from other intracranial neoplasms. Material and Methods. We retrospectively analyzed clinical and medical imaging data of six patients who had pathologically confirmed intracranial chondromas in our two institutions between July 2006 and September 2011. Both CT and MRI scanning were performed in all six cases. Results. Five tumors were located at the skull base and one originated from the falx. CT images revealed well-demarcated, irregular lobulated and variable density masses with obvious calci?cation (6/6), no or slight enhancement, without peritumoral edema, and frequently accompanied by erosion and destruction of surrounding bone (5/6). Tumor parenchyma appeared heterogeneously hypointense on T1WI, and hyperintense or mixed hyperintense and hypointense on T2WI, while the calcification appeared hypointense on T1WI and T2WI in five cases, demonstrating significant inhomogeneous enhancement on postcontrast MRI, which revealed the typical 'punica granatum seeds' sign. Only one case showed homogeneous low signal intensity on T1WI and high signal intensity on T2WI, and relatively uniform obvious enhancement on postcontrast scans. Conclusion. These characteristic CT and MR findings, combined with the location of the lesions and the history of a long duration of clinical symptoms, may prove helpful in differentiating intracranial chondromas from other more common tumors.

  10. Characteristic CT and MRI findings of intracranial chondroma

    International Nuclear Information System (INIS)

    Duan, Fuhong; Qiu, Shijun; Liu, Zhenyin; Lv, Xiaofei; Feng, Xia; Xiong, Wei; An, Jie; Chen, Jing; Yang, Weicong; Wen, Chuhong; Jiang, Jianwei; Chang, Jun

    2012-01-01

    Background. Intracranial chondromas are rare benign tumors. To date, few data are available on their neuroradiological features. Purpose. To describe a series of patients with intracranial chondroma and to analyze and discuss the computed tomography (CT) and magnetic resonance imaging (MRI) features that may distinguish chondromas from other intracranial neoplasms. Material and Methods. We retrospectively analyzed clinical and medical imaging data of six patients who had pathologically confirmed intracranial chondromas in our two institutions between July 2006 and September 2011. Both CT and MRI scanning were performed in all six cases. Results. Five tumors were located at the skull base and one originated from the falx. CT images revealed well-demarcated, irregular lobulated and variable density masses with obvious calci?cation (6/6), no or slight enhancement, without peritumoral edema, and frequently accompanied by erosion and destruction of surrounding bone (5/6). Tumor parenchyma appeared heterogeneously hypointense on T1WI, and hyperintense or mixed hyperintense and hypointense on T2WI, while the calcification appeared hypointense on T1WI and T2WI in five cases, demonstrating significant inhomogeneous enhancement on postcontrast MRI, which revealed the typical 'punica granatum seeds' sign. Only one case showed homogeneous low signal intensity on T1WI and high signal intensity on T2WI, and relatively uniform obvious enhancement on postcontrast scans. Conclusion. These characteristic CT and MR findings, combined with the location of the lesions and the history of a long duration of clinical symptoms, may prove helpful in differentiating intracranial chondromas from other more common tumors

  11. Traumatic Fetal Intracranial Hemorrhage Suggested by Point-of-Care Ultrasound

    Directory of Open Access Journals (Sweden)

    Lei Wu

    2018-01-01

    Full Text Available While the use of ultrasound to diagnose a fetal intracranial hemorrhage in utero is not a new concept, the emphasis of point-of-care ultrasound (POCUS at the initial trauma presentation of the mother to evaluate for fetal injury is novel. A review of the literature failed to reveal a single case report wherein POCUS in the workup of a pregnant trauma patient led to the diagnosis of fetal intracranial hemorrhage. This is such a case.

  12. Intracranial aneurysms in twins: case report and review of the literature.

    Science.gov (United States)

    Leung, H K; Lam, Y; Cheng, K M; Chan, C M; Cheung, Y L

    2011-04-01

    Intracranial aneurysm in twins is a rare clinical disease entity. Only 15 cases have been described in the literature. We report on a pair of identical twins with intracranial aneurysms. One presented with subarachnoid haemorrhage; digital subtraction angiography showed a left posterior communicating artery aneurysm, which was treated by coiling. The patient's twin sister was called for screening, whereupon digital subtraction angiography revealed a right ophthalmic internal carotid artery aneurysm that was treated conservatively.

  13. A Game Player Expertise Level Classification System Using Electroencephalography (EEG

    Directory of Open Access Journals (Sweden)

    Syed Muhammad Anwar

    2017-12-01

    Full Text Available The success and wider adaptability of smart phones has given a new dimension to the gaming industry. Due to the wide spectrum of video games, the success of a particular game depends on how efficiently it is able to capture the end users’ attention. This leads to the need to analyse the cognitive aspects of the end user, that is the game player, during game play. A direct window to see how an end user responds to a stimuli is to look at their brain activity. In this study, electroencephalography (EEG is used to record human brain activity during game play. A commercially available EEG headset is used for this purpose giving fourteen channels of recorded EEG brain activity. The aim is to classify a player as expert or novice using the brain activity as the player indulges in the game play. Three different machine learning classifiers have been used to train and test the system. Among the classifiers, naive Bayes has outperformed others with an accuracy of 88 % , when data from all fourteen EEG channels are used. Furthermore, the activity observed on electrodes is statistically analysed and mapped for brain visualizations. The analysis has shown that out of the available fourteen channels, only four channels in the frontal and occipital brain regions show significant activity. Features of these four channels are then used, and the performance parameters of the four-channel classification are compared to the results of the fourteen-channel classification. It has been observed that support vector machine and the naive Bayes give good classification accuracy and processing time, well suited for real-time applications.

  14. Analysis of Arm Movement Prediction by Using the Electroencephalography Signal

    Directory of Open Access Journals (Sweden)

    Reza Darmakusuma

    2016-04-01

    Full Text Available Various technological approaches have been developed in order to help those people who are unfortunateenough to be afflicted with different types of paralysis which limit them in performing their daily life activitiesindependently. One of the proposed technologies is the Brain-Computer Interface (BCI. The BCI system uses electroencephalography (EEG which is generated by the subject’s mental activityas input, and converts it into commands. Some previous experiments have shown the capability of the BCI system to predict the movement intention before the actual movement is onset. Thus research has predicted the movement by discriminating between data in the “rest” condition, wherethere is no movement intention, with “pre-movement” condition, where movement intention is detected before actual movement occurs. This experiment, however, was done to analyze the system for which machine learning was applied to data obtained in a continuous time interval, between 3 seconds before the movement was detected until 1 second after the actual movement was onset. This experiment shows that the system can discriminate the “pre-movement” condition and “rest” condition by using the EEG signal in 7-30 Hzwhere the Mu and Beta rhythm can be discovered with an average True Positive Rate (TPR value of 0.64 ± 0.11 and an average False Positive Rate (FPR of 0.17 ± 0.08. This experiment also shows that by using EEG signals obtained nearing the movement onset, the system has higher TPR or a detection rate in predicting the movement intention.

  15. Electroencephalography signatures of attention-deficit/hyperactivity disorder: clinical utility

    Directory of Open Access Journals (Sweden)

    Alba G

    2015-10-01

    Full Text Available Guzmán Alba,1 Ernesto Pereda,2 Soledad Mañas,3 Leopoldo D Méndez,3 Almudena González,1 Julián J González1 1Physiology Unit, Health Sciences Faculty (S Medicine, 2Department of Industrial Engineering, School of Engineering and Technology, University of La Laguna, 3Clinical Neurophysiology Unit, University Hospital La Candelaria, Tenerife, Spain Abstract: The techniques and the most important results on the use of electroencephalography (EEG to extract different measures are reviewed in this work, which can be clinically useful to study subjects with attention-deficit/hyperactivity disorder (ADHD. First, we discuss briefly and in simple terms the EEG analysis and processing techniques most used in the context of ADHD. We review techniques that both analyze individual EEG channels (univariate measures and study the statistical interdependence between different EEG channels (multivariate measures, the so-called functional brain connectivity. Among the former ones, we review the classical indices of absolute and relative spectral power and estimations of the complexity of the channels, such as the approximate entropy and the Lempel-Ziv complexity. Among the latter ones, we focus on the magnitude square coherence and on different measures based on the concept of generalized synchronization and its estimation in the state space. Second, from a historical point of view, we present the most important results achieved with these techniques and their clinical utility (sensitivity, specificity, and accuracy to diagnose ADHD. Finally, we propose future research lines based on these results. Keywords: EEG, ADHD, power spectrum, functional connectivity, clinical assessment

  16. The Correlation between Electroencephalography Amplitude and Interictal Abnormalities: Audit study

    Directory of Open Access Journals (Sweden)

    Sami F. Al-Rawas

    2014-10-01

    Full Text Available Objectives: The aim of this study was to establish the relationship between background amplitude and interictal abnormalities in routine electroencephalography (EEG. Methods: This retrospective audit was conducted between July 2006 and December 2009 at the Department of Clinical Physiology at Sultan Qaboos University Hospital (SQUH in Muscat, Oman. A total of 1,718 electroencephalograms (EEGs were reviewed. All EEGs were from patients who had been referred due to epilepsy, syncope or headaches. EEGs were divided into four groups based on their amplitude: group one ≤20 μV; group two 21–35 μV; group three 36–50 μV, and group four >50 μV. Interictal abnormalities were defined as epileptiform discharges with or without associated slow waves. Abnormalities were identified during periods of resting, hyperventilation and photic stimulation in each group. Results: The mean age ± standard deviation of the patients was 27 ± 12.5 years. Of the 1,718 EEGs, 542 (31.5% were abnormal. Interictal abnormalities increased with amplitude in all four categories and demonstrated a significant association (P <0.05. A total of 56 EEGs (3.3% had amplitudes that were ≤20 μV and none of these showed interictal epileptiform abnormalities. Conclusion: EEG amplitude is an important factor in determining the presence of interictal epileptiform abnormalities in routine EEGs. This should be taken into account when investigating patients for epilepsy. A strong argument is made for considering long-term EEG monitoring in order to identify unexplained seizures which may be secondary to epilepsy. It is recommended that all tertiary institutions provide EEG telemetry services.

  17. Evaluation of Electroencephalography Source Localization Algorithms with Multiple Cortical Sources.

    Science.gov (United States)

    Bradley, Allison; Yao, Jun; Dewald, Jules; Richter, Claus-Peter

    2016-01-01

    Source localization algorithms often show multiple active cortical areas as the source of electroencephalography (EEG). Yet, there is little data quantifying the accuracy of these results. In this paper, the performance of current source density source localization algorithms for the detection of multiple cortical sources of EEG data has been characterized. EEG data were generated by simulating multiple cortical sources (2-4) with the same strength or two sources with relative strength ratios of 1:1 to 4:1, and adding noise. These data were used to reconstruct the cortical sources using current source density (CSD) algorithms: sLORETA, MNLS, and LORETA using a p-norm with p equal to 1, 1.5 and 2. Precision (percentage of the reconstructed activity corresponding to simulated activity) and Recall (percentage of the simulated sources reconstructed) of each of the CSD algorithms were calculated. While sLORETA has the best performance when only one source is present, when two or more sources are present LORETA with p equal to 1.5 performs better. When the relative strength of one of the sources is decreased, all algorithms have more difficulty reconstructing that source. However, LORETA 1.5 continues to outperform other algorithms. If only the strongest source is of interest sLORETA is recommended, while LORETA with p equal to 1.5 is recommended if two or more of the cortical sources are of interest. These results provide guidance for choosing a CSD algorithm to locate multiple cortical sources of EEG and for interpreting the results of these algorithms.

  18. Brain herniation in a patient with apparently normal intracranial pressure: a case report

    Directory of Open Access Journals (Sweden)

    Dahlqvist Mats B

    2010-08-01

    Full Text Available Abstract Introduction Intracranial pressure monitoring is commonly implemented in patients with neurologic injury and at high risk of developing intracranial hypertension, to detect changes in intracranial pressure in a timely manner. This enables early and potentially life-saving treatment of intracranial hypertension. Case presentation An intraparenchymal pressure probe was placed in the hemisphere contralateral to a large basal ganglia hemorrhage in a 75-year-old Caucasian man who was mechanically ventilated and sedated because of depressed consciousness. Intracranial pressures were continuously recorded and never exceeded 17 mmHg. After sedation had been stopped, our patient showed clinical signs of transtentorial brain herniation, despite apparently normal intracranial pressures (less than 10 mmHg. Computed tomography revealed that the size of the intracerebral hematoma had increased together with significant unilateral brain edema and transtentorial herniation. The contralateral hemisphere where the intraparenchymal pressure probe was placed appeared normal. Our patient underwent emergency decompressive craniotomy and was tracheotomized early, but did not completely recover. Conclusions Intraparenchymal pressure probes placed in the hemisphere contralateral to an intracerebral hematoma may dramatically underestimate intracranial pressure despite apparently normal values, even in the case of transtentorial brain herniation.

  19. Reactivity of dogs' brain oscillations to visual stimuli measured with non-invasive electroencephalography.

    Directory of Open Access Journals (Sweden)

    Miiamaaria V Kujala

    Full Text Available Studying cognition of domestic dogs has gone through a renaissance within the last decades. However, although the behavioral studies of dogs are beginning to be common in the field of animal cognition, the neural events underlying cognition remain unknown. Here, we employed a non-invasive electroencephalography, with adhesive electrodes attached to the top of the skin, to measure brain activity of from 8 domestic dogs (Canis familiaris while they stayed still to observe photos of dog and human faces. Spontaneous oscillatory activity of the dogs, peaking in the sensors over the parieto-occipital cortex, was suppressed statistically significantly during visual task compared with resting activity at the frequency of 15-30 Hz. Moreover, a stimulus-induced low-frequency (~2-6 Hz suppression locked to the stimulus onset was evident at the frontal sensors, possibly reflecting a motor rhythm guiding the exploratory eye movements. The results suggest task-related reactivity of the macroscopic oscillatory activity in the dog brain. To our knowledge, the study is the first to reveal non-invasively measured reactivity of brain electrophysiological oscillations in healthy dogs, and it has been based purely on positive operant conditional training, without the need for movement restriction or medication.

  20. Natural Malignant Transformation of an Intracranial Epidermoid Cyst

    Directory of Open Access Journals (Sweden)

    Shuyu Hao

    2010-05-01

    Full Text Available Malignant transformation of intracranial epidermoid cyst (EC is very rare, and when it does occur, the clinical course is aggressive. We present an unusual case of natural malignant transformation of an intracranial EC, without a history of surgery. A 61-year-old woman was diagnosed with an EC in the right cerebellopontine angle and prepontine cistern 6 years before the operation described in this report. Her neurological symptoms deteriorated in the 2 months prior to the present admission. Magnetic resonance imaging revealed an irregular, nodular enhanced lesion in the cerebellopontine angle, prepontine cistern, and temporoparietal lobe. Subtotal resection of the lesion was performed. Pathological examination revealed malignant transformation of the EC. The patient died on postoperative day 36 from brainstem infarction, chemical meningitis, and hydrocephalus. Spontaneous rupture of the EC could have contributed to the malignant transformation. This could have been avoided by early removal of the EC.

  1. Intracranial MR imaging of achondroplasia

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, Shinichi; Ootsuka, Ryouichi; Hayashi, Yoshinori; Nishitani, Hiromu; Shirakawa, Norihisa; Hashimoto, Toshiaki (Tokushima Univ. (Japan). School of Medicine)

    1992-10-01

    Intracranial MR imaging was performed in five patients with achondroplasia. All patients had narrowing of the subarachnoid space at the level of the formen magnum that was mainly due to protrusion of the posterior aspect. Three patients had compressive deformities of the brainstem and/or upper cervical spine. Among them, two patients had deformities of the pons. Relative upward displacement of the brainstem was seen in all patients. Hydrocephalus was seen in three patients. (author).

  2. Neonatal intracranial hemorrhages (perinatal onset)

    International Nuclear Information System (INIS)

    Ban, Sadahiko; Ogata, Masahiro; Yamamoto, Toyoshiro; Nakao, Satoshi; Mizue, Hidenari; Kobayashi, Yutaka.

    1982-01-01

    1. We have reviewed 34 cases of neonatal intracranial hemorrhages (perinatal onset, 23 mature and 11 premature infants) experienced in 10-year period from 1971 to 1980, with special reference to gestational age, birth weight, type of delivery, presence or absence of asphyxia, symptoms and cause of death. 2. Regarding 9 autopsied cases and 7 cases diagnosed by CT-scan, 10 mature infants composed of 3 subarachnoid hemorrhages, 2 intraventricular hemorrhages, 2 subdural hematomas, 2 intracerebral and 1 subependymal hemorrhage; 6 premature infants consisted of 4 subependymal hemorrhages with ventricular rupture and 2 subarachnoid hemorrhages. Most of them presented with respiratory distress, vomiting and convulsive seizures which developed within 5 days after birth. 3. Poor outcome including death amounted 49% of mature and 63% of premature infants. Along with degree of intracranial hematoma, prematurity and pulmonary complication were felt to be important prognostic factors. 4. Introduction of CT-scan led to prompt diagnosis and treatment, thus lowering mortality rate of neonatal intracranial hemorrhages. (author)

  3. Multiple intracranial aneurysms in polyarteritis nodosa: MRI and angiography

    International Nuclear Information System (INIS)

    Oran, I.; Memis, A.; Parildar, M.; Yunten, N.

    1999-01-01

    In polyarteritis nodosa involvement of the central nervous system is infrequent; small cerebral infarcts are the most common neuroradiological finding. We report a 10-year-old boy with polyarteritis nodosa and intracranial haemorrhage. MRI showed an intracerebral haemorrhage. Angiography revealed two peripheral aneurysms in the posterior cerebral circulation, previously reported on only two occasions, and multiple microaneurysms in the hepatic, renal, mesenteric and even the lumbar arteries. (orig.)

  4. Intracranial hemorrhagic embolus

    Directory of Open Access Journals (Sweden)

    Yu-Hang Yeh

    2017-01-01

    Full Text Available A febrile and unconscious man was sent to our emergency department. On physical examinations, some dark red ecchymosis/discoloration over the trunk and track mark in the left-sided groin region were seen. Brain CT scan showed septic emboli complicated with hemorrhage. Chest X-ray revealed pulmonary emboli. Aortic valve vegetation was found by echocardiography. Although aggressive treatment and resuscitation were taken, he died of methicillin-sensitive Staphylococcus aureus sepsis and multiple organ failure. Intravenous drug users are susceptible to right-sided infective endocarditis. In our case, leftsided infective endocarditis with lung and brain embolism resulting in fatality was relatively uncommon. Review of literature was also made for this article.

  5. Simultaneous resting-state functional MRI and electroencephalography recordings of functional connectivity in patients with schizophrenia.

    Science.gov (United States)

    Kirino, Eiji; Tanaka, Shoji; Fukuta, Mayuko; Inami, Rie; Arai, Heii; Inoue, Reiichi; Aoki, Shigeki

    2017-04-01

    It remains unclear how functional connectivity (FC) may be related to specific cognitive domains in neuropsychiatric disorders. Here we used simultaneous resting-state functional magnetic resonance imaging (rsfMRI) and electroencephalography (EEG) recording in patients with schizophrenia, to evaluate FC within and outside the default mode network (DMN). Our study population included 14 patients with schizophrenia and 15 healthy control participants. From all participants, we acquired rsfMRI data, and simultaneously recorded EEG data using an MR-compatible amplifier. We analyzed the rsfMRI-EEG data, and used the CONN toolbox to calculate the FC between regions of interest. We also performed between-group comparisons of standardized low-resolution electromagnetic tomography-based intracortical lagged coherence for each EEG frequency band. FC within the DMN, as measured by rsfMRI and EEG, did not significantly differ between groups. Analysis of rsfMRI data showed that FC between the right posterior inferior temporal gyrus and medial prefrontal cortex was stronger among patients with schizophrenia compared to control participants. Analysis of FC within the DMN using rsfMRI and EEG data revealed no significant differences between patients with schizophrenia and control participants. However, rsfMRI data revealed over-modulated FC between the medial prefrontal cortex and right posterior inferior temporal gyrus in patients with schizophrenia compared to control participants, suggesting that the patients had altered FC, with higher correlations across nodes within and outside of the DMN. Further studies using simultaneous rsfMRI and EEG are required to determine whether altered FC within the DMN is associated with schizophrenia. © 2016 The Authors. Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.

  6. Successful Resection of Intracranial Metastasis of Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Kenichiro Okimoto

    2013-03-01

    Full Text Available Intracranial metastasis of hepatocellular carcinoma (HCC is rare, but has an extremely poor prognosis. We report a case with successful surgical removal of intracranial metastasis of HCC. A 32-year-old man was admitted to our hospital with severe vomiting. He had been followed for liver cirrhosis due to hepatitis B virus infection and received a right hepatic trisectionectomy for HCC 1 year earlier. For the recurrence of HCC, sorafenib had been administered 6 months before admission. On admission, he exhibited consciousness disturbance, which gradually worsened. Two days later, both computed tomography and magnetic resonance imaging revealed an intra-axial tumor with perifocal edema and hemorrhage in the left frontal lobe. The tumor was successfully removed by craniotomy and pathological examination revealed that it was composed of moderately differentiated HCC cells. The day after surgical resection of the tumor, his consciousness returned to normal. Subsequently, he was treated with hepatic arterial infusion chemotherapy with 5-fluorouracil and cisplatin using an implanted port-catheter system. Surgical resection of intracranial metastasis of HCC would be important and meaningful in some cases.

  7. Idiopathic hypoparathyroidism with extensive intracranial calcification in children

    Science.gov (United States)

    Kamal, Naglaa M.; Alghamdi, Hamed A.; Halabi, Abdulrahman A.; Bakkar, Ayman A.; Algarni, Ali; Alharbi, Abdullah; Alharthi, Abdulla A.; Alharbi, Rawan A.; Sherief, Laila M.

    2017-01-01

    Abstract Rationale: Pediatric idiopathic hypoparathyroidism with extensive intracranial calcifications outside the basal ganglia (BG) is extremely rare with less than 10 cases worldwide. Patient concerns: An 11-year-old Saudi male child presented with tetany with otherwise normal neurological and other body system examination diagnoses severe hypocalcemia for differential diagnosis. Interventions: Further investigations revealed hyperphosphatemia and undetectable serum intact parathyroid hormone. Brain computed tomography revealed BG and extensive brain calcifications. He has no dysmorphic features, vitiligo, mucocuataneous manifestations, or hair loss. He had normal hemoglobin, electroencephalogram, and skeletal survey, with negative autoantibodies to alpha and omega interferons and negative genetic testing for Glial Cell Missing 2 (GCM2) and calcium-sensing receptors (CaSRs) excluding known causes of hypoparathyroidism. Outcomes: This case presents a rare entity of idiopathic hypoparathyroidism with extensive intracranial calcification, not only in BG but also outside the extrapyramidal system with normal mentality, development, pubertal achievement, and neurological examination. To our knowledge, this is the first report from Saudi Arabia in pediatrics. Lessons: Idiopathic hypoparathyroidism is a diagnosis of exclusion after ruling out all known causes of hypoparathyroidism. It is associated with BG calcifications, but extensive intracranial calcifications outside the BG are extremely rare. PMID:28422826

  8. Stereotactic intracranial radiotherapy: Dose prescription

    International Nuclear Information System (INIS)

    Schlienger, M.; Lartigau, E.; Nataf, F.; Mornex, F.; Latorzeff, I.; Lisbona, A.; Mahe, M.

    2012-01-01

    The aim of this article was the study of the successive steps permitting the prescription of dose in stereotactic intracranial radiotherapy, which includes radiosurgery and fractionated stereotactic radiotherapy. The successive steps studied are: the choice of stereotactic intracranial radiotherapy among the therapeutic options, based on curative or palliative treatment intent, then the selection of lesions according to size/volume, pathological type and their number permitting the choice between radiosurgery or fractionated stereotactic radiotherapy, which have the same methodological basis. Clinical experience has determined the level of dose to treat the lesions and limit the irradiation of healthy adjacent tissues and organs at risk structures. The last step is the optimization of the different parameters to obtain a safe compromise between the lesion dose and healthy adjacent structures. Study of dose-volume histograms, coverage indices and 3D imaging permit the optimization of irradiation. For lesions close to or included in a critical area, the prescribed dose is planned using the inverse planing method. Implementation of the successively described steps is mandatory to insure the prescription of an optimized dose. The whole procedure is based on the delineation of the lesion and adjacent healthy tissues. There are sometimes difficulties to assess the delineation and the volume of the target, however improvement of local control rates and reduction of secondary effects are the proof that the totality of the successive procedures are progressively improved. In practice, stereotactic intracranial radiotherapy is a continually improved treatment method, which constantly benefits from improvements in the choice of indications, imaging, techniques of irradiation, planing/optimization methodology and irradiation technique and from data collected from prolonged follow-up. (authors)

  9. Visual Impairment and Intracranial Hypertension: An Emerging Spaceflight Risk

    Science.gov (United States)

    Taddeo, Terrance A.

    2010-01-01

    During recent long duration missions to the International Space Station (ISS) crewmembers have reported changes in visual acuity or visual field defects. Exams in the postflight period revealed changes to the visual system and elevated intracranial pressures. As a result, NASA Space Medicine has added a number of tests to be performed in the preflight, inflight and postflight periods for ISS and shuttle missions with the goal of determining the processes at work and any potential mitigation strategies. This discussion will acquaint you with the changes that NASA has made to its medical requirements in order to address the microgravity induced intracranial hypertension and associated visual changes. Key personnel have been assembled to provide you information on this topic. Educational Objectives: Provide an overview of the current Medical Operations requirements and the mitigation steps taken to operationally address the issue.

  10. A case of multiple intracranial tuberculomas accompanied by tuberculous meningitis

    International Nuclear Information System (INIS)

    Fukabori, Takashi; Takamatsu, Hajime; Nakanishi, Yasuhiro

    1986-01-01

    A 63-year-old man was admitted for headache and progressive drowsiness. In spite of negative results from cerebrospinal fluid (CSF) stains and cultures of tuberculosis and other bacteria, CSF findings and tuberculosis-positive sputum culture led to a tentative diagnosis of tuberculous meningitis. Symptoms and neurological test results both improved remarkably during antituberculous chemotherapy. Although the brain CT scan taken on admission showed no abnormal findings, one taken two months later revealed multiple high-density areas after enhancement with a contrast medium, suggesting multiple intracranial tuberculomas accompanied by tuberculous meningitis. The size of the multiple high-density areas gradually decreased during antituberculous chemotherapy. The CT scan can clearly locate lesions, detect complications, and evaluate the effects of treatment in patients with intracranial tuberculosis. (author)

  11. Traumatic Spinal Subdural Hematoma with Intracranial Subdural Hematoma.

    Science.gov (United States)

    Kim, Hyun Gon; Kim, Tae Wan; Park, Kwan Ho; Chi, Moon Pyo

    2014-10-01

    Traumatic spinal subdural hematoma associated with intracranial subdural hematoma is a rare condition. Herein, we report the case of a 62-year-old man with lower back pain, radiating pain, and numbness in both lower extremities, without motor weakness, for 2 weeks. Lumbar magnetic resonance imaging (MRI) revealed high signal intensity on T1-weighted image (WI), and low signal intensity on T2-WI from L2 to L5. Two weeks after conservative management, follow-up lumbar MRI did not show the hematoma and his symptoms were relieved and there was no neurological deficit; therefore, he was discharged. However, subsequently, intracranial subdural hematoma increased and upper extremity motor weakness appeared. This was treated surgically. If there is no neurological deficit, conservative treatment may be a good option. Follow-up evaluation for asymptomatic cranial subdural hematoma is necessary.

  12. Traumatic Lumbar Subdural Hematoma in the Absence of Intracranial Disease.

    Science.gov (United States)

    Cooper, Jared; Gillick, John L; LaBagnara, Michael; Das, Kaushik; Hillard, Virany H

    2016-06-01

    Traumatic spinal subdural hematoma is an exceedingly rare condition, with those occurring in the absence of intracranial disease being particularly uncommon. Only 13 such cases have been reported. Although theories exist to describe the pathophysiology of traumatic spinal subdural hematoma, the precise mechanism and guidelines for management remain unclear. This report describes a 37-year-old woman who suffered a traumatic assault who developed progressive low back pain with radicular symptoms 2 days after presentation. Magnetic resonance imaging revealed a lumbar subdural hematoma extending from L1 to L5. No intracranial disease was detected on imaging. Definitive guidelines for management of this condition are uncertain; however, successful use of conservative management, lumbar drainage, and surgical evacuation has been reported. This patient underwent a lumbar laminectomy with evacuation of the hematoma, resulting in immediate pain relief and resolution of symptoms within 1 week of the procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Migraine before rupture of intracranial aneurysms

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Gurary, Natalia M; Sakovich, Vladimir P

    2013-01-01

    Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA.......Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA....

  14. Phase contrast MRI in intracranial aneurysms

    NARCIS (Netherlands)

    van Ooij, P.

    2012-01-01

    Intracranial aneurysms are outpouchings of intracranial arteries that cause brain hemorrhage after rupture. Unruptured aneurysms can be treated but the risk of treatment may outweigh the risk of rupture. Local intra-aneurysmal hemodynamics can contribute substantially to the rupture risk estimation

  15. Acute surgical management in idiopathic intracranial hypertension.

    LENUS (Irish Health Repository)

    Zakaria, Zaitun

    2012-01-01

    Idiopathic intracranial hypertension is a headache syndrome with progressive symptoms of raised intracranial pressure. Most commonly, it is a slow process where surveillance and medical management are the main treatment modalities. We describe herein an acute presentation with bilateral sixth nerve palsies, papilloedema and visual deterioration, where acute surgical intervention was a vision-saving operation.

  16. Computerised tomographic detection of intracranial complications of ...

    African Journals Online (AJOL)

    These include cerebral, subdural and epidural abscesses, frontal bone osteomyelitis. The maxillary and ethmoidal sinuses were mostly involved and can be implicated as the sinogenic causes of intracranial infections. Sphenoidal sinus was not involved in any of the patients. Key Words: Intracranial Complications, Sinusitis, ...

  17. Traumatic and alternating delayed intracranial hematomas

    International Nuclear Information System (INIS)

    Lesoin, F.; Redford, H.; Jomin, M.; Viaud, C.; Pruvo, J.

    1984-01-01

    Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma. (orig.)

  18. MRI of intracranial meningeal malignant fibrous histiocytoma

    International Nuclear Information System (INIS)

    Ogino, A.; Ochi, M.; Hayashi, K.; Hirata, K.; Hayashi, T.; Yasunaga, A.; Shibata, S.

    1996-01-01

    We describe the CT and MRI findings in a patient with primary intracranial meningeal malignant fibrous histiocytoma (MFH). CT delineated the anatomical relations and MRI aided in tissue characterisation. To our knowledge, this is the first report describing the MRI findings in primary intracranial meningeal MFH. (orig.). With 1 fig

  19. Traumatic and alternating delayed intracranial hematomas

    Energy Technology Data Exchange (ETDEWEB)

    Lesoin, F.; Redford, H.; Jomin, M.; Viaud, C.; Pruvo, J.

    1984-11-01

    Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma.

  20. Neonatal Intracranial Aneurysm Rupture Treated by Endovascular Management: A Case Report

    Directory of Open Access Journals (Sweden)

    Yi-Pei Tai

    2010-08-01

    Full Text Available Pediatric intracranial aneurysm rupture is rare, and is traditionally managed by surgical clipping. To the best of our knowledge, endovascular embolization of aneurysms in neonates has not previously been reported in Taiwan. We report a 9-day-old boy with intracranial aneurysms who underwent endovascular embolization, representing the youngest reported case in Taiwan. The 9-day-old boy presented with non-specific symptoms of irritable crying, seizure and respiratory distress. Computed tomography disclosed intraventricular hemorrhage, subarachnoid hemorrhage and focal intracranial hemorrhage around the right cerebellum. Subsequent computed tomographic angiography showed two sequential fusiform aneurysms, measuring 3 mm, located in the right side posterior inferior cerebellar artery (PICA. The patient underwent endovascular embolization because of the high risk of aneurysm re-rupture and the impossibility of surgical clipping due to the fusiform nature of the aneurysms. A postembolization angiogram revealed complete obliteration of the right distal PICA and proximal aneurysm. The distal PICA aneurysm was revascularized from the collateral circulation, but demonstrated a slow and delayed filling pattern. The patient's condition remained stable over the following week, and he was discharged without anticonvulsant therapy. No significant developmental delay was noted at follow-up at when he was 3 months old. This case emphasizes the need for clinical practitioners to consider a diagnosis of intracranial hemorrhage in neonates with seizure and increased intracranial pressure. Neonatal intracranial aneurysms can be treated safely by endovascular treatment.

  1. Endovascular treatment of intracranial aneurysm

    International Nuclear Information System (INIS)

    Wang Zhigang; Li Guoxin; Qu Yuanming; Tang Jun; Liu Zuoqin

    2001-01-01

    Objective: To setup an endovascular treatment of intracranial aneurysm with detachable balloon and micro-coil. Methods: Trans-femoral artery Seldinger's catheterization was used. Balloons and free MDS, GDC micro-coils were pushed into the aneurysm or carrying arteries. Results: No mortality occurred in authors' group. Internal carotid arteries (ICA) were occluded with detachable balloons in 5 aneurysms at sinus segment of ICA and 4 traumatic pseudo-aneurysms. No complications occurred. 9 aneurysms were completely occluded with micro-coils and 2 were partly (95%) occluded. 2 patients got mild paralysis due to vasospasm or mal detaching of MDS coils. Conclusions: Balloon occlusion of ICA for treatment of aneurysm at sinus segment is safe and effective in case of having abundant collateral circulation. Coil occlusion of intracranial aneurysm is a promising method of endovascular treatment. Compared with MDS, GDC coil is safer but expensive. Free coil is not very safe theoretically, but can be used with careful consideration as it is much cheaper

  2. Management of intracranial arteriovenous malformations

    International Nuclear Information System (INIS)

    Miyamoto, Susumu; Takahashi, Jun C.

    2008-01-01

    Intracranial arteriovenous malformations (AVMs) are congenital lesions that can cause serious neurological deficits or even death. They can manifest as intracranial hemorrhage, epileptic seizure, or other symptoms such as headache or tinnitus. They are detected by computed tomography or magnetic resonance imaging. Recently there have been significant developments in the management of AVMs. In this paper, the authors represent an overview of the epidemiology of AVMs and the existing treatment strategies. AVMs are ideally excised by standard microsurgical techniques. The grading scale which was proposed by Spetzler and Martin is widely used to estimate the risk of direct surgery. Stereotactic radiosurgery such as that using a gamma knife is very useful for small lesions located in eloquent areas. Technological advances in endovascular surgery have provided new alternatives in the treatment of AVMs. Currently indications for embolization can be divided into presurgical embolization in large AVMs to occlude deep arterial feeding vessels and embolization before stereotactic radiosurgery to reduce the size of the nidus. Palliative embolization can be also applied for patients with large, inoperable AVMs who are suffering from progressive neurological deficits secondary to venous hypertension and/or arterial steal phenomenon. (author)

  3. Desmopressin Acetate in Intracranial Haemorrhage

    Directory of Open Access Journals (Sweden)

    Thomas Kapapa

    2014-01-01

    Full Text Available Introduction. The secondary increase in the size of intracranial haematomas as a result of spontaneous haemorrhage or trauma is of particular relevance in the event of prior intake of platelet aggregation inhibitors. We describe the effect of desmopressin acetate as a means of temporarily stabilising the platelet function. Patients and Methods. The platelet function was analysed in 10 patients who had received single (N=4 or multiple (N=6 doses of acetylsalicylic acid and 3 patients (control group who had not taken acetylsalicylic acid. All subjects had suffered intracranial haemorrhage. Analysis was performed before, half an hour and three hours after administration of desmopressin acetate. Statistical analysis was performed by applying a level of significance of P≤0.05. Results. (1 Platelet function returned to normal 30 minutes after administration of desmopressin acetate. (2 The platelet function worsened again after three hours. (3 There were no complications related to electrolytes or fluid balance. Conclusion. Desmopressin acetate can stabilise the platelet function in neurosurgical patients who have received acetylsalicylic acid prior to surgery without causing transfusion-related side effects or a loss of time. The effect is, however, limited and influenced by the frequency of drug intake. Further controls are needed in neurosurgical patients.

  4. Neural Correlates of Sevoflurane-induced Unconsciousness Identified by Simultaneous Functional Magnetic Resonance Imaging and Electroencephalography.

    Science.gov (United States)

    Ranft, Andreas; Golkowski, Daniel; Kiel, Tobias; Riedl, Valentin; Kohl, Philipp; Rohrer, Guido; Pientka, Joachim; Berger, Sebastian; Thul, Alexander; Maurer, Max; Preibisch, Christine; Zimmer, Claus; Mashour, George A; Kochs, Eberhard F; Jordan, Denis; Ilg, Rüdiger

    2016-11-01

    The neural correlates of anesthetic-induced unconsciousness have yet to be fully elucidated. Sedative and anesthetic states induced by propofol have been studied extensively, consistently revealing a decrease of frontoparietal and thalamocortical connectivity. There is, however, less understanding of the effects of halogenated ethers on functional brain networks. The authors recorded simultaneous resting-state functional magnetic resonance imaging and electroencephalography in 16 artificially ventilated volunteers during sevoflurane anesthesia at burst suppression and 3 and 2 vol% steady-state concentrations for 700 s each to assess functional connectivity changes compared to wakefulness. Electroencephalographic data were analyzed using symbolic transfer entropy (surrogate of information transfer) and permutation entropy (surrogate of cortical information processing). Functional magnetic resonance imaging data were analyzed by an independent component analysis and a region-of-interest-based analysis. Electroencephalographic analysis showed a significant reduction of anterior-to-posterior symbolic transfer entropy and global permutation entropy. At 2 vol% sevoflurane concentrations, frontal and thalamic networks identified by independent component analysis showed significantly reduced within-network connectivity. Primary sensory networks did not show a significant change. At burst suppression, all cortical networks showed significantly reduced functional connectivity. Region-of-interest-based thalamic connectivity at 2 vol% was significantly reduced to frontoparietal and posterior cingulate cortices but not to sensory areas. Sevoflurane decreased frontal and thalamocortical connectivity. The changes in blood oxygenation level dependent connectivity were consistent with reduced anterior-to-posterior directed connectivity and reduced cortical information processing. These data advance the understanding of sevoflurane-induced unconsciousness and contribute to a

  5. Seizure semiology and electroencephalography in young children with lesional temporal lobe epilepsy.

    Science.gov (United States)

    Lv, Rui-Juan; Sun, Zhen-Rong; Cui, Tao; Shao, Xiao-Qiu

    2014-02-01

    This study aimed to discuss the clinical features of seizure semiology and electroencephalography (EEG) in young children with lesional temporal lobe epilepsy (TLE). Children with lesional TLE received presurgical evaluation for intractable epilepsy. They were followed up for more than one year after temporal lobectomy. We reviewed the medical history and video-EEG monitoring of children with TLE to analyze the semiology of seizures and EEG findings and compared the semiology of seizures and EEG findings of childhood TLE and adult TLE. A total of 84 seizures were analyzed in 11 children (aged 23-108 months). The age of seizure onset was from 1 month to 26 months (a mean of 17.6 months). All of the patients exhibited prominent motor manifestations including epileptic spasm, tonic seizure, and unilateral clonic seizure. Seven children manifested behavioral arrest similar to an automotor seizure in adult TLE but with a shorter duration and higher frequency. The automatisms were typically orofacial, whereas manual automatisms were rarely observed. The EEG recordings revealed that diffuse discharge patterns were more common in younger children, whereas focal or unilateral patterns were more typical in older children. All of the patients were seizure-free after temporal lobectomy with more than one-year follow-up. All of the children had a mental development delay or regression; however, there was improvement after surgery, especially in those with surgery performed early. In contrast to TLE in adults, young children with lesional TLE probably represent a distinct nosological and probably less homogeneous syndrome. Although they had generalized clinical and electrographic features, resective epilepsy surgery should be considered as early as possible to obtain seizure control and improvement in mental development. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  6. Neurodevelopmental retardation, as assessed clinically and with magnetoencephalography and electroencephalography, associated with perinatal dioxin exposure.

    Science.gov (United States)

    Ten Tusscher, G W; Leijs, M M; de Boer, L C C; Legler, J; Olie, K; Spekreijse, H; van Dijk, B W; Vulsma, T; Briët, J; Ilsen, A; Koppe, J G

    2014-09-01

    In 1980s Western Europe, human perinatal exposure to background levels of dioxins was rather high. We therefore evaluated the neurodevelopment of our cohort during the prepubertal period and in adolescence. At prepubertal age (7-12 years) 41 children were tested. Both neuromotor functioning and psychological testing were performed (Dutch version of the Wechsler Intelligence Scale for Children (WISC-R) and the Dutch version of the Child Behavior Checklist for ages 4-18 years (CBCL 4-18) and the Teacher Report Form (TRF)). Neurophysiological tests were performed using magnetoencephalography and electroencephalography. In adolescence (14-18 years) the behavior of 33 children was studied again (CBCL and TRF). And the levels of dioxins and dioxin-like PCBs (dl-PCBs) were measured in serum. At prepubertal age no association was found between perinatal dioxin exposure and verbal, performal and total IQ or with the Touwen's test for neuromotor development. There were behavioral problems associated with both prenatal and postnatal dioxin exposure. In adolescence there were problems associated with the current dioxin levels and dioxin-like-PCBs. Neurophysiological tests revealed clear negative dysfunction. An increase in latency time after a motion stimulus (N2b) of 13 ms (= a delay of 10%) is associated with the higher prenatal dioxin exposure. A similar delay was measured in testing cognitive ability by analyzing the odd ball measurements, N200 and P300, together with an amplitude decrease of 12 %. The delay is indicative of a defective myelinisation and the decrease in amplitude of a loss of neurons. We found effects on behavior in association with the perinatal dioxin exposure and in adolescence in association with the current dioxin levels. Neurophysiological testing is instrumental in the detection of effects of perinatal background levels of chemicals on brain development in normal, healthy children. The clinical, neurological and psychological tests commonly used are

  7. Intracranial epidural hemorrhage during lumbar spinal surgery.

    Science.gov (United States)

    Imajo, Yasuaki; Kanchiku, Tsukasa; Suzuki, Hidenori; Yoshida, Yuichiro; Nishida, Norihiro; Goto, Hisaharu; Suzuki, Michiyasu; Taguchi, Toshihiko

    2016-01-01

    The authors report a case of intracranial epidural hemorrhage (ICEH) during spinal surgery. We could not find ICEH, though we recorded transcranial electrical stimulation motor evoked potentials (TcMEPs). A 35-year-old man was referred for left anterior thigh pain and low back pain that hindered sleep. Sagittal T2-weighted magnetic resonance imaging revealed an intradural tumor at L3-L4 vertebral level. We performed osteoplastic laminectomy and en bloc tumor resection. TcMEPs were intraoperatively recorded at the bilateral abductor digiti minimi (ADM), quadriceps, tibialis anterior and abductor hallucis. When we closed a surgical incision, we were able to record normal TcMEPs in all muscles. The patient did not fully wake up from the anesthesia. He had right-sided unilateral positive ankle clonus 15 min after surgery in spite of bilateral negative of ankle clonus preoperatively. Emergent brain computed tomography scans revealed left epidural hemorrhage. The hematoma was evacuated immediately via a partial craniotomy. There was no restriction of the patient's daily activities 22 months postoperatively. We should pay attention to clinical signs such as headache and neurological findgings such as DTR and ankle clonus for patients with durotomy and cerebrospinal fluid (CSF) leakage. Spine surgeons should know that it was difficult to detect ICEH by monitoring with TcMEPs.

  8. A case of intracranial mesenchymal chondrosarcoma

    International Nuclear Information System (INIS)

    Hoshino, Masami; Tanji, Hiroyuki; Watanabe, Masakazu

    1981-01-01

    Intracranial mesenchymal chondrosarcoma is very rare, only 14 cases being reported in Europe and in the United States of America. Recently we experienced a case in which the follow-up indicating computed tomograms (CT) demonstrated interesting data on the radiosensitivity of this tumor. The patient, a 14-year-old female was admitted to our hospital with the complaint of left hemiplegia which had gradually progressed. CT revealed an area spreading upward from the right median base of the skull and consisted of two components showing (A) a density as high as that of calcium and (B) a density higher than that of surrounding brain tissue, but much lower than that of calcium. Temporoparietal craniotomy was performed to resect approximately one-half of the tumor. Histological finding revealed mesenchymal chondrosarcoma. The component-A was though to be a cartilaginous tissue, and-B to be an undifferentiated mesenchymal tissue. Postoperative irradiation of 7,000 rad was initiated. The effect of radiotherapy as seen on computed tomograms is as follows, (1) decrease in the volume of the tumor by 26%, (2) decrease in density and enhancement of the area which is considered to be the undifferentiated mesenchymal cells, (3) mild reduction of the area which is considered to be the caltilaginous tissue, and (4) a very high density of the entire tumor similar in degree to that of the bone one year later. These results suggested that radiotherapy is effective for this tumor. (author)

  9. Effect of epilepsy magnetic source imaging on intracranial electrode placement

    Science.gov (United States)

    Knowlton, Robert C.; Razdan, Shantanu N.; Limdi, Nita; Elgavish, Rotem A.; Killen, Jeff; Blount, Jeffrey; Burneo, Jorge G.; Ver Hoef, Lawrence; Paige, Lebron; Faught, Edward; Kankirawatana, Pongkiat; Bartolucci, Al; Riley, Kristen; Kuzniecky, Ruben

    2009-01-01

    Objective Intracranial electroencephalography (ICEEG) with chronically implanted electrodes is a costly invasive diagnostic procedure that remains necessary for a large proportion of patients who undergo evaluation for epilepsy surgery. This study was designed to evaluate whether magnetic source imaging (MSI), a non-invasive test based on magnetoencephalography source localization, can supplement ICEEG by affecting electrode placement to improve sampling of the seizure onset zone(s). Methods Of 298 consecutive epilepsy surgery candidates (between 2001-2006) 160 cases were prospectively enrolled on the basis of insufficient localization from seizure monitoring and MRI results. Prior to presenting MSI results, decisions were made as to whether to proceed with ICEEG, and if so, where to place electrodes such that the hypothetical seizure onset zone would be sampled. MSI results were then provided with allowance of changes to the original plan. Results MSI indicated additional electrode coverage in 18 of 77 (23%) ICEEG cases. In 39% percent (95% CI: 16.4, 61.4) seizure onset ICEEG patterns involved the additional electrodes indicated by MSI. Sixty-two patients underwent surgical resection based on ICEEG recording of seizures. Highly localized MSI was significantly associated with seizure-free outcome (mean=3.4 years, minimum > 1 year) for the entire surgical population (n=62). Interpretation MSI spike localization increases the chance that the seizure onset zone is sampled when patients undergo ICEEG for presurgical epilepsy evaluations. The clinical impact of this effect–-improving diagnostic yield of ICEEG–-should be considered in surgery candidates that do not have satisfactory indication of epilepsy localization from seizure semiology, EEG, and MRI. PMID:19557860

  10. Intracranial stenosis in cognitive impairment and dementia.

    Science.gov (United States)

    Hilal, Saima; Xu, Xin; Ikram, M Kamran; Vrooman, Henri; Venketasubramanian, Narayanaswamy; Chen, Christopher

    2017-06-01

    Intracranial stenosis is a common vascular lesion observed in Asian and other non-Caucasian stroke populations. However, its role in cognitive impairment and dementia has been under-studied. We, therefore, examined the association of intracranial stenosis with cognitive impairment, dementia and their subtypes in a memory clinic case-control study, where all subjects underwent detailed neuropsychological assessment and 3 T neuroimaging including three-dimensional time-of-flight magnetic resonance angiography. Intracranial stenosis was defined as ≥50% narrowing in any of the intracranial arteries. A total of 424 subjects were recruited of whom 97 were classified as no cognitive impairment, 107 as cognitive impairment no dementia, 70 vascular cognitive impairment no dementia, 121 Alzheimer's Disease, and 30 vascular dementia. Intracranial stenosis was associated with dementia (age/gender/education - adjusted odds ratios (OR): 4.73, 95% confidence interval (CI): 1.93-11.60) and vascular cognitive impairment no dementia (OR: 3.98, 95% CI: 1.59-9.93). These associations were independent of cardiovascular risk factors and MRI markers. However, the association with Alzheimer's Disease and vascular dementia became attenuated in the presence of white matter hyperintensities. Intracranial stenosis is associated with vascular cognitive impairment no dementia independent of MRI markers. In Alzheimer's Disease and vascular dementia, this association is mediated by cerebrovascular disease. Future studies focusing on perfusion and functional markers are needed to determine the pathophysiological mechanism(s) linking intracranial stenosis and cognition so as to identify treatment strategies.

  11. Intracranial extension of spinal subarachnoid hematoma causing severe cerebral vasospasm.

    Science.gov (United States)

    Nam, Kyoung Hyup; Lee, Jae Il; Choi, Byung Kwan; Han, In Ho

    2014-12-01

    Spinal subarachnoid hemorrhages (SAH) can extend into the intracranial subarachnoid space, but, severe cerebral vasospasm is rare complication of the extension of intracranial SAH from a spinal subarachnoid hematoma. A 67-year-old woman started anticoagulant therapy for unstable angina. The next day, she developed severe back pain and paraplegia. MRI showed intradural and extramedullar low signal intensity at the T2-3, consistent with intradural hematoma. High signal intensity was also noted in the spinal cord from C5 to T4. We removed subarachnoid hematoma compressing the spinal cord. The following day, the patient complained of severe headache. Brain CT revealed SAH around both parietal lobes. Three days later, her consciousness decreased and left hemiplegia also developed. Brain MRI demonstrated multiple cerebral infarctions, mainly in the right posterior cerebral artery territory, left parietal lobe and right watershed area. Conventional cerebral angiography confirmed diffuse severe vasospasm of the cerebral arteries. After intensive care for a month, the patient was transferred to the rehabilitation department. After 6 months, neurologic deterioration improved partially. We speculate that surgeons should anticipate possible delayed neurological complications due to cerebral vasospasm if intracranial SAH is detected after spinal subarachnoid hematoma.

  12. Outcome of endovascular treatment in symptomatic intracranial vascular stenosis

    International Nuclear Information System (INIS)

    Suh, Dae Chul; Kim, Sang Joon; Lee, Duk Hee; Kim, Won; Choi, Choong Gon; Lee, Jeong Hyun; Kwon, Sun Uck; Kim, Jong Sung; Kim, Hyun Jeong

    2005-01-01

    The outcome evaluation for the revascularization of intracranial vascular stenoses has not been fully described due to the highly technical nature of the procedure. We report here on the early and late clinical outcome of angioplasty and/or stenting of symptomatic severe intracranial vascular stenoses at a single institute. Since 1995, we have treated 35 patients with symptomatic intracranial vascular stenosis (more than 70% stenosis, mean stenosis: 78.6% ± 6.2%). Angioplasty (n = 19) was performed for the horizontal segment of the middle cerebral artery (M1) (n = 16) and the basilar artery (BA) (n = 1), the intradural vertebral artery (VA) (n = 1), and the cavernous internal carotid artery (ICA) (n = 1). Stenting (n = 16) was performed for the cavernous or petrous ICAs (n = 9), the intradural VA (n = 3), BA (n = 2), and M1 (n = 2) artery. We assessed the angiographic success (defined as residual stenosis < 50%) rate, the periprocedural complications during the 30-day periprocedural period, the symptomatic recurrence and restenosis during a mean 22-month follow-up (FU) period. The Kaplan-Meier estimate of the cumulative even-free rate of the major cerebrovascular events, i.e. death, stroke or restenosis, was also done. Angiographic success was achieved in 97% of our patients (34/35). There were four procedure-related complications (11%) including a death and a minor stroke. During the mean 22-month FU, the asymptomatic restenosis rate was 9% and the symptomatic restenosis rate was 6% in the target lesion and 9% in all the vascular territories. The Kaplan-Meier estimate was 70.6% (95% confidence interval = 46.5-94.7) after 33 month of FU. In addition to a high angiographic success rate and an acceptable periprocedural complication rate, intracranial angioplasty and/or stenting revealed a relatively low symptomatic recurrence rate. Hemorrhage is a rare, but the physician must aware that potentially fatal periprocedural complications can occur

  13. Computed tomography and intracranial hemorrhages in the neonate

    International Nuclear Information System (INIS)

    Shibata, Iekado; Kushida, Yoshimasa; Shishido, Masaru; Nagasawa, Sadatsugu; Seiki, Yoshikatsu

    1983-01-01

    Thirty-two of 290 neonates admitted to the Perinatal Intensive Care Unit, Toho University Medical School, were examined by CT scan because of tentative clinical diagnosis of intracranial hemorrhage. CT scanner employed in this study was TCT-60 A from the Toshiba The Electric Co., Ltd. Fourteen cases (44%) were confirmed by the CT scan to have intracranial hemorrhage. Four cases had hemorrhage in the ventricle, while the remaining ten cases had subarachnoid hemorrhage. Subdural hemorrhage was not revealed in our series. Three of the four cases with intraventricular hemorrhage showed a typical subependymal germinal matrix hemorrhage. The prognosis of intraventricular hemorrhage in neonates seemed to be poor; two of the four cases died within a week. Their body weight at birth was apparently under the standard, and their Apgar score was 3 points. The subarachnoid hemorrhage was the main type of intracranial neonatal hemorrhages. In our series, it was constituted approximately 70% of the intracranial hemorrhages. The CT images of the subarachnoid hemorrhage in neonate were greatly different from those in adults. An irregular, wide high-density area around the falxtentorial junction was characteristic of the CT in many neonatal subarachnoid hemorrhages. In severe subarachnoid hemorrhages, a characteristic Y-shaped, high-density figure was demonstrated. In cases of subarachnoid hemorrhage from the deep venous system, high-density spreading immediately ventral to the falx-tentrium junction was demonstrated. These high-density areas due to blood in the subarachnoid space rapidly disappeared with the lapse of time. On the other hand, high-density areas in cerebral cisterns and/or fissures were rarely demonstrated in neonatal subarachnoid hemorrhages. The prognosis of subarachnoid hemorrhage in neonates was fairly good in the sense of life and cerebral functions. (author)

  14. A study of the intracranial hemorrhagic lesions by computed tomography

    International Nuclear Information System (INIS)

    Honda, Kazuyoshi

    1983-01-01

    Changes in X-ray density corresponding to intracranial hemorrhagic lesions were follwed in fourteen patients. In addition, X-ray density of solutions with oxyhemoglobin, CO-hemoglobin and methehemoglobin as well as suspension of blood corpuscles, hemolysate, calcium, sodium, iron, copper, magnesium and phosphate was measured. The following results were obtained: 1) The average X-ray density of hemorrhagic lesions within 48 hours after intracranial hemorrhage was 73.80 H.N.: 55.81 H.N. between 48 hours and three weeks : 49.5 H.N. between three and four weeks: 26.81 H.N. over four weeks. In all cases, the intracranial hemorrhage in its acute stage revealed a high X-ray density as compared to the surrounding cerebral tissue. This was helpful for the detection of hemorrhagic lesions. 2) X-ray density of the lesion decreased 1.68 H.N./day after the hemorrhage. 3) Among various constituents of blood, the solution of sodium showed the highest X-ray density, followed by hemoglobin, magnesium, calcium, phosphate, copper and iron. 4) However, when the concentration of each blood constituent was taken into consideration, hemoglobin showed the highest X-ray density, followed by calcium, copper, sodium, magnesium, phosphate and iron. 5) There was no significant difference in X-ray density between the suspension of blood corpuscles and hemolysate. The findings were the same whether hemoglobin was oxyhemoglobin, CO-hemoglobin or methehemoglobin. 6) Oxyhemoglobin showed the highest X-ray density, followed by CO-hemoglobin and methehemoglobin. These findings suggested that hemoglobin in the intracranial hemorrhagic lesion seems to be a major factor producing a high X-ray density particularly in its acute stage. (author)

  15. Frequency Domain Characterization of the Somatosensory Steady State Response in Electroencephalography

    NARCIS (Netherlands)

    Vlaar, Martijn P.; van der Helm, Frans C.T.; Schouten, Alfred C.

