A comparison of occipital and temporal lobe epilepsies.

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Appel, S; Sharan, A D; Tracy, J I; Evans, J; Sperling, M R

2015-10-01

Differentiating between occipital lobe epilepsy (OLE) and temporal lobe epilepsy (TLE) is often challenging. This retrospective case-control study compares OLE to TLE and explores markers that suggest the diagnosis of OLE. We queried the Jefferson Epilepsy Center surgery database for patients who underwent a resection that involved the occipital lobe. For each patient with OLE, three sequential case-control patients with TLE were matched. Demographic characteristics, symptoms, electrophysiological findings, imaging findings, and surgical outcome were compared. Nineteen patients with OLE and 57 patients with TLE were included in the study. Visual symptoms were unique to patients with OLE (8/19) and were not reported by patients with TLE (P Occipital interictal spikes (IIS) were found only in one-third of the patients with OLE (6/19) and in no patients with TLE (P lobe were found in five of 19 patients with OLE vs one of 57 patients with TLE (P = 0.003). IIS involved more than one lobe of the brain in most patients with OLE (11/19) but only in nine of 57 the TLE group. (P = 0.0003) Multilobar resection was needed in most patients with OLE (15/19), typically including the temporal lobe, but in only one of the patients with TLE (P Occipital lobe epilepsy is difficult to identify and may masquerade as temporal lobe epilepsy. Visual symptoms and occipital findings in the EEG suggest the diagnosis of OLE, but absence of these features, does not exclude the diagnosis. When posterior temporal EEG findings or multilobar involvement occurs, the diagnosis of OLE should be considered. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improvement of visual field defects after focal resection for occipital lobe epilepsy: case report.

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Yamamoto, Takahiro; Hamasaki, Tadashi; Nakamura, Hideo; Yamada, Kazumichi

2018-03-01

Improvement of visual field defects after surgical treatment for occipital lobe epilepsy is rare. Here, the authors report on a 24-year-old man with a 15-year history of refractory epilepsy that developed after he had undergone an occipital craniotomy to remove a cerebellar astrocytoma at the age of 4. His seizures started with an elementary visual aura, followed by secondary generalized tonic-clonic convulsion. Perimetry revealed left-sided incomplete hemianopia, and MRI showed an old contusion in the right occipital lobe. After evaluation with ictal video-electroencephalography, electrocorticography, and mapping of the visual cortex with subdural electrodes, the patient underwent resection of the scarred tissue, including the epileptic focus at the occipital lobe. After surgery, he became seizure free and his visual field defect improved gradually. In addition, postoperative 123 I-iomazenil (IMZ) SPECT showed partly normalized IMZ uptake in the visual cortex. This case is a practical example suggesting that neurological deficits attributable to the functional deficit zone can be remedied by successful focal resection.

Versive seizures in occipital lobe epilepsy: lateralizing value and pathophysiology.

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Usui, Naotaka; Mihara, Tadahiro; Baba, Koichi; Matsuda, Kazumi; Tottori, Takayasu; Umeoka, Shuichi; Kondo, Akihiko; Nakamura, Fumihiro; Terada, Kiyohito; Usui, Keiko; Inoue, Yushi

2011-11-01

To clarify the value of versive seizures in lateralizing and localizing the epileptogenic zone in patients with occipital lobe epilepsy, we studied 13 occipital lobe epilepsy patients with at least one versive seizure recorded during preoperative noninvasive video-EEG monitoring, who underwent occipital lobe resection, and were followed postoperatively for more than 2 years with Engel's class I outcome. The videotaped versive seizures were analyzed to compare the direction of version and the side of surgical resection in each patient. Moreover, we examined other motor symptoms (partial somatomotor manifestations such as tonic and/or clonic movements of face and/or limbs, automatisms, and eyelid blinking) associated with version. Forty-nine versive seizures were analyzed. The direction of version was always contralateral to the side of resection except in one patient. Among accompanying motor symptoms, partial somatomotor manifestations were observed in only five patients. In conclusion, versive seizure is a reliable lateralizing sign indicating contralateral epileptogenic zone in occipital lobe epilepsy. Since versive seizures were accompanied by partial somatomotor manifestations in less than half of the patients, it is suggested that the mechanism of version in occipital lobe epilepsy is different from that in frontal lobe epilepsy. Copyright © 2011 Elsevier B.V. All rights reserved.

Reduced frontal and occipital lobe asymmetry on the CT-scans of schizophrenic patients. Its specificity and clinical significance

International Nuclear Information System (INIS)

Falkai, P.; Schneider, T.; Greve, B.; Klieser, E.; Bogerts, B.

1995-01-01

Frontal and occipital lobe widths were determined in the computed tomographic (CT) scans of 135 schizophrenic patients, 158 neuro psychiatrically healthy and 102 psychiatric control subjects, including patients with affective psychosis, neurosis and schizoaffective psychosis. Most healthy right-handed subjects demonstrate a relative enlargement of the right frontal as well as left occipital lobe compared to the opposite hemisphere. These normal frontal and occipital lobe asymmetries were selectively reduced in schizophrenics (f.: 5%, p < .0005; o.: 3%, p < .05), irrespective of the pathophysiological subgroup. Schizophrenic neuroleptic non-responders revealed a significant reduction of frontal lobe asymmetry (3%, p < .05), while no correlation between BPRS-sub scores and disturbed cerebral laterality could be detected. In sum the present study demonstrates the disturbed cerebral lateralisation in schizophrenic patients supporting the hypothesis of interrupted early brain development in schizophrenia. (author)

Origin of frontal lobe spikes in the early onset benign occipital lobe epilepsy (Panayiotopoulos syndrome).

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Leal, Alberto J R; Ferreira, José C; Dias, Ana I; Calado, Eulália

2008-09-01

Early onset benign occipital lobe epilepsy (Panayiotopoulos syndrome [PS]) is a common and easily recognizable epilepsy. Interictal EEG spike activity is often multifocal but most frequently localized in the occipital lobes. The origin and clinical significance of the extra-occipital spikes remain poorly understood. Three patients with the PS and interictal EEG spikes with frontal lobe topography were studied using high-resolution EEG. Independent component analysis (ICA) was used to decompose the spikes in components with distinct temporal dynamics. The components were mapped in the scalp with a spline-laplacian algorithm. The change in scalp potential topography from spike onset to peak, suggests the contribution of several intracranial generators, with different kinetics of activation and significant overlap. ICA was able to separate the major contributors to frontal spikes and consistently revealed an early activating group of components over the occipital areas in all the patients. The local origin of these early potentials was established by the spline-laplacian montage. Frontal spikes in PS are consistently associated with early and unilateral occipital lobe activation, suggesting a postero-anterior spike propagation. Frontal spikes in the PS represent a secondary activation triggered by occipital interictal discharges and do not represent an independent focus.

Pathways of seizure propagation from the temporal to the occipital lobe.

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Jacobs, Julia; Dubeau, François; Olivier, André; Andermann, Frederick

2008-12-01

Propagation of ictal epileptic discharges influences the clinical appearance of seizures. Fast propagation from the occipital to temporal lobe has been well described, but until now the reverse direction of spread has not been emphasized. We describe two patients who experienced ictal propagation from temporal to occipital regions. One case presented with amaurosis during a seizure with temporal onset and temporal-occipital spread. In the second, temporal-occipital spread was documented during a seizure, which continued in the occipital lobe for six minutes. Depth electrode studies suggested the temporal ictal onset of seizures in both patients. Propagation from temporal to occipital lobe structures must be considered in the assessment of patients who have seizures with both temporal and occipital features. The propagation may have predictive value for their surgical outcome. The underlying anatomical structure might be the inferior longitudinal fasciculus.

Metabolic changes in occipital lobe epilepsy with automatisms.

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Wong, Chong H; Mohamed, Armin; Wen, Lingfeng; Eberl, Stefan; Somerville, Ernest; Fulham, Michael; Bleasel, Andrew F

2014-01-01

Some studies suggest that the pattern of glucose hypometabolism relates not only to the ictal-onset zone but also reflects seizure propagation. We investigated metabolic changes in patients with occipital lobe epilepsy (OLE) that may reflect propagation of ictal discharge during seizures with automatisms. Fifteen patients who had undergone epilepsy surgery for intractable OLE and had undergone interictal Fluorine-18-fluorodeoxyglucose positron-emission tomography ((18)F-FDG-PET) between 1994 and 2004 were divided into two groups (with and without automatisms during seizure). Significant regions of hypometabolism were identified by comparing (18)F-FDG-PET results from each group with 16 healthy controls by using statistical parametric mapping. Significant hypometabolism was confined largely to the epileptogenic occipital lobe in the patient group without automatisms. In patients with automatisms, glucose hypometabolism extended from the epileptogenic occipital lobe into the ipsilateral temporal lobe. We identified a distinctive hypometabolic pattern that was specific for OLE patients with automatisms during a seizure. This finding supports the postulate that seizure propagation is a cause of glucose hypometabolism beyond the region of seizure onset.

Explicit memory and implicit memory in occipital lobe stroke patients.

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Gong, Liang; Wang, JiHua; Feng, Lei; Wang, MeiHong; Li, Xiu; Hu, JiaYun; Wang, Kai

2015-03-01

Occipital stroke patients mainly showed cortical blindness and unilateral vision loss; memory is generally reserved. Recent reports from neuroimaging show the occipital lobe may be involved in the processing of implicit memory (IM), especially the perception type of IM processing. In this study, we explored the explicit memory (EM) and IM damage in occipital lobe stroke patients. A total of 25 occipital strokes and 29 years of age, educational level equivalent healthy controls (HCs), evaluated by using immediate recall, delayed recall, recognition for EM tasks, picture identification, and category exemplar generation for IM tasks. There was no significant difference between occipital stroke patients and HCs in EM tasks and category exemplar generation task. In the picture identification task, occipital lobe stroke group score was poorer than HC group, the results were statistically significant, but in the pictures identify rate, occipital stroke patients and normal control group had no significant difference. The occipital stroke patients may have IM damage, primarily damage the perception type of IM priming effects, which was unrelated with their cortical blindness. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Metabolic changes in occipital lobe epilepsy with automatisms

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Chong H Wong

2014-07-01

Full Text Available Purpose: Some studies suggest that the pattern of glucose hypometabolism relates not only to the ictal-onset zone, but also reflects seizure propagation. We investigated metabolic changes in patients with occipital lobe epilepsy (OLE that may reflect propagation of ictal discharge during seizures with automatisms.Methods: Fifteen patients who had undergone epilepsy surgery for intractable OLE and had undergone interictal Fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG-PET between 1994 and 2004 were divided into two groups (with and without automatisms during seizure. Significant regions of hypometabolism were identified by comparing 18F-FDG-PET results from each group with 16 healthy controls by using Statistical Parametric Mapping (SPM 2.Key Findings: Significant hypometabolism was confined largely to the epileptogenic occipital lobe in the patient group without automatisms. In patients with automatisms, glucose hypometabolism extended from the epileptogenic occipital lobe into the ipsilateral temporal lobe.Significance: We identified a distinctive hypometabolic pattern that was specific for OLE patients with automatisms during a seizure. This finding supports the postulate that seizure propagation is a cause of glucose hypometabolism beyond the region of seizure onset.

[Intracranial remote epidural haematoma as a complication after resection of an occipital lobe metastatic tumour from a testicular embryonal carcinoma – a case report].

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Andrusewicz, Wojciech; Limanówka, Bartosz; Sagan, Leszek; Kojder, Ireneusz

We present the case of a patient who suffered from intracranial epidural haematoma in the left fronto -temporo -parietal region as a complication after left parieto -occipital craniotomy and a resection of a metastatic lesion from a testicular embryonal carcinoma to the left occipital lobe. We also discuss possible causes of this complication.

Prevalence of resistant occipital lobe epilepsy associated with celiac disease in children.

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Dai, Alper I; Akcali, Aylin; Varan, Celal; Demiryürek, Abdullah T

2014-06-01

Celiac disease (CD) is a chronic, inflammatory autoimmune disorder caused by intolerance to ingested gluten. Increased frequency of CD has been reported in occipital lobe epilepsy. The aim of the present study is to investigate the frequency of CD among children followed up due to epilepsy and diagnosed with epileptic activity in the occipital lobe in at least one electroencephalography (EEG) test. For this research, 90 pediatric epilepsy patients with epileptic activity in the occipital lobe were enrolled in the study group, while the control group comprised of 100 healthy children. In addition to the EEG examination, tissue transglutaminase (tTG) antibody was determined on duodenal biopsy. None of the healthy children in the control group was positive in terms of the tTG antibody test used to scan CD. In the group with epileptic activity in the occipital lobe, two patients out of 90 were tTG antibody positive. The seroprevalence was 1/45 (2.22 %) in this group. These two patients were diagnosed with CD based on the endoscopic duodenal biopsy. In these patients, the seizures were uncontrollable through monotherapy. Our results showed that the prevalence of CD is observed to be higher than the normal population among the patients with occipital lobe epilepsy. This type of seizure disorder seems to be more resistant to monotherapy, compared with other types of occipital epilepsy. Therefore, screening for CD is recommended in children with resistant epileptic activity in the occipital lobe.

Early seizure propagation from the occipital lobe to medial temporal structures and its surgical implication.

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Usui, Naotaka; Mihara, Tadahiro; Baba, Koichi; Matsuda, Kazumi; Tottori, Takayasu; Umeoka, Shuichi; Nakamura, Fumihiro; Terada, Kiyohito; Usui, Keiko; Inoue, Yushi

2008-12-01

Intracranial EEG documentation of seizure propagation from the occipital lobe to medial temporal structures is relatively rare. We retrospectively analyzed intracranial EEG recorded with electrodes implanted in the medial temporal lobe in patients who underwent occipital lobe surgery. Four patients with occipital lesions, who underwent intracranial EEG monitoring with intracerebral electrodes implanted in the medial temporal lobe prior to occipital lobe surgery, were studied. Subdural electrodes were placed over the occipital lobe and adjacent areas. Intracerebral electrodes were implanted into bilateral hippocampi and the amygdala in three patients, and in the hippocampus and amygdala ipsilateral to the lesion in one. In light of the intracranial EEG findings, the occipital lobe was resected but the medial temporal lobe was spared in all patients. The follow-up period ranged from six to 16 years, and seizure outcome was Engel Class I in all patients. Sixty six seizures were analyzed. The majority of the seizures originated from the occipital lobe. In complex partial seizures, ictal discharges propagated to the medial temporal lobe. No seizures originating from the temporal lobe were documented. In some seizures, the ictal-onset zone could not be identified. In these seizures, very early propagation to the medial temporal lobe was observed. Interictal spikes were recorded in the medial temporal lobe in all cases. Intracranial EEG revealed very early involvement of the medial temporal lobe in some seizures. Seizure control was achieved without resection of the medial temporal structures.

Activation on occipital lobe in children with abacus mental calculation training: an fMRI study

International Nuclear Information System (INIS)

Shen Xiaojun; Long Jinfeng; Zhao Kunyuan; Li Lixin; Sun Jining; Wang Bin

2011-01-01

Objective: By exploring the activation on occipital lobe in children with and without abacus mental calculation training when they engaged in different calculation tasks with functional magnetic resonance imaging (fMRI), to identify the possible mechanism of occipital lobe in abacus mental calculation. Methods: fMRI was performed in children trained with and without (sixteen in each group) abacus mental calculation when they engaged in addition, subtraction. multiplication, division, and number-object control judging tasks. The data processing and statistical analysis were performed on SPM 2.0 (statistical parametric mapping 2.0) and the related-brain functional areas were identified. The activation on occipital lobe was observed carefully. The difference in activated areas of occipital lobe was statistically significant between two groups engaged in different tasks of calculations (P<0.01). Result: Bilateral occipital lobe, especially in the cuneus and lingual gyrus, were activated in children trained with abacus mental calculation. The main activated area was lingual gyrus in children without abacus mental calculation. Conclusion: The occipital lobe participates visuospatial processing in the abacus mental calculations. The neuromechanism maybe account for the specific activation in occipital lobe. (authors)

Occipital lobe epilepsy with fear as leading ictal symptom.

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Oehl, Bernhard; Schulze-Bonhage, Andreas; Lanz, Michael; Brandt, Armin; Altenmüller, Dirk-Matthias

2012-03-01

Ictal fear is a semiological feature which is commonly associated with mesial temporal lobe epilepsy. Here, we describe fear as a leading symptom in cryptogenic occipital lobe epilepsy. In a patient with negative MRI findings, intracranial EEG recordings documented a strict correlation between habitual ictal anxiety attacks and both spontaneous and stimulation-induced epileptic activity in a right occipital epileptogenic area with subsequent spreading to the symptomatogenic zone in the amygdala. Circumscribed occipital topectomy led to seizure freedom. Episodes of non-epileptic fear ceased shortly afterwards. This report provides insight into pathways of propagation of epileptic activity, illustrates different etiologies of pathologic fear and underlines the importance of ictal EEG recordings. Copyright © 2012 Elsevier Inc. All rights reserved.

Sulcal and gyral anatomy of the basal occipital-temporal lobe.

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Chau, Anthony Minh Tien; Stewart, Fiona; Gragnaniello, Cristian

2014-12-01

The sulcal and gyral anatomy of the basal occipital-temporal lobe is highly variable and detailed descriptions of this region are limited and often inconsistent. The aim of this study was to describe the salient features of the sulcal and gyral anatomy of the basal occipital-temporal lobe. We studied the sulcal and gyral patterns of 30 formalin-fixed cerebral hemispheres. The major landmarks are the collateral sulcus (separated into the rhinal, proper, and caudal segments) and occipitotemporal sulcus (often interrupted), which were always present in this study. The bifurcation of the caudal collateral sulcus is a useful landmark. In relation to these sulci, we have described the surface anatomy and nominated landmarks of the medial (parahippocampal and lingual) and lateral (fusiform) occipitotemporal gyri. Understanding of the sulcal and gyral patterns of the basal occipital-temporal lobe may provide valuable information in its radiological and intraoperative interpretation.

Occipital lobe infarctions are different

OpenAIRE

Naess, Halvor; Waje-Andreassen, Ulrikke; Thomassen, Lars

2007-01-01

Halvor Naess, Ulrikke Waje-Andreassen, Lars ThomassenDepartment of Neurology, Haukeland University Hospital, University of Bergen, N-5021 Bergen, NorwayObjectives: We hypothesized that occipital lobe infarctions differ from infarctions in other locations as to etiology, risk factors and prognosis among young adults.Methods: Location, etiology, risk factors and long-term outcome were evaluated among all young adults 15–49 years suffering from cerebral infarction in Hordaland County, Norw...

Epileptiform transients of the occipital lobe in pediatrics.

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Campbell, Stefan

2013-09-01

Differentiating between benign occipital transients and epileptic discharges from the occipital lobes is imperative. Focal occipital spikes and sharp waves are not always associated with benign disorders. The occurrence of occipital spikes and spike and wave complexes depends on the child's age, the maturation of the occipital cortex, and the cortex's connection with other structures (Beaumanoir et al. 1993). Clinical manifestations also evolve as the patient ages. Seizure semiology is due to the maturation of the visual system and its connections. An infant from birth to twelve months of age could experience autonomic symptoms such as pallor and vomiting with possible minor motor movements. Visual symptoms and/or headaches are usually not noticed until between five and seven years of age. These visual phenomena can continue into adulthood.

Decreased occipital lobe metabolism by FDG-PET/CT: An anti-NMDA receptor encephalitis biomarker.

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Probasco, John C; Solnes, Lilja; Nalluri, Abhinav; Cohen, Jesse; Jones, Krystyna M; Zan, Elcin; Javadi, Mehrbod S; Venkatesan, Arun

2018-01-01

To compare brain metabolism patterns on fluorodeoxyglucose (FDG)-PET/CT in anti-NMDA receptor and other definite autoimmune encephalitis (AE) and to assess how these patterns differ between anti-NMDA receptor neurologic disability groups. Retrospective review of clinical data and initial dedicated brain FDG-PET/CT studies for neurology inpatients with definite AE, per published consensus criteria, treated at a single academic medical center over a 10-year period. Z-score maps of FDG-PET/CT were made using 3-dimensional stereotactic surface projections in comparison to age group-matched controls. Brain region mean Z scores with magnitudes ≥2.00 were interpreted as significant. Comparisons were made between anti-NMDA receptor and other definite AE patients as well as among patients with anti-NMDA receptor based on modified Rankin Scale (mRS) scores at the time of FDG-PET/CT. The medial occipital lobes were markedly hypometabolic in 6 of 8 patients with anti-NMDA receptor encephalitis and as a group (Z = -4.02, interquartile range [IQR] 2.14) relative to those with definite AE (Z = -2.32, 1.46; p = 0.004). Among patients with anti-NMDA receptor encephalitis, the lateral and medial occipital lobes were markedly hypometabolic for patients with mRS 4-5 (lateral occipital lobe Z = -3.69, IQR 1; medial occipital lobe Z = -4.08, 1) compared with those with mRS 0-3 (lateral occipital lobe Z = -0.83, 2; p occipital lobe Z = -1.07, 2; p = 0.001). Marked medial occipital lobe hypometabolism by dedicated brain FDG-PET/CT may serve as an early biomarker for discriminating anti-NMDA receptor encephalitis from other AE. Resolution of lateral and medial occipital hypometabolism may correlate with improved neurologic status in anti-NMDA receptor encephalitis.

Brain mapping of epileptic activity in a case of idiopathic occipital lobe epilepsy (Panayiotopoulos syndrome).

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Leal, Alberto J R; Nunes, Sofia; Martins, António; Secca, Mário Forjaz; Jordão, Constança

2007-06-01

The Panayiotopoulos type of occipital lobe epilepsy has generated great interest, but the particular brain areas involved in the peculiar seizure manifestations have not been established. We studied a patient with the syndrome, using high-resolution EEG and simultaneous EEG and functional magnetic resonance imaging (fMRI). Resolution of the scalp EEG was improved using a realistic spline Laplacian algorithm, and produced a complex distribution of current sinks and sources over the occipital lobe. The spike-related blood oxygen level dependent (BOLD) effect was multifocal, with clusters in lateral and inferior occipital lobe and lateral and anterior temporal lobe. We also performed regional dipole seeding in BOLD clusters to determine their relative contribution to generation of scalp spikes. The integrated model of the neurophysiologic and vascular data strongly suggests that the epileptic activity originates in the lateral occipital area, spreading to the occipital pole and lateral temporal lobe.

Balint′s Syndrome As a Manifestation of Solitary Right Occipital Lobe Metastasis

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Sarat Chandra P

1998-01-01

Full Text Available Balint′s syndrome is a rare clinical condition characterized by a triad of occulomotor apraxia (psychic paralysis of gaze, optic ataxia and visual inattention and usually follows bilateral parieto-occipital lesions. We report this syndrome occurring in a patient with a solitary metastasis in right occipital lobe. To the best of our knowledge it has not been previously described in English literature. Pressure over the opposite occipital lobe due to mass effect, diaschisis and extension of edema along the corpus callosum involvement may contribute to this exceptional phenomenon.

Visual interhemispheric communication and callosal connections of the occipital lobes.

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Berlucchi, Giovanni

2014-07-01

Callosal connections of the occipital lobes, coursing in the splenium of the corpus callosum, have long been thought to be crucial for interactions between the cerebral hemispheres in vision in both experimental animals and humans. Yet the callosal connections of the temporal and parietal lobes appear to have more important roles than those of the occipital callosal connections in at least some high-order interhemispheric visual functions. The partial intermixing and overlap of temporal, parietal and occipital callosal connections within the splenium has made it difficult to attribute the effects of splenial pathological lesions or experimental sections to splenial components specifically related to select cortical areas. The present review describes some current contributions from the modern techniques for the tracking of commissural fibers within the living human brain to the tentative assignation of specific visual functions to specific callosal tracts, either occipital or extraoccipital. Copyright © 2013 Elsevier Ltd. All rights reserved.

Intralobar fibres of the occipital lobe: a post mortem dissection study.

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Vergani, Francesco; Mahmood, Sajedha; Morris, Cristopher M; Mitchell, Patrick; Forkel, Stephanie J

2014-07-01

The atlas by Heinrich Sachs (1892) provided an accurate description of the intralobar fibres of the occipital lobe, with a detailed representation of the short associative tracts connecting different parts of the lobe. Little attention has been paid to the work of Sachs since its publication. In this study, we present the results of the dissection of three hemispheres, performed according to the Klingler technique (1935). Our anatomical findings are then compared to the original description of the occipital fibres anatomy as detailed by Sachs. Three hemispheres were dissected according to Klingler's technique (1935). Specimens were fixed in 10% formalin and frozen at -15 °C for two weeks. After defreezing, dissection of the white matter fibres was performed with blunt dissectors. Coronal sections were obtained according to the cuts originally described by Sachs. In addition, medial to lateral and lateral to medial dissection of the white matter of the occipital lobe was also performed. A network of short association fibres was demonstrated in the occipital lobe, comprising intralobar association fibres and U-shaped fibres, which are connecting neighbouring gyri. Lateral to the ventricles, longitudinal fibres of the stratum sagittale were also identified that are arranged as external and internal layers. Fibres of the forceps major were also found to be in direct contact with the ventricular walls. We were able to replicate all tracts originally described by Sachs. In addition, a previously unrecognised tract, connecting the cuneus to the lingual gyrus, was identified. This tract corresponds to the "sledge runner", described in tractography studies. The occipital lobe shows a rich network of intralobar fibres, arranged around the ventricular wall. Good concordance was observed between the Klingler dissection technique and the histological preparations of Sachs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Perimetric demonstration of spontaneous visual field recovery following occipital lobe haemorrhage.

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Lin, Siying; George, Badie Z; Wilson-Holt, Nicholas J

2013-08-29

A 45-year-old patient on lifelong warfarin therapy after a metal aortic valve replacement developed a homonymous visual field defect following an occipital lobe haemorrhage. The patient received only conservative management and yet described continued improvement in her visual field defect for up to 20 months following the initial cerebral insult. We present the first conclusive illustrative documentation of visual recovery in a patient with an occipital lobe haemorrhage with sequential automated perimetric assessments over an extended period of time.

Long term prognosis of symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia.

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Montassir, Hesham; Maegaki, Yoshihiro; Ohno, Kousaku; Ogura, Kaeko

2010-02-01

To report on long-term clinical course in patients with symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia. Six patients with neonatal hypoglycemia and symptomatic occipital lobe epilepsy were studied in our hospital through reviewing their medical records retrospectively. The median onset age of epilepsy was 2 years 8 months and median follow-up period was 12 years and 4 months. Initial seizure types were generalized convulsions in 4 patients, hemiconvulsion in 1, and infantile spasms in 1. Ictal manifestations of main seizures were identical to occipital lobe seizures, such as eye deviation, eye blinking, ictal vomiting, and visual hallucination. Seizure frequency was maximum during infancy and early childhood and decreased thereafter with no seizure in 2 patients, a few seizures a year in 3, and once a month in 1. All patients had status epilepticus in the early course of epilepsy. EEGs showed parieto-occipital spikes in all patients. MRI revealed cortical atrophy and T2 prolongation parieto-occipitally in 4 patients, hippocampal atrophy in 1, and unremarkable in 1. This study indicates that epilepsy secondary to neonatal hypoglycemia is intractable during infancy and early childhood with frequent status epilepticus but tends to decrease in older age.

Correlation of neuropsychological and metabolic changes after epilepsy surgery in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis.

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Güvenç, Canan; Dupont, Patrick; Van den Stock, Jan; Seynaeve, Laura; Porke, Kathleen; Dries, Eva; Van Bouwel, Karen; van Loon, Johannes; Theys, Tom; Goffin, Karolien E; Van Paesschen, Wim

2018-04-12

Epilepsy surgery often causes changes in cognition and cerebral glucose metabolism. Our aim was to explore relationships between pre- and postoperative cerebral metabolism as measured with 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological test scores in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), who were rendered seizure-free after epilepsy surgery. Thirteen patients were included. All had neuropsychological testing and an interictal FDG-PET scan of the brain pre- and postoperative. Correlations between changes in neuropsychological test scores and metabolism were examined using statistical parametric mapping (SPM). There were no significant changes in the neuropsychological test scores pre- and postoperatively at the group level. Decreased metabolism was observed in the left mesial temporal regions and occipital lobe. Increased metabolism was observed in the bi-frontal and right parietal lobes, temporal lobes, occipital lobes, thalamus, cerebellum, and vermis. In these regions, we did not find a correlation between changes in metabolism and neuropsychological test scores. A significant negative correlation, however, was found between metabolic changes in the precuneus and Boston Naming Test (BNT) scores. There are significant metabolic decreases in the left mesial temporal regions and increases in the bi-frontal lobes; right parietal, temporal, and occipital lobes; right thalamus; cerebellum; and vermis in patients with left MTLE-HS who were rendered seizure-free after epilepsy surgery. We could not confirm that these changes translate into significant cognitive changes. A significant negative correlation was found between changes in confrontation naming and changes in metabolism in the precuneus. We speculate that the precuneus may play a compensatory role in patients with postoperative naming difficulties after left TLE surgery. Understanding of these neural mechanisms may aid in

Rapid recurrence and bilateral lungs, multiple bone metastasis of malignant solitary fibrous tumor of the right occipital lobe: report of a case and review.

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Wu, Zhengrong; Yang, Hongjun; Weng, Desheng; Ding, Yanqing

2015-07-09

Intracranial malignant solitary fibrous tumor (MSFT) is extremely rare. The authors report a case of MSFT of the right occipital lobe with a rapid recurrence and bilateral lung, multiple bone metastasis. The patient was a 25-year-old male presenting with headache, nausea and visual disturbances without obvious cause. Three times right-side occipital craniotomies were performed and two times postoperative conformal radiotherapy were administered within one year. 4 months after the third time of right-side occipital craniotomy, the patient felt right chest pain and neck pain. Positron emission tomography/computed tomography (PET/CT) showed tumor recurrence of the right occipital lobe and bilateral lung metastasis, multiple bone metastasis including: vertebrae, libs, the left iliac wing, sacrum, the right ischium and upper parts of both femurs. Ultrasound guided puncture biopsy of left-side back of the neck and CT guided puncture biopsy of the third lumbar vertebra were performed. General sample showed grayish white or grayish red with irregular shape. Histopathologically, the tumor was composed of areas of alternating hypercellularity and hypocellularity with spindle-shaped cells, which arranged as fascicular, storiform pattern or patternless pattern, with intervening irregular eosinophilic collagen bundles. Some areas showed hemangiopericytoma-like perivascular pattern and perivascular hyalinization. Tumor cells were pleomorphic with mitotic counts of more than 4 per 10 high power fields and showed coagulative necrosis. Immunohistochemically, tumor cells were diffusely positive for vimentin and CD99, focal positive for CD34, bcl-2 and Actin. Ki-67 labelling index was more than 40%. The final pathological diagnosis was MSFT of the right occipital lobe, metastatic MSFT of left-side back of the neck and the third lumbar vertebra. The MSFT of the right occipital lobe with recurrence and bilateral lung, multiple bone metastasis is extremely rare. Although intracranial

Temporal and occipital lobe features in children with hypochondroplasia/FGFR3 gene mutation.

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Philpott, Cristina M; Widjaja, Elysa; Raybaud, Charles; Branson, Helen M; Kannu, Peter; Blaser, Susan

2013-09-01

Thanatophoric dysplasia (TD) and hypochondroplasia are both caused by FGFR3 (fibroblast growth factor receptor 3) gene mutations. Temporal lobe dysplasia has been well described in thanatophoric dysplasia; however, only a couple of anecdotal cases of temporal lobe dysplasia in hypochondroplasia have been described. To define temporal lobe abnormalities in patients with hypochondroplasia, given that they share the same genetic mutation. We identified brain imaging studies of nine children with hypochondroplasia. The temporal lobes were assessed on CT and MRI for size and configuration of the temporal horn and aberrant sulcation of the inferior surface of the temporal lobe. All children had a triangular-shape temporal horn and deep transverse fissures of the inferior temporal lobe surface. Neuroimaging in our cohort revealed enlarged temporal lobes and oversulcation of the mesial temporal and occipital lobes, with abnormal inferomedial orientation of these redundant gyri. Hippocampal dysplasia was also universal. We confirmed frequent inferomesial temporal and occipital lobe abnormalities in our cohort of children with hypochondroplasia. Murine models with mutant fgfr3 display increased neuroprogenitor proliferation, cortical thickness and surface area in the temporo-occipital cortex. This is thought to result in excessive convolution and likely explains the imaging findings in this patient cohort. (Note that fgfr3 is the same genetic mutation in mice as FGFR3 is in humans.).

Grooves on the occipital lobe of Indian brains.

OpenAIRE

Bisaria, K K

1984-01-01

The existence of a groove on the occipital lobe formed by the dural venous sinus or ridge has only rarely been described in the past. As observed in this study such grooves are either unilateral or bilateral and their incidence is very high in Indian brains.

Intractable occipital lobe epilepsy: clinical characteristics and surgical treatment.

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Jobst, Barbara C; Williamson, Peter D; Thadani, Vijay M; Gilbert, Karen L; Holmes, Gregory L; Morse, Richard P; Darcey, Terrance M; Duhaime, Ann-Christine; Bujarski, Krysztof A; Roberts, David W

2010-11-01

Intractable occipital lobe epilepsy remains a surgical challenge. Clinical characteristics of 14 patients were analyzed. Twelve patients had surgery, seven patients had visual auras (50%) and only eight patients (57%) had posterior scalp EEG changes. Ictal single-proton emission computed tomography (SPECT) incorrectly localized in 7 of 10 patients. Six patients (50%) had Engel's class I outcome. Patients with inferior occipital seizure onset appeared to fare better (three of four class I) than patients with lateral or medial occipital seizure onset (three of eight class I). Patients who had all three occipital surfaces covered with electrodes had a better outcome (four of five class I) than patients who had limited electroencephalography (EEG) coverage (two of seven class I). Magnetic resonance imaging (MRI) lesions did not guarantee a seizure free outcome. In conclusion, visual auras, scalp EEG, and imaging findings are not reliable for correct identification of occipital onset. Occipital seizure onset can be easily missed in nonlesional epilepsy. Comprehensive intracranial EEG coverage of all three occipital surfaces leads to better outcomes.

Anton's Syndrome due to Bilateral Ischemic Occipital Lobe Strokes.

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Zukić, Sanela; Sinanović, Osman; Zonić, Lejla; Hodžić, Renata; Mujagić, Svjetlana; Smajlović, Edina

2014-01-01

We present a case of a patient with Anton's syndrome (i.e., visual anosognosia with confabulations), who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton's syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

Perinatal occipital lobe injury in children: analysis of twenty-one cases.

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Wang, San-Mei; Yang, Chang-Shuan; Hou, Yu; Ma, Xiu-Wei; Feng, Zhi-Chun; Liao, Yu-Zhen

2012-12-01

This study used magnetic resonance imaging to analyze causes and clinical courses of pediatric occipital lobe injury. Patients undergoing magnetic resonance imaging for suspected bilateral occipital lobe injury at our Neurodevelopmental Department between July 2007 and June 2011 were included. We evaluated magnetic resonance imaging characteristics, clinical courses, electroencephalogram monitoring, and Denver Development Screen Test scores. Twenty-one infants were examined. Of these, 10 had been born preterm. Thirteen patients demonstrated hypoglycemia. Perinatal period hypoglycemia comprised the most common cause (71.4%) of occipital brain injury. Visual abnormalities were evident in 18 patients. Seventeen (80.9%) patients manifested epilepsy. Infantile spasms were observed in 13 cases (76.5%). According to Denver Development Screen Test assessment, 17 patients demonstrated delayed motor development. Motor function and language improved in 10 patients after effective control of their seizures. Hypoglycemia constitutes the most common cause of occipital injury in infants. Visual impairment, startle episodes, infantile spasms, and motor developmental delay comprise the most common complications, whereas language function is usually spared. Copyright © 2012 Elsevier Inc. All rights reserved.

Occipital bending (Yakovlevian torque) in bipolar depression.

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Maller, Jerome J; Anderson, Rodney; Thomson, Richard H; Rosenfeld, Jeffrey V; Daskalakis, Zafiris J; Fitzgerald, Paul B

2015-01-30

Differing levels of occipital lobe asymmetry and enlarged lateral ventricles have been reported within patients with bipolar disorder (BD) compared with healthy controls, suggesting different rates of occipital bending (OB). This may exert pressure on subcortical structures, such as the hippocampus, reduced among psychiatric patients. We investigated OB prevalence in 35 patients with BD and 36 healthy controls, and ventricular and occipital volumes. Prevalence was four times higher among BD patients (12/35 [34.3%]) than in control subjects (3/36 [8.3%]), as well as larger lateral ventricular volumes (LVVs). Furthermore, we found OB to relate to left-to-right ventricular and occipital lobe volume (OLV) ratios. Those with OB also had reduced left-to-right hippocampal volume ratios. The results suggest that OB is more common among BD patients than healthy subjects, and prevalent in both BD Type I and Type II patients. We posit that anomalies in neural pruning or ventricular enlargement may precipitate OB, consequently resulting in one occipital lobe twisting around the other. Although the clinical implications of these results are unclear, the study suggests that asymmetrical ventricular volume matched with a pattern of oppositely asymmetrical occipital volume is related to OB and may be a marker of psychiatric illness. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Grooves on the occipital lobe of Indian brains.

Science.gov (United States)

Bisaria, K K

1984-01-01

The existence of a groove on the occipital lobe formed by the dural venous sinus or ridge has only rarely been described in the past. As observed in this study such grooves are either unilateral or bilateral and their incidence is very high in Indian brains. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6490537

Multimodal imaging of language reorganization in patients with left temporal lobe epilepsy.

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Chang, Yu-Hsuan A; Kemmotsu, Nobuko; Leyden, Kelly M; Kucukboyaci, N Erkut; Iragui, Vicente J; Tecoma, Evelyn S; Kansal, Leena; Norman, Marc A; Compton, Rachelle; Ehrlich, Tobin J; Uttarwar, Vedang S; Reyes, Anny; Paul, Brianna M; McDonald, Carrie R

2017-07-01

This study explored the relationships among multimodal imaging, clinical features, and language impairment in patients with left temporal lobe epilepsy (LTLE). Fourteen patients with LTLE and 26 controls underwent structural MRI, functional MRI, diffusion tensor imaging, and neuropsychological language tasks. Laterality indices were calculated for each imaging modality and a principal component (PC) was derived from language measures. Correlations were performed among imaging measures, as well as to the language PC. In controls, better language performance was associated with stronger left-lateralized temporo-parietal and temporo-occipital activations. In LTLE, better language performance was associated with stronger right-lateralized inferior frontal, temporo-parietal, and temporo-occipital activations. These right-lateralized activations in LTLE were associated with right-lateralized arcuate fasciculus fractional anisotropy. These data suggest that interhemispheric language reorganization in LTLE is associated with alterations to perisylvian white matter. These concurrent structural and functional shifts from left to right may help to mitigate language impairment in LTLE. Copyright © 2017 Elsevier Inc. All rights reserved.

Benign occipital lobe seizures: Natural progression and atypical evolution

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Prithika Chary

2013-01-01

Full Text Available Benign occipital seizure syndromes are benign childhood epilepsy syndromes and are mainly of two types, Panayiotopoulos syndrome, an autonomic epilepsy and idiopathic childhood occipital epilepsy of Gastaut (ICOE-G including the idiopathic photosensitive occipital lobe epilepsy. Although both these types are categorized as occipital seizures, they are distinct in presentation and management. They can also be tricky to diagnose as visual symptoms may not always be the presenting feature and it is also not very easy to elicit visual hallucinations during history taking. These seizures have a good response to treatment; however, there could be atypical evolution and refractoriness to treatment especially with ICOE-G. We describe three children who presented with visual and non-visual symptoms and the electroencephalography (EEG in all the three cases showed occipital paroxysms. We have emphasized the clues in the clinical history and EEG leading to the diagnosis of these distinct epilepsy syndromes. We have also discussed the natural course of these epilepsy syndromes with some atypical evolution, which clinicians need to be aware of during treatment of these children.

Benign occipital lobe seizures: Natural progression and atypical evolution.

Science.gov (United States)

Chary, Prithika; Rajendran, Bhuvaneshwari

2013-10-01

Benign occipital seizure syndromes are benign childhood epilepsy syndromes and are mainly of two types, Panayiotopoulos syndrome, an autonomic epilepsy and idiopathic childhood occipital epilepsy of Gastaut (ICOE-G) including the idiopathic photosensitive occipital lobe epilepsy. Although both these types are categorized as occipital seizures, they are distinct in presentation and management. They can also be tricky to diagnose as visual symptoms may not always be the presenting feature and it is also not very easy to elicit visual hallucinations during history taking. These seizures have a good response to treatment; however, there could be atypical evolution and refractoriness to treatment especially with ICOE-G. We describe three children who presented with visual and non-visual symptoms and the electroencephalography (EEG) in all the three cases showed occipital paroxysms. We have emphasized the clues in the clinical history and EEG leading to the diagnosis of these distinct epilepsy syndromes. We have also discussed the natural course of these epilepsy syndromes with some atypical evolution, which clinicians need to be aware of during treatment of these children.

Panayiotopoulos syndrome and symptomatic occipital lobe epilepsy of childhood: a clinical and EEG study.

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Tata, Gulten; Guveli, Betul Tekin; Dortcan, Nimet; Cokar, Ozlem; Kurucu, Hatice; Demirbilek, Veysi; Dervent, Aysin

2014-06-01

Panayiotopoulos syndrome (PS) is an age-related seizure susceptibility syndrome that affects the central autonomic system. Although the majority of the few ictal recordings obtained so far suggest an occipital origin, semiological and interictal EEG data appear to favour more extensive involvement. In this study, the characteristics (including those based on semiology and EEG) of children with Panayiotopoulos syndrome (n=24) and those with lesion-related, symptomatic occipital lobe epilepsy (SOLE) (n=23) were compared. Detailed semiological information and EEG parameters including the localisation, distribution, density (n/sec), reactivity, and morphological characteristics of spike-wave foci and their relationship with different states of vigilance were compared between the two groups. The age at seizure onset was significantly younger in patients with symptomatic occipital lobe epilepsy than in those with PS (mean age at onset: 3.4 versus 5.6 years, respectively; p=0.044). Autonomic seizures (p=0.001) and ictal syncope (p=0.055) were more frequent in PS than in symptomatic occipital lobe epilepsy (87.5% and 37.5% versus 43.5% and 13%, respectively). The interictal spike-wave activity increased significantly during non-rapid eye movement (non-REM) sleep in both groups. The spike waves in non-REM seen in PS tended to spread mainly to central and centro-temporal regions. The results indicate that although common features do exist, Panayiotopoulos syndrome differs from symptomatic occipital lobe epilepsy and has a unique low epileptogenic threshold related to particular brain circuits.

Mirror Focus in a Patient with Intractable Occipital Lobe Epilepsy

OpenAIRE

Kim, Jiyoung; Shin, Hae kyung; Hwang, Kyoung Jin; Choi, Su Jung; Joo, Eun Yeon; Hong, Seung Bong; Hong, Seung Chul; Seo, Dae-Won

2014-01-01

Mirror focus is one of the evidence of progression in epilepsy, and also has practical points for curative resective epilepsy surgery. The mirror foci are related to the kindling phenomena that occur through interhemispheric callosal or commissural connections. A mirror focus means the secondary epileptogenic foci develop in the contralateral hemispheric homotopic area. Thus mirror foci are mostly reported in patients with temporal or frontal lobe epilepsy, but not in occipital lobe epilepsy....

Anton’s Syndrome due to Bilateral Ischemic Occipital Lobe Strokes

Directory of Open Access Journals (Sweden)

Sanela Zukić

2014-01-01

Full Text Available We present a case of a patient with Anton’s syndrome (i.e., visual anosognosia with confabulations, who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton’s syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

Relationship between cortical resection and visual function after occipital lobe epilepsy surgery.

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Heo, Won; Kim, June Sic; Chung, Chun Kee; Lee, Sang Kun

2017-10-27

OBJECTIVE In this study, the authors investigated long-term clinical and visual outcomes of patients after occipital lobe epilepsy (OLE) surgery and analyzed the relationship between visual cortical resection and visual function after OLE surgery. METHODS A total of 42 consecutive patients who were diagnosed with OLE and underwent occipital lobe resection between June 1995 and November 2013 were included. Clinical, radiological, and histopathological data were reviewed retrospectively. Seizure outcomes were categorized according to the Engel classification. Visual function after surgery was assessed using the National Eye Institute Visual Functioning Questionnaire 25. The relationship between the resected area of the visual cortex and visual function was demonstrated by multivariate linear regression models. RESULTS After a mean follow-up period of 102.2 months, 27 (64.3%) patients were seizure free, and 6 (14.3%) patients had an Engel Class II outcome. Nineteen (57.6%) of 33 patients had a normal visual field or quadrantanopia after surgery (normal and quadrantanopia groups). Patients in the normal and quadrantanopia groups had better vision-related quality of life than those in the hemianopsia group. The resection of lateral occipital areas 1 and 2 of the occipital lobe was significantly associated with difficulties in general vision, peripheral vision, and vision-specific roles. In addition, the resection of intraparietal sulcus 3 or 4 was significantly associated with decreased social functioning. CONCLUSIONS The authors found a favorable seizure control rate (Engel Class I or II) of 78.6%, and 57.6% of the subjects had good visual function (normal vision or quadrantanopia) after OLE surgery. Lateral occipital cortical resection had a significant effect on visual function despite preservation of the visual field.

Value of analyzing deep gray matter and occipital lobe perfusion to differentiate dementia with Lewy bodies from Alzheimer's disease.

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Shimizu, Soichiro; Hanyu, Haruo; Hirao, Kentaro; Sato, Tomohiko; Iwamoto, Toshihiko; Koizumi, Kiyoshi

2008-12-01

Dementia with Lewy bodies (DLB) is generally characterized by a decrease in regional cerebral blood flow (rCBF) in the occipital lobe. However, not all patients with DLB have this feature. We explored characteristics of rCBF pattern changes to improve the identification of DLB, in addition to occipital hypoperfusion. The study population comprised 30 patients with probable DLB and 49 patients with probable Alzheimer's disease (AD) who underwent single-photon emission computed tomography. The data were analyzed using Neurological Statistical Image Analysis Software (NEUROSTAT). We established a template of the region of interest (ROI) presenting the parietal lobe, posterior cingulate, striatum, thalamus, and occipital lobe on the standard brain atlas. We then compared the mean Z scores in each ROI between DLB and AD. Moreover, we investigated the value of analyzing relative rCBF changes in both the deep gray matter and occipital lobe in differentiating DLB from AD. The DLB group showed a significant relative rCBF increase in the bilateral striatum and thalamus, and a significant relative rCBF decrease in the bilateral occipital lobe when compared with the AD group. Receiver-operating characteristic analysis revealed that determining the hyperperfusion in the thalamus together with the hypoperfusion in the occipital lobe enabled a more accurate differentiation between DLB and AD than studying individual areas. Studying the relative increase of rCBF in the deep gray matter, and the relative decrease of that in the occipital lobe achieved a high differentiation between DLB and AD. This suggests that determining both an increase and a decrease in rCBF pattern may be important in differentiating between the two diseases.

Value of analyzing deep gray matter and occipital lobe perfusion to differentiate dementia with Lewy bodies from Alzheimer's disease

International Nuclear Information System (INIS)

Shimizu, Soichiro; Hanyu, Haruo; Hirao, Kentaro; Sato, Tomohiko; Iwamoto, Toshihiko; Koizumi, Kiyoshi

2008-01-01

Dementia with Lewy bodies (DLB) is generally characterized by a decrease in regional cerebral blood flow (rCBF) in the occipital lobe. However, not all patients with DLB have this feature. We explored characteristics of rCBF pattern changes to improve the identification of DLB, in addition to occipital hypoperfusion. The study population comprised 30 patients with probable DLB and 49 patients with probable Alzheimer's disease (AD) who underwent single-photon emission computed tomography. The data were analyzed using Neurological Statistical Image Analysis Soft-ware (NEUROSTAT). We established a template of the region of interest (ROI) presenting the parietal lobe, posterior cingulate, striatum, thalamus, and occipital lobe on the standard brain atlas. We then compared the mean Z scores in each ROI between DLB and AD. Moreover, we investigated the value of analyzing relative rCBF changes in both the deep gray matter and occipital lobe in differentiating DLB from AD. The DLB group showed a significant relative rCBF increase in the bilateral striatum and thalamus, and a significant relative rCBF decrease in the bilateral occipital lobe when compared with the AD group. Receiver-operating characteristic analysis revealed that determining the hyperperfusion in the thalamus together with the hypoperfusion in the occipital lobe enabled a more accurate differentiation between DLB and AD than studying individual areas. Studying the relative increase of rCBF in the deep gray matter, and the relative decrease of that in the occipital lobe achieved a high differentiation between DLB and AD. This suggests that determining both an increase and a decrease in rCBF pattern may be important in differentiating between the two diseases. (author)

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

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Parmar, Hemant A; Trobe, Jonathan D

2016-09-01

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

Focal epileptic seizures with secondary generalization in cortical atrophy and gliosis dysplasia in the left temporal lobe and hemimegalencephaly in the left occipital lobe

International Nuclear Information System (INIS)

Manchev, I.; Mancheva-Ganeva, V.; Manolova, T.; Manchev, L.

2016-01-01

It is a case of an eight-year-old patient with cortical dysplasia and gliosis in the left temporal lobe clinically manifested with focal epileptic seizures with secondary generalization. Signs of mental retardation and a number of somatic complications - diabetes, etc., were found. The complex therapy with anticonvulsant medications, immunovenin, plasmaphoresis and anti-diabetic drugs was partially effective

Abnormal activation of the occipital lobes during emotion picture processing in major depressive disorder patients

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Li, Jianying; Xu, Cheng; Cao, Xiaohua; Gao, Qiang; Wang, Yan; Wang, Yanfang; Peng, Juyi; Zhang, Kerang

2013-01-01

A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cognitive changes. However, there is still controversy regarding abnormalities in brain functions or correlation between cognitive impairment and brain function changes. Thus, it is important to design an emotion-related task for research into brain function changes. We selected positive, neutral, and negative pictures from the International Affective Picture System. Patients with major depressive disorder were asked to judge emotion pictures. In addition, functional MRI was performed to synchronously record behavior data and imaging data. Results showed that the total correct rate for recognizing pictures was lower in patients compared with normal controls. Moreover, the consistency for recognizing pictures for depressed patients was worse than normal controls, and they frequently recognized positive pictures as negative pictures. The consistency for recognizing pictures was negatively correlated with the Hamilton Depression Rating Scale. Functional MRI suggested that the activation of some areas in the frontal lobe, temporal lobe, parietal lobe, limbic lobe, and cerebellum was enhanced, but that the activation of some areas in the frontal lobe, parietal lobe and occipital lobe was weakened while the patients were watching positive and neutral pictures compared with normal controls. The activation of some areas in the frontal lobe, temporal lobe, parietal lobe, and limbic lobe was enhanced, but the activation of some areas in the occipital lobe were weakened while the patients were watching the negative pictures compared with normal controls. These findings indicate that patients with major depressive disorder have negative cognitive disorder and extensive brain dysfunction. Thus, reduced activation of the occipital lobe may be an initiating factor for

Dissociation between Conceptual and Perceptual Implicit Memory: Evidence from Patients with Frontal and Occipital Lobe Lesions.

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Gong, Liang; Wang, JiHua; Yang, XuDong; Feng, Lei; Li, Xiu; Gu, Cui; Wang, MeiHong; Hu, JiaYun; Cheng, Huaidong

2015-01-01

The latest neuroimaging studies about implicit memory (IM) have revealed that different IM types may be processed by different parts of the brain. However, studies have rarely examined what subtypes of IM processes are affected in patients with various brain injuries. Twenty patients with frontal lobe injury, 25 patients with occipital lobe injury, and 29 healthy controls (HC) were recruited for the study. Two subtypes of IM were investigated by using structurally parallel perceptual (picture identification task) and conceptual (category exemplar generation task) IM tests in the three groups, as well as explicit memory (EM) tests. The results indicated that the priming of conceptual IM and EM tasks in patients with frontal lobe injury was poorer than that observed in HC, while perceptual IM was identical between the two groups. By contrast, the priming of perceptual IM in patients with occipital lobe injury was poorer than that in HC, whereas the priming of conceptual IM and EM was similar to that in HC. This double dissociation between perceptual and conceptual IM across the brain areas implies that occipital lobes may participate in perceptual IM, while frontal lobes may be involved in processing conceptual memory.

Recovery of visual-field defects after occipital lobe infarction: a perimetric study.

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Çelebisoy, Mehmet; Çelebisoy, Neşe; Bayam, Ece; Köse, Timur

2011-06-01

To assess the temporal course of homonymous visual-field defects due to occipital lobe infarction, by using automated perimetry. 32 patients with ischaemic infarction of the occipital lobe were studied prospectively, using a Humphrey Visual Field Analyser II. The visual field of each eye was divided into central, paracentral and peripheral zones. The mean visual sensitivity of each zone was calculated and used for the statistical analysis. The results of the initial examination, performed within 2 weeks of stroke, were compared with the results of the sixth-month control. The lesions were assigned to the localisations, optic radiation, striate cortex, occipital pole and occipital convexity, by MRI. A statistically significant improvement was noted, especially for the lower quadrants. Lesions of the occipital pole and convexity were not significantly associated with visual-field recovery. However, involvement of the striate cortex and extensive lesions involving all the areas studied was significantly associated with poor prognosis. Homonymous visual-field defects in our patients improved within 6 months. Restoration of the lower quadrants and especially the peripheral zones was noted. Incomplete damage to the striate cortex, which has a varying pattern of vascular supply, could explain this finding. Magnification factor theory, which is the increment of the receptive-field size of striate cortex cells with visual-field eccentricity, may explain the more significant improvement in the peripheral zones.

Dissociation between conceptual and perceptual implicit memory：Evidence from patients with frontal and occipital lobe lesions

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Liang eGong

2016-01-01

Full Text Available The latest neuroimaging studies about implicit memory have revealed that different implicit memory types may be processed by different parts of the brain. However, studies have rarely examined what subtypes of implicit memory processes are affected in patients with various brain-injuries. Twenty patients with frontal lobe injury, 25 patients with occipital lobe injury, and 29 healthy controls were recruited for the study. Two subtypes of implicit memory were investigated by using structurally parallel perceptual (picture identification task and conceptual (category exemplar generation task implicit memory tests in the three groups, as well as explicit memory tests. The results indicated that the priming of conceptual implicit memory and explicit memory tasks in patients with frontal lobe injury was poorer than that observed in healthy controls, while perceptual implicit memory was identical between the two groups. In contrast, the priming of perceptual implicit memory in patients with occipital lobe injury was poorer than that in healthy controls, while the priming of conceptual implicit memory and explicit memory was similar to that in healthy controls. This double dissociation between perceptual and conceptual implicit memory across the brain areas implies that occipital lobes may participate in perceptual implicit memory, while frontal lobes may be involved in processing conceptual memory.

Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

International Nuclear Information System (INIS)

Maeshima, S.; Matsumoto, T.; Ueyoshi, A.; Toshiro, H.; Sekiguchi, E.; Okita, R.; Yamaga, H.; Ozaki, F.; Moriwaki, H.; Roger, P.

2002-01-01

We present a case of transcortical mixed aphasia caused by a cerebral embolism. A 77-year-old right-handed man was admitted to our hospital with speech disturbance and a right hemianopia. His spontaneous speech was remarkably reduced, and object naming, word fluency, comprehension, reading and writing were all severely disturbed. However, repetition of phonemes and sentences and reading aloud were fully preserved. Although magnetic resonance imaging (MRI) showed cerebral infarcts in the left frontal and parieto-occipital lobe which included the inferior frontal gyrus and angular gyrus, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere except for part of the left perisylvian language areas. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. Hence, it appears that transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas, even if there is a lesion in the inferior frontal gyrus, due to disconnection from surrounding areas. (orig.)

Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

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Maeshima, S.; Matsumoto, T.; Ueyoshi, A. [Department of Physical Medicine and Rehabilitation, Wakayama Medical University, Wakayama (Japan); Toshiro, H.; Sekiguchi, E.; Okita, R.; Yamaga, H.; Ozaki, F.; Moriwaki, H. [Department of Neurological Surgery, Hidaka General Hospital, Wakayama (Japan); Roger, P. [School of Communication Sciences and Disorders, University of Sydney, Sydney, NSW (Australia)

2002-02-01

We present a case of transcortical mixed aphasia caused by a cerebral embolism. A 77-year-old right-handed man was admitted to our hospital with speech disturbance and a right hemianopia. His spontaneous speech was remarkably reduced, and object naming, word fluency, comprehension, reading and writing were all severely disturbed. However, repetition of phonemes and sentences and reading aloud were fully preserved. Although magnetic resonance imaging (MRI) showed cerebral infarcts in the left frontal and parieto-occipital lobe which included the inferior frontal gyrus and angular gyrus, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere except for part of the left perisylvian language areas. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. Hence, it appears that transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas, even if there is a lesion in the inferior frontal gyrus, due to disconnection from surrounding areas. (orig.)

Neonatal apneic seizure of occipital lobe origin: continuous video-EEG recording.