    2015-01-01

    A continuous somatosensory stimulation evokes a steady state response in the cortex, which can be measured using electroencephalography. We applied mechanical multisine stimulation of the wrist to investigate the properties of the steady state response in the frequency domain. Our results show a

  16. Quantitative Electroencephalography as a Diagnostic Tool for Alzheimer's Dementia in Adults with Down Syndrome

    DEFF Research Database (Denmark)

    Salem, Lise Cronberg; Sabers, Anne; Kjaer, Troels W

    2015-01-01

    BACKGROUND: Assessment of dementia in individuals with intellectual disability is complex due to great inter-individual variability in cognitive function prior to dementia and a lack of standardized instruments. Studies have indicated that quantitative electroencephalography (qEEG) results may be...

  17. The Use of Amplitude Integrated Electroencephalography for Assessing Neonatal Neurologic Injury

    NARCIS (Netherlands)

    Toet, Mona C.; van Rooij, Linda G. M.; deVries, Linda S.

    2008-01-01

    Amplitude-integrated electroencephalography (aEEG) plays an important role in integrated care of the full-term infant with neonatal encephalopathy. The three main features that are provided with aEEG are the background pattern on admission and the rate of recovery seen during the first 24 to 48

  18. Intracranial hemorrhage due to intracranial hypertension caused by the superior vena cava syndrome

    DEFF Research Database (Denmark)

    Bartek, Jiri; Abedi-Valugerdi, Golbarg; Liska, Jan

    2013-01-01

    We report a patient with intracranial hemorrhage secondary to venous hypertension as a result of a giant aortic pseudoaneurysm that compressed the superior vena cava and caused obstruction of the venous return from the brain. To our knowledge, this is the first patient reported to have an intracr......We report a patient with intracranial hemorrhage secondary to venous hypertension as a result of a giant aortic pseudoaneurysm that compressed the superior vena cava and caused obstruction of the venous return from the brain. To our knowledge, this is the first patient reported to have...... an intracranial hemorrhage secondary to a superior vena cava syndrome. The condition appears to be caused by a reversible transient rise in intracranial pressure, as a result of compression of the venous return from the brain. Treatment consisted of surgery for the aortic pseudoaneurysm, which led...... to normalization of the intracranial pressure and resorption of the intracranial hemorrhage....

  19. Stent-assisted angioplasty for intracranial atherosclerosis

    International Nuclear Information System (INIS)

    Nakahara, Toshinori; Sakamoto, Shigeyuki; Hamasaki, Osamu; Sakoda, Katsuaki

    2002-01-01

    We report on two patients with intracranial atherosclerosis of the carotid artery or vertebral artery treated with stent-assisted angioplasty. Both patients have severe intracranial atherosclerosis (>70%) with refractory symptoms despite optimal medical treatment. In both patients, a coronary balloon-expandable stent was successfully placed using a protective balloon technique without procedural complications. The patients were asymptomatic and neurologically intact at a mean clinical follow-up of 13 months. Follow-up angiograms did not show restenosis 3 or 4 months after procedure, respectively. Stent-assisted angioplasty for intracranial atherosclerosis in the elective patient has proven effective, with an acceptable low rate of morbidity and mortality. (orig.)

  20. Hypertensive response to raised intracranial pressure in infancy.

    OpenAIRE

    Kaiser, A M; Whitelaw, A G

    1988-01-01

    Mean arterial pressure and intracranial pressure were measured serially in six infants with intracranial hypertension (intracranial pressure greater than 20 mm Hg), and cerebral perfusion pressure was calculated from their difference. Overall, mean arterial pressure increased with rising intracranial pressure at a mean rate of 0.20 mm Hg/mm Hg. This caused a fall in cerebral perfusion pressure with increasing intracranial pressure at a mean rate of 0.80 mm Hg/mm Hg overall, although cerebral ...

  1. Headache following intracranial neuroendovascular procedures.

    Science.gov (United States)

    Baron, Eric P; Moskowitz, Shaye I; Tepper, Stewart J; Gupta, Rishi; Novak, Eric; Hussain, Muhammad Shazam; Stillman, Mark J

    2012-05-01

    Predicting who will develop post-procedure headache (PPH) following intracranial endovascular procedures (IEPs) would be clinically useful and potentially could assist in reducing the excessive diagnostic testing so often obtained in these patients. Although limited safety data exist, the use of triptans or dihydroergotamine (DHE) often raise concern when used with pre/post-coiled aneurysms. We sought to determine risk factors for PPH following IEP, to evaluate the utility of diagnostic testing in patients with post-coil acute headache (HA), and to record whether triptans and DHE have been used safely in this clinical setting. We conducted a retrospective chart review of adult patients undergoing IEPs. Bivariate analyses were conducted to compare patients who did and did not develop PPH. We reviewed records pertaining to 372 patients, of whom 263 underwent intracranial coil embolizations, 21 acrylic glue embolizations, and 88 stent placements. PPH occurred in 72% of coil patients, 33% of glue patients, and 14% of stent patients. Significant risk factors for post-coil HA were female gender, any pre-coil HA history, smoking, and anxiety/depression. A pre-stent history of HA exceeding 1 year's duration, and smoking were risk factors for post-stent HA. A pre-glue history of HA exceeding 1 year was the only risk factor for post-glue HA. In the small subgroup available for study, treatment with triptans or DHE was not associated with adverse events in pre/post-coiled aneurysms. Diagnostic testing was low yield. Occurrence of PPH was common after IEPs and especially so with coiling and in women, smokers, and those with anxiety/depression, and was often of longer duration than allowed by current International Classification of Headache Disorders-II criteria. The yield of diagnostic testing was low, and in a small subgroup treatment with triptans or DHE did not cause adverse events in pre/post-coiled aneurysms. Prospective studies are needed to confirm these findings.

  2. Nephrogenic diabetes insipidus with intracranial calcification in a child with thalassemia minor.

    Science.gov (United States)

    Dimple, Jain; Alka, Jadhav; Mona, Gajre; Atul, Deshmukh

    2013-09-01

    There are numerous causes for intracranial calcification in children. We describe an unusual cause of intracranial calcification in a child, namely, nephrogenic diabetes insipidus (NDI). A 12-year-old boy presented with seizures and developmental delay. MRI of the brain revealed intracranial calcification. Evaluation showed findings suggestive of NDI. The lack of evidence of any other metabolic defect suggests that these calcifications were secondary to NDI. He also had anemia for which he was investigated and diagnosed as thalassemia minor. Detailed literature review failed to reveal any reported association between NDI and thalassemia minor. We report this case to emphasize the importance of early diagnosis and treatment of NDI to prevent organic brain damage.

  3. Suppurative intracranial processes in 15 domestic ruminants

    Directory of Open Access Journals (Sweden)

    Antônio Carlos Lopes Câmara

    2014-05-01

    Full Text Available In addition to listeriosis which is relatively common in ruminants, there are three other uncommon suppurative intracranial processes (SIP identifiable in adult ungulates as brain abscess, basilar empyema and suppurative meningitis. The present paper reports the epidemiological, clinical, laboratorial, pathological and microbiological findings of 15 domestic ruminants with SIP. A total of 15 animals were selected (eight sheep, four cattle and three goats; with the definitive diagnoses of basilar empyema (n=3, brain abscess (n=1, listeriosis (n=5 and suppurative meningitis (n=6. Hematology revealed leukocytosis with inversion of the lymphocyte/ neutrophil ratio in 4 cases. In the majority of animals, cerebrospinal fluid (CSF presented light yellow coloration and cloudy aspect due to neutrophilic pleocytosis (15 - 997 leukocytes/µL. Microbiological culture of CSF or central nervous system (CNS fragments resulted on isolation of Trueperella (Arcanobacterium pyogenes,Listeria monocytogenes,Escherichia coli and Stenotrophomonas sp. In a goat with thalamic abscess, microbiological assay was not performed, but Gram positive bacilli type bacteria were observed in histology. The diagnosis of these outbreaks was based on the association of epidemiological, clinical, pathological and bacteriological findings; reiterating that the infectious component remains an important cause of CNS disease in domestic ruminants and also shows the need for dissemination of information about the most effective preventive measures for the ranchers.

  4. Intracranial EEG Connectivity Analysis and Result Imaging

    Czech Academy of Sciences Publication Activity Database

    Klimeš, Petr; Janeček, Jiří; Jurák, Pavel; Halámek, Josef; Chládek, Jan; Brázdil, M.

    2012-01-01

    Roč. 2, č. 4 (2012), s. 275-279 ISSN 2010-3638 Institutional support: RVO:68081731 Keywords : Connectivity * Correlation * Intracranial EEG * Signal Processing Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering

  5. MR angiography after coiling of intracranial aneurysms

    NARCIS (Netherlands)

    Schaafsma, J.D.

    2012-01-01

    Introduction Endovascular occlusion with detachable coils has become an alternative treatment to neurosurgical clipping of intracranial aneurysms over the last two decades. Its minimal invasiveness is the most important advantage of this treatment compared to clipping. The disadvantage of occlusion

  6. The commonly missed diagnosis of intracranial hypotension

    Directory of Open Access Journals (Sweden)

    Ashlee N. Ruggeri-McKinley, BSN, RN

    2016-06-01

    Full Text Available We report a 28 year old female who presented with a subacute onset of a severe throbbing and stabbing headache after a morning spin class 9 months ago. We confirmed the diagnosis of spontaneous intracranial hypotension cause by a cerebrospinal fluid leak. The headache finally resolved after a 55 ml blood patch. Affecting an estimated 5/100,000 patients, spontaneous intracranial hypotension is considered rare in medical literature. Many patients with spontaneous intracranial hypotension are incapacitated for years and even decades. The misdiagnosis of intracranial hypotension can have serious consequences and lead to unnecessary testing and treatment. Healthcare professionals need to be aware of this diagnosis when evaluating a patient with acute head pain. Considering that physical exams are usually normal, clinicians must focus on the patient history and physical. Clues in the patient interviewing process can lead to an immediate and accurate diagnosis.

  7. Intracranial Hemorrhage Following a 3-week Headache

    Directory of Open Access Journals (Sweden)

    John Jiao

    2017-01-01

    Full Text Available History of present illness: A 35-year-old female presented to the ED with a Glasgow Coma Scale (GCS of 11. Per her boyfriend, the patient was having headaches for the past 3 weeks. She was initially taken to an outside hospital where her GCS was reported as 13. A non-contrast head computed tomography (CT revealed a large lobar intraparenchymal hemorrhage within the left frontal parietal lobe with midline shift. Upon examination, vitals were notable for blood pressure of 209/88mmHg, and her left pupil was fixed and dilated. The patient had extension of her right arm to noxious stimuli, paralysis of her right leg, and purposeful movement of the left arm and left leg. The patient was started on a nicardipine drip in the ED and subsequently taken to the operating room for a decompressive craniectomy. Significant findings: The patient’s head CT showed a significant area of hyperdensity consistent with an intracranial hemorrhage located within the left frontal parietal lobe (red arrow. Additionally, there is rightward midline shift up to 1.1cm (green arrow and entrapment of the right lateral ventricle (blue arrow. Discussion: Intraparenchymal hemorrhage (IPH is associated with high morbidity and mortality. Although the mortality for subarachnoid hemorrhage (SAH has declined steadily over the past several decades, the mortality for IPH mortality has not significantly.1 One of the most serious considerations when treating a patient with IPH is the management of intracranial pressure (ICP.2 Once an IPH is identified, immediate steps should be taken to bring ICP within acceptable levels including elevating the head of the bed to 30 degrees, sedation, and controlling hypertension with medications.2-3 Even with early and aggressive care, the prognosis for IPH remains poor; the 30-day mortality rate for IPH is estimated to be less than 50%, and a 2010 systematic review estimated only 12-39% of IPH patients achieve independent function.4-5 Predictors of

  8. Spontaneous intracranial epidural hematoma during rivaroxaban treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ruschel, Leonardo Gilmone; Rego, Felipe Marques Monteiro do; Milano, Jeronimo Buzetti; Jung, Gustavo Simiano; Silva Junior, Luis Fernando; Ramina, Ricardo, E-mail: leonardoruschel@yahoo.com.br [Instituto de Neurologia de Curitiba (INC), Curitiba, PR (Brazil)

    2016-11-15

    According to our research, this is the first case described in the literature of spontaneous intracranial epidural hematoma secondary to the use of Xarelto®. Spontaneous intracranial epidural hematomas are rarely described in the literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura mater and metastasis to the skull. Long-term post-marketing monitoring and independent reports will probably detect the full spectrum of hemorrhagic complications of the use of rivaroxaban. (author)

  9. Spontaneous Intracranial Hypotension without Orthostatic Headache

    Directory of Open Access Journals (Sweden)

    Tülay Kansu

    2009-03-01

    Full Text Available We report 2 cases of spontaneous intracranial hypotension that presented with unilateral abducens nerve palsy, without orthostatic headache. While sixth nerve palsies improved without any intervention, subdural hematoma was detected with magnetic resonance imaging. We conclude that headache may be absent in spontaneous intracranial hypotension and spontaneous improvement of sixth nerve palsy can occur, even after the development of a subdural hematoma

  10. Mucocele and pyocele with marked intracranial extension

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, Kazuhiro; Machida, Tohru; Iio, Masahiro

    1984-08-01

    Two cases are presented with frontal sinus pyocele and fronto-ethmoid sinus mucocele in which marked intracranial extension is shown. Their intracranial part appeared as a large biconvex mass, which showed iso or slightly low density homogeneously and had gross calcification in the posterior rim. The findings of the paranasal sinuses and the orbit in tomograms and CT scans are thought to be useful in the differential diagnosis of chronic subdural hematoma.

  11. Spontaneous intracranial epidural hematoma during rivaroxaban treatment.

    Science.gov (United States)

    Ruschel, Leonardo Gilmone; Rego, Felipe Marques Monteiro do; Milano, Jerônimo Buzetti; Jung, Gustavo Simiano; Silva, Luis Fernando; Ramina, Ricardo

    2016-11-01

    According to our research, this is the first case described in the literature of spontaneous intracranial epidural hematoma secondary to the use of Xareltor. Spontaneous intracranial epidural hematomas are rarely described in the literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura mater and metastasis to the skull. Long-term post-marketing monitoring and independent reports will probably detect the full spectrum of hemorrhagic complications of the use of rivaroxaban.

  12. Neural decoding of expressive human movement from scalp electroencephalography (EEG)

    OpenAIRE

    Zachery Ryan Hernandez; Zachery Ryan Hernandez; Jesus Gabriel Cruz-Garza; Jesus Gabriel Cruz-Garza; Sargoon eNepaul; Karen Kohn Bradley; Jose Luis Contreras-Vidal; Jose Luis Contreras-Vidal

    2014-01-01

    Although efforts to characterize human movement through EEG have revealed neural activities unique to limb control that can be used to infer movement kinematics, it is still unknown the extent to which EEG can be used to discern the expressive qualities that influence such movements. In this study we used EEG and inertial sensors to record brain activity and movement of five skilled and certified Laban Movement Analysis (LMA) dancers. Each dancer performed whole body functional movements of t...

  13. Applicability of long-term electroencephalography in pre-mortem diagnosis of Creutzfeldt-Jakob disease: A case report.

    Science.gov (United States)

    Attaripour Isfahani, Sanaz; Dougherty, Michelle; Gliebus, Gediminas Peter

    2017-01-01

    Creutzfeldt-Jakob disease accounts for more than 90% of all sporadic prion disease cases. The molecular MM2 genotype has been divided into cortical and thalamic subtypes based on structures involved and is characterized clinically by progressive dementia without ataxia or typical electroencephalography changes. Proposed diagnostic criteria for MM2 cortical type sporadic Creutzfeldt-Jakob disease include progressive dementia, cortical hyper-intensity on diffusion-weighted magnetic resonance imaging, increased cerebrospinal fluid 14-3-3 protein level, and the exclusion of other types of dementia. The presence of periodic discharges on electroencephalography in MM2 cortical type were reported in 42% of the cases. We are reporting a case of sporadic Creutzfeldt-Jakob disease cortical MM2-type presenting with rapid cognitive decline, who survived 8 months since symptom onset. Brain imaging, cerebrospinal fluid analysis, and long-term electroencephalography monitoring were obtained and diagnosis was confirmed by autopsy. Short-term electroencephalography recording, performed 5 months after symptom onset, demonstrated diffuse background slowing without epileptiform activity. Long-term video electroencephalography monitoring demonstrated generalized slowing, maximum in bilateral frontal areas, which intermittently would become rhythmic (1-2 Hz) without hemispheric predominance. If the findings do not clearly meet the proposed clinical criteria for sporadic Creutzfeldt-Jakob disease, the use of long-term electroencephalography could increase the sensitivity. We question whether the lack of the characteristic findings on electroencephalography in some cases could be due to insufficient time of recording. Application of long-term electroencephalography monitoring increases the sensitivity of electroencephalography and the certainty of pre-mortem diagnosis of sporadic Creutzfeldt-Jakob disease.

  14. Delayed Catheter-Related Intracranial Hemorrhage After a Ventriculoperitoneal or Ventriculoatrial Shunt in Hydrocephalus.

    Science.gov (United States)

    Qian, Zhouqi; Gao, Liang; Wang, Ke; Pandey, Sajan

    2017-11-01

    Delayed catheter-related intracranial hemorrhage is not rare after a ventriculoperitoneal (VP) or ventriculoatrial (VA) shunt for the treatment of hydrocephalus. Immediate postoperative catheter-related intracranial hemorrhage is possibly due to the procedure itself; however, delayed intracranial hemorrhage may have other underlying mechanisms. This study aimed to investigate the clinical characteristics and reveal the risk factors of delayed catheter-related intracranial hemorrhage after a VP or VA shunt. We did a retrospective study to review patients with hydrocephalus and underwent VP or VA shunt in our department from September 2011 to December 2015. We reviewed the clinical characteristics of the patients with delayed catheter-related intracranial hemorrhage, and its risk factors were analyzed with SPSS 16.0. Of the 218 patients enrolled in the study (145 male, 73 female), 17 (7.8%) patients experienced delayed catheter-related intracranial hemorrhage, including 11 of 151 (7.3%) patients with a VP shunt and 6 of 67 (9.0%) patients with a VA shunt. Additionally, 4 of the 16 patients with postoperative low-molecular-weight heparin (LMWH) therapy and 13 of the 202 patients without LMWH experienced bleeding, showing a significant difference (25% vs. 6.4%, P = 0.026). The relative risk was 4.8 (95% confidence interval: 1.4-17.1). Delayed catheter-related intracranial hemorrhage is not rare after a VP or VA shunt. However, most patients can be cured after appropriate treatment. Postoperative anticoagulation therapy with enoxaparin may be associated with an increased risk of bleeding. Copyright © 2017. Published by Elsevier Inc.

  15. Comparison of MR angiography with conventional angiography in cervical and intracranial vascular disease

    International Nuclear Information System (INIS)

    Choi, D. S.; Chang, K. H.; Jung, H. W.; Han, M. H.

    1995-01-01

    To assess the usefulness of magnetic resonance angiography (MRA) in evaluation of stenosis of carotid and large cerebral vessels and cerebral aneurysm. Twenty-seven patients with either arterial stenosis in cervical or intracranial major vessels (n = 18) or cerebral aneurysm (n = 8) or both (n 1) were examined with both MRA and conventional angiography (CA). MRA was performed with 3D TOF technique with magnetization transfer suppression at 1.5T system (Magnetom, Siemens, Germany); both intracranial MRA and cervical MRA in 16 patients, intracranial MRA only in the remaining patients. For evaluation of arterial stenosis, 32 carotid bifurcations and 383 segments of intracranial major vessels were assessed in blind fashion, and were compared with those of CA. Each arterial segment was arbitrarily classified into one of five grades (< 10, 10-49, 50-74, 75-99, 100%) for carotid bifurcation and one of four (< 10, 10-49, 50-99, 100%) for intracranial vessels. For aneurysm, its location, size shape and direction were compared. For arterial stenosis, concordance rate between MRA and CA was 88% (28/32) in carotid bifurcation and 89% (340/383) in intracranial vessels. All discordant cases were overgraded on MRA. For aneurysm, 7 of 9 were demonstrated on both MRA and CA, one of which was partially demonstrated on MRA. One of the other two patients showed aneurysm only on MRA, whereas the remaining one revealed aneurysm only on CA. MRA may be performed as a screening test for occlusive disease of cervical and major intracranial vessels and cerebral aneurysm

  16. Fatal Intracranial Hemorrhage in a Patient with Severe Dengue Fever.

    Science.gov (United States)

    Sam, Jo Ee; Gee, Teak Sheng; Wahab, Nasser Abdul

    2018-01-01

    Dengue fever has been a major cause of morbidity and mortality in subtropical and tropical countries. We report a rare case of severe dengue with spontaneous intracranial hemorrhage. A search of literature through PubMed revealed that the largest series analyzed so far only included five cases. A 47-year-old man presented with 7 days history of fever, headache, myalgia, and vomiting with hematemesis. On the day of presentation, he had reduced consciousness and an episode of generalized tonic-clonic seizure. His Glasgow Coma Scale was E1V1M3 with anisocoria. Postresuscitation computed tomography of the brain revealed a right subdural and left thalamic hemorrhage. His blood investigations revealed thrombocytopenia, dengue virus type 1 nonstructural protein antigen test was positive, dengue IgM negative, and dengue IgG positive. A right decompressive craniectomy was done. Unfortunately, the patient died soon after. Spontaneous intracranial hemorrhage in patients with dengue fever is an uncommon entity but usually carry a grave prognosis. To date, there has been no clear management guideline for such cases, as both operative and nonoperative approaches have their own inherent risks.

  17. Rapid development of a mycotic aneurysm of the intracranial artery secondary to Scedosporium apiospermum sinusitis

    Directory of Open Access Journals (Sweden)

    Yoshihiko Ogawa

    2016-12-01

    Full Text Available An 85-year-old man complained of a 2-month history of pain on the left side of his face. Brain computed tomography (CT and magnetic resonance imaging/magnetic resonance angiography did not clearly show any intracranial abnormality and only showed fluid effusion in his left sphenoid sinus. Filamentous fungi were detected from the left sphenoid sinus specimen. The isolate was Scedosporium apiospermum. He was empirically treated with voriconazole, to which the isolate was susceptible. His consciousness decreased rapidly. Urgent 3D-CT angiography revealed an intracranial aneurysm near the left sphenoid sinus. Despite urgent coil embolization, the aneurysm ruptured, and he died.

  18. Occurrence studies of intracranial tumours

    Energy Technology Data Exchange (ETDEWEB)

    Larjavaara, S.

    2011-07-01

    Intracranial tumours are a histopathologically heterogeneous group of tumours. This thesis focused on three types of intracranial tumours; gliomas, meningiomas and vestibular schwannomas (VS). The main objectives of the dissertation were to estimate the occurrence of intracranial tumours by different subtypes, and to assess the validity and completeness of the cancer registry data. The specific aims of the publications were to evaluate the validity of reported incidence rates of meningioma cases, to describe the trends of VS incidence in four Nordic countries, and to define the anatomic distribution of gliomas and to investigate their location in relation to mobile phone use. Completeness of meningioma registration was examined by comparing five separate sources of information, and by defining the frequencies of cases reported to the Finnish Cancer Registry (FCR). Incidence trends of VS were assessed in the four Nordic countries over a twenty-one-year period (1987 - 2007) using cancer registry data. The anatomic site of gliomas was evaluated using both crude locations in the cerebral lobes and, in more detail, a three-dimensional (3D) distribution in the brain. In addition, a study on specific locations of gliomas in relation to the typical position of mobile phones was conducted using two separate approaches: a case-case and a case-specular analysis. The thesis was based on four sets of materials. Data from the international Interphone study were used for the studies on gliomas, while the two other studies were register-based. The dataset for meningiomas included meningioma cases from the FCR and four clinical data sources in Tampere University Hospital (neurosurgical clinic, pathology database, hospital discharge register and autopsy register). The data on VS were obtained from the national cancer registries of Denmark, Finland, Norway and Sweden. The coverage of meningiomas was not comprehensive in any of the data sources. The completeness of FCR was

  19. Intracranial structures of meningomyelocels studied by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Asada, M.; Tamaki, N.; Matsumoto, S. (Kobe Univ. (Japan). School of Medicine)

    1980-10-01

    We have had experience with forty-two patients with meningomyeloceles; their intracranial structures have been studied and analysed by CT. Six patients (16%) revealed no abnormalities, while thirty-six (82%) had hydrocephalus. All the cases have undergone repair of the meningomyelocele, and thirty-five parties, a shunt operation for hydrocephalus. The CT analysis of the intracranial structures of the meningomyelocele revealed that scaphocephalus was present in 40%, posteriorly dominant ventricular dilatation in the lateral ventricle in 73%, and enlarged massa intermedia in 54%. The following postoperative changes were found: sharp edges of the anterior and posterior horns were found in 81%, prominent dilatation of quadrigeminal and retrothalamic cisterns in 76%, and the interdigitation of the medial cerebral cortex in 69%. In the posterior fossa, a hypoplastic cerebellar tentorium was found in 70% of the cases and a pear-shaped deformity of the upper cerebellum in 62%. The brain stem was enclosed laterally by the anteriorly situated ventral portion of the cerebellum in 74%, and the fourth ventricle was collapsed or narrowed in 76%. An absence of the septum pellucidum was associated in six cases; a quadrigeminal cyst, in two, and a cavum septi pellucidum, in one. CT is a useful and safe apparatus for evaluating the intracranial structures of Arnold-Chiari malformations. Trivial morphological changes, such as the ectopic gray matter, beaking tectum, enlarged accessory commissure, and aqueduct stenosis observed in autopsy cases, are still impossible to demonstrate on CT. It is, however, hoped that with the improvement of the CT image, the sagittal image will become more precise for evaluating the downward displacement of the brain stem and the fourth ventricle.

  20. Elevation of intracranial pressure in acute AIDS-related cryptococcal meningitis.

    Science.gov (United States)

    Malessa, R; Krams, M; Hengge, U; Weiller, C; Reinhardt, V; Volbracht, L; Rauhut, F; Brockmeyer, N H

    1994-12-01

    Prior to the AIDS-era, elevation of intracranial pressure was known to be a typical complication of cryptococcal meningitis associated with an increased risk of early death. In AIDS-patients, however, the prevalence and clinical significance of this complication are as yet unclear. We analysed clinical features and courses, CSF findings, serological results and neuroimaging scans in acute cryptococcal meningitis in eight patients with AIDS. Five showed symptoms and signs compatible with raised intracranial pressure, which was life-threatening in one and the most probable cause of death in another. Serial monitoring of intracranial pressure together with repeated CSF analysis revealed that severe intracranial pressure elevation in AIDS related cryptococcal meningitis can occur in spite of effective antimycotic treatment, does not depend on an increased CSF/serum osmolality ratio or CSF overproduction and can be associated with normal cranial computed tomography and magnetic resonance imaging findings. Our data support the hypothesis that CSF reabsorption failure plays the crucial role in the pathophysiological mechanism. External lumbar drainage may be of benefit in selected cases of acute AIDS related cryptococcal meningitis with persisting life threatening elevation in intracranial pressure and normal computed tomogram.

  1. High resolution transbulbar sonography in children with suspicion of increased intracranial pressure.

    Science.gov (United States)

    Steinborn, Marc; Friedmann, Melanie; Makowski, Christine; Hahn, Helmut; Hapfelmeier, Alexander; Juenger, Hendrik

    2016-04-01

    To evaluate the accuracy of high resolution transbulbar sonography for the estimation of intracranial pressure (ICP) in children. In children and adolescents with acute neurologic symptoms of various origin, transbulbar sonography was performed. Besides measurement of the optic nerve sheath diameter (ONSD), the ultrastructure of the subarachnoid space of the optic nerve sheath was evaluated. The results of transbulbar sonography were correlated with clinical data based on cross-sectional imaging, ICP measurement, and ophthalmologic examination. Eighty-one patients (age 3-17.8 years, mean 11.7 years) were included. In 25 children, cross-sectional imaging and ICP measurement revealed increased intracranial pressure. The mean ONSD was 6.85 ± 0.81 mm. Twenty patients (20/25, 80 %) had a microcystic appearance of the subarachnoid space of the optic nerve. In 56 children without evidence of increased intracranial pressure, the mean ONSD was 5.77 ± 0.48 mm. Forty-nine patients (49/56, 87.5 %) had a normal homogenous appearance of the subarachnoid space. The ONSD in children with increased intracranial pressure was significantly higher than in patients without (p intracranial pressure in children. Besides measurement of the optic nerve sheath diameter, evaluation of the ultrastructure of the subarachnoid space of the optic nerve is a helpful parameter.

  2. Intracranial Chronic Subdural Hematoma Presenting with Intractable Headache after Cervical Epidural Steroid Injection.

    Science.gov (United States)

    Kim, Myungsoo; Park, Ki-Su

    2015-08-01

    Postdural punctural headache (PDPH) following spinal anesthesia is due to intracranial hypotension caused by cerebrospinal fluid (CSF) leakage, and it is occasionally accompanied by an intracranial hematoma. To the best of our knowledge, an intracranial chronic subdural hematoma (CSDH) presenting with an intractable headache after a cervical epidural steroid injection (ESI) has not been reported. A 39-year-old woman without any history of trauma underwent a cervical ESI for a herniated nucleus pulposus at the C5-6 level. One month later, she presented with a severe headache that was not relieved by analgesic medication, which changed in character from being positional to non-positional during the preceding month. Brain magnetic resonance imaging revealed a CSDH along the left convexity. Emergency burr-hole drainage was performed and the headache abated. This report indicates that an intracranial CSDH should be considered a possible complication after ESI. In addition, the event of an intractable and changing PDPH after ESI suggests further evaluation for diagnosis of an intracranial hematoma.

  3. Fourier analysis of intracranial aneurysms: towards an objective and quantitative evaluation of the shape of aneurysms

    International Nuclear Information System (INIS)

    Rohde, Stefan; Lahmann, Katharina; Nafe, Reinhold; Yan, Bernard; Berkefeld, Joachim; Beck, Juergen; Raabe, Andreas

    2005-01-01

    Shape irregularities of intracranial aneurysms may indicate an increased risk of rupture. To quantify morphological differences, Fourier analysis of the shape of intracranial aneurysms was introduced. We compared the morphology of 45 unruptured (UIA) and 46 ruptured intracranial aneurysms (RIA) in 70 consecutive patients on the basis of 3D-rotational angiography. Fourier analysis, coefficient of roundness and qualitative shape assessment were determined for each aneurysm. Morphometric analysis revealed significantly smaller coefficient of roundness (P<0.02) and higher values for Fourier amplitudes numbers 2, 3 and 7 (P<0.01) in the RIA group, indicating more complex and irregular morphology in RIA. Qualitative assessment from 3D-reconstructions showed surface irregularities in 78% of RIA and 42% of UIA (P<0.05). Our data have shown significant differences in shape between RIA and UIA, and further developments of Fourier analysis may provide an objective factor for the assessment of the risk of rupture. (orig.)

  4. Simultaneous Spinal and Intracranial Chronic Subdural Hematoma Cured by Craniotomy and Laminectomy: A Video Case Report

    Directory of Open Access Journals (Sweden)

    Hideki Kanamaru

    2016-04-01

    Full Text Available Simultaneous spinal and intracranial chronic subdural hematoma (CSDH is a rare entity. A 67-year-old man visited our hospital due to headache after diving into a river 2 weeks before. Non-enhanced computed tomography (CT and magnetic resonance imaging (MRI revealed bilateral intracranial CSDH. The bilateral CSDH was evacuated and his symptoms improved. Three days after craniotomy, he complained of sensory disturbance on his buttocks. Lumbar MRI showed a space-occupying lesion behind the thecal sac at L5. CT with myelography showed a subdural mass lesion; there was no communication with the subarachnoid space. Fourteen days after craniotomy, L5 laminectomy was performed and the dura mater was incised carefully. The video shows that a liquid hematoma similar to the intracranial CSDH flowed out, followed by cerebrospinal fluid. His symptoms improved after the operation and the hematoma did not recur. This is a rare condition of spinal CSDH demonstrated by neuroimaging and intraoperative video.

  5. Post-irradiation vasculopathy of intracranial major arteries in children; Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Nishizawa, Shigeru; Ryu, Hiroshi; Yokoyama, Tetsuo; Ninchoji, Toshiaki; Shimoyama, Ichiro; Yamamoto, Seiji; Uemura, Kenichi (Hamamatsu Univ. School of Medicine, Shizuoka (Japan))

    1991-06-01

    We report two rare cases of post-irradiation vasculopathy of intracranial major arteries in children. A 13-year-old girl suffered from transient right hemiparesis 1 year after irradiation for suprasellar germinoma. Left carotid angiograms revealed marked stenoses of the intracranial internal carotid, middle cerebral, and anterior cerebral arteries, which were previously normal, and moyamoya vessels. A 2.5-year-old girl underwent internal irradiation with {sup 198}Au colloid for cystic craniopharyngioma. At the age of 10 years, she suddenly became unconscious after vomiting. Computed tomographic scans showed a right frontal intracerebral hematoma. Right carotid angiograms disclosed complete obstruction of the intracranial internal carotid, middle cerebral, and anterior cerebral arteries and moyamoya vessels, previously not present. The danger of radiation therapy causing occlusive vasculopathy in small and major cerebral arteries in children is emphasized. To prevent permanent ischemic neurological deficits, vasculopathy should be treated either medically or surgically as early as possible. (author).

  6. Simultaneous Spinal and Intracranial Chronic Subdural Hematoma Cured by Craniotomy and Laminectomy: A Video Case Report.

    Science.gov (United States)

    Kanamaru, Hideki; Kanamaru, Kenji; Araki, Tomohiro; Hamada, Kazuhide

    2016-01-01

    Simultaneous spinal and intracranial chronic subdural hematoma (CSDH) is a rare entity. A 67-year-old man visited our hospital due to headache after diving into a river 2 weeks before. Non-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) revealed bilateral intracranial CSDH. The bilateral CSDH was evacuated and his symptoms improved. Three days after craniotomy, he complained of sensory disturbance on his buttocks. Lumbar MRI showed a space-occupying lesion behind the thecal sac at L5. CT with myelography showed a subdural mass lesion; there was no communication with the subarachnoid space. Fourteen days after craniotomy, L5 laminectomy was performed and the dura mater was incised carefully. The video shows that a liquid hematoma similar to the intracranial CSDH flowed out, followed by cerebrospinal fluid. His symptoms improved after the operation and the hematoma did not recur. This is a rare condition of spinal CSDH demonstrated by neuroimaging and intraoperative video.

  7. Applying data mining techniques to medical time series: an empirical case study in electroencephalography and stabilometry

    Directory of Open Access Journals (Sweden)

    A. Anguera

    2016-01-01

    This paper illustrates the application of different knowledge discovery techniques for the purposes of classification within the above domains. The accuracy of this application for the two classes considered in each case is 99.86% and 98.11% for epilepsy diagnosis in the electroencephalography (EEG domain and 99.4% and 99.1% for early-age sports talent classification in the stabilometry domain. The KDD techniques achieve better results than other traditional neural network-based classification techniques.

  8. PENGEMBANGAN ALAT BANTU PEMODELAN TERAPI LENGAN PASCA STROKE DENGAN MEMANFAATKAN SINYAL ELECTROENCEPHALOGRAPHY (EEG) MENGGUNAKAN EMOTIV

    OpenAIRE

    Fatmawati, Ester; Prawito, Prawito; Wijaya, Sastra Kusuma

    2016-01-01

    Design modeling has been done post-stroke therapy arm by utilizing command brain signals generated by Electroencephalography (EEG). EEG signals provides a lot of information, one of which is motor information. Every body moving describe the unique form of brain signals. In conditions paralysis, motor information on the EEG signals will still be found when someone tries to move his limbs. The basic concepts of this study are the EEG signal acquisition using the Emotiv EPOC +, controling signal...

  9. Critical cerebral perfusion pressure at high intracranial pressure measured by induced cerebrovascular and intracranial pressure reactivity.

    Science.gov (United States)

    Bragin, Denis E; Statom, Gloria L; Yonas, Howard; Dai, Xingping; Nemoto, Edwin M

    2014-12-01

    The lower limit of cerebral blood flow autoregulation is the critical cerebral perfusion pressure at which cerebral blood flow begins to fall. It is important that cerebral perfusion pressure be maintained above this level to ensure adequate cerebral blood flow, especially in patients with high intracranial pressure. However, the critical cerebral perfusion pressure of 50 mm Hg, obtained by decreasing mean arterial pressure, differs from the value of 30 mm Hg, obtained by increasing intracranial pressure, which we previously showed was due to microvascular shunt flow maintenance of a falsely high cerebral blood flow. The present study shows that the critical cerebral perfusion pressure, measured by increasing intracranial pressure to decrease cerebral perfusion pressure, is inaccurate but accurately determined by dopamine-induced dynamic intracranial pressure reactivity and cerebrovascular reactivity. Cerebral perfusion pressure was decreased either by increasing intracranial pressure or decreasing mean arterial pressure and the critical cerebral perfusion pressure by both methods compared. Cortical Doppler flux, intracranial pressure, and mean arterial pressure were monitored throughout the study. At each cerebral perfusion pressure, we measured microvascular RBC flow velocity, blood-brain barrier integrity (transcapillary dye extravasation), and tissue oxygenation (reduced nicotinamide adenine dinucleotide) in the cerebral cortex of rats using in vivo two-photon laser scanning microscopy. University laboratory. Male Sprague-Dawley rats. At each cerebral perfusion pressure, dopamine-induced arterial pressure transients (~10 mm Hg, ~45 s duration) were used to measure induced intracranial pressure reactivity (Δ intracranial pressure/Δ mean arterial pressure) and induced cerebrovascular reactivity (Δ cerebral blood flow/Δ mean arterial pressure). At a normal cerebral perfusion pressure of 70 mm Hg, 10 mm Hg mean arterial pressure pulses had no effect on

  10. Neural decoding of expressive human movement from scalp electroencephalography (EEG

    Directory of Open Access Journals (Sweden)

    Zachery Ryan Hernandez

    2014-04-01

    Full Text Available Although efforts to characterize human movement through EEG have revealed neural activities unique to limb control that can be used to infer movement kinematics, it is still unknown the extent to which EEG can be used to discern the expressive qualities that influence such movements. In this study we used EEG and inertial sensors to record brain activity and movement of five skilled and certified Laban Movement Analysis (LMA dancers. Each dancer performed whole body functional movements of three Action types: movements devoid of expressive qualities ('Neutral', non-expressive movements while thinking about specific expressive qualities ('Think’, and enacted expressive movements ('Do'. The expressive movement qualities that were used in the 'Think' and 'Do' actions consisted of a sequence of eight Laban Efforts as defined by LMA - a notation system and language for describing, visualizing, interpreting and documenting all varieties of human movement. We used delta band (0.2 – 4 Hz EEG as input to a machine learning algorithm that computed locality-preserving Fisher’s discriminant analysis (LFDA for dimensionality reduction followed by Gaussian mixture models (GMMs to decode the type of Action. We also trained our LFDA-GMM models to classify all the possible combinations of Action Type and Laban Effort (giving a total of 17 classes. Classification accuracy rates were 59.4 ± 0.6% for Action Type and 88.2 ± 0.7% for Laban Effort Type. Ancillary analyses of the potential relations between the EEG and movement kinematics of the dancer's body, indicated that motion-related artifacts did not significantly influence our classification results. In summary, this research demonstrates that EEG has valuable information about the expressive qualities of movement. These results may have applications for advancing the understanding of the neural basis of expressive movements and for the development of neuroprosthetics to restore movements.

  11. The radiological appearance of intracranial aneurysms in adults ...

    African Journals Online (AJOL)

    2014-04-04

    %. Limited literature is available on intracranial aneurysms in HIV-infected patients. Objectives: To describe the radiological appearance of intracranial aneurysms in HIV- positive adults. Method: In this retrospective analysis of ...

  12. Idiopathic intracranial hypertension, hormones, and 11β-hydroxysteroid dehydrogenases

    DEFF Research Database (Denmark)

    Markey, Keira A; Uldall, Maria; Botfield, Hannah

    2016-01-01

    Idiopathic intracranial hypertension (IIH) results in raised intracranial pressure (ICP) leading to papilledema, visual dysfunction, and headaches. Obese females of reproductive age are predominantly affected, but the underlying pathological mechanisms behind IIH remain unknown. This review provi...

  13. Predictors of severe complications in intracranial meningioma surgery

    DEFF Research Database (Denmark)

    Bartek, Jiri; Sjåvik, Kristin; Förander, Petter

    2015-01-01

    OBJECTIVE: To investigate predictors of complications after intracranial meningioma resection using a standardized reporting system for adverse events. METHODS: A retrospective review was conducted in a Scandinavian population-based cohort of 979 adult operations for intracranial meningioma perfo...

  14. Intracranial Atypical Meningiomas: A Case Series

    Directory of Open Access Journals (Sweden)

    Chi-Man Yip

    2016-01-01

    Full Text Available Background: Atypical meningiomas fall into a category World Health Organization Grade II, which have higher local recurrence rates and lower survival rates than their benign counterparts. The aim of this study is to review the outcome of newly diagnosed patients with atypical meningioma after therapy. Methods: We conducted a retrospective review of the medical records of patients having atypical meningiomas who were treated in our hospital between January 2005 and December 2014. Their age, sex, initial presentation, tumor location, tumor size, extent of resection, tumor recurrence or tumor progression, duration of follow-up, adjuvant therapy, and outcome were reviewed. Results: There were 27 consecutive patients (15 male and 12 female having fresh intracranial atypical meningiomas treated in our hospital between January 2005 and December 2014. Their mean age at diagnosis was 60.81 years. Twenty-three patients (85.19% underwent total resection of the tumor, whereas 4 patients (14.81% had partial resection of their tumors during their first time of surgery. Fifteen patients (55.56% had finished adjuvant radiotherapy. Nine patients (33.33% had tumor progression or recurrence during follow-up, and 4 of them were proved to have malignant transformation to anaplastic meningiomas in the following operations. The mean time to tumor progression or recurrence of these nine patients was 17.67 months. Nineteen patients (70.37% had a favorable outcome, 7 patients (25.93% had an unfavorable outcome, and we lost 1 patient (3.7% due to disease progression. Conclusions: Surgery remains the standard treatment to atypical meningioma, and postoperative adjuvant radiotherapy is still controversial especially to those who undergo total surgical resection of the tumors. Our study reveals that early postoperative adjuvant radiotherapy seems to play a role in local control. Atypical meningioma can have malignant transformation to anaplastic meningioma, so aggressive

  15. Intracranial sewing needles in an adult patient.

    Science.gov (United States)

    Kazanci, Atilla; Ozdemir, Halil Ibrahim; Kazanci, Burak; Kazanci, Dilek Ozturk; Er, Uygur

    2012-01-01

    A 37-year-old patient is reported with intracranial sewing needles, which were located in the right frontal lobe. Both clinical and radiological findings suggested that these needles must have been introduced in infancy before the closure of anterior fontanelle during an unsuccessful homicide. Usually intracranial foreign objects are placed due to penetrating trauma or surgical procedures. Child abuse has been known for centuries. Many types of physical traumas have been reported, especially in Western countries. In Iran, insertion of sewing needles into the brain aiming to kill the infant have been seen in a lot of cases. This situation takes part in a lot of Persian stories. We reported a 37-year-old man who had 2 intracranial sewing needles with unknown etiology.

  16. Endovascular treatment for intracranial venous sinus thrombosis

    International Nuclear Information System (INIS)

    Zhang Qiang; Li Shenmao; Ji Xunming; Miao Zhongrong; Zhu Fengshui; Zhi Xinglong; Ling Feng

    2007-01-01

    Objective: To evaluate the efficacy and risk of endovascular treatment for intracranial venous sinus thrombosis. Methods: Twenty seven patients with intracranial venous sinus thrombosis confirmed by CT, MRI, MRV and/or DSA, from 2004 September to 2006 September, were treated with anticoagulant therapy but without response and then followed by multiple modalities including endovascular treatment. Nineteen of them accepted intravenous thrombolysis and mechanical thrombus maceration, another 5 accepted intravenous thrombolysis, mechanical thrombus maceration and intraarterial thrombolysis and the last 3 with stenting. Results: After thrombolysis, symptoms and signs of 23 patients improved obviously and headache disappeared in 18 of them, but with only mild degree in other 5 and no improvement in 3. Twenty one patients among them achieved recanalization of sinuses completely as confirmed on postprocedural angiography, MRI and MRV studies taken prior to hospital discharge and other 3 achieved recanalization of sinuses partly. Conclusion: Endovascular treatment is an effective and safe measure for potentially catastrophic intracranial dural sinus thrombosis. (authors)

  17. Cognitive function in idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne Maria; Fagerlund, Birgitte; Forchhammer, Hysse Birgitte

    2014-01-01

    OBJECTIVE: To explore the extent and nature of cognitive deficits in patients with idiopathic intracranial hypertension (IIH) at the time of diagnosis and after 3 months of treatment. DESIGN: Prospective case-control study. SETTING: Neurological department, ophthalmological department and a terti......OBJECTIVE: To explore the extent and nature of cognitive deficits in patients with idiopathic intracranial hypertension (IIH) at the time of diagnosis and after 3 months of treatment. DESIGN: Prospective case-control study. SETTING: Neurological department, ophthalmological department...... and a tertiary headache referral clinic at a Danish university hospital. PARTICIPANTS: 31 patients with definite IIH referred from June 2011 to February 2013 and included within 1 week of diagnostic intracranial pressure (ICP) measurement. 29 patients completed re-examination at the 3-month follow...

  18. Computed tomographic findings of spontaneous intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Seung Sook; Kim, Young Sook; Kim, Young Chul [College of Medicine, Chosun University, Kwangju (Korea, Republic of)

    1987-10-15

    Computed tomography (CT) was a reliable technique to evaluate the exact size and location of spontaneous intracranial hemorrhage and to predict it's prognosis. Fifty-nine cases of spontaneous intracranial hemorrhage were evaluated and reviewed by CT scan. The following results were obtained. 1. The sex ratio of male to female was 1 to 1.4, The highest incidence was in 6th and 7th decades. 2. The most common cause of spontaneous intracranial hemorrhage was hypertension (74.6%), followed by the aneurysm (13.5%), arteriovenous malformation (5.1%), occlusive vascular disease (3.4%), and blood dyscrasia (3.4%). 3. The most common location was basal ganglia and thalamic hemorrhage (37.3%), followed by lobar hemorrhage (27.1%), cerebellar hemorrhage (13.5%), and subarachnoid hemorrhage (11.9%). 4. Primary intraventricular hemorrhage carried the highest mortality. 5. The larger volume of hematoma, the higher the mortality rate.

  19. Prevention and treatment of intracranial hypertension.

    Science.gov (United States)

    Jantzen, Jan-Peter A H

    2007-12-01

    Intracranial pressure (ICP) is the pressure exerted by cranial contents on the dural envelope. It comprises the partial pressures of brain, blood and cerebrospinal fluid (CSF). Normal intracranial pressure is somewhere below 10 mmHg; it may increase as a result of traumatic brain injury, stroke, neoplasm, Reye's syndrome, hepatic coma, or other pathologies. When ICP increases above 20 mmHg it may damage neurons and jeopardize cerebral perfusion. If such a condition persists, treatment is indicated. Control of ICP requires measurement, which can only be performed invasively. Standard techniques include direct ventricular manometry or measurement in the parenchyma with electronic or fiberoptic devices. Displaying the time course of pressure (high-resolution ICP tonoscopy) allows assessment of the validity of the signal and identification of specific pathological findings, such as A-, B- and C-waves. When ICP is pathologically elevated--at or above 20-25 mmHg--it needs to be lowered. A range of treatment modalities is available and should be applied with consideration of the underlying cause. When intracranial hypertension is caused by hematoma, contusion, tumor, hygroma, hydrocephalus or pneumatocephalus, surgical treatment is indicated. In the absence of a surgically treatable condition, ICP may be controlled by correcting the patient's position, temperature, ventilation or hemodynamics. If intracranial hypertension persists, drainage of CSF via external drainage is most effective. Other first-tier options include induced hypocapnea (hyperventilation; paCO2 < 35 mmHg), hyperosmolar therapy (mannitol, hypertonic saline) and induced arterial hypertension (CPP concept). When autoregulation of cerebral blood flow is compromised, hyperoncotic treatment aimed at reducing vasogenic edema and intracranial blood volume may be applied. When intracranial hypertension persists, second-tier treatments may be indicated. These include 'forced hyperventilation' (paCO2 < 25 mm

  20. Role of MRI in Diagnosis of Ruptured Intracranial Dermoid Cyst.

    Science.gov (United States)

    Muçaj, Sefedin; Ugurel, Mehmet Sahin; Dedushi, Kreshnike; Ramadani, Naser; Jerliu, Naim

    2017-06-01

    Intracranial dermoid cystic tumors account for <1% of all intracranial masses. A 52-year-old male, having headaches, nausea and is presented with a history of 2 episodes of new onset seizures. On presentation, the patient had a normal physical exam, including a complete neurological and cranial nerve exam. Precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D - HI-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W, Flash/T2W oblique coronal plane, GRE/T2W axial. Post-contrast TSE/T1W sequence in axial, coronal and sagittal planes. Diffusion weighted and ADC mapping, postcontrast: TSE/T1W sequence in axial, coronal and sagittal planes. Subsequent MRI of the brain revealed an oval and lobulated 47x34x30mm (TRxAPxCC) non-enhancing T1-hyperintense mass in right cavernous sinus, with compression of surrounding mesial temporal lobe and right anterolateral aspect of mesencephalon. Findings are consistent with ruptured dermoid cyst, given the evacuated sebum content at its lower half. Sebum particles in millimetric sizes are seen within right Sylvian fissure, anterior horns of lateral ventricles and to a lesser extent within left Sylvian fissure, right parietal sulci, cerebral aqueduct, and basal cisterns. No restricted diffusion is seen, eliminating the possibility of epidermoid. A shunt catheter is evident traversing between right lateral ventricle and right parietal bone; besides, slit-like right lateral ventricle is noted (likely secondary to over-draining shunt catheter). Intracranial dermoid cysts are benign rare slow-growing tumors that upon rupture, however, widespread presence of T1 hyperintense droplets and leptomeningeal enhancement can be noted-making MRI the best imaging modality for diagnosis of this rare entity.

  1. Treatment of unruptured intracranial aneurysms with the pipeline embolization device.

    Science.gov (United States)

    Murthy, Santosh B; Shah, Shreyansh; Venkatasubba Rao, Chethan P; Bershad, Eric M; Suarez, Jose I

    2014-01-01

    The pipeline embolization device (PED; ev3 Endovascular, Plymouth, MN, USA) is a flow-diverter used in the endovascular treatment of intracranial aneurysms, particularly those with unfavorable configurations. It causes progressive flow redirection leading to aneurysm thrombosis. This study aimed to present a systematic review of the published literature on the clinical outcomes of PED. A Medline search of the English language literature was performed using the keywords "intracranial aneurysms" and "pipeline embolization device" or "flow diverters". The inclusion criteria were: n>10 patients; unruptured aneurysms; documentation of complications; and at least 3 months of follow-up. A total of 13 studies, with 905 patients and 1043 aneurysms, were included. The mean age was 53.8 years, with women comprising 76.3% of patients. The mean aneurysm diameter was 11.1mm with 37% classed as large aneurysms and 10% classed as giant. The cumulative mortality rate was 2.3%. Seventeen patients had a stroke (1.9%), while 19 (2.0%) had a transient ischemic attack and 21 patients (2.3%) had an intracranial hemorrhage. The two outcome measures were the cumulative event rate (16.7%) and the 6 month aneurysm occlusion rate (79.7%). A funnel plot with study size plotted against the two outcome measures revealed publication bias. Data from recent studies suggest that complication and mortality rates associated with PED may be similar to other contemporary endovascular techniques, with a better 6 month aneurysm occlusion rate. More prospective clinical trials are warranted to further validate these results. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    LENUS (Irish Health Repository)

    Kaliaperumal, Chandrasekaran

    2013-11-12

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

  3. Intracranial meningiomas in the present era of modern neuroimaging

    African Journals Online (AJOL)

    Background: Intracranial meningioma is the most common primary, intracranial, extra-axial neoplasm. It is mesenchymal in origin and arises from meningothelial cells of arachnoid villi of meninges. Objectives: To re-emphasize the regional anatomic localisation and diagnostic radiological features of intracranial ...

  4. Idiopathic Intracranial Hypertension – Pathophysiology Based on Case Series

    Directory of Open Access Journals (Sweden)

    Ljubisavljević Srdjan

    2016-09-01

    Full Text Available According to the definition, idiopathic intracranial hypertension (IIH is a pathological state characterized by an increase in intracranial pressure; however, there are no obvious intracranial pathological processes. The pathophysiology of this disorder is not clear, although there are many reports related to it.

  5. Cerebral Abcess and Intracranial Empyemas in Children (Francais ...

    African Journals Online (AJOL)

    And in both cases because of brain herniation secondary to severe raised intracranial pressure. We observed no recurrence of pus collection. Neurological sequelae was observed in 8 cases. Conclusion Intracranial subdural empyemas are most common form of intracranial suppurations seen in children in our unit.

  6. 21 CFR 882.1620 - Intracranial pressure monitoring device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intracranial pressure monitoring device. 882.1620... pressure monitoring device. (a) Identification. An intracranial pressure monitoring device is a device used for short-term monitoring and recording of intracranial pressures and pressure trends. The device...

  7. Simultaneous Intracranial and Spinal Subdural Hematoma: Two Case Reports

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Chung Dae; Song, Chang Joon; Lee, Jeong Eun; Choi, Seung Won [Chungnam National University, Daejeon (Korea, Republic of)

    2009-02-15

    Spinal subdural hematoma is a rare disease. Simultaneous intracranial and spinal subdural hematoma is extremely rare and only 14 such cases have been reported. We report here on two cases of simultaneous intracranial and spinal subdural hematoma that occurred following a fall-down head injury and intracranial surgery, and we discuss the pathogenesis of the disease.

  8. Primary intracranial leiomyoma in renal transplant recipient

    Directory of Open Access Journals (Sweden)

    Upasana Patel

    2017-01-01

    Full Text Available Leiomyoma, the benign tumor of smooth muscle cell origin, is commonly seen in genitourinary and gastrointestinal tracts. Primary intracranial leiomyoma, however, is extremely rare occurrence. We hereby report a case of Epstein-Barr negative primary intracranial leiomyoma in a middle-aged renal transplant recipient, which mimicked left frontal parasagittal meningioma on neuroimaging. The tumor was completely excised and diagnosis of leiomyoma was clinched on pathological analysis with immunohistochemistry. The patient improved after tumor removal, and no evidence of tumor recurrence was noted on follow-up study after 10 months postsurgically.

  9. Traumatic rupture of an intracranial dermoid cyst

    Directory of Open Access Journals (Sweden)

    Raksha Ramlakhan, BMedSc, MBBCh

    2015-01-01

    Full Text Available Intracranial dermoid cysts are congenital tumors of ectodermal origin. Rupture of these cysts can occur spontaneously, but rupture in association with trauma is reported infrequently. The diagnosis of rupture is made by the presence of lipid (cholesterol droplets in the subarachnoid spaces and ventricles. Nonenhanced CT of the head demonstrates multiple foci of low attenuation that correspond with hyperintense signal on T1-weighted MRI. We present a case of an adult patient with rupture of an intracranial dermoid cyst, precipitated by minor trauma.