Science.gov (United States)

Castro Conde, José Ramón; González-Hernández, Tomás; González Barrios, Desiré; González Campo, Candelaria

2012-06-01

We present 2 term newborn infants with apneic seizure originating in the occipital lobe that was diagnosed by video-EEG. One infant had ischemic infarction in the distribution of the posterior cerebral artery, extending to the cingulate gyrus. In the other infant, only transient occipital hyperechogenicity was observed by using neurosonography. In both cases, although the critical EEG discharge was observed at the occipital level, the infants presented no clinical manifestations. In patient 1, the discharge extended to the temporal lobe first, with subtle motor manifestations and tachycardia, then synchronously to both hemispheres (with bradypnea/hypopnea), and the background EEG activity became suppressed, at which point the infant experienced apnea. In patient 2, background EEG activity became suppressed right at the end of the focal discharge, coinciding with the appearance of apnea. In neither case did the clinical description by observers coincide with video-EEG findings. The existence of connections between the posterior limbic cortex and the temporal lobe and midbrain respiratory centers may explain the clinical symptoms recorded in these 2 cases. The novel features reported here include video-EEG capture of apneic seizure, ischemic lesion in the territory of the posterior cerebral artery as the cause of apneic seizure, and the appearance of apnea when the epileptiform ictal discharge extended to other cerebral areas or when EEG activity became suppressed. To date, none of these clinical findings have been previously reported. We believe this pathology may in fact be fairly common, but that video-EEG monitoring is essential for diagnosis.

Flash visual evoked potentials are not specific enough to identify parieto-occipital lobe involvement in term neonates after significant hypoglycaemia.

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Hu, Liyuan; Gu, Qiufang; Zhu, Zhen; Yang, Chenhao; Chen, Chao; Cao, Yun; Zhou, Wenhao

2014-08-01

Hypoglycaemia is a significant problem in high-risk neonates and predominant parieto-occipital lobe involvement has been observed after severe hypoglycaemic insult. We explored the use of flash visual evoked potentials (FVEP) in detecting parieto-occipital lobe involvement after significant hypoglycaemia. Full-term neonates (n = 15) who underwent FVEP from January 2008 to May 2013 were compared with infants (n = 11) without hypoglycaemia or parietal-occipital lobe injury. Significant hypoglycaemia was defined as being symptomatic or needing steroids, glucagon or a glucose infusion rate of ≥12 mg/kg/min. The hypoglycaemia group exhibited delayed latency of the first positive waveform on FVEP. The initial detected time for hypoglycaemia was later in the eight subjects with seizures (median 51-h-old) than those without (median 22-h-old) (P = 0.003). Magnetic resonance imaging showed that 80% of the hypoglycaemia group exhibited occipital-lobe injuries, and they were more likely to exhibit abnormal FVEP morphology (P = 0.007) than the controls. FVEP exhibited 100% sensitivity, but only 25% specificity, for detecting injuries to the parieto-occipital lobes. Flash visual evoked potential (FVEP) was sensitive, but not sufficiently specific, in identifying parieto-occipital lobe injuries among term neonates exposed to significant hypoglycaemia. Larger studies exploring the potential role of FVEP in neonatal hypoglycaemia are required. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Brain metabolite changes in alcoholism: Localized proton magnetic resonance spectroscopy study of the occipital lobe

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Modi, Shilpi; Bhattacharya, Manisha; Kumar, Pawan; Deshpande, Smita N.; Tripathi, Rajendra Prasad; Khushu, Subash

2011-01-01

Chronic alcoholism is associated with altered brain metabolism, morphology and cognitive abilities. Besides deficits in higher order cognitive functions, alcoholics also show a deficit in the processing of basic sensory information viz. visual stimulation. To assess the metabolic changes associated with this deficit, 1 H MRS was carried out in the occipital lobe of alcohol dependents. A significant increase in Cho/Cr ratio (p < 0.015) was observed in occipital lobe in the alcoholic group indicating altered cell membrane metabolism, which may probably be associated with the alterations in the cognitive abilities associated with vision.

[Mirror movement due to the medial frontal lobe lesion].

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Takahashi, N; Kawamura, M; Hirayama, K

1995-01-01

We reported a case with acquired mirror movement in upper limbs due to the lesion of right medial frontal lobe including supplementary motor area, and also discussed a possible mechanism underlying it. A 59-year-old right-handed woman developed left hemiparesis caused by cerebral hemorrhage in the right frontoparietal lobe, on April 5, 1981. She had right hemiparesis and right hemianopsia due to cerebral hemorrhage in the left parieto-occipital lobe, 13 days later. As the patient was recovering from paresis, mirror movement appeared on upper limbs. The features of the mirror movement of this case are summarized as follows: (1) it appeared when using both proximal and distal region of upper limbs; (2) it appeared on left upper limb when the patient intended to move right upper limb or on right upper limb when intended to move left upper limb, while it appeared predominantly in the former; and (3) it was more remarkably found in habitual movement using gesture and pantomimic movement for the use of objects, and it was found in lower degree when actual object was used or when the patient tried to imitate the gesture of the examiner. The lesions in MRI were found in medial region of right frontal lobe (supplementary motor area, medial region of motor area, and cingulate gyrus), right medial parietal lobe, posterior region of right occipital lobe, and medial regions of left parietal and occipital lobes. There was no apparent abnormality in corpus callosum.(ABSTRACT TRUNCATED AT 250 WORDS)

Subcomponents and connectivity of the inferior fronto-occipital fasciculus revealed by diffusion spectrum imaging fiber tracking

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Yupeng Wu

2016-09-01

Full Text Available The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF are still controversial. In this study, we aimed to investigate the connectivity, asymmetry and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI analysis was performed on ten healthy adults and a 90-subject DSI template (NTU-90 Atlas. In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous standard definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient

Subcomponents and Connectivity of the Inferior Fronto-Occipital Fasciculus Revealed by Diffusion Spectrum Imaging Fiber Tracking

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Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yibao

2016-01-01

The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous “standard” definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole, and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole, and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe, and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient sensitivity

Subcomponents and Connectivity of the Inferior Fronto-Occipital Fasciculus Revealed by Diffusion Spectrum Imaging Fiber Tracking.

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Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yibao

2016-01-01

The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous "standard" definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole, and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole, and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe, and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient sensitivity to

Brain metabolite changes in alcoholism: Localized proton magnetic resonance spectroscopy study of the occipital lobe

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Modi, Shilpi; Bhattacharya, Manisha; Kumar, Pawan [NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (DRDO), Lucknow Road, Timarpur, Delhi 110054 (India); Deshpande, Smita N. [Department of Psychiatry, Dr. Ram Manohar Lohia Hospital, New Delhi (India); Tripathi, Rajendra Prasad [NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (DRDO), Lucknow Road, Timarpur, Delhi 110054 (India); Khushu, Subash, E-mail: skhushu@yahoo.com [NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (DRDO), Lucknow Road, Timarpur, Delhi 110054 (India)

2011-07-15

Chronic alcoholism is associated with altered brain metabolism, morphology and cognitive abilities. Besides deficits in higher order cognitive functions, alcoholics also show a deficit in the processing of basic sensory information viz. visual stimulation. To assess the metabolic changes associated with this deficit, {sup 1}H MRS was carried out in the occipital lobe of alcohol dependents. A significant increase in Cho/Cr ratio (p < 0.015) was observed in occipital lobe in the alcoholic group indicating altered cell membrane metabolism, which may probably be associated with the alterations in the cognitive abilities associated with vision.

Pure alexia after right temporo-occipital hemorrhage in a right-handed female

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Buse Rahime Hasırcı

2016-12-01

Full Text Available Alexia without agraphia is a rare clinical disorder which is characterized by impairment of reading in spite of protection of writing ability. It usually results from infarction within the vascular territory of the posterior cerebral artery. The lesions of left occipital lobe or splenium of corpus callosum can cause alexia without agraphia by the deterioration of connection between the right occipital lobe and left parietal lobe. We describe the case of a 70-year-old right-handed woman who was presented with moderate headache and blurred vision and affected by alexia without agraphia and aphasia. Our case indicates that pure alexia may arise as a consequence of damage to the right hemisphere in right-handed patients and may lead to a severe reading disorder, as in individuals with left-hemisphere dominance for language.

Transient attenuation of visual evoked potentials during focal status epilepticus in a patient with occipital lobe epilepsy.

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Tsai, Meng-Han; Hsu, Shih-Pin; Huang, Chi-Ren; Chang, Chen-Sheng; Chuang, Yao-Chung

2010-06-01

Seizures originating in the occipital areas are relatively uncommon. They are usually characterized by visual hallucinations and illusions or other symptoms related to the eyes and vision. In a 54-year-old woman with occipital lobe epilepsy, complex visual hallucinations, illusions, and migraine-like headache constitute the major clinical manifestations. During focal status epilepticus, ictal electroencephalography revealed rhythmic focal spikes in the right occipital region, rapidly propagating to the right parietal and contralateral occipital areas. Ictal brain single-photon emission computed topography revealed hyperperfusion of the right occipital region. Using a full-field pattern-shift visual evoked potential (VEP) study, we found that the P100 responses on both sides were markedly attenuated in amplitude during occipital focal status epilepticus, whereas the latencies of the VEPs were normal. The amplitude and morphology of P100 responses on both sides, however, returned to the normal range 7 days after cessation of the seizures. In addition to clinical seizure semiology, scalp EEG, SPECT and neuroimaging studies, VEP studies may be used as a supplementary examination tool to provide further information in the patients with occipital lobe seizures or epilepsies.

Conceito anátomo-fisiológico do lobo occipital Functional anatomy of the occipital lobe

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M. Caetano de Barros

1972-03-01

ção conjunta. Como toda função superior, a função visual não pode ser estritamente localizada e resulta da integração de estruturas funcionando conjugadamente.} Melhor entendimento desta função vem sendo progressivamente favorecido mediante o estudo da patologia, dos resultados da neurocirurgia experimental, dos efeitos de certas ablações neurocirúrgicas no homem e, sobretudo, das atuais referinadas técnicas eletro-neurofisiológicas. Malgrado êstes avanços há ainda muitos aspectos mal definidos aguardando melhores elucidações.Only from a strictly anatomical point of view the occipital lobe can be traced with relative facility. Apparentely it constitues a morphological unit representing the site of structures basically related to visual perception, therein included some other oculo-motor integrative mechanisms which are nothing else but components of this complex perceptive phenomenon. The principal parts of the conventional superficial anatomy of the occipital lobe (striated, peristriaded and para-striated cortical areas and the principal connections (optical radiations, association tracts, projection and commissural libers with different structures of the nervous system are indicated. The vascularization of the occipital lobe is revised by the use of serial and selective anatomic-radiological preparations of the different arterial trunks in which it could be verified wide intercommunications between the terminal sectors of posterior, medial and anterior cerebral arterial systems. Some morphological variations of the occipital horns of the lateral ventricles are emphasized. However purely anatomic data are not sufficient enough for the understanding of the psycho-physiological functions of the occipital lobe which has to be considered as a part of a perceptive highly complex system. Very probably this system in the same way of many other cerebral ones is composed by several circuits mutually conjugated acting under the principle of servomechanisms and ruled

Epilepsy classification and additional definitions in occipital lobe epilepsy.

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Yilmaz, Kutluhan; Karatoprak, Elif Yüksel

2015-09-01

To evaluate epileptic children with occipital lobe epilepsy (OLE) in the light of the characteristics of Panayiotopoulos syndrome and late-onset occipital lobe epilepsy of Gastaut (OLE-G). Patients were categorized into six groups: primary OLE with autonomic symptoms (Panayiotopoulos syndrome), primary OLE with visual symptoms (OLE-G), secondary OLE with autonomic symptoms (P-type sOLE), secondary OLE with visual symptoms (G-type sOLE), and non-categorized primary OLE and non-categorized secondary OLE according to characteristic ictal symptoms of both Panayiotopoulos syndrome and OLE-G, as well as aetiology (primary or secondary). Patients were compared with regards to seizure symptoms, aetiology, cranial imaging, EEG, treatment and outcome. Of 108 patients with OLE (6.4±3.9 years of age), 60 patients constituted primary groups (32 with Panayiotopoulos syndrome, 11 with OLE-G, and 17 with non-categorized primary OLE); the other 48 patients constituted secondary groups (eight with P-type sOLE, three with G-type sOLE, and 37 with non-categorized sOLE). Epileptiform activity was restricted to the occipital area in half of the patients. Generalized epileptiform activity was observed in three patients, including a patient with Panayiotopoulos syndrome (PS). Only one patient had refractory epilepsy in the primary groups while such patients made up 29% in the secondary groups. In OLE, typical autonomic or visual ictal symptoms of Panayiotopoulos syndrome and OLE-G do not necessarily indicate primary (i.e. genetic or idiopathic) aetiology. Moreover, primary OLE may not present with these symptoms. Since there are many patients with OLE who do not exhibit the characteristics of Panayiotopoulos syndrome or OLE-G, additional definitions and terminology appear to be necessary to differentiate between such patients in both clinical practice and studies.

Prenatal ultrasound and MRI findings of temporal and occipital lobe dysplasia in a twin with achondroplasia.

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Pugash, D; Lehman, A M; Langlois, S

2014-09-01

Thanatophoric dysplasia, hypochondroplasia and achondroplasia are all caused by FGFR3 (fibroblast growth factor receptor 3) mutations. Neuropathological findings of temporal lobe dysplasia are found in thanatophoric dysplasia, and temporal and occipital lobe abnormalities have been described recently in brain imaging studies of children with hypochondroplasia. We describe twins discordant for achondroplasia, in one of whom the prenatal diagnosis was based on ultrasound and fetal MRI documentation of temporal and occipital lobe abnormalities characteristic of hypochondroplasia, in addition to the finding of short long bones. Despite the intracranial findings suggestive of hypochondroplasia, achondroplasia was confirmed following postnatal clinical and genetic testing. These intracranial abnormalities have not been previously described in a fetus with achondroplasia. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Significance of the Tentorial Alignment in Protecting the Occipital Lobe with the Poppen Approach for Tentorial or Pineal Area Meningiomas.

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Li, Deling; Zhang, Haoyu; Jia, Wang; Zhang, Liwei; Zhang, Junting; Liu, Weiming; Ni, Ming; Jia, Guijun

2017-12-01

We aimed to identify the factors that can predict the risk of occipital lobe damage preoperatively when resecting tumors located at the tentorial or pineal regions with the occipital-transtentorial approach (Poppen approach). In 27 consecutive patients who underwent tumor resection with the Poppen approach for tentorial or pineal region meningiomas, the following morphologic parameters were assessed on a preoperative magnetic resonance imaging: (1) tentorial angle, (2) tentorial length, and (3) the shortest distance from the confluence of the sinus to the tumor. These parameters, together with tumor size, texture, and resection extent, were correlated with occipital lobe damage by using the one-way analysis of variance, χ 2 , or Fisher's exact tests. The mean value was 55.3° ± 5.6° (range, 45°-66°) for the tentorial angle, which was significantly associated with the occipital lobe damage grades (P = 0.008), but this was not the case for the tentorial length (P = 0.802) and the shortest distance from the confluence of the sinus to the tumor (P = 0.695). Interestingly, age was also strongly associated with occipital lobe damage risk (P = 0.020). The patients in the subgroup with no occipital damage (grade 4) were the youngest (aged 47.3 years), compared with other grades, with age of 58.0 years for grade 1, 54.3 years for grade 2, and 58.6 years for grade 3. These 2 parameters were also significant after multivariate analysis. No correlation was observed between either tumor nature or the extent of resection and damage grades. The risk of occipital lobe damage increases in the presence of a steep tentorial angle during the Poppen approach for tentorial or pineal area tumors. Awareness of such anatomic features preoperatively is important for minimizing operative complications. Copyright © 2017. Published by Elsevier Inc.

Cognitive dysfunctions in occipital lobe epilepsy compared to temporal lobe epilepsy.

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Santangelo, Gabriella; Trojano, Luigi; Vitale, Carmine; Improta, Ilaria; Alineri, Irma; Meo, Roberta; Bilo, Leonilda

2017-06-01

To compare cognitive profiles of occipital lobe epilepsy (OLE) and temporal lobe epilepsy (TLE) and to investigate whether impairment of visuospatial functions is a specific deficit of OLE. Eighteen patients with OLE, 18 patients with TLE, and 18 controls underwent a neuropsychological battery assessing memory, visuospatial functions, and frontal/executive functions. Multivariate analysis evidenced poorer performance of patients with TLE and patients with OLE relative to controls on tasks assessing verbal and non-verbal long-term memory, frontal functions, and visuospatial functions. Patients with OLE had poorer performance than patients with TLE on visuospatial tasks, whereas patients with TLE performed worse than patients with OLE on verbal long-term memory test. Discriminant analysis identified two canonical discriminant functions: The first explained 53.3% of the variance, and the second explained 46.7% of the variance. The first function included verbal and non-verbal memory tests distinguishing controls from both OLE and TLE, whereas the second factor including a visuoconstructional test distinguished OLE from TLE and controls. The results demonstrate that visuoconstructional dysfunction is related to OLE and support the idea that alterations of occipito-parietal stream may be specific to patients with OLE. © 2015 The British Psychological Society.

Analysis of occipital lobe activation during functional MRI in patients with open-angle glaucoma and correlation with clinical results

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Dai Hui; Liu Yunlian; Hu Chunhong; Li Yonggang; Guo Liang; Qi Jianpin; Xia Liming

2013-01-01

Objective: To evaluate the activation of the visual cortex in patients with primary open angle glaucoma (POAG) and to explore whether the neuronal activity corresponds with retinal nerve fiber layer (RNFL) and cup-to-disc (C/D) values. Methods: Twenty-five patients and 25 gender-and age matched healthy volunteers were studied. Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) and three-dimensional brain volume imaging (3D BRAVO) sequences were obtained using 3 T MR imaging system. A full-screen black-white shift checkerboard was used for visual stimulus during the fMRI experiment and was performed on each eye of all subjects using a visual-acoustical system. All acquired data were postprocessed and analyzed by statistical parametric mapping (SPM). After analysis, individual activated mapping, intra-group mean activated mapping, and inter-group variant mapping were observed. The voxel number, intensity, and Montreal Neurological Institute (MNI) coordinate of the activated clusters were recorded. The Xjviewer software was utilized to obtain activated voxel numbers in occipital lobe. A Pearson correlated test was performed to test the correlation between the number of activated voxels and RNFL, C/D and Hodapp-Anderson-Parrish (HAP) clinical stage. Results: Intra-group mean activated mappings of both patients and volunteers showed obvious activation in bilateral occipital lobes. As compared with healthy volunteers, the POAG patients exhibited statistically significantly decreased activation in bilateral occipital lobes, left hippocampus, and left cerebellum, along with lower mean RNFL [(71.56 ± 21.54) μm versus (111.88 ± 9.96) μm] and higher C/D values (0.71 ± 0.18 versus 0.36 ± 0.08 ; t value was respectively -10.901 and 11.643, P 0.05). Conclusions: fMRI demonstrated differences in visual cortex activation in POAG patients relative to healthy volunteers, suggesting it might be a promising complementary method for diagnosing

The impact of occipital lobe cortical thickness on cognitive task performance: An investigation in Huntington's Disease.

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Johnson, Eileanoir B; Rees, Elin M; Labuschagne, Izelle; Durr, Alexandra; Leavitt, Blair R; Roos, Raymund A C; Reilmann, Ralf; Johnson, Hans; Hobbs, Nicola Z; Langbehn, Douglas R; Stout, Julie C; Tabrizi, Sarah J; Scahill, Rachael I

2015-12-01

The occipital lobe is an important visual processing region of the brain. Following consistent findings of early neural changes in the occipital lobe in Huntington's Disease (HD), we examined cortical thickness across four occipital regions in premanifest (preHD) and early HD groups compared with controls. Associations between cortical thickness in gene positive individuals and performance on six cognitive tasks, each with a visual component, were examined. In addition, the association between cortical thickness in gene positive participants and one non-visual motor task was also examined for comparison. Cortical thickness was determined using FreeSurfer on T1-weighted 3T MR datasets from controls (N=97), preHD (N=109) and HD (N=69) from the TRACK-HD study. Regression models were fitted to assess between-group differences in cortical thickness, and relationships between performance on the cognitive tasks, the motor task and occipital thickness were examined in a subset of gene-positive participants (N=141). Thickness of the occipital cortex in preHD and early HD participants was reduced compared with controls. Regionally-specific associations between reduced cortical thickness and poorer performance were found for five of the six cognitive tasks, with the strongest associations in lateral occipital and lingual regions. No associations were found with the cuneus. The non-visual motor task was not associated with thickness of any region. The heterogeneous pattern of associations found in the present study suggests that occipital thickness negatively impacts cognition, but only in regions that are linked to relatively advanced visual processing (e.g., lateral occipital, lingual regions), rather than in basic visual processing regions such as the cuneus. Our results show, for the first time, the functional implications of occipital atrophy highlighted in recent studies in HD. Copyright © 2015 Elsevier Ltd. All rights reserved.

Natural evolution from idiopathic photosensitive occipital lobe epilepsy to idiopathic generalized epilepsy in an untreated young patient.

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Bonini, Francesca; Egeo, Gabriella; Fattouch, Jinan; Fanella, Martina; Morano, Alessandra; Giallonardo, Anna Teresa; di Bonaventura, Carlo

2014-04-01

Idiopathic photosensitive occipital lobe epilepsy (IPOE) is an idiopathic localization-related epilepsy characterized by age-related onset, specific mode of precipitation, occipital photic-induced seizures--frequently consisting of visual symptoms--and good prognosis. This uncommon epilepsy, which usually starts in childhood or adolescence, has rarely been observed in families in which idiopathic generalized epilepsy also affects other members. We describe a nuclear family in which the proband showed electro-clinical features of idiopathic photosensitive occipital lobe epilepsy in childhood, which subsequently evolved into absences and a single generalized tonico-clonic seizure in early adolescence. His mother had features suggestive of juvenile myoclonic epilepsy. This case illustrates a continuum between focal and generalized entities in the spectrum of the so-called idiopathic (genetically determined) epileptic syndromes. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Occipital lobe lesions result in a displacement of magnetoencephalography visual evoked field dipoles.

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Pang, Elizabeth W; Chu, Bill H W; Otsubo, Hiroshi

2014-10-01

The pattern-reversal visual evoked potential measured electrically from scalp electrodes is known to be decreased, or absent, in patients with occipital lobe lesions. We questioned whether the measurement and source analysis of the neuromagnetic visual evoked field (VEF) might offer additional information regarding visual cortex relative to the occipital lesion. We retrospectively examined 12 children (6-18 years) with occipital lesions on MRI, who underwent magnetoencephalography and ophthalmology as part of their presurgical assessment. Binocular half-field pattern-reversal VEFs were obtained in a 151-channel whole-head magnetoencephalography. Data were averaged and dipole source analyses were performed for each half-field stimulation. A significant lateral shift (P occipital lesions. Magnetoencephalography may be useful as a screening test of visual function in young patients. We discuss potential explanations for this lateral shift and emphasize the utility of adding the magnetoencephalography pattern-reversal visual evoked field protocol to the neurologic work-up.

Occipital lobe seizures: Rare hyperglycemic sequelae of type 1 diabetes mellitus.

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Jalal, Muhammed Jasim Abdul; Menon, Murali Krishna; Kumar, K Arun; Gomez, Ramesh

2015-01-01

A 15-year-old boy presented with osmotic symptoms and photopsia. He had short-term memory impairment, visual hallucinations, and headache. His random blood sugar was 474 mg/dl, HbA1c -9.4%, and glutamic acid decarboxylase -65 >2000 IU/ml. Magnetic resonance imaging brain and cerebrospinal fluid study were normal. Digital electroencephalography was suggestive of bilateral hemispheric occipital lobe seizures. He responded well to insulin and antiepileptic medications.

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

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

2016-01-01

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

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

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Bhavesh Trikamji

2016-01-01

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

Occipital and occipital "plus" epilepsies: A study of involved epileptogenic networks through SEEG quantification.

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Marchi, Angela; Bonini, Francesca; Lagarde, Stanislas; McGonigal, Aileen; Gavaret, Martine; Scavarda, Didier; Carron, Romain; Aubert, Sandrine; Villeneuve, Nathalie; Médina Villalon, Samuel; Bénar, Christian; Trebuchon, Agnes; Bartolomei, Fabrice

2016-09-01

Compared with temporal or frontal lobe epilepsies, the occipital lobe epilepsies (OLE) remain poorly characterized. In this study, we aimed at classifying the ictal networks involving OLE and investigated clinical features of the OLE network subtypes. We studied 194 seizures from 29 consecutive patients presenting with OLE and investigated by stereoelectroencephalography (SEEG). Epileptogenicity of occipital and extraoccipital regions was quantified according to the 'epileptogenicity index' (EI) method. We found that 79% of patients showed widespread epileptogenic zone organization, involving parietal or temporal regions in addition to the occipital lobe. Two main groups of epileptogenic zone organization within occipital lobe seizures were identified: a pure occipital group and an occipital "plus" group, the latter including two further subgroups, occipitotemporal and occipitoparietal. In 29% of patients, the epileptogenic zone was found to have a bilateral organization. The most epileptogenic structure was the fusiform gyrus (mean EI: 0.53). Surgery was proposed in 18/29 patients, leading to seizure freedom in 55% (Engel Class I). Results suggest that, in patient candidates for surgery, the majority of cases are characterized by complex organization of the EZ, corresponding to the occipital plus group. Copyright © 2016 Elsevier Inc. All rights reserved.

[Chronic subdural hematoma (CSH) complicated by bilateral occipital lobe infarction: two case reports].

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Kudo, Kanae; Naraoka, Masato; Shimamura, Norihito; Ohkuma, Hiroki

2013-04-01

Chronic subdural hematoma (CSH) is a common disease that is treated with burr hole drainage by neurosurgeons. The outcome of CSH is mostly favorable. We treated 2 cases with bilateral occipital lobe infarction due to CSH. A 57-year-old woman was ambulatory when she visited a clinic for evaluation of headache. One hour after the CT was taken, she developed acute impairment of consciousness, so that she was referred to our hospital. The second patient was a 73-year-old woman with a history of depression who was involved in a traffic accident 5 weeks before admission to our hospital. She was at first admitted to a psychiatric hospital for evaluation of gait disturbance. Three weeks after she was admitted to the psychiatric hospital, she fell into a coma. She was referred to our hospital. Their brain CT on admission revealed compressed ambient and interpeduncular cistern and bilateral CSH. Although burr hole drainage surgery was performed, the 2 patients developed severe sequelae due to occipital lobe infarction caused by central transtentorial herniation.

Occipital lobe seizures related to marked elevation of hemoglobin A1C: report of two cases.

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Hung, Wan-Ling; Hsieh, Peiyuan F; Lee, Yi-Chung; Chang, Ming-Hong

2010-07-01

Occipital lobe seizures caused by nonketotic hyperglycemia (NKH) have been reported in only a few cases and are not fully characterized. We report two cases of NKH-related occipital lobe seizures with high hemoglobin A1C (HbA1C), epileptiform electroencephalograph (EEG) and MRI abnormalities. Both patients had moderate hyperglycemia (310-372 mg/dl) and mildly elevated serum osmolarity (295-304 mOsm/kg) but markedly elevated HbA1C (13.8-14.4%). One patient had a clinico-EEG seizure originating from the right occipital region during sleep. The other patient had an interictal epileptiform discharge consisting of unilateral occipital beta activity in sleep. None of the previously reported cases fulfilled the criteria of a nonketotic hyperglycemic hyperosmolar (NKHH) state, or showed any interictal beta paroxysms, spikes, sharp waves, or spike/sharp-slow wave complexes. We suggest that prolonged exposure to uncontrolled hyperglycemia, as indicated by HbA1C, rather than an acute NKHH state is crucial in the development of this peculiar seizure. We also suggest clinicians look for the presence of interictal focal beta paroxysms in addition to the usual epileptiform discharges while reading the EEG of these patients. 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Widespread temporo-occipital lobe dysfunction in amyotrophic lateral sclerosis.

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Loewe, Kristian; Machts, Judith; Kaufmann, Jörn; Petri, Susanne; Heinze, Hans-Jochen; Borgelt, Christian; Harris, Joseph Allen; Vielhaber, Stefan; Schoenfeld, Mircea Ariel

2017-01-09

Recent studies suggest that amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) lie on a single clinical continuum. However, previous neuroimaging studies have found only limited involvement of temporal lobe regions in ALS. To better delineate possible temporal lobe involvement in ALS, the present study aimed to examine changes in functional connectivity across the whole brain, particularly with regard to extra-motor regions, in a group of 64 non-demented ALS patients and 38 healthy controls. To assess between-group differences in connectivity, we computed edge-level statistics across subject-specific graphs derived from resting-state functional MRI data. In addition to expected ALS-related decreases in functional connectivity in motor-related areas, we observed extensive changes in connectivity across the temporo-occipital cortex. Although ALS patients with comorbid FTD were deliberately excluded from this study, the pattern of connectivity alterations closely resembles patterns of cerebral degeneration typically seen in FTD. This evidence for subclinical temporal dysfunction supports the idea of a common pathology in ALS and FTD.

The Safe Area in the Parieto-Occipital Lobe in the Human Brain: Diffusion Tensor Tractography.

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Jang, Sung Ho; Kim, Seong Ho; Kwon, Hyeok Gyu

2015-06-01

A recent study reported on the relatively safe area in the frontal lobe for performance of neurological interventions; however, no study on the posterior safe area has been reported. In this study, using diffusion tensor tractography, we attempted to identify the safe area in the parieto-occipital lobe in healthy subjects. A total of 47 healthy subjects were recruited for this study. Eleven neural tracts were reconstructed in and around the parieto-occipital area of the brain using diffusion tensor tractography. The safe area, which is free from any trajectory of 10 neural tracts, was measured anteriorly and medially from the line of the most posterior and lateral margin of the brain at 5 axial levels (from the cerebral cortex to the corona radiata). The anterior boundaries of the safe area in the upper cerebral cortex, lower cerebral cortex, centrum semiovale, upper corona radiata, and lower corona radiata levels were located at 31.0, 32.6, 32.7, 35.1, and 35.2 mm anteriorly from the line of the most posterior margin of the brain, respectively, and the medial boundaries were located at an average of 34.7, 38.1, 39.2, 36.1, and 33.6 mm medially from the line of the most lateral margin of the brain, respectively. According to our findings, the safe area was located in the posterolateral portion of the parieto-occipital lobe in the shape of a triangle. However, we found no safe area in the deep white matter around the lateral ventricle. Copyright © 2015 Elsevier Inc. All rights reserved.

The white matter of the human cerebrum: Part I The occipital lobe by Heinrich Sachs

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Forkel, Stephanie J.; Mahmood, Sajedha; Vergani, Francesco; Catani, Marco

2015-01-01

This is the first complete translation of Heinrich Sachs' outstanding white matter atlas dedicated to the occipital lobe. This work is accompanied by a prologue by Prof Carl Wernicke who for many years was Sachs' mentor in Breslau and enthusiastically supported his work. PMID:25527430

Headache Following Occipital Brain Lesion: A Case of Migraine Triggered by Occipital Spikes?

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Vollono, Catello; Mariotti, Paolo; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazzucchi, Edoardo; Valentini, Piero; De Rose, Paola; Della Marca, Giacomo

2015-10-01

This study describes the case of an 8-year-old boy who developed a genuine migraine after the surgical excision, from the right occipital lobe, of brain abscesses due to selective infestation of the cerebrum by Entamoeba histolytica. After the surgical treatment, the boy presented daily headaches with typical migraine features, including right-side parieto-temporal pain, nausea, vomiting, and photophobia. Electroencephalography (EEG) showed epileptiform discharges in the right occipital lobe, although he never presented seizures. Clinical and neurophysiological observations were performed, including video-EEG and polygraphic recordings. EEG showed "interictal" epileptiform discharges in the right occipital lobe. A prolonged video-EEG recording performed before, during, and after an acute attack ruled out ictal or postictal migraine. In this boy, an occipital lesion caused occipital epileptiform EEG discharges without seizures, probably prevented by the treatment. We speculate that occipital spikes, in turn, could have caused a chronic headache with features of migraine without aura. Occipital epileptiform discharges, even in absence of seizures, may trigger a genuine migraine, probably by means of either the trigeminovascular or brainstem system. © EEG and Clinical Neuroscience Society (ECNS) 2014.

Occipital Lobe Gray Matter Volume in Male Patients with Chronic Schizophrenia: A Quantitative MRI Study

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Onitsuka, Toshiaki; McCarley, Robert W.; Kuroki, Noriomi; Dickey, Chandlee C.; Kubicki, Marek; Demeo, Susan S.; Frumin, Melissa; Kikinis, Ron; Jolesz, Ferenc A.; Shenton, Martha E.

2008-01-01

Schizophrenia is characterized by deficits in cognition as well as visual perception. There have, however, been few magnetic resonance imaging (MRI) studies of the occipital lobe as an anatomically defined region of interest in schizophrenia. To examine whether or not patients with chronic schizophrenia show occipital lobe volume abnormalities, we measured gray matter volumes for both the primary visual area (PVA) and the visual association areas (VAA) using MRI based neuroanatomical landmarks and three-dimensional information. PVA and VAA gray matter volumes were measured using high-spatial resolution MRI in 25 male patients diagnosed with chronic schizophrenia and in 28 male normal controls. Chronic schizophrenia patients showed reduced bilateral VAA gray matter volume (11%), compared with normal controls, whereas patients showed no group difference in PVA gray matter volume. These results suggest that reduced bilateral VAA may be a neurobiological substrate of some of the deficits observed in early visual processing in schizophrenia. PMID:17350226

Accessory hepatic lobe simulating a left hemidiaphragmatic tumor

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Kuroiwa, Toshiro; Hirata, Hitoshi; Iwashita, Akinori; Yasumori, Kotaro; Mogami, Hiroshi; Teraoka, Hiroaki

1984-01-01

A 72-year-old woman with a 20-year history of neuralgia was confirmed at surgery to have a tumor in the left hemidiaphragmatic region which was connected with the left lobe of the liver. Reassessment of radiological diagnosis after surgery revealed that hepatobiliary scintigraphy and computed tomography using left anterior oblique scanning are useful in differentiating the accessory hepatic lobe of the liver from a tumor and in confirming the diagnosis, respectively. (Namekawa, K.)

Occipital bending in depression.

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Maller, Jerome J; Thomson, Richard H S; Rosenfeld, Jeffrey V; Anderson, Rodney; Daskalakis, Zafiris J; Fitzgerald, Paul B

2014-06-01

There are reports of differences in occipital lobe asymmetry within psychiatric populations when compared with healthy control subjects. Anecdotal evidence and enlarged lateral ventricles suggests that there may also be a different pattern of curvature whereby one occipital lobe wraps around the other, termed 'occipital bending'. We investigated the prevalence of occipital bending in 51 patients with major depressive disorder (males mean age = 41.96 ± 14.00 years, females mean age = 40.71 ± 12.41 years) and 48 age- and sex-matched healthy control subjects (males mean age = 40.29 ± 10.23 years, females mean age = 42.47 ± 14.25 years) and found the prevalence to be three times higher among patients with major depressive disorder (18/51, 35.3%) when compared with control subjects (6/48, 12.5%). The results suggest that occipital bending is more common among patients with major depressive disorder than healthy subjects, and that occipital asymmetry and occipital bending are separate phenomena. Incomplete neural pruning may lead to the cranial space available for brain growth being restricted, or ventricular enlargement may exacerbate the natural occipital curvature patterns, subsequently causing the brain to become squashed and forced to 'wrap' around the other occipital lobe. Although the clinical implications of these results are unclear, they provide an impetus for further research into the relevance of occipital bending in major depression disorder. © The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Quantitative Magnetic Resonance Imaging of Brainstem Volumes, Plaques, and Surface Area in the Occipital Regions of Patients with Multiple Sclerosis

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Alper, F.; Kantarci, M.; Altunkaynak, E.; Varoglu, A. O.; Karaman, A.; Oral, E.; Okur, A. [Ataturk Univ., Erzurum (Turkey). Depts. of Radiology, Histology, Neurology and Embryology, Psychiatry

2006-07-15

Purpose: To determine brainstem volumes, number of plaques, and surface areas in the occipital lobes of patients with relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), and to investigate whether there is any correlation between brainstem volume and the number/surface areas of plaque in the occipital lobes. Material and Methods: Magnetic resonance imaging was obtained on 14 relapsing-remitting (RR) and 13 secondary progressive (SP) MS patients and 26 female control subjects. The Cavalieri method was used by modern design stereology to measure brainstem volume. The point-counting grid was used to evaluate sclerotic plaque surface areas in the occipital lobe. The number of plaques in the imaging section was calculated. Results: Brainstem volumes for RR and SP with multiple sclerosis and control subjects were 3647 mm{sup 3} , 3515 mm{sup 3} , and 4517 mm{sup 3} , respectively. Mean number of plaques in the right-left occipital lobe was found to be 2.7-3.4 in RR-MS and 5.2-2.8 in SP-MS. Mean plaque surface area in the right-left occipital lobe was determined to be 58.52-88.24 mm{sup 2} in RR MS and 124.3-64.82 mm{sup 2} in SP MS. Brainstem volumes were significantly reduced in both groups of patients with MS compared to controls ( P <0.01). Conclusion: Magnetic-resonance-estimated volume and surface area values in multiple sclerosis may facilitate our understanding of the clinical situation of patients and provide a simple index for evaluating therapeutic efficiency.

Quantitative Magnetic Resonance Imaging of Brainstem Volumes, Plaques, and Surface Area in the Occipital Regions of Patients with Multiple Sclerosis

International Nuclear Information System (INIS)

Alper, F.; Kantarci, M.; Altunkaynak, E.; Varoglu, A. O.; Karaman, A.; Oral, E.; Okur, A.

2006-01-01

Purpose: To determine brainstem volumes, number of plaques, and surface areas in the occipital lobes of patients with relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), and to investigate whether there is any correlation between brainstem volume and the number/surface areas of plaque in the occipital lobes. Material and Methods: Magnetic resonance imaging was obtained on 14 relapsing-remitting (RR) and 13 secondary progressive (SP) MS patients and 26 female control subjects. The Cavalieri method was used by modern design stereology to measure brainstem volume. The point-counting grid was used to evaluate sclerotic plaque surface areas in the occipital lobe. The number of plaques in the imaging section was calculated. Results: Brainstem volumes for RR and SP with multiple sclerosis and control subjects were 3647 mm 3 , 3515 mm 3 , and 4517 mm 3 , respectively. Mean number of plaques in the right-left occipital lobe was found to be 2.7-3.4 in RR-MS and 5.2-2.8 in SP-MS. Mean plaque surface area in the right-left occipital lobe was determined to be 58.52-88.24 mm 2 in RR MS and 124.3-64.82 mm 2 in SP MS. Brainstem volumes were significantly reduced in both groups of patients with MS compared to controls ( P <0.01). Conclusion: Magnetic-resonance-estimated volume and surface area values in multiple sclerosis may facilitate our understanding of the clinical situation of patients and provide a simple index for evaluating therapeutic efficiency

The white matter of the human cerebrum: part I The occipital lobe by Heinrich Sachs.

Science.gov (United States)

Forkel, Stephanie J; Mahmood, Sajedha; Vergani, Francesco; Catani, Marco

2015-01-01

This is the first complete translation of Heinrich Sachs' outstanding white matter atlas dedicated to the occipital lobe. This work is accompanied by a prologue by Prof Carl Wernicke who for many years was Sachs' mentor in Breslau and enthusiastically supported his work. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Temporal order processing of syllables in the left parietal lobe.

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Moser, Dana; Baker, Julie M; Sanchez, Carmen E; Rorden, Chris; Fridriksson, Julius

2009-10-07

Speech processing requires the temporal parsing of syllable order. Individuals suffering from posterior left hemisphere brain injury often exhibit temporal processing deficits as well as language deficits. Although the right posterior inferior parietal lobe has been implicated in temporal order judgments (TOJs) of visual information, there is limited evidence to support the role of the left inferior parietal lobe (IPL) in processing syllable order. The purpose of this study was to examine whether the left inferior parietal lobe is recruited during temporal order judgments of speech stimuli. Functional magnetic resonance imaging data were collected on 14 normal participants while they completed the following forced-choice tasks: (1) syllable order of multisyllabic pseudowords, (2) syllable identification of single syllables, and (3) gender identification of both multisyllabic and monosyllabic speech stimuli. Results revealed increased neural recruitment in the left inferior parietal lobe when participants made judgments about syllable order compared with both syllable identification and gender identification. These findings suggest that the left inferior parietal lobe plays an important role in processing syllable order and support the hypothesized role of this region as an interface between auditory speech and the articulatory code. Furthermore, a breakdown in this interface may explain some components of the speech deficits observed after posterior damage to the left hemisphere.

Q-Ball of Inferior Fronto-Occipital Fasciculus and Beyond

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Amirbekian, Bagrat; Berger, Mitchel S.; Henry, Roland G.

2014-01-01

The inferior fronto-occipital fasciculus (IFOF) is historically described as the longest associative bundle in the human brain and it connects various parts of the occipital cortex, temporo-basal area and the superior parietal lobule to the frontal lobe through the external/extreme capsule complex. The exact functional role and the detailed anatomical definition of the IFOF are still under debate within the scientific community. In this study we present a fiber tracking dissection of the right and left IFOF by using a q-ball residual-bootstrap reconstruction of High-Angular Resolution Diffusion Imaging (HARDI) data sets in 20 healthy subjects. By defining a single seed region of interest on the coronal fractional anisotropy (FA) color map of each subject, we investigated all the pathways connecting the parietal, occipital and posterior temporal cortices to the frontal lobe through the external/extreme capsule. In line with recent post-mortem dissection studies we found more extended anterior-posterior association connections than the “classical” fronto-occipital representation of the IFOF. In particular the pathways we evidenced showed: a) diffuse projections in the frontal lobe, b) fronto-parietal lobes connections trough the external capsule in almost all the subjects and c) widespread connections in the posterior regions. Our study represents the first consistent in vivo demonstration across a large group of individuals of these novel anterior and posterior terminations of the IFOF detailed described only by post-mortem anatomical dissection. Furthermore our work establishes the feasibility of consistent in vivo mapping of this architecture with independent in vivo methodologies. In conclusion q-ball tractography dissection supports a more complex definition of IFOF, which includes several subcomponents likely underlying specific function. PMID:24945305

Q-ball of inferior fronto-occipital fasciculus and beyond.

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Eduardo Caverzasi

Full Text Available The inferior fronto-occipital fasciculus (IFOF is historically described as the longest associative bundle in the human brain and it connects various parts of the occipital cortex, temporo-basal area and the superior parietal lobule to the frontal lobe through the external/extreme capsule complex. The exact functional role and the detailed anatomical definition of the IFOF are still under debate within the scientific community. In this study we present a fiber tracking dissection of the right and left IFOF by using a q-ball residual-bootstrap reconstruction of High-Angular Resolution Diffusion Imaging (HARDI data sets in 20 healthy subjects. By defining a single seed region of interest on the coronal fractional anisotropy (FA color map of each subject, we investigated all the pathways connecting the parietal, occipital and posterior temporal cortices to the frontal lobe through the external/extreme capsule. In line with recent post-mortem dissection studies we found more extended anterior-posterior association connections than the "classical" fronto-occipital representation of the IFOF. In particular the pathways we evidenced showed: a diffuse projections in the frontal lobe, b fronto-parietal lobes connections trough the external capsule in almost all the subjects and c widespread connections in the posterior regions. Our study represents the first consistent in vivo demonstration across a large group of individuals of these novel anterior and posterior terminations of the IFOF detailed described only by post-mortem anatomical dissection. Furthermore our work establishes the feasibility of consistent in vivo mapping of this architecture with independent in vivo methodologies. In conclusion q-ball tractography dissection supports a more complex definition of IFOF, which includes several subcomponents likely underlying specific function.

Tempo-spatial analysis of vision-related acupoint specificity in the occipital lobe using fMRI: an ICA study.

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Dong, Minghao; Qin, Wei; Sun, Jinbo; Liu, Peng; Yuan, Kai; Liu, Jixin; Zhou, Guangyu; von Deneen, Karen M; Tian, Jie

2012-02-03

Functional acupoint specificity is one of the most debated topics in acupuncture neuroimaging research. Conventional studies investigating vision-related acupoint specificity empirically assume that acupuncture-induced hemodynamic response can be defined a priori and thus concentrate on distinguishing the spatial variations of response patterns across acupoints in the occipital lobe. However, evidence suggests that acupuncture-invoked BOLD signal changes are independent of a priori time shape. Additionally, temporal profiles reflect how a stimulus corresponds with the brain, implying the hemodynamic coherence induced by stimulation. Therefore, temporal information carried in acupuncture-related neural activity may be more crucial to specificity issues. This paper initiates the detection into tempo-spatial dimension and the goal of this study is to detect functional acupoint specificity by uniquely comparing the temporal activities of the occipital lobe among vision-related acupoints (VRA) and a non-acupoint (NAP). We utilized the independent component analysis (ICA) to extract temporal patterns of occipital response by stimulating a VRA, i.e. GB37, and a NAP. As an improvement over previous ones, another VRA, i.e., BL60 was employed to consolidate our findings. Results showed that although all groups showed V1 activity in the occipital lobe, dissociable temporal activities in this region categorized GB37 and NAP (r=0.05, p=0.64). This finding was replicable with regard to BL60 and NAP (r=-0.03, p=0.77). Intriguingly, stimulation at two VRAs induced highly correlated temporal activities (p<0.0001). This study adds positive evidence to the issue of vision-related acupoint specificity. The utilization of ICA and consideration of temporal dynamics may shed light on future studies. Copyright © 2011 Elsevier B.V. All rights reserved.

Occipital lobe epilepsy secondary to posterior reversible encephalopathy syndrome (PRES) during a post-partum eclampsia in Mali (West Africa).

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Youssoufa, Maïga; Callixte, Kuate Tegueu; Christian, Napon

2013-08-13

Eclampsia is known to cause posterior reversible encephalopathy syndrome (PRES) that is often associated with an extensive neurovascular damage affecting preferably posterior regions, often leading to reversible cortical blindness. In spite the magnitude of these lesions, post eclamptic symptomatic epilepsy is rare. We therefore report a case of symptomatic occipital lobe epilepsy secondary to PRES. A 39-year-old female right handed teacher who presented with headache of progressive onset, phosphenes, rapid decline of visual acuity to blindness, vomiting, repeated generalized tonic-clonic seizures followed by altered consciousness and very high blood pressure (HBP) of 240/120 mmHg, all of which started about 12 hours following a normal delivery. Nine months later, the patient presented with paroxysmal visual symptoms predominating in the right visual field followed by partial tonic clonic seizures with secondary generalization and recurrence of partial occipital lobe seizures. The pathophysiologic mechanism of irreversible tissue damage during PRES syndrome could result from a combination of events including the delay for early treatment, inadequate antihypertensive drugs that could worsen the brain damage by hypo perfusion, inadequate or delayed treatment for seizures or status epilepticus. Despite its high incidence in the third world, eclampsia is not a usual cause of epilepsy. Our case is the first description of post eclamptic occipital lobe epilepsy in Africa. With this report, we draw practitioners' attention on this rare complication.

Socintigraphic evaluation of lateral segment of the left lobe of the liver

International Nuclear Information System (INIS)

Oyama, Kazuyuki; Hayashi, Sanshin; Kogure, Takashi; Hirakawa, Ken; Akaike, Akira

1979-01-01

Lateral segment of left lobe of the liver is clearly demarcated on sup(99m) Tc-labeled cholescintigram. With analysis of 112 sup(99m) Tc-pyridoxylideneisoleucine scintigrams about lateral border of left lobe, there are some variants in 22 cases (19.7%) in shape in lateral segment of Type 4 left lobe in morphologic classification. Of lateral segment of left lobe, there are classified into five types in the anterior view according to the degeneration; Type 1 is gradually elongated tapered type in 8 cases (36.4%), Type 2 is laterally elongated type as rod shape or island shape in 5 cases (22.7%), Type 3 is lobulated type in 1 case (4.6%), Type 4 is narrowing type in 5 cases (22.7%), Type 5 is indentation type in 3 cases (13.6%). Using colloidal radiopharmaceuticals in liver scintigraphy, lateral segment of left lobe often overlapps with the spleen, which disturb to interpret the abnormality in left lobe of the liver and in the spleen. This analysis depends upon the recent advances in sup(99m) Tc-labeled hepatobiliary radiopharmaceuticals and equipment, and there has never discussed about the shape of lateral segment of left lobe in roentgenologic and scintigraphic evaluations. (author)

Multifocal epilepsy: the role of palliative resection - intractable frontal and occipital lobe epilepsy secondary to radiotherapy for acute lymphoblastic leukaemia.

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Radhakrishnan, Ashalatha; Sithinamsuwan, Pasiri; Harvey, A Simon; Flanagan, Danny; Fitt, Gregory; Berlangieri, Sam; Jackson, Graeme D; Berkovic, Samuel F; Scheffer, Ingrid E

2008-12-01

Patients with multifocal epilepsy are often considered unsuitable for epilepsy surgery. We report an adolescent with intractable frontal and occipital lobe seizures, secondary to complications of treatment for acute lymphoblastic leukaemia as a young child. Chemotherapy and radiotherapy were complicated by bilateral, posterior leukoencephalopathy and later an acquired frontal cerebral cavernous malformation (CCM). Detailed electro-clinical and imaging studies showed multiple, frontal lobe seizures per day with less frequent and non-debilitating, simple, occipital lobe seizures. Focal resection of the frontal CCM abolished the socially-disabling seizures with resultant marked improvement in the patient's quality of life at 12 months. Careful analysis of the type and impact of focal seizures in the setting of multifocal epilepsy may demonstrate that one seizure type is more deleterious to quality of life and may be amenable to surgery. In this situation, the patient may benefit significantly from surgery to resect the more active epileptic focus.

A case of luftsichel sign for left upper lobe collapse

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Erden Erol Ünlüer

2015-01-01

Full Text Available The differential diagnosis of dyspnea in Emergency Department (ED patients is broad and atelectasis is one of the differentials among these. We present a 29-year-old women presented to our ED for evaluation of shortness of breath. On her chest examination, air entry and breath sounds were diminished on the left side but normal on the right. A posteroanterior chest radiograph showed radioluscent area in the upper zone of the left lung, around the aortic arch and also hyperdens area neighbouring this, like covered by a veil. Luftsichel sign together with this hiperdensity were consistent with the diagnose of left lung upper lobe collapse. The Luftsichel sign represents the hyperexpanded superior segment of the left lower lobe interposed between the atelectatic left upper lobe and aortic arch. Patient was discharged to home with chest physiotherapy and breathing exercises together with analgesic prescreption.

Long-term visual outcome after microsurgical removal of occipital lobe cavernomas.

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Kivelev, Juri; Koskela, Elina; Setälä, Kirsi; Niemelä, Mika; Hernesniemi, Juha

2012-08-01

Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatment of occipital cavernomas with special emphasis on visual outcome. Of the 390 consecutive patients with cavernomas who were treated at Helsinki University Central Hospital between 1980 and 2011, 19 (5%) had occipital cavernomas. Sixteen patients (4%) were surgically treated and are included in this study. The median age was 39 years (range 3-59 years). Seven patients (56%) suffered from hemorrhage preoperatively, 5 (31%) presented with visual field deficits, 11 (69%) suffered from seizures, and 4 (25%) had multiple cavernomas. Surgery was indicated for progressive neurological deterioration. The median follow-up after surgery was 5.25 years (range 0.5-14 years). All patients underwent thorough neuroophthalmological assessment to determine visual outcome after surgery. Visual fields were classified as normal, mild homonymous visual field loss (not disturbing the patient, driving allowed), moderate homonymous visual field loss (disturbing the patient, driving prohibited), and severe visual field loss (total homonymous hemianopia or total homonymous quadrantanopia). At the last follow-up, 4 patients (25%) had normal visual fields, 6 (38%) had a mild visual field deficit, 1 (6%) complained of moderate visual field impairment, and 5 (31%) had severe homonymous visual field loss. Cavernomas seated deeper than 2 cm from the pial surface carried a 4.4-fold risk of postoperative visual field deficit relative to superficial ones (p = 0.034). Six (55%) of the 11 patients presenting with seizures were seizure-free postoperatively. Eleven (69%) of 16 patients had no disability during the long-term follow-up. Surgical removal of occipital cavernomas may carry a

Reactivation of medial temporal lobe and occipital lobe during the retrieval of color information: A positron emission tomography study.

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Ueno, Aya; Abe, Nobuhito; Suzuki, Maki; Hirayama, Kazumi; Mori, Etsuro; Tashiro, Manabu; Itoh, Masatoshi; Fujii, Toshikatsu

2007-02-01

It is widely accepted that memory traces of an event include various types of information about the content of the event and about the circumstances in which the individual experienced it. However, how these various types of information are stored and later retrieved is poorly understood. One hypothesis postulates that the retrieval of specific event information reactivates regions that were active during the encoding of this information, with the aid of binding functions of the medial temporal lobe (MTL) structures. We used positron emission tomography to identify the brain regions related to the encoding and retrieval of color information. Specifically, we assessed whether overlapping activity was found in both the MTL structures and color-related cortical regions during the encoding and retrieval of color information attached with meaningless shapes. During the study, subjects were asked to encode colored (red or green) and achromatic random shapes. At subsequent testing, subjects were presented with only achromatic shapes, which had been presented with or without colors during encoding, and were engaged in retrieval tasks of shapes and colors. Overlapping activity was found in the MTL and occipital lobe (the lingual and inferior occipital gyri) in the right hemisphere during the encoding and retrieval of meaningless shapes with color information compared with those without color information. Although there are some limitations to be considered, the present findings seem to support the view that the retrieval of specific event information is associated with reactivation of both the MTL structures and the regions involved during encoding of the information.

Ictal spitting in left temporal lobe epilepsy: report of three cases.

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Caboclo, Luís Otávio Sales Ferreira; Miyashira, Flavia Saori; Hamad, Ana Paula Andrade; Lin, Katia; Carrete, Henrique; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

2006-09-01

Ictal spitting is rarely reported in patients with epilepsy. More often it is observed in patients with temporal lobe epilepsy (TLE) and is presumed to be a lateralizing sign to language nondominant hemisphere. We report three patients with left TLE who had ictal spitting registered during prolonged video-EEG monitoring. Medical charts of all patients with medically refractory partial epilepsy submitted to prolonged video-EEG monitoring in the Epilepsy Unit at UNIFESP during a 3-year period were reviewed, in search of reports of ictal spitting. The clinical, neurophysiological and neuroimaging data of the identified patients were reviewed. Among 136 patients evaluated with prolonged video-EEG monitoring, three (2.2%) presented spitting automatisms during complex partial seizures. All of them were right-handed, and had clear signs of left hippocampal sclerosis on MRI. In two patients, in all seizures in which ictal spitting was observed, EEG seizure onset was seen in the left temporal lobe. In the third patient, ictal onset with scalp electrodes was observed in the right temporal lobe, but semi-invasive monitoring with foramen ovale electrodes revealed ictal onset in the left temporal lobe, confirming false lateralization in surface records. The three patients became seizure-free following left anterior temporal lobectomy. Ictal spitting is a rare finding in patients with epilepsy, and may be considered a localizing sign of seizure onset in the temporal lobe. It may be observed in seizures originating from the left temporal lobe, and thus should not be considered a lateralizing sign of nondominant TLE.

Comparison of IMP-SPECT findings to subtest scores of Wechsler intelligence adult Scale-Revised in temporal lobe epilepsy patients

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Kan, Rumiko; Uejima, Masahiko; Kaneko, Yuko; Miyamoto, Yuriko; Watabe, Manabu; Takahashi, Ruriko; Niwa, Shin-ichi; Shishido, Fumio [Fukushima Medical Coll. (Japan)

1998-02-01

In this study, 40 temporal lobe epilepsy patients were assessed, using the Laterality Index (LI) of ROI values in IMP-SPECT findings, Wechsler adult intelligence Scale-Revised (WAIS-R) and subtest scores. LIs of the frontal, temporal and occipital lobes were calculated as follows: the ROI values on the right side were subtracted from those on the left, and the results was divided by the sum of the ROI values on the right and left sides. The individual subtest scores on WAIS-R were standardized by all evaluation scores in order to exclude the influence of differences in intelligence level as much as possible. The results were as follows: there was a positive correlation (r=0.74, p<0.001) between LI values and the performance in Arithmetic in the left temporal lobe hypoperfusion group. And there was a positive correlation (r=0.50, p<0.02) between LI values and the performance in Vocabulary in the left temporal lobe hypoperfusion group. In the right occipital lobe hypoperfusion group, there was a negative correlation (r=-O.44, p

Comparison of IMP-SPECT findings to subtest scores of Wechsler intelligence adult Scale-Revised in temporal lobe epilepsy patients

International Nuclear Information System (INIS)

Kan, Rumiko; Uejima, Masahiko; Kaneko, Yuko; Miyamoto, Yuriko; Watabe, Manabu; Takahashi, Ruriko; Niwa, Shin-ichi; Shishido, Fumio

1998-01-01

In this study, 40 temporal lobe epilepsy patients were assessed, using the Laterality Index (LI) of ROI values in IMP-SPECT findings, Wechsler adult intelligence Scale-Revised (WAIS-R) and subtest scores. LIs of the frontal, temporal and occipital lobes were calculated as follows: the ROI values on the right side were subtracted from those on the left, and the results was divided by the sum of the ROI values on the right and left sides. The individual subtest scores on WAIS-R were standardized by all evaluation scores in order to exclude the influence of differences in intelligence level as much as possible. The results were as follows: there was a positive correlation (r=0.74, p<0.001) between LI values and the performance in Arithmetic in the left temporal lobe hypoperfusion group. And there was a positive correlation (r=0.50, p<0.02) between LI values and the performance in Vocabulary in the left temporal lobe hypoperfusion group. In the right occipital lobe hypoperfusion group, there was a negative correlation (r=-O.44, p< O.05) between LI values and the performance in Coding. It is suggested that decreased blood flow areas detected by SPECT might influence brain function. (author)

Medial Occipital Lobe Hyperperfusion Identified by Arterial Spin-Labeling: A Poor Prognostic Sign in Patients with Hypoxic-Ischemic Encephalopathy.

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de Havenon, A; Sultan-Qurraie, A; Tirschwell, D; Cohen, W; Majersik, J; Andre, J B

2015-12-01

Hypoxic-ischemic encephalopathy carries an uncertain prognosis. We sought to retrospectively assess the prognostic value of arterial spin-labeling MR imaging in 22 adult patients diagnosed with hypoxic-ischemic encephalopathy. Quantitative CBF maps were generated from the M0 map, and arterial spin-labeling data on a per-voxel basis were regionally interrogated via visual inspection and ROI placement. Hyperperfusion was defined as regional increases in CBF of >20% (relative to global CBF) and/or >100 mL/100 g/min. Eleven of 22 patients had prominent bilateral medial occipital lobe hyperperfusion, all of whom died before hospital discharge. One patient who had nondistinct arterial spin-labeling hyperperfusion and restricted diffusion survived. Medial occipital lobe hyperperfusion is a distinctive pattern that merits prospective investigation in a cohort of patients with moderate hypoxic-ischemic encephalopathy to determine its predictive ability in patients with a higher likelihood of survival. © 2015 by American Journal of Neuroradiology.

More than blindsight: Case report of a child with extraordinary visual capacity following perinatal bilateral occipital lobe injury.

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Mundinano, Inaki-Carril; Chen, Juan; de Souza, Mitchell; Sarossy, Marc G; Joanisse, Marc F; Goodale, Melvyn A; Bourne, James A

2017-11-13

Injury to the primary visual cortex (V1, striate cortex) and the geniculostriate pathway in adults results in cortical blindness, abolishing conscious visual perception. Early studies by Larry Weiskrantz and colleagues demonstrated that some patients with an occipital-lobe injury exhibited a degree of unconscious vision and visually-guided behaviour within the blind field. A more recent focus has been the observed phenomenon whereby early-life injury to V1 often results in the preservation of visual perception in both monkeys and humans. These findings initiated a concerted effort on multiple fronts, including nonhuman primate studies, to uncover the neural substrate/s of the spared conscious vision. In both adult and early-life cases of V1 injury, evidence suggests the involvement of the Middle Temporal area (MT) of the extrastriate visual cortex, which is an integral component area of the dorsal stream and is also associated with visually-guided behaviors. Because of the limited number of early-life V1 injury cases for humans, the outstanding question in the field is what secondary visual pathways are responsible for this extraordinary capacity? Here we report for the first time a case of a child (B.I.) who suffered a bilateral occipital-lobe injury in the first two weeks postnatally due to medium-chain acyl-Co-A dehydrogenase deficiency. At 6 years of age, B.I. underwent a battery of neurophysiological tests, as well as structural and diffusion MRI and ophthalmic examination at 7 years. Despite the extensive bilateral occipital cortical damage, B.I. has extensive conscious visual abilities, is not blind, and can use vision to navigate his environment. Furthermore, unlike blindsight patients, he can readily and consciously identify happy and neutral faces and colors, tasks associated with ventral stream processing. These findings suggest significant re-routing of visual information. To identify the putative visual pathway/s responsible for this ability, MRI

Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve

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Son, Byung-chul; Choi, Jin-gyu

2017-01-01

Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although re...

Utility of pharmacologic provocative neurological testing before embolization of occipital lobe arteriovenous malformations.

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Tawk, Rabih G; Tummala, Ramachandra P; Memon, Muhammad Z; Siddiqui, Adnan H; Hopkins, L Nelson; Levy, Elad I

2011-01-01

Endovascular treatment is an established option for treatment of cerebral arteriovenous malformations (AVMs). However, embolization has been associated with postprocedural neurological complications. We sought to evaluate the usefulness of intra-arterial pharmacologic provocative (superselective Wada) testing before embolization of occipital lobe AVMs. We performed a retrospective review of cases of occipital AVMs that were embolized at our institution (Millard Fillmore Gates Hospital) while the patient was under conscious sedation. Visual field testing was performed before and after superselective Wada testing and again after embolization. After microcatheterization of the target feeding pedicle, amobarbital (or, occasionally, methohexital) was administered, followed immediately by neurological testing. If the provocative test results were negative, the evaluated feeder was embolized with a liquid agent. Complications were categorized as transient or permanent neurological deficit, visual field loss, ischemic or hemorrhagic stroke, and death. Thirteen patients with occipital AVMs underwent 39 Wada tests of 34 pedicles before embolization during 26 endovascular treatment sessions. Patients were treated under conscious sedation with local anesthesia. The mean age of these patients was 43.5 years (range 16-62 years); 6 were women. Testing induced a neurological deficit in six patients. A positive test result led us to abort embolization attempts in four pedicles. In the two remaining cases, advancement of the catheter tip distally within the feeding pedicle allowed us to proceed with embolization after initial test failure. Neither patient developed a visual field deficit after embolization. Despite passing the Wada test before embolization, one other patient had a visual deficit that was detected a few hours after the procedure; this deficit lessened but was permanent. No further ischemic complications and no hemorrhagic complications occurred. Pharmacologic

Dissociative Disturbance in Hangul-Hanja Reading after a Left Posterior Occipital Lesion

Directory of Open Access Journals (Sweden)

Key-Chung Park

2008-01-01

Full Text Available Since the Korean language has two distinct writing systems, phonogram (Hangul and ideogram (Hanja: Chinese characters, alexia can present with dissociative disturbances in reading between the two systems. A 74-year-old right-handed man presented with a prominent reading impairment in Hangul with agraphia of both Hangul and Hanja after a left posterior occipital- parietal lesion. He could not recognize single syllable words and nonwords in Hangul, and visual errors were predominant in both Hanja reading and the Korean Boston Naming Test. In addition, he had difficulties in visuoperceptual tests including Judgment of Line Orientation, Hierarchical Navon figures, and complex picture scanning. These findings are consistent with the hypothesis that Hangul reading impairment results from a general visual perceptual deficit. However, this assumption cannot explain why performance on visually complex Hanja was better than performance on visually simple Hanja in our patient. In addition, the patient did not demonstrate higher accuracy on Hanja characters with fewer strokes than on words with more strokes. Thus, we speculate that the left posterior occipital area may be specialized for Hangul letter identification in this patient. This case demonstrates that Hangul-Hanja reading dissociation impairment can occur after occipital-parietal lesions.

Altered organization of face processing networks in temporal lobe epilepsy

Science.gov (United States)

Riley, Jeffrey D.; Fling, Brett W.; Cramer, Steven C.; Lin, Jack J.

2015-01-01

SUMMARY Objective Deficits in social cognition are common and significant in people with temporal lobe epilepsy (TLE), but the functional and structural underpinnings remain unclear. The present study investigated how the side of seizure focus impacts face processing networks in temporal lobe epilepsy. Methods We used functional magnetic resonance imaging (fMRI) of a face processing paradigm to identify face responsive regions in 24 individuals with unilateral temporal lobe epilepsy (Left = 15; Right = 9) and 19 healthy controls. fMRI signals of face responsive regions ispilateral and contralateral to the side of seizure onset were delineated in TLE and compared to the healthy controls with right and left side combined. Diffusion tensor images were acquired to investigate structural connectivity between face regions that differed in fMRI signals between the two groups. Results In temporal lobe epilepsy, activation of the cortical face processing networks varied according to side of seizure onset. In temporal lobe epilepsy, the laterality of amygdala activation was shifted to the side contralateral to the seizure focus while controls showed no significant asymmetry. Furthermore, compared to controls, patients with TLE showed decreased activation of the occipital face responsive region in the ipsilateral side and an increased activity of the anterior temporal lobe in the contralateral side to the seizure focus. Probabilistic tractography revealed that the occipital face area and anterior temporal lobe are connected via the inferior longitudinal fasciculus, which in individuals with temporal lobe epilepsy showed reduced integrity. Significance Taken together, these findings suggest that brain function and white matter integrity of networks subserving face processing are impaired on the side of seizure onset, accompanied by altered responses on the side contralateral to the seizure. PMID:25823855

Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

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Uchida, R.R.; Del-Ben, C.M.; Araujo, D.; Crippa, J.A.; Graeff, F.G. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Neurologia e Psicologia Medica]. E-mail: fgraeff@keynet.com.br; Santos, A.C. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Clinica Medica; Guimaraes, F.S. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Farmacologia

2003-07-01

Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t{sub 21} = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t{sub 21} = 1.99, P = 0.06), right amygdala (8%, t{sub 21} = 1.83, P = 0.08), left amygdala (5%, t{sub 21} = 1.78, P 0.09) and left hippocampus (9%, t{sub 21} = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures. (author)

Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

International Nuclear Information System (INIS)

Uchida, R.R.; Del-Ben, C.M.; Araujo, D.; Crippa, J.A.; Graeff, F.G.; Santos, A.C.; Guimaraes, F.S.

2003-01-01

Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t 21 = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t 21 = 1.99, P = 0.06), right amygdala (8%, t 21 = 1.83, P = 0.08), left amygdala (5%, t 21 = 1.78, P 0.09) and left hippocampus (9%, t 21 = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures. (author)

"Capgras" Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures.

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Lilly, Brandon; Maynard, Erika; Melvin, Kelly; Holroyd, Suzanne

2018-01-01

Capgras syndrome is characterized by the delusional belief that a familiar person has been replaced by a visually similar imposter or replica. Rarely, the delusional focus may be objects rather than people. Numerous etiologies have been described for Capgras to include seizures. Similarly, visual hallucinations, both simple and complex, can occur secondary to seizure activity. We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology.

Occipital bending in schizophrenia.

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Maller, Jerome J; Anderson, Rodney J; Thomson, Richard H; Daskalakis, Zafiris J; Rosenfeld, Jeffrey V; Fitzgerald, Paul B

2017-01-01

To investigate the prevalence of occipital bending (an occipital lobe crossing or twisting across the midline) in subjects with schizophrenia and matched healthy controls. Occipital bending prevalence was investigated in 37 patients with schizophrenia and 44 healthy controls. Ratings showed that prevalence was nearly three times higher among schizophrenia patients (13/37 [35.1%]) than in control subjects (6/44 [13.6%]). Furthermore, those with schizophrenia had greater normalized gray matter volume but less white matter volume and had larger brain-to-cranial ratio. The results suggest that occipital bending is more prevalent among schizophrenia patients than healthy subjects and that schizophrenia patients have different gray matter-white matter proportions. Although the cause and clinical ramifications of occipital bending are unclear, the results infer that occipital bending may be a marker of psychiatric illness.

Does shape discrimination by the mouth activate the parietal and occipital lobes? - near-infrared spectroscopy study.

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Tomonori Kagawa

Full Text Available A cross-modal association between somatosensory tactile sensation and parietal and occipital activities during Braille reading was initially discovered in tests with blind subjects, with sighted and blindfolded healthy subjects used as controls. However, the neural background of oral stereognosis remains unclear. In the present study, we investigated whether the parietal and occipital cortices are activated during shape discrimination by the mouth using functional near-infrared spectroscopy (fNIRS. Following presentation of the test piece shape, a sham discrimination trial without the test pieces induced posterior parietal lobe (BA7, extrastriate cortex (BA18, BA19, and striate cortex (BA17 activation as compared with the rest session, while shape discrimination of the test pieces markedly activated those areas as compared with the rest session. Furthermore, shape discrimination of the test pieces specifically activated the posterior parietal cortex (precuneus/BA7, extrastriate cortex (BA18, 19, and striate cortex (BA17, as compared with sham sessions without a test piece. We concluded that oral tactile sensation is recognized through tactile/visual cross-modal substrates in the parietal and occipital cortices during shape discrimination by the mouth.

The Anterolateral Limit of the Occipital Lobe: An Anatomical and Imaging Study.

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Reis, Cassius Vinicius C; Yagmurlu, Kaan; Elhadi, Ali M; Dru, Alexander; Lei, Ting; Gusmão, Sebastião N S; Tazinaffo, Uédson; Zabramski, Joseph M; Spetzler, Robert F; Preul, Mark C

2016-12-01

Objectives  The boundaries of the temporal lobe, the parietal lobe, and the anterior portion of the occipital lobe (OL) are poorly defined. Lesions in these areas can be difficult to localize. Therefore, we studied the anterolateral limit of the OL to identify reliable anatomical landmarks. Design  In 10 formalin-fixed cadaveric heads, the boundaries of the OL and relative anatomical landmarks were studied. Main Outcome Measures  Distances between the following structures were measured: (1) preoccipital tentorial plica (POTP) to the junction between lambdoid suture and superior border of the transverse sinus (POTP-SL), (2) POTP to the sinodural angle of Citelli (POTP-PP), (3) lambda to parietooccipital sulcus (L-POS), and (4) preoccipital notch to termination of the vein of Labbé (PON-VL). Landmarks in 559 computed tomography and magnetic resonance images were also studied. Results  The POTP was found on the tentorium of all anatomical specimens, located at the same coronal level as the PON and its attachment to the bony protuberance (BP) at the lateral cranial wall. The mean distances were POTP-SL, 6.5 ± 6.4 mm; POTP-PP, 18.1 ± 7.8 mm; L-POS, 10.8 ± 5.0 mm; and PON-VL, 8.8 ± 10.1 mm. Conclusion  Osseous (asterion, lambda, and BP), dural (POTP), and vascular (VL) landmarks can be used as reference structures to identify the anterolateral limit of the OL.

Intractable occipital lobe epilepsy: clinical characteristics, surgical treatment, and a systematic review of the literature.

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Yang, Peng-Fan; Jia, Yan-Zeng; Lin, Qiao; Mei, Zhen; Chen, Zi-Qian; Zheng, Zhi-Yong; Zhang, Hui-Jian; Pei, Jia-Sheng; Tian, Jun; Zhong, Zhong-Hui

2015-01-01

We reported our experience in the surgical treatment of a relatively large cohort of patients with occipital lobe epilepsy (OLE). We also carried out a systematic review of the literature on OLE. Thirty-five consecutive patients who underwent occipital resection for epilepsy were included. Diagnoses were made following presurgical evaluations, including magnetic resonance imaging (MRI), fluorodeoxyglucose-positron emission tomography (FDG-PET), scalp video-electroencephalogram (EEG) monitoring, and intracranial EEG monitoring. At last follow-up, seizure outcome was classified using the Engel classification scheme. Twenty-five of 35 patients experienced/had experienced ≥1 type of aura before the seizure. Invasive recordings were used to define the epileptogenic area in 30 of 35 patients (85.7 %). All patients underwent occipital lesionectomies or topectomies. Histopathology revealed: cortical dysplasias, gliosis, dysembryoplastic neuroepithelial tumor, ganglioglioma, and tuberous sclerosis. After a mean follow-up of 44 months, 25 patients (71.4 %) were seizure free (Engel class I), 3 (8.6 %) rarely had seizures (Engel class II), 5 (14.3 %) improved more than 75 % (Engel class III), and 2 (5.7 %) had no significant improvement (Engel class IV). Preoperatively, 12 of 33 patients (36.4 %) had visual field deficits. Postoperatively, 25 patients (75.8 %) had new or aggravated visual field deficits. The management of OLE has been aided greatly by the availability of high-resolution diagnosis. Postoperative visual field deficits occur in a significant proportion of patients. Comprehensive intracranial EEG coverage of all occipital surfaces helps to define the epileptogenic area and preserve visual function, especially in cases of focal cortical dysplasia undetectable by MRI.

CT evaluation of decrease in attenuation in the superior segment of the left lower lobe

International Nuclear Information System (INIS)

Inaoka, Tsutomu; Takahashi, Koji; Ono, Hidetoshi

2003-01-01

We occasionally see decrease in attenuation in the superior segment of the left lower lobe on normal chest CT and notice that this finding could be seen in elder population. Then, we assessed the frequency, age distribution and cause of decrease in attenuation in the superior segment of the left lower lobe. Chest CT scans of 246 patients without lung or cardiac disorders were retrospectively reviewed. Segmental low attenuation area in the superior segment of the left lower lobe was identified in 12 patients (4.9%), which were 65-92 years old with mean age of 77.2 years old. In all of them, chest CT demonstrated that the tortuous descending aorta compressed directly the superior segmental bronchus of the left lower lobe. It is concluded that the lateral tortuousity of the descending aorta could cause decrease in attenuation in the superior segment of the left lower lobe. (author)

Prevention of postoperative visual field defect after the occipital transtentorial approach: anatomical study.

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Matsuo, Satoshi; Baydin, Serhat; Güngör, Abuzer; Middlebrooks, Erik H; Komune, Noritaka; Iihara, Koji; Rhoton, Albert L

2017-10-20

OBJECTIVE A postoperative visual field defect resulting from damage to the occipital lobe during surgery is a unique complication of the occipital transtentorial approach. Though the association between patient position and this complication is well investigated, preventing the complication remains a challenge. To define the area of the occipital lobe in which retraction is least harmful, the surface anatomy of the brain, course of the optic radiations, and microsurgical anatomy of the occipital transtentorial approach were examined. METHODS Twelve formalin-fixed cadaveric adult heads were examined with the aid of a surgical microscope and 0° and 45° endoscopes. The optic radiations were examined by fiber dissection and MR tractography techniques. RESULTS The arterial and venous relationships of the lateral, medial, and inferior surfaces of the occipital lobe were defined anatomically. The full course of the optic radiations was displayed via both fiber dissection and MR tractography. Although the stems of the optic radiations as exposed by both techniques are similar, the terminations of the fibers are slightly different. The occipital transtentorial approach provides access for the removal of lesions involving the splenium, pineal gland, collicular plate, cerebellomesencephalic fissure, and anterosuperior part of the cerebellum. An angled endoscope can aid in exposing the superior medullary velum and superior cerebellar peduncles. CONCLUSIONS Anatomical findings suggest that retracting the inferior surface of the occipital lobe may avoid direct damage and perfusion deficiency around the calcarine cortex and optic radiations near their termination. An accurate understanding of the course of the optic radiations and vascular relationships around the occipital lobe and careful retraction of the inferior surface of the occipital lobe may reduce the incidence of postoperative visual field defect.

Lateral chest radiographic findings in lobar collapse of the left lung : the distance between both upper lobe bronchi

International Nuclear Information System (INIS)

Chin, G. H.; Sung, D. W.; Yoon, Y.; Kim, H. C.

1996-01-01

To evaluate the distance between both upper love bronchi on lateral radiographs and its change in left upper or lower lobe collapse. 144 true lateral radiographs were analyzed on which both upper lobe bronchi were clearly identified. They included 116 normal cases, 11 cases of left upper lobe collapse, 13 of left lower lobe collapse, and 4 cases of left lower lobe lobectomy. Line A was drawn parallel to the vertebral end plate through the upper margin of the lift upper lobe bronchus. Line B was drawn parallel to line A through the upper margin of the right upper love bronchus. The shortest distance between line A and line B was measured as the distance between both upper lobe bronchi. In normal cases, the mean value of the distance was 2.19 cm ± S.D. 0.37 cm on right and on right and 2.16 cm ± S.D. 0.40 cm on left lateral radiographs ; these results were not significantly different(P=0.79). In cases of collapse, the mean value of the distance was 0.43 cm ± S.D. 0.99 cm in upper lobe collapse and 3.56 cm ± S.D. 0.72 cm in lower lobe collapse, results which were significantly different from those of normal cases(p<0.01). In eight cases(73%) of left upper lobe collapse, the distance was less than 1 cm and in 10 cases(77%) of left lower lobe collapse, the distance was more than 3 cm. The distance between both upper lobe bronchi varies markedly in case of lobar collapse. A distance of less than 1 cm suggests collapse of the left upper lobe and a distance more than 3 cm suggests collapse of the left lower lobe

Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve.

Science.gov (United States)

Son, Byung-Chul; Choi, Jin-Gyu

2017-01-01

Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although referral of pain from the stimulation of occipital and cervical structures innervated by upper cervical nerves to the frontal head of V1 trigeminal distribution has been reported, the development of hemifacial sensory change associated with referred trigeminal pain from chronic occipital neuralgia is extremely rare. Chronic continuous and strong afferent input of occipital neuralgia caused by pathological vascular contact with the greater occipital nerve seemed to be associated with sensitization and hypersensitivity of the second-order neurons in the trigeminocervical complex, a population of neurons in the C2 dorsal horn characterized by receiving convergent input from dural and cervical structures.

Reorganization of retinotopic maps after occipital lobe infarction.

Science.gov (United States)

Vaina, Lucia M; Soloviev, Sergei; Calabro, Finnegan J; Buonanno, Ferdinando; Passingham, Richard; Cowey, Alan

2014-06-01

We studied patient JS, who had a right occipital infarct that encroached on visual areas V1, V2v, and VP. When tested psychophysically, he was very impaired at detecting the direction of motion in random dot displays where a variable proportion of dots moving in one direction (signal) were embedded in masking motion noise (noise dots). The impairment on this motion coherence task was especially marked when the display was presented to the upper left (affected) visual quadrant, contralateral to his lesion. However, with extensive training, by 11 months his threshold fell to the level of healthy participants. Training on the motion coherence task generalized to another motion task, the motion discontinuity task, on which he had to detect the presence of an edge that was defined by the difference in the direction of the coherently moving dots (signal) within the display. He was much better at this task at 8 than 3 months, and this improvement was associated with an increase in the activation of the human MT complex (hMT(+)) and in the kinetic occipital region as shown by repeated fMRI scans. We also used fMRI to perform retinotopic mapping at 3, 8, and 11 months after the infarct. We quantified the retinotopy and areal shifts by measuring the distances between the center of mass of functionally defined areas, computed in spherical surface-based coordinates. The functionally defined retinotopic areas V1, V2v, V2d, and VP were initially smaller in the lesioned right hemisphere, but they increased in size between 3 and 11 months. This change was not found in the normal, left hemisphere of the patient or in either hemispheres of the healthy control participants. We were interested in whether practice on the motion coherence task promoted the changes in the retinotopic maps. We compared the results for patient JS with those from another patient (PF) who had a comparable lesion but had not been given such practice. We found similar changes in the maps in the lesioned

Evidence for intact local connectivity but disrupted regional function in the occipital lobe in children and adolescents with schizophrenia.

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White, Tonya; Moeller, Steen; Schmidt, Marcus; Pardo, Jose V; Olman, Cheryl

2012-08-01

It has long been known that specific visual frequencies result in greater blood flow to the striate cortex. These peaks are thought to reflect synchrony of local neuronal firing that is reflective of local cortical networks. Since disrupted neural connectivity is a possible etiology for schizophrenia, our goal was to investigate whether localized connectivity, as measured by aberrant synchrony, is abnormal in children and adolescents with schizophrenia. Subjects included 25 children and adolescents with schizophrenia and 39 controls matched for age and gender. Subjects were scanned on a Siemens 3 Tesla Trio scanner while observing flashing checkerboard presented at either 1, 4, 8, or 12 Hz. Image processing included both a standard GLM model and a Fourier transform analysis. Patients had significantly smaller volume of activation in the occipital lobe compared to controls. There were no differences in the integral or percent signal change of the hemodynamic response function for each of the four frequencies. Occipital activation was stable during development between childhood and late adolescence. Finally, both patients and controls demonstrated an increased response between 4 and 8 Hz consistent with synchrony or entrainment in the neuronal response. Children and adolescents with schizophrenia had a significantly lower volume of activation in the occipital lobe in response to the flashing checkerboard task. However, features of intact local connectivity in patients, such as the hemodynamic response function and maximal response at 8 Hz, were normal. These results are consistent with abnormalities in regional connectivity with preserved local connectivity in early-onset schizophrenia. Copyright © 2011 Wiley Periodicals, Inc.

Clinico-anatomical correlations of left posterior cerebral artery occlusion

International Nuclear Information System (INIS)

Isono, Osamu; Shiota, Junichi; Kawamura, Mitsuru; Hirayama, Keizou; Maki, Toshiyuki.

1988-01-01

The relation between neurological signs and symptoms and computed tomography (CT) and magnetic resonance imaging (MRI) was examined in 11 cases of occlusion of the left posterior cerebral artery. All the patients were righthanded. Right homonimous hemianopia was noted in 8 cases, right upper quadrantanopia in 2 cases, and right lower quadrantanopia in 1 case. Of the 11 cases, alexia without agraphia was noted in 9 cases, all 9 of which showed lesions of inferior occipital cortex (lingual and fusiform gyri) and subjacent white matter. Lesions of splenium were found in only 5 of the cases of alexia without agraphia. In 2 cases with neither alexia nor agraphia, lesions were seen in the medial occipital cortex and the subjacent white matter but not in the inferior occipital lobe. Three patients had color anomia which was accompanied by memory disturbances and alexia without agraphia. In 2 of these 3, lesions were widespread in the region of the left posterior cerebral artery. Memory disturbances were observed in 6 cases, all of which also showed alexia without agraphia. The lesions extended not only of the inferior surface of the occipital lobe and along the interhemispheric fissure, but also of hippocampal and parahippocampal gyri. In 3 cases of alexia without agraphia in which no memory distrubance was found, the symptoms of alexia were slight and disappeared at an early stage. (J.P.N.)

The timing of associative memory formation: frontal lobe and anterior medial temporal lobe activity at associative binding predicts memory

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Hales, J. B.

2011-01-01

The process of associating items encountered over time and across variable time delays is fundamental for creating memories in daily life, such as for stories and episodes. Forming associative memory for temporally discontiguous items involves medial temporal lobe structures and additional neocortical processing regions, including prefrontal cortex, parietal lobe, and lateral occipital regions. However, most prior memory studies, using concurrently presented stimuli, have failed to examine the temporal aspect of successful associative memory formation to identify when activity in these brain regions is predictive of associative memory formation. In the current study, functional MRI data were acquired while subjects were shown pairs of sequentially presented visual images with a fixed interitem delay within pairs. This design allowed the entire time course of the trial to be analyzed, starting from onset of the first item, across the 5.5-s delay period, and through offset of the second item. Subjects then completed a postscan recognition test for the items and associations they encoded during the scan and their confidence for each. After controlling for item-memory strength, we isolated brain regions selectively involved in associative encoding. Consistent with prior findings, increased regional activity predicting subsequent associative memory success was found in anterior medial temporal lobe regions of left perirhinal and entorhinal cortices and in left prefrontal cortex and lateral occipital regions. The temporal separation within each pair, however, allowed extension of these findings by isolating the timing of regional involvement, showing that increased response in these regions occurs during binding but not during maintenance. PMID:21248058

Percutaneous transhepatic biliary drainage(PTBD): comparative data of right and left hepatic lobe approach

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Lee, Choon Hyeong; Oh, Joo Hyeong; Yoon, Yup [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1995-08-15

To evaluate the difference in each procedure time and complication rates related to percutaneous transhepatic biliary drainage(PTBD) via the right and the left hepatic lobe. We performed PTBD in 120 patients with biliary obstruction below both main hepatic ducts. Of the 120 catheters, 54 were introduced via a left lobe approach and 66 through the right lobe. All procedures were performed under fluoroscopic guidance by the same operator. For each patient, procedure time was recorded prospectively. PTBD related complications were classified as either early(up to 30 days after procedure) or late(after 30 days), and each complication graded as major, or minor according to its intensity. The difference in the mean procedure time(28.8 min, versus 36.2 min, left versus right approach group) and that in complication rates (37% versus 58%) were statistically significant({rho} < 0.05). Concerning major complication(bile peritonitis, sepsis, massive hemobilia, liver abscess, pyothorax), the percentages related to left and right lobe approach were 1.8% and 10.6%, and concerning minor complications(catheter obstruction or dislodgement, transient hemobilia, persistent fever or pain), the percentages were 36% and 51% respectively. PTBD via the left lobe approach was superior with short procedure time and low complication rates than the right approach.

Transsynaptic neuronal degeneration of optic nerves associated with bilateral occipital lesions

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Sachdev Mahipal

1990-01-01

Full Text Available A case is reported of a 9-year old male who presented with abnormal behaviour and progressive diminution of vision. Pupils were middilated in both eyes but the pupillary reflexes were preserved. Fundus examination revealed a bilateral optic atrophy and radiological investigations showed a bilateral occipital calcification. We hereby document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions. Transsynapptic neuronal degeneration of optic nerves consequent to occipital lobe lesions is a rare phenomenon. Experimentally occipital lobe ablation in non-human primates has been shown to result in optic atrophy. Herein, we document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions.

Fatal stroke after completion pneumonectomy for torsion of left upper lobe following left lower lobectomy

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Apostolakis Efstratios

2006-09-01

Full Text Available Abstract Background The lobar torsion after lung surgery is a rare complication with an incidence of 0.09 to 0.4 %. It may occur after twisting of the bronchovascular pedicle of the remaining lobe after lobectomy, usually on the right side. The 180-degree rotation of the pedicle produces an acute obstruction of the lobar bronchus (atelectasis and of the lobar vessels as well. Without prompt treatment it progresses to lobar ischemia, pulmonary infarction and finally fatal gangrene. Case Presentation A 62 years old female patient was admitted for surgical treatment of lung cancer. She underwent elective left lower lobectomy for squamous cell carcinoma (pT2 N0. The operation was unremarkable, and the patient was extubated in the operating room. After eight hours the patient established decrease of pO2 and chest x-ray showed atelectasis of the lower lobe. To establish diagnosis, bronchoscopy was performed, demonstrating obstructed left lobar bronchus. The patient was re-intubated, and admitted to the operating room where reopening of the thoracotomy was performed. Lobar torsion was diagnosed, with the diaphragmatic surface of the upper lobe facing in an anterosuperior orientation. A completion pneumonectomy was performed. At the end of the procedure the patient developed a right pupil dilatation, presumably due to a cerebral embolism. A subsequent brain angio-CT scan established the diagnosis. She died at the intensive care unit 26 days later. Conclusion The thoracic surgeon should suspect this rare early postoperative complication after any thoracic operation in every patient with atelectasis of the neighboring lobe. High index of suspicion and prompt diagnosis may prevent catastrophic consequences, such as, infarction or gangrene of the pulmonary lobe. During thoracic operations, especially whenever the lung or lobe hilum is full mobilized, fixation of the remaining lobe may prevent this life threatening complication.

Evaluation of Posterior Hippocampal Epileptogenicity During Epilepsy Surgery For Temporal Lobe Cavernoma by the Occipital Approach.

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Akiyama, Yukinori; Suzuki, Kengo; Ochi, Satoko; Miyamoto, Susumu; Mikuni, Nobuhiro

2015-11-01

Cavernomas frequently are associated with intractable epilepsy. When cavernomas located in the temporal lobe are associated with intractable epilepsy, the hippocampus also may have an epileptic focus. The objective in the present study was to clarify the importance of evaluation of the posterior hippocampal epileptogenicity during epilepsy surgery for posteromedial temporal lobe cavernoma. In this study, we describe 2 rare cases of medically intractable epilepsy in patients with posteromedial temporal lobe cavernomas who underwent surgery via the occipital approach. Using longitudinal insertion of depth electrodes into the hippocampus, we evaluated epileptogenicity in both patients from the cavernoma cavity and its surrounding hemosiderin, as well as from the posterior hippocampus near the cavernoma. We show that the transoccipital approach to the posteromedial temporal lobe is compatible with depth electrode insertion and subdural electrode placement on the temporal lobe, enabling an accurate evaluation of potential epileptogenic zones in the posterior part of the hippocampus. Both patients did not experience any seizures and had no postoperative neurologic deficits, and their cognitive functions were intact. The transoccipital approach enables the optimization of the extent of posterior hippocampectomy while avoiding unnecessary resection for seizure control. We suggest resecting the posterior part of the hippocampus in addition to the cavernoma and surrounding areas in patients with medically refractory epilepsy due to a posteromedial temporal cavernoma. Tailored systematic resection guided by intraoperative electrocorticography and electroencephalography with a depth electrode was important and necessary in the present cases. Copyright © 2015 Elsevier Inc. All rights reserved.

The Pivotal Role of the Parieto-Occipital Lobe in Card Game-Induced Reflex Epilepsy: A Voxel-Based Morphometry Study.

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Park, Kang Min; Kim, Sung Eun; Lee, Byung In

2016-01-01

The pathogenesis of card game-induced reflex epilepsy has not been determined so far. The aim of this study was to evaluate structural abnormalities using voxel-based morphometry (VBM) analysis, which may give some clue about the pathogenesis in card game-induced reflex epilepsy. The 3 subjects were diagnosed with card game-induced reflex epilepsy. Evaluation involved a structured interview to obtain clinical information and brain MRI. In VBM analysis, Statistical Parametric Mapping 8 running on the MATLAB platform was employed to analyze the structural differences between patients with card game-induced reflex epilepsy and age- and sex-matched control subjects. The results of VBM analysis revealed that patients with card game-induced reflex epilepsy had significantly increased gray matter volume in the right occipital and parietal lobe. However, there were no structures with decreased gray matter volume in patients with card game-induced reflex epilepsy compared with control subjects. In addition, we found that the patients with card game-induced reflex epilepsy had onset of seizures in adulthood rather than in adolescence, and all of the patients were men. The parieto-occipital lobes might be partially involved in the neuronal network responsible for card game-induced reflex epilepsy. © 2016 S. Karger AG, Basel.

“Capgras” Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures

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Brandon Lilly

2018-01-01

Full Text Available Capgras syndrome is characterized by the delusional belief that a familiar person has been replaced by a visually similar imposter or replica. Rarely, the delusional focus may be objects rather than people. Numerous etiologies have been described for Capgras to include seizures. Similarly, visual hallucinations, both simple and complex, can occur secondary to seizure activity. We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology.

Bilateral occipital lobe infarction with altitudinal field loss following radiofrequency cardiac catheter ablation

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Chen Celia S

2010-03-01

Full Text Available Abstract Background Bilateral stroke following radiofrequency catheter ablation is an unusual complication and may result in bilateral altitudinal visual field defects. Bilateral altitudinal visual field defects usually result from prechiasmal pathology causing damage to both retinas or optic nerves and rarely from bilateral symmetric damage to the post chiasmal visual pathways. Case presentation A 48-year-old man complained of visual disturbance on wakening following radiofrequency catheter ablation. The patient had a CHADS score of 1 pre-operatively and no complications were noted intra-operatively. Examination revealed a bilateral superior altitudinal defect and MRI of the brain showed multifocal areas of infarction predominantly involving the occipital lobes which correlated to with the visual deficits. Conclusion While the risk of thromboembolism and perioperative stroke during radiofrequency catheter ablation is small, it is not insignificant.

First reported case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland.

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Chen, Louis C; Green, Jennifer B

2011-06-01

Unilateral Graves' disease is a rare disease variant that can occur in a bilobar thyroid gland. We report the first documented case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland and review the pertinent literature. A 48-year-old man presented in June 2010 with thyrotoxicosis. I-131 radioisotope uptake was elevated at 33.4%, and scintigraphy revealed that uptake of the radioisotope was uniformly increased in the left lobe of the thyroid gland. Ultrasonography of the thyroid gland revealed a non-nodular, enlarged, and heterogeneous left lobe; Doppler investigation of the lobe showed hypervascularity classically seen in Graves' disease. The right lobe of the thyroid, on the other hand, appeared homogeneous and hypovascular on ultrasonography. Thyroid-stimulating immunoglobulin was significantly elevated at 191% (reference range disease was the most likely diagnosis. As has occasionally been described in the literature, unilateral involvement of the thyroid gland is a rare presentation of Graves' disease. Pre-existing functional or structural differences (either congenital or acquired) between the two lobes may contribute to this rare presentation. To our knowledge, this is the first reported case of unilateral Graves' disease presenting in the left lobe of a bilobar thyroid gland. Although the pathophysiology of unilateral Graves's disease has not been clearly elucidated, clinicians should be aware that Graves' disease can present unilaterally in either lobe of the thyroid gland.

Giant Occipital Intradiploic Epidermoid Cyst.

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Oommen, Arun; Govindan, Jayasree; Peroor, Devan Surendran; Azeez, C Roshan; Rashmi, R; Abdul Jalal, Muhammed Jasim

2018-01-01

Intraparenchymal or intradiploic epidermoid cysts are very rare. Most of these cysts, when present, tend to involve the frontal and temporal lobes, and occasionally, the pineal gland or the brain stem. Here, we report a 45-year-old female, who presented with localized occipital headache and a tender occipital swelling, gradually increasing in size. She was hemodynamically and neurologically stable and did not have any focal neurological deficits. Whole skull and brain imaging revealed a well-demarcated expansile lytic lesion in the right occipital bone, which was hypointense on T1-weighted and hyperintense on both T2-weighted imaging and diffusion-weighted imaging without any contrast enhancement. The patient underwent a right occipital craniotomy and total excision of the intradiploic space occupying lesion. Histopathological examination confirmed the lytic bone lesion over occipital bone as intradiploic epidermoid cyst.

Occipital lobe and posterior cingulate perfusion in the prediction of dementia with Lewy body pathology in a clinical sample.

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Prosser, Angus M J; Tossici-Bolt, Livia; Kipps, Christopher M

2017-12-01

The aim of this study was to investigate the diagnostic value of occipital lobe and posterior cingulate perfusion in predicting dopamine transporter imaging outcome using a quantitative measure of analysis. In total, 99 patients with cognitive complaints who had undergone both technetium-99m-hexamethylpropyleneamine oxime single-photon emission computed tomography (Tc-HMPAO SPECT) and I ioflupane (I-FP-CIT also called DaTSCAN) imaging in a dementia diagnostic center were analyzed. Measures of perfusion were calculated from HMPAO SPECT images for the medial and lateral occipital lobe, the posterior cingulate cortex, precuneus and cuneus regions of interest using statistical parametric mapping 8. DaTSCAN images were quantified and specific binding ratios were calculated independent from HMPAO SPECT results. Statistical parametric mapping and tests of associations between perfusion and I-FP-CIT imaging were completed. Regions of interest on HMPAO yielded poor predictive values when used independently to predict I-FP-CIT status; however, the combination of normal posterior cingulate perfusion with medial and lateral occipital hypoperfusion was associated significantly with I-FP-CIT status, χ (1, N=99)=9.72, P=0.002. This combination also yielded a high positive likelihood ratio and specificity (11.1, 98%). Sensitivity was, however, low (22%). No significant perfusion differences were found when abnormal and normal I-FP-CIT groups were compared directly using voxel-based morphometry (Poccipital hypoperfusion with preserved posterior cingulate gyrus perfusion is highly specific for individuals with a positive I-FP-CIT scan in a clinical sample where diagnostic doubt exists. This regional combination, however, lacks sensitivity; therefore, absence of the sign cannot be used to rule out dementia with Lewy bodies. A positive finding provides strong evidence to rule in dementia with Lewy bodies.

Occipital cortex of blind individuals is functionally coupled with executive control areas of frontal cortex.

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Deen, Ben; Saxe, Rebecca; Bedny, Marina

2015-08-01

In congenital blindness, the occipital cortex responds to a range of nonvisual inputs, including tactile, auditory, and linguistic stimuli. Are these changes in functional responses to stimuli accompanied by altered interactions with nonvisual functional networks? To answer this question, we introduce a data-driven method that searches across cortex for functional connectivity differences across groups. Replicating prior work, we find increased fronto-occipital functional connectivity in congenitally blind relative to blindfolded sighted participants. We demonstrate that this heightened connectivity extends over most of occipital cortex but is specific to a subset of regions in the inferior, dorsal, and medial frontal lobe. To assess the functional profile of these frontal areas, we used an n-back working memory task and a sentence comprehension task. We find that, among prefrontal areas with overconnectivity to occipital cortex, one left inferior frontal region responds to language over music. By contrast, the majority of these regions responded to working memory load but not language. These results suggest that in blindness occipital cortex interacts more with working memory systems and raise new questions about the function and mechanism of occipital plasticity.

The time course of retrograde trans-synaptic degeneration following occipital lobe damage in humans.

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Jindahra, Panitha; Petrie, Aviva; Plant, Gordon T

2012-02-01

Following damage to the human post-geniculate visual pathway retrograde trans-synaptic degeneration of the optic nerve fibres occurs. It has been known for some time from investigations carried out in primates that a decline in the number of retinal ganglion cells follows occipital lobectomy. However, this is not detectable in all species studied and whether this occurs in humans was controversial until recent studies that have shown that following lesions of the occipital lobe, the retinal nerve fibre layer thickness measured by optical coherence tomography is reduced and corresponding shrinkage of the optic tract can be demonstrated by magnetic resonance imaging. The time course of the degeneration in humans is, however, unknown. In the present study, we have used optical coherence tomography to demonstrate for the first time progressive thinning of the retinal nerve fibre layer following occipital lobe/optic radiation damage due to stroke. First, in a group of 38 patients the measurement was taken on a single occasion at a known time interval since the stroke, ranging from 6 days to 67 years. Here, a negative straight line relationship (linear regression r = 0.54, P < 0.001) was found between nerve fibre layer thickness and elapsed time since injury in log years, giving a rate of decline of 9.08 µm per log year after adjusting for age. This indicates a decelerating rate of loss that differs from the rate of decline found with chronological age in this same group, which shows a steady rate of thinning by 0.4 µm per year (P = 0.006) after adjusting for duration of the disease. In a second study serial measurements were taken following the acute event in a group of seven patients with homonymous hemianopia; here a negative straight line relationship was found between time and nerve fibre layer thickness in micrometres over a period of data collection beginning at a mean of 36.9 days post-stroke (range 5-112) and ending at a mean of 426.6 days post

Scannographic appearance of increased colloid uptake in the left liver lobe (Case presentation)

International Nuclear Information System (INIS)

Tadzher, Isak S.; Josifovska, Tatjana; Popgjorcheva, Daniela

1996-01-01

Incidentally increased uptake of Tc-99m sulfur colloid was found in scannographic images in the whole left liver lobe in all positions (PA, AP, DL, LL). The patient, a 60-year-old woman, was three years earlier cholocystecomized and had since occasional pain in the right upper abdominal quadrant due to biliary dyskinesia. Accessory spleen tissue was seen as well in the inferior lineal pole, probably presenting Shurer's phenomenon of 'lienis in liene' thus augmenting the serendipity of the scanographic findings. Imaging of the accessory spleen with heat denaturated spherocytes - Tc-99m confirmed the lienal structure of the tissue with preserved red pulp trabecular trapping mechanism in addition to phagocytic function of lineal Kupffer cells (in white pulp). Mebrofenin-Tc-99m (IDA-agent) showed in our patient normal distribution in both liver lobes contrary to focal nodular hyperplasia and adenoma of the liver where IDA-radio- pharmaceuticals have delayed clearance due to abnormal biliary canaliculi. In our patient uptake, distribution, excretion and liver washout of mebrofenin-Tc-99m was found to be normal. This is in favor of an exclusive, solitary increase of the number of Kupffer cells confined to the whole left lobe of the liver. Increased colloid uptake in the left liver lobe is dependent on a greater number of Kupffer cells pro volume than in the right lobe. (Author)

The Classical Pathways of Occipital Lobe Epileptic Propagation Revised in the Light of White Matter Dissection.

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Latini, Francesco; Hjortberg, Mats; Aldskogius, Håkan; Ryttlefors, Mats

2015-01-01

The clinical evidences of variable epileptic propagation in occipital lobe epilepsy (OLE) have been demonstrated by several studies. However the exact localization of the epileptic focus sometimes represents a problem because of the rapid propagation to frontal, parietal, or temporal regions. Each white matter pathway close to the supposed initial focus can lead the propagation towards a specific direction, explaining the variable semiology of these rare epilepsy syndromes. Some new insights in occipital white matter anatomy are herein described by means of white matter dissection and compared to the classical epileptic patterns, mostly based on the central position of the primary visual cortex. The dissections showed a complex white matter architecture composed by vertical and longitudinal bundles, which are closely interconnected and segregated and are able to support specific high order functions with parallel bidirectional propagation of the electric signal. The same sublobar lesions may hyperactivate different white matter bundles reemphasizing the importance of the ictal semiology as a specific clinical demonstration of the subcortical networks recruited. Merging semiology, white matter anatomy, and electrophysiology may lead us to a better understanding of these complex syndromes and tailored therapeutic options based on individual white matter connectivity.

The Classical Pathways of Occipital Lobe Epileptic Propagation Revised in the Light of White Matter Dissection

Science.gov (United States)

Latini, Francesco; Hjortberg, Mats; Aldskogius, Håkan; Ryttlefors, Mats

2015-01-01

The clinical evidences of variable epileptic propagation in occipital lobe epilepsy (OLE) have been demonstrated by several studies. However the exact localization of the epileptic focus sometimes represents a problem because of the rapid propagation to frontal, parietal, or temporal regions. Each white matter pathway close to the supposed initial focus can lead the propagation towards a specific direction, explaining the variable semiology of these rare epilepsy syndromes. Some new insights in occipital white matter anatomy are herein described by means of white matter dissection and compared to the classical epileptic patterns, mostly based on the central position of the primary visual cortex. The dissections showed a complex white matter architecture composed by vertical and longitudinal bundles, which are closely interconnected and segregated and are able to support specific high order functions with parallel bidirectional propagation of the electric signal. The same sublobar lesions may hyperactivate different white matter bundles reemphasizing the importance of the ictal semiology as a specific clinical demonstration of the subcortical networks recruited. Merging semiology, white matter anatomy, and electrophysiology may lead us to a better understanding of these complex syndromes and tailored therapeutic options based on individual white matter connectivity. PMID:26063964

Occipital transtentorial/falcine approach, a "cross-court" trajectory to accessing contralateral posterior thalamic lesions: case report.

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Iwami, Kenichiro; Fujii, Masazumi; Saito, Kiyoshi

2017-07-01

Surgical treatment of lesions in the posterior thalamus, especially those extending laterally, is technically challenging because of a deep surgical field, narrow operative corridor, and the surrounding critical neurovascular structures. The authors describe an occipital transtentorial/falcine approach (OTFA) that was successfully used in the treatment of a cavernous malformation (CM) extending laterally from thalamus to midbrain. A 40-year-old man complained of progressive right hemiparesis and numbness. Radiological evaluation revealed a large CM in the left thalamus, surfacing on the pulvinar thalami, and extending 4 cm laterally from the midline. In addition to the usual procedures of a right-sided occipital transtentorial approach, the authors incised the falx cerebri to expand the operative corridor to the left thalamus. They achieved generous exposure of the left thalamus through a "cross-court" oblique trajectory while avoiding excessive retraction on the occipital lobe. The CM was completely removed, and no newly developed or worsening deficits were detected postoperatively. To better understand the OTFA and its application, the authors performed a cadaveric dissection. The OTFA provides increased exposure of the posterior thalamus without cortical incision and facilitates lateral access to this area through the "cross-court" operative corridor. This approach adds to the armamentarium for neurosurgeons treating thalamic lesions.

Is the macromolecule signal tissue-specific in healthy human brain? A (1)H MRS study at 7 Tesla in the occipital lobe.

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Schaller, Benoît; Xin, Lijing; Gruetter, Rolf

2014-10-01

The macromolecule signal plays a key role in the precision and the accuracy of the metabolite quantification in short-TE (1) H MR spectroscopy. Macromolecules have been reported at 1.5 Tesla (T) to depend on the cerebral studied region and to be age specific. As metabolite concentrations vary locally, information about the profile of the macromolecule signal in different tissues may be of crucial importance. The aim of this study was to investigate, at 7T for healthy subjects, the neurochemical profile differences provided by macromolecule signal measured in two different tissues in the occipital lobe, predominantly composed of white matter tissue or of grey matter tissue. White matter-rich macromolecule signal was relatively lower than the gray matter-rich macromolecule signal from 1.5 to 1.8 ppm and from 2.3 to 2.5 ppm with mean difference over these regions of 7% and 12% (relative to the reference peak at 0.9 ppm), respectively. The neurochemical profiles, when using either of the two macromolecule signals, were similar for 11 reliably quantified metabolites (CRLB occipital lobe at 7T in healthy human brain. Copyright © 2013 Wiley Periodicals, Inc.

Left lower lobe sleeve lobectomy for lung cancer using the Da Vinci surgical system.

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Zhao, Yandong; Jiao, Wenjie; Ren, Xiaoyang; Zhang, Liangdong; Qiu, Tong; Fu, Bo; Wang, Lei

2016-04-12

Despite the robotic surgery is widely applied, sleeve lobectomy for lung cancer using the Da Vinci surgical system is still less performed. We described a sleeve lobectomy for adenocarcinoma located at the left lower lobe using the Da Vinci surgical system. A case of 57-year old female referred to our hospital. Computed tomography scan showed an occupation located at the left lower lobe and adenocarcinoma project from the lobe bronchus was diagnosed by bronchoscope examination. A sleeve lobectomy was performed using the Da Vinci surgical system and the postoperative recovery was uneventful. Robotic thoracic surgery is feasible to perform sleeve lobectomy inspite of inadequate experience.

MRI in occipital lobe infarcts: classification by involvement of the striate cortex

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Kitajima, M. [Department of Radiology, Kumamoto University School of Medicine, Kumamoto (Japan)]|[Department of Radiology, Kumamoto Rousai Hospital, Kumamoto (Japan); Korogi, Y.; Takahashi, M. [Department of Radiology, Kumamoto University School of Medicine, Kumamoto (Japan); Kido, T.; Ikeda, O.; Morishita, S. [Department of Radiology, Kumamoto Rousai Hospital, Kumamoto (Japan)

1998-11-01

We reviewed the MRI studies of 25 patients with occipital lobe infarcts to clarify the distribution of infarcts in the posterior cerebral arterial territory, focussing on their relationship to the striate cortex. Visual field defects and MRI findings were also correlated in 16 patients. On coronal and/or sagittal images, the distribution of the infarct and its relationship to the striate cortex were classified. Involvement of the cortex of both upper and lower lips of the calcarine fissure was observed in 10 patients, and involvement of the lower lip alone in 15. The upper cortical lesions were always accompanied by lower cortical lesions. The visual field defects were complete hemianopia in nine patients, superior quadrantanopia in six and hemianopia with a preserved temporal crescent in one. All patients with superior quadrantanopia had involvement of the lower cortex alone; there were no cases of inferior quadrantanopia. The characteristic vascular anatomy, and poor development of the collateral circulation in the lower cortical area, may explain the vulnerability of this area to infarcts. (orig.) With 6 figs., 21 refs.

Occipital lobe infarction: a rare presentation of bilateral giant cavernous carotid aneurysms: a case report.

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Vanikieti, Kavin; Poonyathalang, Anuchit; Jindahra, Panitha; Cheecharoen, Piyaphon; Chokthaweesak, Wimonwan

2018-02-02

Cavernous carotid aneurysm (CCA) represents 2-9% of all intracranial aneurysms and 15% of internal carotid artery (ICA) aneurysms; additionally, giant aneurysms are those aneurysms that are > 25 mm in size. Bilateral CCAs account for 11-29% of patients and are commonly associated with structural weaknesses in the ICA wall, secondary to systemic hypertension. CCAs are considered benign lesions, given the low risk for developing major neurologic morbidities (i.e., subarachnoid hemorrhage, cerebral infarction, or carotid cavernous fistula). Moreover, concurrent presentation with posterior circulation cerebral infarction is even rarer, given different circulation territory from CCA. Here, we report on a patient with bilateral giant CCAs who presented with both typical and atypical symptoms. An 88-year-old hypertensive woman presented with acute vertical oblique binocular diplopia, followed by complete ptosis of the right eye. Ophthalmic examination showed dysfunction of the right third, fourth, and sixth cranial nerves. Further examination revealed hypesthesia of the areas supplied by the ophthalmic (V1) and maxillary (V2) branches of the right trigeminal nerve. Bilateral giant cavernous carotid aneurysms, with a concurrent subacute right occipital lobe infarction, were discovered on brain imaging and angiogram. Additionally, a prominent right posterior communicating artery (PCOM) was revealed. Seven months later, clinical improvement with stable radiographic findings was documented without any intervention. Dysfunction of the third, fourth, and sixth cranial nerves, and the ophthalmic (V 1 ) and maxillary (V 2 ) branches of the trigeminal nerves, should necessitate brain imaging, with special attention given to the cavernous sinus. Despite unilateral symptomatic presentation, bilateral lesions cannot be excluded solely on the basis of clinical findings. CCA should be included in the differential diagnosis of cavernous sinus lesions. Although rare, ipsilateral

Visuo-spatial construction in patients with frontal and parietal lobe lesions

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Himani Kashyap

2011-04-01

Full Text Available Visuospatial construction, traditionally viewed as a putative parietal function, also requires sustained attention, planning, organization strategies and error correction, and hence frontal lobe mediation. The relative contributions of the frontal and parietal lobes are poorly understood. To examine the contributions of parietal, frontal lobes, as well as right and left cerebral hemispheres to visuospatial construction. The Stick Construction Test for two-dimensional construction and the Block Construction Test for three-dimensional construction were administered pre-surgically to patients with lesions in the parietal lobe (n =9 and the frontal lobe (n=11, along with normal control subjects (n =20 matched to the patients on age (+/- 3 years, gender, education (+/- 3 years and handedness. The patients were significantly slower than the controls on both two-dimensional and three-dimensional tests. Patients with parietal lesions were slower than those with frontal lesions on the test of three-dimensional construction. Within each lobe patients with right and left sided lesions did not differ significantly. It appears that tests of three-dimensional construction might be most sensitive to visuospatial construction deficits. Visuospatial construction involves the mediation of both frontal and parietal lobes. The function does not appear to be lateralized. The networks arising from the parieto-occipital areas and projecting to the frontal cortices (e.g., occipito-frontal fasciculus may be the basis of the mediation of both lobes in visuospatial construction. The present findings need replication from studies with larger sample sizes.

Three Cases with Visual Hallucinations following Combined Ocular and Occipital Damage

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Bogusław Paradowski

2013-01-01

Full Text Available Charles Bonnet syndrome is an underrecognized disease that involves visual hallucinations in visually impaired patients. We present the cases of three patients who experienced complex visual hallucinations following various pathomechanisms. In two cases, diagnosis showed coexistence of occipital lobe damage with ocular damage, while in the third case it showed occipital lobe damage with retrobulbar optic neuritis. Theories of pathogenesis and the neuroanatomical basis of complex visual hallucinations are discussed and supported by literature review.

Differential contribution of right and left temporo-occipital and anterior temporal lesions to face recognition disorders

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Guido eGainotti

2011-06-01

Full Text Available In the study of prosopagnosia, several issues (such as the specific or non-specific manifestations of prosopagnosia, the unitary or non-unitary nature of this syndrome and the mechanisms underlying face recognition disorders are still controversial. Two main sources of variance partially accounting for these controversies could be the qualitative differences between the face recognition disorders observed in patients with prevalent lesions of the right or left hemisphere and in those with lesions encroaching upon the temporo-occipital or the (right anterior temporal cortex.Results of our review seem to confirm these suggestions. Indeed, they show that (a the most specific forms of prosopagnosia are due to lesions of a right posterior network including the OFA and the FFA, whereas (b the face identification defects observed in patients with left temporo-occipital lesions seem due to a semantic defect impeding access to person-specific semantic information from the visual modality. Furthermore, face recognition defects resulting from right anterior temporal lesions can usually be considered as part of a multimodal people recognition disorder.The implications of our review are, therefore, the following: (1 to consider the components of visual agnosia often observed in prosopagnosic patients with bilateral temporo-occipital lesions as part of a semantic defect, resulting from left-sided lesions (and not from prosopagnosia proper; (2 to systematically investigate voice recognition disorders in patients with right anterior temporal lesions to determine whether the face recognition defect should be considered a form of ‘associative prosopagnosia’ or a form of the ‘multimodal people recognition disorder’.

Gastric injury from 90Y to left hepatic lobe tumors adjacent to the stomach: fact or fiction?

International Nuclear Information System (INIS)

Gates, Vanessa L.; Hickey, Ryan; Marshall, Karen; Williams, Melissa; Salzig, Krystina; Lewandowski, Robert J.; Salem, Riad

2015-01-01

Radioembolization with 90 Y microspheres is a locoregional radiation therapy for unresectable hepatic neoplasm. Non-target delivery of 90 Y microspheres resulting in gastrointestinal (GI) symptoms is a recognized complication; there is minimal knowledge regarding the radiation effect to the gastric wall from left hepatic lobe 90 Y treatments. Our aim was to study the incidence of GI complications when the target tissue (hepatic parenchyma ± tumor) is in close proximity to the gastric wall. We hypothesized that liver (tumor) to stomach proximity does not correlate with increased toxicity. Between November 2011 and September 2013, we studied all patients who underwent left lobe radioembolization with 90 Y glass microspheres. With Institutional Review Board (IRB) approval, we retrospectively reviewed MRI/CT images of these patients, identifying a subset of patients with the left hepatic lobe <1 cm from the gastric wall. Patients were seen in clinic 1 month posttreatment and subsequently at 3-month intervals. Short- and long-term gastric adverse events were tabulated. Ninety-seven patients successfully underwent left hepatic lobe 90 Y microsphere radioembolization in which the average distance from the liver to the stomach wall was 1.0 ± 2.8 mm. The average dose for patients who received radioembolization to the left hepatic lobe was 109 ± 57 Gy. Fifty patients had tumor within 1 cm of the gastric wall. The average dose for patients who received radioembolization to the left hepatic lobe with tumor within 1 cm of the gastric wall was 121 ± 41 Gy. There were no reportable or recordable medical events. Of the patients, 34 % reported abdominal pain that was grade 1-2; 65 % of the patients reported no abdominal pain. None of the 97 patients developed a clinically evident GI ulcer. Patients with left lobe tumors adjacent to or abutting the stomach do not exhibit acute or chronic radiation effects following radioembolization with glass microspheres. (orig.)

Occipital White Matter Tracts in Human and Macaque.