  10. Intracranial osteosarcoma after radiosurgery. Case report

    International Nuclear Information System (INIS)

    Sanno, Naoko; Hayashi, Shinkichi; Shimura, Toshiro; Maeda, Shotaro; Teramoto, Akira

    2004-01-01

    A 56-year-old woman presented with an intracranial osteosarcoma at the site of previous radiosurgery, manifesting as sudden onset of headache and left hemiparesis with aphasia. She had a previous history of stereotactic radiosurgery for an intracranial tumor under a diagnosis of falx meningioma. Computed tomography showed intratumoral and peritumoral hemorrhage at the right parietofrontal region. Gross total resection of the tumor with hematoma was performed. The histological diagnosis was osteosarcoma. Sarcomatous change is a rare complication of radiotherapy. This case illustrates that osteosarcoma may develop years after radiosurgery for benign brain neoplasm. (author)

  11. Attention, in and Out: Scalp-Level and Intracranial EEG Correlates of Interoception and Exteroception

    Science.gov (United States)

    García-Cordero, Indira; Esteves, Sol; Mikulan, Ezequiel P.; Hesse, Eugenia; Baglivo, Fabricio H.; Silva, Walter; García, María del Carmen; Vaucheret, Esteban; Ciraolo, Carlos; García, Hernando S.; Adolfi, Federico; Pietto, Marcos; Herrera, Eduar; Legaz, Agustina; Manes, Facundo; García, Adolfo M.; Sigman, Mariano; Bekinschtein, Tristán A.; Ibáñez, Agustín; Sedeño, Lucas

    2017-01-01

    Interoception, the monitoring of visceral signals, is often presumed to engage attentional mechanisms specifically devoted to inner bodily sensing. In fact, most standardized interoceptive tasks require directing attention to internal signals. However, most studies in the field have failed to compare attentional modulations between internally- and externally-driven processes, thus probing blind to the specificity of the former. Here we address this issue through a multidimensional approach combining behavioral measures, analyses of event-related potentials and functional connectivity via high-density electroencephalography, and intracranial recordings. In Study 1, 50 healthy volunteers performed a heartbeat detection task as we recorded modulations of the heartbeat-evoked potential (HEP) in three conditions: exteroception, basal interoception (also termed interoceptive accuracy), and post-feedback interoception (sometimes called interoceptive learning). In Study 2, to evaluate whether key interoceptive areas (posterior insula, inferior frontal gyrus, amygdala, and somatosensory cortex) were differentially modulated by externally- and internally-driven processes, we analyzed human intracranial recordings with depth electrodes in these regions. This unique technique provides a very fine grained spatio-temporal resolution compared to other techniques, such as EEG or fMRI. We found that both interoceptive conditions in Study 1 yielded greater HEP amplitudes than the exteroceptive one. In addition, connectivity analysis showed that post-feedback interoception, relative to basal interoception, involved enhanced long-distance connections linking frontal and posterior regions. Moreover, results from Study 2 showed a differentiation between oscillations during basal interoception (broadband: 35–110 Hz) and exteroception (1–35 Hz) in the insula, the amygdala, the somatosensory cortex, and the inferior frontal gyrus. In sum, this work provides convergent evidence for the

  12. Alveolar soft part sarcoma: the new primary intracranial malignancy : A case report and review of the literature.

    Science.gov (United States)

    Kumar, Aditaya; Alrohmain, B; Taylor, W; Bhattathiri, P

    2017-07-26

    The purpose of this paper is to serve as a reference to aid in the management of this poorly understood intracranial malignancy. The authors report their experience treating the eighth ostensible case of a primary intracranial alveolar soft part sarcoma (ASPS). A 21-year-old man presented to hospital after collapsing. He gave a 1-year history of headache, a 2-month history of reduced visual acuity and on examination had left facial paraesthesia with left-sided incoordination. MRI of the brain revealed a large left posterior fossa mass. The patient underwent resection of the tumour with good recovery in function. Immunohistochemical analysis of the tumour specimen confirmed an ASPS, and multimodal imaging in search of an extra-cranial disease primary was negative. A review of the literature yielded only seven other cases of primary intracranial ASPS. A variety of diagnostic imaging modalities were employed in search of a disease primary, as were various combinations of surgical resection, chemotherapy and radiotherapy as treatment. Half of the cases documented delayed disease recurrence. The authors discuss the following: the unique radiological and immunohistological characteristics of this disease including the potential for its misdiagnosis; the investigations required to diagnose a primary intracranial ASPS; the efficacy of current medical and surgical treatment options and the factors that will aid in prognostication. This is the first review of this new primary intracranial malignancy. From our analysis, we offer a joint radiological and immunohistochemical algorithm for the diagnosis of primary intracranial ASPS and specific operative considerations prior to resection.

  13. Software-triggered contrast-enhanced three-dimensional MR angiography of the intracranial arteries.

    Science.gov (United States)

    Isoda, H; Takehara, Y; Isogai, S; Takeda, H; Tanaka, T; Takahashi, M; Nozaki, A; Sun, Y

    2000-02-01

    We investigated the effectiveness of software-triggered contrast-enhanced three-dimensional (3D) MR angiography in evaluating intracranial arteries. We studied 38 patients with suspected brain lesions. Imaging was performed using a 1.5-T superconducting MR system with a commercially available head coil. To monitor signal intensity changes we used software to place a tracker volume at the basilar artery or the internal carotid artery. A 20-ml bolus of gadodiamide hydrate was administered through the antecubital vein at a rate of 2-4 ml/sec, followed by a saline flush. Three-dimensional MR angiography using a spoiled gradient-echo sequence with centric K-space ordering was triggered by the arrival of the contrast bolus in the tracker volume. Imaging times ranged from 12 to 20 sec. We used MR images to assess the effectiveness of contrast-enhanced 3D MR angiography in revealing intracranial arteries with minimal venous overlap. The software triggered imaging on the arrival of the contrast bolus in 81.6% of examinations. In 77.6% of examinations, the resulting MR angiograms revealed intracranial arteries with minimal venous overlap. Software-triggered contrast-enhanced 3D MR angiography with centric K-space ordering is a promising technique for viewing intracranial arteries.

  14. Intracranial metastasis from primary transitional cell carcinoma of female urethra: case report & review of the literature

    International Nuclear Information System (INIS)

    Moon, Kyung-Sub; Jung, Shin; Lee, Kyung-Hwa; Hwang, Eu Chang; Kim, In-Young

    2011-01-01

    Transitional cell carcinoma (TCC) of the female urethra is a rare urological malignancy, and intracranial metastasis of this cancer has not yet been reported in the literature. This review is intended to present a case of multiple intracranial metastasis in a female patient with a remote history of primary urethral TCC. A 49-year-old woman, presented with a prolapsed mass in urethral orifice that was diagnosed as primary urethral TCC with distant lung and multiple bone metastases. The patient subsequently underwent chemotherapy under various regimens. A year later, the patient developed headache and vomiting which as was found to be due to multiple intracranial metastasis. The patient underwent surgical resection of the largest lesion located on the cerebellum, and consecutively gamma knife radiosurgery was performed for other small-sized lesions. Pathological examination of the resected mass revealed a metastatic carcinoma from a known urethral TCC. Serial work-up of systemic metastasis revealed concomitant aggravation of lung, spleen, and liver metastasis. The patient died of lung complication 2 months after the diagnosis of brain metastasis. To the best of our knowledge, this is the first reported case of cerebral metastasis from primary urethral TCC, with pathological confirmation. As shown in intracranial metastasis of other urinary tract carcinoma, this case occurred in the setting of uncontrolled systemic disease and led to dismal prognosis in spite of aggressive interventional modalities

  15. Refractory High Intracranial Pressure following Intraventricular Hemorrhage due to Moyamoya Disease in a Pregnant Caucasian Woman

    Directory of Open Access Journals (Sweden)

    Virginie Montiel

    2009-02-01

    Full Text Available Intraventricular hemorrhage during pregnancy is usually followed by a poor recovery. When caused by moyamoya disease, ischemic or hemorrhagic episodes may complicate the management of high intracranial pressure. A 26-year-old Caucasian woman presented with generalized seizures and a Glasgow Coma Score (GCS of 3 during the 36th week of pregnancy. The fetus was delivered by caesarean section. The brain CT in the mother revealed bilateral intraventricular hemorrhage, a callosal hematoma, hydrocephalus and right frontal ischemia. Refractory high intracranial pressure developed and required bilateral ventricular drainage and intensive care treatment with barbiturates and hypothermia. Magnetic resonance imaging and cerebral angiography revealed a moyamoya syndrome with rupture of the abnormal collateral vascular network as the cause of the hemorrhage. Intracranial pressure could only be controlled after the surgical removal of the clots after a large opening of the right ventricle. Despite an initially low GCS, this patient made a good functional recovery at one year follow-up. Management of refractory high intracranial pressure following moyamoya related intraventricular bleeding should require optimal removal of ventricular clots and appropriate control of cerebral hemodynamics to avoid ischemic or hemorrhagic complications.

  16. Human neuronal changes in brain edema and increased intracranial pressure.

    Science.gov (United States)

    Faragó, Nóra; Kocsis, Ágnes Katalin; Braskó, Csilla; Lovas, Sándor; Rózsa, Márton; Baka, Judith; Kovács, Balázs; Mikite, Katalin; Szemenyei, Viktor; Molnár, Gábor; Ozsvár, Attila; Oláh, Gáspár; Piszár, Ildikó; Zvara, Ágnes; Patócs, Attila; Barzó, Pál; Puskás, László G; Tamás, Gábor

    2016-08-04

    Functional and molecular changes associated with pathophysiological conditions are relatively easily detected based on tissue samples collected from patients. Population specific cellular responses to disease might remain undiscovered in samples taken from organs formed by a multitude of cell types. This is particularly apparent in the human cerebral cortex composed of a yet undefined number of neuron types with a potentially different involvement in disease processes. We combined cellular electrophysiology, anatomy and single cell digital PCR in human neurons identified in situ for the first time to assess mRNA expression and corresponding functional changes in response to edema and increased intracranial pressure. In single pyramidal cells, mRNA copy numbers of AQP1, AQP3, HMOX1, KCNN4, SCN3B and SOD2 increased, while CACNA1B, CRH decreased in edema. In addition, single pyramidal cells increased the copy number of AQP1, HTR5A and KCNS1 mRNAs in response to increased intracranial pressure. In contrast to pyramidal cells, AQP1, HMOX1and KCNN4 remained unchanged in single cell digital PCR performed on fast spiking cells in edema. Corroborating single cell digital PCR results, pharmacological and immunohistochemical results also suggested the presence of KCNN4 encoding the α-subunit of KCa3.1 channels in edema on pyramidal cells, but not on interneurons. We measured the frequency of spontaneous EPSPs on pyramidal cells in both pathophysiological conditions and on fast spiking interneurons in edema and found a significant decrease in each case, which was accompanied by an increase in input resistances on both cell types and by a drop in dendritic spine density on pyramidal cells consistent with a loss of excitatory synapses. Our results identify anatomical and/or physiological changes in human pyramidal and fast spiking cells in edema and increased intracranial pressure revealing cell type specific quantitative changes in gene expression. Some of the edema

  17. Delayed intracranial hematoma following stereoelectroencephalography for intractable epilepsy: case report.

    Science.gov (United States)

    Derrey, Stéphane; Lebas, Axel; Parain, Dominique; Baray, Marie Gilles; Marguet, Christophe; Freger, Pierre; Proust, François

    2012-12-01

    Intracranial bleeding following stereoelectroencephalography (sEEG) is rare and commonly occurs early after electrode implantation. The authors report the case of a delayed intracranial hematoma following sEEG. This 10-year-old boy was referred to the authors' department to undergo an sEEG study for intractable epilepsy, with the hypothesis of a single localized epileptic zone in the left precentral region. To perform the exploration, 14 depth electrodes were implanted under stereotactic conditions. The results of a postoperative CT scan performed routinely at the end of the surgical procedure were normal. Eight days later, following an epileptic seizure, the child's condition worsened. The neurological examination revealed a left hemiparesis, agitation, and coma due to a right subdural hematoma with intraparenchymal bleeding. Despite a surgical evacuation followed by a decompressive craniectomy, the curative treatments were stopped 1 week later due to severe diffuse ischemic lesions found on MRI studies. This is the first observation of a delayed hematoma following an sEEG procedure. The mechanism underlying this complication remains unclear, but the rupture of a growing pseudoaneurysm caused by the electrode's implantation or the tearing of a neighboring vessel by an electrode were suspected. In consequence, physicians must remain vigilant during the entire sEEG recording period and probably also several days after electrode removal.

  18. Demographic profile of patients diagnosed with intracranial ...

    African Journals Online (AJOL)

    Background: Meningiomas are common brain tumours and display gender, racial and ethnic differences in their demographic profile. The demographic profile of our patients diagnosed with intracranial meningiomas is presented and compared with the literature. Objectives: To determine the age, gender, racial and ethnic ...

  19. CT and MRI of ruptured intracranial dermoids

    Energy Technology Data Exchange (ETDEWEB)

    Wilms, G.; Demaerel, P.; Baert, A.L. (Leuven Univ. Hospital (Belgium). Dept. of Radiology); Casselman, J. (Akademisch Ziekenhuis St. Jan, Brugge (Belgium). Dept. of Radiology); Plets, C. (Leuven Univ. Hospital (Belgium). Dept. of Neurosurgery); Haene, I. de (Akademisch Ziekenhuis St. Jan, Brugge (Belgium). Dept. of Neurology)

    1991-04-01

    Two patients with ruptured intracranial dermoids, examined with both CT and MRI are reported. Clinical presentation was transient cerebral ischemia in one patient and acute meningeal signs in the other. CT scan showed typical fat density of the tumor and the subarachnoid space. On MRI both the tumor and the subarachnoid fat, were strongly hyperintense on T1-weighted images. (orig.).

  20. Genetics of intracranial aneurysms and related diseases

    NARCIS (Netherlands)

    van 't Hof, F.N.G.

    2017-01-01

    Intracranial aneurysms (IA) are dilatations of the vessel walls of cerebral arteries. Some can rupture and result in a subarachnoid hemorrhage (SAH), a severe subtype of stroke. This thesis is set out to elucidate the pathophysiology of IA from a genetic perspective. The main conclusions are: 1.

  1. CONTEMPORARY ENDOVASCULAR TREATMENT OF INTRACRANIAL ANEURYSMS

    Directory of Open Access Journals (Sweden)

    Dragan Stojanov

    2015-06-01

    Full Text Available In the past twenty years we have witnessed a revolution in the treatment of intracranial aneurysms. Endovascular technique and materials have rapidly developed since the approval of Guglielmi detachable coils in 1995 which now allow successful treatment of most aneurysms. The development of intracranial stents and balloons for stent-assisted coiling and balloon-remodeling technique further expanded the spectrum of aneurysms treatable with endovascular technique. For these reasons, the aim of this review was to describe endovascular technique and materials which we use in our daily practice, to show benefits of endovascular treatment and to discus complications of endovascular treatment and surgical treatment of intracranial aneurysms. Endovascular treatment is more comfortable for the patient not only because it is minimally invasive but also because it does not require long hospitalization equal to that after surgical treatment. It is a fact that with further development of endovascular materials, this a procedure will have even a more significant place in the treatment of intracranial aneurysms.

  2. Calcification of intracranial vessels in neurocysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez-Bouzas, A. [ENEP Iztacala, Universidad Nacional Autonoma de Mexico, Mexico (Mexico); Ballesteros-Maresma, A. [Radiologia Clinica de Cuernavaca (Mexico); Casian, G.; Hernandez-Martinez, P. [Hospital Juarez de Mexico S. S. (Mexico); Martinez-Lopez, M. [Fundacion Clinica Medica Sur (Mexico)

    2000-07-01

    We report calcification of intracranial vessels in neurocysticercosis. Calcification was observed in the middle cerebral arteries in two patients, and the circle of Willis in two others. The patients with middle cerebral artery calcification underwent CT with inhaled stable xenon and an area of mild hypoperfusion was observed in the ipsilateral cerebral hemisphere. (orig.)

  3. Measuring elevated intracranial pressure through noninvasive methods

    DEFF Research Database (Denmark)

    Kristiansson, Helena; Nissborg, Emelie; Bartek, Jiri

    2013-01-01

    Elevated intracranial pressure (ICP) is an important cause of secondary brain injury, and a measurement of ICP is often of crucial value in neurosurgical and neurological patients. The gold standard for ICP monitoring is through an intraventricular catheter, but this invasive technique...

  4. Intracranial neoplasmin Ibadan, Nigeria | Olasode | East African ...

    African Journals Online (AJOL)

    Objective: To determine the pattern of histopathological variants of intracranial neoplasms, relative distribution of the variants in the age groups and also to determine the gender differences that exist in these tumours. Design: Case control study. Setting: Department of Pathology, University College Hospital, Ibadan, Nigeria.

  5. MR diffusion imaging of human intracranial tumours

    DEFF Research Database (Denmark)

    Krabbe, K; Gideon, P; Wagn, P

    1997-01-01

    We used MRI for in vivo measurement of brain water self-diffusion in patients with intracranial tumours. The study included 28 patients (12 with high-grade and 3 with low-grade gliomas, 7 with metastases, 5 with meningiomas and 1 with a cerebral abscess). Apparent diffusion coefficients (ADC) wer...

  6. Prediction of intracranial hypertension through noninvasive intracranial pressure waveform analysis in pediatric hydrocephalus.

    Science.gov (United States)

    Ballestero, Matheus Fernando Manzolli; Frigieri, Gustavo; Cabella, Brenno Caetano Troca; de Oliveira, Sergio Mascarenhas; de Oliveira, Ricardo Santos

    2017-09-01

    The purpose of this study is to evaluate a noninvasive device to assess intracranial pressure wave form in children with hydrocephalus. A prospective and non-experimental descriptive-analytic study was performed. Fifty-six patients were enrolled in this study. They were divided in four groups: group A, children with clinically compensated hydrocephalus; B, surgically treated hydrocephalus; C, patients with acute intracranial hypertension due to hydrocephalus; and D, children without neurological disease (control). Data were collected through the installation of an extracranial deformation sensor, coupled to the children's scalp, which allowed registration of noninvasive intracranial pressure curves. Parameters obtained were analyzed: P2/P1 ratio, "classification P1 and P2 and P1 slope. P2/P1 index and "classification of P1 and P2" had a sensitivity of 80% and specificity of 100% for predicting intracranial hypertension. "P1 slope" presented no statistical difference. This study showed a useful and noninvasive method for monitoring intracranial pressure, which was able to indicate the intracranial hypertension in children with hydrocephalus and, thus, should be further investigated for clinical applications.

  7. Active Deep Learning-Based Annotation of Electroencephalography Reports for Cohort Identification

    Science.gov (United States)

    Maldonado, Ramon; Goodwin, Travis R; Harabagiu, Sanda M

    2017-01-01

    The annotation of a large corpus of Electroencephalography (EEG) reports is a crucial step in the development of an EEG-specific patient cohort retrieval system. The annotation of multiple types of EEG-specific medical concepts, along with their polarity and modality, is challenging, especially when automatically performed on Big Data. To address this challenge, we present a novel framework which combines the advantages of active and deep learning while producing annotations that capture a variety of attributes of medical concepts. Results obtained through our novel framework show great promise. PMID:28815135

  8. Hybrid Thermoelectric-Photovoltaic Generators in Wireless Electroencephalography Diadem and Electrocardiography Shirt

    Science.gov (United States)

    Leonov, Vladimir; Torfs, Tom; Vullers, Ruud J. M.; van Hoof, Chris

    2010-09-01

    Hybrid wearable energy harvesters consisting of a thermoelectric generator (TEG) and photovoltaic (PV) cells are used in this work for powering two autonomous medical devices: an electroencephalography (EEG) system and an electrocardiography (ECG) system in a shirt. Two alternative solutions for powering the systems have been implemented. In the battery-free EEG diadem, PV cells cover the outer surface of radiators used in a TEG. In the ECG shirt, thermoelectric modules are the main power supply that constantly recharges a battery, while PV cells are used mainly to provide standby power, i.e., when the shirt is not worn. Both devices are maintenance free for their entire service life.

  9. Amplitude-Integrated Electroencephalography Interpretation During Therapeutic Hypothermia: An Educational Program and Novel Teaching Tool.

    Science.gov (United States)

    Sacco, Lauren

    2016-01-01

    Therapeutic hypothermia (TH) is now considered a standard in tertiary NICUs. Amplitude-integrated electroencephalography (aEEG) is an important adjunct to this therapy and is gaining acceptance for use on the neonatal population. It can be easily incorporated into practice with appropriate education and training. Current publications are lacking regarding nursing care of neonatal patients undergoing th with the use of aEEG. This article presents a broad educational program as well as novel teaching tool for neonatal nurses caring for this population.

  10. Designing an efficient electroencephalography system using database with embedded images management approach.

    Science.gov (United States)

    Yu, Tzu-Yi; Ho, Hsu-Hua

    2014-01-01

    Many diseases associated with mental deterioration among aged patients can be effectively treated using neurological treatments. Research shows that electroencephalography (EEG) can be used as an independent prognostic indicator of morbidity and mortality. Unfortunately, EEG data are typically inaccessible to modern software. It is therefore important to design a comprehensive approach to integrate EEG results into institutional medical systems. A customized EEG system utilizing a database management approach was designed to bridge the gap between the commercial EEG software and hospital data management platforms. Practical and useful medical findings are discoursed from statistical analysis of large amounts of EEG data. © 2013 Published by Elsevier Ltd.

  11. Sixth Nerve Palsy in Paediatric Intracranial Hypertension.

    Science.gov (United States)

    Reid, Julia E; Reem, Rachel E; Aylward, Shawn C; Rogers, David L

    2016-02-01

    The purpose of this study was to report the incidence and describe the characteristics of sixth cranial nerve (CN VI) palsy in paediatric patients with intracranial hypertension (IH). A retrospective chart review of central Ohio children diagnosed with IH over the 3-year period from 2010 to 2013 was conducted. IH without identifiable cause was defined as idiopathic intracranial hypertension (IIH), whereas IH with identifiable pathologic aetiology was deemed secondary intracranial hypertension (SIH). A subset of patients with CN VI palsy was identified. Data collected included patient age, gender, past medical history, aetiology of SIH, ophthalmic examination, lumbar puncture results, neuroimaging results, and response to treatment. Seventy-eight children with intracranial hypertension were included in the study. Nine (11.5%) children (four males, five females; median age 14, range: 3-18) were found to have a unilateral ( n = 2) or bilateral ( n = 7) CN VI palsy. Five children had IIH; the remaining four had SIH from cerebral venous sinus thrombosis ( n = 2) and infection ( n = 2). The mean lumbar puncture opening pressure for the nine patients with CN VI palsy was 40 cm H 2 O (range: 21-65 cm H 2 O). Papilloedema was present in 8/9 (89%) patients. One patient required a lumboperitoneal shunt, and two others required optic nerve sheath fenestrations in addition to medical management. All cases of CN VI palsy resolved with treatment. In our primary service area, the incidence of CN VI palsy is approximately 12% among paediatric IH patients. The majority of cases with CN VI palsy presented with papilloedema and all cases resolved with treatment of intracranial hypertension.

  12. Mapping of electrophysiological response to transcranial infrared laser stimulation on the human brain in vivo measured by electroencephalography (Conference Presentation)

    Science.gov (United States)

    Wang, Xinlong; Reddy, Divya Dhandapani; Gonzalez-Lima, F.; Liu, Hanli

    2017-02-01

    Transcranial infrared laser stimulation (TILS) is a non-destructive and non-thermal photobiomodulation therapy or process on the human brain; TILS uses infrared light from lasers or LEDs and has gained increased recognition for its beneficial effects on a variety of neurological and psychological conditions. While the mechanism of TILS has been assumed to stem from cytochrome-c-oxidase (CCO), which is the last enzyme in the electron transportation chain and is the primary photoacceptor, no literature is found to report electrophysiological response to TILS. In this study, a 64-channel electroencephalography (EEG) system was employed to monitor electrophysiological activities from 15 healthy human participants before, during and after TILS. A placebo experimental protocol was also applied for rigorous comparison. After recording a 3-minute baseline, we applied a 1064-nm laser with a power of 3.5W on the right forehead of each human participant for 8 minutes, followed by a 5-minute recovery period. In 64-channel EEG data analysis, we utilized several methods (root mean square, principal component analysis followed by independent component analysis, permutation conditional mutual information, and time-frequency wavelet analysis) to reveal differences in electrophysiological response to TILS between the stimulated versus placebo group. The analyzed results were further investigated using general linear model and paired t-test to reveal statistically meaningful responses induced by TILS. Moreover, this study will provide spatial mapping of human electrophysiological and possibly neural network responses to TILS for first time, indicating the potential of EEG to be an effective method for monitoring neurological improvement induced by TILS.

  13. Epidemiology and genetics of intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Caranci, F., E-mail: ferdinandocaranci@libero.it [Unit of Neuroradiology, Department of Diagnostic Radiology and Radiotherapy, Federico II University, Naples (Italy); Briganti, F., E-mail: frabriga@unina.it [Unit of Neuroradiology, Department of Diagnostic Radiology and Radiotherapy, Federico II University, Naples (Italy); Cirillo, L.; Leonardi, M. [Neuroradiology service, Bellaria Hospital, Bologna (Italy); Muto, M., E-mail: mutomar@tiscali.it [Neuroradiology Service Cardarelli Hospital Naples (Italy)

    2013-10-01

    Intracranial aneurysms are acquired lesions (5–10% of the population), a fraction of which rupture leading to subarachnoid hemorrhage with devastating consequences. Until now, the exact etiology of intracranial aneurysms formation remains unclear. The low incidence of subarachnoid hemorrhage in comparison with the prevalence of unruptured IAs suggests that the vast majority of intracranial aneurysms do not rupture and that identifying those at highest risk is important in defining the optimal management. The most important factors predicting rupture are aneurysm size and site. In addition to ambiental factors (smoking, excessive alcohol consumption and hypertension), epidemiological studies have demonstrated a familiar influence contributing to the pathogenesis of intracranial aneurysms, with increased frequency in first- and second-degree relatives of people with subarachnoid hemorrhage. In comparison to sporadic aneurysms, familial aneurysms tend to be larger, more often located at the middle cerebral artery, and more likely to be multiple. Other than familiar occurrence, there are several heritable conditions associated with intracranial aneurysm formation, including autosomal dominant polycystic kidney disease, neurofibromatosis type I, Marfan syndrome, multiple endocrine neoplasia type I, pseudoxanthoma elasticum, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II and IV. The familial occurrence and the association with heritable conditions indicate that genetic factors may play a role in the development of intracranial aneurysms. Genome-wide linkage studies in families and sib pairs with intracranial aneurysms have identified several loci on chromosomes showing suggestive evidence of linkage, particularly on chromosomes 1p34.3–p36.13, 7q11, 19q13.3, and Xp22. For the loci on 1p34.3–p36.13 and 7q11, a moderate positive association with positional candidate genes has been demonstrated (perlecan gene, elastin gene, collagen type 1 A2

  14. Epidemiology and genetics of intracranial aneurysms

    International Nuclear Information System (INIS)

    Caranci, F.; Briganti, F.; Cirillo, L.; Leonardi, M.; Muto, M.

    2013-01-01

    Intracranial aneurysms are acquired lesions (5–10% of the population), a fraction of which rupture leading to subarachnoid hemorrhage with devastating consequences. Until now, the exact etiology of intracranial aneurysms formation remains unclear. The low incidence of subarachnoid hemorrhage in comparison with the prevalence of unruptured IAs suggests that the vast majority of intracranial aneurysms do not rupture and that identifying those at highest risk is important in defining the optimal management. The most important factors predicting rupture are aneurysm size and site. In addition to ambiental factors (smoking, excessive alcohol consumption and hypertension), epidemiological studies have demonstrated a familiar influence contributing to the pathogenesis of intracranial aneurysms, with increased frequency in first- and second-degree relatives of people with subarachnoid hemorrhage. In comparison to sporadic aneurysms, familial aneurysms tend to be larger, more often located at the middle cerebral artery, and more likely to be multiple. Other than familiar occurrence, there are several heritable conditions associated with intracranial aneurysm formation, including autosomal dominant polycystic kidney disease, neurofibromatosis type I, Marfan syndrome, multiple endocrine neoplasia type I, pseudoxanthoma elasticum, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II and IV. The familial occurrence and the association with heritable conditions indicate that genetic factors may play a role in the development of intracranial aneurysms. Genome-wide linkage studies in families and sib pairs with intracranial aneurysms have identified several loci on chromosomes showing suggestive evidence of linkage, particularly on chromosomes 1p34.3–p36.13, 7q11, 19q13.3, and Xp22. For the loci on 1p34.3–p36.13 and 7q11, a moderate positive association with positional candidate genes has been demonstrated (perlecan gene, elastin gene, collagen type 1 A2

  15. Analysis of risk factors for perifocal oedema after endovascular embolization of unruptured intracranial arterial aneurysms.

    Science.gov (United States)

    Lukic, Snezana; Jankovic, Slobodan; Popovic, Katarina Surlan; Bankovic, Dragic; Popovic, Peter; Mijailovic, Milan

    2015-12-01

    Endovascular embolization is a treatment of choice for the management of unruptured intracranial aneurysms, but sometimes is complicated with perianeurysmal oedema. The aim of our study was to establish incidence and outcomes of perianeurysmal oedema after endovascular coiling of unruptured intracranial aneurysms, and to reveal possible risk factors for development of this potentially serious complication. In total 119 adult patients with endovascular embolization of unruptured intracranial aneurysm (performed at Department for Interventional Neuroradiology, Clinical Center, Kragujevac, Serbia) were included in our study. The embolizations were made by electrolite-detachable platinum coils: pure platinum, hydrophilic and combination of platinum and hydrophilic coils. Primary outcome variable was perianeurysmal oedema visualized by magnetic resonance imaging (MRI) 7, 30 and 90 days after the embolization. The perianurysmal oedema appeared in 47.6% of patients treated with hydrophilic coils, in 21.6% of patients treated with platinum coils, and in 53.8% of those treated with mixed type of the coils. The multivariate logistic regression showed that variables associated with occurrence of perianeurysmal oedema are volume of the aneurysm, hypertension, diabetes and smoking habit. Hypertension is the most important independent predictor of the perianeurysmal oedema, followed by smoking and diabetes. The results of our study suggest that older patients with larger unruptured intracranial aneurysms, who suffer from diabetes mellitus and hypertension, and have the smoking habit, are under much higher risk of having perianeurysmal oedema after endovascular coiling.

  16. Migration of an Intracranial Subdural Hematoma to the Spinal Subdural Space: A Case Report.

    Science.gov (United States)

    Kwon, O Ik; Son, Dong Wuk; Kim, Young Ha; Kim, Young Soo; Sung, Soon Ki; Lee, Sang Weon; Song, Geun Sung

    2015-09-01

    A 57-year-old man complained of severe lower back pain and radicular pain in both legs for 1 week after falling from a ladder. Magnetic resonance imaging (MRI) of the spine showed a subdural hematoma (SDH), which was surgically removed. The patient had no back pain or the radicular leg pain at 2 weeks post-surgery. However, he complained of diffuse headaches upon follow-up. Brain computed tomography (CT) and MRI revealed an intracranial SDH, which was immediately removed by surgery. During his 1-year follow-up, he reported that the pain had resolved without recurrence. Simultaneous spinal and intracranial SDH are rare and no standard treatment exists for this condition. This case suggests that it is possible that an intracranial SDH can migrate into the cerebrospinal fluid (CSF) space through an arachnoid tear. CSF circulation allows the intracranial SDH to enter subarachnoid spaces encasing the spinal cord. In order to prevent irreversible damage, surgical intervention should be considered for case of spinal SDH with progressive neurological deficits.

  17. Diagnosis and treatment of traumatic intracranial hypotension (cerebrospinal fluid hypovolemia)

    International Nuclear Information System (INIS)

    Shinonaga, Masamichi; Suzuki, Shinichi

    2003-01-01

    Patients who complain headache, neck pain, dizziness or vertigo, tinnitus, blurred vision, loss of concentration, memory disturbance and fatigue for over one year after mild head injury and whiplash injury are diagnosed as post-traumatic syndrome. Mechanism and treatment of post-traumatic syndrome are not well established. We studied radioisotope (RI) cisternography and enhanced brain magnetic resonance imaging (MRI) for the patient of post-traumatic syndrome. Of 175 cases in post-traumatic syndrome 141 cases (120 cases of motor vehicle accident, 21 cases of sports injury) were diagnosed, as intracranial hypotension (cerebrospinal fluid hypovolemia). RI cisternography showed 86% positive findings (early accumulation of RI in bladder and leakage). Prominent findings in MRI were dilatation of subdural space and venous dilatation. In every case epidural blood patch was performed and symptoms were improved in almost 70% of patients. This study revealed cerebrospinal fluid hypovolemia might be one cause of post-traumatic syndrome. (author)

  18. Radionuclide cisternography: a prudent investigation in diagnosing spontaneous intracranial hypotension

    International Nuclear Information System (INIS)

    Sehgal, Aditi Khurana; Sethi, Ravinder Singh; Namgyal, Padma A.; Raghavan, Samudrala

    2013-01-01

    Spontaneous intracranial hypotension (SIH) is a cause of new persistent headache, which disappears on recumbence and reappears in sitting/standing position (orthostatic headache). We present a case of orthostatic headache, where the patient was suspected to have SIH and was subjected to radionuclide cisternography (RNC) using 99m Technetium Diethylenetriaminepenta acetic acid for confirmation of diagnosis. After due consent from the patient, the radiotracer was injected intra-thecally and serial images were acquired until 24 h. The direct and indirect evidences of Cerebrospinal fluid (CSF) leakage, which were revealed in our study, provided objective evidence to the clinical diagnosis. RNC is an important investigation in diagnosing SIH and also identifying the site of CSF leak, which may aid the management. (author)

  19. Neonatal intracranial aneurysms: case report and review of the literature.

    Science.gov (United States)

    Mohotti, Jeewaka E; Carter, Nicole S; Zhang, Victor Jia Wei; Lai, Leon T; Xenos, Christopher; Asadi, Hamed; Chandra, Ronil V

    2018-03-02

    Intracranial aneurysms in the neonate, presenting in the first 4 weeks of life, are exceedingly rare. They appear to have characteristics, including presentation and location, that vary from those found in adults. The authors present a case of a 28-day-old neonate with a ruptured distal middle cerebral artery (MCA) aneurysm. Initial noninvasive imaging with transfontanelle ultrasound and CT confirmed intraparenchymal and subarachnoid hemorrhage. Contrast-enhanced MRI revealed a 14-mm ruptured fusiform MCA aneurysm that was not identified on time-of-flight magnetic resonance angiography (MRA). Microsurgical treatment was performed with partial neurological recovery. A comprehensive review of the literature from 1949 to 2017 revealed a total of 40 aneurysms in 37 neonates, including the present case. The most common presenting symptom was seizure. Although subarachnoid hemorrhage was the most common form of hemorrhage, 40% had intraparenchymal hemorrhage. The median aneurysm size was 10 mm (range 2-30 mm) and the most common location was the MCA, with two-thirds of cases involving the distal intracranial vasculature. Over the last 10 years, there has been a trend of increasing noninvasive diagnosis of ruptured cerebral aneurysms in neonates, with CT angiography and contrast-enhanced MRI being the most useful diagnostic modalities. The use of contrast-enhanced MRI may improve sensitivity over time-of-flight MRA. Microsurgical treatment was the most common treatment modality overall, with increased use of endovascular treatment in the last decade. Most patients underwent microsurgical vessel ligation or endovascular parent vessel occlusion. There were high rates of neurological recovery after microsurgical or endovascular treatment, particularly for patients with distal aneurysms.

  20. Massive neonatal intracranial hemorrhage caused by bromadiolone: A case report.

    Science.gov (United States)

    Ma, Mingsheng; Zhang, Mengqi; Tang, Xiaoyan; Li, Zhenghong

    2017-11-01

    Bromadiolone, often called a super-warfarin, is a potent rodenticide with long half-life. Skin and mucosal bleeding is the most common clinical manifestations of its intoxication. Bromadiolone intoxications in adults and children have been reported, but this phenomenon is rarely seen in fetuses. This paper presents a case of neonate with massive intracranial hemorrhage mediated by bromadiolone intoxication, highlighting that the bromadiolone is potentially lethal to the fetus. The male neonate presented with poor respiratory effort, decreased muscle tone, and pallor at birth. He developed generalized seizures on day 1 of life. His mother suffered from bleeding of oral mucosa and the subsequent lab screening for toxicants showed a bromadiolone level of 126 ng/mL. Laboratory tests revealed that prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT). A computed tomography (CT) of his head revealed a severe subdural hematoma, which lead to midline shift, bilateral intraventricular hemorrhage, and subarachnoid hemorrhage. Serum from cord blood was collected and screened for toxicants. The result returned with a bromadiolone level of 94 ng/mL. The neonate was treated with vitamin K, fresh-frozen plasma, and red blood cells. His parents required termination of all treatments, and the neonate unfortunately died shortly after. Through clinical experience from this case, we believe that bromadiolone can be passed down to the fetus via placenta. Neonatal intracranial hemorrhage caused by bromadiolone is rare but potentially lethal. Pregnant women should be informed of the serious side effects of bromadiolone and this poisonous reagent should be avoided in any period during pregnancy.

  1. Prognostic factors in childhood intracranial neoplasms

    International Nuclear Information System (INIS)

    Ampil, F.L.

    1987-01-01

    Thirty-six cases of primary intracranial neoplasm in children (over 1 year but under 13 years of age) seen at the university medical center between 1951 and 1982 were reviewed because of concern as to the results and after-effects of applied therapy. The overall 5-year actuarial survival rate was 17 %. Several factors of possible prognostic relevance, such as patient's age, intracranial location of the tumor, application or nonapplication of therapy, single or multiple modes of therapy, and extent of surgery, were analyzed. Completeness of surgical removal of the tumor proved to be the only statistically significant factor that correlated with survival. There was only one recorded case of severe learning disability and abnormal neuropsychologic development among the 12 living patients. The influence of patient's age (and technical factors) at the time of irradiation in correlation with the child's subsequent posttreatment functional performance, as reported in the literature, is reviewed. (author)

  2. Intracranial hemorrhage of the mature newborn infant

    International Nuclear Information System (INIS)

    Takemine, Hisao

    1983-01-01

    Concerning four mature newborn infants with intracranial hemorrhage diagnosed by CT, the labour course, treatment, and prognoses were discussed. Of intracranial hemorrhage, 70.7% was small hemorrhage along the cerebellar tentorium and the falx cerebri, 12.2% subdural hemorrhage in the posterior cranial fossa, and 9.8% subdural hemorrhage in the fornex. Intraventricular or extradural hemorrhage was rarely found. The prognosis is determined by severeness of neurotic symptoms due to cerebral hypoxia. Subdural hemorrhage of the posterior cranial fossa resulted in cerebral palsy in one fifth of the cases, and in slight enlargement of the ventricle in three fifths. Subdural hematoma left porencephaly in one fourth of the patients, but the remaining recovered to normal. (Ueda, J.)

  3. The contemporary management of intracranial atherosclerotic disease.

    Science.gov (United States)

    Leng, Xinyi; Wong, Ka Sing; Leung, Thomas W

    2016-06-01

    Intracranial atherosclerotic disease is the most common cause of cerebral vasculopathy and an important stroke etiology worldwide, with a higher prevalence in Asian, Hispanic and African ethnicities. Symptomatic intracranial atherosclerotic disease portends a recurrent stroke risk as high as 18% at one year. The key to secondary prevention is an understanding of the underlying stroke mechanism and aggressive control of conventional cardiovascular risks. Contemporary treatment includes antiplatelet therapy, optimal glycemic and blood pressure control, statin therapy and lifestyle modifications. For patients with high-grade (70-99%) symptomatic steno-occlusion, short-term dual antiplatelet therapy with aspirin and clopidogrel followed by life-long single antiplatelet therapy may reduce the recurrent risk. Current evidence does not advocate percutaneous transluminal angioplasty and stenting as an initial treatment. External counterpulsation, encephaloduroarteriosynangiosis and remote limb ischemic preconditioning are treatments under investigation. Future studies should aim at predicting patients prone to recurrence despite of medical therapies and testing the efficacy of emerging therapies.

  4. MR diffusion imaging of human intracranial tumours

    DEFF Research Database (Denmark)

    Krabbe, K; Gideon, P; Wagn, P

    1997-01-01

    We used MRI for in vivo measurement of brain water self-diffusion in patients with intracranial tumours. The study included 28 patients (12 with high-grade and 3 with low-grade gliomas, 7 with metastases, 5 with meningiomas and 1 with a cerebral abscess). Apparent diffusion coefficients (ADC) were...... (P meningiomas did not differ significantly from those seen with high-grade gliomas or cerebral metastases...

  5. Intracranial capillary hemangioma mimicking a dissociative disorder

    Directory of Open Access Journals (Sweden)

    Alexander Lacasse

    2012-01-01

    Full Text Available Capillary hemangiomas, hamartomatous proliferation of vascular endothelial cells, are rare in the central nervous system (CNS. Intracranial capillary hemangiomas presenting with reversible behavioral abnormalities and focal neurological deficits have rarely been reported. We report a case of CNS capillary hemangioma presenting with transient focal neurological deficits and behavioral abnormalities mimicking Ganser’s syndrome. Patient underwent total excision of the vascular malformation, resulting in complete resolution of his symptoms.

  6. Intracranial Volume Quantification from 3D Photography

    OpenAIRE

    Tu, Liyun; Porras, Antonio R.; Ensel, Scott; Tsering, Deki; Paniagua, Beatriz; Enquobahrie, Andinet; Oh, Albert; Keating, Robert; Rogers, Gary F.; Linguraru, Marius George

    2017-01-01

    3D photography offers non-invasive, radiation-free, and anesthetic-free evaluation of craniofacial morphology. However, intracranial volume (ICV) quantification is not possible with current non-invasive imaging systems in order to evaluate brain development in children with cranial pathology. The aim of this study is to develop an automated, radiation-free framework to estimate ICV. Pairs of computed tomography (CT) images and 3D photographs were aligned using registration. We used the real I...

  7. Natural history of intracranial meningioma after radiotherapy

    International Nuclear Information System (INIS)

    Monzen, Yoshio

    1999-01-01

    The author examined the natural history of intracranial meningioma after radiotherapy using CT or MR imaging. Twenty patients with intracranial meningioma received radiotherapy from a high-energy linear accelerator (4-10 MV X rays) from 1980 to 1996. The total doses were 50 Gy to the tumor bed in single doses of 2 Gy in 5 weekly fractions. Meningiomas in 10 of 20 patients were reduced within 1 to 38 months after radiotherapy, the average being 11 months. The tumors were controlled for a median of 60 months after radiotherapy (range 19-126 months). Four other patients have shown no change in tumor size after radiotherapy. The tumors were controlled for a median of 70 months after radiotherapy (range 37-127 months). The other six patients have shown tumor growth within 3 to 25 months after radiotherapy, after which the tumors stopped growing for a median of 71 months (range 2-181 months). Neither tumor size nor histological type was related to response. The growth of tumors was controlled by radiotherapy for a median duration of 43 months in the meningothelial type, 52 months in the fibroblastic type, and 61 months in the transitional type. The median duration for all benign tumors was 52 months. A moderate correlation was noted between tumor response and functional outcome after radiotherapy in 9 patients with neurological deficits. The natural histories of intracranial meningiomas after radiotherapy were grouped into three categories. Some tumors showed no change in size over a long period. This was a characteristic response after radiotherapy that differed from that of other brain tumors. The results of this study provide important information for the follow-up of intracranial meningiomas after radiotherapy. (author)

  8. Computed tomography in intracranial hemorrhage in leukemia

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Katsunuma, Hideyo; Yoshimura, Masahiro; Tomonaga, Masanori.

    1984-01-01

    In tracranial hemorrhage in leukemia was clinicopathologically studied in 62 cases of autopsy materials, with special attention paid to a morphological comparison of CT images with pathological findings. Intracranial hemorrhage was found in 32 of the 62 leukemic patients (51.6%), and in 13 of these patients (21.0%) it was responsible for death. Leukemic intracranial hemorrhage occurred more often in the acute leukemic type than in the chronic type, and even more often in younger leukemic patinents; it was pathologically characterized by multiple lesions in the white matter of the cerebral hemisphere, prone to combination with SAH or SDH. The hemorrhages could be divided into five types: (1) scattered small hemorrhagic type, (2) hematoma type, (3) fusion type (large hemorrhage composed of assembled small hemorrhages), (4) SAH type, and (5) SDH type. Among these types, the fusion type was considered to be characteristic of leukemia. CT was undertaken in 5 pathologically proven cases, with findings of the scattered small hemorrhagic type in 1, of the SDH type in 3, and of the fusion type in 1. Yet, one case with scattered small hemorrhages and two cases with SDH failed to be detected by CT. However, one case with a typical fusion hemorrhage was found to have multiple, irregular, high-density areas with surrounding edema and a mass effect as well as pathological findings. Therefore, a large-fusion hemorrhage, which is one of the most characteristic types of leukemic intracranial hemorrhage, could be demonstrated as distinctive CT images which reflected neuropathological findings. On the other hand, small parenchymal hemorrhages and relatively thin subdural hemorrhages could not be detected by CT. In conclusion, it seems that CT has value in the diagnosis of intracranial hemorrhage in leukemia. (J.P.N.)

  9. Computed tomographic findings of traumatic intracranial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seong Wook; Kim, Il Young; Lee, Byung Ho; Kim, Ki Jeoung; Yoon, Il Gyu [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1985-10-15

    Traumatic intracranial lesion has been one of the most frequent and serious problem in neurosurgical pathology. Computed tomography made it possible to get prompt diagnosis and surgical intervention of intracranial lesions by its safety, fastness and accuracy. Computed tomographic scan was carried out on 1309 cases at Soonchunhyang Chunan Hospital for 15 months from October 1983 to December 1984. We have reviewed the computed tomographic scans of 264 patients which showed traumatic intracranial lesion. The result were as follows: 1. Head trauma was the most frequent diagnosed disease using computed tomographic scans (57.8%) and among 264 cases the most frequent mode of injury was traffic accident (73.9%). 2. Skull fracture was accompanied in frequency of 69.7% and it was detected in CT in 38.6%: depression fracture was more easily detected in 81%. 3. Conutercoup lesion (9.5%) was usually accompanied with temporal and occipital fracture, and it appeared in lower incidence among pediatric group. 4. Intracranial lesions of all 264 cases were generalized cerebral swelling (24.6%), subdural hematoma (22.3%), epidural hematoma (20.8%), intracerebral hematoma (6.1%), and subarachnoid hemorrhage (3.0%). 5. The shape of hematoma was usually biconvex (92.7%) in acute epidural hematoma and cresentic (100%) in acute subdural hematoma, but the most chronic the case became, they showed planoconvex and bicconvex shapes. 6. Extra-axial hematoma was getting decreased in density as time gone by. 7. Hematoma density was not in direct proportion to serum hemoglobin level as single factor.

  10. Magnetic resonance imaging of intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Smith, H.J. (Rikshospitalet, Oslo (Norway))

    1989-04-01

    The signal intensity of a hematoma at Magnetic Resonance Imaging (MRI) is largely determined by the presence of paramagnetic substances derived from hemoglobin. Depending upon their structure and molecular mobility, paramagnetic substances may shorten the T1 and T2 of surrounding water protons and thus alter the MRI signal intensity and contrast. The article describes the evolution of intracranial hematomas and explains the relationship between the paramagnetic substance present and the result signal intensity at 1.5 T.

  11. Idiopathic intracranial hypertension without papilledema in children: A case series

    Directory of Open Access Journals (Sweden)

    Kaliopy Matheos

    2015-05-01

    Full Text Available Papilledema has long been considered a hallmark of idiopathic intracranial hypertension, a disease defined by elevated intracranial pressure with indiscernible etiology. Papilledema is often seen in the pediatric population, and as such can lead to delays in diagnosis, and often misdiagnosis. Here, we describe three children who were confirmed to have idiopathic intracranial hypertension with raised intracranial pressure by repeated lumbar puncture or intracranial pressure monitoring, normal neuroimaging and absence of papilledema. All three cases had atypical clinical presentations with visual disturbances or photophobia. The patients had a normal body mass index. This case series demonstrates that idiopathic intracranial hypertension can manifest in the absence of clinically obvious papilledema, and has, as such, the potential to cause permanent visual loss if the diagnosis is missed.

  12. Idiopathic intracranial hypertension in pediatric patients

    Directory of Open Access Journals (Sweden)

    Nada Jirásková

    2008-11-01

    Full Text Available Nada Jirásková, Pavel RozsívalDepartment of Ophthalmology, University Hospital, Hradec Králové, Czech RepublicPurpose: To evaluate retrospectively the features, treatment, and outcome of idiopathic intracranial hypertension (IIH in children.Methods: Nine patients, 15 years and younger, diagnosed with IIH. Inclusion criteria were papilledema, normal brain computer tomography or magnetic resonance imaging, cerebrospinal fluid pressure greater than 250 mm H2O, normal cerebrospinal fluid content, and a nonfocal neurologic examination except for sixth nerve palsy.Results: Of the nine patients, eight were girls. Five girls were overweight and one boy was obese. The most common presenting symptom was headache (5 patients. Diplopia or strabismus did not occur in our group. Visual field abnormalities were present in all eyes, and severe visual loss resulting in light perception vision occurred in both eyes of one patient. Eight patients were treated medically with acetazolamide alone, and one girl needed a combination of acetazolamide and corticosteroids. This girl also required optic nerve sheath decompression surgery. Resolution of papilledema and recovery of visual function occurred in all patients.Conclusions: Idiopathic intracranial hypertension in prepubertal children is rather uncommon. Prompt diagnosis and management are important to prevent permanent visual loss.Keywords: idiopathic intracranial hypertension, pediatric, treatment

  13. Spaceflight-Induced Intracranial Hypertension: An Overview

    Science.gov (United States)

    Traver, William J.

    2011-01-01

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

  14. Brain MRI findings of spontaneous intracranial hypotension

    Energy Technology Data Exchange (ETDEWEB)

    Park, Won Kyu; Byun, Woo Mok; Cho, Jae Ho; Cho Kil Ho; Hwang, Mi Soo; Park, Bok Hwan [Yeungnam Univ. College of Medicine, Taegu (Korea, Republic of); Joo, Yang Gu [Keimyoung Univ. College of Medicine, Taegu (Korea, Republic of); Lee, Sang Jin [Soonchunhyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    To evaluate brain MRI findings of spontaneous intracranial hypotension. A retrospective review of MRI findings was conducted on six patients with clinically proven spontaneous intracranial hypotension; no patient had a history of previous spinal puncture. Follow-up MRI was available in two patients, and to detect CSF leakage, radio-nuclide cisternography(n=3D5), myelography(n=3D1), and MR myelography(n=3D1) were performed. On contrast-enhanced T1WI, diffuse dural enhancement was seen in all cases, subdural hematoma or hygroma was seen in four cases, pituitary gland prominence in four, dural sinus dilatation in four, downward displacement of the cerebellar tonsil in two, downward displacement of the iter in one, and suprasellar and prepontine cistern effacement in two. In no patient was abnormal CSF leakage found. Although dural enhancement, as seen on MRI, is not specific, diffuse enhancement of the dura mater accompanied by subdural hematoma, hygroma, pituitary gland prominence, dural sinus dilatation, downward displacement of the cerebellar tonsil, or suprasellar and prepontine cistern effacement can strongly suggest intracranial hypotension.=20.

  15. Endovascular treatment for pediatric intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Xianli; Jiang, Chuhan; Li, Youxiang; Yang, Xinjian; Wu, Zhongxue [Capital Medical University, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Beijing, Hebei (China)

    2009-11-15

    The purpose of this study is to report the characteristics and outcomes of pediatric patients with intracranial aneurysms. From 1998 to 2005, 25 pediatric patients (aged {<=}17 years) with intracranial aneurysm were treated at our institute. Eleven of 25 patients had subarachnoid hemorrhage. In ten patients, the aneurysm was an incidental finding. One patient presented with cranial nerves dysfunction and three with neurological deficits. The locations of the aneurysms were as follows: vertebral artery (VA; n = 9), middle cerebral artery (MCA; n = 5), posterior cerebral artery (PCA; n = 4), basilar artery (BA; n = 2), anterior communicating artery (n = 2), anterior cerebral artery (n = 2), and internal carotid artery (n = 1). Five patients were treated with selective embolization with coils. Sixteen patients were treated with parent vessel occlusion (PVO). Eight PVOs were performed with balloons and eight were performed with coils. One patient with a VA aneurysm was spontaneously thrombosed 4 days after the initial diagnostic angiogram. In three patients treated with stent alone or stent-assisted coiling, one with BA trunk aneurysm died. One aneurismal recurrence occurred and was retreated. At a mean follow-up duration of 23.5 months, 96% of patients had a Glasgow Outcome Scale score of 4 or 5. Pediatric intracranial aneurysms occur more commonly in male patients and have a predilection for the VA, PCA, and MCA. PVO is an effective and safe treatment for fusiform aneurysms. Basilar trunk fusiform aneurysms were difficult to treat and were associated with a high mortality rate. (orig.)

  16. The effect of intracranial pressure on the performance of an aphasic subject: A case history

    Directory of Open Access Journals (Sweden)

    Michelle Shapiro

    1981-11-01

    Full Text Available A battery of tests involving the language modalities of speech, comprehension, reading and writing were administered to an aphasic subject who presented with a predictable fluctuation  in intracranial pressure. Results revealed a consistency in performance in the two situations, across all modalities. The subject's performance  was found  to be of  a concrete nature, demonstrating a cognitive deficit  concomitant with his linguistic impairment.

  17. Intracranial Subdural Hematoma after Spinal Anesthesia for Cesarean Section

    OpenAIRE

    Schweiger, Vittorio; Zanconato, Giovanni; Lonati, Gisella; Baggio, Silvia; Gottin, Leonardo; Polati, Enrico

    2013-01-01

    Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence in the obstetric population. Nevertheless, it is a potentially life-threatening complication. In the majority of the cases, the first clinical symptom associated with intracranial subdural bleeding is severe headache, but the clinical course may have different presentations. In this report, we describe the case of a 38-year-old woman with an acute intracranial subdural hematoma shortly after spinal anesthe...