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Takemura, Hiromasa; Pestilli, Franco; Weiner, Kevin S; Keliris, Georgios A; Landi, Sofia M; Sliwa, Julia; Ye, Frank Q; Barnett, Michael A; Leopold, David A; Freiwald, Winrich A; Logothetis, Nikos K; Wandell, Brian A

2017-06-01

We compare several major white-matter tracts in human and macaque occipital lobe using diffusion magnetic resonance imaging. The comparison suggests similarities but also significant differences in the tracts. There are several apparently homologous tracts in the 2 species, including the vertical occipital fasciculus (VOF), optic radiation, forceps major, and inferior longitudinal fasciculus (ILF). There is one large human tract, the inferior fronto-occipital fasciculus, with no corresponding fasciculus in macaque. We could identify the macaque VOF (mVOF), which has been little studied. Its position is consistent with classical invasive anatomical studies by Wernicke. VOF homology is supported by similarity of the endpoints in V3A and ventral V4 across species. The mVOF fibers intertwine with the dorsal segment of the ILF, but the human VOF appears to be lateral to the ILF. These similarities and differences between the occipital lobe tracts will be useful in establishing which circuitry in the macaque can serve as an accurate model for human visual cortex. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Cystic solitary fibrous tumor arising from the left occipital meninges: a case report

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Oh, Bae Geun; Hwang, Yoon Joon; Cha, Soon Joo; Hur, Gham; Kim, Yong Hoon; Kim, Su Young; Seo, Jung Wook; Lee, Ji Young; Kim, Han Seung [Ilsan Paik Hospital, Inje University, School of Medicine, Goyang (Korea, Republic of)

2007-02-15

Solitary fibrous tumor (SFT) is a benign mesenchymal neoplasm of a spindle-cell origin, and it usually involves the pleura. It's occurrence in various organs of the body has recently been described. Meningeal SFT is very rare. Radiologically, it is a strongly enhancing solid mass and is undistinguishable from fibrous meningioma and hemangiopericytoma. Yet we report here on a case of SFT with massive cystic degeneration that arose from the meninges of the left occipital region.

Three cases of acute encephalopathy with low density areas in the occipital lobes on CT

International Nuclear Information System (INIS)

Nakajima, Masako; Nakano, Chizuko; Takakura, Hiroki; Otani, Kyoichi.

1985-01-01

Three female infants with acute encephalopathy (aged from 5 months to 1 year and 8 months) are presented in whom peculiar features were obtained on cranial CT. Disturbances of consciousness and spasm were seen in all patients. Although two patients had been in good health until the onset, the other patient had had nodular sclerosis. Laboratory data showed no evidence of inflammation in the spinal fluid, but increased levels of transaminase and LDH. CT around 7 days after the onset revealed diffuse low density areas. This was noted in the temporal and occipital lobes, mainly resulting from edema. Follow-up CT examinations revealed localized low density areas corresponding to the surface area, being probably attributable to disturbances of the arterial and venous circulations. In two patients with severe disturbances of consciousness, low density areas became more marked with time. (Namekawa, K.)

Can FDG PET predict verbal specific memory decline after surgery for left temporal lobe epilepsy when MRI is normal?

International Nuclear Information System (INIS)

Sagona, J.A.; Rowe, C.C.; Thomas, D.; Dickinson-Rowe, K.L.

2002-01-01

Full text: Temporal lobectomy gives excellent control of seizures in over 80% of patients with temporal lobe epilepsy. The left temporal lobe, particularly the left hippocampus, is primarily responsible for verbal memory. In most patients, the hippocampus which lies in the medial temporal lobe is abnormal and can be removed without loss of memory function. However, removal of the left hippocampus when it appears normal on MRI, often causes a significant decline in verbal specific memory (VSM) function. This paper explores the significance of pre-operative FDG-PET asymmetry in temporal lobe metabolism in predicting the VSM outcome after left temporal lobectomy when MRI demonstrates a normal hippocampus. Fifteen patients between 1993 and 2000, underwent left temporal lobectomy including left hippocampal resection, Pre-operatively all patients underwent 1.5T MRI, FDG PET and neuropsychological assessment. Neuropsychological assessment was repeated post-operatively. The left hippocampus was normal on MRI in nine and demonstrated mild T2 signal change without atrophy in six. FDG PET demonstrated temporal lobe hypometabolism in 12 patients. Post-operatively, neuropsychological evaluation documented a decline in verbal specific memory function in six patients, three with normal MRI and three with mild T2 change. We found that all patients with normal FDG PET studies (n=3) demonstrated significant verbal memory deterioration post-operatively. Nine of twelve patients (75%) with left temporal lobe hypometabolism did not show new verbal memory deficits. FDG PET improves the risk stratification for verbal specific memory decline with left temporal lobectomy in patients with normal hippocampi on MRI. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Intramuscular Lipoma-Induced Occipital Neuralgia on the Lesser Occipital Nerve.

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Han, Hyun Ho; Kim, Hak Soo; Rhie, Jong Won; Moon, Suk Ho

2016-06-01

Occipital neuralgia (ON) is commonly characterized by a neuralgiform headache accompanied by a paroxysmal burning sensation in the dermatome area of the greater, lesser, or third occipital nerve. The authors report a rare case of ON caused by an intramuscular lipoma originating from the lesser occipital nerve.A 52-year-old man presented with sharp pain in the left postauricular area with a 3 × 2-cm palpable mass. Computed tomography revealed a mass suspiciously resembling an intramuscular lipoma within splenius muscle. In the operation field, a protruding mass causing stretching of the lesser occipital nerve was found. After complete resection, the neuralgiform headache symptom had resolved and the intramuscular lipoma was confirmed through histopathology.Previous studies on the causes of ON have reported that variation in normal anatomic structures results in nerve compression. Occipital neuralgia, however, caused by intramuscular lipomas in splenius muscles have not been previously reported, and the dramatic resolution following surgery makes it an interesting case worth reporting.

Disrupted topological properties of brain white matter networks in left temporal lobe epilepsy: a diffusion tensor imaging study.

Science.gov (United States)

Xu, Y; Qiu, S; Wang, J; Liu, Z; Zhang, R; Li, S; Cheng, L; Liu, Z; Wang, W; Huang, R

2014-10-24

Mesial temporal lobe epilepsy (mTLE) is the most common drug-refractory focal epilepsy in adults. Although previous functional and morphological studies have revealed abnormalities in the brain networks of mTLE, the topological organization of the brain white matter (WM) networks in mTLE patients is still ambiguous. In this study, we constructed brain WM networks for 14 left mTLE patients and 22 age- and gender-matched normal controls using diffusion tensor tractography and estimated the alterations of network properties in the mTLE brain networks using graph theoretical analysis. We found that networks for both the mTLE patients and the controls exhibited prominent small-world properties, suggesting a balanced topology of integration and segregation. However, the brain WM networks of mTLE patients showed a significant increased characteristic path length but significant decreased global efficiency, which indicate a disruption in the organization of the brain WM networks in mTLE patients. Moreover, we found significant between-group differences in the nodal properties in several brain regions, such as the left superior temporal gyrus, left hippocampus, the right occipital and right temporal cortices. The robustness analysis showed that the results were likely to be consistent for the networks constructed with different definitions of node and edge weight. Taken together, our findings may suggest an adverse effect of epileptic seizures on the organization of large-scale brain WM networks in mTLE patients. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

Gastric injury from {sup 90}Y to left hepatic lobe tumors adjacent to the stomach: fact or fiction?

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Gates, Vanessa L.; Hickey, Ryan; Marshall, Karen; Williams, Melissa; Salzig, Krystina; Lewandowski, Robert J. [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Salem, Riad [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States)

2015-12-15

Radioembolization with {sup 90}Y microspheres is a locoregional radiation therapy for unresectable hepatic neoplasm. Non-target delivery of {sup 90}Y microspheres resulting in gastrointestinal (GI) symptoms is a recognized complication; there is minimal knowledge regarding the radiation effect to the gastric wall from left hepatic lobe {sup 90}Y treatments. Our aim was to study the incidence of GI complications when the target tissue (hepatic parenchyma ± tumor) is in close proximity to the gastric wall. We hypothesized that liver (tumor) to stomach proximity does not correlate with increased toxicity. Between November 2011 and September 2013, we studied all patients who underwent left lobe radioembolization with {sup 90}Y glass microspheres. With Institutional Review Board (IRB) approval, we retrospectively reviewed MRI/CT images of these patients, identifying a subset of patients with the left hepatic lobe <1 cm from the gastric wall. Patients were seen in clinic 1 month posttreatment and subsequently at 3-month intervals. Short- and long-term gastric adverse events were tabulated. Ninety-seven patients successfully underwent left hepatic lobe {sup 90}Y microsphere radioembolization in which the average distance from the liver to the stomach wall was 1.0 ± 2.8 mm. The average dose for patients who received radioembolization to the left hepatic lobe was 109 ± 57 Gy. Fifty patients had tumor within 1 cm of the gastric wall. The average dose for patients who received radioembolization to the left hepatic lobe with tumor within 1 cm of the gastric wall was 121 ± 41 Gy. There were no reportable or recordable medical events. Of the patients, 34 % reported abdominal pain that was grade 1-2; 65 % of the patients reported no abdominal pain. None of the 97 patients developed a clinically evident GI ulcer. Patients with left lobe tumors adjacent to or abutting the stomach do not exhibit acute or chronic radiation effects following radioembolization with glass

Respiratory arrest at the onset of idiopathic childhood occipital epilepsy of Gastaut.

Science.gov (United States)

Funata, Keiko; Shike, Tatsuhiko; Takenouchi, Toshiki; Yamashita, Yukio; Takahashi, Takao

2018-01-01

Occipital lobe epilepsy of childhood includes two entities: Panayiotopoulos syndrome in pre-school children, and idiopathic childhood occipital epilepsy of Gastaut (ICOEG) in school-age children. The typical initial manifestation of the former is vomiting, and that of the latter is visual hallucinations. Ictal cardiopulmonary arrest at initial presentation has been reported for Panayiotopoulos syndrome, but not for ICOEG. We document a 7-year-old previously healthy girl who experienced an acute elemental visual hallucination of seeing insects, followed by a new-onset generalized seizure. Upon arrival at the local hospital, she was unconscious and soon thereafter, developed respiratory arrest. She was resuscitated and initiated on mechanical ventilation. An electroencephalogram taken three days after seizure cessation showed frequent occipital spikes, consistent with the diagnosis of ICOEG. The sequence of acute elementary visual hallucination followed by a motor seizure, and then witnessed respiratory arrest illustrated occurrence of life-threatening autonomic involvement at initial onset in ICOEG. We speculate that the epileptic propagation from the occipital lobes eventually compromised the respiratory center in the brainstem. The possibility of occipital lobe epilepsy should be considered in school-age children presenting with acute visual hallucination followed by respiratory arrest. Such a presentation should prompt an urgent electroencephalogram and initiation of antiepileptic treatment if indicated. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI.

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Geisel, Dominik; Lüdemann, Lutz; Keuchel, Thomas; Malinowski, Maciej; Seehofer, Daniel; Stockmann, Martin; Hamm, Bernd; Gebauer, Bernhard; Denecke, Timm

2013-09-01

To prospectively evaluate the early development of regional liver function after right portal vein embolisation (PVE) with Gd-EOB-DTPA-enhanced MRI in patients scheduled for extended right hemihepatectomy. Ten patients who received a PVE before an extended hemihepatectomy were examined before and 14 days after PVE using Gd-EOB-DTPA-enhanced MRI of the liver. In these sequences representative region of interest measurements were performed in the embolised right (RLL) and the non-embolised left liver lobe (LLL). The volume as well as hepatic uptake index (HUI) was calculated independently for each lobe. Relative enhancement 14 days after PVE decreased in the RLL and increased significantly in the LLL (P DTPA-enhanced MRI, which could reflect the redirected portal venous blood flow and the rapid utilisation of a hepatic functional reserve. • Preoperative portal vein embolisation (PVE) is widely performed before right-sided hepatic resection. • PVE increases intravenous contrast medium uptake in the left lobe of liver. • The hepatic uptake index for the left liver lobe increases rapidly after PVE. • Left liver lobe function increase may be visualised by Gd-EOB-DTPA-enhanced MRI.

Clinical study of the visual field defects caused by occipital lobe lesions.

Science.gov (United States)

Ogawa, Katsuhiko; Ishikawa, Hiroshi; Suzuki, Yutaka; Oishi, Minoru; Kamei, Satoshi

2014-01-01

The central visual field is projected to the region from the occipital tip to the posterior portion of the medial area in the striate cortex. However, central visual field disturbances have not been compared with the location of the lesions in the striate cortex. Thirteen patients with visual field defects caused by partial involvement of the striate cortex were enrolled. The lesions were classified according to their location into the anterior portion, the posterior portion of the medial area, and the occipital tip. Visual field defects were examined by the Goldmann perimetry, the Humphrey perimetry and the auto-plot tangent screen. We defined a defect within the central 10° of vision as a central visual field disturbance. The visual field defects in 13 patients were compared with the location of their lesions in the striate cortex. The medial area was involved in 7 patients with no involvement of the occipital tip. In 2 of them, peripheral homonymous hemianopia without central visual field disturbance was shown, and their lesions were located only in the anterior portion. One patient with a lesion in the posterior portion alone showed incomplete central homonymous hemianopia. Three of 4 patients with lesions located in both the anterior and posterior portions of the medial area showed incomplete central homonymous hemianopia and peripheral homonymous hemianopia. The occipital tip was involved in 6 patients. Five of them had small lesions in the occipital tip alone and showed complete central homonymous hemianopia or quadrantanopia. The other patient with a lesion in the lateral posterior portion and bilateral occipital tip lesions showed bilateral slight peripheral visual field disturbance in addition to complete central homonymous hemianopia on both sides. Lesions in the posterior portion of the medial area as well as the occipital tip caused central visual field disturbance in our study, as indicated in previous reports. Central homonymous hemianopia tended to

Left lower lobe atelectasis and consolidation following cardiac surgery: the effect of topical cooling on the phrenic nerve

International Nuclear Information System (INIS)

Benjamin, J.J.; Cascade, P.N.; Rubenfire, M.; Wajszczuk, W.; Kerin, N.Z.

1982-01-01

Retrospective and prospective analyses of chest radiographs of patients following coronary artery bypass surgery were undertaken. Left lower lobe pulmonary infiltrate and/or atelectasis developed in 13 of 40 (32.5%) patients who were operated upon without topical cooling of the heart with ice, and in 77 of 122 (63.1%) patients in one group and 34 of 40 (85.0%) patients in another group who were operated upon with topical cooling of the heart with ice. This difference was highly significant (p<0.001). Of the patients in one group in whom left lower lobe abnormality developed, 69.2% had paralysis or paresis of the left hemidiaphragm. It is evident that application of ice to the phrenic nerve can lead to temporary paralysis of the left leaf of the diaphragm, with subsequent development of left lower lobe pulmonary infiltrate and/or atelectasis

Left lower lobe atelectasis and consolidation following cardiac surgery: the effect of topical cooling on the phrenic nerve

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Benjamin, J.J.; Cascade, P.N.; Rubenfire, M.; Wajszczuk, W.; Kerin, N.Z.

1982-01-01

Retrospective and prospective analyses of chest radiographs of patients following coronary artery bypass surgery were undertaken. Left lower lobe pulmonary infiltrate and/or atelectasis developed in 13 of 40 (32.5%) patients who were operated upon without topical cooling of the heart with ice, and in 77 of 122 (63.1%) patients in one group and 34 of 40 (85.0%) patients in another group who were operated upon with topical cooling of the heart with ice. This difference was highly significant (p<0.001). Of the patients in one group in whom left lower lobe abnormality developed, 69.2% had paralysis or paresis of the left hemidiaphragm. It is evident that application of ice to the phrenic nerve can lead to temporary paralysis of the left leaf of the diaphragm, with subsequent development of left lower lobe pulmonary infiltrate and/or atelectasis.

Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

International Nuclear Information System (INIS)

Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun

2017-01-01

Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location

Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

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Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

2017-08-15

Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location.

The association between hemispheric specialization for language production and for spatial attention depends on left-hand preference strength.

Science.gov (United States)

Zago, Laure; Petit, Laurent; Mellet, Emmanuel; Jobard, Gaël; Crivello, Fabrice; Joliot, Marc; Mazoyer, Bernard; Tzourio-Mazoyer, Nathalie

2016-12-01

Cerebral lateralization for language production and spatial attention and their relationships with manual preference strength (MPS) were assessed in a sample of 293 healthy volunteers, including 151 left-handers, using fMRI during covert sentence production (PROD) and line bisection judgment (LBJ) tasks, as compared to high- and low-level reference tasks. At the group level, we found the expected complementary hemispheric specialization (HS) with leftward asymmetries for PROD within frontal and temporal regions and rightward asymmetries for LBJ within frontal and posterior occipito-parieto-temporal regions. Individual hemispheric (HLI) and regional (frontal and occipital) lateralization indices (LI) were then calculated on the activation maps for PROD and LBJ. We found a correlation between the degree of rightward cerebral asymmetry and the leftward behavioral attentional bias recorded during LBJ task. This correlation was found when LBJ-LI was computed over the hemispheres, in the frontal lobes, but not in the occipital lobes. We then investigated whether language production and spatial attention cerebral lateralization relate to each other, and whether manual preference was a variable that impacted the complementary HS of these functions. No correlation was found between spatial and language LIs in the majority of our sample of participants, including right-handers with a strong right-hand preference (sRH, n=97) and mixed-handers (MH, n=97), indicating that these functions lateralized independently. By contrast, in the group of left-handers with a strong left-hand preference (sLH, n= 99), a negative correlation was found between language and spatial lateralization. This negative correlation was found when LBJ-LI and PROD-LI were computed over the hemispheres, in the frontal lobes and between the occipital lobes for LBJ and the frontal lobes for PROD. These findings underline the importance to include sLH in the study sample to reveal the underlying mechanisms of

Rare Presentation of Left Lower Lobe Pulmonary Artery Dissection

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René Hako

2017-01-01

Full Text Available Background. Pulmonary arterial dissection with chronic pulmonary arterial hypertension as its major cause is a very rare but life-threatening condition. In most cases the main pulmonary trunk is the affected site usually without involvement of its branches. Segmental or lobar pulmonary artery dissection is extremely rare. Case Presentation. We report a unique case of left lower lobe pulmonary artery dissection in a 70-year-old male, with confirmed chronic pulmonary hypertension. To confirm dissection MDCT pulmonary angiography was used. Multiplanar reformation (MPR images in sagittal, coronal, oblique sagittal, and curved projections were generated. This case report presents morphologic CT features of rare chronic left lobar pulmonary artery dissection associated with chronic pulmonary hypertension at a place of localised pulmonary artery calcification. CT pulmonary angiography excluded signs of thromboembolism and potential motion or flow artefacts. Conclusion. To the best of our knowledge, no case of lower lobe pulmonary artery dissection with flap calcification has been reported yet. CT imaging of the chest is a key diagnostic tool that is able to detect an intimal flap and a false lumen within the pulmonary arterial tree and is preferred in differential diagnosis of rare complications of sustained pulmonary arterial hypertension.

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

Science.gov (United States)

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

2017-10-01

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

Inattention Predicts Increased Thickness of Left Occipital Cortex in Men with Attention-Deficit/Hyperactivity Disorder

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Peter Sörös

2017-09-01

Full Text Available BackgroundAttention-deficit/hyperactivity disorder (ADHD in adulthood is a serious and frequent psychiatric disorder with the core symptoms inattention, impulsivity, and hyperactivity. The principal aim of this study was to investigate associations between brain morphology, i.e., cortical thickness and volumes of subcortical gray matter, and individual symptom severity in adult ADHD.MethodsSurface-based brain morphometry was performed in 35 women and 29 men with ADHD using FreeSurfer. Linear regressions were calculated between cortical thickness and the volumes of subcortical gray matter and the inattention, hyperactivity, and impulsivity subscales of the Conners Adult ADHD Rating Scales (CAARS. Two separate analyses were performed. For the first analysis, age was included as additional regressor. For the second analysis, both age and severity of depression were included as additional regressors. Study participants were recruited between June 2012 and January 2014.ResultsLinear regression identified an area in the left occipital cortex of men, covering parts of the middle occipital sulcus and gyrus, in which the score on the CAARS inattention subscale predicted increased mean cortical thickness [F(1,27 = 26.27, p < 0.001, adjusted R2 = 0.4744]. No significant associations were found between cortical thickness and the scores on CAARS subscales in women. No significant associations were found between the volumes of subcortical gray matter and the scores on CAARS subscales, neither in men nor in women. These results remained stable when severity of depression was included as additional regressor, together with age.ConclusionIncreased cortical thickness in the left occipital cortex may represent a mechanism to compensate for dysfunctional attentional networks in male adult ADHD patients.

Inverted Lobes Have Satisfactory Functions Compared With Noninverted Lobes in Lung Transplantation.

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Kayawake, Hidenao; Chen-Yoshikawa, Toyofumi F; Motoyama, Hideki; Hamaji, Masatsugu; Hijiya, Kyoko; Aoyama, Akihiro; Goda, Yasufumi; Oda, Hiromi; Ueda, Satoshi; Date, Hiroshi

2018-04-01

To overcome the problem of small-for-size grafts in standard living-donor lobar lung transplantation (LDLLT), we developed inverted LDLLT, in which a right lower lobe from 1 donor is implanted as a right graft and another right lower lobe from another donor is implanted as a left graft. We retrospectively analyzed the functions of inverted grafts vs noninverted grafts. Between 2008 and 2015, 64 LDLLTs were performed. Included were 35 LDLLTs whose recipients were adults and monitored for more than 6 months without developing chronic lung allograft dysfunction. Among them, 65 implanted lobes were eligible for this analysis. There were 31 right lower lobes implanted as right grafts (right-to-right group), 7 right lower lobes as inverted left grafts (right-to-left group), and 27 left lower lobes as left grafts (left-to-left group). We evaluated the graft forced vital capacity (G-FVC) and graft volume of the 65 lobes before and 6 months after LDLLT and compared them among the three groups. Preoperatively, G-FVC in the right-to-left group (1,050 mL) was comparable to that in the right-to-right group (1,177 mL) and better than that in the left-to-left group (791 mL, p satisfactory compared with those of noninverted grafts. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

BULLOUS DEGENERATION OF THE LEFT LOWER LOBE IN A HEROIN-ADDICT

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SMEENK, FWJM; SERLIE, J; VANDERJAGT, EJ; POSTMUS, PE

1990-01-01

A 34 yr old heroin addict was referred because of chest pain caused by air-trapping in a bulla in the left lower lobe. There was a marked difference between the functional residual capacity measured by body-plethysmography and helium dilution. A slow wash-in and wash-out were demonstrated by

Processing of Words and Faces by Patients with Left and Right Temporal Lobe Epilepsy

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Andrew W. Ellis

1991-01-01

Full Text Available Tests of word and face processing were given to patients with complex partial epilepsy focussed on the left or right temporal lobe, and to non-epileptic control subjects. The left TLE group showed the greatest impairment on object naming and on reading tests, but the right TLE group also showed a lesser impairment relative to the normal control subjects on both tests. The right TLE group was selectively impaired on distinguishing famous from non-famous faces while the left TLE group was impaired at naming famous faces they had successfully recognized as familiar. There was no significant difference between the three groups on recognition memory for words. The implications of the results for theories of the role of the temporal lobes in word and face processing, and the possible neural mechanisms responsible for the deficits in TLE patients, are discussed.

A Technique for Resecting Occipital Pole Gliomas Using a Keyhole Lobectomy.

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Conner, Andrew K; Baker, Cordell M; Briggs, Robert G; Burks, Joshua D; Glenn, Chad A; Smitherman, Adam D; Morgan, Jake P; Pittman, Nathan A; Sughrue, Michael E

2017-10-01

Our purpose is to describe a method of resecting occipital pole gliomas through a keyhole lobectomy and share the patient outcomes of this technique. We performed a retrospective review of data obtained on all patients who underwent resection of occipital pole gliomas by the senior author between 2012 and 2016. We describe our technique for resecting these tumors using a keyhole lobectomy and share the patient outcomes of this operation. Eight patients were included in this study. Four patients (50%) had not received previous surgery. One patient (13%) was diagnosed with a World Health Organization grade II tumor, and 7 patients (88%) were diagnosed with glioblastoma. Two tumors (25%) were left sided and 6 (75%) right sided. The median size of resection was 28 cm 3 . The median extent of resection was 96%, and at least 90% of the tumor was resected in all cases. None of the patients experienced permanent postoperative complications. Temporary neurologic complications included 3 patients (38%) with encephalopathy and 1 patient (13%) with aphasia. There were no neurosurgical complications. Our study provides details on the technical aspects of occipital keyhole lobectomies and gives the outcomes of patients who have received an operation for tumors in this uncommon location. Taking white matter tract anatomy into consideration, we show that the keyhole method can be applied to gliomas of the occipital lobe. Copyright © 2017 Elsevier Inc. All rights reserved.

Disentangling the cognitive components supporting Austin Maze performance in left versus right temporal lobe epilepsy.

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Hocking, Julia; Thomas, Hannah J; Dzafic, Ilvana; Williams, Rebecca J; Reutens, David C; Spooner, Donna M

2013-12-01

Neuropsychological tests requiring patients to find a path through a maze can be used to assess visuospatial memory performance in temporal lobe pathology, particularly in the hippocampus. Alternatively, they have been used as a task sensitive to executive function in patients with frontal lobe damage. We measured performance on the Austin Maze in patients with unilateral left and right temporal lobe epilepsy (TLE), with and without hippocampal sclerosis, compared to healthy controls. Performance was correlated with a number of other neuropsychological tests to identify the cognitive components that may be associated with poor Austin Maze performance. Patients with right TLE were significantly impaired on the Austin Maze task relative to patients with left TLE and controls, and error scores correlated with their performance on the Block Design task. The performance of patients with left TLE was also impaired relative to controls; however, errors correlated with performance on tests of executive function and delayed recall. The presence of hippocampal sclerosis did not have an impact on maze performance. A discriminant function analysis indicated that the Austin Maze alone correctly classified 73.5% of patients as having right TLE. In summary, impaired performance on the Austin Maze task is more suggestive of right than left TLE; however, impaired performance on this visuospatial task does not necessarily involve the hippocampus. The relationship of the Austin Maze task with other neuropsychological tests suggests that differential cognitive components may underlie performance decrements in right versus left TLE. © 2013.

Analysis of the volumetric relationship among human ocular, orbital and fronto-occipital cortical morphology

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Masters, Michael; Bruner, Emiliano; Queer, Sarah; Traynor, Sarah; Senjem, Jess

2015-01-01

Recent research on the visual system has focused on investigating the relationship among eye (ocular), orbital, and visual cortical anatomy in humans. This issue is relevant in evolutionary and medical fields. In terms of evolution, only in modern humans and Neandertals are the orbits positioned beneath the frontal lobes, with consequent structural constraints. In terms of medicine, such constraints can be associated with minor deformation of the eye, vision defects, and patterns of integration among these features, and in association with the frontal lobes, are important to consider in reconstructive surgery. Further study is therefore necessary to establish how these variables are related, and to what extent ocular size is associated with orbital and cerebral cortical volumes. Relationships among these anatomical components were investigated using magnetic resonance images from a large sample of 83 individuals, which also included each subject’s body height, age, sex, and uncorrected visual acuity score. Occipital and frontal gyri volumes were calculated using two different cortical parcellation tools in order to provide a better understanding of how the eye and orbit vary in relation to visual cortical gyri, and frontal cortical gyri which are not directly related to visual processing. Results indicated that ocular and orbital volumes were weakly correlated, and that eye volume explains only a small proportion of the variance in orbital volume. Ocular and orbital volumes were also found to be equally and, in most cases, more highly correlated with five frontal lobe gyri than with occipital lobe gyri associated with V1, V2, and V3 of the visual cortex. Additionally, after accounting for age and sex variation, the relationship between ocular and total visual cortical volume was no longer statistically significant, but remained significantly related to total frontal lobe volume. The relationship between orbital and visual cortical volumes remained significant for

Analysis of the volumetric relationship among human ocular, orbital and fronto-occipital cortical morphology.

Science.gov (United States)

Masters, Michael; Bruner, Emiliano; Queer, Sarah; Traynor, Sarah; Senjem, Jess

2015-10-01

Recent research on the visual system has focused on investigating the relationship among eye (ocular), orbital, and visual cortical anatomy in humans. This issue is relevant in evolutionary and medical fields. In terms of evolution, only in modern humans and Neandertals are the orbits positioned beneath the frontal lobes, with consequent structural constraints. In terms of medicine, such constraints can be associated with minor deformation of the eye, vision defects, and patterns of integration among these features, and in association with the frontal lobes, are important to consider in reconstructive surgery. Further study is therefore necessary to establish how these variables are related, and to what extent ocular size is associated with orbital and cerebral cortical volumes. Relationships among these anatomical components were investigated using magnetic resonance images from a large sample of 83 individuals, which also included each subject's body height, age, sex, and uncorrected visual acuity score. Occipital and frontal gyri volumes were calculated using two different cortical parcellation tools in order to provide a better understanding of how the eye and orbit vary in relation to visual cortical gyri, and frontal cortical gyri which are not directly related to visual processing. Results indicated that ocular and orbital volumes were weakly correlated, and that eye volume explains only a small proportion of the variance in orbital volume. Ocular and orbital volumes were also found to be equally and, in most cases, more highly correlated with five frontal lobe gyri than with occipital lobe gyri associated with V1, V2, and V3 of the visual cortex. Additionally, after accounting for age and sex variation, the relationship between ocular and total visual cortical volume was no longer statistically significant, but remained significantly related to total frontal lobe volume. The relationship between orbital and visual cortical volumes remained significant for a

Kinesthetic alexia due to left parietal lobe lesions.

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Ihori, Nami; Kawamura, Mitsuru; Araki, Shigeo; Kawachi, Juro

2002-01-01

To investigate the neuropsychological mechanisms of kinesthetic alexia, we asked 7 patients who showed kinesthetic alexia with preserved visual reading after damage to the left parietal region to perform tasks consisting of kinesthetic written reproduction (writing down the same letter as the kinesthetic stimulus), kinesthetic reading aloud, visual written reproduction (copying letters), and visual reading aloud of hiragana (Japanese phonograms). We compared the performance in these tasks and the lesion sites in each patient. The results suggested that deficits in any one of the following functions might cause kinesthetic alexia: (1) the retrieval of kinesthetic images (motor engrams) of characters from kinesthetic stimuli, (2) kinesthetic images themselves, (3) access to cross-modal association from kinesthetic images, and (4) cross-modal association itself (retrieval of auditory and visual images from kinesthetic images of characters). Each of these factors seemed to be related to different lesion sites in the left parietal lobe. Copyright 2002 S. Karger AG, Basel

Differential neuropsychological test sensitivity to left temporal lobe epilepsy.

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Loring, David W; Strauss, Esther; Hermann, Bruce P; Barr, William B; Perrine, Kenneth; Trenerry, Max R; Chelune, Gordon; Westerveld, Michael; Lee, Gregory P; Meador, Kimford J; Bowden, Stephen C

2008-05-01

We examined the sensitivity of the Rey Auditory Verbal Learning Test (AVLT), California Verbal Learning Test (CVLT), Boston Naming Test (BNT), and Multilingual Aphasia Examination Visual Naming subtest (MAE VN) to lateralized temporal lobe epilepsy (TLE) in patients who subsequently underwent anterior temporal lobectomy. For the AVLT (n = 189), left TLE patients performed more poorly than their right TLE counterparts [left TLE = 42.9 (10.6), right TLE = 47.7 (9.9); p LTE = 40.7 (11.1), right TLE = 43.8 (9.9); (p measures of confrontation naming ability [BNT: left LTE = 43.1 (8.9), right TLE = 48.1 (8.9); p < .001 (Cohen's d = .56); MAE VN: left TLE = 42.2, right TLE = 45.6, p = .02 (Cohen's d = .36)]. When these data were modeled in independent logistic regression analyses, the AVLT and BNT both significantly predicted side of seizure focus, although the positive likelihood ratios were modest. In the subset of 108 patients receiving both BNT and AVLT, the AVLT was the only significant predictor of seizure laterality, suggesting individual patient variability regarding whether naming or memory testing may be more sensitive to lateralized TLE.

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

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

2009-06-01

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

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

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

2015-01-01

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

Brain Herniation in Neurofibromatosis with Dysplasia of Occipital Bone and Posterior Skull Base

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Vithal Rangarajan

2015-01-01

Full Text Available A 22-year-old female, a known case of neurofibromatosis 1 (NF1, presented with a congenital swelling in the left occipital region. She had developed recent onset dysphagia and localized occipital headache. Neuroradiology revealed a left occipital meningoencephalocele and a left parapharyngeal meningocele. This was associated with ventriculomegaly. She was advised on cranioplasty along with duraplasty which she denied. She agreed to a lumbar-peritoneal shunt. She described a dramatic improvement in her symptoms following the lumbar-peritoneal shunt. Occipital dysplasias, though uncommon, have been reported in the literature. We review this case and its management and discuss relevant literature on occipital dysplasias in NF1.

Elevated occipital β-amyloid deposition is associated with widespread cognitive impairment in logopenic progressive aphasia.

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Whitwell, Jennifer L; Lowe, Val J; Duffy, Joseph R; Strand, Edythe A; Machulda, Mary M; Kantarci, Kejal; Wille, Samantha M; Senjem, Matthew L; Murphy, Matthew C; Gunter, Jeffrey L; Jack, Clifford R; Josephs, Keith A

2013-12-01

Most subjects with logopenic variant of primary progressive aphasia (lvPPA) have β-amyloid (Aβ) deposition on Pittsburgh Compound B positron emission tomography (PiB-PET), usually affecting prefrontal and temporoparietal cortices, with less occipital involvement. To assess clinical and imaging features in lvPPA subjects with unusual topographic patterns of Aβ deposition with highest uptake in occipital lobe. Thirty-three lvPPA subjects with Aβ deposition on PiB-PET were included in this case-control study. Line plots of regional PiB uptake were created, including frontal, temporal, parietal and occipital regions, for each subject. Subjects in which the line sloped downwards in occipital lobe (lvPPA-low), representing low uptake, were separated from those where the line sloped upwards in occipital lobe (lvPPA-high), representing unusually high occipital uptake compared to other regions. Clinical variables, atrophy on MRI, hypometabolism on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and presence and distribution of microbleeds and white matter hyperintensities (WMHs) were assessed. Seventeen subjects (52%) were classified as lvPPA-high. Mean occipital PiB uptake in lvPPA-high was higher than all other regions and higher than all regions in lvPPA-low. The lvPPA-high subjects performed more poorly on cognitive testing, including executive and visuospatial testing, but the two groups did not differ in aphasia severity. Proportion of microbleeds and WMH was higher in lvPPA-high than lvPPA-low. Parietal hypometabolism was greater in lvPPA-high than lvPPA-low. Unusually high occipital Aβ deposition is associated with widespread cognitive impairment and different imaging findings in lvPPA. These findings help explain clinical heterogeneity in lvPPA and suggest that Aβ influences severity of overall cognitive impairment but not aphasia.

Illusory consolidation of the left lower lobe: A pitfall of portable radiography

International Nuclear Information System (INIS)

Zylak, C.J.; Litteton, J.T.; Lighter, M.D.; Zurizch, M.L.

1986-01-01

A frequent finding on a portable chest radiography is obscuration of the left hemidiaphragm. Experimental evidence based on radiography of a frozen unembalmed human chest phantom corroborated the hypothesis that this finding can be the result of tube angulation. Clinical examples are provided that supplement the experimental evidence. To avoid this potential pitfall it is essential that the patient be imaged in a position which will ensure that the hemidiaphragm is tangent to the beam. To do otherwise can mislead, creating the false impression of disease in the left lower lobe or pleural space

Rudhe syndrome: reversible right middle lobe emphysema in infants with left-to-right shunts - an historical review

International Nuclear Information System (INIS)

Collins, Lee K.; Levin, Terry L.; Berdon, Walter E.; Cowles, Robert A.; Newman, Beverley

2010-01-01

In 1971, the Swedish radiologist Ulf Rudhe wrote a provocative paper on right middle lobe emphysema in infants with left-to-right shunts in which he suggested cardiac surgery rather than lung resection. At the time, this was counter to accepted medical practice. Earlier diagnosis and better medical management of ventricular septal defect in infants has proved Rudhe correct. However, two current cases of large left-to-right shunts in infants with emphysema of the right middle lobe prompt this historical review of what seemed a closed-episode in pediatric cardiac surgery. (orig.)

The extratemporal lobe epilepsies in the epilepsy monitoring unit

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Dash, Deepa; Tripathi, Manjari

2014-01-01

Extratemporal lobe epilepsies (ETLE) are characterized by the epileptogenic foci outside the temporal lobe. They have a wide spectrum of semiological presentation depending upon the site of origin. They can arise from frontal, parietal, occipital lobes and from hypothalamic hamartoma. We discuss in this review the semiology of different types of ETLE encountered in the epilepsy monitoring unit. PMID:24791090

Transient facial nerve palsy after occipital nerve block: a case report.

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Strauss, Lauren; Loder, Elizabeth; Rizzoli, Paul

2014-01-01

Occipital nerve blocks are commonly performed to treat a variety of headache syndromes and are generally believed to be safe and well tolerated. We report the case of an otherwise healthy 24-year-old woman with left side-locked occipital, parietal, and temporal pain who was diagnosed with probable occipital neuralgia. She developed complete left facial nerve palsy within minutes of blockade of the left greater and lesser occipital nerves with a solution of bupivicaine and triamcinolone. Magnetic resonance imaging of the brain with gadolinium contrast showed no abnormalities, and symptoms had completely resolved 4-5 hours later. Unintended spread of the anesthetic solution along tissue planes seems the most likely explanation for this adverse event. An aberrant course of the facial nerve or connections between the facial and occipital nerves also might have played a role, along with the patient's prone position and the use of a relatively large injection volume of a potent anesthetic. Clinicians should be aware that temporary facial nerve palsy is a possible complication of occipital nerve block. © 2014 American Headache Society.

A conceptual lemon: theta burst stimulation to the left anterior temporal lobe untangles object representation and its canonical color.

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Chiou, Rocco; Sowman, Paul F; Etchell, Andrew C; Rich, Anina N

2014-05-01

Object recognition benefits greatly from our knowledge of typical color (e.g., a lemon is usually yellow). Most research on object color knowledge focuses on whether both knowledge and perception of object color recruit the well-established neural substrates of color vision (the V4 complex). Compared with the intensive investigation of the V4 complex, we know little about where and how neural mechanisms beyond V4 contribute to color knowledge. The anterior temporal lobe (ATL) is thought to act as a "hub" that supports semantic memory by integrating different modality-specific contents into a meaningful entity at a supramodal conceptual level, making it a good candidate zone for mediating the mappings between object attributes. Here, we explore whether the ATL is critical for integrating typical color with other object attributes (object shape and name), akin to its role in combining nonperceptual semantic representations. In separate experimental sessions, we applied TMS to disrupt neural processing in the left ATL and a control site (the occipital pole). Participants performed an object naming task that probes color knowledge and elicits a reliable color congruency effect as well as a control quantity naming task that also elicits a cognitive congruency effect but involves no conceptual integration. Critically, ATL stimulation eliminated the otherwise robust color congruency effect but had no impact on the numerical congruency effect, indicating a selective disruption of object color knowledge. Neither color nor numerical congruency effects were affected by stimulation at the control occipital site, ruling out nonspecific effects of cortical stimulation. Our findings suggest that the ATL is involved in the representation of object concepts that include their canonical colors.

Potential role of a cognitive rehabilitation program following left temporal lobe epilepsy surgery

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Camila de Vasconcelos Geraldi

Full Text Available ABSTRACT Research into memory and epilepsy has focused on measuring problems and exploring causes with limited attention directed at the role of neuropsychological rehabilitation in alleviating post-operative memory difficulties. Objectives To assess the effects of a memory rehabilitation program in patients with left temporal lobe epilepsy following surgery. Methods Twenty-four patients agreed to participate and 18 completed the study; nine received memory rehabilitation while nine had no input and were designated as controls. Verbal learning efficiency, naming abilities, memory subjective ratings, ecological activity measures and a language fMRI paradigm were used as outcome measures. Results Improved verbal learning and naming test performance, increase in memory strategy use and improved self-perception were observed following the rehabilitation. Changes in fMRI activation patterns were seen in the rehabilitation group over the long term. Conclusion The findings support the potential role of a cognitive rehabilitation program following left temporal lobe surgery.

Reduced sensitivity of the N400 and late positive component to semantic congruity and word repetition in left temporal lobe epilepsy.

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Olichney, John M; Riggins, Brock R; Hillert, Dieter G; Nowacki, Ralph; Tecoma, Evelyn; Kutas, Marta; Iragui, Vicente J

2002-07-01

We studied 14 patients with well-characterized refractory temporal lobe epilepsy (TLE), 7 with right temporal lobe epilepsy (RTE) and 7 with left temporal lobe epilepsy (LTE), on a word repetition ERP experiment. Much prior literature supports the view that patients with left TLE are more likely to develop verbal memory deficits, often attributable to left hippocampal sclerosis. Our main objectives were to test if abnormalities of the N400 or Late Positive Component (LPC, P600) were associated with a left temporal seizure focus, or left temporal lobe dysfunction. A minimum of 19 channels of EEG/EOG data were collected while subjects performed a semantic categorization task. Auditory category statements were followed by a visual target word, which were 50% "congruous" (category exemplars) and 50% "incongruous" (non-category exemplars) with the preceding semantic context. These auditory-visual pairings were repeated pseudo-randomly at time intervals ranging from approximately 10-140 seconds later. The ERP data were submitted to repeated-measures ANOVAs, which showed the RTE group had generally normal effects of word repetition on the LPC and the N400. Also, the N400 component was larger to incongruous than congruous new words, as is normally the case. In contrast, the LTE group did not have statistically significant effects of either word repetition or congruity on their ERPs (N400 or LPC), suggesting that this ERP semantic categorization paradigm is sensitive to left temporal lobe dysfunction. Further studies are ongoing to determine if these ERP abnormalities predict hippocampal sclerosis on histopathology, or outcome after anterior temporal lobectomy.

A new method for automated high-dimensional lesion segmentation evaluated in vascular injury and applied to the human occipital lobe.

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Mah, Yee-Haur; Jager, Rolf; Kennard, Christopher; Husain, Masud; Nachev, Parashkev

2014-07-01

Making robust inferences about the functional neuroanatomy of the brain is critically dependent on experimental techniques that examine the consequences of focal loss of brain function. Unfortunately, the use of the most comprehensive such technique-lesion-function mapping-is complicated by the need for time-consuming and subjective manual delineation of the lesions, greatly limiting the practicability of the approach. Here we exploit a recently-described general measure of statistical anomaly, zeta, to devise a fully-automated, high-dimensional algorithm for identifying the parameters of lesions within a brain image given a reference set of normal brain images. We proceed to evaluate such an algorithm in the context of diffusion-weighted imaging of the commonest type of lesion used in neuroanatomical research: ischaemic damage. Summary performance metrics exceed those previously published for diffusion-weighted imaging and approach the current gold standard-manual segmentation-sufficiently closely for fully-automated lesion-mapping studies to become a possibility. We apply the new method to 435 unselected images of patients with ischaemic stroke to derive a probabilistic map of the pattern of damage in lesions involving the occipital lobe, demonstrating the variation of anatomical resolvability of occipital areas so as to guide future lesion-function studies of the region. Copyright © 2012 Elsevier Ltd. All rights reserved.

Occipital deep white matter hyperintensity as seen by MRI, 1

International Nuclear Information System (INIS)

Miyazaki, Masahito; Hashimoto, Toshiaki; Tayama, Masanobu; Kuroda, Yasuhiro

1992-01-01

Magnetic resonance imaging was performed in 270 patients with various neurologic complaints (1-15Y) with a 0.5 tesla superconducting imaging system using a field echo T1-weighted sequence and spin echo T2-weighted and PD-weighted sequences. Twenty-seven of them had deep white matter hyperintensity (DWMH) in the occipital lobe on T2-weighted images. The frequency of mild DWMH differed in different age groups, suggesting that mild DWMH may result from delayed myelination in the central nervous system. However, the frequency of severe DWMH, which was revealed as isointense relative to cerebrospinal fluid, did not differ in different age groups and it was significantly more common in severely retarded patients. Classification of DWMH based on the signal intensity is valuable to distinguish white matter abnormalities in the occipital lobe from delayed myelination in the same site. (author)

The occipital cortex in detection and categorisation abilities: an fMRI study in hemianopia

International Nuclear Information System (INIS)

Perez, C.; Coubard, O.; Cavezian, C.; Gout, O.; Chokron, S.; Peyrin, C.; Andersson, F.; Doucet, G.

2011-01-01

Complete text of publication follows: Previous studies have shown that the right and left hemispheres are predominant for detection and categorization tasks, respectively. This asymmetry appears to be instantiated at a processing stage as early as the occipital cortex. The present study was intended to assess the cerebral network responsible for natural scenes perception in hemianopic patients suffering from an occipital cortex lesion. One Left and one Right hemianopic patient (LH or RH; respectively right and left occipital damage) were compared with 14 healthy controls in detection and categorisation tasks of natural scenes. Both tasks were performed in a 1.5 T scanner to collect anatomical and functional data. In healthy controls, occipital activation was observed in the extra-striate areas of both hemispheres in the detection task but only of the left hemisphere in the categorization task. The LH (patient showed a bilateral occipital activation in both tasks. while, the RH patient showed unilateral right (intact) occipital activation in both tasks. These results highlight the importance of the perceptual task (detection vs. categorization) on the hemispheric asymmetry. They also suggest that different cortical reorganisations take place depending on the occipital lesion side

Human V4 and ventral occipital retinotopic maps

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Winawer, Jonathan; Witthoft, Nathan

2016-01-01

The ventral surface of the human occipital lobe contains multiple retinotopic maps. The most posterior of these maps is considered a potential homolog of macaque V4, and referred to as human V4 (‘hV4’). The location of the hV4 map, its retinotopic organization, its role in visual encoding, and the cortical areas it borders have been the subject of considerable investigation and debate over the last 25 years. We review the history of this map and adjacent maps in ventral occipital cortex, and consider the different hypotheses for how these ventral occipital maps are organized. Advances in neuroimaging, computational modeling, and characterization of the nearby anatomical landmarks and functional brain areas have improved our understanding of where human V4 is and what kind of visual representations it contains. PMID:26241699

A functional MRI study of language networks in left medial temporal lobe epilepsy

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Yu Aihong, E-mail: yuaihong163@tom.com [Department of Radiology, the 4th Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China); Wang Xiaoyi; Xu Guoqing [Beijing Normal University, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing 100875 (China); Li Yongjie [Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China); Qin Wen; Li Kuncheng [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences (China); Wang, Yuping [Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences (China)

2011-11-15

Purpose: The purpose of this study was to investigate the abnormality of language networks in left medial temporal lobe epilepsy (MTLE) using fMRI. Materials and methods: Eight patients with left MTLE and 15 healthy subjects were evaluated. An auditory semantic judgment (AJ) paradigm was used. The fMRI data were collected on a 3T MR system and analyzed by AFNI (analysis of functional neuroimages) to generate the activation map. Results: Behavioral data showed that the reaction time of the left MTLE patients was significantly longer than that of controls on the AJ task (t = -3.396, P < 0.05). The left MTLE patients also exhibited diffusively decreased activation in the AJ task. Right hemisphere dominance of Broca's and Wernicke's areas was demonstrated in left MTLE patients. Conclusions: Long-term activation of spikes in left MTLE patients results in language impairment, which is associated with an abnormality of the brain neural network.

A functional MRI study of language networks in left medial temporal lobe epilepsy

International Nuclear Information System (INIS)

Yu Aihong; Wang Xiaoyi; Xu Guoqing; Li Yongjie; Qin Wen; Li Kuncheng; Wang, Yuping

2011-01-01

Purpose: The purpose of this study was to investigate the abnormality of language networks in left medial temporal lobe epilepsy (MTLE) using fMRI. Materials and methods: Eight patients with left MTLE and 15 healthy subjects were evaluated. An auditory semantic judgment (AJ) paradigm was used. The fMRI data were collected on a 3T MR system and analyzed by AFNI (analysis of functional neuroimages) to generate the activation map. Results: Behavioral data showed that the reaction time of the left MTLE patients was significantly longer than that of controls on the AJ task (t = -3.396, P < 0.05). The left MTLE patients also exhibited diffusively decreased activation in the AJ task. Right hemisphere dominance of Broca's and Wernicke's areas was demonstrated in left MTLE patients. Conclusions: Long-term activation of spikes in left MTLE patients results in language impairment, which is associated with an abnormality of the brain neural network.

Hyperfamiliarity for unknown faces after left lateral temporo-occipital venous infarction: a double dissociation with prosopagnosia.

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Vuilleumier, Patrik; Mohr, Christine; Valenza, Nathalie; Wetzel, Corinne; Landis, Theodor

2003-04-01

Right hemisphere dominance in face processing is well established and unilateral right inferior temporo-occipital damage can result in prosopagnosia. Here, we describe a 21-year-old right-handed woman with acute impairment in face recognition that selectively concerned unfamiliar faces, following a focal left lateral temporo-occipital venous infarct. She was severely impaired in discerning that unknown people seen in everyday life were unfamiliar, although she had no difficulty recognizing familiar people. Thus, she had no prosopagnosia, but abnormal 'hyperfamiliarity' for unknown faces. Her difficulty was not accompanied by delusions or deficits in discrimination, identification or memory for faces. Standard neuropsychological testing showed that her recognition of familiar faces was entirely normal. By contrast, her sense of personally knowing faces was severely impaired when unknown faces evoked weak signals of familiarity based on spurious cues, to the extent that she would misattribute fame to faces that were unknown but to which she had been incidentally exposed on a prior occasion. Priming experiments also revealed that, unlike normal subjects, she made familiarity judgements without accessing semantic identity representations. Moreover, in face recognition tests, she generally showed bias in that she relied more on right-hemisphere strategies to identify global traits and less on left-hemisphere processes compared with healthy subjects. This case provides novel evidence for a differential contribution of the two hemispheres to face recognition. Hyperfamiliarity for unknown faces might arise from an imbalance between reciprocal hemispheric functions in face recognition, with relative hypoactivation of left hemisphere processes but hyperactivation of right-hemisphere processes for retrieving stored associations about people, linking seen faces to representations of affective and personal relevance. Hence, abnormal bias in attributing some personal meaning to

Intractable Occipital Neuralgia Caused by an Entrapment in the Semispinalis Capitis

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Kim, Deok-ryeong; Lee, Sang-won

2013-01-01

Occipital neuralgia is a rare pain syndrome characterized by periodic lancinating pain involving the occipital nerve complex. We present a unique case of entrapment of the greater occipital nerve (GON) within the semispinalis capitis, which was thought to be the cause of occipital neuralgia. A 66-year-old woman with refractory left occipital neuralgia revealed an abnormally low-loop of the left posterior inferior cerebellar artery on the magnetic resonance imaging, suggesting possible vascular compression of the upper cervical roots. During exploration, however, the GON was found to be entrapped at the perforation site of the semispinalis capitis. There was no other compression of the GON or of C1 and C2 dorsal roots in their intracranial course. Postoperatively, the patient experienced almost complete relief of typical neuralgic pain. Although occipital neuralgia has been reported to occur by stretching of the GON by inferior oblique muscle or C1-C2 arthrosis, peripheral compression in the transmuscular course of the GON in the semispinalis capitis as a cause of refractory occipital neuralgia has not been reported and this should be considered when assessing surgical options for refractory occipital neuralgia. PMID:24278663

Statistical parametric mapping for analyzing interictal magnetoencephalography in patients with left frontal lobe epilepsy.

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Zhu, Haitao; Zhu, Jinlong; Bao, Forrest Sheng; Liu, Hongyi; Zhu, Xuchuang; Wu, Ting; Yang, Lu; Zou, Yuanjie; Zhang, Rui; Zheng, Gang

2016-01-01

Frontal lobe epilepsy is a common epileptic disorder and is characterized by recurring seizures that arise in the frontal lobes. The purpose of this study is to identify the epileptogenic regions and other abnormal regions in patients with left frontal lobe epilepsy (LFLE) based on the magnetoencephalogram (MEG), and to understand the effects of clinical variables on brain activities in patients with LFLE. Fifteen patients with LFLE (23.20 ± 8.68 years, 6 female and 9 male) and 16 healthy controls (23.13 ± 7.66 years, 6 female and 10 male) were included in resting-stage MEG examinations. Epileptogenic regions of LFLE patients were confirmed by surgery. Regional brain activations were quantified using statistical parametric mapping (SPM). The correlation between the activations of the abnormal brain regions and the clinical seizure parameters were computed for LFLE patients. Brain activations of LFLE patients were significantly elevated in left superior/middle/inferior frontal gyri, postcentral gyrus, inferior temporal gyrus, insula, parahippocampal gyrus and amygdala, including the epileptogenic regions. Remarkable decreased activations were found mainly in the left parietal gyrus and precuneus. There is a positive correlation between the duration of the epilepsy (in month) and activations of the abnormal regions, while no relation was found between age of seizure onset (year), seizure frequency and the regions of the abnormal activity of the epileptic patients. Our findings suggest that the aberrant brain activities of LFLE patients were not restricted to the epileptogenic zones. Long duration of epilepsy might induce further functional damage in patients with LFLE. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Inattention Predicts Increased Thickness of Left Occipital Cortex in Men with Attention-Deficit/Hyperactivity Disorder.

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Sörös, Peter; Bachmann, Katharina; Lam, Alexandra P; Kanat, Manuela; Hoxhaj, Eliza; Matthies, Swantje; Feige, Bernd; Müller, Helge H O; Thiel, Christiane; Philipsen, Alexandra

2017-01-01

Attention-deficit/hyperactivity disorder (ADHD) in adulthood is a serious and frequent psychiatric disorder with the core symptoms inattention, impulsivity, and hyperactivity. The principal aim of this study was to investigate associations between brain morphology, i.e., cortical thickness and volumes of subcortical gray matter, and individual symptom severity in adult ADHD. Surface-based brain morphometry was performed in 35 women and 29 men with ADHD using FreeSurfer. Linear regressions were calculated between cortical thickness and the volumes of subcortical gray matter and the inattention, hyperactivity, and impulsivity subscales of the Conners Adult ADHD Rating Scales (CAARS). Two separate analyses were performed. For the first analysis, age was included as additional regressor. For the second analysis, both age and severity of depression were included as additional regressors. Study participants were recruited between June 2012 and January 2014. Linear regression identified an area in the left occipital cortex of men, covering parts of the middle occipital sulcus and gyrus, in which the score on the CAARS inattention subscale predicted increased mean cortical thickness [ F (1,27) = 26.27, p  attentional networks in male adult ADHD patients.

Evaluation of lateral margin of left lobe of the liver on CT scan : focus on perisplenic extension

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Seo, Chang Hye; Cha, Seong Sook; Lee, Byung Jin; Choi, Jae Young; Choi, Seok Jin; Eun, Choong Ki

1996-01-01

The perisplenic extension of the left lobe of the liver can be misinterpreted as a splenic or perisplenic lesion on ultrasonography(US) and computed tomography(CT). The purpose of our study is to classify the lateral margin of the left lobe of the liver into three types and to evaluate the incidence and the relationship between each type and abnormal liver on CT scan. A total of 515 abdominal CT scans from patients over 15 years old were retrospectively evaluated. Liver contours were divided into three types on the basis of degree of the left lateral extension of the left lobe of the liver. Type A was defined as the lateral extension of the left lobe of liver to the medial portion of the stomach, type C as the perisplenic portion, and type B as between the two types. Each type was further divided into normal and abnormal liver groups based on clinical, CT, surgical and patholigic findings and evaluated on its ratio of normal and abnormal liver, intrahepatic diseases associated with an abnormal liver and statistical significance between a normal and abnormal liver. The incidence of the three types of liver among the 515 patients was 360(69.9%), 121(23.5%) and 34(6.6%) patients in type A, B and C, respectively. Type C showed normal liver in six patients, which was 2.7% of all normal livers(221/515) and abnormal liver in 28 patients, which was 9.5% of all abnormal livers(294/515). Type A showed normal liver in 49.7%, abnormal liver in 50.3% and there was not statistically significant difference between normal and abnormal liver(p>0.05). Type B showed normal liver in 29.8% and abnormal liver in 70.2%;type C showed normal liver in 17.6%, abnormal liver in 82.4% and there was a statistically significant difference between normal and abnormal liver(P<0.001). The space occupying lesion(SOL) was most common(52.6%) in all the abnormal livers and hepatoma was the most common disease in the SOL(47.2%). In the abnormal type C liver, SOL(58%) and diffuse hepatopathy(32.8%) were

OCCIPITAL SOURCES OF RESTING STATE ALPHA RHYTHMS ARE RELATED TO LOCAL GRAY MATTER DENSITY IN SUBJECTS WITH AMNESIC MILD COGNITIVE IMPAIRMENT AND ALZHEIMER’S DISEASE

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Claudio, Babiloni; Claudio, Del Percio; Marina, Boccardi; Roberta, Lizio; Susanna, Lopez; Filippo, Carducci; Nicola, Marzano; Andrea, Soricelli; Raffaele, Ferri; Ivano, Triggiani Antonio; Annapaola, Prestia; Serenella, Salinari; Rasser Paul, E; Erol, Basar; Francesco, Famà; Flavio, Nobili; Görsev, Yener; Durusu, Emek-Savaş Derya; Gesualdo, Loreto; Ciro, Mundi; Thompson Paul, M; Rossini Paolo, M.; Frisoni Giovanni, B

2014-01-01

Occipital sources of resting state electroencephalographic (EEG) alpha rhythms are abnormal, at the group level, in patients with amnesic mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Here we evaluated the hypothesis that amplitude of these occipital sources is related to neurodegeneration in occipital lobe as measured by magnetic resonance imaging (MRI). Resting-state eyes-closed EEG rhythms were recorded in 45 healthy elderly (Nold), 100 MCI, and 90 AD subjects. Neurodegeneration of occipital lobe was indexed by weighted averages of gray matter density (GMD), estimated from structural MRIs. EEG rhythms of interest were alpha 1 (8–10.5 Hz) and alpha 2 (10.5–13 Hz). EEG cortical sources were estimated by low resolution brain electromagnetic tomography (LORETA). Results showed a positive correlation between occipital GMD and amplitude of occipital alpha 1 sources in Nold, MCI and AD subjects as a whole group (r=0.3, p=0.000004, N=235). Furthermore, there was a positive correlation between amplitude of occipital alpha 1 sources and cognitive status as revealed by Mini Mental State Evaluation (MMSE) score across all subjects (r=0.38, p=0.000001, N=235). Finally, amplitude of occipital alpha 1 sources allowed a moderate classification of individual Nold and AD subjects (sensitivity: 87.8%; specificity: 66.7%; area under the Receiver Operating Characteristic (ROC) curve: 0.81). These results suggest that the amplitude of occipital sources of resting state alpha rhythms is related to AD neurodegeneration in occipital lobe along pathological aging. PMID:25442118

High resolution anatomical and quantitative MRI of the entire human occipital lobe ex vivo at 9.4T.

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Sengupta, S; Fritz, F J; Harms, R L; Hildebrand, S; Tse, D H Y; Poser, B A; Goebel, R; Roebroeck, A

2018-03-01

Several magnetic resonance imaging (MRI) contrasts are sensitive to myelin content in gray matter in vivo which has ignited ambitions of MRI-based in vivo cortical histology. Ultra-high field (UHF) MRI, at fields of 7T and beyond, is crucial to provide the resolution and contrast needed to sample contrasts over the depth of the cortex and get closer to layer resolved imaging. Ex vivo MRI of human post mortem samples is an important stepping stone to investigate MRI contrast in the cortex, validate it against histology techniques applied in situ to the same tissue, and investigate the resolutions needed to translate ex vivo findings to in vivo UHF MRI. Here, we investigate key technology to extend such UHF studies to large human brain samples while maintaining high resolution, which allows investigation of the layered architecture of several cortical areas over their entire 3D extent and their complete borders where architecture changes. A 16 channel cylindrical phased array radiofrequency (RF) receive coil was constructed to image a large post mortem occipital lobe sample (~80×80×80mm 3 ) in a wide-bore 9.4T human scanner with the aim of achieving high-resolution anatomical and quantitative MR images. Compared with a human head coil at 9.4T, the maximum Signal-to-Noise ratio (SNR) was increased by a factor of about five in the peripheral cortex. Although the transmit profile with a circularly polarized transmit mode at 9.4T is relatively inhomogeneous over the large sample, this challenge was successfully resolved with parallel transmit using the kT-points method. Using this setup, we achieved 60μm anatomical images for the entire occipital lobe showing increased spatial definition of cortical details compared to lower resolutions. In addition, we were able to achieve sufficient control over SNR, B 0 and B 1 homogeneity and multi-contrast sampling to perform quantitative T 2 * mapping over the same volume at 200μm. Markov Chain Monte Carlo sampling provided

Weighing the value of memory loss in the surgical evaluation of left temporal lobe epilepsy: a decision analysis.

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Akama-Garren, Elliot H; Bianchi, Matt T; Leveroni, Catherine; Cole, Andrew J; Cash, Sydney S; Westover, M Brandon

2014-11-01

Anterior temporal lobectomy is curative for many patients with disabling medically refractory temporal lobe epilepsy, but carries an inherent risk of disabling verbal memory loss. Although accurate prediction of iatrogenic memory loss is becoming increasingly possible, it remains unclear how much weight such predictions should have in surgical decision making. Here we aim to create a framework that facilitates a systematic and integrated assessment of the relative risks and benefits of surgery versus medical management for patients with left temporal lobe epilepsy. We constructed a Markov decision model to evaluate the probabilistic outcomes and associated health utilities associated with choosing to undergo a left anterior temporal lobectomy versus continuing with medical management for patients with medically refractory left temporal lobe epilepsy. Three base-cases were considered, representing a spectrum of surgical candidates encountered in practice, with varying degrees of epilepsy-related disability and potential for decreased quality of life in response to post-surgical verbal memory deficits. For patients with moderately severe seizures and moderate risk of verbal memory loss, medical management was the preferred decision, with increased quality-adjusted life expectancy. However, the preferred choice was sensitive to clinically meaningful changes in several parameters, including quality of life impact of verbal memory decline, quality of life with seizures, mortality rate with medical management, probability of remission following surgery, and probability of remission with medical management. Our decision model suggests that for patients with left temporal lobe epilepsy, quantitative assessment of risk and benefit should guide recommendation of therapy. In particular, risk for and potential impact of verbal memory decline should be carefully weighed against the degree of disability conferred by continued seizures on a patient-by-patient basis. Wiley

Amount of lifetime video gaming is positively associated with entorhinal, hippocampal and occipital volume.

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Kühn, S; Gallinat, J

2014-07-01

Playing video games is a popular leisure activity among children and adults, and may therefore potentially influence brain structure. We have previously shown a positive association between probability of gray matter (GM) volume in the ventral striatum and frequent video gaming in adolescence. Here we set out to investigate structural correlates of video gaming in adulthood, as the effects observed in adolescents may reflect only a fraction of the potential neural long-term effects seen in adults. On magnetic resonance imaging (MRI) scans of 62 male adults, we computed voxel-based morphometry to explore the correlation of GM with the lifetime amount of video gaming (termed joystick years). We found a significant positive association between GM in bilateral parahippocamal region (entorhinal cortex) and left occipital cortex/inferior parietal lobe and joystick years (Pvideo game genres played, such as logic/puzzle games and platform games contributing positively, and action-based role-playing games contributing negatively. Furthermore, joystick years were positively correlated with hippocampus volume. The association of lifetime amount of video game playing with bilateral entorhinal cortex, hippocampal and occipital GM volume could reflect adaptive neural plasticity related to navigation and visual attention.

The anatomy of fronto-occipital connections from early blunt dissections to contemporary tractography.

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Forkel, Stephanie J; Thiebaut de Schotten, Michel; Kawadler, Jamie M; Dell'Acqua, Flavio; Danek, Adrian; Catani, Marco

2014-07-01

The occipital and frontal lobes are anatomically distant yet functionally highly integrated to generate some of the most complex behaviour. A series of long associative fibres, such as the fronto-occipital networks, mediate this integration via rapid feed-forward propagation of visual input to anterior frontal regions and direct top-down modulation of early visual processing. Despite the vast number of anatomical investigations a general consensus on the anatomy of fronto-occipital connections is not forthcoming. For example, in the monkey the existence of a human equivalent of the 'inferior fronto-occipital fasciculus' (iFOF) has not been demonstrated. Conversely, a 'superior fronto-occipital fasciculus' (sFOF), also referred to as 'subcallosal bundle' by some authors, is reported in monkey axonal tracing studies but not in human dissections. In this study our aim is twofold. First, we use diffusion tractography to delineate the in vivo anatomy of the sFOF and the iFOF in 30 healthy subjects and three acallosal brains. Second, we provide a comprehensive review of the post-mortem and neuroimaging studies of the fronto-occipital connections published over the last two centuries, together with the first integral translation of Onufrowicz's original description of a human fronto-occipital fasciculus (1887) and Muratoff's report of the 'subcallosal bundle' in animals (1893). Our tractography dissections suggest that in the human brain (i) the iFOF is a bilateral association pathway connecting ventro-medial occipital cortex to orbital and polar frontal cortex, (ii) the sFOF overlaps with branches of the superior longitudinal fasciculus (SLF) and probably represents an 'occipital extension' of the SLF, (iii) the subcallosal bundle of Muratoff is probably a complex tract encompassing ascending thalamo-frontal and descending fronto-caudate connections and is therefore a projection rather than an associative tract. In conclusion, our experimental findings and review of the

Differences in graph theory functional connectivity in left and right temporal lobe epilepsy.

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Chiang, Sharon; Stern, John M; Engel, Jerome; Levin, Harvey S; Haneef, Zulfi

2014-12-01

To investigate lateralized differences in limbic system functional connectivity between left and right temporal lobe epilepsy (TLE) using graph theory. Interictal resting state fMRI was performed in 14 left TLE patients, 11 right TLE patients, and 12 controls. Graph theory analysis of 10 bilateral limbic regions of interest was conducted. Changes in edgewise functional connectivity, network topology, and regional topology were quantified, and then left and right TLE were compared. Limbic edgewise functional connectivity was predominantly reduced in both left and right TLE. More regional connections were reduced in right TLE, most prominently involving reduced interhemispheric connectivity between the bilateral insula and bilateral hippocampi. A smaller number of limbic connections were increased in TLE, more so in left than in right TLE. Topologically, the most pronounced change was a reduction in average network betweenness centrality and concurrent increase in left hippocampal betweenness centrality in right TLE. In contrast, left TLE exhibited a weak trend toward increased right hippocampal betweenness centrality, with no change in average network betweenness centrality. Limbic functional connectivity is predominantly reduced in both left and right TLE, with more pronounced reductions in right TLE. In contrast, left TLE exhibits both edgewise and topological changes that suggest a tendency toward reorganization. Network changes in TLE and lateralized differences thereof may have important diagnostic and prognostic implications. Published by Elsevier B.V.

Quantitative analyses of postmortem heat shock protein mRNA profiles in the occipital lobes of human cerebral cortices: implications in cause of death.

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Chung, Ukhee; Seo, Joong-Seok; Kim, Yu-Hoon; Son, Gi Hoon; Hwang, Juck-Joon

2012-11-01

Quantitative RNA analyses of autopsy materials to diagnose the cause and mechanism of death are challenging tasks in the field of forensic molecular pathology. Alterations in mRNA profiles can be induced by cellular stress responses during supravital reactions as well as by lethal insults at the time of death. Here, we demonstrate that several gene transcripts encoding heat shock proteins (HSPs), a gene family primarily responsible for cellular stress responses, can be differentially expressed in the occipital region of postmortem human cerebral cortices with regard to the cause of death. HSPA2 mRNA levels were higher in subjects who died due to mechanical asphyxiation (ASP), compared with those who died by traumatic injury (TI). By contrast, HSPA7 and A13 gene transcripts were much higher in the TI group than in the ASP and sudden cardiac death (SCD) groups. More importantly, relative abundances between such HSP mRNA species exhibit a stronger correlation to, and thus provide more discriminative information on, the death process than does routine normalization to a housekeeping gene. Therefore, the present study proposes alterations in HSP mRNA composition in the occipital lobe as potential forensic biological markers, which may implicate the cause and process of death.

Lateralized occipital degeneration in posterior cortical atrophy predicts visual field deficits.

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Millington, Rebecca S; James-Galton, Merle; Maia Da Silva, Mari N; Plant, Gordon T; Bridge, Holly

2017-01-01

Posterior cortical atrophy (PCA), the visual variant of Alzheimer's disease, leads to high-level visual deficits such as alexia or agnosia. Visual field deficits have also been identified, but often inconsistently reported. Little is known about the pattern of visual field deficits or the underlying cortical changes leading to this visual loss. Multi-modal magnetic resonance imaging was used to investigate differences in gray matter volume, cortical thickness, white matter microstructure and functional activity in patients with PCA compared to age-matched controls. Additional analyses investigated hemispheric asymmetries in these metrics according to the visual field most affected by the disease. Analysis of structural data indicated considerable loss of gray matter in the occipital and parietal cortices, lateralized to the hemisphere contralateral to the visual loss. This lateralized pattern of gray matter loss was also evident in the hippocampus and parahippocampal gyrus. Diffusion-weighted imaging showed considerable effects of PCA on white matter microstructure in the occipital cortex, and in the corpus callosum. The change in white matter was only lateralized in the occipital lobe, however, with greatest change in the optic radiation contralateral to the visual field deficit. Indeed, there was a significant correlation between the laterality of the optic radiation microstructure and visual field loss. Detailed brain imaging shows that the asymmetric visual field deficits in patients with PCA reflect the pattern of degeneration of both white and gray matter in the occipital lobe. Understanding the nature of both visual field deficits and the neurodegenerative brain changes in PCA may improve diagnosis and understanding of this disease.

Activation of the occipital cortex and deactivation of the default mode network during working memory in the early blind.

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Park, Hae-Jeong; Chun, Ji-Won; Park, Bumhee; Park, Haeil; Kim, Joong Il; Lee, Jong Doo; Kim, Jae-Jin

2011-05-01

Although blind people heavily depend on working memory to manage daily life without visual information, it is not clear yet whether their working memory processing involves functional reorganization of the memory-related cortical network. To explore functional reorganization of the cortical network that supports various types of working memory processes in the early blind, we investigated activation differences between 2-back tasks and 0-back tasks using fMRI in 10 congenitally blind subjects and 10 sighted subjects. We used three types of stimulus sequences: words for a verbal task, pitches for a non-verbal task, and sound locations for a spatial task. When compared to the sighted, the blind showed additional activations in the occipital lobe for all types of stimulus sequences for working memory and more significant deactivation in the posterior cingulate cortex of the default mode network. The blind had increased effective connectivity from the default mode network to the left parieto-frontal network and from the occipital cortex to the right parieto-frontal network during the 2-back tasks than the 0-back tasks. These findings suggest not only cortical plasticity of the occipital cortex but also reorganization of the cortical network for the executive control of working memory.

Distinctive Structural and Effective Connectivity Changes of Semantic Cognition Network across Left and Right Mesial Temporal Lobe Epilepsy Patients

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Xiaotong Fan

2016-01-01

Full Text Available Occurrence of language impairment in mesial temporal lobe epilepsy (mTLE patients is common and left mTLE patients always exhibit a primary problem with access to names. To explore different neuropsychological profiles between left and right mTLE patients, the study investigated both structural and effective functional connectivity changes within the semantic cognition network between these two groups and those from normal controls. We found that gray matter atrophy of left mTLE patients was more severe than that of right mTLE patients in the whole brain and especially within the semantic cognition network in their contralateral hemisphere. It suggested that seizure attacks were rather targeted than random for patients with hippocampal sclerosis (HS in the dominant hemisphere. Functional connectivity analysis during resting state fMRI revealed that subregions of the anterior temporal lobe (ATL in the left HS patients were no longer effectively connected. Further, we found that, unlike in right HS patients, increased causal linking between ipsilateral regions in the left HS epilepsy patients cannot make up for their decreased contralateral interaction. It suggested that weakened contralateral connection and disrupted effective interaction between subregions of the unitary, transmodal hub of the ATL may be the primary cause of anomia in the left HS patients.

Distinctive Structural and Effective Connectivity Changes of Semantic Cognition Network across Left and Right Mesial Temporal Lobe Epilepsy Patients

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Fan, Xiaotong; Shang, Kun; Wang, Xiaocui; Wang, Peipei; Shan, Yongzhi; Lu, Jie

2016-01-01

Occurrence of language impairment in mesial temporal lobe epilepsy (mTLE) patients is common and left mTLE patients always exhibit a primary problem with access to names. To explore different neuropsychological profiles between left and right mTLE patients, the study investigated both structural and effective functional connectivity changes within the semantic cognition network between these two groups and those from normal controls. We found that gray matter atrophy of left mTLE patients was more severe than that of right mTLE patients in the whole brain and especially within the semantic cognition network in their contralateral hemisphere. It suggested that seizure attacks were rather targeted than random for patients with hippocampal sclerosis (HS) in the dominant hemisphere. Functional connectivity analysis during resting state fMRI revealed that subregions of the anterior temporal lobe (ATL) in the left HS patients were no longer effectively connected. Further, we found that, unlike in right HS patients, increased causal linking between ipsilateral regions in the left HS epilepsy patients cannot make up for their decreased contralateral interaction. It suggested that weakened contralateral connection and disrupted effective interaction between subregions of the unitary, transmodal hub of the ATL may be the primary cause of anomia in the left HS patients. PMID:28018680

Lateralized occipital degeneration in posterior cortical atrophy predicts visual field deficits

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Rebecca S Millington

2017-01-01

Conclusions: Detailed brain imaging shows that the asymmetric visual field deficits in patients with PCA reflect the pattern of degeneration of both white and gray matter in the occipital lobe. Understanding the nature of both visual field deficits and the neurodegenerative brain changes in PCA may improve diagnosis and understanding of this disease.

LEFT LOBE LIVER TRANSPLANTATION FROM AB0-INCOMPATIBLE LIVING DONOR WITH SITUS INVERSUS

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S. V. Gautier

2014-01-01

Full Text Available Situs inversus is a rare congenital abnormality that affects approximately 0.005% of all live births. Traditionally, this condition is considered as a contraindication for liver donation, primarily due to the peculiarities of the vascular anatomy and the diffi culties in graft placement in the abdominal cavity. Review of the world literature testifi es to fi ve cases of use of the whole liver from deceased donor with situs inversus in adult recipients, and to just one case of inverted right lobe transplantation from living donor to 53-year-old man. Thus, transplantation of an inverted left liver lobe from a living related donor in pediatric patients was performed for the fi rst time. The article presents a successful experience of liver transplantation in child with tyrosinemia type 1 from AB0-incompatible living donor with situs inversus.

Anomalous Systemic Artery to the Left Lower Lobe: Literature Review and a New Surgical Technique.

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Miller, Jacob R; Lancaster, Timothy S; Abarbanell, Aaron M; Manning, Peter B; Eghtesady, Pirooz

2018-05-01

Anomalous systemic arterial supply to the basal segments of the left lower lobe without coexisting pulmonary artery connection is a rare anomaly. Most feel treatment is necessary; however, the ideal strategy is unclear. Treatments described include embolization, pulmonary resection, or anastomosis to the native pulmonary artery. We recently encountered an infant with this anomaly and present a literature review summarizing all recent reports. Additionally, we describe a novel surgical technique to create a tension-free anastomosis utilizing segmental aortic translocation that we employed in our patient due to a large distance between the anomalous vessel and native left pulmonary artery.

[Hyperlexia in an adult patient with lesions in the left medial frontal lobe].

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Suzuki, K; Yamadori, A; Kumabe, T; Endo, K; Fujii, T; Yoshimoto, T

2000-04-01

A 69-year-old right-handed woman developed a transcortical motor aphasia with hyperlexia following resection of a glioma in the left medial frontal lobe. Neurological examination revealed grasp reflex in the right hand and underutilization of the right upper extremity. An MRI demonstrated lesions in the left medial frontal lobe including the supplementary motor area and the anterior part of the cingulate gyrus, which extended to the anterior part of the body of corpus callosum. Neuropsychologically she was alert and cooperative. She demonstrated transcortical motor aphasia. Her verbal output began with echolalia. Furthermore hyperlexia was observed in daily activities and during examinations. During conversation she suddenly read words written on objects around her which were totally irrelevant to the talk. When she was walking in the ward with an examiner she read words written on a trash bag that passed by and signboards which indicated a name of a room. Her conversation while walking was intermingled with reading words, which was irrelevant to the conversation. She also read time on analog clocks, which were hung on a wall in a watch store. In a naming task, she read words written on objects first and named them upon repeated question about their names. When an examiner opened a newspaper in front of her without any instructions she began reading until the examiner prohibited it. Then she began reading again when an examiner turned the page, although she remembered that she should not read it aloud. She showed mild ideomotor apraxia of a left hand. Utilization behavior, imitation behavior, hypergraphia, or compulsive use of objects was not observed throughout the course. Hyperlexic tendency is a prominent feature of this patient's language output. Hyperlexia was often reported in children with pervasive developmental disorders including autism. There are only a few reports about hyperlexia in adults and some of them were related to diffuse brain dysfunction

Task activation and functional connectivity show concordant memory laterality in temporal lobe epilepsy.

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Sideman, Noah; Chaitanya, Ganne; He, Xiaosong; Doucet, Gaelle; Kim, Na Young; Sperling, Michael R; Sharan, Ashwini D; Tracy, Joseph I

2018-04-01

In epilepsy, asymmetries in the organization of mesial temporal lobe (MTL) functions help determine the cognitive risk associated with procedures such as anterior temporal lobectomy. Past studies have investigated the change/shift in a visual episodic memory laterality index (LI) in mesial temporal lobe structures through functional magnetic resonance imaging (fMRI) task activations. Here, we examine whether underlying task-related functional connectivity (FC) is concordant with such standard fMRI laterality measures. A total of 56 patients with temporal lobe epilepsy (TLE) (Left TLE [LTLE]: 31; Right TLE [RTLE]: 25) and 34 matched healthy controls (HC) underwent fMRI scanning during performance of a scene encoding task (SET). We assessed an activation-based LI of the hippocampal gyrus (HG) and parahippocampal gyrus (PHG) during the SET and its correspondence with task-related FC measures. Analyses involving the HG and PHG showed that the patients with LTLE had a consistently higher LI (right-lateralized) than that of the HC and group with RTLE, indicating functional reorganization. The patients with RTLE did not display a reliable contralateral shift away from the pathology, with the mesial structures showing quite distinct laterality patterns (HG, no laterality bias; PHG, no evidence of LI shift). The FC data for the group with LTLE provided confirmation of reorganization effects, revealing that a rightward task LI may be based on underlying connections between several left-sided regions (middle/superior occipital and left medial frontal gyri) and the right PHG. The FCs between the right HG and left anterior cingulate/medial frontal gyri were also observed in LTLE. Importantly, the data demonstrate that the areas involved in the LTLE task activation shift to the right hemisphere showed a corresponding increase in task-related FCs between the hemispheres. Altered laterality patterns based on mesial temporal lobe epilepsy (MTLE) pathology manifest as several

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

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

1985-01-01

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

Composing lexical versus functional adjectives: Evidence for uniformity in the left temporal lobe.

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Zhang, Linmin; Pylkkänen, Liina

2018-04-24

Featural information (e.g., color or shape) allows interlocutors to focus their attention on the specific items under discussion from the vast set of possibilities in the environment. Intriguingly, when they are used to modify and restrict nouns, adjectives can either carry featural information themselves (e.g., green car) or retrieve featural information from the context (e.g., somebody points at a car and claims that she has the same car or a different car). Do the processing of same/different car and green car share neural correlates? For the composition of nouns with feature-carrying adjectives, prior work revealed early compositional effects (roughly 200 ms after noun onset) in the left anterior temporal lobe. However, although we know that such effects do not extend to cases of numeral quantification, which add no conceptual features to the noun (e.g., two boats), we do not know whether they extend to functional adjectives that themselves introduce no features, but instead reference features in the context. To address this question, we measured magnetoencephalography (MEG) during the processing of five types of noun phrases (NPs): same NPs (e.g., same star), different NPs (e.g., different star), color NPs (e.g., green star), comparative NPs (e.g., larger star), and another NPs (e.g., another star). Our main finding was that between 185 to 240 ms after noun onset, same and different NPs patterned with the color NPs in their elicited left temporal lobe activity, and same NPs even trended toward higher amplitudes than the color NPs. This shows that the mechanism driving combinatory effects in the left temporal cortex does not require the input words to directly name conceptual features, as long as the words reference featural information in the context, and that overlapping neural correlates underlie the composition of featural information from both linguistic and nonlinguistic sources.

Multiple-slice spiral CT evaluation of occipital condyle fractures

International Nuclear Information System (INIS)

Wang Xifu; Zhang Guixiang; Li Kang'an; Zhao Jinglong; Wang Han; Feng Yan; Zheng Linfeng

2011-01-01

Objective: To explore the MSCT findings of occipital condyle fracture (OCF) and improve its diagnostic accuracy. Methods: Nineteen patients with OCF, selected from 110 patients suffering high energy injuries at the craniocervical junction, were enrolled into the study. The MSCT appearances of OCFs were retrospectively analyzed by two experienced radiologists. OCF had four types: type Ⅰ was a comminuted fracture, type Ⅱ was a extension of basilar skull fracture, type Ⅲ was an avulsion fracture at the attachment site of alar ligament on occipital condyle, type Ⅳ was a fracture of mixed pattern consisting of two or more above fracture types. Results: In 19 patients, the left, right and bilateral OCFs were seen in 7, 11 cases, and 1 case, respectively. Type Ⅰ was found in one case, which was a comminution of the left occipital condyle. Type Ⅱ was found in 5 cases, which involved the middle and posterior parts of occipital condyles with 2 on the left and 3 on the right, Type Ⅲ was found in 12 cases which showed various degree of fragment displacement with 3 occurring on the left, 8 on the right, 1 involving bilateral sides, 6 involving articular surfaces and 7 accompanying by enlargement of alar ligaments. Type Ⅳ was found in one case, with coexistence of Type Ⅱ and type Ⅲ In addition, OCFs were accompanied by head and (or) cervical spine injuries in 14 cases, which included cranial fracture in 8 cases, epidural hematoma in 4 cases, subarachnoid hemorrhage in one case, cerebral contusion and laceration in one case, subfalcial hernia in one case, cervical spine fracture and dislocation in 9 cases, and so on. Conclusion: OCFs can be accurately diagnosed by MSCT, which is important for selection of treatment protocols. (authors)

Selective hypertrophy of the lobus caudatus as a novel approach enabling extended right hepatectomy in the presence of a non-perfused left lateral liver lobe.

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Atanasov, Georgi; Schmelzle, Moritz; Thelen, Armin; Wiltberger, Georg; Hau, Hans-Michael; Krenzien, Felix; Petersen, Tim-Ole; Moche, Michael; Jonas, Sven

2014-08-01

Portal vein embolization (PVE) is a well-established technique to enhance functional hepatic reserves of segments II and III before curative extended right hepatectomy for tumors of the right liver lobe. However, an adequate hepatopetal flow of the left lateral portal vein branches is required for a sufficient PVE-associated hypertrophy. Here, we report a 65-year old patient suffering from a locally advanced intrahepatic cholangiocarcinoma in the right liver lobe and segment IV. A curative extended right hepatectomy after preoperative PVE of liver segments IV-VIII was initially impossible because of partial thrombosis of the left lateral portal vein branches resulting in an ischemic-type atrophy of segments II and III. However, due to a massive hypertrophy of the caudate lobe following PVE of liver segments IV-VIII, subsequent extended right hepatectomy with intraoperative thrombectomy of segments II and III was made possible. To our knowledge this is the first case in which an extended right hepatectomy for a liver malignancy, in the presence of atrophic left lateral section, was made possible by a massive PVE-associated hypertrophy of the caudate lobe.

Aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery arising from the right pulmonary artery: A case report

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Cho, Yong Seok; Kang, Mi Jin; Bae, Kyung Eun; Lee, Jin Hae; Lee, Han Bee; Kim, Jae Hyung; Jeong, Myeong Ja; Kang, Tae Kyung

2013-01-01

Aberrant origins of the pulmonary artery are rare anomalies, but are being reported several times in the world literature. Among them, pulmonary artery sling is the most well known anomaly, which is the left pulmonary artery arising from the right pulmonary artery. In case of pulmonary artery sling, the left pulmonary artery causes compression of the trachea and esophagus while it courses in between. In this case, we describe a case on incidentally found aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery without any compressions of the esophagus or trachea. In the world literature, aberrant origins of the left pulmonary artery without pulmonary artery sling was reported at one time, but currently, this is the first case of aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery arising from the right pulmonary artery.

Aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery arising from the right pulmonary artery: A case report

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Cho, Yong Seok; Kang, Mi Jin; Bae, Kyung Eun; Lee, Jin Hae; Lee, Han Bee; Kim, Jae Hyung; Jeong, Myeong Ja; Kang, Tae Kyung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul, (Korea, Republic of)

2013-10-15

Aberrant origins of the pulmonary artery are rare anomalies, but are being reported several times in the world literature. Among them, pulmonary artery sling is the most well known anomaly, which is the left pulmonary artery arising from the right pulmonary artery. In case of pulmonary artery sling, the left pulmonary artery causes compression of the trachea and esophagus while it courses in between. In this case, we describe a case on incidentally found aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery without any compressions of the esophagus or trachea. In the world literature, aberrant origins of the left pulmonary artery without pulmonary artery sling was reported at one time, but currently, this is the first case of aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery arising from the right pulmonary artery.

[Transient charles bonnet syndrome after excision of a right occipital meningioma: a case report].

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Arai, Takao; Hasegawa, Yuzuru; Tanaka, Toshihide; Kato, Naoki; Watanabe, Mitsuyoshi; Nakamura, Aya; Murayama, Yuichi

2014-05-01

Charles Bonnet syndrome is a condition characterized by visual hallucinations. These simple or complex visual hallucinations are more common in elderly individuals with impaired peripheral vision. The current report describes a case of transient Charles Bonnet syndrome appearing after the removal of a meningioma. The patient was a 61-year-old man who already had impaired visual acuity due to diabetic retinopathy. Brain MRI revealed a cystic tumor severely compressing the right occipital lobe. Starting on day 2 postoperatively, the patient was troubled by recurring visual hallucinations involving people, flowers, pictures, and familiar settings(the train and a coffee shop). These continued for 3.5 months. This period roughly coincided with the time for the occipital lobe to recover from the compression caused by the tumor, a fact that was confirmed by several MRI scans. ¹²³I-IMP SPECT performed 1 month after the surgical operation showed an area of hypoperfusion in the right parieto-occipital lobe. Based on the patient's clinical course and MRI findings, the mechanism of onset of visual hallucinations in this patient was put forward. The release of pressure in the brain by tumor removal and subsequent recovery changed the blood flow to the brain. This triggered visual hallucinations in the patient, who was already predisposed to developing Charles Bonnet syndrome because of diabetic retinopathy. This case is interesting since it indicates that central neurological factors, as well as visual deficits, may induce the appearance of visual hallucinations in Charles Bonnet syndrome.

Anterograde and Retrograde Amnesia following Bitemporal Infarction

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A. Schnider

1994-01-01

Full Text Available A patient suffered very severe anterograde and retrograde amnesia following infarction of both medial temporal lobes (hippocampus and adjacent cortex and the left inferior temporo-occipital area. The temporal stem and the amygdala were intact; these structures do not appear to be critical for new learning in humans. Extension of the left-sided infarct into the inferior temporo-occipital lobe, an area critically involved in visual processing, appears to be responsible for our patient's loss of remote memories.

A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion.

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King, Nicolas K K; Rajendra, Tiruchelvarayan; Ng, Ivan; Ng, Wai Hoe

2014-01-01

Occipital-cervical fusion (OCF) has been used to treat instability of the occipito-cervical junction and to provide biomechanical stability after decompressive surgery. The specific areas that require detailed morphologic knowledge to prevent technical failures are the thickness of the occipital bone and diameter of the C2 pedicle, as the occipital midline bone and the C2 pedicle have structurally the strongest bone to provide the biomechanical purchase for cranio-cervical instrumentation. The aim of this study was to perform a quantitative morphometric analysis using computed tomography (CT) to determine the variability of the occipital bone thickness and C2 pedicle thickness to optimize screw placement for OCF in a South East Asian population. Thirty patients undergoing cranio-cervical junction instrumentation during the period 2008-2010 were included. The thickness of the occipital bone and the length and diameter of the C2 pedicle were measured based on CT. The thickest point on the occipital bone was in the midline with a maximum thickness below the external occipital protuberance of 16.2 mm (±3.0 mm), which was thicker than in the Western population. The average C2 pedicle diameter was 5.3 mm (±2.0 mm). This was smaller than Western population pedicle diameters. The average length of the both pedicles to the midpoint of the C2 vertebral body was 23.5 mm (±3.3 mm on the left and ±2.3 mm on the right). The results of this first study in the South East Asian population should help guide and improve the safety in occipito-cervical region instrumentation. Thus reducing the risk of technical failures and neuro-vascular injury.

Alteration of Interictal Brain Activity in Patients with Temporal Lobe Epilepsy in the Left Dominant Hemisphere: A Resting-State MEG Study

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Haitao Zhu

2014-01-01

Full Text Available Resting MEG activities were compared between patients with left temporal lobe epilepsy (LTLE and normal controls. Using SAMg2, the activities of MEG data were reconstructed and normalized. Significantly elevated SAMg2 signals were found in LTLE patients in the left temporal lobe and medial structures. Marked decreases of SAMg2 signals were found in the wide extratemporal lobe regions, such as the bilateral visual cortex. The study also demonstrated a positive correlation between the seizure frequency and brain activities of the abnormal regions after the multiple linear regression analysis. These results suggested that the aberrant brain activities not only were related to the epileptogenic zones, but also existed in other extratemporal regions in patients with LTLE. The activities of the aberrant regions could be further damaged with the increase of the seizure frequency. Our findings indicated that LTLE could be a multifocal disease, including complex epileptic networks and brain dysfunction networks.

Tracing short connections of the temporo-parieto-occipital region in the human brain using diffusion spectrum imaging and fiber dissection.

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Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yunjie; Wang, Yibao

2016-09-01

The temporo-parieto-occipital (TPO) junction plays a unique role in human high-level neurological functions. Long-range fibers from and to this area have been described in detail but little is known about short TPO tracts mediating local connectivity. In this study, we performed high angular diffusion spectrum imaging (DSI) analyses to visualize the short TPO connections in the human brain. Fiber tracking was conducted on a subject-specific approach (10 subjects) and a template of 90 subjects (NTU-90 Atlas). Three tracts were identified: posterior segment of the superior longitudinal fasciculus (SLF-V), connecting the posterior part of the middle and inferior temporal gyri with the angular gyrus and supramarginal gyrus, vertical occipital fasciculus (VOF), connecting the inferior parietal with the lower temporal and occipital lobe, and a novel temporo-parietal (TP) connection, interconnecting the inferior temporal gyrus, middle temporal gyrus and fusiform gyrus, and inferior occipital lobe with the superior parietal lobe. These studies were complemented by fiber dissection techniques. It is the first study that demonstrated the trajectory and connectivity of the VOF using fiber dissection, as well as displayed the spatial relationship of the SLF-V with the cortex and the adjacent fiber bundles on one dissecting hemisphere. By providing a more accurate and detailed description of the local connectivity of the TPO junction, our findings help to develop new insights into its functional role in the human brain. Copyright © 2016 Elsevier B.V. All rights reserved.

The frontal lobes and inhibitory function

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Konishi, Seiki

2011-01-01

Neuropsychological studies using traditional tasks of inhibitory functions, such as the Wisconsin card sorting test (WCST) and the Go/No-Go Task have revealed that the frontal lobe is responsible for several types of inhibitory functions. However, the detailed psychological nature of the inhibitory functions and the precise location of their critical foci within the frontal lobe remain to be investigated. Functional magnetic resonance imaging provides spatial and temporal resolution that allowed us to illuminate at least 4 frontal regions involved in inhibitory functions: the dorsolateral, ventrolateral, and rostral parts of the frontal lobe and the presupplementary motor area (preSMA). The ventrolateral part of the frontal lobe in the right hemisphere was activated during response inhibition. The preSMA in the left hemisphere was activated during inhibition of proactive interference immediately after the dimension changes of the WCST. The rostral part of the frontal lobe in the left hemisphere was activated during inhibition long after the dimension changes. The dorsolateral part of the frontal lobe in the left hemisphere was activated at the dimension changes in the first time, but not in the second time. These findings provide clues to our understanding of functional differentiation of inhibitory functions and their localization in the frontal lobe. (author)

Phosphene-guided transcranial magnetic stimulation of occipital but not parietal cortex suppresses stimulus visibility

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Tapia, Evelina; Mazzi, Chiara; Savazzi, Silvia; Beck, Diane M.

2014-01-01

Transcranial magnetic stimulation (TMS) applied over the occipital lobe approximately 100 ms after the onset of a stimulus decreases its visibility if it appears in the location of the phosphene. Because phosphenes can also be elicited by stimulation of the parietal regions, we asked if the same procedure that is used to reduce visibility of stimuli with occipital TMS will lead to decreased stimulus visibility when TMS is applied to parietal regions. TMS was randomly applied at 0 to 130 ms after the onset of the stimulus (SOA) in steps of 10 ms in occipital and parietal regions. Participants responded to the orientation of the line stimulus and rated its visibility. We replicate previous reports of phosphenes from both occipital and parietal TMS. As previously reported, we also observed visual suppression around the classical 100 ms window both in the objective line orientation and subjective visibility responses with occipital TMS. Parietal stimulation, on the other hand, did not consistently reduce stimulus visibility in any time window. PMID:24584900

Impaired cerebral blood flow networks in temporal lobe epilepsy with hippocampal sclerosis: A graph theoretical approach.

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Sone, Daichi; Matsuda, Hiroshi; Ota, Miho; Maikusa, Norihide; Kimura, Yukio; Sumida, Kaoru; Yokoyama, Kota; Imabayashi, Etsuko; Watanabe, Masako; Watanabe, Yutaka; Okazaki, Mitsutoshi; Sato, Noriko

2016-09-01

Graph theory is an emerging method to investigate brain networks. Altered cerebral blood flow (CBF) has frequently been reported in temporal lobe epilepsy (TLE), but graph theoretical findings of CBF are poorly understood. Here, we explored graph theoretical networks of CBF in TLE using arterial spin labeling imaging. We recruited patients with TLE and unilateral hippocampal sclerosis (HS) (19 patients with left TLE, and 21 with right TLE) and 20 gender- and age-matched healthy control subjects. We obtained all participants' CBF maps using pseudo-continuous arterial spin labeling and analyzed them using the Graph Analysis Toolbox (GAT) software program. As a result, compared to the controls, the patients with left TLE showed a significantly low clustering coefficient (p=0.024), local efficiency (p=0.001), global efficiency (p=0.010), and high transitivity (p=0.015), whereas the patients with right TLE showed significantly high assortativity (p=0.046) and transitivity (p=0.011). The group with right TLE also had high characteristic path length values (p=0.085), low global efficiency (p=0.078), and low resilience to targeted attack (p=0.101) at a trend level. Lower normalized clustering coefficient (p=0.081) in the left TLE and higher normalized characteristic path length (p=0.089) in the right TLE were found also at a trend level. Both the patients with left and right TLE showed significantly decreased clustering in similar areas, i.e., the cingulate gyri, precuneus, and occipital lobe. Our findings revealed differing left-right network metrics in which an inefficient CBF network in left TLE and vulnerability to irritation in right TLE are suggested. The left-right common finding of regional decreased clustering might reflect impaired default-mode networks in TLE. Copyright © 2016 Elsevier Inc. All rights reserved.

Right Occipital Cortex Activation Correlates with Superior Odor Processing Performance in the Early Blind

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Grandin, Cécile B.; Dricot, Laurence; Plaza, Paula; Lerens, Elodie; Rombaux, Philippe; De Volder, Anne G.

2013-01-01

Using functional magnetic resonance imaging (fMRI) in ten early blind humans, we found robust occipital activation during two odor-processing tasks (discrimination or categorization of fruit and flower odors), as well as during control auditory-verbal conditions (discrimination or categorization of fruit and flower names). We also found evidence for reorganization and specialization of the ventral part of the occipital cortex, with dissociation according to stimulus modality: the right fusiform gyrus was most activated during olfactory conditions while part of the left ventral lateral occipital complex showed a preference for auditory-verbal processing. Only little occipital activation was found in sighted subjects, but the same right-olfactory/left-auditory-verbal hemispheric lateralization was found overall in their brain. This difference between the groups was mirrored by superior performance of the blind in various odor-processing tasks. Moreover, the level of right fusiform gyrus activation during the olfactory conditions was highly correlated with individual scores in a variety of odor recognition tests, indicating that the additional occipital activation may play a functional role in odor processing. PMID:23967263

The Impact of Sex and Language Dominance on Material-Specific Memory Before and After Left Temporal Lobe Surgery

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Helmstaedter, C.; Brosch, T.; Kurthen, M.; Elger, C. E.

2004-01-01

Recent findings raised evidence that in early-onset left temporal lobe epilepsy, women show greater functional plasticity for verbal memory than men. In particular, women with lesion- or epilepsy-driven atypical language dominance show an advantage over men. The question asked in this study was whether there is evidence of sex- and language…

Primary Occipital Ewing's Sarcoma with Subsequent Spinal Seeding.

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Alqahtani, Ali; Amer, Roaa; Bakhsh, Eman

2017-01-01

Ewing's sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing's sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis. Computed tomography (CT) imaging showed a mass in the left posterior fossa compressing the brainstem. The patient then underwent surgical excision followed by adjuvant chemoradiation therapy. Two years later, the patient presented with severe lower back pain and urinary incontinence. Whole-spine magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) seeding from the L5 to the S4 vertebrae. Primary cranial Ewing's sarcoma is considered in the differential diagnosis of children with extra-axial posterior fossa mass associated with destructive permeative bone lesions. Although primary cranial Ewing's sarcoma typically has good prognosis, our patient developed metastasis in the lower spine. Therefore, with CNS Ewing's sarcoma, screening of the entire neural axis should be taken into consideration for early detection of CSF seeding metastasis in order to decrease the associated morbidity and mortality.

Gender differences in brain regional homogeneity of healthy subjects after normal sleep and after sleep deprivation: a resting-state fMRI study.

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Dai, Xi-Jian; Gong, Hong-Han; Wang, Yi-Xiang; Zhou, Fu-Qing; Min, You-Jiang; Zhao, Feng; Wang, Si-Yong; Liu, Bi-Xia; Xiao, Xiang-Zuo

2012-06-01

To explore the gender differences of brain regional homogeneity (ReHo) in healthy subjects during the resting-state, after normal sleep, and after sleep deprivation (SD) using functional magnetic resonance imaging (fMRI) and the ReHo method. Sixteen healthy subjects (eight males and eight females) each underwent the resting-state fMRI exams twice, i.e., once after normal sleep and again after 24h's SD. According to the gender and sleep, 16 subjects were all measured twice and divided into four groups: the male control group (MC), female control group (FC), male SD group (MSD), and female SD group (FSD). The ReHo method was used to calculate and analyze the data, SPM5 software was used to perform a two-sample T-test and a two-pair T-test with a P value right paracentral lobule (BA3/6), but in no obviously lower regions. Compared with the FC, the FSD showed significantly higher ReHo in bilateral parietal lobes (BA2/3), bilateral vision-related regions of occipital lobes (BA17/18/19), right frontal lobe (BA4/6), and lower ReHo in the right frontal lobe. Compared with the FC, the MC showed significantly higher ReHo in the left occipital lobe (BA18/19), and left temporal lobe (BA21), left frontal lobe, and lower ReHo in the right insula and in the left parietal lobe. Compared with the FSD, the MSD showed significantly higher ReHo in the left cerebellum posterior lobe (uvula/declive of vermis), left parietal lobe, and bilateral frontal lobes, and lower ReHo in the right occipital lobe (BA17) and right frontal lobe (BA4). The differences of brain activity in the resting state can be widely found not only between the control and SD group in a same gender group, but also between the male group and female group. Thus, we should take the gender differences into consideration in future fMRI studies, especially the treatment of brain-related diseases (e.g., depression). Copyright © 2012 Elsevier B.V. All rights reserved.

Endoscopic-assisted interhemispheric parieto-occipital transtentorial approach for microsurgical resection of a pineal region tumor: operative video and technical nuances.

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Liu, James K

2016-01-01

The angle of the straight sinus and tentorium cerebelli can often influence the choice of surgical approach to the pineal region. The supracerebellar infratentorial approach can be technically challenging and a relative contraindication in cases where the angle of the straight sinus and tentorium is very steep. Similarly, an occipital transtentorial approach, which uses a low occipital craniotomy at the junction of the superior sagittal sinus and transverse sinus, may not provide the best trajectory to the pineal region in patients with a steep tentorium. In addition, this approach often necessitates retraction on the occipital lobe to access the tentorial incisura and pineal region, which can increase the risk of visual compromise. In this operative video, the author demonstrates an alternative route using an endoscopic-assisted interhemispheric parieto-occipital transtentorial approach to a pineal region tumor in a patient with a steep straight sinus and tentorium. The approach provided a shorter route and more direct trajectory to the tumor at the tentorial incisura, and avoided direct fixed retraction on the occipital lobe when performed using the lateral position, thereby minimizing visual complications. This video atlas demonstrates the operative technique and surgical nuances, including the application of endoscopic-assisted microsurgical resection and operative pearls for preservation of the deep cerebral veins. In summary, the parieto-occipital transtentorial approach with endoscopic assistance is an important approach in the armamentarium for surgical management of pineal region tumors. The video can be found here: https://youtu.be/Ph4veG14aTk .

Aphasia following left thalamic hemorrhage

International Nuclear Information System (INIS)

Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro.

1984-01-01

We reported 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months), and described language disorders examined by Western Aphasia Battery (WAB) and measured cerebral blood flow by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in watershed area that involved the territory between posterior cerebral and middle cerebral arteries in the left temporooccipital region in addition to low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, whose score of repetition (8.4) was higher than that of comprehension (7.4), emission CT showed slight low flow area at the temporo-occipital region similarly as the case with transcortical sensory aphasia. In another case with anomic aphasia, scored 9 on both fluensy and comprehension subtests and 10 on repetition, there was wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. On the other hand, in all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus. (J.P.N.)

A Rare Case of Craniopharyngioma in the Temporal Lobe

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Sasan Razmjoo

2017-01-01

Full Text Available Herein, we report on a rare case of craniopharyngioma arising in the left temporal lobe with no prior history of head trauma or surgery. There was a solid-cystic mass in the left temporal lobe on MR images. To the best of our knowledge, this is the second case of a craniopharyngioma occurring in the temporal lobe.

The Medial Temporal Lobe and the Left Inferior Prefrontal Cortex Jointly Support Interference Resolution in Verbal Working Memory

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Oztekin, Ilke; Curtis, Clayton E.; McElree, Brian

2009-01-01

During working memory retrieval, proactive interference (PI) can be induced by semantic similarity and episodic familiarity. Here, we used fMRI to test hypotheses about the role of the left inferior frontal gyrus (LIFG) and the medial temporal lobe (MTL) regions in successful resolution of PI. Participants studied six-word lists and responded to a…

Non-intubated uniportal left-lower lobe upper segmentectomy (S6).

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Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Sesma, Julio; Lirio, Francisco; Galiana, Maria; Rivera, Maria Jesus

2017-01-01

Worldwide accepted indications of anatomical segmentectomies are mainly early stage primary adenocarcinomas, pulmonary metastasis and benign conditions. Their performance through uniportal VATS has become more and more popular due to the less invasiveness of the whole procedure under this approach. Recently, many efforts have focused on non-intubated spontaneously breathing management of lobectomies and anatomical segmentectomies, although specific selection criteria and main advantages are not completely standardized. In a 62-year-old thin man with two pulmonary residual metastasis from sigma adenocarcinoma, after chemotherapy plus antiangiogenic treatment, we indicated a single-incision video-assisted left-lower lobe (LLL) upper segmentectomy (S6) under spontaneous breathing and intercostal blockade. Total operation time was 240 minutes. Chest tube was removed at 24 hours and the patient was discharge on postoperative day 2 without any complication. Non-intubated uniportal VATS is a safe and reasonable approach for lung-sparing resections in selected patients, although more evidence is required for selecting which patients can benefit more over standard intubated procedures.

[A case of brain metastasis discovered after surgery for lung cancer based on changes in CEA, in which long-term survival was obtained by repeated gammaknife irradiation].

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Kakeya, Hiroshi; Inoue, Yuichi; Sawai, Toyomitsu; Ikuta, Yasushi; Ohno, Hideaki; Yanagihara, Katsunori; Higashiyama, Yasuhito; Miyazaki, Yoshitsugu; Soda, Hiroshi; Tashiro, Takayoshi; Kohno, Shigeru

2005-12-01

A 58-year-old man underwent right lower lobectomy for lung adenocarcinoma in June 1998. Since a high level of tumor marker CEA persisted after surgery, chemotherapy was additionally performed, and the CEA level subsequently normalized. However, the CEA level increased in April 1999, and brain metastasis was found in the left occipital lobe, and the first gammaknife irradiation was performed. Multiple brain metastases were found when CEA increased again in August 1999, and the second gammaknife irradiation was performed. Moreover, brain metastases were found in the left frontal and occipital lobes in February 2000, and the third gammaknife irradiation was performed. CEA normalized thereafter, but increased in February 2001. Brain metastasis was found in the right occipital lobe, and the fourth gammaknife irradiation was performed. CEA has remained within the normal range for about 4 years thereafter. Long-term survival was possible by repeated gammaknife irradiation for brain metastases. Monitoring of CEA played an important role in finding recurrent brain metastasis in this patient.

Seizure Outcomes in Occipital Lobe and Posterior Quadrant Epilepsy Surgery: A Systematic Review and Meta-Analysis.

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Harward, Stephen C; Chen, William C; Rolston, John D; Haglund, Michael M; Englot, Dario J

2018-03-01

Occipital lobe epilepsy (OLE) is an uncommon but debilitating focal epilepsy syndrome with seizures often refractory to medical management. While surgical resection has proven a viable treatment, previous studies examining postoperative seizure freedom rates are limited by small sample size and patient heterogeneity, thus exhibiting significant variability in their results. To review the medical literature on OLE so as to investigate rates and predictors of both seizure freedom and visual outcomes following surgery. We reviewed manuscripts exploring surgical resection for drug-resistant OLE published between January 1990 and June 2015 on PubMed. Seizure freedom rates were analyzed and potential predictors were evaluated with separate meta-analyses. Postoperative visual outcomes were also examined. We identified 27 case series comprising 584 patients with greater than 1 yr of follow-up. Postoperative seizure freedom (Engel class I outcome) was observed in 65% of patients, and was significantly predicted by age less than 18 yr (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.13-2.18), focal lesion on pathological analysis (OR 2.08, 95% CI 1.58-2.89), and abnormal preoperative magnetic resonance imaging (OR 3.24, 95% 2.03-6.55). Of these patients, 175 also had visual outcomes reported with 57% demonstrating some degree of visual decline following surgery. We did not find any relationship between postoperative visual and seizure outcomes. Surgical resection for OLE is associated with favorable outcomes with nearly two-thirds of patients achieving postoperative seizure freedom. However, patients must be counseled regarding the risk of visual decline following surgery. Copyright © 2017 by the Congress of Neurological Surgeons

TMS of the occipital cortex induces tactile sensations in the fingers of blind Braille readers.

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Ptito, M; Fumal, A; de Noordhout, A Martens; Schoenen, J; Gjedde, A; Kupers, R

2008-01-01

Various non-visual inputs produce cross-modal responses in the visual cortex of early blind subjects. In order to determine the qualitative experience associated with these occipital activations, we systematically stimulated the entire occipital cortex using single pulse transcranial magnetic stimulation (TMS) in early blind subjects and in blindfolded seeing controls. Whereas blindfolded seeing controls reported only phosphenes following occipital cortex stimulation, some of the blind subjects reported tactile sensations in the fingers that were somatotopically organized onto the visual cortex. The number of cortical sites inducing tactile sensations appeared to be related to the number of hours of Braille reading per day, Braille reading speed and dexterity. These data, taken in conjunction with previous anatomical, behavioural and functional imaging results, suggest the presence of a polysynaptic cortical pathway between the somatosensory cortex and the visual cortex in early blind subjects. These results also add new evidence that the activity of the occipital lobe in the blind takes its qualitative expression from the character of its new input source, therefore supporting the cortical deference hypothesis.

Dandy-Walker syndrome together with occipital encephalocele.

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Cakmak, A; Zeyrek, D; Cekin, A; Karazeybek, H

2008-08-01

Dandy-Walker malformation is an anomaly characterized by dysgenesis of the foramina of Magendie and Lushka in the upper 4(th) ventricle, hypoplasia of the cerebellar vermis and agenesis of the corpus callosum. Encephalocele is diagnosed from the calvarium defect, cerebrospinal fluid (CSF) and herniation of the meninges. It is the rarest neural tube defect. A 7 x 9 cm encephalocele was found on physical examination of a 6-day old baby boy patient. From cranial magnetic resonance, it was seen that the posterior fossa was enlarged with cysts and there was agenesis of the vermis. A connection was established between the ventricle and the development of cysts on the posterior fossa. These findings were evaluated as significant from the aspect of Dandy-Walker malformation. The extension of the bone defect in the left occipital area towards the posterior, and the cranio-caudal diameter reaching 9 cm was seen to be in accordance with encephalocele. It is rare for Dandy-Walker syndrome to occur together with occipital encephalocele. The authors present a case of Dandy-Walker syndrome together with occipital encephalocele.

Morphologic Analysis of Occipital Sinuses for Occipital Screw Fixation Using Digital Subtraction Angiography.

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Lee, Dong Hoon; Hong, Jae Taek; Sung, Jae Hoon; Jain, Ashish; Huh, Joon; Kim, Sang Uk; Kim, Joon Young; Kwon, Jae Yoel; Cho, Chul Bum; Kim, Il Sup; Lee, Sang Won

2016-07-01

Numerous methods to achieve occipitocervical stabilization have been described, including the use of occipital plate/screw constructs. Bicortical screws may increase the pullout strength, but intracranial injuries to venous sinuses have been reported. This study was performed to analyze the variations in occipital sinuses to prevent sinus injury caused by the bicortical screw. Occipital sinuses of 1720 patients were examined using digital subtraction angiography. The data collected included patient age and sex, occipital sinus type, distance between occipital sinus and midline, depth from inion to occipital sinus, and distance between occipital sinus and midline occiput at different levels. The mean age of patients was 57 years ± 13. There were 807 (46.9%) men and 913 (53.1%) women. The most common occipital sinus type was single occipital sinus off-midline (type B2). The least common occipital sinus type was absent occipital sinuses (type A; 8.7% of patients). There was no significant difference between age and occipital sinus type (P = 0.310). Also, the difference between sexes was not significant in regard to occipital sinus type in general. However, in subgroup analysis of type B1 and B2, there was a significant difference between sexes (P occipital sinus was 19.913 mm ± 7.437. The occipital sinus shows several variations, and many morphologic differences can be seen. Preoperative detailed examination by magnetic resonance venography or vertebral angiography may be required for cases in which bicortical occipital screw fixation is necessary to avoid occipital sinus-related complications. Copyright © 2016 Elsevier Inc. All rights reserved.

The cerebral functional location in normal subjects when they listened to a story in unfamiliar Japanese

International Nuclear Information System (INIS)

Sun Da; Xu Wei; Zhang Hongwei; Liu Hongbiao; Liu Qichang

2004-01-01

Purpose: To detect the cerebral functional location when normal subjects listened to a story in unfamiliar Japanese. Methods: 7 normal young students of the medical collage of Zhejiang University, 22-24 years old, 4 male and 3 female. The first they underwent a 99mTc-ECD brain imaging at rest using a dual-head gamma camera with fan beam collimators. After 2-4 days they were asked to listen a story in unfamiliar Japanese carefully on a tap for 20 minters. 99mTc-ECD was administered in the first 3 minutes during they listened the story. The brain imaging was performed in 30-60 minutes after the tracer was administered. Results: To compare the rest state, during listen to the story in unfamiliar Japanese the right superior temporal in 5 cases, left superior temporal in 2 cases, right inferior temporal in 2 cases, and left inferior temporal in 1 case were activated. Among them, dual temporal were activated in 2 cases, only right temporal in 4 cases and left temporal in 1 case. Although they were no asked to remember the plot of the story, the frontal lobes were activated lightly in all 9 subjects. Among them dual inferior frontal and/or medial frontal lobes (3 cases), right inferior frontal and/or medial frontal lobes (2 cases), left inferior frontal (5 cases), right inferior frontal (1 case), right superior frontal (3 cases) were activated. The were activated in 6 subjects, and dual occipital in 5 cases, left occipital in 1 case. Other regions that were activated included parietal lobes (right in 2 cases and left in 1 case), and left occipital lobes (in 1 case) were activated. Conclusion: During listened to the story in unfamiliar Japanese the auditory association cortex in the superior temporal and some right midtemporal (it is more in right than in left) were activated. The frontal lobes were activated widely too, and mainly in left inferior frontal lobes (Broca's area), and in the frontal eye fields and the superolateral prefrontal cortex. It is consistent with the

Verbal memory after temporal lobe epilepsy surgery in children: Do only mesial structures matter?

Science.gov (United States)

Law, Nicole; Benifla, Mony; Rutka, James; Smith, Mary Lou

2017-02-01

Previous findings have been mixed regarding verbal memory outcome after left temporal lobectomy in children, and there are few studies comparing verbal memory change after lateral versus mesial temporal lobe resections. We compared verbal memory outcome associated with sparing or including the mesial structures in children who underwent left or right temporal lobe resection. We also investigated predictors of postsurgical verbal memory change. We retrospectively assessed verbal memory change approximately 1 year after unilateral temporal lobe epilepsy surgery using a list learning task. Participants included 23 children who underwent temporal lobe surgery with sparing of the mesial structures (13 left), and 40 children who had a temporal lobectomy that included resection of mesial structures (22 left). Children who underwent resection from the left lateral and mesial temporal lobe were the only group to show decline in verbal memory. Furthermore, when we considered language representation in the left temporal resection group, patients with left language representation and spared mesial structures showed essentially no change in verbal memory from preoperative to follow-up, whereas those with left language representation and excised mesial structures showed a decline. Postoperative seizure status had no effect on verbal memory change in children after left temporal lobe surgery. Finally, we found that patients with intact preoperative verbal memory experienced a significant decline compared to those with below average preoperative verbal memory. Our findings provide evidence of significant risk factors for verbal memory decline in children, specific to left mesial temporal lobe epilepsy. Children who undergo left temporal lobe surgery that includes mesial structures may be most vulnerable for verbal memory decline, especially when language representation is localized to the left hemisphere and when preoperative verbal memory is intact. Wiley Periodicals, Inc. �

Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy.