  18. Computerized tomographic evaluation of intracranial metastases

    International Nuclear Information System (INIS)

    Kim, Bo Yong; Lee, Mi Sook; Choi, Jin Ok; Jeon, Doo Sung; Kim, Hong Soo; Rhee, Hak Song

    1986-01-01

    In a study of intracranial metastases, 46 cases having satisfactory clinical, operative and histological proofs were analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to February, 1986. The results were as follows: 1. The male to female ratio of intracranial metastases were 67:33. The 5th decade group (34.8%) was the most prevalent age group, followed by the 6th decade (21.7%) and 7th decade (21.7%). 2. The number of lesions was found be: single -25 cases (54.3%); multiple -21 cases (45.7%). 3. The source of intracranial metastases found to be: lung 15 cases (32.6%); unknown 12 cases (26.0%); chorioca 3 cases (6.5%); liver 3 cases (6.5%); stomach 2 cases (4.3%); parotid, breast, kidney, prostate, melanoma, rectal ca, rhabdomyosarcoma, nasal ca, lymphoma, testicular ca, cervix, each 1 case (2.2%). 4. The locations of the intracranial metastases were as follows: Cerebral hemisphere 37.7% in parietal region Cerebral hemisphere 15.9% in in frontal region Cerebral hemisphere 13.4% in occipital region Cerebral hemisphere 10.5% in temporal region Cerebellar hemisphere 3.2% Cerebellopontine angle 3.2% Intraventricular 4.8% Meninges 4.8% Skull vault 6.5% 5. Peritumor edema was found to be: Grade II-17 cases (37.0%): Grade III-14 cases (30.4%); Grade I-8 cases (17.4%); Grade 0-7 cases (15.2%) in that order. 6. The chief complaints of intracranial metastases on admission, were as follows: Headache 30 cases (65.2%); Vomiting 11 cases (23.9%); deteriorated mental state 10 cases (21.7%); Hemiplegia 7 cases (15.2%); visual disturbance 6 cases (13.0%); hemiparesis 4 cases (8.7%); seizure 4 cases (8.7%); other symptoms were less frequent. 7. On pre-contrast scan, hyperdense lesions were present in 18 cases (39.1%); hypodense lesions in 15 cases (32.6%); mixed density in 8 cases (17.4%); isodensity was present in 5 cases (10.9%). On post-contrast scan, ring enhancement was seen in 19 cases (41.3%); nodular enhancement in 17 cases (37%), mixed ring

  19. Computerized tomographic evaluation of intracranial metastases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Yong; Lee, Mi Sook; Choi, Jin Ok; Jeon, Doo Sung; Kim, Hong Soo; Rhee, Hak Song [Presbyterian Medical Center, Chonju (Korea, Republic of)

    1986-12-15

    In a study of intracranial metastases, 46 cases having satisfactory clinical, operative and histological proofs were analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to February, 1986. The results were as follows: 1. The male to female ratio of intracranial metastases were 67:33. The 5th decade group (34.8%) was the most prevalent age group, followed by the 6th decade (21.7%) and 7th decade (21.7%). 2. The number of lesions was found be: single -25 cases (54.3%); multiple -21 cases (45.7%). 3. The source of intracranial metastases found to be: lung 15 cases (32.6%); unknown 12 cases (26.0%); chorioca 3 cases (6.5%); liver 3 cases (6.5%); stomach 2 cases (4.3%); parotid, breast, kidney, prostate, melanoma, rectal ca, rhabdomyosarcoma, nasal ca, lymphoma, testicular ca, cervix, each 1 case (2.2%). 4. The locations of the intracranial metastases were as follows: Cerebral hemisphere 37.7% in parietal region Cerebral hemisphere 15.9% in in frontal region Cerebral hemisphere 13.4% in occipital region Cerebral hemisphere 10.5% in temporal region Cerebellar hemisphere 3.2% Cerebellopontine angle 3.2% Intraventricular 4.8% Meninges 4.8% Skull vault 6.5% 5. Peritumor edema was found to be: Grade II-17 cases (37.0%): Grade III-14 cases (30.4%); Grade I-8 cases (17.4%); Grade 0-7 cases (15.2%) in that order. 6. The chief complaints of intracranial metastases on admission, were as follows: Headache 30 cases (65.2%); Vomiting 11 cases (23.9%); deteriorated mental state 10 cases (21.7%); Hemiplegia 7 cases (15.2%); visual disturbance 6 cases (13.0%); hemiparesis 4 cases (8.7%); seizure 4 cases (8.7%); other symptoms were less frequent. 7. On pre-contrast scan, hyperdense lesions were present in 18 cases (39.1%); hypodense lesions in 15 cases (32.6%); mixed density in 8 cases (17.4%); isodensity was present in 5 cases (10.9%). On post-contrast scan, ring enhancement was seen in 19 cases (41.3%); nodular enhancement in 17 cases (37%), mixed ring

  20. [Measurement of intracranial hematoma using the improved cubature formula].

    Science.gov (United States)

    Lu, Xiao; Lu, Wen

    2010-06-01

    The more accurate calculate method was investigated according to the improved formula of intracranial hematoma using segment deducing. The improved formula was deduced to calculate the intracranial hematoma using the volume formula of the solid geometry. The volume of intracranial hematoma was measured as a related accurate standards using software. The volumes of intracranial hematoma calculated by the improved formula, Tada's formula and the software were compared. The measure accuracy of the improved formula was higher than that of Tada's formula, and showed a similarity with that by using software method. The improved formula method shows a more accurate result than Tada's formula, and can be used in forensic practice.

  1. Diagnostic value of optical coherence tomography for intracranial pressure in idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Skau, M; Yri, H; Sander, B

    2013-01-01

    BACKGROUND: Idiopathic intracranial hypertension (IIH) is a condition of raised intracranial pressure (ICP) in the absence of space-occupying lesions or other known etiology. It primarily affects young obese females, and potentially causes permanent visual loss due to papilledema and secondary....... The diagnostic ability of OCT as a marker of increased ICP (> 25 cmH(2)O) was investigated using multiple regression and receiver operating characteristic (ROC) curves. RESULTS: OCT elevation diagrams showed that in 60 % of patients newly diagnosed with IIH and in 10 % of patients with long-term IIH, 50...

  2. Idiopathic Intracranial Hypertension in Monozygotic Female Twins: Intracranial Pressure Dynamics and Treatment Outcome.

    Science.gov (United States)

    Polemikos, Manolis; Heissler, Hans E; Hermann, Elvis J; Krauss, Joachim K

    2017-05-01

    Familial cases of idiopathic intracranial hypertension (IIH) are exceedingly rare, and its occurrence in monozygotic twins has not been reported previously. We report monozygotic female twins who developed IIH, one at age 25 years and the other at age 28 years. Continuous intracranial pressure (ICP) monitoring confirmed elevated ICP as measured initially by lumbar puncture. In both cases, successful treatment with resolution of papilledema and symptoms relief was achieved after ventriculoperitoneal shunting. This report documents the first case of IIH in monozygotic twins and the associated changes in ICP dynamics. Interestingly, almost equivalent alterations in ICP dynamics were found in the 2 patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Classification of four-class motor imagery employing single-channel electroencephalography.

    Directory of Open Access Journals (Sweden)

    Sheng Ge

    Full Text Available With advances in brain-computer interface (BCI research, a portable few- or single-channel BCI system has become necessary. Most recent BCI studies have demonstrated that the common spatial pattern (CSP algorithm is a powerful tool in extracting features for multiple-class motor imagery. However, since the CSP algorithm requires multi-channel information, it is not suitable for a few- or single-channel system. In this study, we applied a short-time Fourier transform to decompose a single-channel electroencephalography signal into the time-frequency domain and construct multi-channel information. Using the reconstructed data, the CSP was combined with a support vector machine to obtain high classification accuracies from channels of both the sensorimotor and forehead areas. These results suggest that motor imagery can be detected with a single channel not only from the traditional sensorimotor area but also from the forehead area.

  4. Polymer-based candle-shaped microneedle electrodes for electroencephalography on hairy skin

    Science.gov (United States)

    Arai, Miyako; Kudo, Yuta; Miki, Norihisa

    2016-06-01

    In this paper, we report on the optimization of the shape of dry microneedle electrodes for electroencephalography (EEG) on hairy locations and compare the electrodes we developed with conventional wet electrodes. We propose the use of SU-8-based candle-shaped microneedle electrodes (CMEs), which have pillars of 1.0 mm height and 0.4 mm diameter with a gap of 0.43 mm between pillars. Microneedles are formed on the top of the pillars. The shape was determined by how well the pillars can avoid hairs and support the microneedles to penetrate through the stratum corneum. The skin-electrode contact impedances of the fabricated CMEs were found to be higher and less stable than those of conventional wet electrodes. However, the CMEs successfully acquired signals with qualities as good as those of conventional wet electrodes. Given the usability of the CMEs, which do not require skin preparation or gel, they are promising alternatives to conventional wet electrodes.

  5. Dilated and unreactive pupils and burst-suppression on electroencephalography due to buproprion overdose.

    Science.gov (United States)

    Mundi, Jyoti Pathria; Betancourt, Jaime; Ezziddin, Omar; Tremayne, Brandie; Majic, Tamara; Mosenifar, Zab

    2012-01-01

    Burst-suppression pattern on electroencephalography (EEG) occurs upon dissociation of the cortex from underlying brain structures. Unless the pattern is a physiologic consequence of administered sedatives, this electroencephalographic pattern is indicative of a poor neurologic outcome and high mortality. We report a case of a 29-year-old female thought to be brain dead based on initial physical examination and EEG findings of burst-suppression, who was later found to have supratherapeutic serum levels of bupropion. This is the second documented case of burst-suppression pattern on EEG in a patient who overdosed on bupropion. We propose that burst-suppression in the setting of bupropion toxicity may revert with drug clearance.

  6. Two volume integral equations for the inhomogeneous and anisotropic forward problem in electroencephalography

    Science.gov (United States)

    Rahmouni, Lyes; Mitharwal, Rajendra; Andriulli, Francesco P.

    2017-11-01

    This work presents two new volume integral equations for the Electroencephalography (EEG) forward problem which, differently from the standard integral approaches in the domain, can handle heterogeneities and anisotropies of the head/brain conductivity profiles. The new formulations translate to the quasi-static regime some volume integral equation strategies that have been successfully applied to high frequency electromagnetic scattering problems. This has been obtained by extending, to the volume case, the two classical surface integral formulations used in EEG imaging and by introducing an extra surface equation, in addition to the volume ones, to properly handle boundary conditions. Numerical results corroborate theoretical treatments, showing the competitiveness of our new schemes over existing techniques and qualifying them as a valid alternative to differential equation based methods.

  7. The diagnostic value of power spectra analysis of the sleep electroencephalography in narcoleptic patients

    DEFF Research Database (Denmark)

    Christensen, Julie Anja Engelhard; Munk, Emil Gammelmark Schreiner; Peppard, Paul E.

    2015-01-01

    Objective: Manifestations of narcolepsy with cataplexy (NC) include disturbed nocturnal sleep – hereunder sleep–wake instability, decreased latency to rapid eye movement (REM) sleep, and dissociated REM sleep events. In this study, we characterized the electroencephalography (EEG) of various sleep...... on 19 NC patients and 708 non-NC patients from a sleep clinic. Reproducible features were analyzed using receiver operating characteristic (ROC) curves. Results: Thirteen features were selected based on the training dataset. Three were applicable in the validation dataset, indicating that NC patients...... show (1) increased alpha power in REM sleep, (2) decreased sigma power in wakefulness, and (3) decreased delta power in stage N1 versus wakefulness. Sensitivity of these features ranged from 4% to 10% with specificity around 98%, and it did not vary substantially with and without treatment. Conclusions...

  8. Enhancing accuracy of mental fatigue classification using advanced computational intelligence in an electroencephalography system.

    Science.gov (United States)

    Chai, Rifai; Tran, Yvonne; Craig, Ashley; Ling, Sai Ho; Nguyen, Hung T

    2014-01-01

    A system using electroencephalography (EEG) signals could enhance the detection of mental fatigue while driving a vehicle. This paper examines the classification between fatigue and alert states using an autoregressive (AR) model-based power spectral density (PSD) as the features extraction method and fuzzy particle swarm optimization with cross mutated of artificial neural network (FPSOCM-ANN) as the classification method. Using 32-EEG channels, results indicated an improved overall specificity from 76.99% to 82.02%, an improved sensitivity from 74.92 to 78.99% and an improved accuracy from 75.95% to 80.51% when compared to previous studies. The classification using fewer EEG channels, with eleven frontal sites resulted in 77.52% for specificity, 73.78% for sensitivity and 75.65% accuracy being achieved. For ergonomic reasons, the configuration with fewer EEG channels will enhance capacity to monitor fatigue as there is less set-up time required.

  9. Altered Brain Network Dynamics in Schizophrenia: A Cognitive Electroencephalography Study.

    Science.gov (United States)

    Naim-Feil, Jodie; Rubinson, Mica; Freche, Dominik; Grinshpoon, Alexander; Peled, Abraham; Moses, Elisha; Levit-Binnun, Nava

    2018-01-01

    Alterations in the dynamic coordination of widespread brain networks are proposed to underlie cognitive symptoms of schizophrenia. However, there is limited understanding of the temporal evolution of these networks and how they relate to cognitive impairment. The current study was designed to explore dynamic patterns of network connectivity underlying cognitive features of schizophrenia. In total, 21 inpatients with schizophrenia and 28 healthy control participants completed a cognitive task while electroencephalography data were simultaneously acquired. For each participant, Pearson cross-correlation was applied to electroencephalography data to construct correlation matrices that represent the static network (averaged over 1200 ms) and dynamic network (1200 ms divided into four windows of 300 ms) in response to cognitive stimuli. Global and regional network measures were extracted for comparison between groups. Dynamic network analysis identified increased global efficiency; decreased clustering (globally and locally); reduced strength (weighted connectivity) around the frontal, parietal, and sensory-motor areas; and increased strength around the occipital lobes (a peripheral hub) in patients with schizophrenia. Regional network measures also correlated with clinical features of schizophrenia. Network differences were prominent 900 ms following the cognitive stimuli before returning to levels comparable to those of healthy control participants. Patients with schizophrenia exhibited altered dynamic patterns of network connectivity across both global and regional measures. These network differences were time sensitive and may reflect abnormalities in the flexibility of the network that underlies aspects of cognitive function. Further research into network dynamics is critical to better understanding cognitive features of schizophrenia and identification of network biomarkers to improve diagnosis and treatment models. Copyright © 2017 Society of Biological

  10. Acute effect of blows to the head due one bout of amateur boxing match on electroencephalography (EEG

    Directory of Open Access Journals (Sweden)

    keyvan Shabanimoghadam

    2011-06-01

    Conclusion: It is seems that in boxing sport the nature of blow to the head can lead to brain tissue electrical flow disturbance. This tension that is accompanied with acute mild brain injury and is observed in boxers, electroencephalography, is serious and can lead to next complications and injuries.

  11. The wondrous eyes of a new technology : A history of the early electroencephalography (EEG) of psychopathy, delinquency, and immorality

    NARCIS (Netherlands)

    Schirmann, Felix

    2014-01-01

    This article presents a history of the early electroencephalography (EEG) of psychopathy, delinquency, and immorality in Great Britain and the United States in the 1940s and 1950s. Then, EEG was a novel research tool that promised ground-breaking insights in psychiatry and criminology. Experts

  12. Measuring the Differences between Traditional Learning and Game-Based Learning Using Electroencephalography (EEG) Physiologically Based Methodology

    Science.gov (United States)

    Chen, Ching-Huei

    2017-01-01

    Students' cognitive states can reflect a learning experience that results in engagement in an activity. In this study, we used electroencephalography (EEG) physiologically based methodology to evaluate students' levels of attention and relaxation, as well as their learning performance within a traditional and game-based learning context. While no…

  13. Detection of cerebral arterial gas embolism using regional cerebral oxygen saturation, quantitative electroencephalography, and brain oxygen tension in the swine

    NARCIS (Netherlands)

    Weenink, R. P.; Hollmann, M. W.; Stevens, M. F.; Kager, J.; van Gulik, T. M.; van Hulst, R. A.

    2014-01-01

    Cerebral air emboli occur as a complication of invasive medical procedures. The sensitivity of cerebral monitoring methods for the detection of air emboli is not known. This study investigates the utility of electroencephalography and non-invasively measured cerebral oxygen saturation in the

  14. Impact on electroencephalography of Adolf Beck, a prominent Polish scientist and founder of the Lviv School of Physiology

    NARCIS (Netherlands)

    Zayachkivska, O.; Gzhegotsky, M.; Coenen, A.M.L.

    2012-01-01

    Adolf Beck (1863–1942) can be regarded as the co-founder of electroencephalography. His studies on the cerebral cortex of animals have facilitated the introduction of the electroencephalogram (EEG) as a main tool for studying the brain. The localization of senses on the cortex with evoked potentials

  15. Frontal mucocele with intracranial extension causing frontal lobe syndrome.

    Science.gov (United States)

    Weidmayer, Sara

    2015-06-01

    Mucoceles are mucus-containing cysts that form in paranasal sinuses; although mucoceles themselves are benign, this case report highlights the extensive damage they can cause as their expansion may lead to bony erosion and extension of the mucocele into the orbit and cranium; it also presents a rarely reported instance of frontal sinus mucocele leading to frontal lobe syndrome. A thorough discussion and review of mucoceles is included. A 68-year-old white man presented with intermittent diplopia and a pressure sensation in the right eye. He had a history of chronic sinusitis and had had endoscopic sinus surgery 5 years prior. A maxillofacial computed tomography scan revealed a large right frontal sinus mucocele, which had caused erosion along the medial wall of the right orbit and the outer and inner tables of the right frontal sinus. The mucocele had protruded both into the right orbit and intracranially, causing mass effect on the frontal lobe, which led to frontal lobe syndrome. The patient was successfully treated with endoscopic right ethmoidectomy, radial frontal sinusotomy, marsupialization of the mucocele, and transcutaneous irrigation. Paranasal sinus mucoceles may expand and lead to bony erosion and can become very invasive in surrounding structures such as the orbit and cranium. This case not only exhibits a very rare presentation of frontal sinus mucocele with intracranial extension and frontal lobe mass effect causing a frontal lobe syndrome but also demonstrates many of the ocular and visual complications commonly associated with paranasal sinus mucoceles. Early identification and surgical intervention is vital for preventing and reducing morbidity associated with invasive mucoceles, and the patient must be followed regularly to monitor for recurrence.

  16. Utility of Intracranial Pressure Monitoring for Diagnosis of Idiopathic Intracranial Hypertension in the Absence of Papilledema.

    Science.gov (United States)

    Bridges, Kelly J; Raslan, Ahmed M

    2018-03-01

    Idiopathic intracranial hypertension (IIH) is characterized by headaches, visual obscurations, and papilledema, and the diagnosis involves lumbar puncture (LP) with an elevated opening pressure (OP) ≥20 cm H 2 0. When papilledema is absent, the diagnosis becomes less clear. Some physicians have argued that the absence of papilledema rules out IIH, whereas others maintain that elevated OP is sufficient for diagnosis. The authors performed a single-institution 4-year retrospective analysis of patients who underwent invasive intracranial pressure (ICP) monitoring for presumed IIH. A total of 22 patients were reviewed, and 13 had classic symptoms of IIH, documented elevated OP, and absence of papilledema; 5/13 (38%) patients had proven intracranial hypertension as shown by invasive ICP monitoring, whereas 8/13 (62%) had normal ICP. With the use of current diagnostic algorithms of clinical presentation and elevated OP, over half of patients without papilledema in our series would be falsely diagnosed with IIH, which could result in unnecessary medical and surgical intervention. Thus, elevated OP as determined by LP is insufficient to diagnose IIH. On the other hand, the absence of papilledema does not rule out intracranial hypertension. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The risk of intravenous thrombolysis-induced intracranial hemorrhage in Taiwanese patients with unruptured intracranial aneurysm.

    Directory of Open Access Journals (Sweden)

    Wei Ting Chiu

    Full Text Available The presence of an intracranial aneurysm is contraindicated to recombinant tissue plasminogen activator (r-tPA treatment for acute ischemic stroke. However, it is difficult to exclude asymptomatic intracranial aneurysms by using conventional, noncontrast head computed tomography (CT, which is the only neuroimaging suggested before r-tPA. Recent case reports and series have shown that administering r-tPA to patients with a pre-existing aneurysm does not increase the bleeding risk. However, Asians are known to have a relatively higher bleeding risk, and little evidence is available regarding the risk of using r-tPA on Asian patients with intracranial aneurysms.Medical records from the Shuang Ho hospital stroke registration between July 2010 and December 2014 were retrospectively reviewed, and 144 patients received r-tPA. Unruptured intracranial aneurysms were detected using CT, or magnetic resonance or conventional angiography after r-tPA. The primary and secondary outcomes were the difference in overall intracranial hemorrhage (ICH and symptomatic ICH after r-tPA. The differences were analyzed using Fisher's exact or Mann-Whitney U tests, and p < 0.05 was defined as the statistical significance.A total of 144 patients were reviewed, and incidental unruptured intracranial aneurysms were found in 11 of them (7.6%. No significant difference was observed in baseline demographic data between the aneurysm and nonaneurysm groups. Among patients with an unruptured aneurysm, two had giant aneurysms (7.7 and 7.4 mm, respectively. The bleeding risk was not significant different between aneurysm group (2 out of 11, 18% with nonaneurysm group (7 out of 133, 5.3% (p = 0.14. None of the patients with an unruptured aneurysm had symptomatic ICH, whereas one patient without an aneurysm exhibited symptomatic ICH.The presence of an unruptured intracranial aneurysm did not significantly increase the risk of overall and symptomatic ICH in Taiwanese patients after they

  18. Idiopathic hypoparathyroidism with extensive intracranial calcification in children: First report from Saudi Arabia.

    Science.gov (United States)

    Kamal, Naglaa M; Alghamdi, Hamed A; Halabi, Abdulrahman A; Bakkar, Ayman A; Algarni, Ali; Alharbi, Abdullah; Alharthi, Abdulla A; Alharbi, Rawan A; Sherief, Laila M

    2017-04-01

    Pediatric idiopathic hypoparathyroidism with extensive intracranial calcifications outside the basal ganglia (BG) is extremely rare with less than 10 cases worldwide. An 11-year-old Saudi male child presented with tetany with otherwise normal neurological and other body system examination diagnoses severe hypocalcemia for differential diagnosis. Further investigations revealed hyperphosphatemia and undetectable serum intact parathyroid hormone. Brain computed tomography revealed BG and extensive brain calcifications. He has no dysmorphic features, vitiligo, mucocuataneous manifestations, or hair loss. He had normal hemoglobin, electroencephalogram, and skeletal survey, with negative autoantibodies to alpha and omega interferons and negative genetic testing for Glial Cell Missing 2 (GCM2) and calcium-sensing receptors (CaSRs) excluding known causes of hypoparathyroidism. This case presents a rare entity of idiopathic hypoparathyroidism with extensive intracranial calcification, not only in BG but also outside the extrapyramidal system with normal mentality, development, pubertal achievement, and neurological examination. To our knowledge, this is the first report from Saudi Arabia in pediatrics. Idiopathic hypoparathyroidism is a diagnosis of exclusion after ruling out all known causes of hypoparathyroidism. It is associated with BG calcifications, but extensive intracranial calcifications outside the BG are extremely rare.

  19. [Progressive Intracranial Hypertension due to Superior Sagittal Sinus Thrombosis Following Mild Head Trauma: A Case Report].

    Science.gov (United States)

    Suto, Yuta; Maruya, Jun; Watanabe, Jun; Nishimaki, Keiichi

    2015-07-01

    Cerebral venous sinus thrombosis after mild head trauma without skull fracture or intracranial hematoma is exceptionally rare. We describe an unusual case of progressive intracranial hypertension due to superior sagittal sinus thrombosis following mild head trauma. A 17-year-old boy presented with nape pain a day after a head blow during a gymnastics competition (backward double somersault). On admission, he showed no neurological deficit. CT scans revealed no skull fractures, and there were no abnormalities in the brain parenchyma. However, his headache worsened day-by-day and he had begun to vomit. Lumbar puncture was performed on Day 6, and the opening pressure was 40 cm of water. After tapping 20 mL, he felt better and the headache diminished for a few hours. MR venography performed on Day 8 revealed severe flow disturbance in the posterior third of the superior sagittal sinus with multiple venous collaterals. Because of the beneficial effects of lumbar puncture, we decided to manage his symptoms of intracranial hypertension conservatively with repeated lumbar puncture and administration of glycerol. After 7 days of conservative treatment, his symptoms resolved completely, and he was discharged from the hospital. Follow-up MR venography performed on Day 55 showed complete recanalization of the superior sagittal sinus. The exact mechanism of sinus thrombosis in this case is not clear, but we speculate that endothelial damage caused by shearing stress because of strong rotational acceleration or direct impact to the superior sagittal sinus wall may have initiated thrombus formation.

  20. Intracranial vessel wall imaging at 7.0 tesla MRI

    NARCIS (Netherlands)

    van der Kolk, A.G.

    2014-01-01

    Intracranial atherosclerosis is one of the main causes of ischemic stroke. Current conventional imaging techniques assessing intracranial arterial disease in vivo only visualize the vessel wall lumen instead of the pathological vessel wall itself. Therefore, not much is known about the imaging

  1. Genus zero graph segmentation: Estimation of intracranial volume

    DEFF Research Database (Denmark)

    Jensen, Rasmus Ramsbøl; Thorup, Signe Strann; Paulsen, Rasmus Reinhold

    2014-01-01

    The intracranial volume (ICV) in children with premature fusion of one or more sutures in the calvaria is of interest due to the risk of increased intracranial pressure. Challenges for automatic estimation of ICV include holes in the skull e.g. the foramen magnum and fontanelles. In this paper, w...

  2. INTRACRANIAL NEOPLASMS IN IBADAN, NIGERIA B.J. OLASODE ...

    African Journals Online (AJOL)

    hi-tech

    2000-01-01

    Jan 1, 2000 ... embryogenetic classifications of intracranial neoplasms in which terms like neuroblastoma, spongioblastoma, astroblastoma and ependymoblastoma were coined to indicate neoplasms arising from these primitive cells(1). Advances in our understanding of the morphobiology of intracranial neoplasms have ...

  3. The radiological appearance of intracranial aneurysms in adults ...

    African Journals Online (AJOL)

    2014-04-04

    Apr 4, 2014 ... has been described in young adults and affects predominantly the extracranial blood vessels.2. Intracranial aneurysms in HIV-positive adults are described infrequently. About 22 case reports of HIV-infected adult patients who presented with intracranial aneurysms could be located in the literature. Isolated ...

  4. Idiopathic intracranial hypertension with altered consciousness in a ...

    African Journals Online (AJOL)

    Idiopathic intracranial hypertension (IIH) is a clinical condition of increased intracranial pressure (ICP) without an obvious underlying pathological brain lesion. It is usually characterized by headache, neck pain, vomiting, visual disturbances, papilledema, cranial nerve palsy or a combination of these signs and symptoms.

  5. Mannitol-induced rebleeding from intracranial aneurysm. Case report

    DEFF Research Database (Denmark)

    Rosenørn, J; Westergaard, L; Hansen, P H

    1983-01-01

    A case is presented in which rebleeding from an intracranial saccular aneurysm occurred a few minutes after intravenous administration of mannitol during surgery. The relationship between the reducing effect of mannitol on elevated intracranial pressure and the increased pressure gradient across...

  6. Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

    NARCIS (Netherlands)

    Debette, Stéphanie; Compter, A; Labeyrie, Marc Antoine; Uyttenboogaart, Maarten; Metso, Tina M.; Majersik, Jennifer J.; Goeggel-Simonetti, Barbara; Engelter, Stefan T.; Pezzini, Alessandro; Bijlenga, Philippe; Southerland, Andrew M.; Naggara, Olivier; Béjot, Yannick; Cole, John W.; Ducros, Anne; Giacalone, Giacomo; Schilling, Sabrina; Reiner, Peggy; Sarikaya, Hakan; Specken-Welleweerd, Jantien; Kappelle, L. Jaap; de Borst, Gert Jan; Bonati, Leo H.; Jung, Simon; Thijs, Vincent; Martin, Juan J.; Brandt, Tobias; Grond-Ginsbach, Caspar; Kloss, Manja; Mizutani, Tohru; Minematsu, Kazuo; Meschia, James F.; Pereira, Vitor M.; Bersano, Anna; Touzé, Emmanuel; Lyrer, Philippe A.; Leys, Didier; Chabriat, Hugues; Markus, Hugh S.; Worrall, Bradford B.; Chabrier, Stéphane; Baumgartner, Ralph; Stapf, Christian; Tatlisumak, Turgut; Arnold, Marcel; Bousser, Marie Germaine

    2015-01-01

    Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with

  7. Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

    NARCIS (Netherlands)

    Debette, Stephanie; Compter, Annette; Labeyrie, Marc-Antoine; Uyttenboogaart, Maarten; Metso, Tina M.; Majersik, Jennifer J.; Goeggel-Simonetti, Barbara; Engelter, Stefan T.; Pezzini, Alessandro; Bijlenga, Philippe; Southerland, Andrew M.; Naggara, Olivier; Bejot, Yannick; Cole, John W.; Ducros, Anne; Giacalone, Giacomo; Schilling, Sabrina; Reiner, Peggy; Sarikaya, Hakan; Welleweerd, Janna C.; Kappelle, L. Jaap; de Borst, Gert Jan; Bonati, Leo H.; Jung, Simon; Thijs, Vincent; Martin, Juan J.; Brandt, Tobias; Grand-Ginsbach, Caspar; Kloss, Manja; Mizutani, Tohru; Minematsu, Kazuo; Meschia, James F.; Pereira, Vitor M.; Bersano, Anna; Touze, Emmanuel; Lyrer, Philippe A.; Leys, Didier; Chabriat, Hugues; Markus, Hugh S.; Worrall, Bradford B.; Chabrier, Stephane; Baumgartner, Ralph; Stapf, Christian; Tatlisumak, Turgut; Arnold, Marcel; Bousser, Marie-Germaine

    Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with

  8. Intracranial Convexity Lipoma with Massive Calcification: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Tae; Park, Dong Woo; Ryu, Jeong Ah; Park, Choong Ki; Lee, Young Jun; Lee, Seung Ro [Dept. of Radiology, Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    Intracranial lipoma is a rare entity, accounting for less than 0.5% of intracranial tumors, which usually develops in the callosal cisterns. We report a case of lipoma with an unusual location; in the high parietal convexity combined with massive calcification, and no underlying vascular malformation or congenital anomaly.

  9. Report on the second Intracranial Hypertension Research Foundation conference

    Directory of Open Access Journals (Sweden)

    Tanne Emanuel

    2008-08-01

    Full Text Available Abstract This report highlights a conference designed for patient education on elevated cerebrospinal fluid (CSF pressure. The conference centered on chronic intracranial hypertension (IH including the latest research and clinical information. It was sponsored by the Intracranial Hypertension Research Foundation and held at the University of Texas Medical School, Houston, on June 21–22nd, 2008.

  10. THE DIAGNOSIS AND TREATMENT OF INTRACRANIAL ARACHNOID CYSTS

    NARCIS (Netherlands)

    GO, KG

    Intracranial arachnoid cysts have been found in 0.3% of computed tomography (CT) scans and in 0.1% of brain autopsy specimens, more often in children than in adults. Intracranial arachnoid cysts occur prevalently in males, on the left side, and in the temporal fossa. Their occasional association

  11. Unruptured intracranial aneurysms: initial and follow-up screening

    NARCIS (Netherlands)

    Bor, A.S.E.

    2014-01-01

    Unruptured intracranial aneurysms may rupture, causing subarachnoid haemorrhage (SAH). SAH is a devastating subtype of stroke, resulting in death or severe disability in half the patients. This thesis has a focus on initial and follow-up screening for unruptured intracranial aneurysms, and consists

  12. Genetic Determinants of Unruptured Intracranial Aneurysms in the General Population.

    Science.gov (United States)

    Peymani, Abbas; Adams, Hieab H H; Cremers, Lotte G M; Krestin, Gabriel; Hofman, Albert; van Duijn, Cornelia M; Uitterlinden, André G; van der Lugt, Aad; Vernooij, Meike W; Ikram, M Arfan

    2015-10-01

    Genome-wide association studies have identified single-nucleotide polymorphisms (SNPs) for intracranial aneurysms in clinical samples. In addition, SNPs have been discovered for blood pressure, one of the strongest risk factors for intracranial aneurysms. We studied the role of these genetic variants on occurrence and size of unruptured intracranial aneurysms, discovered incidentally in a general community-dwelling population. In 4890 asymptomatic participants from the Rotterdam Study, 120 intracranial aneurysms were identified on brain imaging and segmented for maximum diameter and volume. Genetic risk scores (GRS) were calculated for intracranial aneurysms (10 SNPs), systolic blood pressure (33 SNPs), and diastolic blood pressure (41 SNPs). The GRS for intracranial aneurysms was not statistically significantly associated with presence of aneurysms in this population (OR, 1.16; 95% CI, 0.96-1.40; P=0.119), but showed a significant association with both maximum diameter (difference in log-transformed mm per SD increase of GRS, 0.10; 95% CI, 0.02-0.19; P=0.018) and volume (difference in log-transformed µL per SD increase of GRS, 0.21; 95% CI, 0.01-0.41; P=0.040) of aneurysms. GRSs for blood pressures were associated with neither presence nor size of aneurysms. Genetic variants previously identified for intracranial aneurysms in clinical studies relate to the size rather than the presence of incidentally discovered, unruptured intracranial aneurysms in the general population. © 2015 American Heart Association, Inc.

  13. Unintended Complication of Intracranial Subdural Hematoma after Percutaneous Epidural Neuroplasty

    OpenAIRE

    Kim, Sung Bum; Kim, Min Ki; Kim, Kee D.; Lim, Young Jin

    2014-01-01

    Percutaneous epidural neuroplasty (PEN) is a known interventional technique for the management of spinal pain. As with any procedures, PEN is associated with complications ranging from mild to more serious ones. We present a case of intracranial subdural hematoma after PEN requiring surgical evacuation. We review the relevant literature and discuss possible complications of PEN and patholophysiology of intracranial subdural hematoma after PEN.

  14. Idiopathic intracranial hypertension is not benign

    DEFF Research Database (Denmark)

    Yri, Hanne M; Wegener, Marianne; Sander, Birgit

    2012-01-01

    Idiopathic intracranial hypertension (IIH) primarily affects young obese females, and potentially causes visual loss and severe headache. The aim of this experiment is to examine relapse rate and long-term outcome in IIH patients. The methods involved in this experiment include a prospective...... and comprehensive neuro-ophthalmological examination, including fundus photography, Humphrey visual fields, and measurement of the retinal thickness (RT) and retinal nerve fiber layers (RNFL) by optical coherence tomography (OCT). Relapse was defined as recurrence of either: (1) papilledema or (2) symptoms...

  15. Benign intracranial hypertension diagnosed with bilateral papilloedema

    Directory of Open Access Journals (Sweden)

    K. C. Phillips

    2013-12-01

    Full Text Available This article presents a case of benign intracranial hypertension (BIH diagnosed from the presence of papilloedema. This potentially sight-threatening condition particularly affects younger obese females and can be idiopathic, caused by adverse reaction to certain prescription medications or by systemic disease. Prompt treatment is essentialto avoid optic atrophy and low energy diet and exercise forms part of long-term treatment to avoid relapse. Optometrists can play a critical primary health care role in the detection of papilloedema and referring appropriately.

  16. Imaging features of unusual intracranial cystic meningiomas

    International Nuclear Information System (INIS)

    Demir, M.K.; Musluman, M.; Kilicoglu, G.; Hakan, T.; Aker, F.V.

    2007-01-01

    To describe the imaging features of unusual intracranial cystic meningiomas in infants and adults. We retrospectively reviewed the magnetic resonance and computed tomography findings for 2 female patients and 3 male patients, ranging in age from 1 to 73 years (median 41 years), with histopathologically proven cystic meningioma. Although cystic meningiomas usually appear as solid and cystic masses, they may present as a mainly multicystic lesion. The wall of a cystic part of the meningioma may include both enhancing and unenhancing areas at imaging. The cystic portion of a meningioma is hypointense on diffusion-weighted images and markedly hyperintense on corresponding apparent diffusion coefficient maps. (author)

  17. Secondary Intracranial Hypotension: A Case Report

    Directory of Open Access Journals (Sweden)

    Pinar Gundogan Bozdag

    2014-04-01

    Full Text Available Intracranial hypotension is a clinical condition that characterized by postural (orthostatic headache and low pressure. It apperas with cerebrospinal fluid leak which occurs spontaneous or depending on the secondary attempts. 31 years old female patient which has diagnosis of acute appendicitis and underwent appendectomy under spinal anesthesia. postoperative 5.day she admitted with a postural headache, diplopia. Patient was treated with conservative methods after diagnosed with magnetic resonance imaging. We aim to asses an encountered complication after spinal anesthesia which widely applied for surgical procedures with imaging findings and literature.

  18. Increased intracranial volume in Parkinson's disease

    DEFF Research Database (Denmark)

    Krabbe, Katja; Karlsborg, Merete; Hansen, Andreas

    2005-01-01

    BACKGROUND: Parkinson's disease (PD) and multiple system atrophy (MSA) are neurodegenerative diseases that can be difficult to diagnose and distinguish from each other. STUDY AIMS AND METHODS: Patients with PD and MSA and controls were studied with magnetic resonance imaging (MRI) using tissue...... segmentation and outlining of regions in order to identify regional volume changes that might be useful in the diagnosis of the two diseases. RESULTS: Patients with PD had significantly larger intracranial volumes (ICVs) and significantly smaller putaminal and sustantia nigra volumes than controls. MSA...

  19. MRI diagnosis of intracranial tuberculosis (73 cases report)

    International Nuclear Information System (INIS)

    Zeng Qingyong; Li Xin; He Zhihui; Cheng Chuanhu; Deng Kaijun; Deng Ming

    2008-01-01

    Objective: To assess the MRI features, classification and diagnostic value for intracranial tuberculosis. Methods MRI findings of 73 patients suffering from intracranial tuberculosis proved by pathology or clinic were analyzed respectively. Among the total 73 patients, 39 cases were tuberculosis meningitis, 12 cases simple intracranial tuberculoma, while 22 cases were tuberculoma combining with meningitis. Results: The MRI features of tuberculous meningitis are cerebral infarction, hydrocephalus, abnormal meningeal and cerebral cistern enhancement. 12 cases mature tuberculoma demon- strated typical features with high or low density on T 2 WI images and ring contrast enhancement; 22 cases non-mature tuberculoma showed focal nodular contrast enhancement with evident cerebral edema. FLAIR is more sensitive to find out focus than T 2 WI. Small lesions could be showed definitively by contrast-enhanced scan. Conclusion: MRI possess typical features in the diagnosis of intracranial tuberculosis. It plays an important role in evaluating location, range, classification of intracranial tuberculosis, and is helpful to clinical treatment. (authors)

  20. Diagnosis of ruptured intracranial aneurysm in acute stage

    International Nuclear Information System (INIS)

    Yoshiyama, Masataka; Nakagawa, Toshifumi

    1980-01-01

    Subarachnoid hemorrhage at an acute stage within one day from the onset to the first CT scan was classified into subarachnoid hemorrhage secondary to intracranial aneurysm, subarachnoid hemorrhage of unknown origin and subarachnoid hemorrhage of which angiography could not be carried out, and the first CT findings, the severity, and the prognosis of these subarachnoid hemorrhage were compared and discussed. CT findings of subarachnoid hemorrhage secondary to intracranial aneurysm showed various changes according to progress in the severity with time, and intracranial hematoma, intraventricular clots and ventricular dilatation increased according to progress in the severity. Ruptured intracranial aneurysm in middle cerebral artery, anterior cerebral artery and anterior communicating artery could be found easily by CT, but that in internal carotid artery and vertabral basilar artery was difficult to be detected by CT. When cerebral angiography was carried out repeatedly for ruptured intracranial aneurysm of unknown origin, the time of performance must be consifered with attention to angiospasms or hematoma. (Tsunoda, M.)

  1. Viridans streptococci Intracranial Abscess Masquerading as Metastatic Disease

    Directory of Open Access Journals (Sweden)

    Brandon Ruderman

    2018-01-01

    Full Text Available History of present illness: A 64-year-old woman with a remote history of breast cancer presented to the emergency department with one day of worsening right-sided weakness and headaches. She had been seen two weeks prior for similar symptoms and underwent unenhanced brain computed tomography (CT, which revealed a left parietal mass suspected to represent new metastatic disease. The patient presented on this visit not only with weakness of her right upper and lower extremity, but was found to be febrile, tachycardic and exhibiting lethargy. Peripheral white blood cell count (WBC was 27.1 (x109/L. Given her rapidly declining clinical course and expected time to complete magnetic resonance imaging (MRI of the brain, the decision was made to first perform an emergent contrast-enhanced brain CT to further evaluate the mass. The contrast-enhanced brain CT revealed a large rim-enhancing left parietal lesion (Figures 1 and 2. Significant findings: A non-contrast CT (Figure 1 revealed a large hypoattenuating left parietal lesion. When the CT was enhanced with intravenous contrast (Figure 2, the same lesion showed peripheral rim enhancement, suggestive of a brain abscess. Discussion: Intracranial abscess is a rare yet potentially devastating disease process that can often be difficult to diagnosis, with an incidence of about 0.4-0.9 cases per 100,000 people.1 Mortality rates are about 15% within the past decade, but can increase up to 85% if the abscess ruptures. The most common mechanisms for formation of intracranial abscesses include direct spread from local infections (odontogenic infections or sinusitis, hematogenous spread (congenital heart disease, endocarditis, dental procedures, or intrapulmonary shunting, or penetrating trauma.2 Intracranial abscesses are more likely to occur in severely immunosuppressed patients, after neurosurgical procedures, or in head trauma. About 32%-60% of brain abscesses are polymicrobial, but Viridans streptococci, a

  2. Comparing spiking and slow wave activity from invasive electroencephalography in patients with and without seizures.

    Science.gov (United States)

    Lundstrom, Brian Nils; Meisel, Christian; Van Gompel, Jamie; Stead, Matt; Worrell, Greg

    2018-02-27

    To develop quantitative measures for estimating seizure probability, we examine intracranial EEG data from patient groups with three qualitative seizure probabilities: patients with drug resistant focal epilepsy (high), these patients during cortical stimulation (intermediate), and patients who have no history of seizures (low). Patients with focal epilepsy were implanted with subdural electrodes during presurgical evaluation. Patients without seizures were implanted during treatment with motor cortex stimulation for atypical facial pain. The rate and amplitude of spikes correlate with qualitative seizure probability across patient groups and with proximity to the seizure onset zone in focal epilepsy patients. Spikes occur earlier during the negative oscillation of underlying slow activity (0.5-2 Hz) when seizure probability is increased. Similarly, coupling between slow and fast activity is increased. There is likely a continuum of sharply contoured activity between non-epileptiform and epileptiform. Characteristics of spiking and how spikes relate to slow activity can be combined to predict seizure onset zones. Intracranial EEG data from patients without seizures represent a unique comparison group and highlight changes seen in spiking and slow wave activity with increased seizure probability. Slow wave activity and related physiology are an important potential biomarker for estimating seizure probability. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  3. MRI and CT findings of intracranial neurosyphilis

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Hong Kil; Shim, Ya Seong; Kim, Seon Bok; Kim, Uk Jung; Lee, Shin Ho; Jung, Hae Kyuong; Lee, Eil Seong; Kang, Ik Won [Hallym University College of Medicine, Seoul (Korea, Republic of); Cho, Hyeun Cha [Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    1999-02-01

    To evaluate the CT and MRI findings of neurosyphilis. We retrospectively reviewed the CT and MR imaging findings in five patients with intracranial neurosyphilis confirmed by CSF, VDRL, TPHA, and clinical follow-up. MR imaging was performed in all five cases, and CT in two. The MRI and CT findings of intracranial neurosyphilis included infarction (n=3), focal inflammation (n=1) and encephalopathy (n=1). There was a total of ten infaretions : three of the basal ganglia, two each of the frontal lobe, watershed zone, and cerebellum, and one of the occipital lobe. Intaretion was most common in MCA territory (n=9; 50%), followed by the watershed zone (16.6%), posterior cerebral artery territory (16.6%), and posterior inferior cerebellar artery territory (11.1%). The size of the lesion varied from 1cm to larger than one lobe. One patient showed diffuse high signal intensity in the left temporal lobe, but on follow-up MRI, this had resolved. The most common finding of neurosyphilis, as seen on MRI and CT, was infarction in middle cerebral arterial territory.

  4. Genome screen in familial intracranial aneurysm

    Directory of Open Access Journals (Sweden)

    Langefeld Carl

    2009-01-01

    Full Text Available Abstract Background Individuals with 1st degree relatives harboring an intracranial aneurysm (IA are at an increased risk of IA, suggesting genetic variation is an important risk factor. Methods Families with multiple members having ruptured or unruptured IA were recruited and all available medical records and imaging data were reviewed to classify possible IA subjects as definite, probable or possible IA or not a case. A 6 K SNP genome screen was performed in 333 families, representing the largest linkage study of IA reported to date. A 'narrow' (n = 705 definite IA cases and 'broad' (n = 866 definite or probable IA disease definition were used in multipoint model-free linkage analysis and parametric linkage analysis, maximizing disease parameters. Ordered subset analysis (OSA was used to detect gene × smoking interaction. Results Model-free linkage analyses detected modest evidence of possible linkage (all LOD Conclusion These data suggest it is unlikely that there is a single common variant with a strong effect in the majority of the IA families. Rather, it is likely that multiple genetic and environmental risk factors contribute to the susceptibility for intracranial aneurysms.

  5. Endovascular treatment of symptomatic intracranial atherosclerotic disease

    Directory of Open Access Journals (Sweden)

    Syed I Hussain

    2011-02-01

    Full Text Available Abstract: Symptomatic intracranial atherosclerotic disease (ICAD is responsible for approximately 10% of all ischemic strokes in the United States. The risk of recurrent stroke may be as high as 35% in patient with critical stenosis greater than 70% in diameter narrowing. Recent advances in medical and endovascular therapy have placed ICAD at the forefront of clinical stroke research to optimize the best medical and endovascular approach to treat this important underlying stroke etiology. Analysis of symptomatic ICAD studies lead to the question that whether angioplasty and or stenting is a safe, suitable and efficacious therapeutic strategy in patients with critical stenoses that are deemed refractory to medical management. Most of the currently available data in support of angioplasty and or stenting in high risk patients with severe symptomatic ICAD is in the form of case series and randomized trial results of endovascular therapy versus medical treatment are awaited. This is a comprehensive review of the state of the art in the endovascular approach with angioplasty and or stenting of symptomatic intracranial atherosclerotic disease.

  6. Longterm surgery of posttraumatic intracranial hematoma

    Directory of Open Access Journals (Sweden)

    Babochkin D.S.

    2012-03-01

    Full Text Available Purpose. Research objective — studying of consequences of the operated traumatic intracranial hematomas in the remote period. Material. The nearest and remote results of the operated traumatic intracranial hematomas at 105 patients in terms from 6 months till 3 years are analyzed. During research the anamnesis was studied, neurologic investigation, and also research cognitive functions by means of scale MMSE, the test of drawing of hours, a scale of studying of alarm/depression HADS, learning of 5 words, scale quality of life SF-36. Results. It is established, that in the remote period the condition of the majority of patients gradually improves, at the same time, frequent enough and expressed consequences which are necessary for analyzing with the purpose of optimization of outcomes and the forecast at the given disease are observed. The special attention should be given again developing complications to which it is possible to carry epileptic seizures and behavioral-memorable infringements. Conclusion. Studying of the remote consequences of this heavy kind of craniocereberal trauma allows to optimize results of treatment and to provide complex medical, labor, social and family adaptation

  7. Concomitant Intracranial and Lumbar Chronic Subdural Hematoma Treated by Fluoroscopic Guided Lumbar Puncture: A Case Report and Literature Review.

    Science.gov (United States)

    Ichinose, Daisuke; Tochigi, Satoru; Tanaka, Toshihide; Suzuki, Tomoya; Takei, Jun; Hatano, Keisuke; Kajiwara, Ikki; Maruyama, Fumiaki; Sakamoto, Hiroki; Hasegawa, Yuzuru; Tani, Satoshi; Murayama, Yuichi

    2018-02-23

    A 40-year-old man presented with a severe headache, lower back pain, and lower abdominal pain 1 month after a head injury caused by falling. Computed tomography (CT) of the head demonstrated bilateral chronic subdural hematoma (CSDH) with a significant amount in the left frontoparietal region. At the same time, magnetic resonance imaging (MRI) of the lumbar spine also revealed CSDH from L2 to S1 level. A simple drainage for the intracranial CSDH on the left side was performed. Postoperatively, the headache was improved; however, the lower back and abdominal pain persisted. Aspiration of the liquefied spinal subdural hematoma was performed by a lumbar puncture under fluoroscopic guidance. The clinical symptoms were dramatically improved postoperatively. Concomitant intracranial and spinal CSDH is considerably rare so only 23 cases including the present case have been reported in the literature so far. The etiology and therapeutic strategy were discussed with a review of the literature. Therapeutic strategy is not established for these two concomitant lesions. Conservative follow-up was chosen for 14 cases, resulting in a favorable clinical outcome. Although surgical evacuation of lumbosacral CSDH was performed in seven cases, an alteration of cerebrospinal fluid (CSF) pressure following spinal surgery should be reminded because of the intracranial lesion. Since CSDH is well liquefied in both intracranial and spinal lesion, a less invasive approach is recommended not only for an intracranial lesion but also for spinal lesion. Fluoroscopic-guided lumbar puncture for lumbosacral CSDH following burr hole surgery for intracranial CSDH could be a recommended strategy.

  8. Evaluating the Effect of Mozart Music and White Noise on Electroencephalography Pattern toward Visual Memory

    Directory of Open Access Journals (Sweden)

    Syarifah Noor Syakiylla Sayed Daud

    2017-08-01

    Full Text Available Listening to auditory stimuli during study can give positive and negative influence on human cognitive processing. Thus, it has attracted researchers to conduct studies using various types of auditory stimuli. Some researchers believe that Mozart music and white noise are able to give positive influence on cognitive performance. However, most of the past studies gave more attention towards spatial task. Very little studies have been made on the effect of Mozart music and white noise towards memorizing task. Besides, the effect of these auditory stimuli on task difficulty has also not been studied deeply. Hence, the aims of this study were to investigate the effect of Mozart music and white noise on memory performance with different task difficulty levels; and to propose an effective background stimuli condition for memorization. Experiments have been conducted involving 60 healthy adults that required them to memorize the visual memory task with two difficulty levels; i.e. easy and difficult. Brain signal was recorded during memorization duration using 10-20 electrode placement system of electroencephalography (EEG machine. EEG is a neurological test for measuring and recording the electrical activity of the brain. The effect of sound stimuli on memory performance was evaluated based on memorization test score and brain activity. The wavelet approach was used in processing the EEG data. Based on the memorizing test score result, the subjects are able to memorize better when listening to white noise compared to Mozart music at different difficulty levels. Listening to auditory stimuli can influence the electroencephalography pattern and brain activity. The level of sensory processing and attention increases when listening to white noise which cause the increase of relative gamma (easy level: p-value = 0.005; difficult level: p-value = 0.007 and beta power (easy level: p-value = 0.001; difficult level: p-value = 0.003. Thus, in this study, it is

  9. The use of the Psychiatric Electroencephalography Evaluation Registry (PEER to personalize pharmacotherapy

    Directory of Open Access Journals (Sweden)

    Iosifescu DV

    2016-08-01

    Full Text Available Dan V Iosifescu,1 Robert J Neborsky,2–4 Robert J Valuck5–7 1Adult Psychopharmacology Program, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 2School of Medicine, University of California, San Diego, CA, USA; 3University of California, Los Angeles, CA, USA; 4Medical Corps, US Navy, USA; 5Pharmacy, Epidemiology, and Family Medicine, University of Colorado, Denver, CO, USA; 6Center for Pharmaceutical Outcomes Research, University of Colorado, Denver, CO, USA; 7Colorado Consortium for Prescription Drug Abuse Prevention, Denver, CO, USA Purpose: This study aims to determine whether Psychiatric Electroencephalography Evaluation Registry (PEER Interactive (an objective, adjunctive tool based on a comparison of a quantitative electroencephalogram to an existing registry of patient outcomes is more effective than the current standard of care in treatment of subjects suffering from depression. Patients and methods: This is an interim report of an ongoing, 2-year prospective, randomized, double blind, controlled study to evaluate PEER Interactive in guiding medication selection in subjects with a primary diagnosis of depression vs standard treatment. Subjects in treatment at two military hospitals were blinded as to study group assignment and their self-report symptom ratings were also blinded. Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16 depression scores were the primary efficacy endpoint. One hundred and fifty subjects received a quantitative electroencephalography exam and were randomized to either treatment as usual or PEER-informed pharmacotherapy. Subjects in the control group were treated according to Veterans Administration/Department of Defense Guidelines, the current standard of care. In the experimental group, the attending physician received a PEER report ranking the subject’s likely clinical response to on-label medications. Results: In this post hoc interim analysis

  10. Cortical mapping of painful electrical stimulation by quantitative electroencephalography: unraveling the time–frequency–channel domain

    Directory of Open Access Journals (Sweden)

    Goudman L

    2017-11-01

    Full Text Available Lisa Goudman,1–3 Jorne Laton,4 Raf Brouns,4,5 Guy Nagels,4–6 Eva Huysmans,2,3,7,8 Ronald Buyl,7,9 Kelly Ickmans,2,3,10 Jo Nijs,2,3,10 Maarten Moens,1,2,4,11 1Department of Neurosurgery, Universitair Ziekenhuis Brussel, 2Pain in Motion International Research Group, 3Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, 4Center for Neurosciences (C4N, Vrije Universiteit Brussel (VUB, 5Department of Neurology, Universitair Ziekenhuis Brussel, 6National MS Center, 7Department of Public Health (GEWE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 8Interuniversity Centre for Health Economics Research (I-CHER, 9Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 10Department of Physical Medicine and Physiotherapy, 11Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium Abstract: The goal of this study was to capture the electroencephalographic signature of experimentally induced pain and pain-modulating mechanisms after painful peripheral electrical stimulation to determine one or a selected group of electrodes at a specific time point with a specific frequency range. In the first experiment, ten healthy participants were exposed to stimulation of the right median nerve while registering brain activity using 32-channel electroencephalography. Electrical stimulations were organized in four blocks of 20 stimuli with four intensities – 100%, 120%, 140%, and 160% – of the electrical pain threshold. In the second experiment, 15 healthy participants received electrical stimulation on the dominant median nerve before and during the application of a second painful stimulus. Raw data were converted into the time–frequency domain by applying a continuous wavelet transform. Separated domain information was extracted by calculating Parafac models. The results demonstrated that it is possible to capture

  11. Intracranial germinomas in a father and his son.

    Science.gov (United States)

    Shimizu, Kampei; Mineharu, Yohei; Imamura, Hirotoshi; Asai, Katsunori; Imai, Yukihiro; Ichimura, Koichi; Sakai, Nobuyuki

    2014-12-01

    Primary intracranial germ cell tumors (IGCTs) represent an uncommon category of neoplasms, and familial occurrence is rare. We present the first report of parent-child patients with pathologically confirmed pure germinomas. A 36-year-old Japanese man presented with diabetes insipidus and hypopituitarism. Magnetic resonance imaging (MRI) revealed a mass lesion in the pituitary stalk, which was diagnosed as a pure germinoma by open craniotomy tumor biopsy. Seven years later, his 13-year-old son also presented with diabetes insipidus. MRI revealed mass lesions in the pituitary stalk and the pineal region. He underwent endoscopic tumor biopsy for the pineal lesion, which was diagnosed as a pure germinoma. Both the father and his son were treated with combined radiochemotherapeutic regimens and achieved complete remission after one to two cycles of chemotherapy. Although there have been three previous case reports of familial germinoma, all of these involved sibling pairs. The present report represents the first parent-child cases. This type of familial occurrence suggests the possibility that germline mutations may also be involved in the development of IGCTs.