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Fang, Peng; An, Jie; Zeng, Ling-Li; Shen, Hui; Chen, Fanglin; Wang, Wensheng; Qiu, Shijun; Hu, Dewen

2015-01-01

Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE), but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right) mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed for each subject, multivariate pattern analysis was applied to classify the left mTLE from the right mTLE and extract the anatomical connectivity differences between the left and right mTLE patients. The classification results reveal 93.0% accuracy for the left mTLE versus the right mTLE, 93.4% accuracy for the left mTLE versus controls and 90.0% accuracy for the right mTLE versus controls. Compared with the right mTLE, the left mTLE exhibited a different connectivity pattern in the cortical-limbic network and cerebellum. The majority of the most discriminating anatomical connections were located within or across the cortical-limbic network and cerebellum, thereby indicating that these disease-related anatomical network alterations may give rise to a portion of the complex of emotional and memory deficit between the left and right mTLE. Moreover, the orbitofrontal gyrus, cingulate cortex, hippocampus and parahippocampal gyrus, which exhibit high discriminative power in classification, may play critical roles in the pathophysiology of mTLE. The current study demonstrated that anatomical connectivity differences between the left mTLE and the right mTLE may have the potential to serve as a neuroimaging biomarker to guide personalized diagnosis of the left and right mTLE.

Spontaneous and visually-driven high-frequency oscillations in the occipital cortex: Intracranial recording in epileptic patients

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Nagasawa, Tetsuro; Juhász, Csaba; Rothermel, Robert; Hoechstetter, Karsten; Sood, Sandeep; Asano, Eishi

2011-01-01

SUMMARY High-frequency oscillations (HFOs) at ≧80 Hz of nonepileptic nature spontaneously emerge from human cerebral cortex. In 10 patients with extra-occipital lobe epilepsy, we compared the spectral-spatial characteristics of HFOs spontaneously arising from the nonepileptic occipital cortex with those of HFOs driven by a visual task as well as epileptogenic HFOs arising from the extra-occipital seizure focus. We identified spontaneous HFOs at ≧80 Hz with a mean duration of 330 msec intermittently emerging from the occipital cortex during interictal slow-wave sleep. The spectral frequency band of spontaneous occipital HFOs was similar to that of visually-driven HFOs. Spontaneous occipital HFOs were spatially sparse and confined to smaller areas, whereas visually-driven HFOs involved the larger areas including the more rostral sites. Neither spectral frequency band nor amplitude of spontaneous occipital HFOs significantly differed from those of epileptogenic HFOs. Spontaneous occipital HFOs were strongly locked to the phase of delta activity, but the strength of delta-phase coupling decayed from 1 to 3 Hz. Conversely, epileptogenic extra-occipital HFOs were locked to the phase of delta activity about equally in the range from 1 to 3 Hz. The occipital cortex spontaneously generates physiological HFOs which may stand out on electrocorticography traces as prominently as pathological HFOs arising from elsewhere; this observation should be taken into consideration during presurgical evaluation. Coupling of spontaneous delta and HFOs may increase the understanding of significance of delta-oscillations during slow-wave sleep. Further studies are warranted to determine whether delta-phase coupling distinguishes physiological from pathological HFOs or simply differs across anatomical locations. PMID:21432945

Human occipital cortices differentially exert saccadic suppression: intracranial recording in children

Science.gov (United States)

Uematsu, Mitsugu; Matsuzaki, Naoyuki; Brown, Erik C.; Kojima, Katsuaki; Asano, Eishi

2013-01-01

By repeating saccades unconsciously, humans explore the surrounding world every day. Saccades inevitably move external visual images across the retina at high velocity; nonetheless, healthy humans don’t perceive transient blurring of the visual scene during saccades. This perceptual stability is referred to as saccadic suppression. Functional suppression is believed to take place transiently in the visual systems, but it remains unknown how commonly or differentially the human occipital lobe activities are suppressed at the large-scale cortical network level. We determined the spatial-temporal dynamics of intracranially-recorded gamma activity at 80–150 Hz around spontaneous saccades under no-task conditions during wakefulness and those in darkness during REM sleep. Regardless of wakefulness or REM sleep, a small degree of attenuation of gamma activity was noted in the occipital regions during saccades, most extensively in the polar and least in the medial portions. Longer saccades were associated with more intense gamma-attenuation. Gamma-attenuation was subsequently followed by gamma-augmentation most extensively involving the medial and least involving the polar occipital region. Such gamma-augmentation was more intense during wakefulness and temporally locked to the offset of saccades. The polarities of initial peaks of perisaccadic event-related potentials (ERPs) were frequently positive in the medial and negative in the polar occipital regions. The present study, for the first time, provided the electrophysiological evidence that human occipital cortices differentially exert peri-saccadic modulation. Transiently suppressed sensitivity of the primary visual cortex in the polar region may be an important neural basis for saccadic suppression. Presence of occipital gamma-attenuation even during REM sleep suggests that saccadic suppression might be exerted even without external visual inputs. The primary visual cortex in the medial region, compared to the

A simplified CT-guided approach for greater occipital nerve infiltration in the management of occipital neuralgia.

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Kastler, Adrian; Onana, Yannick; Comte, Alexandre; Attyé, Arnaud; Lajoie, Jean-Louis; Kastler, Bruno

2015-08-01

To evaluate the efficacy of a simplified CT-guided greater occipital nerve (GON) infiltration approach in the management of occipital neuralgia (ON). Local IRB approval was obtained and written informed consent was waived. Thirty three patients suffering from severe refractory ON who underwent a total of 37 CT-guided GON infiltrations were included between 2012 and 2014. GON infiltration was performed at the first bend of the GON, between the inferior obliqus capitis and semispinalis capitis muscles with local anaesthetics and cortivazol. Pain was evaluated via VAS scores. Clinical success was defined by pain relief greater than or equal to 50 % lasting for at least 3 months. The pre-procedure mean pain score was 8/10. Patients suffered from left GON neuralgia in 13 cases, right GON neuralgia in 16 cases and bilateral GON neuralgia in 4 cases. The clinical success rate was 86 %. In case of clinical success, the mean pain relief duration following the procedure was 9.16 months. Simplified CT-guided infiltration appears to be effective in managing refractory ON. With this technique, infiltration of the GON appears to be faster, technically easier and, therefore, safer compared with other previously described techniques. • Occipital neuralgia is a very painful and debilitating condition • GON infiltrations have been successful in the treatment of occipital neuralgia • This simplified technique presents a high efficacy rate with long-lasting pain relief • This infiltration technique does not require contrast media injection for pre-planning • GON infiltration at the first bend appears easier and safer.

Cognitive Functioning in Temporal Lobe Epilepsy: A BOLD-fMRI Study.

Science.gov (United States)

Guo, Lili; Bai, Genji; Zhang, Hui; Lu, Daoyan; Zheng, Jiyong; Xu, Gang

2017-12-01

We aimed to analyze the association between resting-state functional magnetic resonance imaging (re-fMRI) and cognitive function (including language, executive, and memory functions) in temporal lobe epilepsy (TLE) patients, which will help to explore the mechanism of brain function in patients. 15 TLE patients and 15 non-TLE patients were recruited. All subjects underwent neuropsychological testing and memory functional evaluation. Changes in verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), full intelligence quotient (FIQ), and memory quotient (MQ) were compared between two groups. Re-fMRI data were also collected from two groups to evaluate these changes. Each individual score of neuropsychological testing and memory functional evaluation were higher in control group, which was statistically different (all P temporal gyrus back, right superior temporal gyrus, left cerebellum, left angular gyrus, left wedge anterior lobe, and left central back; while the negatively activated brain regions were left prefrontal, right cerebellum, right corner back, and right anterior cingulate gyrus. During the language task, the activated brain regions of the TLE patients were right prefrontal lobe, the lateral temporal gyri, the left cerebellum, left cornu laterale gyrus, left precuneus, and the left postcentral gyrus, whereas the negatively activated brain areas were the left prefrontal cortex, the right cerebellum, right cornu laterale gyrus, and the right anterior cingulate gyrus. During the executive task, epilepsy patients showed activation difference in right prefrontal and right frontal lobe and right brain, left superior temporal gyrus, and right cerebellum anterior lobe compared with the control group; no negatively activated differences in brain areas. During the memory task, the difference lay in bilateral anterior cingulate gyrus and bilateral wedge anterior lobe while the negatively activated brain areas were the left inferior frontal

Primary Occipital Ewing’s Sarcoma with Subsequent Spinal Seeding

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Ali Alqahtani

2017-01-01

Full Text Available Ewing’s sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing’s sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis. Computed tomography (CT imaging showed a mass in the left posterior fossa compressing the brainstem. The patient then underwent surgical excision followed by adjuvant chemoradiation therapy. Two years later, the patient presented with severe lower back pain and urinary incontinence. Whole-spine magnetic resonance imaging (MRI showed cerebrospinal fluid (CSF seeding from the L5 to the S4 vertebrae. Primary cranial Ewing’s sarcoma is considered in the differential diagnosis of children with extra-axial posterior fossa mass associated with destructive permeative bone lesions. Although primary cranial Ewing’s sarcoma typically has good prognosis, our patient developed metastasis in the lower spine. Therefore, with CNS Ewing’s sarcoma, screening of the entire neural axis should be taken into consideration for early detection of CSF seeding metastasis in order to decrease the associated morbidity and mortality.

Experience of Surgical Treatment for Occipital Migraine in Taiwan.

Science.gov (United States)

Lin, Shang-Hsi; Lin, Huwang-Chi; Jeng, Chu-Hsu; Hsieh, Cheng-Han; Lin, Yu-Hsien; Chen, Cha-Chun

2016-03-01

Refractory migraine surgery developed since 2003 has excellent results over the past 10 years. According to the pioneer of migraine surgery, Dr. Bahman Guyuron, 5 major surgical classifications of migraines are described in the field of plastic surgery, namely, frontal migraine, temporal migraine, rhinogenic migraine, occipital migraine, and auriculotemporal migraine. In this study, we present the preliminary surgical results of the occipital migraine surgery. A total of 22 patients with simple occipital migraines came to our outpatient clinic for help from June 2014 to February 2015. Thirteen cases were excluded owing to ineligibility for operation or other reasons. The patients who concurrently experienced other types of migraines were precluded even if they received combined migraine surgery. Therefore, 9 simple occipital migraine cases were enrolled in this study. Migraine severity was evaluated by uniform questionnaires to identify the source of migraine. Neurolysis was performed under general anesthesia, with the patient in a prone position. Postoperative conditions were evaluated at the second, fourth, sixth, and eighth weeks by posttreatment questionnaires. Of all the 9 patients, 5 experienced single-sided migraines of greater occipital nerve origin (2 left-sided and 3 right-sided cases). Two patients had bilateral migraines of greater occipital nerve origin, and unilateral right lesser occipital nerve origin was noted in one patient. The last patient had right-sided migraines of greater and lesser occipital nerve origin. As a result in the follow-up, a response rate greater than 90% was documented, and complete resolution was observed in 2 patients. Drug doses were reduced more than 50% in the remaining patients. The overall efficacy of occipital migraine surgery in this study was 88.8% (8/9 cases). Some patients with migraine are good candidates for surgical resolution with appropriate and meticulous selection. Similar to what is observed in Western

Papillary thyroid microcarcinoma in a thyroid pyramidal lobe

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Ha, Tae Kwan; Kim, Dong Wook; Park, Ha Kyoung; Jung, Soo Jin [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

2014-12-15

We report an extremely rare case of papillary thyroid microcarcinoma (PTMC) in the thyroid pyramidal lobe (TPL). A 48-year-old woman underwent ultrasound-guided fine-needle aspiration for a small thyroid nodule in the right lobe in local clinic, and it revealed a malignant cytology. On preoperative ultrasonography for tumor staging in our hospital, another small suspiciously malignant hypoechoic nodule was detected in the left TPL. Total thyroidectomy and central nodal dissection were performed. Histopathology confirmed PTMCs in the left TPL and both thyroid lobes. Ultrasonography for TPL should be required for complete evaluation of possible multifocality of thyroid malignancy.

Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy

Directory of Open Access Journals (Sweden)

Peng Fang

2015-01-01

Full Text Available Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE, but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed for each subject, multivariate pattern analysis was applied to classify the left mTLE from the right mTLE and extract the anatomical connectivity differences between the left and right mTLE patients. The classification results reveal 93.0% accuracy for the left mTLE versus the right mTLE, 93.4% accuracy for the left mTLE versus controls and 90.0% accuracy for the right mTLE versus controls. Compared with the right mTLE, the left mTLE exhibited a different connectivity pattern in the cortical-limbic network and cerebellum. The majority of the most discriminating anatomical connections were located within or across the cortical-limbic network and cerebellum, thereby indicating that these disease-related anatomical network alterations may give rise to a portion of the complex of emotional and memory deficit between the left and right mTLE. Moreover, the orbitofrontal gyrus, cingulate cortex, hippocampus and parahippocampal gyrus, which exhibit high discriminative power in classification, may play critical roles in the pathophysiology of mTLE. The current study demonstrated that anatomical connectivity differences between the left mTLE and the right mTLE may have the potential to serve as a neuroimaging biomarker to guide personalized diagnosis of the left and right mTLE.

Incipient preoperative reorganization processes of verbal memory functions in patients with left temporal lobe epilepsy.

Science.gov (United States)

Milian, Monika; Zeltner, Lena; Erb, Michael; Klose, Uwe; Wagner, Kathrin; Frings, Lars; Veil, Cornelia; Rona, Sabine; Lerche, Holger; Klamer, Silke

2015-01-01

We previously reported nonlinear correlations between verbal episodic memory performance and BOLD signal in memory fMRI in healthy subjects. The purpose of the present study was to examine this observation in patients with left mesial temporal lobe epilepsy (mTLE) who often experience memory decline and need reliable prediction tools before epilepsy surgery with hippocampectomy. Fifteen patients with left mTLE (18-57years, nine females) underwent a verbal memory fMRI paradigm. Correlations between BOLD activity and neuropsychological data were calculated for the i) hippocampus (HC) as well as ii) extrahippocampal mTL structures. Memory performance was systematically associated with activations within the right HC as well as with activations within the left extrahippocampal mTL regions (amygdala and parahippocampal gyrus). As hypothesized, the analyses revealed cubic relationships, with one peak in patients with marginal memory performance and another peak in patients with very good performance. The nonlinear correlations between memory performance and activations might reflect the compensatory recruitment of neural resources to maintain memory performance in patients with ongoing memory deterioration. The present data suggest an already incipient preoperative reorganization process of verbal memory in non-amnesic patients with left mTLE by simultaneously tapping the resources of the right HC and left extrahippocampal mTL regions. Thus, in the preoperative assessment, both neuropsychological performance and memory fMRI should be considered together. Copyright © 2014 Elsevier Inc. All rights reserved.

Alfred Walter Campbell and the visual functions of the occipital cortex.

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Macmillan, Malcolm

2014-07-01

In his pioneering cytoarchitectonic studies of the human brain, Alfred Walter Campbell identified two structurally different areas in the occipital lobes and assigned two different kinds of visual functions to them. The first area, the visuosensory, was essentially on the mesial surface of the calcarine fissure. It was the terminus of nervous impulses generated in the retina and was where simple visual sensations arose. The second area, the visuopsychic, which surrounded or invested the first, was where sensations were interpreted and elaborated into visual perceptions. I argue that Campbell's distinction between the two areas was the starting point for the eventual differentiation of areas V1-V5. After a brief outline of Campbell's early life and education in Australia and of his Scottish medical education and early work as a pathologist at the Lancashire County Lunatic Asylum at Rainhill near Liverpool, I summarise his work on the human brain. In describing the structures he identified in the occipital lobes, I analyse the similarities and differences between them and the related structures identified by Joseph Shaw Bolton. I conclude by proposing some reasons for how that work came to be overshadowed by the later studies of Brodmann and for the more general lack of recognition given Campbell and his work. Those reasons include the effect of the controversies precipitated by Campbell's alliance with Charles Sherrington over the functions of the sensory and motor cortices. Copyright © 2012 Elsevier Ltd. All rights reserved.

Papillary thyroid microcarcinoma in a thyroid pyramidal lobe

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Tae Kwun Ha

2014-10-01

Full Text Available

We report an extremely rare case of papillary thyroid microcarcinoma (PTMC in the thyroid Epub ahead of print pyramidal lobe (TPL. A 48-year-old woman underwent ultrasound-guided fine-needle aspiration for a small thyroid nodule in the right lobe in local clinic, and it revealed a malignant cytology. On preoperative ultrasonography for tumor staging in our hospital, another small suspiciously malignant hypoechoic nodule was detected in the left TPL. Total thyroidectomy and central nodal dissection were performed. Histopathology confirmed PTMCs in the left TPL and both thyroid lobes. Ultrasonography for TPL should be required for complete evaluation of possible multifocality of thyroid malignancy.

Sneddon's syndrotne with anticardiolipin antibodies complications ...

African Journals Online (AJOL)

Heart echocardiographic assessment showed mild mitral and tricuspid valve mcom.petence, electro-encephalography revealed a right postenor temporal lobe epileptiform dysfunction and magnetic resonance imaging of the brain showed three small ~arcts: 1 occipital, 1 in the right temporal lobe and 1 m the left cerebellutn.

Occipital bone thickness: Implications on occipital-cervical fusion. A cadaveric study.

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Zarghooni, Kourosh; Boese, Chrisoph K; Siewe, Jan; Röllinghoff, Marc; Eysel, Peer; Scheyerer, Max J

2016-12-01

The aim of this study was to create a map of the occipital bone using a cadaveric morphometric analysis. Twelve heads, from seven male and five female cadavers, were studied. The thickness of the occipital bone was measured with a digital vernier caliper within a coordinate system. The maximum thickness of the occipital bone could be measured at the external occipital protuberance (mean 15.4 mm; range 9-29.3 mm). All male individuals had higher bone thickness around this point. Further lateral a steady decrease of bone thickness could be observed. Same could be observed in craniocaudal direction. However, values above the superior nuchal line were on average thicker than below. The measurements demonstrated a great individual variability of bone thickness of the occipital bone. The results emphasize the role of preoperative planning for the feasibility of placement of an occipital screw. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

A RARE CASE OF ATYPICAL PRIMARY EWING’S SARCOMA OF OCCIPITAL BONE

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K. Srihari

2016-07-01

Full Text Available BACKGROUND Ewing’s Sarcoma is an aggressive malignant neoplasm most frequently manifesting in the second decade of life and accounting for 4% of childhood and adolescent malignancies. These tumours were first described by James Ewing in 1921 as tumours that arise from bone. These osseous lesions have since become infamous for their highly aggressive course with 20% to 30% of patients having evidence of metastasis at the time of diagnosis and an estimated 10-year survival rate of 50%. Metastases to the CNS have most recently been estimated to occur in less than 5% of cases and are usually due to direct extension of an osseous lesion into the extradural space or more rarely through haematogenous spread. CASE REPORT In this article, we report a case of 17-year-old boy who presented to the radiology department with complaints of recurrent episodes of headache and vomiting for the past 3 days. On radiological investigation, there was a large well-defined, lobulated, extra-axial mass lesion measuring 3.6 X 5.7 X 5.9 cm noted in the supratentorial left occipital region which was fairly enhancing after contrast administration. The mass was causing permeative type of destruction of the left occipital bone and extending into extracranial soft tissue. Final diagnosis was done by biopsy and histopathology which showed “Atypical Ewing’s Sarcoma” of the left occipital bone. Considering its unusual site and soft tissue extension, we report this case of Primary Atypical Ewing’s sarcoma of occipital bone. CONCLUSION Primary cranial Ewing's sarcoma is to be considered in the differential diagnosis in children with a tumour involving the skull with destruction of the bone and presence of extra-axial soft tissue swelling. CT is the excellent modality for demonstration of bone destruction while MRI depicts soft tissue extension and metastasis if any.

CT findings in a case of neonatal acute subdural hematoma

International Nuclear Information System (INIS)

Koshu, K.; Horie, Y.; Hirashima, Y.; Endo, S.; Takaku, A.

1981-01-01

The CT findings in a case of neonatal accute subdural hematoma are presented. CT demonstrated a crescentic high density area in the subdural space over the left cerebral hemisphere and an oval high density area in the left occipital region. The latter was suspected of being an intracerebral hematoma. Emergency craniotomy revealed that the high density area was due to a subdural hematoma between the occipital lobe and the tentorium cerebelli. (orig.)

Presentation of moyamoya disease with occipital hemorrhage: a case report

Directory of Open Access Journals (Sweden)

Serkan Demir

2012-12-01

Full Text Available Moyamoya disease is a cerebrovascular disease which is characterized with stenosis and occlusions at the distal part of internal carotid artery and at the proximal part of anterior and middle cerebral arteries. It rarely causes temporary or recurrent hemiparesis due to intracranial hemorrhage while symptoms like headache, convulsion, nystagmus, aphasia and ataxia may also occur. In this paper, we present a case of Moyamoya disease which was diagnosed with a 23 year old female patient who was admitted to our emergency department with headache, nausea and vomiting complaints and whose radiological findings showed occipital lobe hemorrhage.

Occipital neuralgia: anatomic considerations.

Science.gov (United States)

Cesmebasi, Alper; Muhleman, Mitchel A; Hulsberg, Paul; Gielecki, Jerzy; Matusz, Petru; Tubbs, R Shane; Loukas, Marios

2015-01-01

Occipital neuralgia is a debilitating disorder first described in 1821 as recurrent headaches localized in the occipital region. Other symptoms that have been associated with this condition include paroxysmal burning and aching pain in the distribution of the greater, lesser, or third occipital nerves. Several etiologies have been identified in the cause of occipital neuralgia and include, but are not limited to, trauma, fibrositis, myositis, fracture of the atlas, and compression of the C-2 nerve root, C1-2 arthrosis syndrome, atlantoaxial lateral mass osteoarthritis, hypertrophic cervical pachymeningitis, cervical cord tumor, Chiari malformation, and neurosyphilis. The management of occipital neuralgia can include conservative approaches and/or surgical interventions. Occipital neuralgia is a multifactorial problem where multiple anatomic areas/structures may be involved with this pathology. A review of these etiologies may provide guidance in better understanding occipital neuralgia. © 2014 Wiley Periodicals, Inc.

Declarative long-term memory and the mesial temporal lobe: Insights from a 5-year postsurgery follow-up study on refractory temporal lobe epilepsy.

Science.gov (United States)

Salvato, Gerardo; Scarpa, Pina; Francione, Stefano; Mai, Roberto; Tassi, Laura; Scarano, Elisa; Lo Russo, Giorgio; Bottini, Gabriella

2016-11-01

It is largely recognized that the mesial temporal lobe and its substructure support declarative long-term memory (LTM). So far, different theories have been suggested, and the organization of declarative verbal LTM in the brain is still a matter of debate. In the current study, we retrospectively selected 151 right-handed patients with temporal lobe epilepsy with and without hippocampal sclerosis, with a homogeneous (seizure-free) clinical outcome. We analyzed verbal memory performance within a normalized scores context, by means of prose recall and word paired-associate learning tasks. Patients were tested at presurgical baseline, 6months, 2 and 5years after anteromesial temporal lobe surgery, using parallel versions of the neuropsychological tests. Our main finding revealed a key involvement of the left temporal lobe and, in particular, of the left hippocampus in prose recall rather than word paired-associate task. We also confirmed that shorter duration of epilepsy, younger age, and withdrawal of antiepileptic drugs would predict a better memory outcome. When individual memory performance was taken into account, data showed that females affected by left temporal lobe epilepsy for longer duration were more at risk of presenting a clinically pathologic LTM at 5years after surgery. Taken together, these findings shed new light on verbal declarative memory in the mesial temporal lobe and on the behavioral signature of the functional reorganization after the surgical treatment of temporal lobe epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

Large-scale brain networks are distinctly affected in right and left mesial temporal lobe epilepsy.

Science.gov (United States)

de Campos, Brunno Machado; Coan, Ana Carolina; Lin Yasuda, Clarissa; Casseb, Raphael Fernandes; Cendes, Fernando

2016-09-01

Mesial temporal lobe epilepsy (MTLE) with hippocampus sclerosis (HS) is associated with functional and structural alterations extending beyond the temporal regions and abnormal pattern of brain resting state networks (RSNs) connectivity. We hypothesized that the interaction of large-scale RSNs is differently affected in patients with right- and left-MTLE with HS compared to controls. We aimed to determine and characterize these alterations through the analysis of 12 RSNs, functionally parceled in 70 regions of interest (ROIs), from resting-state functional-MRIs of 99 subjects (52 controls, 26 right- and 21 left-MTLE patients with HS). Image preprocessing and statistical analysis were performed using UF(2) C-toolbox, which provided ROI-wise results for intranetwork and internetwork connectivity. Intranetwork abnormalities were observed in the dorsal default mode network (DMN) in both groups of patients and in the posterior salience network in right-MTLE. Both groups showed abnormal correlation between the dorsal-DMN and the posterior salience, as well as between the dorsal-DMN and the executive-control network. Patients with left-MTLE also showed reduced correlation between the dorsal-DMN and visuospatial network and increased correlation between bilateral thalamus and the posterior salience network. The ipsilateral hippocampus stood out as a central area of abnormalities. Alterations on left-MTLE expressed a low cluster coefficient, whereas the altered connections on right-MTLE showed low cluster coefficient in the DMN but high in the posterior salience regions. Both right- and left-MTLE patients with HS have widespread abnormal interactions of large-scale brain networks; however, all parameters evaluated indicate that left-MTLE has a more intricate bihemispheric dysfunction compared to right-MTLE. Hum Brain Mapp 37:3137-3152, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. © 2016 The Authors Human Brain Mapping Published by

Are personality traits of juvenile myoclonic epilepsy related to frontal lobe dysfunctions? A proton MRS study.

Science.gov (United States)

de Araújo Filho, Gerardo Maria; Lin, Katia; Lin, Jaime; Peruchi, Mirella M; Caboclo, Luís Otávio S F; Guaranha, Mirian S B; Guilhoto, Laura M F F; Carrete, Henrique; Yacubian, Elza Márcia T

2009-05-01

Personality traits characterized by emotional instability and immaturity, unsteadiness, lack of discipline, hedonism, frequent and rapid mood changes, and indifference toward one's disease have been associated with patients who have juvenile myoclonic epilepsy (JME). Literature data demonstrate worse seizure control and more psychosocial dysfunctions among patients with JME who have those traits. In this controlled study we performed a correlation analysis of psychiatric scores with magnetic resonance spectroscopy (MRS) values across JME patients, aiming to verify the existence of a possible relation between frontal lobe dysfunction and the prevalence of personality disorders (PDs) in JME. Sixteen JME patients with cluster B PDs, 41 JME patients without any psychiatric disorder, and 30 healthy controls were submitted to a psychiatric evaluation and to a quantitative multivoxel MRS of thalamus; insula; cingulate gyrus; striatum; and frontal, parietal, and occipital lobes. Groups were homogeneous according to age, gender, and manual dominance. Psychiatric evaluation was performed through the Scheduled Clinical Interview for DSM-IV, Axis I and II (SCID I and II, respectively). A significant reduction of N-acetyl-aspartate over creatinine (NAA/Cr) ratio was observed mainly in the left frontal lobe in the JME and PD group. In addition, a significant increase in the glutamate-glutamine over creatinine GLX/Cr ratio was also observed in this referred region in the same group. These data support the hypothesis that PDs in JME could represent neuronal dysfunction and possibly a more severe form of this epileptic syndrome.

Clinical evaluation of false-positive scintigraphic lesions of the left lobe in portal hypertension

International Nuclear Information System (INIS)

Takayasu, Kenichi; Moriyama, Noriyuki; Suzuki, Masao; Yamada, Tatsuya; Fukutake, Toshio.

1982-01-01

sup(99m)Tc-phytate liver scan and percutaneous transhepatic portography (PTP) were performed in 33 patients with portal hypertension due to various hepatic diseases. A defect or space occupying lesion in the left lobe on the scan in these patients was analysed with reference to portographic changes of the pars umbilicus of the left portal vein and the following results were obtained. 1) A false-positive defect on the scintigram was found in 6 (18.2%) of 33 patients, and portal vein pressure (PVP) was above 200 mmH 2 O in all 6 which constituted 21.4% of 28 with PVP above 200 mmH 2 O. 2) In five out of 6 patients with false-positive scan findings, the pars umbilicus was dilated to more than 25 x 15 mm in size, and it was huge and tortuous in 3 of them. 3) The mean PVP in the group with a false-positive scan tended to be higher than that in patients with no abnormalities on the scintigram. It was concluded that in reading of liver scintigrams in patients with portal hypertension, a dilated pars umbilicus and huge para-umbilical vein should be considered. (author)

Familial temporal lobe epilepsy due to focal cortical dysplasia type IIIa.

Science.gov (United States)

Fabera, Petr; Krijtova, Hana; Tomasek, Martin; Krysl, David; Zamecnik, Josef; Mohapl, Milan; Jiruska, Premysl; Marusic, Petr

2015-09-01

Focal cortical dysplasia (FCD) represents a common cause of refractory epilepsy. It is considered a sporadic disorder, but its occasional familial occurrence suggests the involvement of genetic mechanisms. Siblings with intractable epilepsy were referred for epilepsy surgery evaluation. Both patients were examined using video-EEG monitoring, MRI examination and PET imaging. They underwent left anteromedial temporal lobe resection. Electroclinical features pointed to left temporal lobe epilepsy and MRI examination revealed typical signs of left-sided hippocampal sclerosis and increased white matter signal intensity in the left temporal pole. PET examination confirmed interictal hypometabolism in the left temporal lobe. Histopathological examination of resected tissue demonstrated the presence FCD type IIIa, i.e. hippocampal sclerosis and focal cortical dysplasia in the left temporal pole. We present a unique case of refractory mesial temporal lobe epilepsy in siblings, characterized by an identical clinical profile and histopathology of FCD type IIIa, who were successfully treated by epilepsy surgery. The presence of such a high concordance between the clinical and morphological data, together with the occurrence of epilepsy and febrile seizures in three generations of the family pedigree points towards a possible genetic nature of the observed FCD type IIIa. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Intra- and interhemispheric variations of diffusivity in subcortical white matter in normal human brain

International Nuclear Information System (INIS)

Yoshiura, Takashi; Noguchi, Tomoyuki; Hiwatashi, Akio; Togao, Osamu; Yamashita, Koji; Nagao, Eiki; Kamano, Hironori; Honda, Hiroshi

2010-01-01

Our purpose was to reveal potential regional variations in water molecular diffusivity within each cerebral hemisphere and across the right and left hemispheres. Diffusion-weighted images of 44 healthy right-handed adult male subjects were obtained using a diffusion tensor imaging sequence. Mean diffusivity (MD) values in subcortical white matter (WM) within 39 regions in each hemisphere were measured using an automated method. Intrahemispheric comparisons of MDs in subcortical WM were performed among six brain regions (frontal, parietal, occipital and temporal lobes and pre- and postcentral gyri). Interhemispheric comparisons of MDs were performed between the right and left counterparts of the 39 regions. In both hemispheres, diffusivity in the precentral gyrus was lower than those in other regions, while diffusivity in the parietal lobe was higher than others. MD asymmetry in which the left was lower than the right was found in the parietal lobe, middle occipital gyrus, and medial and orbital aspects of the frontal lobe. The converse asymmetry was revealed in the frontal operculum, supplementary motor cortex, temporal lobe, limbic cortices, precuneus and cuneus. Our results revealed significant intra- and interhemispheric regional variations in MD in subcortical WM, which may be related to different densities of axons and myelin sheaths. (orig.)

Intra- and interhemispheric variations of diffusivity in subcortical white matter in normal human brain

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Yoshiura, Takashi; Noguchi, Tomoyuki; Hiwatashi, Akio; Togao, Osamu; Yamashita, Koji; Nagao, Eiki; Kamano, Hironori; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, Fukuoka (Japan)

2010-01-15

Our purpose was to reveal potential regional variations in water molecular diffusivity within each cerebral hemisphere and across the right and left hemispheres. Diffusion-weighted images of 44 healthy right-handed adult male subjects were obtained using a diffusion tensor imaging sequence. Mean diffusivity (MD) values in subcortical white matter (WM) within 39 regions in each hemisphere were measured using an automated method. Intrahemispheric comparisons of MDs in subcortical WM were performed among six brain regions (frontal, parietal, occipital and temporal lobes and pre- and postcentral gyri). Interhemispheric comparisons of MDs were performed between the right and left counterparts of the 39 regions. In both hemispheres, diffusivity in the precentral gyrus was lower than those in other regions, while diffusivity in the parietal lobe was higher than others. MD asymmetry in which the left was lower than the right was found in the parietal lobe, middle occipital gyrus, and medial and orbital aspects of the frontal lobe. The converse asymmetry was revealed in the frontal operculum, supplementary motor cortex, temporal lobe, limbic cortices, precuneus and cuneus. Our results revealed significant intra- and interhemispheric regional variations in MD in subcortical WM, which may be related to different densities of axons and myelin sheaths. (orig.)

Giant high occipital encephalocele

Directory of Open Access Journals (Sweden)

Agrawal Amit

2016-03-01

Full Text Available Encephaloceles are rare embryological mesenchymal developmental anomalies resulting from inappropriate ossification in skull through with herniation of intracranial contents of the sac. Encephaloceles are classified based on location of the osseous defect and contents of sac. Convexity encephalocele with osseous defect in occipital bone is called occipital encephalocele. Giant occipital encephaloceles can be sometimes larger than the size of baby skull itself and they pose a great surgical challenge. Occipital encephaloceles (OE are further classified as high OE when defect is only in occipital bone above the foramen magnum, low OE when involving occipital bone and foramen magnum and occipito-cervical when there involvement of occipital bone, foramen magnum and posterior upper neural arches. Chiari III malformation can be associated with high or low occipital encephaloceles. Pre-operatively, it is essential to know the size of the sac, contents of the sac, relation to the adjacent structures, presence or absence of venous sinuses/vascular structures and osseous defect size. Sometimes it becomes imperative to perform both CT and MRI for the necessary information. Volume rendered CT images can depict the relation of osseous defect to foramen magnum and provide information about upper neural arches which is necessary in classifying these lesions.

Accelerated long-term forgetting in temporal lobe epilepsy: evidence of improvement after left temporal pole lobectomy.

Science.gov (United States)

Gallassi, Roberto; Sambati, Luisa; Poda, Roberto; Stanzani Maserati, Michelangelo; Oppi, Federico; Giulioni, Marco; Tinuper, Paolo

2011-12-01

Accelerated long term forgetting (ALF) is a characteristic cognitive aspect in patients affected by temporal lobe epilepsy that is probably due to an impairment of memory consolidation and retrieval caused by epileptic activity in hippocampal and parahippocampal regions. We describe a case of a patient with TLE who showed improvement in ALF and in remote memory impairment after an anterior left temporal pole lobectomy including the uncus and amygdala. Our findings confirm that impairment of hippocampal functioning leads to pathological ALF, whereas restoration of hippocampal functioning brings ALF to a level comparable to that of controls. Copyright © 2011 Elsevier Inc. All rights reserved.

Occipital Nerve Stimulation for the Treatment of Refractory Occipital Neuralgia: A Case Series.

Science.gov (United States)

Keifer, Orion P; Diaz, Ashley; Campbell, Melissa; Bezchlibnyk, Yarema B; Boulis, Nicholas M

2017-09-01

Occipital neuralgia is a chronic pain syndrome characterized by sharp, shooting pains in the distribution of the occipital nerves. Although relatively rare, it associated with extremely debilitating symptoms that drastically affect a patient's quality of life. Furthermore, it is extremely difficult to treat as the symptoms are refractory to traditional treatments, including pharmacologic and procedural interventions. A few previous case studies have established the use of a neurostimulation of the occipital nerves to treat occipital neuralgia. The following expands on that literature by retrospectively reviewing the results of occipital nerve stimulation in a relatively large patient cohort (29 patients). A retrospective review of 29 patients undergoing occipital nerve stimulation for occipital neuralgia from 2012 to 2017 at a single institution with a single neurosurgeon. Of those 29 patients, 5 were repair or replacement of previous systems, 4 did not have benefit from trial stimulation, and 20 saw benefit to their trial stage of stimulation and went on to full implantation. Of those 20 patients, even with a history of failed procedures and pharmacological therapies, there was an overall success rate of 85%. The average preoperative 10-point pain score dropped from 7.4 ± 1.7 to a postoperative score of 2.9 ± 1.7. However, as with any peripheral nerve stimulation procedure, there were complications (4 patients), including infection, hardware erosion, loss of effect, and lead migration, which required revision or system removal. Despite complications, the results suggest, overall, that occipital nerve stimulation is a safe and effective procedure for refractory occipital neuralgia and should be in the neurosurgical repertoire for occipital neuralgia treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Application of Normative Occipital Condyle-C1 Interval Measurements to Detect Atlanto-Occipital Injury in Children.

Science.gov (United States)

Corcoran, B; Linscott, L L; Leach, J L; Vadivelu, S

2016-05-01

Prior studies have found that widening or asymmetry of the occipital condyle-C1 interval on CT is a sensitive and specific marker for atlanto-occipital dislocation. Previously reported abnormal occipital condyle-C1 interval values are not age-specific, possibly leading to false-positive findings in younger children, in whom this joint space is normally larger than that in adults. This study assesses the utility of applying age-specific normative occipital condyle-C1 interval ranges to documented cases of atlanto-occipital injury compared with previously reported abnormal cutoff values. Retrospective review of CT and MR imaging of 14 subjects with atlanto-occipital injury was performed, and occipital condyle-C1 interval measurements were made for each subject. Sensitivities and specificities of proposed occipital condyle-C1 interval cutoffs of 2 and 3 SDs above the mean and previously published occipital condyle-C1 interval cutoffs for atlanto-occipital injury were then calculated on the basis of occipital condyle-C1 interval measurements for each subject. An occipital condyle-C1 interval 2 SDs above the age-specific mean has a sensitivity of 50% and specificity of 89%-100%, depending on the age group. An occipital condyle-C1 interval 3 SDs above the age-specific mean has a sensitivity of 50% and a specificity of 95%-100%. A 4.0-mm occipital condyle-C1 interval has a sensitivity of 36% and a specificity of 100% in all age groups. A 2.5-mm occipital condyle-C1 interval has a sensitivity of 93% and a specificity of 18%-100%. Occipital condyle-C1 interval widening cutoffs used to establish atlanto-occipital injury lack both sensitivity and specificity in children and young teenagers. MR imaging is necessary to establish a diagnosis of atlanto-occipital injury in children and young teenagers when the appropriate mechanism of injury is present. © 2016 by American Journal of Neuroradiology.

Occipital GABA correlates with cognitive failures in daily life.

Science.gov (United States)

Sandberg, Kristian; Blicher, Jakob Udby; Dong, Mia Yuan; Rees, Geraint; Near, Jamie; Kanai, Ryota

2014-02-15

The brain has limited capacity, and so selective attention enhances relevant incoming information while suppressing irrelevant information. This process is not always successful, and the frequency of such cognitive failures varies to a large extent between individuals. Here we hypothesised that individual differences in cognitive failures might be reflected in inhibitory processing in the sensory cortex. To test this hypothesis, we measured GABA in human visual cortex using MR spectroscopy and found a negative correlation between occipital GABA (GABA+/Cr ratio) and cognitive failures as measured by an established cognitive failures questionnaire (CFQ). For a second site in parietal cortex, no correlation between CFQ score and GABA+/Cr ratio was found, thus establishing the regional specificity of the link between occipital GABA and cognitive failures. We further found that grey matter volume in the left superior parietal lobule (SPL) correlated with cognitive failures independently from the impact of occipital GABA and together, occipital GABA and SPL grey matter volume statistically explained around 50% of the individual variability in daily cognitive failures. We speculate that the amount of GABA in sensory areas may reflect the potential capacity to selectively suppress irrelevant information already at the sensory level, or alternatively that GABA influences the specificity of neural representations in visual cortex thus improving the effectiveness of successful attentional modulation. © 2013. Published by Elsevier Inc. All rights reserved.

Thalamotemporal impairment in temporal lobe epilepsy: a combined MRI analysis of structure, integrity, and connectivity.

Science.gov (United States)

Keller, Simon S; O'Muircheartaigh, Jonathan; Traynor, Catherine; Towgood, Karren; Barker, Gareth J; Richardson, Mark P

2014-02-01

Thalamic abnormality in temporal lobe epilepsy (TLE) is well known from imaging studies, but evidence is lacking regarding connectivity profiles of the thalamus and their involvement in the disease process. We used a novel multisequence magnetic resonance imaging (MRI) protocol to elucidate the relationship between mesial temporal and thalamic pathology in TLE. For 23 patients with TLE and 23 healthy controls, we performed T1 -weighted (for analysis of tissue structure), diffusion tensor imaging (tissue connectivity), and T1 and T2 relaxation (tissue integrity) MRI across the whole brain. We used connectivity-based segmentation to determine connectivity patterns of thalamus to ipsilateral cortical regions (occipital, parietal, prefrontal, postcentral, precentral, and temporal). We subsequently determined volumes, mean tractography streamlines, and mean T1 and T2 relaxometry values for each thalamic segment preferentially connecting to a given cortical region, and of the hippocampus and entorhinal cortex. As expected, patients had significant volume reduction and increased T2 relaxation time in ipsilateral hippocampus and entorhinal cortex. There was bilateral volume loss, mean streamline reduction, and T2 increase of the thalamic segment preferentially connected to temporal lobe, corresponding to anterior, dorsomedial, and pulvinar thalamic regions, with no evidence of significant change in any other thalamic segments. Left and right thalamotemporal segment volume and T2 were significantly correlated with volume and T2 of ipsilateral (epileptogenic), but not contralateral (nonepileptogenic), mesial temporal structures. These convergent and robust data indicate that thalamic abnormality in TLE is restricted to the area of the thalamus that is preferentially connected to the epileptogenic temporal lobe. The degree of thalamic pathology is related to the extent of mesial temporal lobe damage in TLE. © 2014 The Authors. Epilepsia published by Wiley Periodicals, Inc

Cerebral blood flow and volume in sympton-free migraineurs: A SPECT study

International Nuclear Information System (INIS)

Maini, C.L.; Turco, G.L.; Castellano, G.; Podio, V.; Cornaglia, G.; Liboni, W.; Chianale, G.

1990-01-01

Both CBF and BCV were evaluated by gamma-camera SPECT in 14 patients with classic migraine, all studied while symptom-free. Nuclear data were correlated with CT and MRI. A decreased regional CBF was observed in 13 of the 14 patients. The decreased perfusion was localized in the frontal lobe in 6 patients, the temporal lobe in one, the parietal lobe in 11 and the occipital lobe in 5 patients. The parieto-occipital cortex was involved more often than the frontal cortex; the association of hypoperfusion with parieto-occipital cortex was quite high. The right parieto-occipital regions were affected more often than the left ones. Regional CBV was increased in 8 patients. There was good topographical concordance between decreased CBF and increased CBV, but the increase of CBV was in general more evident at the periphery of the hypoperfusion. It is of interest that the only patient with a normal CBF study had a pathological CBV study. Apparently, CBF derangements are very common in symptom-free patients with classic migraine, a CBF decrease being often accompanied by a CBV increase. In these patients both CT and MRI have a lower diagnostic yield than SPECT. (orig.) [de

Cerebral blood flow and volume in sympton-free migraineurs: A SPECT study

Energy Technology Data Exchange (ETDEWEB)

Maini, C.L. (Ancona Univ. (Italy). Chair of Nuclear Medicine); Turco, G.L.; Castellano, G.; Podio, V.; Cornaglia, G. (Turin Univ. (Italy). Chair of Nuclear Medicine); Liboni, W.; Chianale, G. (Turin Univ. (Italy). Dept. of Neurology)

1990-11-01

Both CBF and BCV were evaluated by gamma-camera SPECT in 14 patients with classic migraine, all studied while symptom-free. Nuclear data were correlated with CT and MRI. A decreased regional CBF was observed in 13 of the 14 patients. The decreased perfusion was localized in the frontal lobe in 6 patients, the temporal lobe in one, the parietal lobe in 11 and the occipital lobe in 5 patients. The parieto-occipital cortex was involved more often than the frontal cortex; the association of hypoperfusion with parieto-occipital cortex was quite high. The right parieto-occipital regions were affected more often than the left ones. Regional CBV was increased in 8 patients. There was good topographical concordance between decreased CBF and increased CBV, but the increase of CBV was in general more evident at the periphery of the hypoperfusion. It is of interest that the only patient with a normal CBF study had a pathological CBV study. Apparently, CBF derangements are very common in symptom-free patients with classic migraine, a CBF decrease being often accompanied by a CBV increase. In these patients both CT and MRI have a lower diagnostic yield than SPECT. (orig.).

Homonymous Hemianopia with Macular Sparing: Clinical and ...

African Journals Online (AJOL)

Dr. Osoba

peripheral vision function in the cerebral cortex is located. Sparing ... Key words: brain, magnetic resonance imaging, macula, occipital lobe, vision ... luminance right homonymous hemianopia affecting inferior and superior ... infarction in left.

Hierarchical clustering of Alzheimer and 'normal' brains using elemental concentrations and glucose metabolism determined by PIXE, INAA and PET

International Nuclear Information System (INIS)

Cutts, D.A.; Spyrou, N.M.

2001-01-01

Brain tissue samples, obtained from the Alzheimer Disease Brain Bank, Institute of Psychiatry, London, were taken from both left and right hemispheres of three regions of the cerebrum, namely the frontal, parietal and occipital lobes for both Alzheimer and 'normal' subjects. Trace element concentrations in the frontal lobe were determined for twenty six Alzheimer (15 male, 11 female) and twenty six 'normal' (8 male, 18 female) brain tissue samples. In the parietal lobe ten Alzheimer (2 male, 8 female) and ten 'normal' (8 male, 2 female) samples were taken along with ten Alzheimer (4 male, 6 female) and ten 'normal' (6 male, 4 female) from the occipital lobe. For the frontal lobe trace element concentrations were determined using proton induced X-ray emission (PIXE) analysis while in parietal and occipital regions instrumental neutron activation analysis (INAA) was used. Additionally eighteen Alzheimer (9 male, 9 female) and eighteen age matched 'normal' (8 male, 10 female) living subjects were examined using positron emission tomography (PET) in order to determine regional cerebral metabolic rates of glucose (rCMRGlu). The rCMRGlu of 36 regions of the brain was investigated including frontal, occipital and parietal lobes as in the trace element study. Hierarchical cluster analysis was applied to the trace element and glucose metabolism data to discover which variables in the resulting dendrograms displayed the most significant separation between Alzheimer and 'normal' subjects. (author)

Pseudoaneurysm of the occipital artery: an unusual cause of persisting headache after minor head injury.

LENUS (Irish Health Repository)

Aquilina, K

2012-02-03

Post-traumatic pseudoaneurysms of the extracranial arteries in the scalp are uncommon sequelae of head injury. We report on a patient who presented four weeks after a minor head injury with a tender, pulsating and enlarging mass in the course of the left occipital artery. There was associated headache radiating to the vertex. Computed tomographic angiography confirmed the lesion to be a pseudoaneurysm of the occipital artery. The lump was resected with complete resolution of symptoms.

Occipital bone thickness: Implications on occipital-cervical fusion. A cadaveric study

Directory of Open Access Journals (Sweden)

Kourosh Zarghooni

2016-12-01

Conclusion: The measurements demonstrated a great individual variability of bone thickness of the occipital bone. The results emphasize the role of preoperative planning for the feasibility of placement of an occipital screw.

Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

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Rademacher, J.; Seitz, R.J. [Department of Neurology, Heinrich-Heine University Duesseldorf (Germany); Aulich, A. [Department of Radiology, Heinrich-Heine University, Duesseldorf (Germany); Reifenberger, G. [Department of Neuropathology, Heinrich-Heine University, Duesseldorf (Germany); Kiwit, J.C.W. [Department of Neurosurgery, Heinrich-Heine University, Duesseldorf (Germany); Langen, K.J.; Schmidt, D. [Institute of Medicine, Research Center Juelich, Heinrich-Heine University, Duesseldorf (Germany)

2000-06-01

We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[{sup 123}I]iodo-{alpha}-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

International Nuclear Information System (INIS)

Rademacher, J.; Seitz, R.J.; Aulich, A.; Reifenberger, G.; Kiwit, J.C.W.; Langen, K.J.; Schmidt, D.

2000-01-01

We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[ 123 I]iodo-α-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

Single-incision video-assisted thoracoscopic surgery left-lower lobe anterior segmentectomy (S8).

Science.gov (United States)

Galvez, Carlos; Lirio, Francisco; Sesma, Julio; Baschwitz, Benno; Bolufer, Sergio

2017-01-01

Unusual anatomical segmentectomies are technically demanding procedures that require a deep knowledge of intralobar anatomy and surgical skill. In the other hand, these procedures preserve more normal lung parenchyma for lesions located in specific anatomical segments, and are indicated for benign lesions, metastasis and also early stage adenocarcinomas without nodal involvement. A 32-year-old woman was diagnosed of a benign pneumocytoma in the anterior segment of the left-lower lobe (S8, LLL), so we performed a single-incision video-assisted thoracoscopic surgery (SI-VATS) anatomical S8 segmentectomy in 140 minutes under intercostal block. There were no intraoperative neither postoperative complications, the chest tube was removed at 24 hours and the patient discharged at 5 th postoperative day with low pain on the visual analogue scale (VAS). Final pathologic exam reported a benign sclerosant pneumocytoma with free margins. The patient has recovered her normal activities at 3 months completely with radiological normal controls at 1 and 3 months.

Effect of invasive EEG monitoring on cognitive outcome after left temporal lobe epilepsy surgery.

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Busch, Robyn M; Love, Thomas E; Jehi, Lara E; Ferguson, Lisa; Yardi, Ruta; Najm, Imad; Bingaman, William; Gonzalez-Martinez, Jorge

2015-10-27

The objective of this cohort study was to compare neuropsychological outcomes following left temporal lobe resection (TLR) in patients with epilepsy who had or had not undergone prior invasive monitoring. Data were obtained from an institutional review board-approved, neuropsychology registry for patients who underwent epilepsy surgery at Cleveland Clinic between 1997 and 2013. A total of 176 patients (45 with and 131 without invasive EEG) met inclusion criteria. Primary outcome measures were verbal memory and language scores. Other cognitive outcomes were also examined. Outcomes were assessed using difference in scores from before to after surgery and by presence/absence of clinically meaningful decline using reliable change indices (RCIs). Effect of invasive EEG on cognitive outcomes was estimated using weighting and propensity score adjustment to account for differences in baseline characteristics. Linear and logistic regression models compared surgical groups on all cognitive outcomes. Patients with invasive monitoring showed greater declines in confrontation naming; however, when RCIs were used to assess clinically meaningful change, there was no significant treatment effect on naming performance. No difference in verbal memory was observed, regardless of how the outcome was measured. In secondary outcomes, patients with invasive monitoring showed greater declines in working memory, which were no longer apparent using RCIs to define change. There were no outcome differences on other cognitive measures. Results suggest that invasive EEG monitoring conducted prior to left TLR is not associated with greater cognitive morbidity than left TLR alone. This information is important when counseling patients regarding cognitive risks associated with this elective surgery. © 2015 American Academy of Neurology.

Riluzole Effect on Occipital Cortex: A Structural and Spectroscopy Pilot Study

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Abdallah, Chadi G.; Coplan, Jeremy D.; Jackowski, Andrea; Sato, João R.; Mao, Xiangling; Shungu, Dikoma C.; Mathew, Sanjay J.

2012-01-01

Background To investigate the mechanism underlying the anxiolytic properties of riluzole, a glutamate-modulating agent, we previously studied the effect of this drug on hippocampal N-Acetylaspartate (NAA) and volume in patients with Generalized Anxiety Disorder (GAD). In the same cohort, we now extend our investigation to the occipital cortex, a brain region that was recently implicated in the antidepressant effect of riluzole. Methods Fourteen medication-free adult patients with GAD received 8-week of open-label riluzole. Ten healthy subjects served as a comparison group. The healthy group did not receive riluzole treatment. Both groups underwent magnetic resonance imaging and spectroscopy at baseline and at the end of Week 8. Hamilton Anxiety Rating Scale (HAM-A) and Penn State Worry Questionnaire (PSWQ) were used as the primary and secondary outcome measures, respectively. Results At baseline, we found clusters of increased cortical thickness in the occipital region in GAD compared to healthy subjects. In the right hemisphere, eight weeks of treatment reduced occipital cortical thickness in the GAD group (t = 3.67, p = 0.004). In addition, the improvement in HAM-A scores was negatively correlated with post-treatment right occipital NAA (r = − 0.68, p = 0.008), and with changes in NAA levels (r = − 0.53, p = 0.051). In the left hemisphere, we found positive associations between changes in occipital cortical thickness and improvement in HAM-A (r = 0.60, p = 0.04) and PSWQ (r = 0.62, p = 0.03). Conclusion These pilot findings implicate the occipital cortex as a brain region associated with pathology and clinical improvement in GAD. In addition, the region specific effect of riluzole implies a distinct pathophysiology in the occipital cortex – compared to other, previously studied, frontolimbic brain structures. PMID:23043888

Chordome extra-axial : a propos d'une localisation latero tracheale ...

African Journals Online (AJOL)

Most chordomas arise in the sacrococcygeal and spheno-occipital region. Extranotochordal chordomas are extremely unusual. Case report : A 50 year women suffering from a left compressive cervical mass with a acute respiratory detress. in cervicotomy, it was an inextirpable tumor in contact with the left thyroid lobe and ...

Ipsiversive ictal eye deviation in inferioposterior temporal lobe epilepsy-Two SEEG cases report.

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Zhang, Wei; Liu, Xingzhou; Zuo, Lijun; Guo, Qiang; Chen, Qi; Wang, Yongjun

2017-02-21

Versive seizure characterized by conjugate eye movement during epileptic seizure has been considered commonly as one of the most valuable semiological signs for epilepsy localization, especially for frontal lobe epilepsy. However, the lateralizing and localizing significance of ictaleye deviation has been questioned by clinical observation of a series of focal epilepsy studies, including frontal, central, temporal, parietal and occipital epilepsy. Two epileptic cases characterized by ipsiversive eye deviation as initial clinical sign during the habitual epileptic seizures are presented in this paper. The localization of the epileptogenic zone of both of the cases has been confirmed as inferioposterior temporal region by the findings of ictalstereoelectroencephalography (SEEG) and a good result after epileptic surgery. Detailed analysis of the exact position of the key contacts of the SEEG electrodes identified the overlap between the location of the epileptogenic zone and human MT/MST complex, which play a crucial role in the control of smooth pursuit eye movement. Ipsiversive eye deviation could be the initial clinical sign of inferioposterior temporal lobe epilepsy and attribute to the involvement of human MT/MST complex, especially human MST whichwas located on the anterior/dorsal bank of the anterior occipital sulcus (AOS).

Insights into Intrinsic Brain Networks based on Graph Theory and PET in right- compared to left-sided Temporal Lobe Epilepsy

OpenAIRE

Thomas Vanicek; Andreas Hahn; Tatjana Traub-Weidinger; Eva Hilger; Marie Spies; Wolfgang Wadsak; Rupert Lanzenberger; Ekaterina Pataraia; Susanne Asenbaum-Nan

2016-01-01

The human brain exhibits marked hemispheric differences, though it is not fully understood to what extent lateralization of the epileptic focus is relevant. Preoperative [18F]FDG-PET depicts lateralization of seizure focus in patients with temporal lobe epilepsy and reveals dysfunctional metabolic brain connectivity. The aim of the present study was to compare metabolic connectivity, inferred from inter-regional [18F]FDG PET uptake correlations, in right-sided (RTLE; n?=?30) and left-sided TL...

Auras and clinical features in temporal lobe epilepsy: a new approach on the basis of voxel-based morphometry.

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Santana, Maria Teresa Castilho Garcia; Jackowski, Andrea Parolin; da Silva, Henrique Hattori; Caboclo, Luis Otávio Sales Ferreira; Centeno, Ricardo Silva; Bressan, Rodrigo A; Carrete, Henrique; Yacubian, Elza Márcia Targas

2010-05-01

MRI investigations in patients with temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) have demonstrated structural abnormalities extending beyond ipsilateral hippocampus which may be studied through voxel-based morphometry (VBM). We investigated brain morphology related to clinical features in patients with refractory TLE with MTS using VBM. One hundred patients with unilateral TLE with MTS (59 left) and 30 controls were enrolled. VBM5 was employed to analyze (1) hemispheric damage, (2) influence of initial precipitating injury (IPI): 23 patients with febrile seizures and 19 with status epilepticus, and (3) types of auras classified as: mesial, including psychic auras (19 patients); anterior mesio-lateral, as autonomic symptoms, specially epigastric auras (27 patients) and neocortical, which included auditory, vertiginous, somatosensory and visual auras (16 patients). (1) Left TLE patients presented more widespread gray matter volume (GMV) reductions affecting ipsilateral hippocampus, temporal neocortex, insula and also left uncus, precentral gyrus, thalamus, parietal lobule, cuneus and bilateral cingulum. (2) Febrile seizures group presented ipsilateral GMV reductions in hippocampus, neocortical temporal, frontal and occipital cortices, insula and cingulum. Status epilepticus group presented more widespread GMV reductions involving temporal and extratemporal lobes. (3) Patients with mesial auras showed significant ipsilateral GMV reductions in hippocampus and amygdala, particularly right TLE group, who presented greater extension of GMV reduction in the entorhinal cortex. Significant reductions in hippocampus, amygdala and insula were seen in patients with anterior mesio-lateral auras. This study evaluated a large number of TLE-MTS patients showing structural damage extending beyond hippocampus, and different types of IPI associated with the extension of brain damage. Subtypes of auras are related to different clusters of areas of GMV reductions in

Occipital headaches and neuroimaging in children.

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Bear, Joshua J; Gelfand, Amy A; Goadsby, Peter J; Bass, Nancy

2017-08-01

To investigate the common thinking, as reinforced by the International Classification of Headache Disorders, 3rd edition (beta), that occipital headaches in children are rare and suggestive of serious intracranial pathology. We performed a retrospective chart review cohort study of all patients ≤18 years of age referred to a university child neurology clinic for headache in 2009. Patients were stratified by headache location: solely occipital, occipital plus other area(s) of head pain, or no occipital involvement. Children with abnormal neurologic examinations were excluded. We assessed location as a predictor of whether neuroimaging was ordered and whether intracranial pathology was found. Analyses were performed with cohort study tools in Stata/SE 13.0 (StataCorp, College Station, TX). A total of 308 patients were included. Median age was 12 years (32 months-18 years), and 57% were female. Headaches were solely occipital in 7% and occipital-plus in 14%. Patients with occipital head pain were more likely to undergo neuroimaging than those without occipital involvement (solely occipital: 95%, relative risk [RR] 10.5, 95% confidence interval [CI] 1.4-77.3; occipital-plus: 88%, RR 3.7, 95% CI 1.5-9.2; no occipital pain: 63%, referent). Occipital pain alone or with other locations was not significantly associated with radiographic evidence of clinically significant intracranial pathology. Children with occipital headache are more likely to undergo neuroimaging. In the absence of concerning features on the history and in the setting of a normal neurologic examination, neuroimaging can be deferred in most pediatric patients when occipital pain is present. © 2017 American Academy of Neurology.

Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

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Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

2016-01-01

Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Retrospective study. This study was conducted at the imaging department of a 1,409 bed university hospital. Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Some of the

Cerebral hemorrhage without manifest motor paralysis. Reports of 5 cases

Energy Technology Data Exchange (ETDEWEB)

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

1982-01-01

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

Cerebral hemorrhage without manifest motor paralysis

International Nuclear Information System (INIS)

Taketani, Torao; Dohi, Ichiro; Miyazaki, Tadahiko; Handa, Akihisa

1982-01-01

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

Cervical myelitis presenting as occipital neuralgia.

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Noh, Sang-Mi; Kang, Hyun Goo

2018-07-01

Occipital neuralgia is a common form of headache that is characterized by paroxysmal severe lancinating pain in the occipital nerve distribution. The exact pathophysiology is still not fully understood and occipital neuralgia often develops spontaneously. There are no specific guidelines for evaluation of patients with occipital neuralgia. Cervical spine, spinal cord and posterior neck muscle lesions can induce occipital neuralgia. Brain and spine imaging may be necessary in some cases, according to the nature of the headache or response to treatment. We report a case of cervical myelitis presenting as occipital neuralgia.

MRI and MRV in differentiation of posterior reversible encephalopathy syndrome and venous occlusion in patients with eclampsia or pre-eclampsia

International Nuclear Information System (INIS)

Xia Shuang; Liu Qingxian; Qi Ji

2009-01-01

Objective: To evaluate the role of MRV and MRI in the diagnosis of posterior encephalopathy syndrome (PRES) and venous sinus occlusion in patients with eclampsia or pre-eclampsia. Methods: We respectively studied the clinical and imaging data of 27 pre-eclampsia or eclampsia patients who occurred epilepsy, headache, and vision deficient during pregnancy or post partum. All patients underwent MRI and MRV examinations. The imaging protocol included coronal, sagittal, and axial T 1 WI, T 2 WI, FLAIR, DWI, and MRV. Results: 14 patients showed evidence of venous occlusion. Among them, 3 occurred in cortical vein, 4 in superior sagittal sinus, 2 in transverse sinus, l in sigmoid sinus, 2 in deep vein system, 3 in jugular vein, and 2 with complete sinus occlusion. Brain edema distributed in the corresponding area of occlusive sinus and 2 cases combined with secondary hemorrhage. 13 patients suffered from hypertensive encephalopathy. All of the lesions involved arcuate fibre in the bilateral parietal lobe (10 cases), right parietal lobe (2 cases), bilateral occipital lobe (7 cases), bilateral frontal lobe (6 cases), right frontal lobe (3 cases), bilateral temporal lobe (4 cases), left temporo-occipital lobe (1 case), splenium of corpus callosum (1 case), bilateral basal ganglia (2 cases), right basal ganglia (1 case), left centrum semiovale (1 case), and bilateral cerebellar hemisphere (1 case). Both of the lesions of PRES and venous occlusion showed hyperintensity on FLAIR and T 2 WI images, isointensity on DWI and hyperintensity on ADC, indicating vasogenic edema. Decreased lesion extent or completely disappeared was identified in 12 patients on follow-up scans. Conclusion: Lesions of PRES are usually located in the parietal and occipital lobes, especially in white matter. The lesion of venous occlusion usually occurs in the area of corresponding occlusive sinus. The MRV has an important value in diagnosis of PRES and venous sinus occlusion. (authors)

Statistical voxel-wise analysis of ictal SPECT reveals pattern of abnormal perfusion in patients with temporal lobe epilepsy Análise estatística baseada em voxel do SPECT ictal revela um padrão de alteração perfusional em pacientes com epilepsia de lobo temporal

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Bárbara Juarez Amorim

2005-12-01

Full Text Available OBJECTIVE: To investigate the pattern of perfusion abnormalities in ictal and interictal brain perfusion SPECT images (BSI from patients with temporal lobe epilepsy (TLE. METHOD: It was acquired interictal and ictal BSI from 24 patients with refractory TLE. BSIs were analyzed by visual inspection and statistical parametric mapping (SPM2. Statistical analysis compared the patients group to a control group of 50 volunteers. The images from patients with left-TLE were left-right flipped. RESULTS: It was not observed significant perfusional differences in interictal scans with SPM. Ictal BSI in SPM analysis revealed hyperperfusion within ipsilateral temporal lobe (epileptogenic focus and also contralateral parieto-occipital region, ipsilateral posterior cingulate gyrus, occipital lobes and ipsilateral basal ganglia. Ictal BSI also showed areas of hypoperfusion. CONCLUSION: In a group analysis of ictal BSI of patients with TLE, voxel-wise analysis detects a network of distant regions of perfusional alteration which may play active role in seizure genesis and propagation.OBJETIVO: Investigar o padrão de anormalidades perfusionais no SPECT de perfusão cerebral (SPC ictal e interictal na epilepsia de lobo temporal (ELT. MÉTODO: Foram realizados SPCs ictal e interictal de 24 pacientes com ELT que foram analisados visualmente e com o statistical parametric mapping (SPM2. A análise estatística comparou o grupo de pacientes versus um grupo controle de 50 voluntários. RESULTADOS: Na análise do SPM não foram observadas diferenças significativas no grupo de SPC interictal. No grupo de SPC ictal o SPM revelou hiperperfusão no lobo temporal ipsilateral (foco epileptogênico e também na região parieto-occipital contralateral, porção posterior do cíngulo ipsilateral, lobos occipitais e núcleos da base ipsilateral. O SPC ictal também mostrou áreas de hipoperfusão. CONCLUSÃO: Em uma análise de grupo do SPC ictal de pacientes com ELT, a an

Aphasia following left thalamic hemorrhage. A study by Western Aphasia Battery and single photon emission CT

Energy Technology Data Exchange (ETDEWEB)

Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro

1984-07-01

A report is given of 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months) in which language disorders were examined by Western Aphasia Battery (WAB) and cerebral blood flow was measured by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in the left temporooccipital region and low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, emission CT showed slight low flow area at the temporo-occipital region similar to the case with transcortical sensory aphasia. In another case with anomic aphasia there was a wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. In all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus.

C1-C2 instability with severe occipital headache in the setting of vertebral artery facet complex erosion.

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Taher, Fadi; Bokums, Kristaps; Aichmair, Alexander; Hughes, Alexander P

2014-05-01

An exact understanding of patient vertebral artery anatomy is essential to safely place screws at the atlanto-axial level in posterior arthrodesis. We aim to report a case of erosion of the left vertebral artery into the C1-C2 facet complex with resultant rotatory and lateral listhesis presenting with severe occipital headache. This represents a novel etiology for this diagnosis and our report illustrates technical considerations when instrumenting the C1-C2 segment. We report a case of severe occipital headache due to C1-C2 instability with resultant left C2 nerve compression in the setting of erosion of the vertebral artery into the C1-C2 facet complex. A 68-year-old woman presented with a 12-month history of progressively debilitating headache and neck pain with atlanto-axial instability. Computed tomography (CT) angiography demonstrated erosion of the left vertebral artery into the left C1-C2 facet complex. In addition, the tortuous vertebral arteries had eroded into the C2 pedicles, eliminating the possibility for posterior pedicle screw placement. The patient underwent posterior arthrodesis of C1-C2 utilizing bilateral lateral mass fixation into C1 and bilateral trans-laminar fixation into C2 with resolution of all preoperative complaints. This study constitutes the first report of a tortuous vertebral artery causing the partial destruction of a C1-C2 facet complex, as well as instability, with the clinical presentation of severe occipital headache. It hereby presents a novel etiology for both the development of C1-C2 segment instability as well as the development of occipital headache. Careful evaluation of such lesions utilizing CT angiography is important when formulating a surgical plan.

Recurrent malignant pilomatrixoma invading the cranial cavity: improved local control with adjuvant radiation

International Nuclear Information System (INIS)

Aherne, N. J.; Fitzpatrick, D. A.; Armstrong, J. G.; Gibbons, D.; Collins, C. D.

2009-01-01

Full text: We report the case of a 41-year-old mentally retarded male with recurrent pilomatrix carcinoma of the occipital region which invaded the occipital bone, left cerebellum and left temporal lobe. At his initial presentation the patient had a craniotomy and subtotal excision of the lesion with positive margins. He received no adjuvant therapy. After an early intracranial recurrence he had subtotal debulking and was referred for external beam radiotherapy. At 27 months follow-up after adjuvant external beam radiotherapy the intracranial component has not progressed and the patient remains clinically well

Ruptured Aneurysms of the Occipital Artery Associated with Congenital Occipital Bone Defect.

Science.gov (United States)

Kawasaki, Toshinari; Yoshida, Kazumichi; Kikuchi, Takayuki; Ishii, Akira; Takagi, Yasushi; Miyamoto, Susumu

2017-01-01

Traumatic aneurysms of the superficial temporal artery have been frequently reported in the literature, whereas traumatic aneurysms of the occipital artery (OA) are extremely rare. A 30-year-old man had been followed at another hospital for meningoencephalocele associated with his congenital occipital bone defect. He was admitted to our hospital with a chief complaint of neck swelling and pain during a football game. Computed tomography and magnetic resonance imaging showed a hematoma in his right neck along with the meningoencephalocele. In addition, it showed an atrophic cerebellum with a cyst protruding from his occipital bone defect. Digital subtraction angiography of the right OA showed 3 aneurysms responsible for the large hematoma in his neck. Endovascular embolization with 20% N-butyl-2-cyanoacrylate was performed for treatment of the ruptured aneurysms followed by emergent surgical evacuation of the hematoma. An occipital cranioplasty with titanium mesh was performed 10 months after the emergent intervention. In this patient, the congenital occipital bone defect with meningoencephalocele might have been the remote source of risk for traumatic pseudoaneurysms along the muscle branches of the OA. Copyright © 2016 Elsevier Inc. All rights reserved.

Ultrasound-Guided Greater Occipital Nerve Blocks and Pulsed Radiofrequency Ablation for Diagnosis and Treatment of Occipital Neuralgia

OpenAIRE

VanderHoek, Matthew David; Hoang, Hieu T; Goff, Brandon

2013-01-01

Occipital neuralgia is a condition manifested by chronic occipital headaches and is thought to be caused by irritation or trauma to the greater occipital nerve (GON). Treatment for occipital neuralgia includes medications, nerve blocks, and pulsed radiofrequency ablation (PRFA). Landmark-guided GON blocks are the mainstay in both the diagnosis and treatment of occipital neuralgia. Ultrasound is being utilized more and more in the chronic pain clinic to guide needle advancement when performing...

Arterial supply of the thoracic lobes of the thymus in dogs of the Great Dane race.

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Rosana Marques Silva

2007-09-01

Full Text Available The origins, numbers and type of arterial branches responsible for the blood supply of thoracic lobes of the thymus were studied in 28 stillborn dogs of the Great Dane, of which 18 were males and 10 were females. The arterial systems of these animals were filled with aqueous solution of Neoprene Latex “450”, 50%. After, the specimens were fixed in 10% formaldehyde aqueous solution. The lobes of the thymus were supplied by direct or indirect arterial branches coming from the right and left internal thoracic arteries, pericardiacophrenicas arteries, right and left costocervicais trunks, and left subclavian artery. The left subclavian artery and brachiocephalic trunk emitted direct branches towards the left thoracic lobe of the thymus.

Altered Brain Network in Amyotrophic Lateral Sclerosis: A Resting Graph Theory-Based Network Study at Voxel-Wise Level.

Science.gov (United States)

Zhou, Chaoyang; Hu, Xiaofei; Hu, Jun; Liang, Minglong; Yin, Xuntao; Chen, Lin; Zhang, Jiuquan; Wang, Jian

2016-01-01

Amyotrophic lateral sclerosis (ALS) is a rare degenerative disorder characterized by loss of upper and lower motor neurons. Neuroimaging has provided noticeable evidence that ALS is a complex disease, and shown that anatomical and functional lesions extend beyond precentral cortices and corticospinal tracts, to include the corpus callosum; frontal, sensory, and premotor cortices; thalamus; and midbrain. The aim of this study is to investigate graph theory-based functional network abnormalities at voxel-wise level in ALS patients on a whole brain scale. Forty-three ALS patients and 44 age- and sex-matched healthy volunteers were enrolled. The voxel-wise network degree centrality (DC), a commonly employed graph-based measure of network organization, was used to characterize the alteration of whole brain functional network. Compared with the controls, the ALS patients showed significant increase of DC in the left cerebellum posterior lobes, bilateral cerebellum crus, bilateral occipital poles, right orbital frontal lobe, and bilateral prefrontal lobes; significant decrease of DC in the bilateral primary motor cortex, bilateral sensory motor region, right prefrontal lobe, left bilateral precuneus, bilateral lateral temporal lobes, left cingulate cortex, and bilateral visual processing cortex. The DC's z-scores of right inferior occipital gyrus were significant negative correlated with the ALSFRS-r scores. Our findings confirm that the regions with abnormal network DC in ALS patients were located in multiple brain regions including primary motor, somatosensory and extra-motor areas, supporting the concept that ALS is a multisystem disorder. Specifically, our study found that DC in the visual areas was altered and ALS patients with higher DC in right inferior occipital gyrus have more severity of disease. The result demonstrated that the altered DC value in this region can probably be used to assess severity of ALS.

Altered brain network in Amyotrophic Lateral Sclerosis: a resting graph theory-based network study at voxel-wise level

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Chaoyang eZhou

2016-05-01

Full Text Available Amyotrophic lateral sclerosis (ALS is a rare degenerative disorder characterized by loss of upper and lower motor neurons. Neuroimaging has provided noticeable evidence that ALS is a complex disease, and shown that anatomical and functional lesions extend beyond precentral cortices and corticospinal tracts, to include the corpus callosum; frontal, sensory, and premotor cortices; thalamus; and midbrain. The aim of this study is to investigate graph theory-based functional network abnormalities at voxel-wise level in ALS patients on a whole brain scale. Forty-three ALS patients and 44 age- and sex- matched healthy volunteers were enrolled. The voxel-wise network degree centrality (DC, a commonly employed graph-based measure of network organization, was used to characterize the alteration of whole brain functional network. Compared with the controls, the ALS patients showed significant increase of DC in the left cerebellum posterior lobes, bilateral cerebellum crus, bilateral occipital poles, right orbital frontal lobe and bilateral prefrontal lobes; significant decrease of DC in the bilateral primary motor cortex, bilateral sensory motor region, right prefrontal lobe, left bilateral precuneus, bilateral lateral temporal lobes, left cingulate cortex, and bilateral visual processing cortex. The DC’s z-scores of right inferior occipital gyrus were significant negative correlated with the ALSFRS-r scores. Our findings confirm that the regions with abnormal network DC in ALS patients were located in multiple brain regions including primary motor, somatosensory and extra-motor areas, supporting the concept that ALS is a multisystem disorder. Specifically, our study found that DC in the visual areas was altered and ALS patients with higher DC in right inferior occipital gyrus have more severity of disease. The result demonstrated that the altered DC value in this region can probably be used to assess severity of ALS.

The Structural Plasticity of White Matter Networks Following Anterior Temporal Lobe Resection

Science.gov (United States)

Yogarajah, Mahinda; Focke, Niels K.; Bonelli, Silvia B.; Thompson, Pamela; Vollmar, Christian; McEvoy, Andrew W.; Alexander, Daniel C.; Symms, Mark R.; Koepp, Matthias J.; Duncan, John S.

2010-01-01

Anterior temporal lobe resection is an effective treatment for refractory temporal lobe epilepsy. The structural consequences of such surgery in the white matter, and how these relate to language function after surgery remain unknown. We carried out a longitudinal study with diffusion tensor imaging in 26 left and 20 right temporal lobe epilepsy…

Analysis of EEG Related Saccadic Eye Movement

Science.gov (United States)

Funase, Arao; Kuno, Yoshiaki; Okuma, Shigeru; Yagi, Tohru

Our final goal is to establish the model for saccadic eye movement that connects the saccade and the electroencephalogram(EEG). As the first step toward this goal, we recorded and analyzed the saccade-related EEG. In the study recorded in this paper, we tried detecting a certain EEG that is peculiar to the eye movement. In these experiments, each subject was instructed to point their eyes toward visual targets (LEDs) or the direction of the sound sources (buzzers). In the control cases, the EEG was recorded in the case of no eye movemens. As results, in the visual experiments, we found that the potential of EEG changed sharply on the occipital lobe just before eye movement. Furthermore, in the case of the auditory experiments, similar results were observed. In the case of the visual experiments and auditory experiments without eye movement, we could not observed the EEG changed sharply. Moreover, when the subject moved his/her eyes toward a right-side target, a change in EEG potential was found on the right occipital lobe. On the contrary, when the subject moved his/her eyes toward a left-side target, a sharp change in EEG potential was found on the left occipital lobe.

Anterior Temporal Lobe Morphometry Predicts Categorization Ability.

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Garcin, Béatrice; Urbanski, Marika; Thiebaut de Schotten, Michel; Levy, Richard; Volle, Emmanuelle

2018-01-01

Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

Occipital cephalocele with neural crest remnants? Radiological and pathological findings in a newborn boy.

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Arishima, Hidetaka; Neishi, Hiroyuki; Kikuta, Ken-Ichiro

2016-06-01

A cephalocele is a congenital anomaly involving the herniation of intracranial tissue from a skull defect. The sac containing the central nervous system (CNS) with the ventricle system is called the encephalocystocele. An atretic cephalocele is thought to be an abortive form of cephalocele, and the essential nature is still controversial. Here, we report the case of a newborn boy with an occipital cephalocele containing a small cystic component which was composed of ependymal cells and the immature CNS tissue. A newborn boy was admitted to our hospital because of an occipital mass, which was about 2.5 cm in diameter, located at the posterior midline, and covered with alopetic skin without CSF leakage. He had a cleft palate. Magnetic resonance imaging (MRI) clearly showed an occipital cephalocele with a tiny cystic component connecting to the subarachnoid space. MRI also showed mild hydrocephalus, hypoplasia of the corpus callosum and tentorium cerebelli, dropping down of the bilateral occipital lobes and vermicular agenesis. We performed the extirpation of the subscalp module under general anesthesia and histologically examined the resected mass. On immunohistopathological examination, most part of the subscalp module was fibrous tissue with numerous vessels and meningeal origin cells. In a small part of the innermost layer, we found a small island consisting of CNS tissue and a tiny cyst lined with a single layer of ependymal cells. Based on radiological and immunohistopathological findings, we speculate that the cystic component at the base of the nodule seems to correspond to neural crest remnants but not to true herniation of the brain and cerebral ventricles.

Altered cortical anatomical networks in temporal lobe epilepsy

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Lv, Bin; He, Huiguang; Lu, Jingjing; Li, Wenjing; Dai, Dai; Li, Meng; Jin, Zhengyu

2011-03-01

Temporal lobe epilepsy (TLE) is one of the most common epilepsy syndromes with focal seizures generated in the left or right temporal lobes. With the magnetic resonance imaging (MRI), many evidences have demonstrated that the abnormalities in hippocampal volume and the distributed atrophies in cortical cortex. However, few studies have investigated if TLE patients have the alternation in the structural networks. In the present study, we used the cortical thickness to establish the morphological connectivity networks, and investigated the network properties using the graph theoretical methods. We found that all the morphological networks exhibited the small-world efficiency in left TLE, right TLE and normal groups. And the betweenness centrality analysis revealed that there were statistical inter-group differences in the right uncus region. Since the right uncus located at the right temporal lobe, these preliminary evidences may suggest that there are topological alternations of the cortical anatomical networks in TLE, especially for the right TLE.

Cognitive deficits are associated with frontal and temporal lobe white matter lesions in middle-aged adults living in the community.

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David Bunce

Full Text Available BACKGROUND: The association between brain white matter lesions and cognitive impairment in old age is well established. However, little is known about this association in midlife. As this information will inform policy for early preventative healthcare initiatives, we investigated non-periventricular frontal, temporal, parietal and occipital lobe white matter hyperintensities (WMH in relation to cognitive function in 428 (232 women community-dwelling adults aged 44 to 48 years. RESULTS: Frontal white matter lesions were significantly associated with greater intraindividual RT variability in women, while temporal WMH were associated with face recognition deficits in men. Parietal and occipital lobe lesions were unrelated to cognitive performance. These findings did not differ when education and a range of health variables, including vascular risk factors, were taken into account. CONCLUSION: Gender differences in WMH-cognition associations are discussed, and we conclude that small vessel disease is present in midlife and has functional consequences which are generally not recognized. Preventative strategies should, therefore, begin early in life.

Anatomo-functional study of the temporo-parieto-occipital region: dissection, tractographic and brain mapping evidence from a neurosurgical perspective

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De Benedictis, Alessandro; Duffau, Hugues; Paradiso, Beatrice; Grandi, Enrico; Balbi, Sergio; Granieri, Enrico; Colarusso, Enzo; Chioffi, Franco; Marras, Carlo Efisio; Sarubbo, Silvio

2014-01-01

The temporo-parieto-occipital (TPO) junction is a complex brain territory heavily involved in several high-level neurological functions, such as language, visuo-spatial recognition, writing, reading, symbol processing, calculation, self-processing, working memory, musical memory, and face and object recognition. Recent studies indicate that this area is covered by a thick network of white matter (WM) connections, which provide efficient and multimodal integration of information between both local and distant cortical nodes. It is important for neurosurgeons to have good knowledge of the three-dimensional subcortical organisation of this highly connected region to minimise post-operative permanent deficits. The aim of this dissection study was to highlight the subcortical functional anatomy from a topographical surgical perspective. Eight human hemispheres (four left, four right) obtained from four human cadavers were dissected according to Klingler's technique. Proceeding latero-medially, the authors describe the anatomical courses of and the relationships between the main pathways crossing the TPO. The results obtained from dissection were first integrated with diffusion tensor imaging reconstructions and subsequently with functional data obtained from three surgical cases, all resection of infiltrating glial tumours using direct electrical mapping in awake patients. The subcortical limits for performing safe lesionectomies within the TPO region are as follows: within the parietal region, the anterior horizontal part of the superior longitudinal fasciculus and, more deeply, the arcuate fasciculus; dorsally, the vertical projective thalamo-cortical fibres. For lesions located within the temporal and occipital lobes, the resection should be tailored according to the orientation of the horizontal associative pathways (the inferior fronto-occipital fascicle, inferior longitudinal fascicle and optic radiation). The relationships between the WM tracts and the ventricle

Hypoplasia of the basi-occipital bone and persistance of the spheno-occipital synchondrosis in a patient with transitory supplementary fissure of the basi-occipital

International Nuclear Information System (INIS)

Wackenheim, A.

1985-01-01

The author had the opportunity to observe the progressive development of a special form of basilar impression characterized by transitory supplementary fissure of the basi-occipital bone, persistance of the spheno-occipital synchondrosis and hypoplasia of the basi-occipital. He proposes to dissociate the general concept of basilar impression and to consider anatomo-clinical entities such as the example described in this paper. (orig.)

Music & Wellbeing

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Garrido, Gemma; Camps, Laia; Herrera, Isabel Herrera; Guillamat, Roser; Vallés, Vicenç; Sanz, Maite; Martínez, Joan

2016-01-01

Introduction: Scientific literature suggests that music may serve as therapeutic function among populations with different illnesses or disorders. Functional neuroimaging studies that incorporate music activity or music method shown an increase activation in several brain areas, with widespread bilateral hemodynamic responses in occipital lobe, bilateral cerebellum, temporal lobe, in the right lateral prefrontal cortex as well hemodynamic responses in the left middle frontal gyrus.Music activ...

IMAGING OF BRAIN FUNCTION BASED ON THE ANALYSIS OF FUNCTIONAL CONNECTIVITY - IMAGING ANALYSIS OF BRAIN FUNCTION BY FMRI AFTER ACUPUNCTURE AT LR3 IN HEALTHY INDIVIDUALS.

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Zheng, Yu; Wang, Yuying; Lan, Yujun; Qu, Xiaodong; Lin, Kelin; Zhang, Jiping; Qu, Shanshan; Wang, Yanjie; Tang, Chunzhi; Huang, Yong

2016-01-01

This Study observed the relevant brain areas activated by acupuncture at the Taichong acupoint (LR3) and analyzed the functional connectivity among brain areas using resting state functional magnetic resonance imaging (fMRI) to explore the acupoint specificity of the Taichong acupoint. A total of 45 healthy subjects were randomly divided into the Taichong (LR3) group, sham acupuncture group and sham acupoint group. Subjects received resting state fMRI before acupuncture, after true (sham) acupuncture in each group. Analysis of changes in connectivity among the brain areas was performed using the brain functional connectivity method. The right cerebrum temporal lobe was selected as the seed point to analyze the functional connectivity. It had a functional connectivity with right cerebrum superior frontal gyrus, limbic lobe cingulate gyrus and left cerebrum inferior temporal gyrus (BA 37), inferior parietal lobule compared by before vs. after acupuncture at LR3, and right cerebrum sub-lobar insula and left cerebrum middle frontal gyrus, medial frontal gyrus compared by true vs. sham acupuncture at LR3, and right cerebrum occipital lobe cuneus, occipital lobe sub-gyral, parietal lobe precuneus and left cerebellum anterior lobe culmen by acupuncture at LR3 vs. sham acupoint. Acupuncture at LR3 mainly specifically activated the brain functional network that participates in visual function, associative function, and emotion cognition, which are similar to the features on LR3 in tradition Chinese medicine. These brain areas constituted a neural network structure with specific functions that had specific reference values for the interpretation of the acupoint specificity of the Taichong acupoint.

Benign occipital unicameral bone cyst causing lower cranial nerve palsies complicated by iophendylate arachnoiditis

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Bradley, W. G.; Kalbag, R. M.; Ramani, P. S.; Tomlinson, B. E.

1974-01-01

A 20 year old girl presented with a history of neck and occipital pain for six weeks, which was found to be due to a unicameral bone cyst of the left occipital condylar region. The differential diagnosis of bone cysts in the skull is discussed. Six months after the operation, the patient again presented with backache due to adhesive arachnoiditis. The latter was believed to have arisen as a result of a combination of spinal infective meningitis and intrathecal ethyl iodophenyl undecylate (iophendylate, Myodil, Pantopaque). The nature of meningeal reactions to iophendylate and the part played by intrathecal corticosteroids in relieving the arachnoiditis in the present case are discussed. Images

Temporal lobe surgery in childhood and neuroanatomical predictors of long-term declarative memory outcome

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Skirrow, Caroline; Cross, J. Helen; Harrison, Sue; Cormack, Francesca; Harkness, William; Coleman, Rosie; Meierotto, Ellen; Gaiottino, Johanna; Vargha-Khadem, Faraneh

2015-01-01

The temporal lobes play a prominent role in declarative memory function, including episodic memory (memory for events) and semantic memory (memory for facts and concepts). Surgical resection for medication-resistant and well-localized temporal lobe epilepsy has good prognosis for seizure freedom, but is linked to memory difficulties in adults, especially when the removal is on the left side. Children may benefit most from surgery, because brain plasticity may facilitate post-surgical reorganization, and seizure cessation may promote cognitive development. However, the long-term impact of this intervention in children is not known. We examined memory function in 53 children (25 males, 28 females) who were evaluated for epilepsy surgery: 42 underwent unilateral temporal lobe resections (25 left, 17 right, mean age at surgery 13.8 years), 11 were treated only pharmacologically. Average follow-up was 9 years (range 5–15). Post-surgical change in visual and verbal episodic memory, and semantic memory at follow-up were examined. Pre- and post-surgical T1-weighted MRI brain scans were analysed to extract hippocampal and resection volumes, and evaluate post-surgical temporal lobe integrity. Language lateralization indices were derived from functional magnetic resonance imaging. There were no significant pre- to postoperative decrements in memory associated with surgery. In contrast, gains in verbal episodic memory were seen after right temporal lobe surgery, and visual episodic memory improved after left temporal lobe surgery, indicating a functional release in the unoperated temporal lobe after seizure reduction or cessation. Pre- to post-surgical change in memory function was not associated with any indices of brain structure derived from MRI. However, better verbal memory at follow-up was linked to greater post-surgical residual hippocampal volumes, most robustly in left surgical participants. Better semantic memory at follow-up was associated with smaller resection

Spatial memory for asymmetrical dot locations predicts lateralization among patients with presurgical mesial temporal lobe epilepsy.

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Brown, Franklin C; Hirsch, Lawrence J; Spencer, Dennis D

2015-11-01

This study examined the ability of an asymmetrical dot location memory test (Brown Location Test, BLT) and two verbal memory tests (Verbal Selective Reminding Test (VSRT) and California Verbal Learning Test, Second Edition (CVLT-II)) to correctly lateralize left (LTLE) or right (RTLE) mesial temporal lobe epilepsy that was confirmed with video-EEG. Subjects consisted of 16 patients with medically refractory RTLE and 13 patients with medically refractory LTLE who were left hemisphere language dominant. Positive predictive values for lateralizing TLE correctly were 87.5% for the BLT, 72.7% for the VSRT, and 80% for the CVLT-II. Binary logistic regression indicated that the BLT alone correctly classified 76.9% of patients with left temporal lobe epilepsy and 87.5% of patients with right temporal lobe epilepsy. Inclusion of the verbal memory tests improved this to 92.3% of patients with left temporal lobe epilepsy and 100% correct classification of patients with right temporal lobe epilepsy. Though of a limited sample size, this study suggests that the BLT alone provides strong laterality information which improves with the addition of verbal memory tests. Copyright © 2015 Elsevier Inc. All rights reserved.

The cerebral functional location in normal subjects with Chinese classical national music auditory stimulus

International Nuclear Information System (INIS)

Sun Da; Xu Wei; Zhan Hongwei; Liu Hongbiao

2004-01-01

Purpose: To detect the cerebral functional location in normal subjects with Chinese classical national music auditory stimulus. Methods: 10 normal young students of the medical collage of Zhejiang University,22-24 years old,5 male and 5 female. The first they underwent a 99mTc-ECD brain imaging during a rest state using a dual detectors gamma camera with fan beam collimators. After 2-4 days they were asked to listen a Chinese classical national music that was played by Erhu and Guzheng for 20 minters. They were also asked to pay special attention to the name of the music, what musical instruments they played and what imagination was opened out in the music. 99mTc-ECD was administered in the first 3 minutes during thy listened the music. The brain imaging was performed in 30-60 minutes after the tracer was administered. Results: To compare the rest state, during listening the Chinese classical national music and paying special attention to the imagination of music the right midtemporal in 6 cases, left midtemporal in 2 cases, right superior temporal in 2 cases, left superior temporal in 6 cases, and right inferior temporal in 2 cases were activated. Among them, dual temporal were activated in 6 cases, right temporal in 3 cases and left temporal in 1 case. It is very interesting that the inferior frontal and/or medial frontal lobes were activated in all 10 subjects, and the activity was markedly higher in frontal than in temporal. Among them dual frontal lobes were activated in 9 subjects, and only right frontal in 1 case. The right superior frontal lobes were activated in 2 cases. The occipital lobes were activated in 4 subjects, and dual occipital in 3 cases, right occipital in 1 case. These 4 subjects stated after listening that they imagined the natural landscape and imagination that was opened out in the music follow the music. Other regions that were activated included parietal lobes (right and left in 1 respectively), pre-cingulated gyms (in 2 cases), and left

[The occipital sinus: a radioanatomic study].

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Gaumont-Darcissac, M; Viart, L; Foulon, P; Le Gars, D; Havet, E; Peltier, J

2015-03-01

The aim of this study was to assess the presence of an occipital sinus in both children and adults, and to detail its main associated anatomical characteristics. One hundred of patients' MRI (3D T1 EG) between 0 and 86 years old were studied, in sagittal and axial sections, with the software DxMM. Occipital sinus length, perimeter, and cerebellar falx length measurements were performed with the software's tools. Forty-three percent of patients had an occipital sinus (average perimeter was 3.02 mm, average length was 19.85 mm), and 23.26% of these patients had a cerebellar falx, 30.23% of these patients had one vein or more draining into the occipital sinus. Sixty-two percent of children had an occipital sinus (average perimeter was 2.87 mm, average length was 21.63 mm), and 29.03% of them had a cerebellar falx. Twenty-four percent of adults had an occipital sinus (average perimeter was 3.4mm, average length was 15.28 mm), and 8.33% of them had a cerebellar falx. This work highlights a link between the age and the occipital sinus existence. The perimeter of this sinus seems to be superior for adults, but its length seems to be superior for children. A cerebellar falx with the occipital sinus was found more frequently for children. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Gray, White Matter Concentration Changes and Their Correlation with Heterotopic Neurons in Temporal Lobe Epilepsy

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Tae, Woo Suk; Joo, Eun Yun; Kim, Sung Tae; Hong, Seung Bong [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2010-02-15

To identify changes in gray and white matter concentrations (GMC, WMC), and their relation to heterotopic neuron numbers in mesial temporal lobe epilepsy (mTLE). The gray matter or white matter concentrations of 16 left and 15 right mTLE patients who achieved an excellent surgical outcome were compared with those of 24 healthy volunteers for the left group and with 23 healthy volunteers for the right group, by optimized voxel-based morphometry using unmodulated and modulated images. A histologic count of heterotopic neurons was obtained in the white matter of the anterior temporal lobe originating from the patients' surgical specimens. In addition, the number of heterotopic neurons were tested to determine if there was a correlation with the GMC or WMC. The GMCs of the left and right mTLE groups were reduced in the ipsilateral hippocampi, bilateral thalami, precentral gyri, and in the cerebellum. The WMCs were reduced in the ipsilateral white matter of the anterior temporal lobe, bilateral parahippocampal gyri, and internal capsules, but increased in the pons and bilateral precentral gyri. The heterotopic neuron counts in the left mTLE group showed a positive correlation (r = 0.819, p < 0.0001) with GMCs and a negative correlation (r = - 0.839, p < 0.0001) with WMCs in the white matter of the anterior temporal lobe. The present study shows the abnormalities of the cortico-thalamo- hippocampal network including a gray matter volume reduction in the anterior frontal lobes and an abnormality of brain tissue concentration in the pontine area. Furthermore, heterotopic neuron numbers were significantly correlated with GMC or WMC in the left white matter of anterior temporal lobe.

Relative signal intensity changes of frontal and occipital white matters on T 2 weighted axial MR image : correlation with age

International Nuclear Information System (INIS)

Kim, You Me; Kim, Seung Cheol

1998-01-01

The purpose of this study is to assess relative signal intensity changes in frontal and occipital white matter with age, as seen on T 2 weighted axial MR images. Thirty eight normal adults (20-29 years old) and 114 children (0-11 years old) were investigated. All had nonspecific neurologic symptoms and their MR images, obtained using a 1.5 T system (Signa, GE Medical Systems, Milwaukee, U.S.A.), appeared to be normal. The signal intensities of frontal and occipital white matter were evaluated on T2 weighted axial images at the level of the foramen of Monro. When the signal intensity of white matter was higher than that of gray matter, grade 0 was assigned; when the opposite situation pertained, this was graded I - III. Grade I indicated that the signal intensity of occipital white matter was lower than that of frontal white matter; grade II, that the signal intensity of white matter of both lobes was similar. When the signal intensity of frontal white matter was lower than that of occipital age, and by one year after 2 years of age, and then determined grade according to age, age distribution according to grade, and the ages at which signal intensities were similar to those of adults. On T2-weighted MR images, the signal intensity of frontal white matter ultimately shows a lower signal intensity than that of occipital white matter. (author). 11 refs., 6 figs

Internal Occipital Crest Misalignment with Internal Occipital Protuberance: A Case Report of Posterior Cranial Fossa Anatomic Variations

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Kim, Jae Ha

2016-01-01

During gross anatomy head and neck laboratory session, one dissection group observed an abnormal anatomic variation in the posterior cranial fossa of a 94-year-old male cadaver. The internal occipital crest was not aligned with internal occipital protuberance and groove for superior sagittal sinus. It seemed that the internal occipital protuberance was shifted significantly to the right side. As a result the skull was overly stretched in order to connect with the internal occipital ridge. These internal skull variations of occipital bone landmarks can influence the location of adjacent dural venous sinuses and possibly influence cerebrospinal fluid flow. Similar anatomical anomalies have been attributed to presence of hydrocephalus and abnormalities in cisterna magna. PMID:27648322

Hierarchical clustering of Alzheimer and "normal" brains using elemental concentrations and glucose metabolism determined by PIXE, INAA and PET

NARCIS (Netherlands)

Cutts, DA; Spyrou, NM; Maguire, RP; Leenders, KL

Brain tissue samples, obtained from the Alzheimer Disease Brain Bank, Institute of Psychiatry, London, were taken from both left and right hemispheres of three regions of the cerebrum, namely the frontal, parietal and occipital lobes for both Alzheimer and 'normal' subjects. Trace element

Amplitude of low-frequency fluctuation (ALFF) and fractional ALFF in migraine patients: a resting-state functional MRI study

International Nuclear Information System (INIS)

Wang, J.-J.; Chen, X.; Sah, S.K.; Zeng, C.; Li, Y.-M.; Li, N.; Liu, M.-Q.; Du, S.-I.

2016-01-01

Aim: To evaluate the amplitude of low-frequency oscillations (LFOs) of the brain in migraine patients using amplitude of low-frequency fluctuation (ALFF) and fractional ALFF in the interictal period, in comparison to healthy controls (HCs). Materials and methods: A total of 54 subjects, including 30 migraineurs and 24 gender- and age-matched HCs completed the fMRI. All the data and ALFF, fALFF analyses were preprocessed with the Data Processing Assistant for Resting-State fMRI (DPARSF). All of the statistical analyses were performed using the REST software to explore the differences in ALFF and fALFF between migraine patients and HCs. Results: In contrast to HCs, migraine patients showed significant ALFF increase in the left medulla and pons, the bilateral cerebellum posterior lobe and right insula. The regions showing decreased ALFF in migraine patients included the bilateral cerebellum posterior lobe, left cerebellum anterior lobe, bilateral orbital cortex, right middle frontal gyrus, bilateral occipital lobe, right fusiform gyrus, and bilateral postcentral gyrus. The fALFFs in migraine patients were significantly increased in the bilateral insular and left orbital cortex, but were decreased in the left occipital lobe and bilateral cerebellum posterior lobe. Conclusion: These ALFF and fALFF alterations in the brain regions of migraineurs are in keeping with the domains associated with pain and cognition. Such brain functional alteration may contribute to further understanding of migraine-related network imbalances demonstrated in previous studies. - Highlights: • Migraine is a common, paroxysmal, highly disabling primary headache disorder. • Resting-state fMRI offers a novel approach to measure spontaneous brain activity in migraine patients • The ALFF and fALFF alterations in migraineurs' brain regions are in keeping with the domains associated with pain and cognition.

Triple pathological findings in a surgically amenable patient with mesial temporal lobe epilepsy

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Fumin Tong

2015-01-01

Full Text Available Mesial temporal sclerosis (MTS is a well-recognized cause of intractable epilepsy; however, coexistence with focal cortical dysplasia (FCD is less common. Middle fossa epidermoid cysts are rare and may involve the temporal lobe. Most epidermoids are clinically silent, slow-growing, and seldom associated with overt symptomatology, including seizures. We describe a patient with multiple comorbidities including left MTS and a large epidermoid cyst involving the left quadrigeminal plate cistern compressing upon the cerebellar vermis and tail of the left hippocampus, resulting in refractory left temporal lobe epilepsy. The patient underwent left anterior temporal lobectomy. The surgical pathology demonstrated a third pathological finding of left temporal FCD type Ia. The patient has been seizure-free since the surgery. This case provides additional information with regard to the understanding of epileptogenicity and surgical planning in patients with MTS and epidermoid cysts.

The value of 3 T MR diffusion tensor fiber tractography study of association fasciculus of normative human in vivo primarily

International Nuclear Information System (INIS)

Sun Xuejin; Dai Jianping; Gao Peiyi; Li Shaowu; Ai Lin; Chen Hongyan; Tian Shengyong; Pang Ruilin

2006-01-01

parts kept in touch with the Broca area of the left posterior of inferior frontal gyre. Conclusions: There is individual difference both sides of association fascicules. There may be a new fiber bundle in the hemisphere, and associate with frontal lobe, temporal lobe, parietal lobe and occipital lobe. (authors)

Left hepatic lobe herniation through an incisional anterior abdominal wall hernia and right adrenal myelolipoma: a case report and review of the literature.

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Nuño-Guzmán, Carlos M; Arróniz-Jáuregui, José; Espejo, Ismael; Valle-González, Jesús; Butus, Hernán; Molina-Romo, Alejandro; Orranti-Ortega, Rodrigo I

2012-01-10

Herniation of the liver through an anterior abdominal wall hernia defect is rare. To the best of our knowledge, only three cases have been described in the literature. A 70-year-old Mexican woman presented with a one-week history of right upper quadrant abdominal pain, nausea, vomiting, and jaundice to our Department of General Surgery. Her medical history included an open cholecystectomy from 20 years earlier and excessive weight. She presented with jaundice, abdominal distension with a midline surgical scar, right upper quadrant tenderness, and a large midline abdominal wall defect with dullness upon percussion and protrusion of a large, tender, and firm mass. The results of laboratory tests were suggestive of cholestasis. Ultrasound revealed choledocholithiasis. A computed tomography scan showed a protrusion of the left hepatic lobe through the anterior abdominal wall defect and a well-defined, soft tissue density lesion in the right adrenal topography. An endoscopic common bile duct stone extraction was unsuccessful. During surgery, the right adrenal tumor was resected first. The hernia was approached through a median supraumbilical incision; the totality of the left lobe was protruding through the abdominal wall defect, and once the lobe was reduced to its normal position, a common bile duct surgical exploration with multiple stone extraction was performed. Finally, the abdominal wall was reconstructed. Histopathology revealed an adrenal myelolipoma. Six months after the operation, our patient remains in good health. The case of liver herniation through an incisional anterior abdominal wall hernia in this report represents, to the best of our knowledge, the fourth such case reported in the literature. The rarity of this medical entity makes it almost impossible to specifically describe predisposing risk factors for liver herniation. Obesity, the right adrenal myelolipoma mass effect, and the previous abdominal surgery are likely to have contributed to

Left hepatic lobe herniation through an incisional anterior abdominal wall hernia and right adrenal myelolipoma: a case report and review of the literature

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Nuño-Guzmán Carlos M

2012-01-01

Full Text Available Abstract Introduction Herniation of the liver through an anterior abdominal wall hernia defect is rare. To the best of our knowledge, only three cases have been described in the literature. Case presentation A 70-year-old Mexican woman presented with a one-week history of right upper quadrant abdominal pain, nausea, vomiting, and jaundice to our Department of General Surgery. Her medical history included an open cholecystectomy from 20 years earlier and excessive weight. She presented with jaundice, abdominal distension with a midline surgical scar, right upper quadrant tenderness, and a large midline abdominal wall defect with dullness upon percussion and protrusion of a large, tender, and firm mass. The results of laboratory tests were suggestive of cholestasis. Ultrasound revealed choledocholithiasis. A computed tomography scan showed a protrusion of the left hepatic lobe through the anterior abdominal wall defect and a well-defined, soft tissue density lesion in the right adrenal topography. An endoscopic common bile duct stone extraction was unsuccessful. During surgery, the right adrenal tumor was resected first. The hernia was approached through a median supraumbilical incision; the totality of the left lobe was protruding through the abdominal wall defect, and once the lobe was reduced to its normal position, a common bile duct surgical exploration with multiple stone extraction was performed. Finally, the abdominal wall was reconstructed. Histopathology revealed an adrenal myelolipoma. Six months after the operation, our patient remains in good health. Conclusions The case of liver herniation through an incisional anterior abdominal wall hernia in this report represents, to the best of our knowledge, the fourth such case reported in the literature. The rarity of this medical entity makes it almost impossible to specifically describe predisposing risk factors for liver herniation. Obesity, the right adrenal myelolipoma mass effect, and

Anterior Temporal Lobe Morphometry Predicts Categorization Ability

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Béatrice Garcin

2018-02-01

Full Text Available Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

Occipital projections in the skeletal dysplasias

International Nuclear Information System (INIS)

Takamine, Yuji; Field, Fiona M.; Lachman, Ralph S.; Rimoin, David L.

2004-01-01

Occipital projections of the cranium have been reported in a number of skeletal dysplasias and syndromes. We observed two cases of atelosteogenesis type I with a bony occipital projection. This finding has neither been noted nor reported in any form of atelosteogenesis. This led us to search the International Skeletal Dysplasia Registry for occipital projections, and we found them in four other syndromes in which they had not been reported. Thus occipital spurs are a non-diagnostic feature that can be found in at least ten distinct disorders as well as a normal variant. (orig.)

Difference in resting-state fractional amplitude of low-frequency fluctuation between bipolar depression and unipolar depression patients.

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Yu, H-L; Liu, W-B; Wang, T; Huang, P-Y; Jie, L-Y; Sun, J-Z; Wang, C; Qian, W; Xuan, M; Gu, Q-Q; Liu, H; Zhang, F-L; Zhang, M-M

2017-04-01

To investigate the difference in fractional amplitude of low-frequency fluctuation (fALFF) of localized brain activities in the resting-state between bipolar depression and unipolar depression patients and to find biological markers that differentiate the two groups of patients. Thirteen patients with bipolar depression, 15 patients with unipolar depression, and 16 healthy control subjects that were matched in age and years of education were subjected to 3.0 T resting-state functional magnetic resonance scans. The values of whole brain fALFF were calculated and statistical analysis was performed. The fALFF-values of the right inferior temporal gyrus, left cerebellar posterior lobe, right middle temporal gyrus, left inferior frontal gyrus/insula, right inferior frontal gyrus/insula, left lingual gyrus and right middle temporal gyrus of the three groups showed significant differences (p superior temporal gyrus, left insula, left inferior frontal gyrus, right inferior frontal gyrus, right supramarginal gyrus and right medial frontal gyrus but significantly decreased in the right medial occipital gyrus, left frontal lobe, right superior parietal lobule; the fALFF-values of the bipolar depression (BD) patient group significantly decreased in the left cerebellum posterior lobe, right lingual gyrus, left lingual gyrus, right middle temporal gyrus, left middle temporal gyrus, and left superior frontal gyrus and significantly increased in the right inferior frontal gyrus and left insula compared to those of the HC group; compared with those of the UD group, the fALFF-values of the BD group significantly decreased in the left middle occipital gyrus, right middle temporal gyrus, left middle frontal gyrus, and left medial frontal gyrus. The brain activities of BD and UD patients in the resting-state exhibit abnormalities, which differ between the two groups of patients.

Virtual assessment of the endocranial morphology of the early modern European fossil calvaria from cioclovina, romania.

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Kranioti, Elena F; Holloway, Ralph; Senck, Sascha; Ciprut, Tudor; Grigorescu, Dan; Harvati, Katerina

2011-07-01

Endocasts provide evidence on size and shape characteristics, blood supply trajectories, and neurological features of the brain, allowing comparative analyses of fossil hominins crucial to our understanding of human brain evolution. Here, we assess the morphological features of the virtual endocast of the Cioclovina Upper Paleolithic calvarium, one of the earliest reliably dated European modern human fossils. Our study was conducted on a computed tomography (CT) scan of the original specimen. The endocranial profile was approximated via a semiautomatic segmentation of the CT data. Virtual reconstructions of the endocast were used for assessing the morphological features of the endocranium and for the estimation of the endocranial volume. Cioclovina exhibits a clockwise torque with a small anterior extension of the left frontal lobe over the right one and a protrusion of the right occipital lobe over the left, most likely due to the superior sagittal sinus coursing over the occipital pole. There is an obvious right predominance of the posterior drainage system. Interestingly, the area of the frontal sinus is occupied by dense bony tissue with small air cells corresponding probably to a natural bony loss in the diploë and to vascular spaces. An estimated endocranial volume of 1498.53 cc was calculated. The convolutional details of the third inferior frontal gyrus (Broca's caps) are indistinguishable from those found in modern Homo sapiens, and the left occipital lobe appears wider than the right, a possible correlate of right-handedness. Our metric analysis of endocranial measurements also aligns Cioclovina with modern humans. Copyright © 2011 Wiley-Liss, Inc.

Particle doses in the pulmonary lobes of electronic and conventional cigarette users

International Nuclear Information System (INIS)

Manigrasso, Maurizio; Buonanno, Giorgio; Stabile, Luca; Morawska, Lidia; Avino, Pasquale

2015-01-01

The main aim of the present study was to estimate size segregated doses from e-cigarette aerosols as a function of the airway generation number in lung lobes. After a 2-second puff, 7.7 × 10 10 particles (D Tot ) with a surface area of 3.6 × 10 3  mm 2 (S Tot ), and 3.3 × 10 10 particles with a surface area of 4.2 × 10 3  mm 2 were deposited in the respiratory system for the electronic and conventional cigarettes, respectively. Alveolar and tracheobronchial deposited doses were compared to the ones received by non-smoking individuals in Western countries, showing a similar order of magnitude. Total regional doses (D R ), in head and lobar tracheobronchial and alveolar regions, ranged from 2.7 × 10 9 to 1.3 × 10 10 particles and 1.1 × 10 9 to 5.3 × 10 10 particles, for the electronic and conventional cigarettes, respectively. D R in the right-upper lung lobe was about twice that found in left-upper lobe and 20% greater in right-lower lobe than the left-lower lobe. - Highlights: • Lobar doses were compared for mainstreams of electronic and conventional cigarettes. • Aerosol doses from e-cigarettes were more than double that from conventional ones. • Doses from a 2-s puff exceed the daily doses of a no smoking Australian subject. • Highest deposition densities occurred at the lobar bronchi. • Aerosol deposition was greater in the right than in the left lung lobes. - Lobar bronchi and right lung lobes represent sites where effects of the aerosol from e-cigarette smoke may be more likely to occur

Impairments in proverb interpretation following focal frontal lobe lesions☆

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Murphy, Patrick; Shallice, Tim; Robinson, Gail; MacPherson, Sarah E.; Turner, Martha; Woollett, Katherine; Bozzali, Marco; Cipolotti, Lisa

2013-01-01

The proverb interpretation task (PIT) is often used in clinical settings to evaluate frontal “executive” dysfunction. However, only a relatively small number of studies have investigated the relationship between frontal lobe lesions and performance on the PIT. We compared 52 patients with unselected focal frontal lobe lesions with 52 closely matched healthy controls on a proverb interpretation task. Participants also completed a battery of neuropsychological tests, including a fluid intelligence task (Raven’s Advanced Progressive Matrices). Lesions were firstly analysed according to a standard left/right sub-division. Secondly, a finer-grained analysis compared the performance of patients with medial, left lateral and right lateral lesions with healthy controls. Thirdly, a contrast of specific frontal subgroups compared the performance of patients with medial lesions with patients with lateral frontal lesions. The results showed that patients with left frontal lesions were significantly impaired on the PIT, while in patients with right frontal lesions the impairments approached significance. Medial frontal patients were the only frontal subgroup impaired on the PIT, relative to healthy controls and lateral frontal patients. Interestingly, an error analysis indicated that a significantly higher number of concrete responses were found in the left lateral subgroup compared to healthy controls. We found no correlation between scores on the PIT and on the fluid intelligence task. Overall our results suggest that specific regions of the frontal lobes contribute to the performance on the PIT. PMID:23850600

Impairments in proverb interpretation following focal frontal lobe lesions.

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Murphy, Patrick; Shallice, Tim; Robinson, Gail; MacPherson, Sarah E; Turner, Martha; Woollett, Katherine; Bozzali, Marco; Cipolotti, Lisa

2013-09-01

The proverb interpretation task (PIT) is often used in clinical settings to evaluate frontal "executive" dysfunction. However, only a relatively small number of studies have investigated the relationship between frontal lobe lesions and performance on the PIT. We compared 52 patients with unselected focal frontal lobe lesions with 52 closely matched healthy controls on a proverb interpretation task. Participants also completed a battery of neuropsychological tests, including a fluid intelligence task (Raven's Advanced Progressive Matrices). Lesions were firstly analysed according to a standard left/right sub-division. Secondly, a finer-grained analysis compared the performance of patients with medial, left lateral and right lateral lesions with healthy controls. Thirdly, a contrast of specific frontal subgroups compared the performance of patients with medial lesions with patients with lateral frontal lesions. The results showed that patients with left frontal lesions were significantly impaired on the PIT, while in patients with right frontal lesions the impairments approached significance. Medial frontal patients were the only frontal subgroup impaired on the PIT, relative to healthy controls and lateral frontal patients. Interestingly, an error analysis indicated that a significantly higher number of concrete responses were found in the left lateral subgroup compared to healthy controls. We found no correlation between scores on the PIT and on the fluid intelligence task. Overall our results suggest that specific regions of the frontal lobes contribute to the performance on the PIT. © 2013 The Authors. Published by Elsevier Ltd. All rights reserved.

Modified skin incision for avoiding the lesser occipital nerve and occipital artery during retrosigmoid craniotomy: potential applications for enhancing operative working distance and angles while minimizing the risk of postoperative neuralgias and intraoperative hemorrhage.

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Tubbs, R Shane; Fries, Fabian N; Kulwin, Charles; Mortazavi, Martin M; Loukas, Marios; Cohen-Gadol, Aaron A

2016-10-01

Chronic postoperative neuralgias and headache following retrosigmoid craniotomy can be uncomfortable for the patient. We aimed to better elucidate the regional nerve anatomy in an effort to minimize this postoperative complication. Ten adult cadaveric heads (20 sides) were dissected to observe the relationship between the lesser occipital nerve and a traditional linear versus modified U incision during retrosigmoid craniotomy. Additionally, the relationship between these incisions and the occipital artery were observed. The lesser occipital nerve was found to have two types of course. Type I nerves (60%) remained close to the posterior border of the sternocleidomastoid muscle and some crossed anteriorly over the sternocleidomastoid muscle near the mastoid process. Type II nerves (40%) left the posterior border of the sternocleidomastoid muscle and swung medially (up to 4.5cm posterior to the posterior border of the sternocleidomastoid muscle) as they ascended over the occiput. The lesser occipital nerve was near a midpoint of a line between the external occipital protuberance and mastoid process in all specimens with the type II nerve configuration. Based on our findings, the inverted U incision would be less likely to injure the type II nerves but would necessarily cross over type I nerves, especially more cranially on the nerve at the apex of the incision. As the more traditional linear incision would most likely transect the type I nerves and more so near their trunk, the U incision may be the overall better choice in avoiding neural and occipital artery injury during retrosigmoid approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

Brain structure in post-traumatic stress disorder: A voxel-based morphometry analysis.

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Tan, Liwen; Zhang, Li; Qi, Rongfeng; Lu, Guangming; Li, Lingjiang; Liu, Jun; Li, Weihui

2013-09-15

This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occipital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

Brain structure in post-traumatic stress disorder: A voxel-based morphometry analysis

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Tan, Liwen; Zhang, Li; Qi, Rongfeng; Lu, Guangming; Li, Lingjiang; Liu, Jun; Li, Weihui

2013-01-01

This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occipital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities. PMID:25206550

Early (N170/M170 face-sensitivity despite right lateral occipital brain damage in acquired prosopagnosia

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Esther eAlonso Prieto

2011-12-01

Full Text Available Compared to objects, pictures of faces elicit a larger early electromagnetic response at occipito-temporal sites on the human scalp, with an onset of 130 ms and a peak at about 170 ms. This N170 face effect is larger in the right than the left hemisphere and has been associated with the early categorization of the stimulus as a face. Here we tested whether this effect can be observed in the absence of some of the visual areas showing a preferential response to faces as typically identified in neuroimaging. Event related potentials were recorded in response to faces, cars and their phase-scrambled versions in a well-known brain-damaged case of prosopagnosia (PS. Despite the patient’s right inferior occipital gyrus lesion encompassing the most posterior cortical area showing preferential response to faces (occipital face area, OFA, we identified an early face-sensitive component over the right occipito-temporal hemisphere of the patient that was identified as the N170. A second experiment supported this conclusion, showing the typical N170 increase of latency and amplitude in response to inverted faces. In contrast, there was no N170 in the left hemisphere, where PS has a lesion to the middle fusiform gyrus and shows no evidence of face-preferential response in neuroimaging (no left fusiform face area, or lFFA. These results were replicated by a magneto-encephalographic (MEG investigation of the patient, disclosing a M170 component only in the right hemisphere. These observations indicate that face preferential activation in the inferior occipital cortex is not necessary to elicit early visual responses associated with face perception (N170/M170 on the human scalp. These results further suggest that when the right inferior occipital cortex is damaged, the integrity of the middle fusiform gyrus and/or the superior temporal sulcus – two areas showing face preferential responses in the patient’s right hemisphere - might be necessary to generate

The study of I-123-IMP-SPECT before and after surgery for craniosynostosis

International Nuclear Information System (INIS)

Satoh, Motohiro; Ishikawa, Nobuyoshi; Enomoto, Takao; Takeda, Tohru; Yoshizawa, Takashi; Nose, Tadao.