  12. Intracranial EEG in predicting surgical outcome in frontal lobe epilepsy.

    Science.gov (United States)

    Holtkamp, Martin; Sharan, Ashwini; Sperling, Michael R

    2012-10-01

    Surgery in frontal lobe epilepsy (FLE) has a worse prognosis regarding seizure freedom than anterior lobectomy in temporal lobe epilepsy. The current study aimed to assess whether intracranial interictal and ictal EEG findings in addition to clinical and scalp EEG data help to predict outcome in a series of patients who needed invasive recording for FLE surgery. Patients with FLE who had resective surgery after chronic intracranial EEG recording were included. Outcome predictors were compared in patients with seizure freedom (group 1) and those with recurrent seizures (group 2) at 19-24 months after surgery. Twenty-five patients (16 female) were included in this study. Mean age of patients at epilepsy surgery was 32.3 ± 15.6 years (range 12-70); mean duration of epilepsy was 16.9 ± 13.4 years (range 1-48). In each outcome group, magnetic resonance imaging revealed frontal lobe lesions in three patients. Fifteen patients (60%) were seizure-free (Engel class 1), 10 patients (40%) continued to have seizures (two were class II, three were class III, and five were class IV). Lack of seizure freedom was seen more often in patients with epilepsy surgery on the left frontal lobe (group 1, 13%; group 2, 70%; p = 0.009) and on the dominant (27%; 70%; p = 0.049) hemisphere as well as in patients without aura (29%; 80%; p = 0.036), whereas sex, age at surgery, duration of epilepsy, and presence of an MRI lesion in the frontal lobe or extrafrontal structures were not different between groups. Electroencephalographic characteristics associated with lack of seizure freedom included presence of interictal epileptiform discharges in scalp recordings (31%; 90%; p = 0.01). Detailed analysis of intracranial EEG revealed widespread (>2 cm) (13%; 70%; p = 0.01) in contrast to focal seizure onset as well as shorter latency to onset of seizure spread (5.8 ± 6.1 s; 1.5 ± 2.3 s; p = 0.016) and to ictal involvement of brain structures beyond the frontal lobe (23.5 ± 22.4 s; 5.8 ± 5.4 s

  13. MRI Diagnosis of Intracranial Hemorrhage : Experimental and Clinical Studies

    Energy Technology Data Exchange (ETDEWEB)

    Alemany Ripoll, Montserrat

    2003-02-01

    The purpose of this work was to improve the diagnosis of intracranial hemorrhage with MRI, and add knowledge about the newer sequences increasing in use to depict intra parenchymal bleeds, especially T2*-w GE sequences. We also compared the effect of magnetic field strengths. The sequences and field strengths were tested in animals. Then, the most effective technique was applied to patients with hematomas of different ages and with hematoma residuals. Occurrence of residuals of earlier, clinically silent, haemorrhages in patients with acute spontaneous hematoma or with suspected ischemic stroke were compared. Experimental studies: The MR detectability of small experimental haematomas in the brain and of blood in the cerebrospinal fluid (CSF) spaces of 30 rabbits was evaluated. MRI examinations were performed at determined intervals using different pulse sequences at two field strengths. The last MR images were compared to the formalin fixed brain sections and, in 16 rabbits, also to the histological findings. T2*-weighted GE sequences revealed all the intra parenchymal haematomas at 1.5 T: they were strongly hypointense. Their sizes became smaller but the signal patterns remained unchanged during the follow-up. The haematoma sizes and shapes corresponded well to gross pathology at acute and subacute stages. At chronic stage, the signal changes were larger than iron deposits. Blood in the CSF spaces was best detected at 1.5T with T2*-weighted GE sequences during the first 2 days. The FLAIR sequence often revealed blood in CSF spaces but not in the brain. SE sequences were rather insensitive. Imaging at 0.5 T was less effective than at 1.5 T. Clinical studies: All MR examinations on patients were performed at 1.5T, including T1- and T2-w SE, FLAIR, T2*-w GE sequences, and, occasionally, diffusion-w sequences. Sixty-six intra parenchymal hematomas were examined in the first clinical study. The hematomas were of different sizes and the ages varied from 8 hours to 3

  14. Stent-assisted recanalization of atherosclerotic intracranial stenosis

    International Nuclear Information System (INIS)

    Soo Mee Lim; Dae Chul Suh

    2006-01-01

    Intracranial atherosclerosis is a major cause of ischemic stroke, and depending on the studied population, it accounts for 8%-15% of all strokes that are due to cerebral atherosclerosis. The prognosis of patients with symptomatic intracranial stenoses seems to depend on the location and extent of intracranial atherosclerosis. Currently, the primary treatment in intracranial atherosclerosis is the control of vascular risk factors such as hypertension, diabetes, hypercholesterolemia, and smoking. Secondary prevention with antiplatelet therapy has been shown to reduce the risk of subsequent vascular events in patients who have suffered a recent ischemic stroke or transient ischemic attack (TIA). Unfortunately, a significant number of patients with intracranial atherosclerosis continue to suffer from repeated strokes or TIA despite maximal medical treatment. Although endovascular revascularization for symptomatic intracranial stenoses remains at the investigational stage and much of the pertinent information is anecdotal, intracranial angioplasty and stenting are being increasingly performed to treat stenotic lesions. This article reviews basic principles involved in the patient selection, premedication, angio-interventional procedures, angiographic and clinical results, periprocedural complication, patients aftercare. (authors)

  15. Intracranial hypertension prediction using extremely randomized decision trees.

    Science.gov (United States)

    Scalzo, Fabien; Hamilton, Robert; Asgari, Shadnaz; Kim, Sunghan; Hu, Xiao

    2012-10-01

    Intracranial pressure (ICP) elevation (intracranial hypertension, IH) in neurocritical care is typically treated in a reactive fashion; it is only delivered after bedside clinicians notice prolonged ICP elevation. A proactive solution is desirable to improve the treatment of intracranial hypertension. Several studies have shown that the waveform morphology of the intracranial pressure pulse holds predictors about future intracranial hypertension and could therefore be used to alert the bedside clinician of a likely occurrence of the elevation in the immediate future. In this paper, a computational framework is proposed to predict prolonged intracranial hypertension based on morphological waveform features computed from the ICP. A key contribution of this work is to exploit an ensemble classifier method based on extremely randomized decision trees (Extra-Trees). Experiments on a representative set of 30 patients admitted for various intracranial pressure related conditions demonstrate the effectiveness of the predicting framework on ICP pulses acquired under clinical conditions and the superior results of the proposed approach in comparison to linear and AdaBoost classifiers. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  16. Mapping the signal-to-noise-ratios of cortical sources in magnetoencephalography and electroencephalography.

    Science.gov (United States)

    Goldenholz, Daniel M; Ahlfors, Seppo P; Hämäläinen, Matti S; Sharon, Dahlia; Ishitobi, Mamiko; Vaina, Lucia M; Stufflebeam, Steven M

    2009-04-01

    Although magnetoencephalography (MEG) and electroencephalography (EEG) have been available for decades, their relative merits are still debated. We examined regional differences in signal-to-noise-ratios (SNRs) of cortical sources in MEG and EEG. Data from four subjects were used to simulate focal and extended sources located on the cortical surface reconstructed from high-resolution magnetic resonance images. The SNR maps for MEG and EEG were found to be complementary. The SNR of deep sources was larger in EEG than in MEG, whereas the opposite was typically the case for superficial sources. Overall, the SNR maps were more uniform for EEG than for MEG. When using a noise model based on uniformly distributed random sources on the cortex, the SNR in MEG was found to be underestimated, compared with the maps obtained with noise estimated from actual recorded MEG and EEG data. With extended sources, the total area of cortex in which the SNR was higher in EEG than in MEG was larger than with focal sources. Clinically, SNR maps in a patient explained differential sensitivity of MEG and EEG in detecting epileptic activity. Our results emphasize the benefits of recording MEG and EEG simultaneously. 2008 Wiley-Liss, Inc.

  17. Cognitive mechanisms and motor control during a saccadic eye movement task: evidence from quantitative electroencephalography

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    Claudia Diniz

    2012-07-01

    Full Text Available The saccadic movement is an important behavioral measure used to investigate several cognitive processes, including attention and sensorimotor integration. The present study aimed at investigating changes in beta coherence over frontal, motor, occipital, and parietal cortices during the performance of two different conditions of a prosacadic paradigm. The conditions involved a different pattern of stimulus presentation: a fixed and random stimulus presentation. Twelve healthy volunteers (three male, mean age of 26.25 (SD=4.13 performed the task, while their brain activity pattern was recorded using quantitative electroencephalography. The results showed an interaction between factors condition and moment for the pair of electrode C3/C4. We observed a main effect for moment to CZ/C4, FZ/F3, and P3/PZ. We also found a main effect for condition to FZ/F4, P3/P4, and O1/O2. Our results demonstrated an important role of the inter-connection of the two hemispheres in visual search and movement preparation. The study demonstrates an automation of action and reduction of the focus of attention during the task. We also found that the inter-hemispheric beta coherence plays an important role in the differentiation of the two conditions, and that beta in the right frontal cortex is able to differentiate the conditions, demonstrating a greater involvement of procedural memory in fixed condition. Our results suggest a neuronal specialization in the execution of prosacadic paradigm involving motor task sequence.

  18. Electroencephalography(EEG)-based instinctive brain-control of a quadruped locomotion robot.

    Science.gov (United States)

    Jia, Wenchuan; Huang, Dandan; Luo, Xin; Pu, Huayan; Chen, Xuedong; Bai, Ou

    2012-01-01

    Artificial intelligence and bionic control have been applied in electroencephalography (EEG)-based robot system, to execute complex brain-control task. Nevertheless, due to technical limitations of the EEG decoding, the brain-computer interface (BCI) protocol is often complex, and the mapping between the EEG signal and the practical instructions lack of logic associated, which restrict the user's actual use. This paper presents a strategy that can be used to control a quadruped locomotion robot by user's instinctive action, based on five kinds of movement related neurophysiological signal. In actual use, the user drives or imagines the limbs/wrists action to generate EEG signal to adjust the real movement of the robot according to his/her own motor reflex of the robot locomotion. This method is easy for real use, as the user generates the brain-control signal through the instinctive reaction. By adopting the behavioral control of learning and evolution based on the proposed strategy, complex movement task may be realized by instinctive brain-control.

  19. Quantitative electroencephalography (qEEG to discriminate primary degenerative dementia from major depressive disorder (depression

    Directory of Open Access Journals (Sweden)

    Deslandes Andréa

    2004-01-01

    Full Text Available Electroencephalography (EEG can be a valuable technique to assess electrophysiological changes related to dementia. In patients suspected of having dementia, the EEG is often quite informative. The sensitivity of the EEG to detect correlates of psychiatric disorders has been enhanced by means of quantitative methods of analysis (quantitative EEG. Quantitative features are extracted from, at least, 2 minutes of artifact-free, eyes closed, resting EEG, log-transformed to obtain Gaussianity, age-regressed, and Z-transformed relative to population norms (Neurometrics database. Using a subset of quantitative EEG (qEEG features, forward stepwise discriminant analyses are used to construct classifier functions. Along this vein, the main objective of this experiment is to distinguish profiles of qEEG, which differentiate depressive from demented patients (n = 125. The results showed that demented patients present deviations above the control group in variables associated to slow rhythms: Normed Monopolar Relative Power Theta for Cz and Normed Bipolar Relative Power Theta for Head. On the other hand, the deviation below the control group occurs with the variable associated to alpha rhythm: Normed Monopolar Relative Power Alpha for P3, in dementia. Using this method, the present investigation demonstrated high discriminant accuracy in separating Primary Degenerative Dementia from Major Depressive Disorder (Depression.

  20. Driver Fatigue Detection System Using Electroencephalography Signals Based on Combined Entropy Features

    Directory of Open Access Journals (Sweden)

    Zhendong Mu

    2017-02-01

    Full Text Available Driver fatigue has become one of the major causes of traffic accidents, and is a complicated physiological process. However, there is no effective method to detect driving fatigue. Electroencephalography (EEG signals are complex, unstable, and non-linear; non-linear analysis methods, such as entropy, maybe more appropriate. This study evaluates a combined entropy-based processing method of EEG data to detect driver fatigue. In this paper, 12 subjects were selected to take part in an experiment, obeying driving training in a virtual environment under the instruction of the operator. Four types of enthrones (spectrum entropy, approximate entropy, sample entropy and fuzzy entropy were used to extract features for the purpose of driver fatigue detection. Electrode selection process and a support vector machine (SVM classification algorithm were also proposed. The average recognition accuracy was 98.75%. Retrospective analysis of the EEG showed that the extracted features from electrodes T5, TP7, TP8 and FP1 may yield better performance. SVM classification algorithm using radial basis function as kernel function obtained better results. A combined entropy-based method demonstrates good classification performance for studying driver fatigue detection.

  1. Quantitative electroencephalography analysis in university students with hazardous alcohol consumption, but not alcohol dependence.

    Science.gov (United States)

    Núñez-Jaramillo, Luis; Vega-Perera, Paulo; Ramírez-Lugo, Leticia; Reyes-López, Julián V; Santiago-Rodríguez, Efraín; Herrera-Morales, Wendy V

    2015-07-08

    Hazardous alcohol consumption is a pattern of consumption that leads to a higher risk of harmful consequences either for the user or for others. This pattern of alcohol consumption has been linked to risky behaviors, accidents, and injuries. Individuals with hazardous alcohol consumption do not necessarily present alcohol dependence; thus, a study of particular neurophysiological correlates of this alcohol consumption pattern needs to be carried out in nondependent individuals. Here, we carried out a quantitative electroencephalography analysis in health sciences university students with hazardous alcohol consumption, but not alcohol dependence (HAC), and control participants without hazardous alcohol consumption or alcohol dependence (NHAC). We analyzed Absolute Power (AP), Relative Power (RP), and Mean Frequency (MF) for beta and theta frequency bands under both eyes closed and eyes open conditions. We found that participants in the HAC group presented higher beta AP at centroparietal region, as well as lower beta MF at frontal and centroparietal regions in the eyes closed condition. Interestingly, participants did not present any change in theta activity (AP, RP, or MF), whereas previous reports indicate an increase in theta AP in alcohol-dependent individuals. Our results partially resemble those found in alcohol-dependent individuals, although are not completely identical, suggesting a possible difference in the underlying neuronal mechanism behind alcohol dependence and hazardous alcohol consumption. Similarities could be explained considering that both hazardous alcohol consumption and alcohol dependence are manifestations of behavioral disinhibition.

  2. Fast monitoring of epileptic seizures using recurrence time statistics of electroencephalography

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    Jianbo eGao

    2013-10-01

    Full Text Available Epilepsy is one of the most common disorders of the brain. Currently, determination of epileptic seizures often involves tedious, time-consuming visual inspection of electroencephalography (EEG data by medical experts. To better monitor seizures and make medications more effective, we propose a recurrence time based approach to characterize brain electrical activity. Recurrence times have a number of distinguished properties that make it very effective for forwarning epileptic seizures as well as studying propagation of seizures: 1 recurrence times amount to periods of periodic signals, 2 recurrence times are closely related to information dimension, Lyapunov exponent, and Kolmogorov entropy of chaotic signals, 3 recurrence times embody Shannon and Renyi entropies of random fields, and 4 recurrence times can readily detect bifurcation-like transitions in dynamical systems. In particular, property 4 dictates that unlike many other nonlinear methods, recurrence time method does not require the EEG data be chaotic and/or stationary. Moreover, the method only contains a few parameters that are largely signal-independent, and hence, is very easy to use. The method is also very fast—it is fast enough to on-line process multi-channel EEG data with a typical PC. Therefore, it has the potential to be an excellent candidate for real-time monitoring of epileptic seizures in a clinical setting.

  3. Fast monitoring of epileptic seizures using recurrence time statistics of electroencephalography.

    Science.gov (United States)

    Gao, Jianbo; Hu, Jing

    2013-01-01

    Epilepsy is a relatively common brain disorder which may be very debilitating. Currently, determination of epileptic seizures often involves tedious, time-consuming visual inspection of electroencephalography (EEG) data by medical experts. To better monitor seizures and make medications more effective, we propose a recurrence time based approach to characterize brain electrical activity. Recurrence times have a number of distinguished properties that make it very effective for forewarning epileptic seizures as well as studying propagation of seizures: (1) recurrence times amount to periods of periodic signals, (2) recurrence times are closely related to information dimension, Lyapunov exponent, and Kolmogorov entropy of chaotic signals, (3) recurrence times embody Shannon and Renyi entropies of random fields, and (4) recurrence times can readily detect bifurcation-like transitions in dynamical systems. In particular, property (4) dictates that unlike many other non-linear methods, recurrence time method does not require the EEG data be chaotic and/or stationary. Moreover, the method only contains a few parameters that are largely signal-independent, and hence, is very easy to use. The method is also very fast-it is fast enough to on-line process multi-channel EEG data with a typical PC. Therefore, it has the potential to be an excellent candidate for real-time monitoring of epileptic seizures in a clinical setting.

  4. Effects of carbamazepine on dexamethasone suppression and sleep electroencephalography in borderline personality disorder.

    Science.gov (United States)

    De la Fuente, José M; Bobes, Julio; Vizuete, Coro; Mendlewicz, Julien

    2002-01-01

    The pathophysiology of borderline personality disorder (BPD) remains obscure, but there is mounting evidence of brain dysfunction without focal abnormality. The dexamethasone suppression test (DST) and sleep electroencephalography (sleep EEG) have been studied in BPD, but the findings seem to be related to a concomitant axis I diagnosis of major depression (MD) rather than to BPD itself. There is no effective treatment for BPD. Carbamazepine (CBZ) has shown contradictory results and in a previous study, our results were negative. In this study, we investigated the effects of CBZ versus placebo on the DST and sleep EEG in a sample of 20 BPD patients without concomitant MD. CBZ given at doses that are therapeutic for epilepsy and affective disorders may have an effect on the DST and sleep EEG in BPD. CBZ significantly increased the postdexamethasone plasma cortisol values. This did not parallel MD or an increase in the Hamilton depression rating scores. CBZ also increased slow wave sleep (SWS). The mechanisms by which CBZ increased postdexamethasone plasma cortisol levels and SWS in BPD are discussed. Copyright 2002 S. Karger AG, Basel

  5. Fuzzy topological digital space and digital fuzzy spline of electroencephalography during epileptic seizures

    Science.gov (United States)

    Shah, Mazlina Muzafar; Wahab, Abdul Fatah

    2017-08-01

    Epilepsy disease occurs because of there is a temporary electrical disturbance in a group of brain cells (nurons). The recording of electrical signals come from the human brain which can be collected from the scalp of the head is called Electroencephalography (EEG). EEG then considered in digital format and in fuzzy form makes it a fuzzy digital space data form. The purpose of research is to identify the area (curve and surface) in fuzzy digital space affected by inside epilepsy seizure in epileptic patient's brain. The main focus for this research is to generalize fuzzy topological digital space, definition and basic operation also the properties by using digital fuzzy set and the operations. By using fuzzy digital space, the theory of digital fuzzy spline can be introduced to replace grid data that has been use previously to get better result. As a result, the flat of EEG can be fuzzy topological digital space and this type of data can be use to interpolate the digital fuzzy spline.

  6. An adaptive singular spectrum analysis method for extracting brain rhythms of electroencephalography

    Directory of Open Access Journals (Sweden)

    Hai Hu

    2017-06-01

    Full Text Available Artifacts removal and rhythms extraction from electroencephalography (EEG signals are important for portable and wearable EEG recording devices. Incorporating a novel grouping rule, we proposed an adaptive singular spectrum analysis (SSA method for artifacts removal and rhythms extraction. Based on the EEG signal amplitude, the grouping rule determines adaptively the first one or two SSA reconstructed components as artifacts and removes them. The remaining reconstructed components are then grouped based on their peak frequencies in the Fourier transform to extract the desired rhythms. The grouping rule thus enables SSA to be adaptive to EEG signals containing different levels of artifacts and rhythms. The simulated EEG data based on the Markov Process Amplitude (MPA EEG model and the experimental EEG data in the eyes-open and eyes-closed states were used to verify the adaptive SSA method. Results showed a better performance in artifacts removal and rhythms extraction, compared with the wavelet decomposition (WDec and another two recently reported SSA methods. Features of the extracted alpha rhythms using adaptive SSA were calculated to distinguish between the eyes-open and eyes-closed states. Results showed a higher accuracy (95.8% than those of the WDec method (79.2% and the infinite impulse response (IIR filtering method (83.3%.

  7. Brain-computer interface with language model-electroencephalography fusion for locked-in syndrome.

    Science.gov (United States)

    Oken, Barry S; Orhan, Umut; Roark, Brian; Erdogmus, Deniz; Fowler, Andrew; Mooney, Aimee; Peters, Betts; Miller, Meghan; Fried-Oken, Melanie B

    2014-05-01

    Some noninvasive brain-computer interface (BCI) systems are currently available for locked-in syndrome (LIS) but none have incorporated a statistical language model during text generation. To begin to address the communication needs of individuals with LIS using a noninvasive BCI that involves rapid serial visual presentation (RSVP) of symbols and a unique classifier with electroencephalography (EEG) and language model fusion. The RSVP Keyboard was developed with several unique features. Individual letters are presented at 2.5 per second. Computer classification of letters as targets or nontargets based on EEG is performed using machine learning that incorporates a language model for letter prediction via Bayesian fusion enabling targets to be presented only 1 to 4 times. Nine participants with LIS and 9 healthy controls were enrolled. After screening, subjects first calibrated the system, and then completed a series of balanced word generation mastery tasks that were designed with 5 incremental levels of difficulty, which increased by selecting phrases for which the utility of the language model decreased naturally. Six participants with LIS and 9 controls completed the experiment. All LIS participants successfully mastered spelling at level 1 and one subject achieved level 5. Six of 9 control participants achieved level 5. Individuals who have incomplete LIS may benefit from an EEG-based BCI system, which relies on EEG classification and a statistical language model. Steps to further improve the system are discussed.

  8. Amplitude-integrated electroencephalography: a survey of practices in the United States.

    Science.gov (United States)

    Shah, Nidhi A; Van Meurs, Krisa P; Davis, Alexis S

    2015-07-01

    Amplitude-integrated electroencephalography (aEEG) is a simplified method for continuous monitoring of brain activity in the neonatal intensive care unit (NICU). Our objective was to describe current aEEG use in the United States. An online survey was distributed to the American Academy of Pediatrics Section on Perinatal Pediatrics' list serve. A total of 654 surveys were received; 55% of respondents reported using aEEG. aEEG was utilized more often in academic and levels III and IV NICUs; hypoxic-ischemic encephalopathy and suspected seizures were the most common indications for use. aEEG was primarily interpreted by neonatologists (87%), with approximately half reporting either self-teaching or hospital-based training for interpretation. For those not using aEEG, uncertain clinical benefit (40%) and cost (17%) were reported as barriers to use. More than half of neonatologists utilize aEEG, with practice variation by NICU setting. Barriers to wider adoption include education regarding potential benefit, training, and cost. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Utilizing Electroencephalography Measurements for Comparison of Task-Specific Neural Efficiencies: Spatial Intelligence Tasks.

    Science.gov (United States)

    Call, Benjamin J; Goodridge, Wade; Villanueva, Idalis; Wan, Nicholas; Jordan, Kerry

    2016-08-09

    Spatial intelligence is often linked to success in engineering education and engineering professions. The use of electroencephalography enables comparative calculation of individuals' neural efficiency as they perform successive tasks requiring spatial ability to derive solutions. Neural efficiency here is defined as having less beta activation, and therefore expending fewer neural resources, to perform a task in comparison to other groups or other tasks. For inter-task comparisons of tasks with similar durations, these measurements may enable a comparison of task type difficulty. For intra-participant and inter-participant comparisons, these measurements provide potential insight into the participant's level of spatial ability and different engineering problem solving tasks. Performance on the selected tasks can be analyzed and correlated with beta activities. This work presents a detailed research protocol studying the neural efficiency of students engaged in the solving of typical spatial ability and Statics problems. Students completed problems specific to the Mental Cutting Test (MCT), Purdue Spatial Visualization test of Rotations (PSVT:R), and Statics. While engaged in solving these problems, participants' brain waves were measured with EEG allowing data to be collected regarding alpha and beta brain wave activation and use. The work looks to correlate functional performance on pure spatial tasks with spatially intensive engineering tasks to identify the pathways to successful performance in engineering and the resulting improvements in engineering education that may follow.

  10. Association of Electroencephalography (EEG) Power Spectra with Corneal Nerve Fiber Injury in Retinoblastoma Patients.

    Science.gov (United States)

    Liu, Jianliang; Sun, Juanjuan; Diao, Yumei; Deng, Aijun

    2016-09-04

    BACKGROUND In our clinical experience we discovered that EEG band power may be correlated with corneal nerve injury in retinoblastoma patients. This study aimed to investigate biomarkers obtained from electroencephalography (EEG) recordings to reflect corneal nerve injury in retinoblastoma patients. MATERIAL AND METHODS Our study included 20 retinoblastoma patients treated at the Department of Ophthalmology, Affiliated Hospital of Weifang Medical University between 2010 and 2014. Twenty normal individuals were included in the control group. EEG activity was recorded continuously with 32 electrodes using standard EEG electrode placement for detecting EEG power. A cornea confocal microscope was used to examine corneal nerve injury in retinoblastoma patients and normal individuals. Spearman rank correlation analysis was used to analyze the correlation between corneal nerve injury and EEG power changes. The sensitivity and specificity of changed EEG power in diagnosis of corneal nerve injury were also analyzed. RESULTS The predominantly slow EEG oscillations changed gradually into faster waves in retinoblastoma patients. The EEG pattern in retinoblastoma patients was characterized by a distinct increase of delta (Pretinoblastoma patients. Corneal nerve injury was positively correlated with delta EEG spectra power and negatively correlated with theta EEG spectra power. The diagnostic sensitivity and specificity by compounding in the series were 60% and 67%, respectively. CONCLUSIONS Changes in delta and theta of EEG appear to be associated with occurrence of corneal nerve injury. Useful information can be provided for evaluating corneal nerve damage in retinoblastoma patients through analyzing EEG power bands.

  11. The prognostic value of electroencephalography in epilepsy: a long-term follow-up study

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    Stylianos Gatzonis

    2010-10-01

    Full Text Available Predicting the evolution of epilepsy is of obvious importance for patients and their families. Value of electroencephalography (EEG is extensively used in the diagnosis of epilepsy yet its role as a prognostication method remains unclear. The aim of the present retrospective study is to investigate the relationship between serial EEG recordings and long-term clinical and social outcomes in a cohort of patients with epilepsy. Thirty-nine epileptic patients were monitored clinically and with repeat EEG recordings for more than 15 years. All patients who initially had epileptiform discharges ended up with poor or moderate seizure control whereas more than half of the patients with normal initial recordings had good clinical outcomes and satisfactory social adjustment. Deterioration of the recordings over time was associated with unfavourable results in a significant proportion of patients (90 %, while stable or improved EEG findings predicted a favourable outcome. It is concluded that serial EEG recordings can be used in the prognostic evaluation of epilepsy.

  12. Impact of video-ambulatory electroencephalography on the medical management of epilepsy.

    Science.gov (United States)

    Manfredonia, Francesco; Lawley, Andrew; Cavanna, Andrea E

    2016-06-15

    Video-ambulatory electroencephalography (video-AEEG) is increasingly being used in secondary care centres for the diagnostic work-up of new cases with suspected epilepsy and for the review of known cases with active seizures despite medical treatment. We reviewed how the outcome of video-AEEG influenced the medical management of patients who underwent this investigation at a neurophysiology department within a secondary care centre. Out of a total of 171 consecutive video-AEEG studies performed over a period of two years, 111 could be included in our retrospective analysis, based on availability and completeness of relevant clinical information pre- and post-investigation. In our sample, 55.9% of patients had typical clinical events captured on video-AEEG and diagnostic yield was higher in patients with a previously established diagnosis of epilepsy (n=62; diagnostic yield 62.9%). A total of 27 patients (24.3%) had changes in medical treatment following video-AEEG, most frequently antiepileptic drug introduction/increase when epileptic seizures were captured. This proportion was similar between patients with or without a previously established diagnosis of epilepsy. Our findings in a real-life setting confirm the usefulness of video-AEEG in influencing the clinical attitude towards complex patients with suspected or longstanding history of epilepsy. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Fuzzy topological digital space and their properties of flat electroencephalography in epilepsy disease

    Science.gov (United States)

    Muzafar Shah, Mazlina; Fatah Wahab, Abdul

    2017-09-01

    There are an abnormal electric activities or irregular interference in brain of epilepsy patient. Then a sensor will be put in patient’s scalp to measure and records all electric activities in brain. The result of the records known as Electroencephalography (EEG). The EEG has been transfer to flat EEG because it’s easier to analyze. In this study, the uncertainty in flat EEG data will be considered as fuzzy digital space. The purpose of this research is to show that the flat EEG is fuzzy topological digital space. Therefore, the main focus for this research is to introduce fuzzy topological digital space concepts with their properties such as neighbourhood, interior and closure by using fuzzy set digital concept and Chang’s fuzzy topology approach. The product fuzzy topology digital also will be shown. By introduce this concept, the data in flat EEG can considering having fuzzy topology digital properties and can identify the area in fuzzy digital space that has been affected by epilepsy seizure in epileptic patient’s brain.

  14. Decoding human swallowing via electroencephalography: a state-of-the-art review

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L.; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  15. Decoding repetitive finger movements with brain activity acquired via non-invasive electroencephalography

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    Andrew Young Paek

    2014-03-01

    Full Text Available We investigated how well repetitive finger tapping movements can be decoded from scalp electroencephalography (EEG signals. A linear decoder with memory was used to infer continuous index finger angular velocities from the low-pass filtered fluctuations of the amplitude of a plurality of EEG signals distributed across the scalp. To evaluate the accuracy of the decoder, the Pearson’s correlation coefficient (r between the observed and predicted trajectories was calculated in a 10-fold cross-validation scheme. We also assessed attempts to decode finger kinematics from EEG data that was cleaned with independent component analysis (ICA, EEG data from peripheral sensors, and EEG data from rest periods. A genetic algorithm was used to select combinations of EEG channels that maximized decoding accuracies. Our results (lower quartile r = 0.20, median r = 0.36, upper quartile r = 0.52 show that delta-band EEG signals contain useful information that can be used to infer finger kinematics. Further, the highest decoding accuracies were characterized by highly correlated delta band EEG activity mostly localized to the contralateral central areas of the scalp. Spectral analysis in alpha (8-13Hz and beta (20-30 Hz EEG respectively also showed focused bilateral alpha event related desynchronizations (ERDs over central scalp areas and contralateral beta event related synchronizations (ERSs localized to central scalp areas. Overall, this study demonstrates the feasibility of decoding finger kinematics from scalp EEG signals.

  16. Early history of electroencephalography and establishment of the American Clinical Neurophysiology Society.

    Science.gov (United States)

    Stone, James L; Hughes, John R

    2013-02-01

    The field of electroencephalography (EEG) had its origin with the discovery of recordable electrical potentials from activated nerves and muscles of animals and in the last quarter of the 19th century from the cerebral cortex of animals. By the 1920s, Hans Berger, a neuropsychiatrist from Germany, recorded potentials from the scalp of patients with skull defects and, a few years later, with more sensitive equipment from intact subjects. Concurrently, the introduction of electronic vacuum tube amplification and the cathode ray oscilloscope was made by American physiologists or "axonologists," interested in peripheral nerve recordings. Berger's findings were independently confirmed in early 1934 by Lord Adrian in England and by Hallowell Davis at Harvard, in the United States. In the United States, the earliest contributions to human EEG were made by Hallowell Davis, Herbert H. Jasper, Frederic A. Gibbs, William Lennox, and Alfred L. Loomis. Remarkable progress in the development of EEG as a useful clinical tool followed the 1935 report by the Harvard group on the electrographic and clinical correlations in patients with absence (petit mal) seizures and altered states of consciousness. Technical aspects of the EEG and additional clinical EEG correlations were elucidated by the above investigators and a number of others. Further study led to gatherings of the EEG pioneers at Loomis' laboratory in New York (1935-1939), Regional EEG society formation, and the American Clinical Neurophysiology Society in 1946.

  17. Computational testing for automated preprocessing: a Matlab toolbox to enable large scale electroencephalography data processing

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    Benjamin U. Cowley

    2017-03-01

    Full Text Available Electroencephalography (EEG is a rich source of information regarding brain function. However, the preprocessing of EEG data can be quite complicated, due to several factors. For example, the distinction between true neural sources and noise is indeterminate; EEG data can also be very large. The various factors create a large number of subjective decisions with consequent risk of compound error. Existing tools present the experimenter with a large choice of analysis methods. Yet it remains a challenge for the researcher to integrate methods for batch-processing of the average large datasets, and compare methods to choose an optimal approach across the many possible parameter configurations. Additionally, many tools still require a high degree of manual decision making for, e.g. the classification of artefacts in channels, epochs or segments. This introduces extra subjectivity, is slow and is not reproducible. Batching and well-designed automation can help to regularise EEG preprocessing, and thus reduce human effort, subjectivity and consequent error. We present the computational testing for automated preprocessing (CTAP toolbox, to facilitate: (i batch-processing that is easy for experts and novices alike; (ii testing and manual comparison of preprocessing methods. CTAP extends the existing data structure and functions from the well-known EEGLAB toolbox, based on Matlab and produces extensive quality control outputs. CTAP is available under MIT licence from https://github.com/bwrc/ctap.

  18. Enterprise stent in recanalizing non-acute atherosclerotic intracranial internal carotid artery occlusion.

    Science.gov (United States)

    Wang, Xiaofei; Wang, Zhigang; Ji, Yong; Ding, Xuan; Zang, Yizheng; Wang, Chengwei

    2017-11-01

    To investigate the safety and effectiveness of recanalization in non-acute occlusion of intracranial internal carotid arteries using the flexible Enterprise self-expanding stent. From June 2014 to June 2016, 12 consecutive patients with non-acute occlusion of intracranial internal carotid arteries received endovascular recanalization with Enterprise stenting. All patients received medication for anti-platelet aggregation therapy before and after the operation. The perioperative complications and recanalization efficacy were evaluated with the modified Rankin scoring system and digital subtraction angiography (DSA) follow-up, respectively. Endovascular recanalization was successfully performed in 10 out of 12 patients with Enterprise stenting. Stent implantation following balloon dilatation failed in one patient because the lumen diameter was too small. Another recanalization failed because the guide wire could not pass through the occlusion. No perioperative mortality was observed. One case of acute thrombosis and one case of intraoperative carotid spasm occurred, but these were resolved with thrombolytic therapy by microcatheter exposure treatment and antispasmodic medications, respectively. DSA follow-up in seven patients revealed no re-occlusion. One stroke event occurred in the 10 patients who completed the follow-up. A meaningful improvement in the modified Rankin score during follow-up was suggested by Wilcoxon signed-rank test results. The Enterprise stent was shown to be safe and efficient in recanalizing non-acute atherosclerotic intracranial internal carotid artery occlusion. However, the long-term outcomes need to be further investigated. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Neuro-ophthalmic presentations and treatment of Cryptococcal meningitis-related increased intracranial pressure.

    Science.gov (United States)

    Espino Barros Palau, Angelina; Morgan, Michael L; Foroozan, Rod; Lee, Andrew G

    2014-10-01

    To illustrate three different ophthalmic presentations of cryptococcal meningitis (CM). CM is the most common manifestation of extra-pulmonary cryptococcosis. Intracranial hypertension occurs in up to 75% of patients with CM and is associated with increased mortality. CM can present to the ophthalmologist as vision loss, papilledema, abducens palsy, and/or other cranial neuropathies. We report three cases, two C. neoformans and one C. gattii, highlighting the various CM presentations. The first was a woman immunosuppressed following kidney transplantation in whom idiopathic intracranial hypertension (IIH) was initially suspected. The second was a man immunocompromised by previously undiagnosed HIV/AIDS who presented with signs and symptoms of increased intracranial pressure. The third case is an immunocompetent man with bilateral disc edema and an incomplete macular star diagnosed with presumed neuroretinitis. Further evaluation revealed positive CSF cryptococcal antigen with culture positive for C. gattii. Ophthalmologists should be aware that cryptococcosis can mimic more benign etiologies including IIH and neuroretinitis. Additionally, C. gattii, an emerging organism, can infect immunocompetent patients. In contrast to the typical treatment of increased ICP, serial lumbar punctures are recommended while acetazolamide and surgical CSF shunting may be harmful. Copyright © 2014 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  20. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury.

    Science.gov (United States)

    Lund, Anton; Damholt, Mette B; Strange, Ditte G; Kelsen, Jesper; Møller-Sørensen, Hasse; Møller, Kirsten

    2017-01-01

    Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension. CT of the brain showed diffuse cerebral edema. CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized. Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content. During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis. In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered.

  1. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury

    Directory of Open Access Journals (Sweden)

    Anton Lund

    2017-01-01

    Full Text Available Dialysis disequilibrium syndrome (DDS is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension. CT of the brain showed diffuse cerebral edema. CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized. Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content. During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis. In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered.

  2. Intracranial structural alteration predicts treatment outcome in patients with spontaneous intracranial hypotension.

    Science.gov (United States)

    Choi, Hanna; Lee, Mi Ji; Choi, Hyun Ah; Cha, Jihoon; Chung, Chin-Sang

    2018-02-01

    Background Intracranial structural dislocation in spontaneous intracranial hypotension (SIH) can be measured by various intracranial angles and distances. We aimed to identify the clinical significance of structural dislocation in relation to treatment outcome in patients with SIH. Methods In this retrospective analysis, we identified patients with SIH who received an epidural blood patch (EBP) at Samsung Medical Center from January 2005 to March 2015. Structural dislocation in pretreatment MRIs of SIH patients was assessed by measuring tonsillar herniation, mamillopontine distance, the angle between the vein of Galen and straight sinus (vG/SS angle), the pontomesencephalic angle, and the lateral ventricular angle. After the first EBP, poor response was defined as the persistence of symptoms that prompted a repeat EBP. Results Out of the 95 patients included, 31 (32.6%) showed poor response. Among the radiological markers of structural dislocation, the vG/SS angle was associated with poor response (49.82 ± 16.40° vs 66.58 ± 26.08°, p = 0.002). Among clinical variables, premorbid migraine ( p = 0.036) was related to poor response. In multivariate analysis, reduced vG/SS angle was independently associated with poor response (OR 1.04 [95% CI 1.01 - 1.07] per 1° decrease, p = 0.006). In 23 patients who underwent MRI after successful treatment, the vG/SS angle significantly increased after the EBP ( p < 0.001, by paired t-test), while two patients with aggravation or recurrence showed a further reduction of their vG/SS angles. Conclusions Intracranial structural dislocation, measured by the vG/SS angle, is associated with poor response to the first EBP in patients with SIH. Successful treatment can reverse the structural dislocation.

  3. Chronic fatigue syndrome and idiopathic intracranial hypertension: Different manifestations of the same disorder of intracranial pressure?

    Science.gov (United States)

    Higgins, J Nicholas P; Pickard, John D; Lever, Andrew M L

    2017-08-01

    Though not discussed in the medical literature or considered in clinical practice, there are similarities between chronic fatigue syndrome and idiopathic intracranial hypertension (IIH) which ought to encourage exploration of a link between them. The cardinal symptoms of each - fatigue and headache - are common in the other and their multiple other symptoms are frequently seen in both. The single discriminating factor is raised intracranial pressure, evidenced in IIH usually by the sign of papilloedema, regarded as responsible for the visual symptoms which can lead to blindness. Some patients with IIH, however, do not have papilloedema and these patients may be clinically indistinguishable from patients with chronic fatigue syndrome. Yet IIH is rare, IIH without papilloedema (IIHWOP) seems rarer still, while chronic fatigue syndrome is common. So are the clinical parallels spurious or is there a way to reconcile these conflicting observations? We suggest that it is a quirk of clinical measurement that has created this discrepancy. Specifically, that the criteria put in place to define IIH have led to a failure to appreciate the existence, clinical significance or numerical importance of patients with lower level disturbances of intracranial pressure. We argue that this has led to a grossly implausible distortion of the epidemiology of IIH such that the milder form of the illness (IIHWOP) is seen as less common than the more severe and that this would be resolved by recognising a connection with chronic fatigue syndrome. We hypothesise, therefore, that IIH, IIHWOP, lesser forms of IIH and an undetermined proportion of chronic fatigue cases are all manifestations of the same disorder of intracranial pressure across a spectrum of disease severity, in which this subset of chronic fatigue syndrome would represent the most common and least severe and IIH the least common and most extreme. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Topographic Surgical Anatomy of the Parasylvian Anterior Temporal Artery for Intracranial-Intracranial Bypass.

    Science.gov (United States)

    Meybodi, Ali Tayebi; Griswold, Dylan; Tabani, Halima; Lawton, Michael T; Mokhtari, Pooneh; Payman, Andre; Benet, Arnau

    2016-09-01

    The anterior temporal artery (ATA) is an appealing donor artery for intracranial-intracranial bypass procedures. However, its identification may be difficult. Current literature lacks useful landmarks to help identify the ATA at the surface of the sylvian fissure. The objective of this study was to define the topographic anatomy of the cortical segment of the ATA relative to constant landmarks exposed during the pterional approach. The temporopolar artery (TPA), ATA, and middle temporal artery (MTA) were examined in 16 cadaveric specimens. The topographic anatomy and key landmarks of the arteries at the sylvian fissure were recorded. The distance between the point of emergence from the sylvian fissure to the lesser sphenoid wing and anterior tip of the temporal lobe was measured. The features of the inferior frontal gyrus relative to each of the arteries at the sylvian fissure were also recorded. The average distances from the lesser sphenoid wing to the TPA, ATA, and MTA were 3.7 mm, 21.2 mm, and 37 mm. The mean distances from the temporal pole were TPA, 14.7 mm; ATA, 32.0 mm; and MTA, 45.4 mm. The differences between the average distances were statistically significant (P < 0.0001). The ATA most frequently faced pars triangularis, whereas the TPA always faced pars orbitalis. The MTA was always found posterior to the junction of pars triangularis and pars opercularis. This article provides topographic evidence for efficient identification of the ATA in the parasylvian space. The key relationship and landmarks identified in this study may increase efficiency and safety when harvesting the ATA for intracranial-intracranial bypass. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Intracranial subdural hematoma coexisting with improvement in spontaneous intracranial hypotension after an epidural blood patch

    Directory of Open Access Journals (Sweden)

    Cheng-Hsi Chang

    2012-11-01

    Full Text Available A 36-year-old male had spontaneous intracranial hypotension (SIH presenting with refractory headache for 4 months. Multiple epidural blood patches (EBPs yielded relief of symptoms, but the course was complicated, with asymptomatic intracranial subdural hematoma (SDH. Except for SDH, other radiological diagnostic signs of SIH were resolved and the patient’s headaches improved after EBP. Owing to a mass effect and persistent cerebrospinal fluid (CSF leakage, surgical repair of the spinal leakage was performed, but no cranial procedures were carried out. Postoperatively, the SDH completely resolved, but there was still CSF leakage at the level where surgery was performed. The patient has remained free of headache or other events for 3 years. It was reduction rather than elimination of the spinal CSF leak that yielded remission of SIH. In summary, intracranial SDH can be a complication of inadequately treated SIH (i.e. persistent minor CSF leakage. Management of SDH should focus on correction of the underlying SIH rather than craniotomy for hematoma evacuation.

  6. Intracranial subdural hematoma coexisting with improvement in spontaneous intracranial hypotension after an epidural blood patch.

    Science.gov (United States)

    Chang, Cheng-Hsi; Wu, Jau-Ching; Tu, Tsung-Hsi; Chen, Hung-Chieh; Huang, Wen-Cheng; Hseu, Shu-Shya; Lirng, Jiing-Feng; Wang, Shuu-Jiun; Cheng, Henrich; Ko, Chin-Chu

    2012-11-01

    A 36-year-old male had spontaneous intracranial hypotension (SIH) presenting with refractory headache for 4 months. Multiple epidural blood patches (EBPs) yielded relief of symptoms, but the course was complicated, with asymptomatic intracranial subdural hematoma (SDH). Except for SDH, other radiological diagnostic signs of SIH were resolved and the patient's headaches improved after EBP. Owing to a mass effect and persistent cerebrospinal fluid (CSF) leakage, surgical repair of the spinal leakage was performed, but no cranial procedures were carried out. Postoperatively, the SDH completely resolved, but there was still CSF leakage at the level where surgery was performed. The patient has remained free of headache or other events for 3 years. It was reduction rather than elimination of the spinal CSF leak that yielded remission of SIH. In summary, intracranial SDH can be a complication of inadequately treated SIH (i.e. persistent minor CSF leakage). Management of SDH should focus on correction of the underlying SIH rather than craniotomy for hematoma evacuation. Copyright © 2012. Published by Elsevier B.V.

  7. Management of raised intracranial pressure and hyperosmolar therapy.

    Science.gov (United States)

    Ropper, Allan H

    2014-06-01

    The management of raised intracranial pressure is undergoing rapid change. The choice of medical treatments to reduce intracranial pressure varies between institutions and regions of the world. The mainstay of therapy, however, continues to be the infusion of a hyperosmolar solution to achieve an osmotic gradient to force the exit of water from the brain. This review introduces the basic concepts of raised intracranial pressure, summarises several recent studies that have challenged dogma in the field, and provides practical advice on hyperosmolar treatment, based on personal experience and a critical reading of the literature.

  8. Natriuretic pro-peptides in idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Skau, Maren Cecilie Kloppenbor; Gøtze, Jens Peter; Rehfeld, Jens F.

    2010-01-01

    Idiopathic intracranial hypertension is a disorder of unknown pathogenesis. Natriuretic peptides may be involved in intracranial pressure regulation, but cerebrospinal fluid (CNS) and plasma concentrations in this disorder are unknown. We evaluated venous and intrathecal concentrations of ANP, BNP...... and CNP precursor peptides in 40 patients with idiopathic intracranial hypertension and in 20 controls. Natriuretic pro-peptides were quantitated using processing-independent assays. In CSF, no differences in peptide concentrations between patients and controls were found (proANP: 239 + or - 23 vs 231...

  9. A Case Of Ollier′s Disease With Intracranial Enchondroma

    Directory of Open Access Journals (Sweden)

    Sidharthan Neeraj

    2005-01-01

    Full Text Available The syndrome of multiple enchondromas is known as Ollier′s disease. Enchondromas are benign tumours of hyaline cartilage arising within the medullary cavity of tubular bones. We are reporting the case of a 16 year old girl with Ollier′s disease who presented with seizures and brainstem compression. A MRI scan of brain showed an intracranial space-occupying lesion in the region of clivus. The intracranial tumour was surgically removed and the histopathology confirmed the diagnosis of enchondroma. Intracranial enchondroma is an extremely rare situation and reported for the first time from south India.

  10. [Measurement of intracranial hematoma volume by personal computer].

    Science.gov (United States)

    DU, Wanping; Tan, Lihua; Zhai, Ning; Zhou, Shunke; Wang, Rui; Xue, Gongshi; Xiao, An

    2011-01-01

    To explore the method for intracranial hematoma volume measurement by the personal computer. Forty cases of various intracranial hematomas were measured by the computer tomography with quantitative software and personal computer with Photoshop CS3 software, respectively. the data from the 2 methods were analyzed and compared. There was no difference between the data from the computer tomography and the personal computer (P>0.05). The personal computer with Photoshop CS3 software can measure the volume of various intracranial hematomas precisely, rapidly and simply. It should be recommended in the clinical medicolegal identification.

  11. Decreased Functional Connectivity and Disturbed Directionality of Information Flow in the Electroencephalography of Intensive Care Unit Patients with Delirium after Cardiac Surgery

    NARCIS (Netherlands)

    van Dellen, E.; van der Kooi, A.W.; Numan, T.; Koek, H.L.; Klijn, F.A.M.; Buijsrogge, M.P.; Stam, C.J.; Slooter, A.J.C.

    2014-01-01

    BACKGROUND:: In this article, the authors explore functional connectivity and network topology in electroencephalography recordings of patients with delirium after cardiac surgery, aiming to improve the understanding of the pathophysiology and phenomenology of delirium. The authors hypothesize that

  12. Bedside Optic Nerve Sheath Diameter Assessment in the Identification of Increased Intracranial Pressure in Suspected Idiopathic Intracranial Hypertension.

    Science.gov (United States)

    Irazuzta, Jose E; Brown, Martha E; Akhtar, Javed

    2016-01-01

    We determined whether the bedside assessment of the optic nerve sheath diameter could identify elevated intracranial pressure in individuals with suspected idiopathic intracranial hypertension. This was a single-center, prospective, rater-blinded study performed in a freestanding pediatric teaching hospital. Patients aged 12 to 18 years scheduled for an elective lumbar puncture with the suspicion of idiopathic intracranial hypertension were eligible to participate. Optic nerve sheath diameter was measured via ultrasonography before performing a sedated lumbar puncture for measuring cerebrospinal fluid opening pressure. Abnormal measurements were predefined as optic nerve sheath diameter ≥4.5 mm and a cerebrospinal fluid opening pressure greater than 20 cmH2O. Thirteen patients participated in the study, 10 of whom had elevated intracranial pressure. Optic nerve sheath diameter was able to predict or rule out elevated intracranial pressure in all patients. Noninvasive assessment of the optic nerve sheath diameter could help to identify patients with elevated intracranial pressure when idiopathic intracranial hypertension is suspected. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Intracranial Infectious Aneurysm in Orbital Cellulitis.

    Science.gov (United States)

    Lee, Brian; Kim, Charles; Carrasco, Jacqueline

    2015-01-01

    Infectious intracranial aneurysm and cavernous sinus thrombosis are rare complications of orbital cellulitis. We report the case of a 46-year-old male presenting with sinusitis and orbital cellulitis complicated by the development of an orbital mass. Following orbitotomy with debulking, the patient underwent bony orbital decompression for increasing proptosis postoperatively. While his exam stabilized, the patient developed complete ptosis and extraocular motor palsy in the contralateral eye after undergoing bilateral sinus debridement. Imaging was notable for the presence of a pseudoaneurysm of the internal carotid artery, which was treated with a stent. This report demonstrates rare complications of orbital cellulitis. These patients should be monitored carefully with noninvasive imaging studies, such as cerebral angiography, for early detection of vascular abnormalities that can progress rapidly.

  14. Computer tomography of intracranial tumours and hematomas

    International Nuclear Information System (INIS)

    Tans, J.T.J.

    1978-01-01

    The value of computed tomography (CT) for the diagnosis of intracranial tumors and hematomas was investigated in a retrospective study comprising 220 patients. All C.T.scans are reviewed and described in detail. To assess the diagnostic accuracy, the original interpretation of the C.T.scans was compared with that of conventional neuroradiological and neurophysiological examinations. The aspect on C.T. of the various types of tumors and hematomas proved to vary widely and specific features were seldom seen. This holds particularly for the malignant tumors. Benign tumors such as meningeomas, adenomas and neurilemmomas showed a rather easily identifiable and almost identical picture of the C.T.scan, and diagnosis had to be based mainly on differences in localization. The hematomas, with the exception of the older intracerebral ones, showed the most characteristic C.T.abnormalities. (Auth.)

  15. Intracranial developmental venous anomaly: is it asymptomatic?

    Science.gov (United States)

    Puente, A Bolívar; de Asís Bravo Rodríguez, F; Bravo Rey, I; Romero, E Roldán

    2018-03-16

    Intracranial developmental venous anomalies are the most common vascular malformation. In the immense majority of cases, these anomalies are asymptomatic and discovered incidentally, and they are considered benign. Very exceptionally, however, they can cause neurological symptoms. In this article, we present three cases of patients with developmental venous anomalies that presented with different symptoms owing to complications derived from altered venous drainage. These anomalies were located in the left insula, right temporal lobe, and cerebellum. The exceptionality of the cases presented as well as of the images associated, which show the mechanism through which the symptoms developed, lies in the low incidence of symptomatic developmental venous anomalies reported in the literature. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Intracranial Aspergillosis in an Immunocompetent Young Woman.

    Science.gov (United States)

    Panda, Prasan Kumar; Mavidi, Sunil Kumar; Wig, Naveet; Garg, Ajay; Nalwa, Aasma; Sharma, M C

    2017-06-01

    Intracranial aspergillosis (ICA) is very rare in the immunocompetent individuals, usually misdiagnosed as a tumor or an abscess. A high index of clinical suspicion is required in patients who present with focal neurological deficits, headache, or seizures. We report the case of a 25-year-old immunocompetent female, who presented with a 15-month history of headache, seizures, left-sided proptosis and ophthalmoplegia, and right hemiparesis. Recovery from the symptoms and decrease in the lesion size seen on the radiological assessment were achieved through two decompressive craniotomies followed by prolonged combined systemic antifungal therapies. Although the initial neuroimaging suggested a mitotic pathology, the surgical sample confirmed ICA. Now the patient is on single antifungal therapy (Tab. voriconazole, 200 mg twice daily) and doing her daily activities, but with a reduced intelligent quotient. We report a challenging case of ICA where multiple courses of combined antifungal therapies and repeat surgeries paved the way for a good prognosis.

  17. Endovascular treatment of very small intracranial aneurysms

    DEFF Research Database (Denmark)

    Iskandar, A; Nepper-Rasmussen, J

    2011-01-01

    to large aneurysms (> 3 mm). However the data also suggest that endovascular treatment of very small aneurysms might be associated with an increased risk of procedural ruptures and mortality. At nine-month follow-up results indicate significantly less compaction in the very small aneurysms....... endovascular treatment was attempted in 956 consecutive intracranial aneurysms. Of 956 aneurysms, 111 aneurysms were very small aneurysms with a maximal diameter of 3 mm or less. We conducted a retrospective analysis of angiographic and clinical outcome following coiling of very small aneurysms...... aneurysms and less than 90% aneurysm occlusion in six aneurysms. Complications occurred in the treatment of 15 aneurysms, including eight procedural ruptures, six thromboembolic events and one case of early hemorrhage. Compared with larger aneurysms, treatment of very small aneurysms was associated...

  18. MRI of intracranial germ cell tumours

    International Nuclear Information System (INIS)

    Sumida, M.; Uozumi, T.; Kiya, K.; Mukada, K.; Arita, K.; Kurisu, K.; Sugiyama, K.; Onda, J.; Satoh, H.; Ikawa, F.; Migita, K.

    1995-01-01

    We reviewed MRI findings in proven intracranial germ cell tumours in 22 cases, 12 of whom received Gd-DTPA. On T1-weighted images, the signal intensity of the tumour parenchyma was moderately low in 19 cases and isointense in 3; on T2-weighted images, it was high in all cases. Regions of different intensity thought to be cysts were found in 17 (77 %): 7 of 12 patients with germinoma (58 %) and in all other cases. Of the 13 patients with pineal lesions T1-weighted sagittal images showed the aqueduct to be obstructed in 5, stenotic in 7 and normal in 1. Strong contrast enhancement was observed in all 12 cases. Of the 14 patients with suprasellar lesions, 5 were found to have an intrasellar extension, and in 3 of these, the normal pituitary gland, which could be distinguished from the tumour, was displaced anteriorly. Ten patients (45 %) had multiple lesions. (orig.)

  19. Effect of radiation therapy against intracranial hemangiopericytoma

    International Nuclear Information System (INIS)

    Uemura, Shozaburo; Kuratsu, Jun-ichi; Hamada, Jun-ichiro; Yoshioka, Susumu; Kochi, Masato; Ushio, Yukitaka; Nakahara, Tadashi; Kishida, Katsuaki.

    1992-01-01

    Seven cases of intracranial hemangiopericytoma were studied retrospectively to investigate the efficacy of radiation therapy. Tumor response evaluated by computed tomography and magnetic resonance imaging was obvious after 20-30 Gy irradiation. The total reduction rate was 80-90% and continued as long as 5-7 months after treatment. In five patients receiving radiation therapy before radical removal, the tumors were easily removed without massive hemorrhage. Histological inspection of specimens after irradiation showed a significant disappearance of tumor cells. Pyknosis frequently occurred in endothelial cells, and proliferating vessels with hyalinoid degeneration were also seen. Reticulin fibers between tumor cells were fewer, split, or absent. Preoperative radiation therapy is useful in the treatment of hemangiopericytoma involving considerable surgical risk. Postoperative radiation therapy should be given even if removal is complete. (author)

  20. Intracranial calcification on paediatric computed tomography

    International Nuclear Information System (INIS)

    Kendall, B.; Cavanagh, N.

    1986-01-01

    An analysis of the computed tomograms of 18000 children examined consecutively form the basis of an assessment of the diagnostic significance of intracranial calcification. The low incidence of physiological calcification in the pineal and choroid of about 2% up to the age of 8 years, but increasing 5-fold by the age of 15 years, is confirmed. Pathological calcification occurred in 1.6%, the commonest causes being neoplasms (43%), neuroectodermal syndromes (20%) and infections (12%). Diffuse basal ganglia calcification (15%) bore little relation to the diverse clinical symptomatology, and routine bio-chemical studies showed a disorder of metabolism to be present in only 6 cases. Calcification has not been previously noted in acute haemorrhagic leukoencephalitis, Pertussis or Cocksackie encephalitis, infantile neuraxonal dystrophy, Marinesco-Sjoegren syndrome or in the basal ganglia in neurofibromatosis. (orig.)

  1. Converging intracranial markers of conscious access.

    Directory of Open Access Journals (Sweden)

    Raphaël Gaillard

    2009-03-01

    Full Text Available We compared conscious and nonconscious processing of briefly flashed words using a visual masking procedure while recording intracranial electroencephalogram (iEEG in ten patients. Nonconscious processing of masked words was observed in multiple cortical areas, mostly within an early time window (<300 ms, accompanied by induced gamma-band activity, but without coherent long-distance neural activity, suggesting a quickly dissipating feedforward wave. In contrast, conscious processing of unmasked words was characterized by the convergence of four distinct neurophysiological markers: sustained voltage changes, particularly in prefrontal cortex, large increases in spectral power in the gamma band, increases in long-distance phase synchrony in the beta range, and increases in long-range Granger causality. We argue that all of those measures provide distinct windows into the same distributed state of conscious processing. These results have a direct impact on current theoretical discussions concerning the neural correlates of conscious access.

  2. Imaging features of intracranial solitary fibrous tumors

    International Nuclear Information System (INIS)

    Yu Shuilian; Man Yuping; Ma Longbai; Liu Ying; Wei Qiang; Zhu Youkai

    2012-01-01

    Objective: To summarize the imaging features of intracranial solitary fibrous tumors (ISFT). Methods: Ten patients with ISFT proven histopathologically were collected. Four cases had CT data and all cases had MR data. The imaging features and pathological results were retrospectively analyzed. Results: All cases were misdiagnosed as meningioma at pre-operation. All lesions arose from intracranial meninges including 5 lesions above the tentorium, 4 lesions beneath the tentorium and 1 lesion growing around the tentorium. The margins of all the masses were well defined, and 8 lesions presented multilobular shape. CT demonstrated hyerattenuated masses in all 4 lesions, smooth erosion of the basicranial skull in 1 lesion, and punctiform calcification of the capsule in 1 lesion. T 1 WI showed most lesions with isointense or slight hyperintense signals including homogeneous in 4 lesions and heterogeneous in 6 lesions. T 2 WI demonstrated isointense or slight hyperintense in 2 lesions, mixed hypointense and hyperintense signals in 4, cystic portion in 2, and two distinct portion of hyperintense and hypointense signal, so called 'yin-yang' pattern, in 2. Strong enhanced was found in all lesions, especially in 8 lesion with heterogeneous with the low T 2 signal. 'Dural tail' was found in 4 lesions. Conclusions: ISFI has some specific CT and MR features including heterogeneous signal intensity on T 2 WI, strong enhancement of areas with low T 2 signal intensity, slight or no 'dural tail', without skull thickening, and the typical 'yin-yang' pattern. (authors)

  3. Visual Impairment/Intracranial Pressure Risk Assessment

    Science.gov (United States)

    Fogarty, Jennifer A.; Durham, T.; Otto, C.; Grounds, D.; Davis, J. R.

    2010-01-01

    Since 2006 there have been 6 reported cases of altered visual acuity and intracranial pressure (ICP) in long duration astronauts. In order to document this risk and develop an integrated approach to its mitigation, the NASA Space Life Sciences Directorate (SLSD) and Human Research Program (HRP) have chosen to use the Human System Risk Board (HSRB) and the risk management analysis tool (RMAT). The HSRB is the venue in which the stakeholders and customers discuss and vet the evidence and the RMAT is the tool that facilitates documentation and comparison of the evidence across mission profiles as well as identification of risk factors, and documentation of mitigation strategies. This process allows for information to be brought forward and dispositioned so that it may be properly incorporated into the RMAT and contribute to the design of the research and mitigation plans. The evidence thus far has resulted in the identification of a visual impairment/intracranial pressure (VIIP) project team, updating of both short and long duration medical requirements designed to assess visual acuity, and a research plan to characterize this issue further. In order to understand this issue more completely, a plan to develop an Accelerated Research Collaboration (ARC) has been approved by the HSRB. The ARC is a novel research model pioneered by the Myelin Repair Foundation. It is a patient centered research model that brings together researchers and clinicians, under the guidance of a scientific advisory panel, to collaborate and produce results much quickly than accomplished through traditional research models. The data and evidence from the updated medical requirements and the VIIP ARC will be reviewed at the HSRB on a regular basis. Each review package presented to the HSRB will include an assessment and recommendation with respect to continuation of research, countermeasure development, occupational surveillance modalities, selection criteria, etc. This process will determine the

  4. Structured Reporting in Neuroradiology: Intracranial Tumors.

    Science.gov (United States)

    Bink, Andrea; Benner, Jan; Reinhardt, Julia; De Vere-Tyndall, Anthony; Stieltjes, Bram; Hainc, Nicolin; Stippich, Christoph

    2018-01-01

    The aim of this pilot study was to assess the clinical feasibility, diagnostic yield, advantages, and disadvantages of structured reporting for routine MRI-reading in patients with primary diagnosis of intracranial tumors as compared to traditional neuroradiological free text reporting. A structured MRI reporting template was developed covering pathological, anatomical, and functional aspects in an itemized fashion. Retrospectively, 60 consecutive patients with first diagnosis of an intracranial tumor were selected from the radiology information system/PACS system. Structured reporting was performed by a senior neuroradiologist, blinded to clinical and radiological data. Reporting times were measured per patient. The diagnostic content was compared to free text reporting which was independently performed on the same MRI exams by two other neuroradiologists. The comparisons were categorized per item as: "congruent," "partially congruent," "incongruent," or "not mentioned in free-style report." Tumor-related items: congruent findings were found for all items (17/17) with congruence rates ranging between 98 and 39% per item. Four items achieved congruence rates ≥90%, 5 items >80%, and 9 items ≥70%. Partially congruent findings were found for all items in up to 50% per item. Incongruent findings were present in 7/17 items in up to 5% per item. Free text reports did not mention 12 of 17 items (range 7-43% per item). Non-tumor-related items, including brain atrophy, microangiopathy, vascular pathologies, and various extracranial pathologies, which were not mentioned in free-text reports between 18 and 85% per item. Mean reporting time for structured reporting was 7:49 min (3:12-17:06 min). First results showed that expert structured reporting ensured reliable detection of all relevant brain pathologies along with reproducible documentation of all predefined diagnostic items, which was not always the case for free text reporting. A mean reporting time of 8

  5. Intracranial pressure changes during mouse development.

    Science.gov (United States)

    Moazen, Mehran; Alazmani, Ali; Rafferty, Katherine; Liu, Zi-Jun; Gustafson, Jennifer; Cunningham, Michael L; Fagan, Michael J; Herring, Susan W

    2016-01-04

    During early stages of postnatal development, pressure from the growing brain as well as cerebrospinal fluid, i.e. intracranial pressure (ICP), load the calvarial bones. It is likely that such loading contributes to the peripheral bone formation at the sutural edges of calvarial bones, especially shortly after birth when the brain is growing rapidly. The aim of this study was to quantify ICP during mouse development. A custom pressure monitoring system was developed and calibrated. It was then used to measure ICP in a total of seventy three wild type mice at postnatal (P) day 3, 10, 20, 31 and 70. Retrospectively, the sample in each age group with the closest ICP to the average value was scanned using micro-computed tomography to estimate cranial growth. ICP increased from 1.33±0.87mmHg at P3 to 1.92±0.78mmHg at P10 and 3.60±1.08mmHg at P20. In older animals, ICP plateaued at about 4mmHg. There were statistically significant differences between the ICP at the P3 vs. P20, and P10 vs. P20. In the samples that were scanned, intracranial volume and skull length followed a similar pattern of increase up to P20 and then plateaued at older ages. These data are consistent with the possibility of ICP being a contributing factor to bone formation at the sutures during early stages of development. The data can be further used for development and validation of computational models of skull growth. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Endovascular Treatment of Unruptured Intracranial Aneurysms

    Science.gov (United States)

    Yue, W.

    2011-01-01

    Summary We report the clinical and angiographic results of endovascular treatment of unruptured intracranial aneurysms. Over a three-year period, 80 unruptured aneurysms in 74 patients were electively treated with endovascular management. One aneurysm was diagnosed during investigations for a second ruptured aneurysm, 54 aneurysms were incidentally discovered, 18 aneurysms presented with symptoms of mass effect and seven aneurysms presented with symptoms of brain stem ischemia. Mean size of the 80 unruptured aneurysms was 12.5±8.0 mm (range, 2-39 mm). Thirty-six aneurysms (45%) were small (<10 mm), 38 aneurysms (47.5%) were large (10-25 mm), and six aneurysms (7.5%) were giant (25-39 mm). Forty-eight wide-necked aneurysms (60%) were coiled with the aid of a supporting device. The mortality rate was 1.25%, and the overall morbidity was 1.25%. Of these, one of the patients suffered a stroke, leading to severe disability (1.25%). In one patient, the aneurysm ruptured during treatment, resulting in death. Initial aneurysm occlusion was complete (100%) in 76.25% aneurysms, nearly complete (90%-98%) in 10% aneurysms and incomplete (60%-85%) in 13.75% aneurysms. Follow-up angiography was available in 67 patients with 73 treated aneurysms (91.25%) from one to 36 months (mean 9.3 months); partial reopening occurred in 7.5%, mainly large and giant aneurysms (5.5%). Additional coiling was performed in four aneurysms. There were no complications in additional treatments. At 14.1-month clinical follow-up (range, 2 to 36 months), mRS score was 0 in 78.75% patients, 1 in 10% patients, 2 in 8.75% and 3 in 1.25%. There was no aneurysmal rupture during the follow-up period. Endovascular treatment of unruptured intracranial aneurysms has low procedural mortality and morbidity rates. PMID:22192544

  7. Magnetic resonance imaging of intracranial hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Todoroki, Koji; Asakura, Tetsuhiko; Uetsuhara, Koichi; Kadota, Koki; Komasaku, Ryuichiro; Kanemaru, Reizou; Fujimoto, Toshirou; Yamamoto, Kunimitsu

    1987-12-01

    A sequential MR scan was performed on 21 patients with intracranial hematoma, and simultaneously the T/sub 1/ values of the hematomas were calculated. The T/sub 1/ value of a hematoma was found to be longer than that of the white matter in the acute phase, but it soon becomes as short as that of the white matter (7 - 10 day after). After several days, the T/sub 1/ value again gradually becomes longer. In the experiment, 30 ml of fresh blood (15 samples) were stored at room temperature, and a sequential MR scan and the calculation of the T/sub 1/ were performed over a period of 20 days. In vitro, most of the T/sub 1/ values were long, but there was much variation on the first day. A shortening of the T/sub 1/ was observed as well in vivo, and after this shortening, no prolongation of the T/sub 1/ was observed. Perhaps the shortening of T/sub 1/ was caused by the denaturation of the hemoglobin to methemoglobin and by the coagulation of the blood. The lysis and absorption of the hematoma may, on the other hand, cause the prolongation of the T/sub 1/ in vitro. For the diagnosis of intracranial hematoma, CT was found to be a method superior to MRI, especially in the acute phase. However, MRI gives us more information about hematoma (concerning the denaturation of the hemoglobin to methemoglobin, the lysis and absorption of the hematoma, the range of hemorrhagic tissue and edema, etc.) than does CT. An IR (T/sub 1/-weighted) image shows a good contrast between the hematoma and the surrounding tissue (hemorrhagic tissue, edema) in the early phase. On the other hand, the SE (T/sub 2/-weighted) image informs us of the lesion when the hematoma is low approx. isodense on the CT in the chronic phase.

  8. Noninvasive assessment of intracranial elastance and pressure in spontaneous intracranial hypotension by MRI.

    Science.gov (United States)

    Tsai, Yi-Hsin; Chen, Hung-Chieh; Tung, Hsin; Wu, Yi-Ying; Chen, Hsian-Min; Pan, Kuan-Jung; Cheng, Da-Chuan; Chen, Jeon-Hor; Chen, Clayton Chi-Chang; Chai, Jyh-Wen; Shen, Wu-Chung

    2018-02-13

    Spontaneous intracranial hypotension (SIH) is often misdiagnosed, and can lead to severe complications. Conventional MR sequences show a limited ability to aid in this diagnosis. MR-based intracranial pressure (MR-ICP) may be able to detect changes of intracranial elastance and pressure. To determine whether MR-ICP is able to differentiate SIH patients from normal subjects, improve diagnostic sensitivity, and provide an insight into the pathophysiology. Prospective. Twenty-eight SIH cases with orthostatic headache and 20 healthy volunteers. Cine phase-contrast MRI on a 1.5T scanner. Intracranial elastance (IE) was derived from the ratio of the peak-to-peak cerebrospinal fluid (CSF) pressure gradient (PG csf-pp ) and intracranial volume change, obtained by summing all flows before each sequential cardiac frame. Student's t-test was used to compare the MR-ICP indexes and flow parameters between SIH patients and healthy volunteers (P < 0.01). The SIH patients with cervical epidural venous dilatation (EVD) had an IE of 0.121 ± 0.027 mmHg/cm/ml, significantly higher than that of the normal volunteers (0.085 ± 0.027 mmHg/cm/ml; P = 0.002). In contradistinction, the EVD-negative SIH patients, including four with no sign of CSF leaks, had significantly lower IE (0.055 ± 0.012 mmHg/cm/ml) compared with the normal volunteers and the EVD-positive group (P = 0.001, P < 0.001). The EVD-negative patients had significantly lower PG csf-pp (0.024 ± 0.007 mmHg/cm) compared with the normal volunteers and the EVD-positive group (0.035 ± 0.011 mmHg/cm, 0.040 ± 0.010 mmHg/cm; P = 0.003, P < 0.001). Additionally, the MRI flow study showed a significant decrease in transcranial inflow and outflow of SIH patients (P < 0.01). We found that the MR-ICP method is potentially more sensitive than morphological MRI in the early diagnosis of SIH. Also, contrary to common belief, our results suggest that an abnormal craniospinal elastance

  9. Lumbosacral Subdural Hematoma After Glioblastoma Multiforme Resection: Possible Radiographic Evidence for the Downward Migration of Intracranial Blood.

    Science.gov (United States)

    Paisan, Gabriella M; Buell, Thomas J; Raper, Daniel; Asthagiri, Ashok

    2017-12-01

    Spinal subdural hematomas (SSDHs) are rare and usually associated with bleeding diatheses, trauma, iatrogenic injury, spinal vascular malformations, or intraspinal tumors. We report a case of a 75-year-old man who developed a symptomatic lumbosacral SSDH after undergoing resection of a right temporal glioblastoma multiforme. The patient subsequently recovered and was discharged home. Over the next 2 weeks, he developed progressively worsening symptoms of lower back pain, lower extremity weakness, and urinary retention. Although the patient had no known risk factors for developing a SSDH, magnetic resonance imaging on postoperative day 16 revealed an extensive L2-sacrum SSDH. The patient underwent L2-L5 total laminectomies for evacuation of the SSDH. His symptoms resolved after surgery. Literature review produced 26 other cases of SSDHs after intracranial surgery in patients without obvious risk factors. In our case, the lumbosacral SSDH may have originated from downward migration of intracranial blood in a gravity-dependent fashion. Radiographic evidence of blood within the posterior thecal sac of the patient's cervical spine supports this hypothesis. In most cases, SSDHs after intracranial surgery resolve with conservative treatment; however, as shown in our case, surgery may be required if there is progressive neurologic decline. Neurosurgeons should be aware of this potential complication after intracranial surgery; a magnetic resonance imaging of the spine may be indicated if there is unexplained lower extremity pain or weakness. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Migraine headache in patients with idiopathic intracranial hypertension

    Science.gov (United States)

    Sina, Farzad; Razmeh, Saeed; Habibzadeh, Neda; Zavari, Arefeh; Nabovvati, Mona

    2017-01-01

    Migraine is a neurological disorder that afflicts many people in the world and can cause severe disability during the attacks. The pathophysiology of migraine is complex and not fully understood. It seems that migraine is common in idiopathic intracranial hypertension (IIH). However, the association between migraine headache and IIH is still unclear. The present study was conducted to assess the prevalence of migraine headache and associated factors in IIH patients. In this cross-sectional study, a total of 68 patients diagnosed with IIH underwent a medical history interview and a neurological examination. The diagnosis of migraine was based on the four diagnostic criteria of the International Classification of Headache Disorders 3rd edition. Forty-five patients (63.2%) met the diagnostic criteria of migraine headache. There was no significant difference between patients with and without migraine headache in respect of their age, gender, body mass. This study revealed high prevalence of migraine headache in IIH patients; appropriate treatment can reduce their headache and prevent unnecessary treatments for IIH. PMID:29071043

  11. An autopsy case of methanol induced intracranial hemorrhage.

    Science.gov (United States)

    Kim, Hye-Jeong; Na, Joo-Young; Lee, Young-Jik; Park, Jong-Tae; Kim, Hyung-Seok

    2015-01-01

    The major component of car washer fluid is a methanol. Intracranial hemorrhage is a rare but lethal complication in methanol poisoning. We report a case of massive bilateral basal ganglia hematoma in a 32-year-old man with methanol poisoning. He drank car washer solution twice time (about 500 ml), and was admitted to a territorial hospital 10 hours post-ingestion for depressed mental status, lower blood pressure, and high anion gap metabolic acidosis. Computed tomographic (CT) scan showed lesions in both putamen and cerebral deep white matter. Twenty-one days after methanol exposure, he suddenly developed cardiorespiratory arrest. In autopsy, external examination revealed moderate cerebral edema, but no evidence of herniation. Coronal sections of the brain showed softening and about 34 g hematoma in the bilateral putamen and 3rd ventricles. The toxic effect of methanol on the visual system has been noted in the absence of neurologic manifestations; however, there have also been a report of concomitant brain in Korea.

  12. Treatment of unruptured intracranial aneurysms using internally expanding coils

    Science.gov (United States)

    Suri, M. Fareed K.; Memon, Muhammad Zeeshan; Qureshi, Adnan I.

    2008-01-01

    Background and Purpose The International Subarachnoid Aneurysm Trial (ISAT) showed that patients with intracranial aneurysms treated with coil embolization have better clinical outcomes than those undergoing neurosurgical clipping. However some patients treated endovascularly have recurrence of aneurysms. Low packing density is often cited as a reason for recurrence. Coiling with hydrogel covered coils significantly improves the packing density. We report our initial experience in using a newly introduced design of hydrogel coils. Methods: Three consecutive patients with unruptured aneurysms were treated with hydrogel coated coils. During embolization, a stable framework was first established with bare metal coils, and gel coated coils were used subsequently to increase the packing density. After the procedure, packing density was estimated by calculating the compaction ratio using an online calculator. Results: Successful coil embolization was achieved in all 3 patients. Hydrogel coated coils comprised 11, 63 and 72% of the total coils deployed. One patient had coil herniation that required stent deployment. All patients remained neurologically intact during and after the procedure. Follow-up angiography in 2 patients at 6 months revealed aneurysm stability without any residual neck remnant. Conclusions: The softness of the hydrogel allowed us to deploy coated coils with good packing density. A slight expansion of these coils at the neck can be expected to reduce any neck remnant and potentially inhibit recurrence. PMID:22518218

  13. Minimally invasive trans-portal resection of deep intracranial lesions.

    NARCIS (Netherlands)

    Raza, S.M.; Recinos, P.F.; Avendano, J.; Adams, H.; Jallo, G.I.; Quinones-Hinojosa, A.

    2011-01-01

    BACKGROUND: The surgical management of deep intra-axial lesions still requires microsurgical approaches that utilize retraction of deep white matter to obtain adequate visualization. We report our experience with a new tubular retractor system, designed specifically for intracranial applications,

  14. Chemical Meningitis with Intracranial Tumours | De Klerk | South ...

    African Journals Online (AJOL)

    Two patients with intracranial epidermoid tumours who had a chemical meningitis as part of their clinical course, are described. The importance of recognising this as a presenting complaint is stressed. The pathogenesis and treatment are discussed.

  15. Intracranial teratoma associated with agenesis of the corpus callosum

    International Nuclear Information System (INIS)

    Williams, H.C.; Sarwar, M.; Virapongse, C.; Bhimani, S.

    1985-01-01

    An unusual case of a congenital intracranial teratoma associated with agenesis of the corpus callosum is presented. The radiographic features and the differentiation of this tumor from others that occur in agenesis is discussed. (orig.)

  16. Magnetic resonance "flip-flop" in idiopathic intracranial hypertension

    Directory of Open Access Journals (Sweden)

    Uttam George

    2011-01-01

    Full Text Available Idiopathic intracranial hypertension (IIH is a headache syndrome with raised CSF pressure in the absence of an intracranial mass lesion. Though earlier confined to excluding intracranial lesions, magnetic resonance imaging (MRI in recent years has been shown to identify intracranial changes from prolonged raised CSF pressure, suggestive of IIH. We present the MRI and TOF (time-of-flight venography findings involving the orbit, sella tursica and cerebral venous structures in a 45-year-old lady with IIH and illustrate their reversibility ("flip-flop" following CSF drainage. Our case highlights the role of imaging in evaluation and follow-up of patients with IIH, without the need for repeated lumbar punctures to monitor pressures.

  17. Intracranial hypertension in 2 children with marfan syndrome

    NARCIS (Netherlands)

    Hilhorst-Hofstee, Yvonne; Kroft, Lucia J. M.; Pals, Gerard; van Vugt, Jeroen P. P.; Overweg-Plandsoen, Wouterina C. G.

    2008-01-01

    Two unrelated children with Marfan syndrome presented with recurrent intracranial hypertension. Both children complained of headache, nausea, and vomiting and one of them had papilledema. Both had increased cerebrospinal fluid pressure, and their complaints disappeared after lumbar puncture.

  18. Congenital intracranial meningioma. A case report and literature review

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D

    1993-01-01

    A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed....

  19. Bathing Trunk Inevus Associated with Neurofibromatosis and Raised Intracranial Tension

    Directory of Open Access Journals (Sweden)

    T.V.S Arya

    1988-01-01

    Full Text Available A 17-year-old boy had bathing trunk nevus with multiple large neurofibromata on the nevus and raised intracranial tension presenting with bilateral papilloedema and pyramidal tract sings. This combination, of features is extremely rare.

  20. Post-operative intracranial foreign body granuloma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Djindjian, M.; Brugieres, P.; Razavi-Encha, F.; Allegret, C.; Poirier, J.

    1987-09-01

    The authors report and discuss some clinical, radiological, histological and ultrastructural aspects of an intracranial foreign body granuloma. This granuloma, which simulated a cavernoma, was due to a surgical swab forgotten during a previous neurosurgical evacuation of an intracerebral hematoma.

  1. High Resolution Topography of Age-Related Changes in Non-Rapid Eye Movement Sleep Electroencephalography

    Science.gov (United States)

    Sprecher, Kate E.; Riedner, Brady A.; Smith, Richard F.; Tononi, Giulio; Davidson, Richard J.; Benca, Ruth M.

    2016-01-01

    Sleeping brain activity reflects brain anatomy and physiology. The aim of this study was to use high density (256 channel) electroencephalography (EEG) during sleep to characterize topographic changes in sleep EEG power across normal aging, with high spatial resolution. Sleep was evaluated in 92 healthy adults aged 18–65 years old using full polysomnography and high density EEG. After artifact removal, spectral power density was calculated for standard frequency bands for all channels, averaged across the NREM periods of the first 3 sleep cycles. To quantify topographic changes with age, maps were generated of the Pearson’s coefficient of the correlation between power and age at each electrode. Significant correlations were determined by statistical non-parametric mapping. Absolute slow wave power declined significantly with increasing age across the entire scalp, whereas declines in theta and sigma power were significant only in frontal regions. Power in fast spindle frequencies declined significantly with increasing age frontally, whereas absolute power of slow spindle frequencies showed no significant change with age. When EEG power was normalized across the scalp, a left centro-parietal region showed significantly less age-related decline in power than the rest of the scalp. This partial preservation was particularly significant in the slow wave and sigma bands. The effect of age on sleep EEG varies substantially by region and frequency band. This non-uniformity should inform the design of future investigations of aging and sleep. This study provides normative data on the effect of age on sleep EEG topography, and provides a basis from which to explore the mechanisms of normal aging as well as neurodegenerative disorders for which age is a risk factor. PMID:26901503

  2. Rapid Diagnosis of Nonconvulsive Status Epilepticus Using Reduced-Lead Electroencephalography

    Directory of Open Access Journals (Sweden)

    Brenner, Jay M.

    2015-05-01

    Full Text Available Introduction: Electroencephalography (EEG is indicated for diagnosing nonconvulsive status epilepticus (NCSE in a patient who has altered level of consciousness after a motor seizure. A study in a neonatal population found 94% sensitivity and 78% specificity for detection of seizure using a single-lead device. This study aims to show that a reduced montage EEG would detect 90% of seizures detected on standard EEG. Methods: A portable Brainmaster EEG device was available in the emergency department (ED at all times. Patients presenting to the ED with altered mental status and known history of seizure or a witnessed seizure having a standard EEG were eligible for this study. The emergency physician obtained informed consent from the legally authorized representative (LAR, while an ED technician attached the electrodes to the patient, and a research associate attached the electrodes to the wiring routing to the portable EEG module. A board-certified epileptologist interpreted the tracings via the Internet. Simultaneously, the emergency physician ordered a standard 23-lead EEG, which would be interpreted by the neurologist on call to read EEGs. We compared the epileptologist’s interpretation of the reduced montage EEG to the results of the 23-lead EEG, which was considered the gold standard for detecting seizures. Results: Twelve of 12 patients or 100% had the same findings on reduced-montage EEG as standard EEG. One of 12 patients or 8% had nonconvulsive seizure activity. Conclusion: The results are consistent with prior studies which have shown that 8-48% of patients who have had a motor seizure continue to have nonconvulsive seizure activity on EEG. This study suggests that a bedside reduced-montage EEG can be used to make the diagnosis of NCSE in the ED. Further study will be conducted to see if this technology can be applied to the inpatient neurological intensive care unit setting. [West J Emerg Med. 2015;16(3:442–446.

  3. The effects of automated artifact removal algorithms on electroencephalography-based Alzheimer’s disease diagnosis

    Directory of Open Access Journals (Sweden)

    Raymundo eCassani

    2014-03-01

    Full Text Available Over the last decade, electroencephalography (EEG has emerged as a reliable tool for the diagnosis of cortical disorders such as Alzheimer's disease (AD. EEG signals, however, are susceptible to several artifacts, such as ocular, muscular, movement, and environmental. To overcome this limitation, existing diagnostic systems commonly depend on experienced clinicians to manually select artifact-free epochs from the collected multi-channel EEG data. Manual selection, however, is a tedious and time-consuming process, rendering the diagnostic system ``semi-automated. Notwithstanding, a number of EEG artifact removal algorithms have been proposed in the literature. The (disadvantages of using such algorithms in automated AD diagnostic systems, however, have not been documented; this paper aims to fill this gap. Here, we investigate the effects of three state-of-the-art automated artifact removal (AAR algorithms (both alone and in combination with each other on AD diagnostic systems based on four different classes of EEG features, namely, spectral, amplitude modulation rate of change, coherence, and phase. The three AAR algorithms tested are statistical artifact rejection (SAR, blind source separation based on second order blind identification and canonical correlation analysis (BSS-SOBI-CCA, and wavelet enhanced independent component analysis (wICA. Experimental results based on 20-channel resting-awake EEG data collected from 59 participants (20 patients with mild AD, 15 with moderate-to-severe AD, and 24 age-matched healthy controls showed the wICA algorithm alone outperforming other enhancement algorithm combinations across three tasks: diagnosis (control vs. mild vs. moderate, early detection (control vs. mild, and disease progression (mild vs. moderate, thus opening the doors for fully-automated systems that can assist clinicians with early detection of AD, as well as disease severity progression assessment.

  4. High Resolution Topography of Age-Related Changes in Non-Rapid Eye Movement Sleep Electroencephalography.

    Directory of Open Access Journals (Sweden)

    Kate E Sprecher

    Full Text Available Sleeping brain activity reflects brain anatomy and physiology. The aim of this study was to use high density (256 channel electroencephalography (EEG during sleep to characterize topographic changes in sleep EEG power across normal aging, with high spatial resolution. Sleep was evaluated in 92 healthy adults aged 18-65 years old using full polysomnography and high density EEG. After artifact removal, spectral power density was calculated for standard frequency bands for all channels, averaged across the NREM periods of the first 3 sleep cycles. To quantify topographic changes with age, maps were generated of the Pearson's coefficient of the correlation between power and age at each electrode. Significant correlations were determined by statistical non-parametric mapping. Absolute slow wave power declined significantly with increasing age across the entire scalp, whereas declines in theta and sigma power were significant only in frontal regions. Power in fast spindle frequencies declined significantly with increasing age frontally, whereas absolute power of slow spindle frequencies showed no significant change with age. When EEG power was normalized across the scalp, a left centro-parietal region showed significantly less age-related decline in power than the rest of the scalp. This partial preservation was particularly significant in the slow wave and sigma bands. The effect of age on sleep EEG varies substantially by region and frequency band. This non-uniformity should inform the design of future investigations of aging and sleep. This study provides normative data on the effect of age on sleep EEG topography, and provides a basis from which to explore the mechanisms of normal aging as well as neurodegenerative disorders for which age is a risk factor.

  5. Abnormalities of Quantitative Electroencephalography in Children with Asperger Disorder Using Spectrogram andCoherence Values

    Directory of Open Access Journals (Sweden)

    Hamid Behnam

    2008-07-01

    Full Text Available "n  "n  "nObjective:To obtain abnormalities in quantitative Electroencephalography QEEG and to observe connectivity between electrodes in children with Asperger disorder. "n  "n  "nMethod: "nIn this study, spectrogram criteria and coherence values are used as a tool for evaluating QEEG in 15 children with Asperger disorder (10 boys and 5 girls aged between 6 to 11 years old and in 11 control children boys and 4 girls with the same age range. "n  "n  "nResults: "nThe evaluation of QEEG using statistical analysis and spectrogram criteria demonstrates that the relaxed eye-opened condition in gamma frequency band (34-44Hz has the best distinction level of 96.2% using spectrogram. The children with Asperger disorder had significant lower spectrogram criteria values (p<0.01 at Fp1 electrode and lower values (p<0.05 at Fp2 and T6 electrodes. Coherence values at 171 pairs EEG electrodes indicate that the connectivity at (T4, P4, (T4, Cz, (T4, C4 electrode pairs and (T4, O1 had significant differences (p<0.01 in the two groups in the gamma band. "n  "n  "nConclusions: "nIt is shown that gamma frequency band can discriminate 96.2% of the two groups using the spectrogram criteria. The results demonstrate that there are more abnormalities in the prefrontal and right temporal lobes using spectrogram criteria and there are more abnormalities "nthe connectivity of right temporal lobe with the other lobes in the gamma "nfrequency band.

  6. Nicotinic modulation of auditory evoked potential electroencephalography in a rodent neurodevelopmental model of schizophrenia.

    Science.gov (United States)

    Kohlhaas, Kathy L; Robb, Holly M; Roderwald, Victoria A; Rueter, Lynne E

    2015-10-15

    Schizophrenia is a chronic disease that has been hypothesized to be linked to neurodevelopmental abnormalities. Schizophrenia patients exhibit impairments in basic sensory processing including sensory gating deficits in P50 and mismatch negativity (MMN). Neuronal nicotinic acetylcholine receptor (nAChR) agonists have been reported to attenuate these deficits. Gestational exposure of rats to methylazoxymethanol acetate (MAM) at embryonic day 17 leads to developmental disruption of the limbic-cortical system. MAM exposed offspring show neuropathological and behavioral changes that have similarities with those seen in schizophrenia. In this study, we aimed to assess whether N40 auditory sensory gating (the rodent form of P50 gating) and MMN deficits as measures of auditory evoked potential (AEP) electroencephalography (EEG) are present in MAM rats and whether nAChR agonists could attend the deficit. E17 male MAM and sham rats were implanted with cortical electrodes at 2 months of age. EEG recordings evaluating N40 gating and MMN paradigms were done comparing effects of vehicle (saline), nicotine and the α7 agonist ABT-107. Deficits were seen for MAM rats compared to sham animals in both N40 auditory sensory gating and MMN AEP recordings. There was a strong trend for N40 deficits to be attenuated by both nicotine (0.16mg/kg i.p. base) and ABT-107 (1.0mg/kg i.p. base). MMN deficits were significantly attenuated by ABT-107 but not by nicotine. These data support the MAM model as a useful tool for translating pharmacodynamic effects in clinical medicine studies of novel therapeutic treatments for schizophrenia. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Using a Wireless Electroencephalography Device to Evaluate E-Health and E-Learning Interventions.

    Science.gov (United States)

    Mailhot, Tanya; Lavoie, Patrick; Maheu-Cadotte, Marc-André; Fontaine, Guillaume; Cournoyer, Alexis; Côté, José; Dupuis, France; Karsenti, Thierry; Cossette, Sylvie

    Measuring engagement and other reactions of patients and health professionals to e-health and e-learning interventions remains a challenge for researchers. The aim of this pilot study was to assess the feasibility and acceptability of using a wireless electroencephalography (EEG) device to measure affective (anxiety, enjoyment, relaxation) and cognitive (attention, engagement, interest) reactions of patients and healthcare professionals during e-health or e-learning interventions. Using a wireless EEG device, we measured patient (n = 6) and health professional (n = 7) reactions during a 10-minute session of an e-health or e-learning intervention. The following feasibility and acceptability indicators were assessed and compared for patients and healthcare professionals: number of eligible participants who consented to participate, reasons for refusal, time to install and calibrate the wireless EEG device, number of participants who completed the full 10-minute sessions, participant comfort when wearing the device, signal quality, and number of observations obtained for each reaction. The wireless EEG readings were compared to participant self-rating of their reactions. We obtained at least 75% of possible observations for attention, engagement, enjoyment, and interest. EEG scores were similar to self-reported scores, but they varied throughout the sessions, which gave information on participants' real-time reactions to the e-health/e-learning interventions. Results on the other indicators support the feasibility and acceptability of the wireless EEG device for both patients and professionals. Using the wireless EEG device was feasible and acceptable. Future studies must examine its use in other contexts of care and explore which components of the interventions affected participant reactions by combining wireless EEG and eye tracking.

  8. Electroencephalography Amplitude Modulation Analysis for Automated Affective Tagging of Music Video Clips

    Science.gov (United States)

    Clerico, Andrea; Tiwari, Abhishek; Gupta, Rishabh; Jayaraman, Srinivasan; Falk, Tiago H.

    2018-01-01

    The quantity of music content is rapidly increasing and automated affective tagging of music video clips can enable the development of intelligent retrieval, music recommendation, automatic playlist generators, and music browsing interfaces tuned to the users' current desires, preferences, or affective states. To achieve this goal, the field of affective computing has emerged, in particular the development of so-called affective brain-computer interfaces, which measure the user's affective state directly from measured brain waves using non-invasive tools, such as electroencephalography (EEG). Typically, conventional features extracted from the EEG signal have been used, such as frequency subband powers and/or inter-hemispheric power asymmetry indices. More recently, the coupling between EEG and peripheral physiological signals, such as the galvanic skin response (GSR), have also been proposed. Here, we show the importance of EEG amplitude modulations and propose several new features that measure the amplitude-amplitude cross-frequency coupling per EEG electrode, as well as linear and non-linear connections between multiple electrode pairs. When tested on a publicly available dataset of music video clips tagged with subjective affective ratings, support vector classifiers trained on the proposed features were shown to outperform those trained on conventional benchmark EEG features by as much as 6, 20, 8, and 7% for arousal, valence, dominance and liking, respectively. Moreover, fusion of the proposed features with EEG-GSR coupling features showed to be particularly useful for arousal (feature-level fusion) and liking (decision-level fusion) prediction. Together, these findings show the importance of the proposed features to characterize human affective states during music clip watching. PMID:29367844

  9. An Ambulatory Electroencephalography System for Freely Moving Horses: An Innovating Approach

    Directory of Open Access Journals (Sweden)

    Hugo Cousillas

    2017-05-01

    Full Text Available Electroencephalography (EEG that has been extensively studied in humans presents also a large interest for studies on animal brain processes. However, since the quality of the recordings is altered by muscular activity, most EEG recordings on animals are obtained using invasive methods with deeply implanted electrodes. This requires anesthesia and can thus only be used in laboratory or clinical settings. As EEG is a very useful tool both for detecting brain alterations due to diseases or accidents and to evaluate the arousal and attentional state of the animal, it seemed crucial to develop a tool that would make such recordings possible in the horse’s home environment, with a freely moving horse. Such a tool should neither be invasive nor cause discomforts to the horse as the usual other practice which consists, after shaving the zone, in gluing the electrodes to the skin. To fulfill these requirements, we developed a novel EEG headset adapted to the horse’s head that allows an easy and fast positioning of the electrodes and that can be used in the home environment on a freely moving horse. In this study, we show that this EEG headset allows to obtain reliable recordings, and we propose an original evaluation of an animal’s “EEG profile” that allows comparisons between individuals and situations. This EEG headset opens new possibilities of investigation on horse cognition, and it can also become a useful tool for veterinarians to evaluate cerebral disorders or check the anesthesia level during a surgery.

  10. Chronic Meningitis Complicating Intracranial Hypertension in Neurobrucellosis: A Case Report.

    Science.gov (United States)

    Tugcu, Betul; Nacaroglu, Senay Asik; Coskun, Cigdem; Kuscu, Demet Yandım; Onder, Feyza

    2015-01-01

    In neurobrucellosis, even though meningitis is encountered frequently, chronic intracranial hypertension is a rare manifestation. Early diagnosis and treatment is very important for the prevention of permanent visual loss secondary to poststasis optic atrophy in these cases. We report a case that presented with permanent visual loss secondary to intracranial hypertension in neurobrucellosis. Our goal is to draw attention to the consideration of neurobrucellosis in cases with papilla stasis, even in the absence of neurological findings in endemic areas.

  11. Congenital intracranial meningioma. A case report and literature review

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D

    1993-01-01

    A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed.......A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed....

  12. Imaging Modalities Relevant to Intracranial Pressure Assessment in Astronauts

    Science.gov (United States)

    Sargsyan, Ashot E.; Kramer, Larry A.; Hamilton, Douglas R.; Fogarty, Jennifer; Polk, J. D.

    2011-01-01

    Learning Objectives of this slide presentation are: 1: To review the morphological changes in orbit structures caused by elevated Intracranial Pressure (ICP), and their imaging representation. 2: To learn about the similarities and differences between MRI and sonographic imaging of the eye and orbit. 3: To learn about the role of MRI and sonography in the noninvasive assessment of intracranial pressure in aerospace medicine, and the added benefits from their combined interpretation.

  13. Probabilistic Modeling of Intracranial Pressure Effects on Optic Nerve Biomechanics

    Science.gov (United States)

    Ethier, C. R.; Feola, Andrew J.; Raykin, Julia; Myers, Jerry G.; Nelson, Emily S.; Samuels, Brian C.

    2016-01-01

    Altered intracranial pressure (ICP) is involved/implicated in several ocular conditions: papilledema, glaucoma and Visual Impairment and Intracranial Pressure (VIIP) syndrome. The biomechanical effects of altered ICP on optic nerve head (ONH) tissues in these conditions are uncertain but likely important. We have quantified ICP-induced deformations of ONH tissues, using finite element (FE) and probabilistic modeling (Latin Hypercube Simulations (LHS)) to consider a range of tissue properties and relevant pressures.

  14. High Intracranial Pressure Induced Injury in the Healthy Rat Brain.

    Science.gov (United States)

    Dai, Xingping; Bragina, Olga; Zhang, Tongsheng; Yang, Yirong; Rao, Gutti R; Bragin, Denis E; Statom, Gloria; Nemoto, Edwin M

    2016-08-01

    We recently showed that increased intracranial pressure to 50 mm Hg in the healthy rat brain results in microvascular shunt flow characterized by tissue hypoxia, edema, and increased blood-brain barrier permeability. We now determined whether increased intracranial pressure results in neuronal injury by Fluoro-Jade stain and whether changes in cerebral blood flow and cerebral metabolic rate for oxygen suggest nonnutritive microvascular shunt flow. Intracranial pressure was elevated by a reservoir of artificial cerebrospinal fluid connected to the cisterna magna. Arterial blood gases, cerebral arterial-venous oxygen content difference, and cerebral blood flow by MRI were measured. Fluoro-Jade stain neurons were counted in histologic sections of the right and left dorsal and lateral cortices and hippocampus. University laboratory. Male Sprague Dawley rats. Arterial pressure support if needed by IV dopamine infusion and base deficit corrected by sodium bicarbonate. Fluoro-Jade stain neurons increased 2.5- and 5.5-fold at intracranial pressures of 30 and 50 mm Hg and cerebral perfusion pressures of 57 ± 4 (mean ± SEM) and 47 ± 6 mm Hg, respectively (p intracranial pressure and decreased cerebral metabolic rate for oxygen. High intracranial pressure likely caused neuronal injury because of a transition from normal capillary flow to nonnutritive microvascular shunt flow resulting in tissue hypoxia and edema, and it is manifest by a reduction in the cerebral metabolic rate for oxygen.

  15. Prenatal ultrasonographic diagnosis of fetal intracranial tumors: a review.

    Science.gov (United States)

    Sherer, D M; Onyeije, C I

    1998-05-01

    Our objective was to review current literature pertaining to prenatal ultrasonography of various fetal intracranial neoplastic and non-neoplastic tumors. To this goal, all manuscripts published in the English language regarding this topic obtained from a MEDLINE search from 1966 through January 1998 were selected and reviewed. Additional sources were identified through cross-referencing. Intracranial fetal tumors are extremely rare and precise diagnosis is dependent on histology examination of tissue obtained at subsequent surgery or autopsy. Currently, prenatal ultrasonographic findings associated with the following fetal intracranial tumors have been described: teratomas; neuroepithelial tumors including: glioblastoma, astrocytoma, gangliocytoma, medulloblastoma, choroid plexus, and papilloma; and mesenchymal tumors. Non-neoplastic fetal intracranial tumors are even less frequent and include: unilateral megalencephaly, heterotopia, and lipoma of the corpus callosum. Cardinal ultrasonographic findings associated with fetal intracranial tumors include: echogenic and semicystic space occupying lesions with or without distortion of normal symmetrical intracranial (usually midline) structures, calcifications, craniomegaly, polyhydramnios, obstructive hydrocephaly, high-output cardiac failure (hydrops fetalis), the presence of other associated structural anomalies, and infrequently abnormal cerebral Doppler flow velocimetry.

  16. Listening to Mozart K.448 decreases electroencephalography oscillatory power associated with an increase in sympathetic tone in adults: a post-intervention study.

    Science.gov (United States)

    Lin, Lung-Chang; Ouyang, Chen-Sen; Chiang, Ching-Tai; Wu, Rong-Ching; Wu, Hui-Chuan; Yang, Rei-Cheng

    2014-10-01

    Listening to Mozart K.448 has been demonstrated to improve spatial task scores, leading to what is known as the Mozart Effect. However, most of these reports only describe the phenomena but lack the scientific evidence needed to properly investigate the mechanism of Mozart Effect. In this study, we used electroencephalography (EEG) and heart rate variability (HRV) to evaluate the effects of Mozart K.448 on healthy volunteers to explore Mozart Effect. An EEG-based post-intervention analysis. Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Twenty-nine college students were enrolled. They received EEG and electrocardiogram examinations simultaneously before, during and after listening to the first movement of Mozart K.448. EEG alpha, theta and beta power and HRV were compared in each stage. The results showed a significant decrease in alpha, theta and beta power when they listened to Mozart K.448. In addition, the average root mean square successive difference, the proportion derived by dividing NN50 by the total number of NN intervals, standard deviations of NN intervals and standard deviations of differences between adjacent NN intervals showed a significant decrease, while the high frequency revealed a significant decrease with a significantly elevated low-frequency/high-frequency ratio. Listening to Mozart K.448 significantly decreased EEG alpha, theta and beta power and HRV. This study indicates that there is brain cortical function and sympathetic tone activation in healthy adults when listening to Mozart K.448, which may play an important role in the mechanism of Mozart Effect.

  17. Holocord oligodendroglioma with intracranial extension in a young adult: a case report and review of literature.

    Science.gov (United States)

    Cruz, Romulus Emmanuel H; De Roxas, Ranhel C; Sales-Callangan, Carmela Concepcion A; Jamora, Roland Dominic G

    2018-01-01

    Widespread primary spinal oligodendrogliomas are a rare variety of tumors that usually affect children. Currently, there are only two adult cases reported worldwide. We report the first case of primary holocord oligodendroglioma with intracranial extension in a young adult female. The patient presented with a 4-month history of fluctuating hemiparesis of the left upper extremity eventually becoming quadriplegic after 1 month. Imaging findings revealed a contrast-enhancing holocord neoplasm spanning from the cervical region to the conus medullaris and with extension to the lower medulla. The patient succumbed to severe pneumonia after 1 month of admission. An autopsy was done and the histopathologic findings were consistent with oligodendroglioma.

  18. Intracranial Hemorrhage as a Source of Headache in a Patient with Postpartum

    Directory of Open Access Journals (Sweden)

    Jamshid Vafaeimanesh

    2014-06-01

    Full Text Available Background: Postpartum thrombotic thrombocytopenic purpura (TTP should be considered in thrombocytopenic patients. Case report: The patient was a 28-year-old pregnant woman referred for cesarean section. After CS, hysterectomy was done due to uncontrolled vaginal bleeding. Peripheral blood smear confirmed the TTP diagnosis. Plasmapheresis was initiated and platelets were infused. Six hours after infusion, tonic-colonic seizure, left hemiplegia and bell's palsy appeared. Brain CT Scan revealed intracranial hemorrhage. 28 plasmapheresis sessions were performed and finally, she was discharged with good general condition.

  19. Structured Reporting in Neuroradiology: Intracranial Tumors

    Directory of Open Access Journals (Sweden)

    Andrea Bink

    2018-02-01

    Full Text Available PurposeThe aim of this pilot study was to assess the clinical feasibility, diagnostic yield, advantages, and disadvantages of structured reporting for routine MRI-reading in patients with primary diagnosis of intracranial tumors as compared to traditional neuroradiological free text reporting.MethodsA structured MRI reporting template was developed covering pathological, anatomical, and functional aspects in an itemized fashion. Retrospectively, 60 consecutive patients with first diagnosis of an intracranial tumor were selected from the radiology information system/PACS system. Structured reporting was performed by a senior neuroradiologist, blinded to clinical and radiological data. Reporting times were measured per patient. The diagnostic content was compared to free text reporting which was independently performed on the same MRI exams by two other neuroradiologists. The comparisons were categorized per item as: “congruent,” “partially congruent,” “incongruent,” or “not mentioned in free-style report.”ResultsTumor-related items: congruent findings were found for all items (17/17 with congruence rates ranging between 98 and 39% per item. Four items achieved congruence rates ≥90%, 5 items >80%, and 9 items ≥70%. Partially congruent findings were found for all items in up to 50% per item. Incongruent findings were present in 7/17 items in up to 5% per item. Free text reports did not mention 12 of 17 items (range 7–43% per item. Non-tumor-related items, including brain atrophy, microangiopathy, vascular pathologies, and various extracranial pathologies, which were not mentioned in free-text reports between 18 and 85% per item. Mean reporting time for structured reporting was 7:49 min (3:12–17:06 min.ConclusionFirst results showed that expert structured reporting ensured reliable detection of all relevant brain pathologies along with reproducible documentation of all predefined diagnostic items, which was not always the

  20. Intracranial Ewing sarcoma: four pediatric examples.

    Science.gov (United States)

    Yang, Michael J; Whelan, Ros; Madden, Jennifer; Mulcahy Levy, Jean M; Kleinschmidt-DeMasters, B K; Hankinson, Todd C; Foreman, Nicholas K; Handler, Michael H

    2018-03-01

    Ewing sarcoma typically arises in bone and is unrelated to intraparenchymal small blue cell embryonal central nervous system (CNS) tumors previously designated primitive neuroectodermal tumors (PNETs). When the CNS is impacted, it is usually secondary to local extension from either the epidural space, skull, or intracranial or spinal metastases. Primary examples within the cranial vault are rare, usually dural-based, and are largely case reports in the literature. We detail four pediatric patients with solitary, primary intracranial Ewing sarcoma, all manifesting the archetypal EWRS1 gene rearrangement that confirms diagnosis. Neurosurgical Department records, spanning 21 years (1995-2016), were reviewed to identify patients. Demographics, clinical history, pathological/genetic features, and clinical course were retrieved from the medical record and personal files of the authors. Four patients, one male and three females, age 5 to 16 years, were identified. One presented in extremis from a large lesion, two with soft tissue masses, and the fourth as an incidental finding after being involved in a motor vehicle collision. Three had clear bony involvement: a 10-year-old girl with a large left temporal lesion had clear origin in the skull, with spiculated calcified striations throughout the mass; a 9-year-old girl presented with a bony left petrous apex mass; and a 16-year-old girl presented with a left temporal mass with extension to the dura and underlying bone erosion. Only the 5-year-old boy had a large left frontoparietal mass traversing the falx with no bony contact. All four tumors manifested the diagnostic EWSR1 mutation and were treated with an Ewing sarcoma regimen. Outcomes were variable, with one patient showing progressive metastatic disease and death 3 years after presentation, one patient with disease-free survival 10.5 years after completion of therapy, and one alive and well at the completion of therapy 1 year after diagnosis. One patient

  1. Somatostatin receptor imaging in intracranial tumours

    International Nuclear Information System (INIS)

    Schmidt, M.; Scheidhauer, K.; Voth, E.; Schicha, H.; Luyken, C.; Hildebrandt, G.; Klug, N.

    1998-01-01

    The somatostatin analogue [ 111 In-DTPA-d-Phe 1 ]-octreotide ( 111 In-octreotide) allows scintigraphic visualization of somatostatin receptor-expressing tissue. While it is well known that a large variety of tissues express somatostatin receptors and 111 In-octreotide scintigraphy has a clearly defined role in various neuroendocrine diseases, the clinical value of 111 In-octreotide scintigraphy in brain tumours is still under clinical investigation. In 124 patients with 141 brain lesions (63 meningiomas, 24 pituitary adenomas, 10 gliomas WHO class I and II, 12 gliomas WHO class III and IV, 11 neurinomas and 2 neurofibromas, 7 metastases and 12 other varieties: three non-Hodgkin B-cell lymphomas, two epidermoids, one abscess, one angioleiomyoma, one chordoma, one haemangiopericytoma, one osteosarcoma, one plasmacytoma and one pseudocyst), 111 In-octreotide scintigraphy was performed 4-6 and 24 h after i.v. injection of 110-220 MBq 111 In-octreotide. Planar images of the head in four views with a 128 x 128 matrix and single-photon emission tomographic images (64 x 64 matrix) were acquired, and lesions were graded according to qualitative tracer uptake. Fifty-nine of the 63 meningiomas showed moderate to intense tracer uptake. Nine of 24 pituitary adenomas were visible; the remaining 15 did not show any tracer uptake. None of the class I and II gliomas with an intact blood-brain barrier were detected whereas 11/12 class III and IV gliomas showed 111 In-octreotide uptake. None of the neurinomas or neurofibromas were positive. Five of seven metastases were classified as positive, as were the osteosarcoma, two of three non-Hodgkin B-cell lymphomas, one abscess, one angioleiomyoma, one chordoma and one haemangiopericytoma. The other varieties (one non-Hodgkin B-cell lymphoma, two epidermoids, one plasmacytoma and one pseudocyst) did not show 111 In-octreotide uptake. The results demonstrate that a large variety of intracranial lesions express somatostatin receptors and

  2. Two cases of intracranial gliomatosis in different types: clinical manifestations and radiological features

    Directory of Open Access Journals (Sweden)

    Yun JIANG

    2015-12-01

    Full Text Available Objective To report one case of gliomatosis cerebri (GC and one case of leptomeningeal gliomatosis (LG, both of them were clearly diagnosed by brain biopsy. Methods and Results 1 The GC patient was a 48-year-old male who presented with epilepsy and focal neurological deficits. Cranial MRI revealed diffuse white matter lesions in bilateral cerebral hemispheres without obvious mass effect and enhancement. Immunohistochemical staining revealed that tumor cells and proliferative glial cells were positive for glial fibrillary acidic protein (GFAP. Ki-67 labeling index was about 10% . 2 The LG patient was a 30-year-old female who mainly presented with high intracranial pressure and epilepsy. Repeated cranial MRI revealed aggressive enlargement of subarachnoid space and ventricles, multiple encapsulated cysts in sulci and fissures, and parenchymal infiltration. Strong enhancement in meninges and the encapsulated cysts could be seen in contrast-enhanced images. Histologically, dense and uneven distribution of tumor cells was the main feature. Obvious atypia of nuclei and proliferation of small vessels could be seen. Tumor cells were positive for GFAP. Ki-67 labeling index was about 5% . By brain biopsy, both cases were diagnosed as anaplastic astrocytoma (WHO Ⅲ. The principle of treatment was temozolomide chemotherapy. Conclusions For intracranial gliomatosis, relatively distinct characteristics in brain MRI could indicate the diagnosis. Brain biopsy should be done early as possible for a clear diagnosis.  DOI: 10.3969/j.issn.1672-6731.2015.12.013 

  3. Pregnant woman with an intracranial meningioma – case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Dumitrescu Bogdan Constantin

    2014-12-01

    Full Text Available It is about a 33-year-old female, with a 36 weeks uncomplicated pregnancy and with signs of increased intracranial pressure. Hours after admission and an obstetric evaluation, uterine contraction started and the patient was taken to the delivery room, where she presented a partial motor seizure on the left side with secondary generalization and urine emission. A caesarean section was performed without fetal or maternal complications. The urgent MRI gadolinium-enhanced brain scan revealed a 39/50/54 mm tumoral mass having an aspect of an anterior third falx cerebri meningioma. The patient was transferred to our neurosurgical department and afterwards surgery was performed with gross total removal of the tumoral mass. Histological examination revealed atypical meningioma with direct invasion into the adjacent brain parenchyma. A week later she was discharged from the hospital in good condition. One month after surgery, a contrastenhanced magnetic resonance imaging of the brain did not reveal any signs of tumor recurrence or residual tumor. Our recommendation is for postpartum surgery when is possible. Urgent neurosurgical interventions should be made in case of patients with malignant tumors, active hydrocephalus or benign intracranial tumor such as meningioma associated with signs of impending herniation, progress

  4. Equal contribution of increased intracranial pressure and subarachnoid blood to cerebral blood flow reduction and receptor upregulation after subarachnoid hemorrhage. Laboratory investigation

    DEFF Research Database (Denmark)

    Ansar, Saema; Edvinsson, Lars

    2009-01-01

    OBJECT: Cerebral ischemia remains the key cause of disability and death in the late phase after subarachnoid hemorrhage (SAH), and its pathogenesis is still poorly understood. The purpose of this study was to examine whether the change in intracranial pressure or the extravasated blood causes....... The effects in all parameters were more pronounced for SAH than for saline injection. CONCLUSIONS: This study revealed that both the elevation of intracranial pressure and subarachnoid blood per se contribute approximately equally to the late CBF reductions and receptor upregulation following SAH....