1990-01-01

Single photon emission computed tomography with N-isopropyl-p-[I-123]iodoamphetamine was performed in 13 cases of craniosynostosis before and after surgery. Of 13 cases, 8 cases (62%) showed focal low perfusion area on preoperative study. Four of seven cases (57%) with brachycephaly showed low perfusion areas in either of frontal lobes, occipital lobes, and cerebellum. Besides, two patients with scaphocephaly and one with plagiocephaly showed low perfusion area in the unilateral cerebral hemisphere. Two Crouzon disease cases showed no focal low perfusion area, but an Apert disease showed low perfusion areas in both frontal lobes, cerebellum, as well as left occipital lobe. Corresponding CT and MRI showed no focal abnormality in any of these cases. These low perfusion areas were diminished or disappeared after surgical treatment in 6 cases (75%). We conclude that the I-123-IMP-SPECT is considered to be a useful index for the evaluation of functional recovery after surgery in cases of craniosynostosis. (author)

CT diagnosis of occipital bone pacchionian depression

International Nuclear Information System (INIS)

Zhu Jianguo; Xu Xiaolin

2004-01-01

Objective: To improve the recognition of the CT findings of occipital bone pacchionian depression, in order to avoid misdiagnosis. Methods: occipital bone pacchionian depression underwent CT with plain scan and intravenous contrast enhancement in 11 cases, and then the CT findings were analyzed. Results: Occipital bone pacchionian depression situated beside the torcular herophilia in 11 cases. The depression or bone defect were found at occipital bone inner plate, they can reach diploe or outer plate and had no enhancement after contrast injection. Conclusions: CT scans play an important role in diagnosis and differential diagnosis of occipital bone pacchionian depression

Aberrant topological patterns of brain structural network in temporal lobe epilepsy.

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Yasuda, Clarissa Lin; Chen, Zhang; Beltramini, Guilherme Coco; Coan, Ana Carolina; Morita, Marcia Elisabete; Kubota, Bruno; Bergo, Felipe; Beaulieu, Christian; Cendes, Fernando; Gross, Donald William

2015-12-01

Although altered large-scale brain network organization in patients with temporal lobe epilepsy (TLE) has been shown using morphologic measurements such as cortical thickness, these studies, have not included critical subcortical structures (such as hippocampus and amygdala) and have had relatively small sample sizes. Here, we investigated differences in topological organization of the brain volumetric networks between patients with right TLE (RTLE) and left TLE (LTLE) with unilateral hippocampal atrophy. We performed a cross-sectional analysis of 86 LTLE patients, 70 RTLE patients, and 116 controls. RTLE and LTLE groups were balanced for gender (p = 0.64), seizure frequency (Mann-Whitney U test, p = 0.94), age (p = 0.39), age of seizure onset (p = 0.21), and duration of disease (p = 0.69). Brain networks were constructed by thresholding correlation matrices of volumes from 80 cortical/subcortical regions (parcellated with Freesurfer v5.3 https://surfer.nmr.mgh.harvard.edu/) that were then analyzed using graph theoretical approaches. We identified reduced cortical/subcortical connectivity including bilateral hippocampus in both TLE groups, with the most significant interregional correlation increases occurring within the limbic system in LTLE and contralateral hemisphere in RTLE. Both TLE groups demonstrated less optimal topological organization, with decreased global efficiency and increased local efficiency and clustering coefficient. LTLE also displayed a more pronounced network disruption. Contrary to controls, hub nodes in both TLE groups were not distributed across whole brain, but rather found primarily in the paralimbic/limbic and temporal association cortices. Regions with increased centrality were concentrated in occipital lobes for LTLE and contralateral limbic/temporal areas for RTLE. These findings provide first evidence of altered topological organization of the whole brain volumetric network in TLE, with disruption of the coordinated patterns of

Association of the interleukin 1 beta gene and brain spontaneous activity in amnestic mild cognitive impairment

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Zhuang Liying

2012-12-01

Full Text Available Abstract Purpose The inflammatory response has been associated with the pathogenesis of Alzheimer’s disease (AD. The purpose of this study is to determine whether the rs1143627 polymorphism of the interleukin-1 beta (IL-1β gene moderates functional magnetic resonance imaging (fMRI-measured brain regional activity in amnestic mild cognitive impairment (aMCI. Methods Eighty older participants (47 with aMCI and 33 healthy controls were recruited for this study. All of the participants were genotyped for variant rs1143627 in the IL1B gene and were scanned using resting-state fMRI. Brain activity was assessed by amplitude of low-frequency fluctuation (ALFF. Results aMCI patients had abnormal ALFF in many brain regions, including decreases in the inferior frontal gyrus, the superior temporal lobe and the middle temporal lobe, and increases in the occipital cortex (calcarine, parietal cortex (Pcu and cerebellar cortex. The regions associated with an interaction of group X genotypes of rs1143627 C/T were the parietal cortex (left Pcu, frontal cortex (left superior, middle, and medial gyrus, right anterior cingulum, occipital cortex (left middle lobe, left cuneus and the bilateral posterior lobes of the cerebellum. Regarding the behavioral significance, there were significant correlations between ALFF in different regions of the brain and with the cognitive scores of each genotype group. Conclusions The present study provided evidence that aMCI patients had abnormal ALFF in many brain regions. Specifically, the rs1143627 C/T polymorphism of the IL1B gene may modulate regional spontaneous brain activity in aMCI patients.

Gender Differences in Regional Brain Activity in Patients with Chronic Primary Insomnia: Evidence from a Resting-State fMRI Study.

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Dai, Xi-Jian; Nie, Xiao; Liu, Xuming; Pei, Li; Jiang, Jian; Peng, De-chang; Gong, Hong-Han; Zeng, Xian-Jun; Wáng, Yì-Xiáng J; Zhan, Yang

2016-03-01

To explore the regional brain activities in patients with chronic primary insomnia (PCPIs) and their sex differences. Forty-two PCPIs (27 females, 15 males) and 42 good sleepers (GSs; 24 females, 18 males) were recruited. Six PCPIs (3 males, 3 females) were scanned twice by MRI to examine the test-retest reliability. Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features. The mean signal values of the different ALFF areas were analyzed with a receiver operating characteristic (ROC) curve. Simple linear regression analysis was performed to investigate the relationships between clinical features and different brain areas. Both female and male PCPIs showed higher ALFF in the temporal lobe and occipital lobe, especially in female PCPIs. Female PCPIs had lower ALFF in the bilateral cerebellum posterior lobe, left dorsolateral prefrontal cortex, and bilateral limbic lobe; however, male PCPIs showed lower ALFF in the left occipital gyrus. The mean signal value of the cerebellum in female PCPIs showed negative correlations with negative emotions. Compared with male PCPIs, female PCPIs showed higher ALFF in the bilateral middle temporal gyrus and lower ALFF in the left limbic lobe. The different areas showed high test-retest stability (Clusters of contiguous volumes ≥ 1080 mm(3) with an intraclass correlation coefficient ≥ 0.80) and high degree of sensitivity and specificity. Female PCPIs showed more regional brain differences with higher and lower ALFF responses than male PCPIs. However, they shared analogous excessive hyperarousal mechanism and wide variations in aberrant brain areas. © 2016 American Academy of Sleep Medicine.

Auditory temporal processing in patients with temporal lobe epilepsy.

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Lavasani, Azam Navaei; Mohammadkhani, Ghassem; Motamedi, Mahmoud; Karimi, Leyla Jalilvand; Jalaei, Shohreh; Shojaei, Fereshteh Sadat; Danesh, Ali; Azimi, Hadi

2016-07-01

Auditory temporal processing is the main feature of speech processing ability. Patients with temporal lobe epilepsy, despite their normal hearing sensitivity, may present speech recognition disorders. The present study was carried out to evaluate the auditory temporal processing in patients with unilateral TLE. The present study was carried out on 25 patients with epilepsy: 11 patients with right temporal lobe epilepsy and 14 with left temporal lobe epilepsy with a mean age of 31.1years and 18 control participants with a mean age of 29.4years. The two experimental and control groups were evaluated via gap-in-noise and duration pattern sequence tests. One-way ANOVA was run to analyze the data. The mean of the threshold of the GIN test in the control group was observed to be better than that in participants with LTLE and RTLE. Also, it was observed that the percentage of correct responses on the DPS test in the control group and in participants with RTLE was better than that in participants with LTLE. Patients with TLE have difficulties in temporal processing. Difficulties are more significant in patients with LTLE, likely because the left temporal lobe is specialized for the processing of temporal information. Copyright © 2016 Elsevier Inc. All rights reserved.

Computed Tomography-Based Occipital Condyle Morphometry in an Indian Population to Assess the Feasibility of Condylar Screws for Occipitocervical Fusion.

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Srivastava, Abhishek; Nanda, Geetanjali; Mahajan, Rajat; Nanda, Ankur; Mishra, Nirajana; Karmaran, Srinivasa; Batra, Sahil; Chhabra, Harvinder Singh

2017-12-01

A retrospective computed tomography (CT)-based morphometric study of 82 occipital condyles in the Indian population, focusing on critical morphometric dimensions with relation to placing condylar screws. This study focused on determining the feasibility of placing occipital condylar screws in an Indian population using CT anatomical morphometric data. The occipital condylar screw is a novel technique being explored as one of the options in occipitocervical stabilization. Sex and ethnic variations in anatomical structures may restrict the feasibility of this technique in some populations. To the best of our knowledge, there are no CT-based data on an Indian population that assess the feasibility of occipital condylar screws. We measured the dimensions of 82 occipital condyles in 41 adults on coronal, sagittal, and axial reconstructed CT images. The differences were noted between the right and left sides and also between males and females. Statistical analysis was performed using the t -test, with a p -value of occipital condyle shows that condylar screws are anatomically feasible in a large portion of the Indian population. However, because a small number of population may not be suitable for this technique, meticulous study of preoperative anatomy using detailed CT data is advised.

Giant lipoma arising from deep lobe of the parotid gland

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Hsu Ying-Che

2006-06-01

Full Text Available Abstract Background Lipomas are common benign soft tissue neoplasms but they are found very rarely in the deep lobe of parotid gland. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus knowledge of the anatomy and meticulous surgical technique are essential. Case presentation A 71-year-old female presented with a large asymptomatic mass, which had occupied the left facial area for over the past fifteen years, and she requested surgical excision for a cosmetically better facial appearance. The computed tomography (CT scan showed a well-defined giant lipoma arising from the left deep parotid gland. The lipoma was successfully enucleated after full exposure and mobilization of the overlying facial nerve branches. The surgical specimen measured 9 × 6 cm in size, and histopathology revealed fibrolipoma. The patient experienced an uneventful recovery, with a satisfying facial contour and intact facial nerve function. Conclusion Giant lipomas involving the deep parotid lobe are extremely rare. The high-resolution CT scan provides an accurate and cost-effective preoperative investigative method. Surgical management of deep lobe lipoma should be performed by experienced surgeons due to the need for meticulous dissection of the facial nerve branches. Superficial parotidectomy before deep lobe lipoma removal may be unnecessary in selected cases because preservation of the superficial lobe may contribute to a better aesthetic and functional result.

Study on memories of temporal lobes and the principles of lateralization using near infrared spectroscopy

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Kamakura, Katsutoshi

2007-01-01

In this study we measured the variation of brain blood quantity (Oxy-Hb, Deoxy-Hb and Total-Hb) in the temporal lobes using near infrared spectroscopy (NIRS) when the tasks of the memories were presented to the subjects. The memories are classified into the short-term memory (STM) and the long-term memory (LTM) including the episodic and semantic memories. The subjects joined in this study are 11 persons who are university students including graduate students. We used the language task of letter-number sequencing, also reverse sequencing to measure STM and the task of the episodic memory to measure LTM. As a result of analysis, concerning the episodic memory, the variation of Oxy-Hb in the left temporal lobe was larger than that of Oxy-Hb in the right temporal lobe. The result might suggest that the episodic memory has a relationship with cerebral dominance concerning language area in the left temporal lobe. It seems that the episodic memory meditated with the function of language used in this study is much stored in the left temporal lobe than in the right temporal lobe. This result coincides with the principles of lateralization. The variation of Oxy-Hb in the language task of letter-number sequencing was smaller than that of Oxy-Hb in the language task of the episodic memory.

Patterns of brain activity in normals and schizophrenics with positron emission tomography

International Nuclear Information System (INIS)

Volkow, N.D.; Wolf, A.P.; Gomez-Mont, F.; Brodie, J.D.; Canero, R.; Van Gelder, P.; Russell, J.A.G.

1985-01-01

The authors investigated the functional interaction among brain areas under baseline and upon activation by a visual task to compare the response of normal subjects from the ones of chronic schizophrenics. Cerebral metabolic images were obtained on twelve healthy volunteers an eighteen schizophrenics with positron emission tomography and 11-C-Deoxyglucose. Correlation coefficients among the relative metabolic values (region of interest divided by the average of whole brain gray matter) of 11 brain regions; frontal, parietal, temporal and occipital left and right lobes, left and right basal ganglia and thalamus were computed for the baseline and for the task. Under baseline, normals showed more functional correlations than schizophrenics. Both groups showed a thalamo-occipital (positive) and thalamo-frontal (negative) interaction. The highest correlations among homologous brain areas were the frontal, occipital and basal ganglia

Functional substrate for memory function differences between patients with left and right mesial temporal lobe epilepsy associated with hippocampal sclerosis.

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Jin, Seung-Hyun; Chung, Chun Kee

2015-10-01

Little is known about the functional substrate for memory function differences in patients with left or right mesial temporal lobe epilepsy (mTLE) associated with hippocampal sclerosis (HS) from an electrophysiological perspective. To characterize these differences, we hypothesized that hippocampal theta connectivity in the resting-state might be different between patients with left and right mTLE with HS and be correlated with memory performance. Resting-state hippocampal theta connectivity, identified via whole-brain magnetoencephalography, was evaluated. Connectivity and memory function in 41 patients with mTLE with HS (left mTLE=22; right mTLE=19) were compared with those in 46 age-matched healthy controls and 28 patients with focal cortical dysplasia (FCD) but without HS. Connectivity between the right hippocampus and the left middle frontal gyrus was significantly stronger in patients with right mTLE than in patients with left mTLE. Moreover, this connectivity was positively correlated with delayed verbal recall and recognition scores in patients with mTLE. Patients with left mTLE had greater delayed recall impairment than patients with right mTLE and FCD. Similarly, delayed recognition performance was worse in patients with left mTLE than in patients with right mTLE and FCD. No significant differences in memory function between patients with right mTLE and FCD were detected. Patients with right mTLE showed significantly stronger hippocampal theta connectivity between the right hippocampus and left middle frontal gyrus than patients with FCD and left mTLE. Our results suggest that right hippocampal-left middle frontal theta connectivity could be a functional substrate that can account for differences in memory function between patients with left and right mTLE. This functional substrate might be related to different compensatory mechanisms against the structural hippocampal lesions in left and right mTLE groups. Given the positive correlation between

Hemispheric Dominance for Stereognosis in a Patient With an Infarct of the Left Postcentral Sensory Hand Area.

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Moll, Jorge; de Oliveira-Souza, Ricardo

2017-09-01

The concept of left hemispheric dominance for praxis, speech, and language has been one of the pillars of neurology since the mid-19th century. In 1906, Hermann Oppenheim reported a patient with bilateral stereoagnosia (astereognosis) caused by a left parietal lobe tumor and proposed that the left hemisphere was also dominant for stereognosis. Surprisingly, few cases of bilateral stereoagnosia caused by a unilateral cerebral lesion have been documented in the literature since then. Here we report a 75-year-old right-handed man who developed bilateral stereoagnosia after suffering a small infarct in the crown of the left postcentral gyrus. He could not recognize objects with either hand, but retained the ability to localize stimuli applied to the palm of his left (ipsilesional) hand. He was severely disabled in ordinary activities requiring the use of his hands. The lesion corresponded to Brodmann area 1, where probabilistic anatomic, functional, and electrophysiologic studies have located one of the multiple somatosensory representations of the hand. The lesion was in a strategic position to interrupt both the processing of afferent tactile information issuing from the primary somatosensory cortex (areas 3a and 3b) and the forward higher-order processing in area 2, the secondary sensory cortex, and the contralateral area 1. The lesion also deprived the motor hand area of its afferent regulation from the sensory hand area (grasping), while leaving intact the visuomotor projections from the occipital cortex (reaching). Our patient supports Oppenheim's proposal that the left postcentral gyrus of some individuals is dominant for stereognosis.

How does occipitalization influence the dimensions of the cranium?

DEFF Research Database (Denmark)

Caspersen, L M; Kjaer, I; Sonnesen, L

2010-01-01

To describe occipitalization on human dry skulls and to compare craniofacial morphology including the posterior cranial fossa in skulls with occipitalization and in skulls without occipitalization and with normal craniofacial morphology (controls).......To describe occipitalization on human dry skulls and to compare craniofacial morphology including the posterior cranial fossa in skulls with occipitalization and in skulls without occipitalization and with normal craniofacial morphology (controls)....

Cortical volumes and atrophy rates in FTD-3 CHMP2B mutation carriers and related non-carriers

DEFF Research Database (Denmark)

Eskildsen, Simon F; Østergaard, Lasse R; Rodell, Anders B

2008-01-01

with a mean interval of 16 months and surface based cortical segmentation we measured cortical thickness and volume, and quantified atrophy rates. Cortical thickness and atrophy rates were averaged within major lobes and focal effects were determined by parametric statistical maps. The volumetric atrophy...... in the frontal and occipital lobes, and in the left temporal lobe. Results indicated that cortical thickness has a higher sensitivity for detecting small changes than whole-brain volumetric measures. Comparing mutation carriers with non-carriers revealed increased atrophy rates in mutation carriers bilaterally...

[Influence of Sympathetic Denervation of the Renal Artery on the Level of Arterial Blood Pressure, Cerebral Blood Flow and Cognitive Function In Patients With Resistant Arterial Hypertension].

Science.gov (United States)

Efimova, Y N; Lichikaki, A V; Lishmanov, B Y

2017-07-01

To study the effect of radiofrequency ablation of renal arteries on regional cerebral blood flow and cognitive function in patients with resistant arterial hypertension (AH). Transcatheter renal denervation (TRD) was performed in 17 patients with resistant AH. Examination before and after TRD included SPECT with mTc-HMPAO, 24-hours blood pressure (BP) monitoring, and comprehensive neuropsychological testing. Fifteen patients without angiographic signs of carotid atherosclerosis, coronary artery disease and AH, neurological and psychiatric disorders were investigated as control group. Compared with control group patients with AH had decreases of regional cerebral blood flow (rCBF) in right (by 13.5%, p=0.00002) and left (by 15.5%, p=0.0006) inferior frontal lobes, in right temporal brain region (by 11.5%, p=0.008); in right and left occipital lobes (by 8.2%, p=0.04). In 6 months after TRD we observed significant improvement of cognitive function, parameters of 24-hour BP monitoring, and rCBF. We also noted definite close interdependence between changes of rCBF, indices of 24-hours BP monitoring, and dynamics of cognitive function. Improvement of long-term verbal memory correlated with increases of rCBF in left superior frontal and right occipital regions while dynamics of mentation and attention correlated positively with augmentation of rCBF in right posterior parietal region. Changes of perfusion in inferior parts of left frontal lobe and in right occipital region correlated with dynamics of index of diurnal diastolic hypertension time (R2=0.64, p=0.001, and R2=0.60, p=0.03, respectively). Our results suggest, that in patients with resistant AH positive effect of TRD on levels of 24-hour mean BP as well as on indices of BP load leads to in augmentation of rCBF and improvement of cognitive function.

Myelination Is Associated with Processing Speed in Early Childhood: Preliminary Insights.

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Nicolas Chevalier

Full Text Available Processing speed is an important contributor to working memory performance and fluid intelligence in young children. Myelinated white matter plays a central role in brain messaging, and likely mediates processing speed, but little is known about the relationship between myelination and processing speed in young children. In the present study, processing speed was measured through inspection times, and myelin volume fraction (VFM was quantified using a multicomponent magnetic resonance imaging (MRI approach in 2- to 5-years of age. Both inspection times and VFM were found to increase with age. Greater VFM in the right and left occipital lobes, the body of the corpus callosum, and the right cerebellum was significantly associated with shorter inspection times, after controlling for age. A hierarchical regression showed that VFM in the left occipital lobe predicted inspection times over and beyond the effects of age and the VFM in the other brain regions. These findings are consistent with the hypothesis that myelin supports processing speed in early childhood.

Semantic memory is impaired in patients with unilateral anterior temporal lobe resection for temporal lobe epilepsy.

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Lambon Ralph, Matthew A; Ehsan, Sheeba; Baker, Gus A; Rogers, Timothy T

2012-01-01

Contemporary clinical and basic neuroscience studies have increasingly implicated the anterior temporal lobe regions, bilaterally, in the formation of coherent concepts. Mounting convergent evidence for the importance of the anterior temporal lobe in semantic memory is found in patients with bilateral anterior temporal lobe damage (e.g. semantic dementia), functional neuroimaging and repetitive transcranial magnetic stimulation studies. If this proposal is correct, then one might expect patients with anterior temporal lobe resection for long-standing temporal lobe epilepsy to be semantically impaired. Such patients, however, do not present clinically with striking comprehension deficits but with amnesia and variable anomia, leading some to conclude that semantic memory is intact in resection for temporal lobe epilepsy and thus casting doubt over the conclusions drawn from semantic dementia and linked basic neuroscience studies. Whilst there is a considerable neuropsychological literature on temporal lobe epilepsy, few studies have probed semantic memory directly, with mixed results, and none have undertaken the same type of systematic investigation of semantic processing that has been conducted with other patient groups. In this study, therefore, we investigated the semantic performance of 20 patients with resection for chronic temporal lobe epilepsy with a full battery of semantic assessments, including more sensitive measures of semantic processing. The results provide a bridge between the current clinical observations about resection for temporal lobe epilepsy and the expectations from semantic dementia and other neuroscience findings. Specifically, we found that on simple semantic tasks, the patients' accuracy fell in the normal range, with the exception that some patients with left resection for temporal lobe epilepsy had measurable anomia. Once the semantic assessments were made more challenging, by probing specific-level concepts, lower frequency

Complications of occipital bone pneumatization

International Nuclear Information System (INIS)

Moss, Mary; Roche, Jim; Biggs, Michael; Forer, Martin; Fagan, Paul; Davis, Martin

2004-01-01

Four cases of occipital bone pneumatization and subsequent complications are described, which include a pathological fracture of C 1 and the occipital bone, spontaneous subcutaneous emphysema and pneumatocele formation. Reviews of the published literature and possible aetiological factors have been discussed Copyright (2004) Blackwell Publishing Asia Pty Ltd

Connectivity pattern differences bilaterally in the cerebellum posterior lobe in healthy subjects after normal sleep and sleep deprivation: a resting-state functional MRI study

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Liu XM

2015-05-01

Full Text Available Xuming Liu,1 Zhihan Yan,2 Tingyu Wang,1 Xiaokai Yang,1 Feng Feng,3 Luping Fan,1 Jian Jiang4 1Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, 2Department of Radiology, The 2nd Affiliated Hospital of Wenzhou Medical University, Wenzhou, 3Peking Union Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 4Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China Objective: The aim of this study was to use functional magnetic resonance imaging (fMRI technique to explore the resting-state functional connectivity (rsFC differences of the bilaterial cerebellum posterior lobe (CPL after normal sleep (NS and after sleep deprivation (SD. Methods: A total of 16 healthy subjects (eight males, eight females underwent an fMRI scan twice at random: once following NS and the other following 24 hours’ SD, with an interval of 1 month between the two scans. The fMRI scanning included resting state and acupuncture stimulation. The special activated regions located during the acupuncture stimulation were selected as regions of interest for rsFC analysis. Results: Bilateral CPLs were positively activated by acupuncture stimulation. In the NS group, the left CPL showed rsFC with the bilateral CPL, bilateral frontal lobe (BFL, left precuneus and right inferior parietal lobule, while the right CPL showed rsFC with the bilateral temporal lobe, right cerebellum anterior lobe, right CPL, left frontal lobe, left anterior cingulate, right posterior cingulate, and bilateral inferior parietal lobule. In the SD group, the left CPL showed rsFC with the left posterior cingulate gyrus bilateral CPL, left precuneus, left precentral gyrus, BFL, and the left parietal lobe, while the right CPL showed rsFC with bilateral cerebellum anterior lobe, bilateral CPL, left frontal lobe and left temporal lobe. Compared with the NS group, the

Functional discrepancy between two liver lobes after hemilobe biliary drainage in patients with jaundice and bile duct cancer: an appraisal using (99m)Tc-GSA SPECT/CT fusion imaging.

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Sumiyoshi, Tatsuaki; Shima, Yasuo; Okabayashi, Takehiro; Noda, Yoshihiro; Hata, Yasuhiro; Murata, Yoriko; Kozuki, Akihito; Tokumaru, Teppei; Nakamura, Toshio; Uka, Kiminori

2014-11-01

To determine the functional discrepancy between the two liver lobes using technetium 99m ((99m)Tc) diethylenetriamine-pentaacetic acid-galactosyl human serum albumin ( GSA diethylenetriamine-pentaacetic acid-galactosyl human serum albumin ) single photon emission computed tomography (SPECT)/computed tomography (CT) fusion imaging following preoperative biliary drainage and portal vein embolization ( PVE portal vein embolization ) in patients with jaundice who have bile duct cancer ( BDC bile duct cancer ). This retrospective study was approved by the institutional review board, with waiver of informed consent. Preoperative (99m)Tc- GSA diethylenetriamine-pentaacetic acid-galactosyl human serum albumin SPECT/CT fusion images from 32 patients with extrahepatic BDC bile duct cancer were retrospectively reviewed. Patients were classified into four groups according to the extent of biliary drainage and presence of a preoperative right PVE portal vein embolization : right lobe drainage group (right drainage), bilateral lobe drainage group (bilateral drainage), left lobe drainage group (left drainage), and left lobe drainage with right PVE portal vein embolization group (left drainage with right PVE portal vein embolization ). Percentage volume and percentage function were measured in each lobe using fusion imaging. The ratio between percentage function and percentage volume (the function-to-volume ratio) was calculated for each lobe, and the results were compared among the four groups. Statistical analysis was performed with Wilcoxon signed-rank tests and Mann-Whitney U tests. The median values for the function-to-volume ratio in the right drainage, bilateral drainage, left drainage, and left drainage with right PVE portal vein embolization group were 1.12, 1.05, 1.02, and 0.81 in the right lobe; and 0.51, 0.88, 0.96, and 1.17 in the left lobe. Significant differences in the function-to-volume ratio were observed among the four groups (right drainage vs bilateral

Hippocampal Atrophy Is Associated with Altered Hippocampus-Posterior Cingulate Cortex Connectivity in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis.

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Shih, Y C; Tseng, C E; Lin, F-H; Liou, H H; Tseng, W Y I

2017-03-01

Unilateral mesial temporal lobe epilepsy and hippocampal sclerosis have structural and functional abnormalities in the mesial temporal regions. To gain insight into the pathophysiology of the epileptic network in mesial temporal lobe epilepsy with hippocampal sclerosis, we aimed to clarify the relationships between hippocampal atrophy and the altered connection between the hippocampus and the posterior cingulate cortex in patients with mesial temporal lobe epilepsy with hippocampal sclerosis. Fifteen patients with left mesial temporal lobe epilepsy with hippocampal sclerosis and 15 healthy controls were included in the study. Multicontrast MR imaging, including high-resolution T1WI, diffusion spectrum imaging, and resting-state fMRI, was performed to measure the hippocampal volume, structural connectivity of the inferior cingulum bundle, and intrinsic functional connectivity between the hippocampus and the posterior cingulate cortex, respectively. Compared with controls, patients had decreased left hippocampal volume (volume ratio of the hippocampus and controls, 0.366% ± 0.029%; patients, 0.277% ± 0.063%, corrected P = .002), structural connectivity of the bilateral inferior cingulum bundle (generalized fractional anisotropy, left: controls, 0.234 ± 0.020; patients, 0.193 ± 0.022, corrected P = .0001, right: controls, 0.226 ± 0.022; patients, 0.208 ± 0.017, corrected P = .047), and intrinsic functional connectivity between the left hippocampus and the left posterior cingulate cortex (averaged z-value: controls, 0.314 ± 0.152; patients, 0.166 ± 0.062). The left hippocampal volume correlated with structural connectivity positively (standardized β = 0.864, P = .001), but it had little correlation with intrinsic functional connectivity (standardized β = -0.329, P = .113). On the contralesional side, the hippocampal volume did not show any significant correlation with structural connectivity or intrinsic functional connectivity ( F 2,12 = 0.284, P = .757, R 2

Condroblastoma benigno do osso occipital: Relato do caso Benign chondroblastoma of the occipital bone: case report

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João Flávio Mattos Araújo

1995-12-01

Full Text Available Condroblastoma benigno é tumor ósseo raro, tendo como origem células cartilagíneas. Classicamente este tumor acomete regiões epifisárias de ossos longos, sendo incomum o envolvimento de ossos do crânio, principalmente o osso occipital. Relatamos o caso de uma paciente com 16 anos de idade, com o diagnóstico de condroblastoma benigno do osso occipital e discutimos os principais aspectos deste tumor.Benign chondroblastoma is a rare bone tumor of immature cartilage cell derivation. This lesion classically occur at the ends of long bones in young persons. Chondroblastoma arising from the occipital bone is extremely rare. We report the case of a 16 year old girl with a benign condroblastoma in the occipital bone, and discuss the clinical, radiological and treatment aspects of this tumor.

The cerebral functional location in normal subjects when they listened to story in Chinese

International Nuclear Information System (INIS)

Sun Da; Zhan Hongwei; Xu Wei; Liu Hongbiao; Bao Chengkan

2004-01-01

Purpose: To detect the cerebral functional location when normal subjects listened to a story in Chinese. Methods: 9 normal young students of the medical collage of Zhejiang University, 23-24 years old, 5 male and 4 female. The first they underwent a 99m Tc-ECD brain imaging at rest using a dual-head gamma camera with fan beam collimators. After 2-4 days they were asked to listen a story in Chinese on a tap for 20 minters. The related an emotional story about a young president of a radio station and his girlfriend as well as his audience and fan, a young girl. They were also asked to pay special attention to the name of the personage in the story, what time and site did the story open out. They were also asked to imagine the imagination of the story. 99m Tc-ECD was administered in the first 3 minutes during they listened the story. The brain imaging was performed in 30-60 minutes after the tracer was administered. Results: To compare the rest state, during listen to the story in Chinese and asked to remember the imagination of story the right superior temporal in 5 cases, left superior temporal in 3 cases, right mid temporal in 2 cases were activated. Among them, dual temporal were activated in l case, only right temporal in 6 cases and left temporal in 2 cases. It is very interesting that the inferior frontal and/or medial frontal lobes were activated lightly in all 9 subjects. Among them dual frontal lobes were activated in 5 subjects, and only right frontal in 3 cases and left frontal in 1 case. The occipital lobes were activated in 6 subjects, and dual occipital in 5 cases, left occipital in 1 case. Other regions that were activated included pre-cingulated gyrus (in 1 case), and left thalamic (in 1 case). Conclusion: During listened to the story in Chinese and asked remember the plot of the story the auditory association cortex in the superior temporal (it is more in right than in left) and some right mid temporal were activated. The inferior frontal and

Cognitive impairments in patients with intractable temporal lobe epilepsy

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Mahgol Tavakoli

2011-01-01

Conclusions: These findings indicated that WMS-III and WAIS-R can differentiate patients with refractory temporal lobe epilepsy from normal subjects. However, the obtained cognitive profile could not differentiate between the right and the left TLE.

Insights into Intrinsic Brain Networks based on Graph Theory and PET in right- compared to left-sided Temporal Lobe Epilepsy.

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Vanicek, Thomas; Hahn, Andreas; Traub-Weidinger, Tatjana; Hilger, Eva; Spies, Marie; Wadsak, Wolfgang; Lanzenberger, Rupert; Pataraia, Ekaterina; Asenbaum-Nan, Susanne

2016-06-28

The human brain exhibits marked hemispheric differences, though it is not fully understood to what extent lateralization of the epileptic focus is relevant. Preoperative [(18)F]FDG-PET depicts lateralization of seizure focus in patients with temporal lobe epilepsy and reveals dysfunctional metabolic brain connectivity. The aim of the present study was to compare metabolic connectivity, inferred from inter-regional [(18)F]FDG PET uptake correlations, in right-sided (RTLE; n = 30) and left-sided TLE (LTLE; n = 32) with healthy controls (HC; n = 31) using graph theory based network analysis. Comparing LTLE and RTLE and patient groups separately to HC, we observed higher lobar connectivity weights in RTLE compared to LTLE for connections of the temporal and the parietal lobe of the contralateral hemisphere (CH). Moreover, especially in RTLE compared to LTLE higher local efficiency were found in the temporal cortices and other brain regions of the CH. The results of this investigation implicate altered metabolic networks in patients with TLE specific to the lateralization of seizure focus, and describe compensatory mechanisms especially in the CH of patients with RTLE. We propose that graph theoretical analysis of metabolic connectivity using [(18)F]FDG-PET offers an important additional modality to explore brain networks.

Visual and SPM Analysis of Brain Perfusion SPECT in Patients of Dementia with Lewy Bodies with Clinical Correlation

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Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [College of Medicine, Univ. of Donga, Busan (Korea, Republic of)

2003-07-01

Dementia with Lewy bodies (DLB) is widely recognized as the second commonest form of degenerative dementia. Its core clinical features include persistent visual hallucinosis, fluctuating cognitive impairment and parkinsonism. We evaluated the brain perfusion of dementia with Lewy bodies by SPM analysis and correlated the findings with clinical symptom. Twelve DLB patients (mean age ; 68.88.3 yrs, K-MMSE ; 17.36) and 30 control subjects (mean age ; 60.17.7 yrs) were included. Control subjects were selected by 28 items of exclusion criteria and checked by brain CT or MRI except 3 subjects. Tc-99m HMPAO brain perfusion SPECT was performed and the image data were analyzed by visual interpretation and SPM99 as routine protocol. In visual analysis, 7 patients showed hypoperfusion in both frontal, temporal, parietal and occipital lobe, 2 patients in both frontal, temporal and parietal lobe, 2 patients in both temporal, parietal and occipital lobe, 1 patients in left temporal, parietal and occipital lobe. In SPM analysis (uncorrected p<0.01), significant hypoperfusion was shown in Lt inf. frontal gyrus (B no.47), both inf. parietal lobule (Rt B no.40), Rt parietal lobe (precuneus), both sup. temporal gyrus (Rt B no.42), Rt mid temporal gyrus, Lt transverse temporal gyrus (B no.41), both para hippocampal gyrus, Rt thalamus (pulvinar), both cingulate gyrus (Lt B no.24, Lt B no.25, Rt B no.23, Rt B no.24, Rt B no.33), Rt caudate body, both occipital lobe (cuneus, Lt B no.17, Rt B no.18). All patients had fluctuating cognition and parkinsonism, and 9 patients had visual hallucination. The result of SPM analysis was well correlated with visual interpretation and may be helpful to specify location to correlate with clinical symptom. Significant perfusion deficits in occipital region including visual cortex and visual association area are characteristic findings in DLB. Abnormalities in these areas may be important in understanding symptoms of visual hallucination and

Visual and SPM Analysis of Brain Perfusion SPECT in Patients of Dementia with Lewy Bodies with Clinical Correlation

International Nuclear Information System (INIS)

Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

2003-01-01

Dementia with Lewy bodies (DLB) is widely recognized as the second commonest form of degenerative dementia. Its core clinical features include persistent visual hallucinosis, fluctuating cognitive impairment and parkinsonism. We evaluated the brain perfusion of dementia with Lewy bodies by SPM analysis and correlated the findings with clinical symptom. Twelve DLB patients (mean age ; 68.88.3 yrs, K-MMSE ; 17.36) and 30 control subjects (mean age ; 60.17.7 yrs) were included. Control subjects were selected by 28 items of exclusion criteria and checked by brain CT or MRI except 3 subjects. Tc-99m HMPAO brain perfusion SPECT was performed and the image data were analyzed by visual interpretation and SPM99 as routine protocol. In visual analysis, 7 patients showed hypoperfusion in both frontal, temporal, parietal and occipital lobe, 2 patients in both frontal, temporal and parietal lobe, 2 patients in both temporal, parietal and occipital lobe, 1 patients in left temporal, parietal and occipital lobe. In SPM analysis (uncorrected p<0.01), significant hypoperfusion was shown in Lt inf. frontal gyrus (B no.47), both inf. parietal lobule (Rt B no.40), Rt parietal lobe (precuneus), both sup. temporal gyrus (Rt B no.42), Rt mid temporal gyrus, Lt transverse temporal gyrus (B no.41), both para hippocampal gyrus, Rt thalamus (pulvinar), both cingulate gyrus (Lt B no.24, Lt B no.25, Rt B no.23, Rt B no.24, Rt B no.33), Rt caudate body, both occipital lobe (cuneus, Lt B no.17, Rt B no.18). All patients had fluctuating cognition and parkinsonism, and 9 patients had visual hallucination. The result of SPM analysis was well correlated with visual interpretation and may be helpful to specify location to correlate with clinical symptom. Significant perfusion deficits in occipital region including visual cortex and visual association area are characteristic findings in DLB. Abnormalities in these areas may be important in understanding symptoms of visual hallucination and

A functional magnetic resonance imaging study mapping the episodic memory encoding network in temporal lobe epilepsy

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Sidhu, Meneka K.; Stretton, Jason; Winston, Gavin P.; Bonelli, Silvia; Centeno, Maria; Vollmar, Christian; Symms, Mark; Thompson, Pamela J.; Koepp, Matthias J.

2013-01-01

Functional magnetic resonance imaging has demonstrated reorganization of memory encoding networks within the temporal lobe in temporal lobe epilepsy, but little is known of the extra-temporal networks in these patients. We investigated the temporal and extra-temporal reorganization of memory encoding networks in refractory temporal lobe epilepsy and the neural correlates of successful subsequent memory formation. We studied 44 patients with unilateral temporal lobe epilepsy and hippocampal sclerosis (24 left) and 26 healthy control subjects. All participants performed a functional magnetic resonance imaging memory encoding paradigm of faces and words with subsequent out-of-scanner recognition assessments. A blocked analysis was used to investigate activations during encoding and neural correlates of subsequent memory were investigated using an event-related analysis. Event-related activations were then correlated with out-of-scanner verbal and visual memory scores. During word encoding, control subjects activated the left prefrontal cortex and left hippocampus whereas patients with left hippocampal sclerosis showed significant additional right temporal and extra-temporal activations. Control subjects displayed subsequent verbal memory effects within left parahippocampal gyrus, left orbitofrontal cortex and fusiform gyrus whereas patients with left hippocampal sclerosis activated only right posterior hippocampus, parahippocampus and fusiform gyrus. Correlational analysis showed that patients with left hippocampal sclerosis with better verbal memory additionally activated left orbitofrontal cortex, anterior cingulate cortex and left posterior hippocampus. During face encoding, control subjects showed right lateralized prefrontal cortex and bilateral hippocampal activations. Patients with right hippocampal sclerosis showed increased temporal activations within the superior temporal gyri bilaterally and no increased extra-temporal areas of activation compared with

IMP-SPECT at patients with hallucinations

International Nuclear Information System (INIS)

Podreka, I.; Mamoli, B.; Lesch, O.; Suess, E.; Wimberger, D.; Mayr, N.; Havelec, L.; Mueller, C.; Steiner, M.; Deecke, L.

1986-01-01

IMP-SPECT was performed in 14 normal volunteers. A 'regional index=RI' of tracer distribution was calculated for 18 regions in each hemisphere RI=(cts/voxel ROI)/(mean cts/voxel of all ROI's). 30 seizure patients (E) and 12 patients with acoustic, partialy also visual hallucinations (H) were investigated. Regions were defined as hypo- or hyperperfused if the RI exceeded the value of the corresponding normal-RI +- 2 std. EEG was recorded in all (E). 93.3% of EEG-findings were abnormal, 50% showed a focus, 46.7% paroxysmal activity. SPECT detected in 93.3% of (E) hypoperfused regions, mostly located in the temporal lobe. All (H) had decreased rCBF, predominantly in the frontal cortex. ANOVA and t-test revealed significant RI-differences in the frontal lobe, both hippocampi, right and left inferior occipital cortex, and right anterior basal ganglia. (H) had lower RI's in frontal lobes, higher RI's in both hippocampal regions as well as inferior occipital regions and anterior basal ganglia Differences between (E) and (H) were found in the frontal lobe ((H)sub(→)), right superior temporal region ((H)sup(→)), left hippocampus ((H)sup(→)), both inferior occipital regions ((H)sup(→)) and right anterior basal ganglia ((H)sup(→)). The study shows that by means of IMP-SPECT hypo- and hyperperfused areas can be detected in the hemispheres of (E) and (H), corresponding to disturbed brain function. Higher hippocampal CBF in (E) and (H) may be related to the role of this limbic structure in generation of seizures and psychotic states. Hallucinations are associated with increased CBF in the right temporal and associative visual cortex. (Author)

Solitary Langerhans cell histiocytosis of the occipital condyle: a case report and review of the literature.

Science.gov (United States)

Teranishi, Yu; Shin, Masahiro; Yoshino, Masanori; Saito, Nobuhito

2016-02-01

Despite the recent advent of various radiographic imaging techniques, it is still very difficult to correctly distinguish a pediatric osteolytic lesion in the occipital condyle, which makes it further complicated to decide on the necessity of and the adequate timing for radical resection and craniocervical fusions. To establish a legitimate therapeutic strategy for this deep-seated lesion, surgical biopsy is a reasonable choice for first-line intervention. The choice of surgical approach becomes very important because a sufficient amount of histological specimen must be obtained to confirm the diagnosis but, ideally, the residual bony structures and the muscular structures should be preserved so as not to increase craniocervical instability. In this report, we present our experience with a case of solitary Langerhans cell histiocytosis (LCH) involving the occipital condyle that was successfully treated with minimally invasive surgical biopsy with a far lateral condylar approach supported by preoperative 3D computer graphic simulation. An 8-year-old girl presented with neck pain. Magnetic resonance imaging and computed tomography (CT) revealed an osteolytic lesion of the left occipital condyle. At surgery, the patient was placed in the prone position. A 3-cm skin incision was made in the posterior auricular region, and the sternocleidomastoid and splenius capitis muscles were dissected in the middle of the muscle bundle along the direction of the muscle fiber. Under a navigation system, we approached the occipital condyle through the space between the longissimus capitis muscle and the posterior belly of the digastric muscle and lateral to the superior oblique muscle, verifying each muscle at each depth of the surgical field and, finally, obtained sufficient surgical specimen. After the biopsy, her craniocervical instability had not worsened, and chemotherapy was performed. Twelve weeks after chemotherapy, her neck pain had gradually disappeared along with her

African Journal of Neurological Sciences 2010 - Vol. 29, No 1 66 ...

African Journals Online (AJOL)

kim

chocolate-like core extending from the Left frontal lobe to the parieto-occipital region (figure 2). Most of the mass was excised but it proved difficult separating the inner layer of the calcification from the underlying brain without provoking bleeding and therefore this was abandoned. Dura hitching stitches were placed in.

Delayed Occipital Artery Pseudoaneurysm Following Blunt Force Trauma.

Science.gov (United States)

Changa, Abhinav R; Meleis, Ahmed M; Bassani, Luigi

2016-05-01

Occipital artery pseudoaneurysms are extremely rare pathologies that manifest after traumatic injury; only 11 cases have been reported in the literature. Because of their low incidence and vague symptoms, the initial diagnosis can be difficult. However, for correctly diagnosed occipital artery pseudoaneurysms, many successful treatment modalities exist. We review the pathology of occipital pseudoaneurysms, elucidate the reasons for their rarity, discuss effective diagnostic measures, and discuss the currently available treatment options. We also present a case of a 16-year-old boy who sustained blunt force trauma in May 2014 and presented 6 months later with a painful, pulsatile mass in the occipital region. The patient underwent surgical resection to alleviate the pain and the potential risk of hemorrhage. He experienced complete resolution of pain and associated symptoms. Our case highlights the fact that occipital swelling, a significant initial sign of pseudoaneurysm development, can be delayed. Therefore, occipital artery pseudoaneurysms cannot be ruled out of the differential diagnosis based on time course alone. Surgical resection is a quick and effective method for relief of severe pain resulting from occipital artery pseudoaneurysms. Although they are rare entities, occipital artery pseudoaneurysms must be considered in the differential diagnosis of cases of pulsatile mass lesions in the posterior scalp. Copyright © 2016 Elsevier Inc. All rights reserved.

Measuring the volume of frontal lobe in healthy Chinese adults of the Han nationality on the high-resolution MRI

International Nuclear Information System (INIS)

Yin Lu; Liu Peifang; Ye Zhaoxiang; Chen Nan; Wang Xing; Li Kuncheng; Zhuo Yan; Chen Lin

2010-01-01

Objective: To explore the normal range of the volume of frontal lobe in Chinese adults of the Han nationality and provide morphological data for the construction of database for Chinese Standard Brain. Methods: This is a clinical multi-center study. Two hundred Chinese healthy volunteers (age range =18 to 70) recruited from 16 hospitals were divided into 5 groups, i.e., age range from 18 to 30, age range from 31 to 40, age range from 41 to 50, age range from 51 to 60, and age range from 61 to 70. Each group contained 20 males and 20 females. All of the volunteers were scanned by MR using T 1 weighted three- dimensional magnetization prepared rapid acquisition gradient echo sequence. We used the manual method to trace the region of interest and measured the left and right frontal lobe volumes separately. All the data were analyzed with SPSS (version 13.0). The sex differences in the frontal lobe volumes were analyzed by independent-samples t test, and the side differences were analyzed by paired-samples t test. Correlation and regression analysis was used between the age and the frontal lobe volumes. Results: In 200 healthy Chinese Han volunteers, the total frontal lobe volumes was (563±73) cm 3 . For male, the volumes of the left and the right frontal lobe were (288±42) cm 3 and (292±41) cm 3 , respectively. The volumes of the left and right frontal lobe in 100 women were (273±30)cm 3 and (274±30) cm 3 respectively. The differences of sex (t=3.334, P 0.05). There were negative correlations between the frontal lobe volumes and age in men and women (r=-0.586, -0.498, P< 0.01). Conclusions: The total frontal lobe volume of men was larger than that of women. The volume of the right frontal lobe was larger than the left frontal lobe in men, and the asymmetries didn't exist in women. The total frontal lobe volumes were both shrinking with age in men and women, which was more rapid in men than in women. (authors)

Correlation between white matter damage and gray matter lesions in multiple sclerosis patients

Directory of Open Access Journals (Sweden)

Xue-mei Han

2017-01-01

Full Text Available We observed the characteristics of white matter fibers and gray matter in multiple sclerosis patients, to identify changes in diffusion tensor imaging fractional anisotropy values following white matter fiber injury. We analyzed the correlation between fractional anisotropy values and changes in whole-brain gray matter volume. The participants included 20 patients with relapsing-remitting multiple sclerosis and 20 healthy volunteers as controls. All subjects underwent head magnetic resonance imaging and diffusion tensor imaging. Our results revealed that fractional anisotropy values decreased and gray matter volumes were reduced in the genu and splenium of corpus callosum, left anterior thalamic radiation, hippocampus, uncinate fasciculus, right corticospinal tract, bilateral cingulate gyri, and inferior longitudinal fasciculus in multiple sclerosis patients. Gray matter volumes were significantly different between the two groups in the right frontal lobe (superior frontal, middle frontal, precentral, and orbital gyri, right parietal lobe (postcentral and inferior parietal gyri, right temporal lobe (caudate nucleus, right occipital lobe (middle occipital gyrus, right insula, right parahippocampal gyrus, and left cingulate gyrus. The voxel sizes of atrophic gray matter positively correlated with fractional anisotropy values in white matter association fibers in the patient group. These findings suggest that white matter fiber bundles are extensively injured in multiple sclerosis patients. The main areas of gray matter atrophy in multiple sclerosis are the frontal lobe, parietal lobe, caudate nucleus, parahippocampal gyrus, and cingulate gyrus. Gray matter atrophy is strongly associated with white matter injury in multiple sclerosis patients, particularly with injury to association fibers.

Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings

International Nuclear Information System (INIS)

Rodrigo, S.; Oppenheim, C.; Meder, J.F.; Chassoux, F.; Golestani, N.; Cointepas, Y.; Poupon, C.; Semah, F.; Mangin, J.F.; Le Bihan, D.

2007-01-01

In temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS), ictal discharge spread to the frontal and insulo-perisylvian cortex is commonly observed. The implication of white matter pathways in this propagation has not been investigated. We compared diffusion tensor imaging (DTI) measurements along the uncinate fasciculus (UF), a major tract connecting the frontal and temporal lobes, in patients and controls. Ten right-handed patients referred for intractable TLE due to a right HS were investigated on a 1.5-T MR scanner including a DTI sequence. All patients had interictal fluorodeoxyglucose PET showing an ipsilateral temporal hypometabolism associated with insular and frontal or perisylvian hypometabolism. The controls consisted of ten right-handed healthy subjects. UF fiber tracking was performed, and its fractional anisotropy (FA) values were compared between patients and controls, separately for the right and left UF. The left-minus-right FA UF asymmetry index was computed to test for intergroup differences. Asymmetries were found in the control group with right-greater-than-left FA. This asymmetrical pattern was lost in the patient group. Right FA values were lower in patients with right HS versus controls. Although preliminary, these findings may be related to the preferential pathway of seizure spread from the mesial temporal lobe to frontal and insulo-perisylvian areas. (orig.)

Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings

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Rodrigo, S.; Oppenheim, C.; Meder, J.F. [Universite Paris-Descartes, Faculte de Medecine, Centre Hospitalier Sainte-Anne, Departement d' Imagerie Morphologique et Fonctionnelle, Paris (France); Chassoux, F. [Universite Paris-Descartes, Faculte de Medecine, Service de Neurochirurgie, Centre Hospitalier Sainte-Anne, Paris (France); Golestani, N.; Cointepas, Y.; Poupon, C.; Semah, F.; Mangin, J.F.; Le Bihan, D. [Service Hospitalier Frederic Joliot, CEA, Orsay (France)

2007-07-15

In temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS), ictal discharge spread to the frontal and insulo-perisylvian cortex is commonly observed. The implication of white matter pathways in this propagation has not been investigated. We compared diffusion tensor imaging (DTI) measurements along the uncinate fasciculus (UF), a major tract connecting the frontal and temporal lobes, in patients and controls. Ten right-handed patients referred for intractable TLE due to a right HS were investigated on a 1.5-T MR scanner including a DTI sequence. All patients had interictal fluorodeoxyglucose PET showing an ipsilateral temporal hypometabolism associated with insular and frontal or perisylvian hypometabolism. The controls consisted of ten right-handed healthy subjects. UF fiber tracking was performed, and its fractional anisotropy (FA) values were compared between patients and controls, separately for the right and left UF. The left-minus-right FA UF asymmetry index was computed to test for intergroup differences. Asymmetries were found in the control group with right-greater-than-left FA. This asymmetrical pattern was lost in the patient group. Right FA values were lower in patients with right HS versus controls. Although preliminary, these findings may be related to the preferential pathway of seizure spread from the mesial temporal lobe to frontal and insulo-perisylvian areas. (orig.)

[Trauma induced left maxillary sinus dislocation of eyeball--a case report].

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Chen, Yu; Liu, Cuiping; Cui, Liping

2013-01-01

Patient male, 27 year old. Left facial and head trauma for 6 hours, due to motor vehicle accident. Patient state of mind was clear at arrival to hospital. Body temperature: 36C; Pulse: 80 Time/Minute; Breath: 20 Time/Minute; Blood pressure: 120/80 mm Hg. An irregular, horizontal laceration at arch of left eyebrow, approximately 8-10 cm. A laceration on left wing of nose skin, approximately 1 cm. A laceration also under lower eyelid skin of right eye, approximately 2 cm. Left blepharedema and enophthalmos. Orbital and nasal sinuses CT indications:contusion and laceration of the left frontal lobe of brain; fracture of the left orbital frontal, ethmoid, sphenoid bone, left nasal, maxillary sinus and zygoma with soft tissue contusion and laceration; the left eyeball and optic nerve sunk into the maxillary sinus (See figure 1). (1) Multiple orbital fractures; (2) Left maxillary sinus dislocation of eyeball; (3) The left frontal lobe contusion and laceration of brain.

Magnetic resonance imaging of functional connectivity in Parkinson disease in the resting brain

International Nuclear Information System (INIS)

Liu Xian; Liu Bo; Luo Xiaodong; Li Ningna; Chen Zhiguang; Chen Jun

2009-01-01

Objective: To investigate functional connectivity changes in Parkinson disease in the resting brain using functional magnetic resonance imaging. Methods: Nine patients with Parkinson disease and eight age-matched healthy volunteers were entered into the study. The bilateral globus pallidus were chosen as seed points, the functional MR data acquired in the resting state were processed to investigate functional connectivity in PD patients and the results were compared with those of the controls. Results: In age-matched healthy controls, there are regions which had functional connectivity with bilateral globus pallidus, including bilateral temporal poles, bilateral hippocampus, bilateral thalami, posterior cingulate cortex, right middle occipital gyms and right superior parietal gyms. In PD patients, brain regions including bilateral cerebellum, left hippocampus, bilateral superior temporal gyri, left inferior frontal gyrus, left middle frontal gyrus, left precentral gyrus, left inferior parietal gyrus and left superior parietal gyrus, had functional connectivity with bilateral globus pallidus. Compared to healthy controls, increased functional connectivity in bilateral cerebellum, bilateral temporal lobes, left frontal lobe and left parietal lobe, and decreased functional connectivity in bilateral thalami were observed in PD patients. Conclusion: Abnormal changes of brain functional connectivity exists in Parkinson's disease in the resting state. (authors)

Fracture of the occipital condyle

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Wessels, L.S.

1990-01-01

The term fracture of the occipital condyle is a misnomer and and usually represents an extensive fracture of the posterior fossa skull base extending onto the squamous portion of the occipital bone and even further forward. These fractures should be suspected when the lower cranial nerves are affected after severe cranial trauma. Conservative management appears to be indicated. 2 figs., 5 refs

Quantitative Evaluation of Medial Temporal Lobe Morphology in Children with Febrile Status Epilepticus: Results of the FEBSTAT Study.

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McClelland, A C; Gomes, W A; Shinnar, S; Hesdorffer, D C; Bagiella, E; Lewis, D V; Bello, J A; Chan, S; MacFall, J; Chen, M; Pellock, J M; Nordli, D R; Frank, L M; Moshé, S L; Shinnar, R C; Sun, S

2016-12-01

The pathogenesis of febrile status epilepticus is poorly understood, but prior studies have suggested an association with temporal lobe abnormalities, including hippocampal malrotation. We used a quantitative morphometric method to assess the association between temporal lobe morphology and febrile status epilepticus. Brain MR imaging was performed in children presenting with febrile status epilepticus and control subjects as part of the Consequences of Prolonged Febrile Seizures in Childhood study. Medial temporal lobe morphologic parameters were measured manually, including the distance of the hippocampus from the midline, hippocampal height:width ratio, hippocampal angle, collateral sulcus angle, and width of the temporal horn. Temporal lobe morphologic parameters were correlated with the presence of visual hippocampal malrotation; the strongest association was with left temporal horn width (P status epilepticus, encompassing both the right and left sides. This association was statistically strongest in the right temporal lobe, whereas hippocampal malrotation was almost exclusively left-sided in this cohort. The association between temporal lobe measurements and febrile status epilepticus persisted when the analysis was restricted to cases with visually normal imaging findings without hippocampal malrotation or other visually apparent abnormalities. Several component morphologic features of hippocampal malrotation are independently associated with febrile status epilepticus, even when complete hippocampal malrotation is absent. Unexpectedly, this association predominantly involves the right temporal lobe. These findings suggest that a spectrum of bilateral temporal lobe anomalies are associated with febrile status epilepticus in children. Hippocampal malrotation may represent a visually apparent subset of this spectrum. © 2016 by American Journal of Neuroradiology.

DCDC2 polymorphism is associated with left temporoparietal gray and white matter structures during development.

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Darki, Fahimeh; Peyrard-Janvid, Myriam; Matsson, Hans; Kere, Juha; Klingberg, Torkel

2014-10-22

Three genes, DYX1C1, DCDC2, and KIAA0319, have been previously associated with dyslexia, neuronal migration, and ciliary function. Three polymorphisms within these genes, rs3743204 (DYX1C1), rs793842 (DCDC2), and rs6935076 (KIAA0319) have also been linked to normal variability of left temporoparietal white matter volume connecting the middle temporal cortex to the angular and supramarginal gyri. Here, we assessed whether these polymorphisms are also related to the cortical thickness of the associated regions during childhood development using a longitudinal dataset of 76 randomly selected children and young adults who were scanned up to three times each, 2 years apart. rs793842 in DCDC2 was significantly associated with the thickness of left angular and supramarginal gyri as well as the left lateral occipital cortex. The cortex was significantly thicker for T-allele carriers, who also had lower white matter volume and lower reading comprehension scores. There was a negative correlation between white matter volume and cortical thickness, but only white matter volume predicted reading comprehension 2 years after scanning. These results show how normal variability in reading comprehension is related to gene, white matter volume, and cortical thickness in the inferior parietal lobe. Possibly, the variability of gray and white matter structures could both be related to the role of DCDC2 in ciliary function, which affects both neuronal migration and axonal outgrowth. Copyright © 2014 the authors 0270-6474/14/3414455-08$15.00/0.

Let's inhibit our excitement: the relationships between Stroop, behavioral disinhibition, and the frontal lobes.

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Heflin, Lara H; Laluz, Victor; Jang, Jung; Ketelle, Robin; Miller, Bruce L; Kramer, Joel H