  5. Retina findings in intracranial aneurysm patients

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    Sung Il Kang

    2017-07-01

    Full Text Available AIM: To evaluate fundus findings in patients with intracranial aneurysm(ICAto determine the relation between ICA and distinguishable retinal features.METHODS: We analyzed the medical records and ocular images of 46 patients with previously diagnosed ICA referred from the Neurosurgical Department. All patients underwent ophthalmologic evaluation including fluorescein angiography(FAG. Furthermore, the presence of drusen, macular degeneration, cotton wool spot, hard exudates, retinal hemorrhage, arteriolar attenuation, A-V crossing signs, arm-to-retina time, and A-V transit time were evaluated. The results of ICA patients(Group 1were compared with those of 22 idiopathic epiretinal membrane patients with unaffected eyes(Group 2.RESULTS: Mean ages were 60.02y(Group 1and 60.68y(Group 2respectively(P=0.70. The prevalence of hypertension was similar in both groups. No case with retinal macroaneurysm was found in either group. The presence of drusen, macular degeneration, cotton wool spot, hard exudates, retinal hemorrhage, arteriolar attenuation, and A-V crossing sign was not significantly different between the two groups. Mean arm-to-retina time was not significantly different in two groups, either.CONCLUSION: We cannot find any evidence that the patients with ICA shows specific changes in the FAG and fundus.

  6. Idiopathic intracranial hypertension: A typical presentation

    International Nuclear Information System (INIS)

    Algahtani, Hussein A.; Obeid, Tahir H.; Abuzinadah, Ahmad R.; Baeesa, Saleh S.

    2007-01-01

    Objective was to describe the clinical features of 5 patients with rare atypical presentation of idiopathic intracranial hypertension (IIH), and propose the possible mechanism of this atypical presentation. We carried out a retrospective study of 5 patients, admitted at King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia with IIH during the period from January 2001 to December 2005. All were females with their age ranges from 24 to 40 years. The clinical presentations, the laboratory and imaging studies were analyzed. The opening pressures of the lumbar puncture tests were documented. All patients were presented with headache. One had typical pain of trigeminal neuralgia and one with neck pain and radiculopathy. Facial diplegia was present in one patient and two patients had bilateral 6th cranial neuropathy. Papilledema was present in all patients except in one patient. Imaging study was normal in all patients, and they had a very high opening pressure during lumbar puncture, except in one patient. All patients achieved full recovery with medical therapy in 6 to 12 weeks with no relapse during the mean follow up of 2 years. Atypical finding in IIH are rare and require a high index of suspicion for early diagnosis. (author)

  7. Intracranial meningiomas after high-dose irradiation

    International Nuclear Information System (INIS)

    Soffer, D.; Gomori, J.M.; Siegal, T.; Shalit, M.N.

    1989-01-01

    Three patients who presented with intracranial meningiomas 12, 15, and 20 years, respectively, after therapeutic high-dose irradiation of a primary brain tumor are described. Analysis of these cases and similar documented cases suggests that meningiomas after high-dose irradiation constitute a recognizable entity. Patients with such tumors received radiation therapy at a young age (mean age, 9.4 years). After a latent period of 2 to 47 years (mean, 19.8 years) they developed meningiomas at the site of irradiation, at a much younger age than patients with ''spontaneous'' meningiomas. Similar to the situation with meningiomas after low-dose irradiation, a relatively high proportion of meningiomas induced by high-dose irradiation tend to be malignant and biologically aggressive. A very young age at the time of irradiation seems to predispose to the induction of malignant meningiomas, rather than benign tumors. These unusual features provide indirect evidence that high-dose radiation may play a role in the pathogenesis of meningiomas.41 references

  8. Intracranial Fluid Redistribution During a Spaceflight Analog

    Science.gov (United States)

    Koppelmans, Vincent; Pasternak, Ofer; Bloomberg, Jacob J.; De Dios, Yiri E.; Wood, Scott J.; Riascos, Roy; Reuter-Lorenz, Patrica A.; Kofman, Igor S.; Mulavara, Ajitkumar P.; Seidler, Rachael D.

    2017-01-01

    The neural correlates of spaceflight-induced sensorimotor impairments are unknown. Head down-tilt bed rest (HDBR) serves as a microgravity analog because it mimics the headward fluid shift and limb unloading of spaceflight. We investigated focal brain white matter (WM) changes and fluid shifts during 70 days of 6 deg HDBR in 16 subjects who were assessed pre (2x), during (3x), and post-HDBR (2x). Changes over time were compared to those in control subjects (n=12) assessed four times over 90 days. Diffusion MRI was used to assess WM microstructure and fluid shifts. Free-Water Imaging, derived from diffusion MRI, was used to quantify the distribution of intracranial extracellular free water (FW). Additionally, we tested whether WM and FW changes correlated with changes in functional mobility and balance measures. HDBR resulted in FW increases in fronto-temporal regions and decreases in posterior-parietal regions that largely recovered by two weeks post-HDBR. WM microstructure was unaffected by HDBR. FW decreased in the post-central gyrus and precuneus. We previously reported that gray matter increases in these regions were associated with less HDBR-induced balance impairment, suggesting adaptive structural neuroplasticity. Future studies are warranted to determine causality and underlying mechanisms.

  9. Total intravenous anesthesia: advantages for intracranial surgery.

    Science.gov (United States)

    Cole, Chad D; Gottfried, Oren N; Gupta, Dhanesh K; Couldwell, William T

    2007-11-01

    Although volatile anesthetics have been widely accepted in anesthetic management for neurosurgery, they reduce vascular resistance, resulting in increased cerebral blood flow and increased intracranial pressure (ICP). In patients with elevated ICP who undergo craniotomy, the increase in ICP during surgery from inhaled anesthetics can make the surgery more difficult, thereby increasing the risk of ischemic cerebral insults. Total intravenous anesthesia (TIVA) using propofol and analgesic drugs (remifentanil or fentanyl) and excluding simultaneous administration of any inhaled drugs is being used in patients undergoing craniotomy because of its potential to reduce ICP and ease access to the operative site. We reviewed the literature and describe our experience with TIVA, with emphasis on hemodynamic stability, effects on ICP, emergence from anesthesia, extubation times, and return of cognitive function in patients undergoing craniotomy for space-occupying lesions. TIVA with propofol is similar to inhaled anesthetics with regard to hemodynamic stability, emergence times, extubation times, early cognitive function, and adverse events. In several prospective, randomized clinical trials, evidence suggests that ICP is decreased and cerebral perfusion pressure is increased in patients receiving TIVA when compared with those receiving volatile anesthetics during elective craniotomy procedures. The impact of TIVA on ICP, brain swelling, and access to the operative site in patients with severely elevated ICP has yet to be evaluated and is the subject of a future study at our institution.

  10. Monitoring of Intracranial Pressure in Meningitis.

    Science.gov (United States)

    Depreitere, Bart; Bruyninckx, Dominike; Güiza, Fabian

    2016-01-01

    The literature on intracranial pressure (ICP) monitoring in meningitis is limited to case reports and a handful of descriptive series. The aim of this study is to investigate relationships among ICP, cerebral perfusion pressure (CPP), and outcome in meningitis and to identify whether ICP affected clinical decisions. Between 1999 and 2011, a total of 17 patients with meningitis underwent ICP monitoring at the University Hospitals Leuven. Charts were reviewed for clinical history, ICP/CPP data, imaging findings, and Glasgow Outcome Scale score. Univariate correlations were computed for outcome and ICP/CPP variables, computed tomography characteristics, and Corticosteroid Randomization After Significant Head Injury outcome model variables. Treatment decisions were assessed regarding whether or not they were based on ICP. At drain placement, Glasgow Coma Scale scores showed a median of 8 (range 3-12). Six of 17 patients had either one or two nonreactive pupils. Significant correlations with outcome were found for the highest documented ICP value (r = -0.70), the number of episodes when CPP meningitis high ICP and low CPP represent secondary insults. The poor condition of the patients illustrates that the level of suspicion for increased ICP in meningitis may not be high enough.

  11. Implementation of Continuous Video-Electroencephalography at a Community Hospital Enhances Care and Reduces Costs.

    Science.gov (United States)

    Kolls, Brad J; Mace, Brian E; Dombrowski, Keith E

    2017-10-24

    Despite data indicating the importance of continuous video-electroencephalography (cvEEG) monitoring, adoption has been slow outside major academic centers. Barriers to adoption include the need for technologists, equipment, and cvEEG readers. Advancements in lower-cost lead placement templates and commercial systems with remote review may reduce barriers to allow community centers to implement cvEEG. Here, we report our experience, lessons learned, and financial impact of implementing a community hospital cvEEG-monitoring program. We implemented an adult cvEEG service at Duke Regional Hospital (DRH), a community hospital affiliate, in June of 2012. Lead placement templates were used in the implementation to reduce the impact on technologists by using other bedside providers for EEG initiation. Utilization of the service, study quality, and patient outcomes were tracked over a 3-year period following initiation of service. Service was implemented at essentially no cost. Utilization varied from a number of factors: intensive care unit (ICU) attending awareness, limited willingness of bedside providers to perform lead placement, and variation in practice of the consulting neurologists. A total of 92 studies were performed on 88 patients in the first 3 years of the program, 24 in year one, 27 in year two, and 38 in year three, showing progressive adoption. Seizures were seen in 25 patients (27%), 19 were in status, of which 18 were successfully treated. Transfers to the main hospital, Duke University Medical Center, were prevented for 53 patients, producing an estimated cost savings of $145,750. The retained patients produced a direct contribution margin of about $75,000, and the margin was just over $100,000 for the entire monitored cohort. ICU cvEEG service is feasible and practical to implement at the community hospital level. Service was initiated at little to no cost and clearly enhanced care, increased breadth of care, increased ICU census, and reduced

  12. Biomarkers identification in Alzheimer’s disease using effective connectivity analysis from electroencephalography recordings

    Directory of Open Access Journals (Sweden)

    Jazmín X. Suárez-Revelo

    2016-09-01

    Full Text Available Alzheimer’s disease (AD is the most common cause of dementia, which generally affects people over 65 years old. Some genetic mutations induce early onset of AD and help to track the evolution of the symptoms and the physiological changes at different stages of the disease. In Colombia there is a large family group with the PSEN1 E280A mutation with a median age of 46,8 years old for onset of symptoms. AD has been defined as a disconnection syndrome; consequently, network approaches could help to capture different features of the disease. The aim of the current work is to identify a biomarker in AD that helps in the tracking of the neurodegenerative process. Electroencephalography (EEG was recorded during the encoding of visual information for four groups of individuals: asymptomatic and mild cognitive impairment carriers of the PSEN1 E280A mutation, and two non-carrier control groups. For each individual, the effective connectivity was estimated using the direct Directed Transfer Function and three measurements from graph theory were extracted: input strength, output strength and total strength. A relation between the cognitive status and age of the participants with the connectivity features was calculated. For those connectivity measures in which there is a relation with the age or the clinical scale, the performance as a diagnostic feature was evaluated. We found that output strength connectivity in the right occipito-parietal region is related to age of the carrier groups (r=−0,54, p=0,0036 and has a high sensitivity and high specificity to distinguish between carriers and non-carriers (67% sensitivity and 80% specificity in asymptomatic cases, and 83% sensitivity and 67% specificity in symptomatic cases. This relationship indicates that output strength connectivity could be related to the neurodegenerative process of the disease and could help to track the conversion from the asymptomatic stage to dementia.

  13. Evaluation of auditory perception development in neonates by quantitative electroencephalography and auditory event-related potentials.

    Science.gov (United States)

    Zhang, Qinfen; Cheng, Qirui; Li, Hongxin; Dong, Xuan; Tu, Wenjuan

    2017-01-01

    The present study was performed to investigate neonatal auditory perception function by quantitative electroencephalography (QEEG) and auditory event-related potentials (aERPs) and identify the characteristics of auditory perception development in newborns. Fifty-three normal full-term neonates were divided into three groups according their age in days. An auditory oddball paradigm was used. QEEG (resting state and task state) and aERPs were performed. EEG δ power in the resting and task states and at different ages was respectively analyzed. The N2 area and latency of aERPs at different ages were also compared. The four main findings of this study are as follows. First, the increase in the EEG δ power was significantly greater in the task than resting state in Group 3 at the Fz lead (t = -3.371, P = 0.004) and in Groups 2 and 3 at the Cz lead (Group 2: t = -3.149, P = 0.005; Group 3: t = -3.609, P = 0.002). Second, the δ power gradually increased from 1 to 10 days of age (Group 1), peaked at 11 to 20 days (Group 2), and gradually decreased from 21 to 28 days (Group 3). The data in the Fz lead during the task state and in the Cz lead during the resting and task states were statistically significant (F = 5.875, P = 0.005; F = 5.523, P = 0.007; and F = 5.402, P = 0.008, respectively). Third, the N2 area significantly increased with age by presentation of target stimuli (F = 5.26, P = 0.01). The N2 area increased most significantly from 21 to 28 days (Group 3). Finally, the N2 latency significantly decreased with age (Fz lead: F = 4.66, P = 0.023; Cz lead: F = 7.18, P = 0.005). The N2 latency decreased most significantly from 11 to 20 days of age (Group 2). Rapid cognitive development occurs during the neonatal period. In the first several days after birth, the EEG δ power and N2 area manifested the characteristic performance of identifying task information. QEEG and aERP measurement can be used as objective indices with which to evaluate auditory perception

  14. Evaluation of auditory perception development in neonates by quantitative electroencephalography and auditory event-related potentials.

    Directory of Open Access Journals (Sweden)

    Qinfen Zhang

    Full Text Available The present study was performed to investigate neonatal auditory perception function by quantitative electroencephalography (QEEG and auditory event-related potentials (aERPs and identify the characteristics of auditory perception development in newborns.Fifty-three normal full-term neonates were divided into three groups according their age in days. An auditory oddball paradigm was used. QEEG (resting state and task state and aERPs were performed. EEG δ power in the resting and task states and at different ages was respectively analyzed. The N2 area and latency of aERPs at different ages were also compared.The four main findings of this study are as follows. First, the increase in the EEG δ power was significantly greater in the task than resting state in Group 3 at the Fz lead (t = -3.371, P = 0.004 and in Groups 2 and 3 at the Cz lead (Group 2: t = -3.149, P = 0.005; Group 3: t = -3.609, P = 0.002. Second, the δ power gradually increased from 1 to 10 days of age (Group 1, peaked at 11 to 20 days (Group 2, and gradually decreased from 21 to 28 days (Group 3. The data in the Fz lead during the task state and in the Cz lead during the resting and task states were statistically significant (F = 5.875, P = 0.005; F = 5.523, P = 0.007; and F = 5.402, P = 0.008, respectively. Third, the N2 area significantly increased with age by presentation of target stimuli (F = 5.26, P = 0.01. The N2 area increased most significantly from 21 to 28 days (Group 3. Finally, the N2 latency significantly decreased with age (Fz lead: F = 4.66, P = 0.023; Cz lead: F = 7.18, P = 0.005. The N2 latency decreased most significantly from 11 to 20 days of age (Group 2.Rapid cognitive development occurs during the neonatal period. In the first several days after birth, the EEG δ power and N2 area manifested the characteristic performance of identifying task information. QEEG and aERP measurement can be used as objective indices with which to evaluate auditory perception

  15. Role of amplitude-integrated electroencephalography in neonates with cardiovascular compromise.

    Science.gov (United States)

    El-Naggar, Walid I; Keyzers, Matthew; McNamara, Patrick J

    2010-06-01

    Neonates with congenital heart disease (CHD) and persistent pulmonary hypertension of the newborn (PPHN) represent conditions with increased risk of abnormal neurologic outcome. The role of aEEG in disorders where cerebral perfusion/oxygenation is affected by cardiac or pulmonary disease is unknown. The aim of the study was to characterize amplitude-integrated electroencephalography (aEEG) traces in nonasphyxiated neonates with cardiorespiratory compromise secondary to PPHN or CHD. Three hundred sixty-three aEEG records (June 2004-November 2006) were reviewed to identify neonates with a diagnosis of isolated CHD or PPHN. Clinical course, critical interventions, and neurodiagnostic investigation data were collected. The aEEG traces were reviewed by a single blinded expert and classified according to background activity (normal, moderate, or severely abnormal) and presence of seizures. The frequency of abnormal aEEG in both groups and its relationship to recognized markers of abnormal neurologic outcome (electrophysiology [EP] testing and neuroimaging [ultrasound (USS), computerized tomography, and magnetic resonance imaging] was studied. Thirty neonates (PPHN [n = 20], CHD [n = 10]) were reviewed at a mean gestation of 39.2 +/- 1.1 weeks and weight of 3,375 +/- 565 g. Neonates with PPHN had lower Apgar scores at 1-minute (P = .02) and were significantly more likely to require inotropic support (P < .001), inhaled nitric oxide (P = .001), or surfactant (P = .01). An abnormal aEEG was found in 15 (50%) babies, but rates did not differ between CHD (n = 6) and PPHN (n = 9). The rates of abnormal composite neurologic outcome (2/3 of abnormal EP, neuroimaging, or neurologic examination) were significantly higher in neonates with abnormal aEEG. An abnormal magnetic resonance imaging was seen in 4 of 5 neonates with abnormal aEEG. The risk of abnormal aEEG is high in sick neonates with PPHN or complex CHD. Prospective evaluation of the relationship between aEEG recordings

  16. Dynamic Cerebrovascular and Intracranial Pressure Reactivity Assessment of Impaired Cerebrovascular Autoregulation in Intracranial Hypertension.

    Science.gov (United States)

    Bragin, Denis E; Statom, Gloria; Nemoto, Edwin M

    2016-01-01

    We previously suggested that the discrepancy between a critical cerebral perfusion pressure (CPP) of 30 mmHg, obtained by increasing intracranial pressure (ICP), and 60 mmHg, obtained by decreasing arterial pressure, was due to pathological microvascular shunting at high ICP [1], and that the determination of the critical CPP by the static cerebral blood flow (CBF) autoregulation curve is not valid with intracranial hypertension. Here, we demonstrated that induced dynamic ICP reactivity (iPRx), and cerebrovascular reactivity (CVRx) tests accurately identify the critical CPP in the hypertensive rat brain, which differs from that obtained by the static autoregulation curve. Step changes in CPP from 70 to 50 and 30 mmHg were made by increasing ICP using an artificial cerebrospinal fluid reservoir connected to the cisterna magna. At each CPP, a transient 10-mmHg increase in arterial pressure was induced by bolus intravenous dopamine. iPRx and iCVRx were calculated as ΔICP/Δ mean arterial pressure (MAP) and as ΔCBF/ΔMAP, respectively. The critical CPP at high ICP, obtained by iPRx and iCVRx, is 50 mmHg, where compromised capillary flow, transition of blood flow to nonnutritive microvascular shunts, tissue hypoxia, and brain-blood barrier leakage begin to occur, which is higher than the 30 mmHg determined by static autoregulation.

  17. Unruptured intracranial aneurysms in the Familial Intracranial Aneurysm and International Study of Unruptured Intracranial Aneurysms cohorts : Differences in multiplicity and location

    NARCIS (Netherlands)

    Mackey, Jason; Brown, Robert D; Moomaw, Charles J; Sauerbeck, Laura; Hornung, Richard; Gandhi, Dheeraj; Woo, Daniel; Kleindorfer, Dawn; Flaherty, Matthew L; Meissner, Irene; Anderson, Craig; Connolly, E Sander; Rouleau, Guy; Kallmes, David F; Torner, James; Huston, John; Broderick, Joseph P; Groen, Rob

    OBJECT: Familial predisposition is a recognized nonmodifiable risk factor for the formation and rupture of intracranial aneurysms (IAs). However, data regarding the characteristics of familial IAs are limited. The authors sought to describe familial IAs more fully, and to compare their

  18. Epidemiological and imaging features of intracranial aneurysms in young adults

    Directory of Open Access Journals (Sweden)

    WANG Huan-yu

    2013-03-01

    Full Text Available Background Nowadays, the epidemiological report and study about the intracranial aneurysms in young adults are very rare, especially in China. This paper aims to investigate the epidemiological and imaging features of intracranial aneurysms in young adults with the age of 16-29 years old. Methods Clinical data of 2119 patients with intracranial aneurysms admitted from January 2010 to October 2012 were retrospectively analyzed. Results Intracranial aneurysms in young adults (16-29 years old accounted for 1.93% of all intracranial aneurysms (41/2119 treated in the same period, and the gender ratio (male : female was 2.15 : 1. A total of 42 intracranial aneurysms were found in 41 patients, including 35 located in the anterior circulation and 7 in the posterior circulation, of which 13 aneurysms (30.95% in the anterior communicating artery, 6 aneurysms (14.29% each in the middle cerebral artery and the distal of anterior cerebral artery, and 2 aneurysms (4.76% in the posterior communicating artery. There were almost 34 aneurysms (80.95% located in bifurcation of Willis circle and proximal aorta and 8 aneurysms (19.05% in the branches of artery. The diameter of aneurysms were ≤5 mm in 19 aneurysms (45.24%, 6-10mm in 13 (30.95%, 11-24 mm in 3 (7.14% and ≥25mm in 7 (16.67%. Conclusion Young men are much more susceptible to intracranial aneurysms than young women, but the incidence in women increases as they grow old. The anterior communicating artery is the predilection site of intracranial aneurysms in young adults (16-29 years old, and the occurence of giant aneurysms and the aneurysms in the posterior circulation and the distal of anterior cerebral artery is common. The epidemiological and imaging features and gender ratio of intracranial aneurysms in young adults (16-29 years old are similar to those in children and adolesents, but much different from adult patients.

  19. Direct cervical arterial access for intracranial endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Blanc, R. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); APHP, Hopital Henri Mondor, Service de Neuroradiologie Diagnostique et Therapeutique, Creteil Cedex (France); Piotin, M.; Mounayer, C.; Spelle, L. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Moret, J. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Hopital de la Fondation Ophtalmologique Adolphe de Rothschild, Service de Neuroradiologie Interventionnelle, Paris Cedex 19 (France)

    2006-12-15

    Tortuous vasculature is a cause of failure of endovascular treatment of intracranial vascular lesions. We report our experience of direct cervical accesses in patients in whom the arterial femoral route was not attainable. In this retrospective study, 42 direct punctures of the carotid or the vertebral arteries at the neck were performed in 38 patients. The vessel harboring the intracranial lesion was punctured at the neck above the main tortuosity, a sheath was then positioned under fluoroscopic control to allow a stable access to the intracranial circulation. After the procedure, the sheath was removed and hemostasis was gained either by manual compression or by an arterial closure device (4 of 42, 9%). The cervical route allowed access to all intracranial lesions in all 42 procedures. A complication was encountered in six procedures (14%) related to the direct puncture. In 2 of the 42 procedures (4%), a transient vasospasm was encountered. A cervical hematoma formed in 3 of the 42 procedures (7%) after sheath withdrawal (one patient in whom an 8F sheath had been used, required surgical evacuation of a hematoma compressing the upper airways; the other patients did well without surgical evacuation). In the remaining patient (1 of 42 procedures, 2%), a small asymptomatic aneurysm at the puncture site was seen on the follow-up angiogram. Direct cervical arterial approaches to accessing the intracranial circulation is effective in patients in whom the femoral route does not allow the navigation and stabilization of guiding catheters. (orig.)

  20. Intracranial hemorrhage: principles of CT and MRI interpretation

    International Nuclear Information System (INIS)

    Parizel, P.M.; Makkat, S.; Miert, E. van; Goethem, J.W. van; Hauwe, L. van den; Schepper, A.M. de

    2001-01-01

    Accurate diagnosis of intracranial hemorrhage represents a frequent challenge for the practicing radiologist. The purpose of this article is to provide the reader with a synoptic overview of the imaging characteristics of intracranial hemorrhage, using text, tables, and figures to illustrate time-dependent changes. We examine the underlying physical, biological, and biochemical factors of evolving hematoma and correlate them with the aspect on cross-sectional imaging techniques. On CT scanning, the appearance of intracranial blood is determined by density changes which occur over time, reflecting clot formation, clot retraction, clot lysis and, eventually, tissue loss. However, MRI has become the technique of choice for assessing the age of an intracranial hemorrhage. On MRI the signal intensity of intracranial hemorrhage is much more complex and is influenced by multiple variables including: (a) age, location, and size of the lesion; (b) technical factors (e.g., sequence type and parameters, field strength); and (c) biological factors (e.g., pO2, arterial vs venous origin, tissue pH, protein concentration, presence of a blood-brain barrier, condition of the patient). We discuss the intrinsic magnetic properties of sequential hemoglobin degradation products. The differences in evolution between extra- and intracerebral hemorrhages are addressed and illustrated. (orig.)

  1. Sinusitis and intracranial sepsis: the CT imaging and clinical presentation

    International Nuclear Information System (INIS)

    Saxton, V.J.; Boldt, D.W.; Shield, L.K.

    1995-01-01

    The CT imaging and clinical presentation in 14 children with coexistent intracranial sepsis and sinusitis were reviewed. A routine CT head scan (10-mm thick semi-axial slices through the cranium done before and after intravenous contrast medium administration) was found to be an inadequate initial investigation as the intracranial collection was missed in four patients and the abnormal sinuses not shown in six. In half the children the dagnosis of sinusitis was unsuspected at the time of admission. The dominant clinical features were fever, intense headache and facial swelling in early adolescent males. In this clinical setting we recommend: (1) The routine scan is extended through the frontal and ethmoidal sinuses and photographed at a window level and width showing both bone detail and air/soft tissue interfaces; (2) direct coronal projections are performed through the anterior cranial fossa if no collection is seen on the routine study; (3) an early repeat scan within 48 h if the initial study shows no intracranial pathology but the fronto-ethomoidal sinuses are abnormal and there is a high clinical supicion of intracranial sepsis; and (4) in the presence of intracranial sepsis the vault is viewed at bone window settings to exclude cranial osteomyelitis. (orig.)

  2. Intracranial hemorrhage: principles of CT and MRI interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Parizel, P.M.; Makkat, S.; Miert, E. van; Goethem, J.W. van; Hauwe, L. van den; Schepper, A.M. de [Dept. of Radiology, University of Antwerp, Edegem (Belgium)

    2001-09-01

    Accurate diagnosis of intracranial hemorrhage represents a frequent challenge for the practicing radiologist. The purpose of this article is to provide the reader with a synoptic overview of the imaging characteristics of intracranial hemorrhage, using text, tables, and figures to illustrate time-dependent changes. We examine the underlying physical, biological, and biochemical factors of evolving hematoma and correlate them with the aspect on cross-sectional imaging techniques. On CT scanning, the appearance of intracranial blood is determined by density changes which occur over time, reflecting clot formation, clot retraction, clot lysis and, eventually, tissue loss. However, MRI has become the technique of choice for assessing the age of an intracranial hemorrhage. On MRI the signal intensity of intracranial hemorrhage is much more complex and is influenced by multiple variables including: (a) age, location, and size of the lesion; (b) technical factors (e.g., sequence type and parameters, field strength); and (c) biological factors (e.g., pO2, arterial vs venous origin, tissue pH, protein concentration, presence of a blood-brain barrier, condition of the patient). We discuss the intrinsic magnetic properties of sequential hemoglobin degradation products. The differences in evolution between extra- and intracerebral hemorrhages are addressed and illustrated. (orig.)

  3. Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy.

    Science.gov (United States)

    Papadelis, Christos; Tamilia, Eleonora; Stufflebeam, Steven; Grant, Patricia E; Madsen, Joseph R; Pearl, Phillip L; Tanaka, Naoaki

    2016-12-06

    Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency Oscillations (HFOs) have emerged as potential presurgical biomarkers for the identification of the EZ in addition to Interictal Epileptiform Discharges (IEDs) and ictal activity. Although they are promising to localize the EZ, they are not yet suited for the diagnosis or monitoring of epilepsy in clinical practice. Primary barriers remain: the lack of a formal and global definition for HFOs; the consequent heterogeneity of methodological approaches used for their study; and the practical difficulties to detect and localize them noninvasively from scalp recordings. Here, we present a methodology for the recording, detection, and localization of interictal HFOs from pediatric patients with refractory epilepsy. We report representative data of HFOs detected noninvasively from interictal scalp EEG and MEG from two children undergoing surgery. The underlying generators of HFOs were localized by solving the inverse problem and their localization was compared to the Seizure Onset Zone (SOZ) as this was defined by the epileptologists. For both patients, Interictal Epileptogenic Discharges (IEDs) and HFOs were localized with source imaging at concordant locations. For one patient, intracranial EEG (iEEG) data were also available. For this patient, we found that the HFOs localization was concordant between noninvasive and invasive methods. The comparison of iEEG with the results from scalp recordings served to validate these findings. To our best knowledge, this is the first study that presents the source localization of scalp HFOs from simultaneous EEG and MEG recordings comparing the results with invasive recordings. These findings suggest that HFOs can be reliably detected and localized noninvasively with scalp EEG and MEG. We conclude that the noninvasive localization of interictal HFOs could significantly improve the

  4. Overall outcomes following early interventions for intracranial arteriovenous malformations with hematomas.

    Science.gov (United States)

    Bir, Shyamal C; Maiti, Tanmoy Kumar; Konar, Subhas; Nanda, Anil

    2016-01-01

    We evaluated the timing and predictors of surgical intervention for intracranial arteriovenous malformations (AVM) with hematoma. A ruptured intracranial AVM with hematoma is an emergency condition, and the optimal timing for surgical intervention is not well understood. In addition, the outcome predictors of surgical intervention have rarely been reported. We identified and analyzed 78 patients treated with microsurgical resection for pathologically proven AVM at Louisiana State University Health in Shreveport from February 1992 to December 2004. All 78 patients were diagnosed with ruptured AVM before surgery. The independent variables, including patient demographics, timing of surgery, location of the AVM and comorbidities were analyzed to assess outcome. The results of this series revealed that surgical intervention after 48hours resulted in poor outcomes for patients with hematoma, following a ruptured AVM. Several other prognostic factors, including younger age (11-40years), Spetzler-Martin Grade I and II, and AVM in a supratentorial location, had significant positive effects on outcomes. However, hypertension, smoking, and a prior embolization showed significant negative effects on outcomes after surgery. The multiple logistic regression analyses also revealed that the timing of surgical intervention had a significant effect on outcomes in patients with hematoma following ruptured AVM. Early intervention is the key to success in these patients. Published by Elsevier Ltd.

  5. [A case of acute intracranial epidural hematoma caused by chronic nasal sinusitis].

    Science.gov (United States)

    Kihara, Kazunori; Sato, Motoki; Kado, Ken; Fukuda, Kazumasa; Nakamura, Takao; Yamakami, Iwao

    2015-01-01

    Non-traumatic intracranial acute epidural hematoma(EDH)is rare. It is mostly caused by coagulation disorders, dural metastasis, or vascular malformations of the dura. We report a case of non-traumatic acute EDH caused by chronic nasal sinusitis and review the literature comprising 10 cases of acute EDH caused by chronic nasal sinusitis. A 16-year-old boy visited our outpatient clinic with a 2-day history of severe headache. He did not have fever or neurological abnormalities and showed no evidence of head trauma. Cranial computed tomography(CT)revealed sphenoid sinusitis and a small amount of epidural air in the middle fossa, but no other intracranial abnormalities. After eight days with no subsequent history of trauma, radiological exams showed a massive acute epidural hematoma in the left middle fossa and temporal convexity without any vascular lesion or skull fracture. The patient underwent a hematoma evacuation that revealed neither a skull fracture nor a vascular abnormality. In this adolescent, chronic nasal sinusitis caused fragility of the meningeal artery wall, an air collection in the epidural space, and the detachment of the dura mater from the inner surface of the skull, thereby resulting in a non-traumatic acute EDH.

  6. Osmolality of Cerebrospinal Fluid from Patients with Idiopathic Intracranial Hypertension (IIH)

    DEFF Research Database (Denmark)

    Wibroe, Elisabeth A; Yri, Hanne M; Jensen, Rigmor H

    2016-01-01

    INTRODUCTION: Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial fluid pressure (ICP) of unknown etiology. This study aims to investigate osmolality of cerebrospinal fluid (CSF) from patients with IIH. METHODS: We prospectively collected CSF from individuals referred...

  7. Recanalization and rupture after intracranial aneurysm treatment.

    Science.gov (United States)

    Costa, Emmanuel; Vaz, Geraldo R; Finet, Patrice; Goffette, Pierre; Docquier, Marie A; Raftopoulos, Christian

    2016-11-25

    Treatment of intra cranial aneurysm (ICA) can sometimes required several procedures. The aim of this study is to analyze the risk of recanalization and rupture recurrence after ICA treatment by endovascular coiling (EVC) or surgical clipping (SC) on a very long follow-up. Clinical data of 373 consecutive patients treated in our group between January 1996 and December 2006 as well by EVC as by SC for ruptured (RIA) or unruptured intracranial aneurysm (UIA), were reviewed. Patients were followed up at least to August 2009. First radiologic follow-up done six months after EVC and between three and five years after SC (median time: 5 years)). All patients underwent a clinical follow-up after treatment, at least by telephonic communication (median time: 6 years). Out of 197 patients with 198 RIAs, 82 (42 %) patients underwent an endovascular treatment and 115 (58%) were allocated to surgical treatment. From a total of 176 patients with 229 UIAs, 66 (37.5%) patients were treated by 74 EVC; and 110 (62.5%) patients were treated with 124 surgical procedures. Fifteen recanalizations of coiled RIAs were detected and only one in the surgical group (27% vs. 2%; p= 0.0008). Of the 15 recanalizations in the EVC group, 6 (40%) were initially completely occluded. We observed two rebleedings, one in each group (1.4% for EVC; 1% for SC; p=0.8). Our findings during the longest reported follow-up confirm a greater risk of recanalization for RIA treated by EVC without so far a significant difference in the rerupture risk.

  8. Fractionated stereotactic radiotherapy of small intracranial malignancies

    International Nuclear Information System (INIS)

    Tokuuye, Koichi; Akine, Yasuyuki; Sumi, Minako; Kagami, Yoshikazu; Murayama, Shigeyuki; Nakayama, Hidetsugu; Ikeda, Hiroshi; Tanaka, Minoru; Shibui, Soichiro; Nomura, Kazuhiro

    1998-01-01

    Purpose: To retrospectively evaluate the effectiveness of fractionated stereotactic radiotherapy (FSRT) in patients with small intracranial malignancies. Methods and Materials: From July 1991 to March 1997, 80 patients with a total of 121 brain or skull-base tumors were treated with FSRT alone, and were followed for periods ranging from 3 to 62 months (median 9.8). The majority of patients received 42 Gy in 7 fractions over 2.3 weeks, but in July 1993, protocols using smaller fraction doses were introduced for patients whose radiation-field diameters were larger than 3 cm or whose tumors were close to critical normal tissues. Results: For 64 patients with metastatic brain tumors the overall median survival was 8.3 months and 1-year actuarial survival rate was 33%. Significant prognostic factors were: the presence of extracranial tumors, pre-treatment performance status, and the lung as a primary site. Patients without extracranial tumors prior to FSRT had a median survival of 21.2 months. For seven patients with high-grade glioma, 1-year actuarial local control rate was 75%, with a median survival of 10.3 months. For patients with skull-base tumors the local control was achieved in 6 of 6 patients (100%), with a median survival of 30.7 months. No one suffered from acute complications, but three patients, two of whom had undergone FSRT as the third course of radiotherapy, developed late radiation injuries. Conclusion: Overall high local control and low morbidity rates suggest that FSRT is an effective and safe modality, even for those with a history of prior irradiation. However, patients with risk factors should be treated with smaller fraction doses

  9. Lifetime Effects of Small Unruptured Intracranial Aneurysms.

    Science.gov (United States)

    Aishima, Kaoru; Shimizu, Tatsuya; Aihara, Masanori; Yoshimoto, Yuhei

    2016-11-01

    Recent prospective multicenter studies have shown that the probability of rupture of unruptured aneurysms with maximal diameter <7 mm is rather low. However, the overall risks and long-term impact of unruptured aneurysms on lifetime quality of life are still unknown. A mathematical model of the natural history of intracranial aneurysms was constructed, in which the hypothetical individuals with or without unruptured aneurysm transit between discrete health states. The annual rupture rate of small aneurysms was assumed to be 0.5% in the baseline analysis, followed by the subsequent sensitivity analysis. The analyses were continued until cumulative death rate from subarachnoid hemorrhage or other causes reached 1.0. Age-specific ratios of death of subarachnoid hemorrhage in the individuals harboring unruptured aneurysm, if dying at 60 years old, were 25% in men and 43% in women. These ratios decreased rapidly with higher age. Most (more than 90%) patients with small aneurysms were expected to die of diseases other than subarachnoid hemorrhage. In the baseline analysis (60-year-old individuals), lifetime lost to small aneurysms could be estimated as 3.8% for men and 4.2% for women, but a somewhat larger impact could be identified in the young and/or female individuals compared with in the elderly and/or male individuals. Lifetime effects of small unruptured aneurysms without risk factors increasing the probability of rupture are relatively small, and most patients were expected to die of diseases other than subarachnoid hemorrhage. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. [Intracranial collision tumor--A case report (author's transl)].

    Science.gov (United States)

    Fukaya, T; Yoshida, J; Banno, T; Kageyama, N; Ito, M

    1976-06-01

    A 21-year-old man with nasopharyngeal tumor was first admitted to the Nagoya University Hospital on April 15, 1972. He had difficulty in speaking and swallowing, and developed double vision prior to admission. A soft and yellow tumor was found in the nasopharynx and revealed typical features of chordoma. The patient underwent Co60 irradiation after the operation. On January 25, 1973, the patient developed double vision of severe degree. Microscopic examination of the specimen which was obtained at the time of the second operation in February 9, 1973, disclosed a coexistence (collision) of chordoma and hemangioblastoma. The two different tumors were situated in juxtaposition on histological examination. Co60 irradiation was added during his second hospitalization. Three months after the second operation, he developed symptoms of meningitis and was hospitalized for the third time on June 3, 1973, at which time the tumor tissue extended through the right frontal and middle fossa. The third operation was done with frontal craniotomy and tumor was partially removed. The histological diagnosis was hemangioblastoma. Postoperatively the patient went downhill and died on September 19, 1973. The report of a collision tumor of intracranial chordoma and hemangioblastoma is not found in the previous literature. There have been many theories as to the origin of collision tumor. Some investigators have proposed that the existence of hyperplastic blood vessels within the glioblastoma is responsible for the collision tumor of sarcoma and glioblastoma. Since the advent of radiotherapy, several examples of sarcoma have been discovered at postmortem examination in patient irradiated for treatment of cerebral neoplasm, both gliogeneous and nongliogenous, suggesting a possible relationship between the tumor and the radiation therapy. In our case, the chordoma showed neither hyperplastic blood vessels nor malignant pattern on histological examination. It was suspected that post

  11. Electroencephalography-based real-time cortical monitoring system that uses hierarchical Bayesian estimations for the brain-machine interface.

    Science.gov (United States)

    Choi, Kyuwan

    2014-06-01

    In this study, a real-time cortical activity monitoring system was constructed, which could estimate cortical activities every 125 milliseconds over 2,240 vertexes from 64 channel electroencephalography signals through the Hierarchical Bayesian estimation that uses functional magnetic resonance imaging data as its prior information. Recently, functional magnetic resonance imaging has mostly been used in the neurofeedback field because it allows for high spatial resolution. However, in functional magnetic resonance imaging, the time for the neurofeedback information to reach the patient is delayed several seconds because of its poor temporal resolution. Therefore, a number of problems need to be solved to effectively implement feedback training paradigms in patients. To address this issue, this study used a new cortical activity monitoring system that improved both spatial and temporal resolution by using both functional magnetic resonance imaging data and electroencephalography signals in conjunction with one another. This system is advantageous as it can improve applications in the fields of real-time diagnosis, neurofeedback, and the brain-machine interface.

  12. Idiopathic intracranial hypertension associated with anaemia, secondary to antiretroviral drug in a human immunodeficiency virus positive patient

    Directory of Open Access Journals (Sweden)

    J Vijay Ananth

    2018-01-01

    Full Text Available Papilledema in a patient with human immunodeficiency virus (HIV/acquired immune deficiency syndrome is an alarming finding. Any condition giving rise to raised intracranial tension (ICT can cause papilledema, and in these patients, it could be secondary to opportunistic infections like meningitis to neoplasm. We report a case of a 28-year old female with HIV on antiretroviral therapy, who presented to us, with papilledema. Her fundus examination revealed superficial hemorrhages and Roth's spots along with papilledema. Patient was diagnosed with idiopathic intracranial hypertension (IIH, and all other possible systemic associations were ruled out. Her blood tests showed severe anemia. The papilledema and retinal changes resolved with treatment of anemia. This is a rare presentation of IIH in HIV positive patient due to anemia, secondary to zidovudine adverse effect.

  13. Intracranial hypotension - a look beyond “bilateral subdural hematomas”

    International Nuclear Information System (INIS)

    Penev, B.

    2015-01-01

    Full text: The intracranial hypotension (ICH) is a disorder due to spontaneous or iatrogenic CSF leak and a low intracranial pressure. The clinical presentation is characterized by drug resistant orthostatic headache, nausea, vomiting, dizziness, neck pain and etc. The intracranial hypotension is defined as a benign disorder and the treatment is predominantly conservative. Due to this fact it is very important to differentiate this entity from subdural hematomas and hygromas which are treated surgically. Magnetic resonance imaging has revolutionized the diagnosis of ICH. Nowadays there are a lot of clinical and imaging features of this disorder. Regardless of clinical varieties and atypical forms, MRI gives enough information for the correct or probable diagnosis in the vast majority of the cases. The initial imaging resemblance with posttraumatic subdural hematomas and hygromas can result in giving the wrong diagnosis and therefore performing unneeded surgical interventions. the aim of this presentation is to discuss the contemporary criteria, algorithm and imaging features of ICH

  14. Proximal Limb Weakness Reverting After CSF Diversion In Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Sinha S

    2005-01-01

    Full Text Available We report about two young girls who developed progressive visual failure secondary to increased intracranial pressure and had significant proximal muscle weakness of limbs. Patients with elevated intracranial pressure (ICP may present with "false localizing signs", besides having headache, vomiting and papilledema. Radicular pain as a manifestation of raised ICP is rare and motor weakness attributable to polyradiculopathy is exceptional. Two patients with increased intracranial pressure without lateralizing signs′ had singnificant muscle weakness. Clinical evaluation and laboratory tests did not disclose any other cause for weakness. Following theco-peritoneal shunt, in both patients, there was variable recovery of vision but the proximal weakness and symptoms of elevated ICP improved rapidly. Recognition of this uncommon manifestation of raised ICP may obviate the need for unnecessary investigation and reduce morbidity due to weakness by CSF diversion procedure.

  15. Intracranial atherosclerosis: Causes of ischemic stroke, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    V.A Sorokoumov

    2014-01-01

    Full Text Available The paper reviews the literature on the identification of the causes of ischemic stroke and transient ischemic attacks in intracranial atherosclerosis. Symptomatic intracranial atherosclerosis is the cause of an ischemic focus in not only the cortical and subcortical structures due to hypoperfusion or arterio-arterial embolism, but also in the deep structures of the cerebral hemispheres and brainstem. Major artery dolichoectasia may make an accurate diagnosis and treatment choice difficult.Progress in the treatment of patients with symptomatic intracranial atherosclerosis depends on the availability of current brain and vessel imaging techniques and cranial artery angioplasty and stenting methods. The efficiency of aggressive medical prevention, primarily blood pressure reduction and different combinations of antiplatelet drugs, is being intensively investigated.

  16. Endoscopic transnasal resection of ameloblastoma with intracranial extension.

    Science.gov (United States)

    Woodroffe, Royce W; Abel, Taylor J; Fletcher, Aaron; Grossbach, Andrew; Van Daele, Douglas J; O'Brien, Erin; Greenlee, Jeremy D W

    2014-05-01

    Ameloblastoma is a rare odontogenic tumor with characteristics of epithelial tissue that produces enamel for the developing tooth. This lesion is generally considered benign, but has malignant forms that invade locally and metastasize. We present a 60-year-old man with maxillary ameloblastoma that after multiple recurrences developed intracranial extension with dural involvement of the middle cranial fossa and was treated by endoscopic transnasal resection followed by radiation therapy. Our technique and intraoperative findings are described with a review of the literature on intracranial ameloblastoma. This patient represents a unique account of endoscopic transnasal resection being utilized in the treatment of intracranial extension of ameloblastoma and demonstrates potential for application in similar cases. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Complete ophthalmoplegia: A rare presentation of idiopathic intracranial hypertension

    Directory of Open Access Journals (Sweden)

    Irfan Yousuf Wani

    2015-01-01

    Full Text Available Idiopathic intracranial hypertension (IIH is a disorder defined by clinical criteria that include signs and symptoms isolated to those produced by increased intracranial pressure (ICP; e. g., headache, papilledema, and vision loss, elevated ICP with normal cerebrospinal fluid (CSF composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. The most common signs in IIH are papilledema, visual field loss, and unilateral or bilateral sixth cranial nerve palsy. Here we report a case of IIH presenting as headache with vision loss, papilledema, complete ophthalmoplegia with proptosis in one eye, and sixth cranial nerve palsy in the other eye. Patient was managed with acetazolamide, topiramate, and diuretics. Symptoms remained static and she was planned for urgent CSF diversion procedure.

  18. [Intracranial sinus thrombosis secondary to the consumption of inhaled speed].

    Science.gov (United States)

    Méndez-Sánchez, Fabiola; Guisado, Juan A; Palacios, Ramón; Teva, Isabel

    2011-01-01

    Speed is a psychostimulant of the Central Nervous System that can cause behavioral alterations, euphoria, psychosis and diverse organic medical pictures. The case of a 19 year old male patient, who consumes amphetamines, who had behavioral alterations and heteroaggressiveness, circumstances that required psychiatric admission is presented. After performing brain imaging tests, intracranial venous sinus thrombosis was found, which has not, up to the present date, developed significant symptoms. The aim of the above-mentioned report is to know the mechanism of action of the speed and to relate it consumption to the appearance of intracranial sinus thrombosis. To do so, a search was conducted in the PubMed database using the following terms: amphetamines and intracranial sinus thrombosis; street drugs and cerebrovascular disease; and adverse effects of the drugs.

  19. Intracranial arterial anatomy: evaluation by computed tomography angiography

    International Nuclear Information System (INIS)

    Regattieri, Neysa Aparecida Tinoco; Haetinger, Rainer Guilherme; Liberti, Edson Aparecido

    2010-01-01

    By many decades, the intracranial arteries study was realized exclusively by angiography through selective arterial catheterization. Nowadays, with the technologic evaluation of computerized tomography devices with multi detectors allowing acquisitions with even more thinner slices, higher speed and better resolution, it had appeared a new modality of investigation: the computed tomography angiography, less invasive and with minor morbidity than conventional arteriography. Many studies in the literature have been analyzing the sensibility of the new method for the detection of intracranial aneurysms and comparing them with the conventional arteriography. There is a necessity to recognize the normal intracranial arterial anatomy and its variations using images obtained from multiplanar reformations, in order to give important information for surgeries strategies, such as wall calcifications, aneurismatic neck position and relationships with surrounding anatomical structures. (author)

  20. CT diagnosis of hyperdense intracranial neoplasms. Review of the literature

    International Nuclear Information System (INIS)

    Ishikura, Reiichi; Ando, Kumiko; Tominaga, Satoru; Nakao, Norio; Ikeda, Jouta; Takemura, Yuriko; Morikawa, Tsutomu

    1999-01-01

    In contrast to typical astrocytic tumors that show hypodense areas on computed tomographic images, some intracranial tumors show hyperdense areas on CT images. The major reasons for hyperdensity on CT images are hypercellular lesions, intratumoral calcification, and intratumoral hemorrhage. Malignant lymphomas, germinomas, and medulloblastomas show homogenous hyperdensity on CT images because of their hypercellularity. Tumorous lesions such as subependymal giant cell astrocytomas, oligodendrogliomas, ependymomas, central neurocytomas, craniopharyngiomas, and meningiomas often present with hyperdense calcified lesions on CT images. Intratumoral hemorrhage also causes hyperdensity on CT images, and is often associated with metastatic brain tumors, glioblastomas, pituitary adenomas, and rarely with any of the other intracranial tumors. Although magnetic resonance imaging is now the major diagnostic tool for diseases of the central nervous system, the first imaging studies for patients with neurologic symptoms are still CT scans. Hyperdense areas on CT images are a clue to making an accurate diagnosis of intracranial neoplasms. (author)

  1. Application of dual volume reconstruction technique in embolization of intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    Xiang-hai ZHANG

    2014-03-01

    Full Text Available Objective To explore the value of dual volume reconstruction technique in Guglielmi detachable coil (GDC embolization of intracranial aneurysms. Methods Three-dimensional imaging data of 20 patients received GDC embolization of intracranial aneurysms from Jun. 2012 to Apr. 2013 were analyzed for dual volume reconstruction. The value of application of dual volume reconstruction was evaluated by the detection rate of coils bolus, degree of aneurysm occlusion, the length of aneurysm sac and aneurysm neck before and after embolization, and the characteristics and clinical value of the reconstructed images. Results  A total of 20 coil boluses were detected by dual volume reconstruction images, and the detection rate was 100%. Among all of 20 patients, no visualization of contrast medium in the aneurysm was found in 13 patients, while contrast agent was found in the aneurysm sac in 3 patients and in the aneurysm neck in 4 patients. The length of aneurysm neck and sac was somewhat changed before and after embolization with no statistically significant difference (P>0.05. The dual volume reconstruction could reveal coil bolus, vessels, cranium and fusion images, and the aneurysms could be shown by different imaging modes according to the clinical requirement. Conclusion Dual volume reconstruction technique can display the location of coil bolus, degree of occlusion and aneurysm size, and evaluate the embolization effect by multifarious imaging modes, providing a great deal of information for the evaluation of GDC embolization of intracranial aneurysm. DOI: 10.11855/j.issn.0577-7402.2014.02.13

  2. Intracranial neurenteric cyst: A rare cause of chemical meningitis

    Directory of Open Access Journals (Sweden)

    Naseer A Choh

    2013-01-01

    Full Text Available Intracranial neurenteric cysts are exceedingly rare congenital intracranial lesions that result from disorder of gastrulation. Still, more rarely, the cyst contents may leak into the CSF and give rise to recurrent episodes of chemical meningitis. We present a case of chemical meningitis due to a leaking posterior fossa neurenteric cyst in a young female, with emphasis on its imaging features. The final diagnosis was achieved by sufficiently characteristic imaging features; histopathologic documentation could not be achieved as the patient denied surgery.

  3. Computerized tomography in the study of intracranial complications in hematology

    International Nuclear Information System (INIS)

    Gastaut, J.L.; Gastaut, J.A.

    1979-01-01

    CT was used to examine 100 patients with various hematologic disorders. It was generally in patients with clinical signs of encephalic alteration (68% of the cases) that we demonstrated lesions. In several cases, the lesions were detected by CT, whereas common neurological investigational methods remained negative. The most interesting findings were in acute leukemias (leucoblastic infiltrations, cerebral hemorrhages and infarctions, and iatrogenic morphologic modifications) and in Hodgkin diseases (intracranial localizations). CT permits a more complete neurologic work-up for patients with hematologic disorders and provides a better knowledge of the frequency and varieties of intracranial complications. (orig.) 891 MG/orig. 892 MB [de

  4. Intracranial dural arterio-venous fistula presenting with progressive myelopathy.

    LENUS (Irish Health Repository)

    Ogbonnaya, Ebere Sunny

    2011-01-01

    Spinal dural arterio-venous fistula (DAVF) is rare and usually involves the thoracic segments. The classical presentation is a slowly progressive ataxia. Clinical presentation of intracranial DAVF depends on the site of the DAVF, as well as the vessels involved. Patients may present with pulsatile tinnitus, occipital bruit, headache, dementia, visual impairment as well as neurological deterioration distant from the DAVF as a result of venous hypertension and cortical haemorrhage. The authors present a rare case of progressive myelopathy secondary to an intracranial DAVF.

  5. Non tumoral intracranial expansive processes: clinical tomographic correlation

    International Nuclear Information System (INIS)

    Campos, P.; Herrera, G.; Valneica, F.

    1991-01-01

    Presentation of clinical-tomographic correlation in 111 cases of non tumoral intracranial expansive processes seen between 1984-1988 in the Hospital Cayetano Heredia (Lima, Peru). Emphasis is given fundamentally to: the importance of establishing the organicity of partial and late epilepsy; the high incidence rate of inflammatory infectious processes with CNS compromise in under developing countries; the necessity of making public the importance of two parasitic diseases in the differential diagnosis of non tumoral intracranial expansive processes: free living amebiasis, and toxoplasmosis (especially in association with AIDS). (author)

  6. The course of headache in idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, H M; Rönnbäck, C; Wegener, Marianne

    2014-01-01

    of the remaining 20 patients reported sustained chronic headache. Early age of onset and high diagnostic intracranial pressure (ICP) were associated with better headache outcome (≤1 headache days/month) after a year. Papilledema decreased rapidly within the first 2 months of diagnosis. After 1 year, OCT measures......BACKGROUND AND PURPOSE: Our aim was to prospectively describe the course of headache during the first year of idiopathic intracranial hypertension (IIH). METHODS: Patients with newly diagnosed IIH were consecutively included from December 2010 to June 2013. Treatment according to standard...

  7. Spontaneous intracranial haemorrhage in children with chronic immune thrombocytopenic purpura.

    Science.gov (United States)

    Muda, Z; Ibrahim, H; Abdulrahman, E J; Mahfuzah, M; Othman, I S; Asohan, T; Menon, B S

    2014-12-01

    Spontaneous intracranial haemorrhage (ICH) is a rare complication of chronic immune thrombocytopenic purpura (ITP) in children. We report four patients with cITP who developed ICH. The latency between onset of ITP and ICH varied from 1-8 years. All our patients were profoundly thrombocytopenic (platelet count of <10 x 109/l) at the time of their intracranial bleed. The presenting features and management are discussed. All patients survived, three had complete neurological recovery while one had a minimal residual neurological deficit.

  8. Usefulness of dynamic subtraction CT for intracranial high density lesions

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, Ryo; Hayashi, Hiromitsu; Ichikawa, Taro; Kumazaki, Tatsuo (Nippon Medical School, Tokyo (Japan))

    1994-04-01

    Dynamic subtraction CT (DSCT) using a high speed Rotate/Rotate CT Scanner (Toshiba Xforce) was performed on 10 patients with intracranial high density lesions such as brain tumors and vascular malformations. In comparison with conventional contrast enhanced CT, the technique of dynamic subtraction CT enabled us to evaluate more clearly the contrast enhancement of high density lesions and to separate more easily the lesions from hematoma and calcification, which are shown as avascular areas. The results suggest that DSCT is a valuable method for evaluating the contrast enhancement of intracranial high density lesions. (author).

  9. Massive intracranial calcifications in a patient with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Gasparetto, Emerson L.; Carvalho Neto, Arnolfo de; Ono, Sergio E.

    2004-01-01

    Central nervous system involvement is frequently reported in patients with systemic lupus erythematosus. Computed tomography and magnetic resonance imaging studies usually show brain atrophy, cerebral infarction and/or intracranial bleeding. Extensive intracranial calcification in patients with systemic lupus erythematosus is rare. We report a case of a patient with systemic lupus erythematosus who presented with seizures and massive basal ganglia calcification and mild calcifications in the frontal lobes, seen on the brain computed tomography scan. Magnetic resonance imaging showed hyperintensity on FLAIR images and hypointense signals on T2 * gradient echo images in the basal ganglia. (author)

  10. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de [University Medical Center Utrecht, Department of Neonatology, Wilhelmina Children' s Hospital, PO Box 85090, Utrecht (Netherlands); Nievelstein, Rutger-Jan A. [University Medical Center Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Han, Sen K. [University Medical Center Utrecht, Department of Neurosurgery, Wilhelmina Children' s Hospital, Utrecht (Netherlands)

    2010-06-15

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  11. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    International Nuclear Information System (INIS)

    Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de; Nievelstein, Rutger-Jan A.; Han, Sen K.

    2010-01-01

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  12. Effect of venous stenting on intracranial pressure in idiopathic intracranial hypertension.

    Science.gov (United States)

    Matloob, Samir A; Toma, Ahmed K; Thompson, Simon D; Gan, Chee L; Robertson, Fergus; Thorne, Lewis; Watkins, Laurence D

    2017-08-01

    Idiopathic intracranial hypertension (IIH) is characterised by an increased intracranial pressure (ICP) in the absence of any central nervous system disease or structural abnormality and by normal CSF composition. Management becomes complicated once surgical intervention is required. Venous sinus stenosis has been suggested as a possible aetiology for IIH. Venous sinus stenting has emerged as a possible interventional option. Evidence for venous sinus stenting is based on elimination of the venous pressure gradient and clinical response. There have been no studies demonstrating the immediate effect of venous stenting on ICP. Patients with a potential or already known diagnosis of IIH were investigated according to departmental protocol. ICP monitoring was performed for 24 h. When high pressures were confirmed, CT venogram and catheter venography were performed to look for venous stenosis to demonstrate a pressure gradient. If positive, venous stenting would be performed and ICP monitoring would continue for a further 24 h after deployment of the venous stent. Ten patients underwent venous sinus stenting with concomitant ICP monitoring. Nine out of ten patients displayed an immediate reduction in their ICP that was maintained at 24 h. The average reduction in mean ICP and pulsatility was significant (p = 0.003). Six out of ten patients reported a symptomatic improvement within the first 2 weeks. Venous sinus stenting results in an immediate reduction in ICP. This physiological response to venous stenting has not previously been reported. Venous stenting could offer an alternative treatment option in correctly selected patients with IIH.

  13. Malignant Transformation Six Months after Removal of Intracranial Epidermoid Cyst: A Case Report

    Directory of Open Access Journals (Sweden)

    Fayçal Lakhdar

    2011-01-01

    Full Text Available Intracranial epidermoid cysts are uncommon benign tumors of developmental origin; malignant transformation of benign epidermoid cysts is rare, and their prognosis remains poor. We report a case of squamous cell carcinoma arising in the cerebellopontine angle. A 52-year-old man presented with left facial paralysis and cerebellar ataxia. He had undergone total removal of a benign epidermoid cyst six months previously. Postoperative magnetic resonance imaging of the brain revealed a heterogeneous and cystic lesion in the left cerebellopontine angle with hydrocephalus. The cyst wall was enhanced by gadolinium. He underwent ventricle-peritoneal shunt and removal again; the histopathological examination revealed a squamous cell carcinoma possibly arising from an underlying epidermoid cyst. This entity is being reported for its rarity. The presence of contrast enhancement at the site of an epidermoid cyst combined with an acute, progressive neurological deficit should alert the neurosurgeon to the possibility of a malignant transformation.

  14. POST-NOAC: Portuguese observational study of intracranial hemorrhage on non-vitamin K antagonist oral anticoagulants.

    Science.gov (United States)

    Marques-Matos, Cláudia; Alves, José Nuno; Marto, João Pedro; Ribeiro, Joana Afonso; Monteiro, Ana; Araújo, José; Silva, Fernando; Grenho, Fátima; Viana-Baptista, Miguel; Sargento-Freitas, João; Pinho, João; Azevedo, Elsa

    2017-08-01

    Background There is a lower reported incidence of intracranial hemorrhage with non-vitamin K antagonist oral anticoagulants compared with vitamin K antagonist. However, the functional outcome and mortality of intracranial hemorrhage patients were not assessed. Aims To compare the outcome of vitamin K antagonists- and non-vitamin K antagonist oral anticoagulants-related intracranial hemorrhage. Methods We included consecutive patients with acute non-traumatic intracranial hemorrhage on oral anticoagulation therapy admitted between January 2013 and June 2015 at four university hospitals. Clinical and demographic data were obtained from individual medical records. Intracranial hemorrhage was classified as intracerebral, extra-axial, or multifocal using brain computed tomography. Three-month functional outcome was assessed using the modified Rankin Scale. Results Among 246 patients included, 24 (9.8%) were anticoagulated with a non-vitamin K antagonist oral anticoagulants and 222 (90.2%) with a vitamin K antagonists. Non-vitamin K antagonist oral anticoagulants patients were older (81.5 vs. 76 years, p = 0.048) and had intracerebral hemorrhage more often (83.3% vs. 63.1%, p = 0.048). We detected a non-significant trend for larger intracerebral hemorrhage volumes in vitamin K antagonists patients ( p = 0.368). Survival analysis adjusted for age, CHA 2 DS 2 VASc, HAS-BLED, and anticoagulation reversal revealed that non-vitamin K antagonist oral anticoagulants did not influence three-month mortality (hazard ratio (HR) = 0.83, 95% confidence interval (CI) = 0.39-1.80, p = 0.638). Multivariable ordinal regression for three-month functional outcome did not show a significant shift of modified Rankin Scale scores in non-vitamin K antagonist oral anticoagulants patients (odds ratio (OR) 1.26, 95%CI 0.55-2.87, p = 0.585). Conclusions We detected no significant differences in the three-month outcome between non-vitamin K antagonist oral anticoagulants

  15. Prolonged Survival following Repetitive Stereotactic Radiosurgery in a Patient with Intracranial Metastatic Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Ethan A. Ferrel

    2015-01-01

    Full Text Available Patients with metastatic renal cell carcinoma (RCC to the brain have a very poor prognosis of three months if left untreated. SRS is an effective treatment modality in numerous patients. This case exemplifies the utility of stereotactic radiosurgery (SRS in prolonging survival and maintaining quality of life in a patient with RCC. This 64-year-old female patient initially presented to her primary care physician 22 months after a left nephrectomy for RCC with complaints of mild, intermittent headaches and difficulty with balance. An MRI revealed five cerebellar lesions suspicious for intracranial metastasis. The patient’s first GKRS treatment targeted four lesions with 22 Gy at the 50% isodose line. She underwent a total of seven GKRS treatments over the next 60 months for recurrent metastases to the brain. 72 months and 12 months have now passed since her brain metastases were first discovered and since her last GKRS treatment, respectively, and this woman is alive with considerable quality of life and no evidence of metastatic reoccurrence. This case shows that repeated GKRS treatments, with minimal surgical intervention, can effectively treat multiple intracranial lesions in select patients, prolonging survival and avoiding iatrogenic neurocognitive decline while maintaining a high quality of life.

  16. Agreement between ultrasonography and computed tomography in detecting intracranial calcifications in congenital toxoplasmosis

    Energy Technology Data Exchange (ETDEWEB)

    Lago, E.G. [Department of Pediatrics, Pontificia Universidade Catolica do Rio Grande do Sul School of Medicine, Sao Lucas Hospital, Porto Alegre (Brazil)], E-mail: eglago@pucrs.br; Baldisserotto, M.; Hoefel Filho, J.R.; Santiago, D. [Department of Radiology, Pontificia Universidade Catolica do Rio Grande do Sul School of Medicine, Sao Lucas Hospital, Porto Alegre (Brazil); Jungblut, R. [Department of Pediatrics, Pontificia Universidade Catolica do Rio Grande do Sul School of Medicine, Sao Lucas Hospital, Porto Alegre (Brazil)

    2007-10-15

    Aim: To evaluate the agreement between ultrasound (US) and computed tomography (CT) in detecting intracranial calcification in infants with congenital toxoplasmosis. Materials and methods: Forty-four infants referred for investigation of congenital toxoplasmosis were prospectively evaluated, and the diagnosis was confirmed or ruled out by serological testing and by follow-up in the first year of life. The investigation protocol included cranial US and cranial CT, and examinations were conducted and interpreted by two radiologists blinded to the results of the other imaging test and to the diagnostic confirmation. Results: The diagnosis of congenital toxoplasmosis was confirmed in 33 patients, and agreement between US and CT findings was found in 31 of these cases. Both methods detected calcifications in 18 patients, and neither detected calcifications in 13 patients. Overall agreement was 94% and the kappa coefficient was 0.88 (95% confidence interval: 0.71, 1; p < 0.001), which revealed almost perfect agreement between the two diagnostic methods. Conclusion: In this study, US and CT demonstrated equal sensitivity in the detection of intracranial calcification in infants with congenital toxoplasmosis.

  17. [Bilateral cerebellar infarction caused by intracranial dissection of the vertebral artery after long periods of "Shiatsu"].

    Science.gov (United States)

    Iwanami, Hisatake; Odaka, Masaaki; Hirata, Koichi

    2007-02-01

    For five years, a 56-year-old woman had undergone "Shiatsu" (a technique that uses fingers and the palm of the hand to apply pressure to particular sections of the body's surface to correct neck stiffness and body imbalances in order to maintain and promote health). She suddenly developed neck pain, dizziness, dysphagia, and speech and gait disturbances during treatment. A neurological examination detected bradylalia and truncal and mild bilateral limb ataxia of the cerebellar type. Diffusion-weighted brain MRI showed multiple hyperintense signal lesions at the bilateral cerebellar hemisphere in the posterior inferior cerebellar artery territory. Three-dimensional computed tomographic angiography (3D-CTA) revealed irregular stenosis of the intracranial right vertebral artery (string sign). Dissection of the intracranial portion of the vertebral artery owing to trauma is rare. Physicians need to be aware of patients who have acute dissecting infarction after long periods of repeated trivial pressure such as "Shiatsu". 3D-CTA is a very useful diagnostic procedure for arterial dissection.

  18. INTRACRANIAL MASS LESIONS IN HIV-POSITIVE PATIENTS ...

    African Journals Online (AJOL)

    m. INTRACRANIAL MASS LESIONS IN. HIV-POSITIVE PATIENTS - THE. KwAZuLU/NATAL EXPERIENCE. A I Bhigjee, K Naidoo, V B Patel, D Govender, for the. Neuroscience AIDS Research Group. Background. Neurological disease heralds the develop1l).~tof. AIDS in 10 - 20% of HIV-seropositive individuals. In over half.

  19. Shared genetic risk factors of intracranial, abdominal, and thoracic aneurysms

    NARCIS (Netherlands)

    van 't Hof, Femke N G; Ruigrok, Ynte M; Lee, Cue Hyunkyu; Ripke, Stephan; Anderson, Graig; de Andrade, Mariza; Baas, Annette F; Blankensteijn, Jan D; Böttinger, Erwin P; Bown, Matthew J; Broderick, Joseph; Bijlenga, Philippe; Carrell, David S; Crawford, Dana C; Crosslin, David R; Ebeling, Christian; Eriksson, Johan G; Fornage, Myriam; Foroud, Tatiana; von Und Zu Fraunberg, Mikael; Friedrich, Christoph M; Gaál, Emília I; Gottesman, Omri; Guo, Dong-Chuan; Harrison, Seamus C; Hernesniemi, Juha; Hofman, Albert; Inoue, Ituro; Jääskeläinen, Juha E; Jones, Gregory T; Kiemeney, Lambertus A L M; Kivisaari, Riku; Ko, Nerissa; Koskinen, Seppo; Kubo, Michiaki; Kullo, Iftikhar J; Kuivaniemi, Helena; Kurki, Mitja I; Laakso, Aki; Lai, Dongbing; Leal, Suzanne M; Lehto, Hanna; LeMaire, Scott A; Low, Siew-Kee; Malinowski, Jennifer; McCarty, Catherine A; Milewicz, Dianna M; Mosley, Thomas H; Nakamura, Yusuke; Nakaoka, Hirofumi; Niemelä, Mika; Pacheco, Jennifer; Peissig, Peggy L; Pera, Joanna; Rasmussen-Torvik, Laura; Ritchie, Marylyn D; Rivadeneira, Fernando; van Rij, Andre M; Santos-Cortez, Regie Lyn P; Saratzis, Athanasios; Slowik, Agnieszka; Takahashi, Atsushi; Tromp, Gerard; Uitterlinden, André G; Verma, Shefali S; Vermeulen, Sita H; Wang, Gao T; Han, Buhm; Rinkel, Gabriël J E; de Bakker, Paul I W

    2016-01-01

    Background--Intracranial aneurysms (IAs), abdominal aortic aneurysms (AAAs), and thoracic aortic aneurysms (TAAs) all have a familial predisposition. Given that aneurysm types are known to co-occur, we hypothesized that there may be shared genetic risk factors for IAs, AAAs, and TAAs. Methods and

  20. Shared Genetic Risk Factors of Intracranial, Abdominal, and Thoracic Aneurysms

    NARCIS (Netherlands)

    van 't Hof, Femke N G; Ruigrok, Ynte M; Lee, Cue Hyunkyu; Ripke, Stephan; Anderson, Graig; de Andrade, Mariza; Baas, Annette F; Blankensteijn, Jan D; Böttinger, Erwin P; Bown, Matthew J; Broderick, Joseph; Bijlenga, Philippe; Carrell, David S; Crawford, Dana C; Crosslin, David R; Ebeling, Christian; Eriksson, Johan G; Fornage, Myriam; Foroud, Tatiana; von Und Zu Fraunberg, Mikael; Friedrich, Christoph M; Gaál, Emília I; Gottesman, Omri; Guo, Dong-Chuan; Harrison, Seamus C; Hernesniemi, Juha; Hofman, Albert; Inoue, Ituro; Jääskeläinen, Juha E; Jones, Gregory T; Kiemeney, Lambertus A L M; Kivisaari, Riku; Ko, Nerissa; Koskinen, Seppo; Kubo, Michiaki; Kullo, Iftikhar J; Kuivaniemi, Helena; Kurki, Mitja I; Laakso, Aki; Lai, Dongbing; Leal, Suzanne M; Lehto, Hanna; LeMaire, Scott A; Low, Siew-Kee; Malinowski, Jennifer; McCarty, Catherine A; Milewicz, Dianna M; Mosley, Thomas H; Nakamura, Yusuke; Nakaoka, Hirofumi; Niemelä, Mika; Pacheco, Jennifer; Peissig, Peggy L; Pera, Joanna; Rasmussen-Torvik, Laura; Ritchie, Marylyn D; Rivadeneira, Fernando; van Rij, Andre M; Santos-Cortez, Regie Lyn P; Saratzis, Athanasios; Slowik, Agnieszka; Takahashi, Atsushi; Tromp, Gerard; Uitterlinden, André G; Verma, Shefali S; Vermeulen, Sita H; Wang, Gao T; Han, Buhm; Rinkel, Gabriël J E; de Bakker, Paul I W

    2016-01-01

    BACKGROUND: Intracranial aneurysms (IAs), abdominal aortic aneurysms (AAAs), and thoracic aortic aneurysms (TAAs) all have a familial predisposition. Given that aneurysm types are known to co-occur, we hypothesized that there may be shared genetic risk factors for IAs, AAAs, and TAAs. METHODS AND

  1. Intracranial aneurysms: risk factors for development and rupture

    NARCIS (Netherlands)

    Kleinloog, R.

    2017-01-01

    Intracranial aneurysms occur in approximately 3% of the population. The pathogenesis of aneurysms is largely unknown, and is thought to be a complex process in which both genetic and environmental factors are involved. Aneurysms can rupture and give rise to subarachnoid haemorrhage, a devastating

  2. Non Traumatic Intracranial Infections at the University Teaching ...

    African Journals Online (AJOL)

    Background: Non traumatic intracranial infections are a well recognized disease process encountered in neurosurgery and otolaryngology practices. In this case series study, we analyze the patients that presented with this condition to the neurosurgical unit of the University Teaching Hospital in Lusaka, Zambia. Methods: ...

  3. Orbital and Intracranial Effects of Microgravity: 3T MRI Findings

    Science.gov (United States)

    Kramer, L. A.; Sargsyan, A.; Hasan, K. M.; Polk, J. D.; Hamilton, D. R.

    2012-01-01

    Goals and Objectives of this presentation are: 1. To briefly describe a newly discovered clinical entity related to space flight. 2. To describe normal anatomy and pathologic changes of the optic nerve, posterior globe, optic nerve sheath and pituitary gland related to exposure to microgravity. 3. To correlate imaging findings with known signs of intracranial hypertension.

  4. Magnetic Resonance Imaging Findings Of Intracranial Glioma In A ...

    African Journals Online (AJOL)

    Seizures can occur as focal or generalized, but can also be the single symptom of intracranial tumors (Oliver and Lorenz, 1993; Bagley and Gavin, 1998; LeCouteur, 2001 and Taylor, 2003). Seizures seen in dogs with a brain tumor are evidences that indicative of an underlying structural brain disease (Oliver and Lorenz, ...

  5. Epilepsy in primary intracranial tumors in a neurosurgical hospital in ...

    African Journals Online (AJOL)

    2015-04-06

    Apr 6, 2015 ... Epileptogenicity of brain tumors is multi‑factorial resulting from the interplay between the microenvironment, genetics, systemic effects, treatment and other external factors.[10]. Epilepsy in primary intracranial tumors in a neurosurgical hospital in Enugu, South‑East Nigeria. WC Mezue, CA Ndubuisi1, MC ...

  6. Is Marfan syndrome associated with symptomatic intracranial aneurysms?

    NARCIS (Netherlands)

    van den Berg, J. S.; Limburg, M.; Hennekam, R. C.

    1996-01-01

    BACKGROUND AND PURPOSE: Marfan syndrome is a heritable disorder of connective tissue caused by a deficiency of the glycoprotein fibrillin. In several publications and neurological textbooks, a relationship between Marfan syndrome and intracranial aneurysms has been assumed. METHODS: The records of

  7. Focal Intracranial Suppuration: Clinical Features and Outcome of 21 ...

    African Journals Online (AJOL)

    Alasia Datonye

    Department of Surgery University of Port Harcourt Teaching Hospital, Port Harcourt,. Nigeria. ... 6.1yrs). Clinical features. Focal Intracranial Suppuration: Clinical Features and Outcome of 21 Patients. The Nigerian Health Journal, Vol. 10, No 1 -2, January - June 2010 .... investigation and early surgical intervention in helping.

  8. Deformation of skull bone as intracranial pressure changing | Yue ...

    African Journals Online (AJOL)

    By using the 'Ansys' finite element processor, a three-dimensional FEM of a hollow sphere was constructed for human skull. The model was used to calculate the deformation of human skull with the intracranial pressure changing. The skull is a layered sphere constructed in a specially designed form with a Tabula externa, ...

  9. Attempt at Ultrasound-Guided Aspiration of Intracranial Abscess in ...

    African Journals Online (AJOL)

    This may be carried out through a burrhole or through a pre-existing cranial defect such as the anterior fontanelle. Aims and Objectives: To demonstrate the benefit of ... for patients who may be too ill for general anaesthesia. Keywords: Intracranial Abscess; Ultrasound guidance; Cranial defect: Anterior fontanelle; Burrhole.

  10. Intracranial epidural hematoma in a newborn with DIC secondary to ...

    African Journals Online (AJOL)

    Epidural hematoma in newborns is rare, it occurs more frequently in infants born from nulliparous mothers with delivery difficulties. Intracranial hemorrhage in infants is usually secondary to vascular malformations, anticoagulation, inherited or acquired coagulopathy. Hematological disorders are infrequently associated with ...

  11. Nodular Purpura and Intracranial Bleeding due to Late Onset ...

    African Journals Online (AJOL)

    She developed nodular purpuric spots for about three days prior to the intracranial bleeding. She was unconscious and responding only to pain, and was severely pale. She was transfused with two units of whole blood and underwent a craniotomy for draining the hemorrhage. She was treated with Vitamin K supplements.

  12. Pulsatile Intracranial Pressure and Cerebral Autoregulation After Traumatic Brain Injury

    NARCIS (Netherlands)

    Radolovich, D. K.; Aries, M.J.H.; Castellani, G.; Corona, A.; Lavinio, A.; Smielewski, P.; Pickard, J. D.; Czosnyka, M.

    2011-01-01

    Strong correlation between mean intracranial pressure (ICP) and its pulse wave amplitude (AMP) has been demonstrated in different clinical scenarios. We investigated the relationship between invasive mean arterial blood pressure (ABP) and AMP to explore its potential role as a descriptor of

  13. Monitoring of Intracranial Pressure in Patients with Traumatic Brain Injury

    Science.gov (United States)

    Hawthorne, Christopher; Piper, Ian

    2014-01-01

    Since Monro published his observations on the nature of the contents of the intracranial space in 1783, there has been investigation of the unique relationship between the contents of the skull and the intracranial pressure (ICP). This is particularly true following traumatic brain injury (TBI), where it is clear that elevated ICP due to the underlying pathological processes is associated with a poorer clinical outcome. Consequently, there is considerable interest in monitoring and manipulating ICP in patients with TBI. The two techniques most commonly used in clinical practice to monitor ICP are via an intraventricular or intraparenchymal catheter with a microtransducer system. Both of these techniques are invasive and are thus associated with complications such as hemorrhage and infection. For this reason, significant research effort has been directed toward development of a non-invasive method to measure ICP. The principle aims of ICP monitoring in TBI are to allow early detection of secondary hemorrhage and to guide therapies that limit intracranial hypertension (ICH) and optimize cerebral perfusion. However, information from the ICP value and the ICP waveform can also be used to assess the intracranial volume–pressure relationship, estimate cerebrovascular pressure reactivity, and attempt to forecast future episodes of ICH. PMID:25076934

  14. Burr Hole Drainage for Complicated Spontaneous Intracranial Hypotension Syndrome

    Directory of Open Access Journals (Sweden)

    Yu-Fang Liu

    2008-09-01

    Full Text Available Spontaneous intracranial hypotension is a potentially severe condition that is caused by continuous cerebrospinal fluid leakage. Clinically, most patients have a benign course and the condition remits after conservative management. We report two consecutive patients who presented with acute expansion of subdural collection and disturbed consciousness. Both patients recovered completely after undergoing burr hole drainage.

  15. Anesthesia practices in intracranial mass surgery: a retrospective study

    Directory of Open Access Journals (Sweden)

    Ozlem Ozmete

    2017-03-01

    Conclusion: Several anesthetic techniques may be used successfully to provide anesthesia for resection of intracranial mass surgery. To reduced morbidity and mortality, the possible complications must be recognized and treated early with invasive monitoring, strict hemodynamics and blood gas monitoring. [Cukurova Med J 2017; 42(1.000: 86-91

  16. SEVERE BRAIN INJURIES: CORRELATION BETWEEN SURVIVAL AND INTRACRANIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Aleksandar Kostić

    2011-09-01

    Full Text Available There are several reasons of intracranial pressure (ICP increase in the brain trauma. Brain edema, due to the brain-blood bariere injury, contusion of brain tissue and intracranial hematomas that represent mass lesion, cerebrovascular autoregulation failure which leads to hemodinamic disorder, and traumatic subarchnoid haemorrhagae that is commonly associated with CSF flow disturbances are the main causes. The aim of our study was to examine the survival of patients with severe brain trauma in the presence of different values of ICP. This prospective study included 32 patients with intracranial pressure monitored, and appropriate treatment undertaken. Twenty-two patients (68.75% had elevated ICP, and in 10 patients (31,25% there were no criteria of intracranial hypertnesion (ICHTN. The results of our study showed that absolute lethal value of ICHTN is 50mmHg and over – none of the injured survived such ICP if lasted more than two hours, because of inevitable brain and brainstem ischemia and failure of the vital functions. The relatively lethal values of ICP ranged from 40 to 50mmHg, in the case of which we menaged to prevent a fatal outcome in one out of five cases.

  17. The cardiovascular and intracranial effects of laryngoscopy and ...

    African Journals Online (AJOL)

    Laryngoscopy and endotracheal intubation is a potent sympathetic stimulus in adults. Neonates are frequendy intubated, but few data exist on the cerebral effects of this intervention. The cardiovascular and intracranial effects of laryngoscopy and endotracheal intubation were studied in 17 hypercarbic neonatal piglets.

  18. Advanced Imaging of Intracranial Atherosclerosis: Lessons from Interventional Cardiology

    Directory of Open Access Journals (Sweden)

    Davor Pavlin-Premrl

    2017-08-01

    Full Text Available Intracranial atherosclerosis is a major cause of ischemic stroke. Patients with a high degree of stenosis have a significant rate of stroke despite medical therapy. Two randomized trials of stenting have failed to show benefit. Improving periprocedural complication rates and patient selection may improve stenting outcomes. Fractional flow reserve (FFR, intravascular ultrasound (IVUS, and optical coherence tomography (OCT are intravascular imaging techniques employed to improve patient selection and stent placement in interventional cardiology. FFR has been shown to improve cardiovascular outcomes when used in patient selection for intervention. Studies of FFR in intracranial atherosclerosis show that the measure may predict which plaques lead to stroke. IVUS is used in cardiology to quantify stenosis and assist with stent placement. Comparisons with histology show that it can reliably characterize plaques. Several case reports of IVUS in intracranial arteries show the technique to be feasible and indicate it may improve stent placement. Plaque characteristics on IVUS may help identify vulnerable plaques. In interventional cardiology, OCT provides excellent visualization of vessel geometry and is useful periprocedurally. Images reliably identify thin-capped fibroatheromas and other plaque features. Case reports indicate that OCT is safe for use in intracranial arteries. OCT can be used to identify perforator vessels and so may be useful in avoiding perforator strokes, a common complication of stenting. Plaque characteristics on OCT may be useful in patient selection.

  19. Unruptured intracranial aneurysms : development, rupture and preventive management

    NARCIS (Netherlands)

    Etminan, Nima; Rinkel, Gabriel J.|info:eu-repo/dai/nl/085712000

    2016-01-01

    Saccular unruptured intracranial aneurysms (UIAs) have a prevalence of 3% in the adult population, and are being increasingly detected because of improved quality and higher frequency of cranial imaging. Large amounts of data, providing varying levels of evidence, have been published on aneurysm

  20. Deformation of skull bone as intracranial pressure changing

    African Journals Online (AJOL)

    STORAGESEVER

    2009-03-06

    Mar 6, 2009 ... The cranium could move and human skull - dura mater system was deformed as the ICP fluctuates. Key words: Deformation, skull bone, intracranial pressure, finite-element model, rat. ..... A silicone rubber cylinder attached to a nylon surgical thread was inserted through the internal carotid artery in rats and ...

  1. Holographic observation of magnetic resonance image CT of intracranial tumors

    International Nuclear Information System (INIS)

    Iwata, Kinjiro; Watanabe, Saburo; Yuasa, Hiromi; Yamada, Takahisa; Hoshino, Daisaku; Suzuki, Masane; Saito, Takayuki.

    1987-01-01

    In 1975, we developed a new method of 3-dimensional observation of CT pictures using Gabor's holography principle. In this study, we are reporting our experience with the multi-tomogram holography using magnetic resonance image CT in order to reconstruct 3-dimensional viewing of the central nervous system and intracranial lesions. (J.P.N.)

  2. Conforming discretizations of boundary element solutions to the electroencephalography forward problem

    Science.gov (United States)

    Rahmouni, Lyes; Adrian, Simon B.; Cools, Kristof; Andriulli, Francesco P.

    2018-01-01

    In this paper, we present a new discretization strategy for the boundary element formulation of the Electroencephalography (EEG) forward problem. Boundary integral formulations, classically solved with the Boundary Element Method (BEM), are widely used in high resolution EEG imaging because of their recognized advantages, in several real case scenarios, in terms of numerical stability and effectiveness when compared with other differential equation based techniques. Unfortunately, however, it is widely reported in literature that the accuracy of standard BEM schemes for the forward EEG problem is often limited, especially when the current source density is dipolar and its location approaches one of the brain boundary surfaces. This is a particularly limiting problem given that during an high-resolution EEG imaging procedure, several EEG forward problem solutions are required, for which the source currents are near or on top of a boundary surface. This work will first present an analysis of standardly and classically discretized EEG forward problem operators, reporting on a theoretical issue of some of the formulations that have been used so far in the community. We report on the fact that several standardly used discretizations of these formulations are consistent only with an L2-framework, requiring the expansion term to be a square integrable function (i.e., in a Petrov-Galerkin scheme with expansion and testing functions). Instead, those techniques are not consistent when a more appropriate mapping in terms of fractional-order Sobolev spaces is considered. Such a mapping allows the expansion function term to be a less regular function, thus sensibly reducing the need for mesh refinements and low-precisions handling strategies that are currently required. These more favorable mappings, however, require a different and conforming discretization, which must be suitably adapted to them. In order to appropriately fulfill this requirement, we adopt a mixed

  3. Incubation of Cue-Induced Craving in Adults Addicted to Cocaine Measured by Electroencephalography.

    Science.gov (United States)

    Parvaz, Muhammad A; Moeller, Scott J; Goldstein, Rita Z

    2016-11-01

    A common trigger for relapse in drug addiction is the experience of craving via exposure to cues previously associated with drug use. Preclinical studies have consistently demonstrated incubation of cue-induced drug-seeking during the initial phase of abstinence, followed by a decline over time. In humans, the incubation effect has been shown for alcohol, nicotine, and methamphetamine addictions, but not for heroin or cocaine addiction. Understanding the trajectory of cue-induced craving during abstinence in humans is of importance for addiction medicine. To assess cue-induced craving for cocaine in humans using both subjective and objective indices of cue-elicited responses. Seventy-six individuals addicted to cocaine with varying durations of abstinence (ie, 2 days, 1 week, 1 month, 6 months, and 1 year) participated in this laboratory-based cross-sectional study from June 19, 2007, to November 26, 2012. The late positive potential component of electroencephalography, a recognized marker of incentive salience, was used to track motivated attention to drug cues across these self-selected groups. Participants also completed subjective ratings of craving for cocaine before presentation of a cue, and ratings of cocaine "liking" (hedonic feelings toward cocaine) and "wanting" (craving for cocaine) after presentation of cocaine-related pictures. Data analysis was conducted from June 5, 2015, to March 30, 2016. The late positive potential amplitudes and ratings of liking and wanting cocaine in response to cocaine-related pictures were quantified and compared across groups. Among the 76 individuals addicted to cocaine, 19 (25%) were abstinent for 2 days, 20 (26%) were abstinent for 1 week, 15 (20%) were abstinent for 1 month, 12 (16%) were abstinent for 6 months, and 10 (13%) were abstinent for 1 year. In response to drug cues, the mean (SD) late positive potential amplitudes showed a parabolic trajectory that was higher at 1 (1.26 [1.36] µV) and 6 (1.17 [1.19] µ

  4. Lumbar puncture opening pressure is not a reliable measure of intracranial pressure in children.

    Science.gov (United States)

    Cartwright, Cathy; Igbaseimokumo, Usiakimi

    2015-02-01

    There is very little data correlating lumbar puncture pressures to formal intracranial pressure monitoring despite the widespread use of both procedures. The hypothesis was that lumbar puncture is a single-point measurement and hence it may not be a reliable evaluation of intracranial pressure. The study was therefore carried out to compare lumbar puncture opening pressures with the Camino bolt intracranial pressure monitor in children. Twelve children with a mean age of 8.5 years who had both lumbar puncture and intracranial pressure monitoring were analyzed. The mean lumbar puncture opening pressure was 22.4 mm Hg versus a mean Camino bolt intracranial pressure of 7.8 mm Hg (P intracranial pressure in children. There were no complications from the intracranial pressure monitoring, and the procedure changed the treatment of all 12 children avoiding invasive operative procedures in most of the patients. © The Author(s) 2014.

  5. Increased Intracranial Pressure in the Setting ofEnterovirusand Other Viral Meningitides.

    Science.gov (United States)

    Beal, Jules C

    2017-01-01

    Increased intracranial pressure due to viral meningitis has not been widely discussed in the literature, although associations with Varicella and rarely Enterovirus have been described. Patients with increased intracranial pressure and cerebrospinal fluid analysis suggestive of a viral process are sometimes classified as having atypical idiopathic intracranial hypertension (IIH). However, a diagnosis of IIH requires normal cerebrospinal fluid, and therefore in these cases an infection with secondary intracranial hypertension may be a more likely diagnosis. Here seven patients are presented with elevated intracranial pressure and cerebrospinal fluid suggestive of viral or aseptic meningitis. Of these, 1 had Enterovirus and the remainder were diagnosed with nonspecific viral meningitis. These data suggest that viral meningitis may be associated with elevated intracranial pressure more often than is commonly recognized. Enterovirus has previously been associated with increased intracranial pressure only in rare case reports.

  6. Increased Intracranial Pressure in the Setting of Enterovirus and Other Viral Meningitides

    Directory of Open Access Journals (Sweden)

    Jules C. Beal

    2017-01-01

    Full Text Available Increased intracranial pressure due to viral meningitis has not been widely discussed in the literature, although associations with Varicella and rarely Enterovirus have been described. Patients with increased intracranial pressure and cerebrospinal fluid analysis suggestive of a viral process are sometimes classified as having atypical idiopathic intracranial hypertension (IIH. However, a diagnosis of IIH requires normal cerebrospinal fluid, and therefore in these cases an infection with secondary intracranial hypertension may be a more likely diagnosis. Here seven patients are presented with elevated intracranial pressure and cerebrospinal fluid suggestive of viral or aseptic meningitis. Of these, 1 had Enterovirus and the remainder were diagnosed with nonspecific viral meningitis. These data suggest that viral meningitis may be associated with elevated intracranial pressure more often than is commonly recognized. Enterovirus has previously been associated with increased intracranial pressure only in rare case reports.

  7. Remote intracranial recurrence of IDH mutant gliomas is associated with TP53 mutations and an 8q gain

    Science.gov (United States)

    Nakae, Shunsuke; Kato, Takema; Murayama, Kazuhiro; Sasaki, Hikaru; Abe, Masato; Kumon, Masanobu; Kumai, Tadashi; Yamashiro, Kei; Inamasu, Joji; Hasegawa, Mitsuhiro; Kurahashi, Hiroki; Hirose, Yuichi

    2017-01-01

    Most IDH mutant gliomas harbor either 1p/19q co-deletions or TP53 mutation; 1p/19q co-deleted tumors have significantly better prognoses than tumors harboring TP53 mutations. To investigate the clinical factors that contribute to differences in tumor progression of IDH mutant gliomas, we classified recurrent tumor patterns based on MRI and correlated these patterns with their genomic characterization. Accordingly, in IDH mutant gliomas (N = 66), 1p/19 co-deleted gliomas only recurred locally, whereas TP53 mutant gliomas recurred both locally and in remote intracranial regions. In addition, diffuse tensor imaging suggested that remote intracranial recurrence in the astrocytomas, IDH-mutant with TP53 mutations may occur along major fiber bundles. Remotely recurrent tumors resulted in a higher mortality and significantly harbored an 8q gain; astrocytomas with an 8q gain resulted in significantly shorter overall survival than those without an 8q gain. OncoScan® arrays and next-generation sequencing revealed specific 8q regions (i.e., between 8q22 and 8q24) show a high copy number. In conclusion, only tumors with TP53 mutations showed patterns of remote recurrence in IDH mutant gliomas. Furthermore, an 8q gain was significantly associated with remote intracranial recurrence and can be considered a poor prognostic factor in astrocytomas, IDH-mutant. PMID:29156679

  8. Remote intracranial recurrence ofIDHmutant gliomas is associated withTP53mutations and an 8q gain.

    Science.gov (United States)

    Nakae, Shunsuke; Kato, Takema; Murayama, Kazuhiro; Sasaki, Hikaru; Abe, Masato; Kumon, Masanobu; Kumai, Tadashi; Yamashiro, Kei; Inamasu, Joji; Hasegawa, Mitsuhiro; Kurahashi, Hiroki; Hirose, Yuichi

    2017-10-17

    Most IDH mutant gliomas harbor either 1p/19q co-deletions or TP53 mutation; 1p/19q co-deleted tumors have significantly better prognoses than tumors harboring TP53 mutations. To investigate the clinical factors that contribute to differences in tumor progression of IDH mutant gliomas, we classified recurrent tumor patterns based on MRI and correlated these patterns with their genomic characterization. Accordingly, in IDH mutant gliomas ( N = 66), 1p/19 co-deleted gliomas only recurred locally, whereas TP53 mutant gliomas recurred both locally and in remote intracranial regions. In addition, diffuse tensor imaging suggested that remote intracranial recurrence in the astrocytomas, IDH-mutant with TP53 mutations may occur along major fiber bundles. Remotely recurrent tumors resulted in a higher mortality and significantly harbored an 8q gain; astrocytomas with an 8q gain resulted in significantly shorter overall survival than those without an 8q gain. OncoScan ® arrays and next-generation sequencing revealed specific 8q regions (i.e., between 8q22 and 8q24) show a high copy number. In conclusion, only tumors with TP53 mutations showed patterns of remote recurrence in IDH mutant gliomas. Furthermore, an 8q gain was significantly associated with remote intracranial recurrence and can be considered a poor prognostic factor in astrocytomas, IDH-mutant.

  9. Analysing the response in R2* relaxation rate of intracranial tumours to hyperoxic and hypercapnic respiratory challenges: initial results

    International Nuclear Information System (INIS)

    Mueller, A.; Traeber, F.; Koenig, R.; Willinek, W.A.; Schild, H.H.; Muertz, P.; Remmele, S.; Wenningmann, I.; Clusmann, H.; Flacke, S.; Gieseke, J.

    2011-01-01

    To investigate the response in R2 * relaxation rate of human intracranial tumours during hyperoxic and hypercapnic respiratory challenges. In seven patients with different intracranial tumours, cerebral R2 * changes during carbogen and CO 2 /air inhalation were monitored at 3 T using a dynamic multigradient-echo sequence of high temporal and spatial resolution. The R2 * time series of each voxel was tested for significant change. Regions of interest were analysed with respect to response amplitude and velocity. The tumours showed heterogeneous R2 * responses with large interindividual variability. In the 'contrast-enhancing' area of five patients and in the 'non-tumoral' tissue most voxels showed a decrease in R2 * for carbogen. For the 'contrast-enhancing' area of two patients hardly any responses were found. In areas of 'necrosis' and perifocal 'oedema' typically voxels with R2 * increase and no response were found for both gases. For tissue responding to CO 2 /air, the R2 * changes were of the same order of magnitude as those for carbogen. The response kinetic was generally attenuated in tumoral tissue. The spatially resolved determination of R2 * changes reveals the individual heterogeneous response characteristic of intracranial human tumours during hyperoxic and hypercapnic respiratory challenges. (orig.)

  10. Effect of inter-tissue inductive coupling on multi-frequency imaging of intracranial hemorrhage by magnetic induction tomography

    Science.gov (United States)

    Xiao, Zhili; Tan, Chao; Dong, Feng

    2017-08-01

    Magnetic induction tomography (MIT) is a promising technique for continuous monitoring of intracranial hemorrhage due to its contactless nature, low cost and capacity to penetrate the high-resistivity skull. The inter-tissue inductive coupling increases with frequency, which may lead to errors in multi-frequency imaging at high frequency. The effect of inter-tissue inductive coupling was investigated to improve the multi-frequency imaging of hemorrhage. An analytical model of inter-tissue inductive coupling based on the equivalent circuit was established. A set of new multi-frequency decomposition equations separating the phase shift of hemorrhage from other brain tissues was derived by employing the coupling information to improve the multi-frequency imaging of intracranial hemorrhage. The decomposition error and imaging error are both decreased after considering the inter-tissue inductive coupling information. The study reveals that the introduction of inter-tissue inductive coupling can reduce the errors of multi-frequency imaging, promoting the development of intracranial hemorrhage monitoring by multi-frequency MIT.

  11. Influence of electroencephalography neurofeedback training on episodic memory: a randomized, sham-controlled, double-blind study.

    Science.gov (United States)

    Guez, Jonathan; Rogel, Ainat; Getter, Nir; Keha, Eldad; Cohen, Tzlil; Amor, Tali; Gordon, Shirley; Meiran, Nachshon; Todder, Doron

    2015-01-01

    The relationships between memory processes and oscillatory electroencephalography (EEG) are well established. Neurofeedback training (NFT) may cause participants to better regulate their brain EEG oscillations. The present study is a double-blind sham-controlled design investigating the effect of NFT on memory. NFT included up-training upper alpha (UA) band, up-training sensory-motor rhythm (SMR) band and sham protocol. Thirty healthy adult volunteers were randomly divided into three treatment groups. NFT sessions (30 min each) took place twice weekly for a total of 10 sessions while memory testing took place pre- and post-training. The results indicate dissociation between SMR and UA NFT and different memory processes. While the SMR protocol resulted in improving automatic, item-specific and familiarity-based processes in memory, the UA protocol resulted in improved strategic and controlled recollection. The implications of the results are discussed.

  12. Secondary Intracranial Hypertension in Pediatric Patients With Leukemia.

    Science.gov (United States)

    Fernández-García, Miguel Ángel; Cantarín-Extremera, Verónica; Andión-Catalán, Maitane; Duat-Rodríguez, Anna; Jiménez-Echevarría, Saioa; Bermejo-Arnedo, Ignacio; Hortigüela-Saeta, Montesclaros; Rekarte-García, Saray; Babín-López, Lara; Ruano Domínguez, David

    2017-12-01

    We investigated the clinical characteristics of a pediatric population with hemato-oncological disease and intracranial hypertension, analyze the therapeutic response and outcome, and compare its characteristics with respect to a control group with idiopathic intracranial hypertension. We retrospectively analyzed patients with hemato-oncological disease and secondary intracranial hypertension in our center during the past five years. We compared these individuals with a historical cohort with idiopathic intracranial hypertension from our institution (control group). We identified eight patients, all with leukemia, and 21 controls. Mean age at diagnosis was 10.6 years, and 62% of individuals were female. Most of them were under treatment with drugs (62% corticosteroids, 75% active chemotherapy). Mean opening pressure of cerebrospinal fluid was 35 cm H 2 O. All had headache, but only 28% complained of visual symptoms. Only 12.5% exhibited papilledema at the time of diagnosis (versus 71% in controls). All of them were treated with acetazolamide, with average therapy duration of nine months, and all had a favorable outcome (versus 57% of controls who needed second-line treatment). None of them showed long-term visual complications (versus 20% of controls). Patients with hemato-oncological disease and secondary intracranial hypertension may not develop typical symptomatology. Thus, diagnosis and recognition of this entity among this cohort may be difficult. Associated factors are diverse and do not show an obvious causal relationship. A high index of suspicion must be maintained for diagnosis, because a favorable outcome is expected with prompt treatment. Acetazolamide is effective as a first-line therapy and caused few side effects. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Intracranial Lesions in Children and Adolescents with Morbid Obesity

    Directory of Open Access Journals (Sweden)

    Ayça Törel Ergür

    2017-04-01

    Full Text Available Background: Intracranial lesions may affect the hypothalamo-hypophyseal axis and lead to some neuro-endocrinological dysfunctions (hyperphagia, sleep disorders and hormonal dysfunctions. There is a very limited number of studies about childhood obesity and intracranial lesions. Aims: To evaluate the incidence of intracranial lesions and its role in clinical symptoms and aetiology in cases with morbid obesity who have been admitted to the paediatric endocrinology department with this complaint. Study Design: Cross-sectional study. Methods: A total of 120 cases admitted to the paediatric endocrinology department with the complaint of morbid obesity between 2002 and 2015 were included in this study. A detailed history was taken and a physical examination was performed; biochemical, hormonal parameters were evaluated. Contrast dynamic magnetic resonance imaging was performed in order to visualize cranial pathologies. Results: An intracranial lesions was detected in 16.6% of the patients and 55% of these lesions were adenoma of the hypophysis. Prolactin levels were increased in six patients but front hypophyseal hormone levels were within normal range in the rest of the patients. Growth velocity of the patients was not affected. Conclusion: In our study, the incidence of intracranial lesions in children and adolescents with morbid obesity was much higher than in the normal population. According to this data, we are of the opinion that contrast dynamic magnetic resonance imaging is helpful in children with morbid obesity for the early detection of the mass before it causes any clinical or neurological symptoms and in the prevention of future complications

  14. Intracranial arterial aneurysm vasculopathies: targeting the outer vessel wall

    International Nuclear Information System (INIS)

    Krings, Timo; Piske, Ronie L.; Lasjaunias, Pierre L.

    2005-01-01

    The pathogenesis of intracranial arterial aneurysms (AA) remains unclear, despite their clinical importance. An improved understanding of this disease is important in choosing therapeutic options. In addition to the ''classical'' berry-type aneurysm, there are various other types of intracranial AA such as infectious, dissecting or giant, partially-thrombosed aneurysms. From the clinician's perspective, the hypothesis that some of these intracranial AA might be due to abluminal factors has been proposed for several years. Indeed, this hypothesis and the empirical use of anti-inflammatory drugs in giant intracranial aneurysms have been confirmed by recent studies reporting that an enzyme involved in the inflammatory cascade (5-lipoxygenase or 5-LO) promotes the pathogenesis of specific aneurysms in humans. 5-LO generates different forms of leukotrienes which are potent mediators of inflammation. Adventitial inflammation leads to a weakening of the media from the abluminal part of the vessel wall due to the release of proinflammatory factors that invade the media, thereby degrading the extracellular matrix, the elastic lamina of the vascular wall, and, finally, the integrity of the vessel lumen. This in turn results in a dilation of the vessel and aneurysm formation. Moreover, neoangiogenesis of vasa vasorum is found in close proximity to 5-LO activated macrophages. In addition to this biological cascade, we argue that repeated subadventitial haemorrhages from the new vasa vasorum play an important role in aneurysm pathogenesis, due to a progressive increase in size mediated by the apposition of new layers of intramural haematoma within the vessel wall. Intracranial giant AA can therefore be regarded as a proliferative disease of the vessel wall induced by extravascular activity. (orig.)

  15. Intracranial current density (LORETA) differences in QEEG frequency bands between depressed and non-depressed alcoholic patients.

    Science.gov (United States)

    Coutin-Churchman, Pedro; Moreno, Rocío

    2008-04-01

    To assess possible differences in intracranial source distribution of surface QEEG power between depressed and non-depressed alcoholic patients in order to find any symptom-related topographic features of physiopathologic relevance. Low-Resolution Electromagnetic Tomography (LORETA) for the delta, theta, alpha and beta bands of EEG spectra was estimated from 38 alcoholic patients, 20 with and 18 without clinical depression, in which QEEG showed decreased slow and increased beta activity diffusely. Statistical non-parametric mapping was used to compare depressed and non-depressed groups. Measures of intracranial current density in individual patients at areas of significant differences were correlated with BDI scores. Patients with clinical depression showed areas of significantly lower current density than non-depressed patients in delta band at left anterior temporal, left midtemporal (including amygdala and hippocampus), and both frontopolar cortices mostly on the right; and in theta band at bilateral parietal lobe, anterior cingulate and medial frontal cortex. No differences were found at alpha and beta band. Intracranial current density in delta band at left parahippocampal, left midfrontal cortex and right frontopolar cortex was negatively correlated with BDI score. Theta band also showed negative correlations with BDI at sites of significant differences. Diffusely decreased delta and theta activity in the surface QEEG of alcoholic patients has a different intracranial distribution linked to the presence or not of clinical depression that seems to reveal a dysfunctional neuronal state at several specific limbic and other cortical locations that have been related to a specific clinical disorder such as depression. These results provided further evidence on the effects of depression in the context of alcohol dependence, in this case decreased slow activity as a possible marker of neuronal damage secondary to alcohol toxicity, clinically expressed as depressive

  16. High frequency repetitive transcranial magnetic over the medial cerebellum induces a shift in the prefrontal electroencephalography gamma spectrum: a pilot study in humans

    NARCIS (Netherlands)

    Schutter, D.J.L.G.; Honk, E.J. van; d'Alfonso, A.A.L.; Peper, J.S.; Panksepp, J.

    2003-01-01

    In the present study the anatomical projections from the medial cerebellum to the prefrontal cortex (PFC) were investigated in healthy human subjects, using high frequency repetitive transcranial magnetic (rTMS) stimulation and electro-encephalography (EEG). Medial cerebellar rTMS, compared to

  17. Comparative observational study on the clinical presentation, intracranial volume measurements, and intracranial pressure scores in patients with either Chiari malformation Type I or idiopathic intracranial hypertension.

    Science.gov (United States)

    Frič, Radek; Eide, Per Kristian

    2017-04-01

    OBJECTIVE Several lines of evidence suggest common pathophysiological mechanisms in Chiari malformation Type I (CMI) and idiopathic intracranial hypertension (IIH). It has been hypothesized that tonsillar ectopy, a typical finding in CMI, is the result of elevated intracranial pressure (ICP) combined with a developmentally small posterior cranial fossa (PCF). To explore this hypothesis, the authors specifically investigated whether ICP is comparable in CMI and IIH and whether intracranial volumes (ICVs) are different in patients with CMI and IIH, which could explain the tonsillar ectopy in CMI. The authors also examined whether the symptom profile is comparable in these 2 patient groups. METHODS The authors identified all CMI and IIH patients who had undergone overnight diagnostic ICP monitoring during the period from 2002 to 2014 and reviewed their clinical records and radiological examinations. Ventricular CSF volume (VV), PCF volume (PCFV), and total ICV were calculated from initial MRI studies by using volumetric software. The static and pulsatile ICP scores during overnight monitoring were analyzed. Furthermore, the authors included a reference (REF) group consisting of patients who had undergone ICP monitoring due to suspected idiopathic normal-pressure hydrocephalus or chronic daily headache and showed normal pressure values. RESULTS Sixty-six patients with CMI and 41 with IIH were identified, with comparable demographics noted in both groups. The occurrence of some symptoms (headache, nausea, and/or vomiting) was comparable between the cohorts. Dizziness and gait ataxia were significantly more common in patients with CMI, whereas visual symptoms, diplopia, and tinnitus were significantly more frequent in patients with IIH. The cranial volume measurements (VV, PCFV, and ICV) of the CMI and IIH patients were similar. Notably, 7.3% of the IIH patients had tonsillar descent qualifying for diagnosis of CMI (that is, > 5 mm). The extent of tonsillar ectopy was

  18. Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial.

    Science.gov (United States)

    Friedman, Deborah I; Quiros, Peter A; Subramanian, Prem S; Mejico, Luis J; Gao, Shan; McDermott, Michael; Wall, Michael

    2017-09-01

    To characterize the phenotype, headache-related disability, medical co-morbidities, use of symptomatic headache medications, and headache response to study interventions in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). Patients with untreated IIH and mild vision loss enrolled in the IIHTT and randomized to acetazolamide (ACZ) and weight loss or placebo (PLB) and weight loss had prospective assessment of headache disability using the Headache Impact Test-6 (HIT-6) questionnaire. Subjects with headache at the baseline visit were assigned a headache phenotype using the International Classification for Headache Disorders version 3 beta (ICHD-3b). Medication overuse was determined using the participants' reported medication use for the preceding month and ICHD-3b thresholds for diagnosing medication overuse headache. We investigated relationships between headache disability and various other clinical characteristics at baseline and at 6 months. Headache was present in 139 (84%) of the 165 enrollees at baseline. The most common headache phenotypes were migraine (52%), tension-type headache (22%), probable migraine (16%), and probable tension-type headache (4%). Fifty-one (37%) participants overused symptomatic medications at baseline, most frequently simple analgesics. A similar amount of improvement in the adjusted mean (± standard error) HIT-6 score occurred in the ACZ (-9.56 ± 1.05) and PLB groups (-9.11 ± 1.14) at 6 months (group difference -0.45, 95% CI -3.50 to 2.60, P = .77). Headache disability did not correlate with any of the studies, variables of interest, which included: the lumbar puncture opening pressure at baseline or at 6 months, body mass index, the amount of weight lost, papilledema grade, perimetric mean deviation, or the use of hormonal contraception. Headache disability was significantly associated with patient-reported quality of life in the physical, mental, and visual domains. Headache was common, of varied

  19. Noninvasive assessment of the intracranial pressure in non-traumatic intracranial hemorrhage.

    Science.gov (United States)

    Vaiman, Michael; Sigal, Tal; Kimiagar, Itzhak; Bekerman, Inessa

    2016-12-01

    The article describes the modified technique of measuring the diameters of the optic nerve sheath (ONSD) for assessment of the intracranial pressure (ICP) in patients with intracerebral or subarachnoid hemorrhage (SAH). The CT scans of 443 patients were analyzed retrospectively. The ONSDs were measured at 3mm behind the globe and at the point where the ophthalmic artery crosses the optic nerve. The ONSD/eyeball transverse diameter (ETD) ratio was calculated. The correlation analysis was performed with the Glasgow Coma Scale score, Hemispheric Stroke Scale score, Glasgow Outcome Score, and invasive ICP readings. ONSD was enlarged in 95% of patients with intracerebral hemorrhage or SAH. Pathological ONSDs were 6.6±0.8mm (cut-off value >5.5mm; pintracranial hemorrhage and SAH, the presence of ONSD greater than a threshold of 5.5mm is significantly predictive of invasively measured elevated ICP. The prediction of raised ICP can be further refined by measuring ONSD at the point where the optic nerve and the ophthalmic artery cross, and by determining the ratio between the ONSD and ETD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Visualizing the pressure and time burden of intracranial hypertension in adult and paediatric traumatic brain injury.

    Science.gov (United States)

    Güiza, Fabian; Depreitere, Bart; Piper, Ian; Citerio, Giuseppe; Chambers, Iain; Jones, Patricia A; Lo, Tsz-Yan Milly; Enblad, Per; Nillson, Pelle; Feyen, Bart; Jorens, Philippe; Maas, Andrew; Schuhmann, Martin U; Donald, Rob; Moss, Laura; Van den Berghe, Greet; Meyfroidt, Geert

    2015-06-01

    To assess the impact of the duration and intensity of episodes of increased intracranial pressure on 6-month neurological outcome in adult and paediatric traumatic brain injury. Analysis of prospectively collected minute-by-minute intracranial pressure and mean arterial blood pressure data of 261 adult and 99 paediatric traumatic brain injury patients from multiple European centres. The relationship of episodes of elevated intracranial pressure (defined as a pressure above a certain threshold during a certain time) with 6-month Glasgow Outcome Scale was visualized in a colour-coded plot. The colour-coded plot illustrates the intuitive concept that episodes of higher intracranial pressure can only be tolerated for shorter durations: the curve that delineates the duration and intensity of those intracranial pressure episodes associated with worse outcome is an approximately exponential decay curve. In children, the curve resembles that of adults, but the delineation between episodes associated with worse outcome occurs at lower intracranial pressure thresholds. Intracranial pressures above 20 mmHg lasting longer than 37 min in adults, and longer than 8 min in children, are associated with worse outcomes. In a multivariate model, together with known baseline risk factors for outcome in severe traumatic brain injury, the cumulative intracranial pressure-time burden is independently associated with mortality. When cerebrovascular autoregulation, assessed with the low-frequency autoregulation index, is impaired, the ability to tolerate elevated intracranial pressures is reduced. When the cerebral perfusion pressure is below 50 mmHg, all intracranial pressure insults, regardless of duration, are associated with worse outcome. The intracranial pressure-time burden associated with worse outcome is visualised in a colour-coded plot. In children, secondary injury occurs at lower intracranial pressure thresholds as compared to adults. Impaired cerebrovascular