Exceptionally rapid recurrence of malignant meningioma: case report

Anaplastic meningioma represents less than 5% of all meningiomas. It is a neoplasm with a poor prognosis due to aggressiveness and a high rate of recurrence. Patients could remain asymptomatic but clinical characteristics of mass effect are the most common presentation. Although diagnosis is made with histological study, this method is difficult to define, with inter-observer variability. When possible, surgical resection is the primary management. We discuss a case of an adult female patient with tonic-clonic seizures and weakness attributed to an anaplastic meningioma in the occipital lobe. The patient was treated with a parietal craniotomy with complete resection. One month later the patient suffered a recurrence of the tumor with the need for further intervention with incomplete resection. Due to extent of the damage the patient deceased two weeks later.

Sneddon’s Syndrome as rare and underdiagnosed cause of stroke: about two cases / A Síndrome de Sneddon como causa rara e subdiagnosticada de AVC: cerca de dois casos

Case 1. Female, 27 years old, with migraine with aura. Use of combined contraceptive therapy. She presented visual and cutaneous complaints for eight months, using prednisone 60mg/day due to the hypothesis of systemic vasculitis. On examination, right temporal hemianopsia, normal fundus of the eye, Raynaud ‘s phenomenon with necrosis stitches in fingers and livedo were noted. Brain MRI with diffusion restriction in the left occipital lobe, hypersignal foci in the parietal lobe, and head of the left caudate nucleus. Reticular Livedo (RL) compatible biopsy. Anticardiolipin IgM (13.3 U/mL), ESR (47mm/h in the 1st hour and 52mm/h in the 2nd hour), and VDRL 1:8 reagents. Normal CSF. Initially treated with warfarin, she has been using rivaroxaban for two years, remaining asymptomatic. Case 2. Female, 39 years old, with a report of sudden dysarthria and right hemiparesis, with a previous episode of vertigo. A lumbosacral spine MRI was performed, presenting no alterations. Normal CSF. Antiphospholipid antibodies: Beta-2-glycoprotein I IgM 21 UR/mL and IgG 9 UR/mL, lupus anticoagulant 0.98, anticardiolipin IgG 9.4 GPL and IgM 31 MPL. Cranial MRI showed old ischemic gaps and hyperintense areas on T2/FLAIR with diffusion restriction affecting the left paramedian portion of the pons, related to acute stroke. Presence of livedo in the distal region of the limbs. In current use of warfarin 7.5mg/day, presenting remission of symptoms. Discussion: Sneddon Syndrome (SS) is a non-inflammatory thrombotic vasculopathy characterized by the concomitant presence of livedo reticularis and stroke. Neurological manifestations are present in up to 77% of cases. It is more prevalent in women between 20 and 42 years old. Treatment is aimed at preventing potentially serious, disabling, and even fatal new vascular events. Final Comments: SS is a rare syndrome that probably results from a series of acquired or congenital hemostatic abnormalities that preferentially involve the cutaneous and cerebral vascular beds. Although it has no specific biomarker, there are reports associating SS with antiphospholipid antibodies and VDRL reactor. Clinical presentation, laboratory findings and skin biopsy associated with an excellent response to anticoagulant treatment were fundamental in the diagnostic elucidation.

Machine Learning Based Color Classification by Means of Visually Evoked Potentials

Visually evoked potentials (VEPs) are widely used for diagnoses of different neurological diseases. Interestingly, there is limited research about the impact of the stimulus color onto the evoked response. Therefore, in our study we investigated the possibility of automatically classifying the stimulus color. The visual stimuli were selected to be red/black and green/black checkerboard patterns with equal light density. Both of these stimuli were presented in a random manner to nine subjects, while the electroencephalogram was recorded at the occipital lobe. After pre-processing and aligning the evoked potentials, an artificial neural network with one hidden layer was used to investigate the general possibility to automatically classify the stimulus color in three different settings. First, color classification with individually trained models, color classification with a common model, and color classification for each individual volunteer with a model trained on the data of the remaining subjects. With an average accuracy (ACC) of 0.83, the best results were achieved for the individually trained model. Also, the second (mean ACC = 0.76) and third experiments (mean ACC = 0.71) indicated a reasonable predictive accuracy across all subjects. Consequently, machine learning tools are able to appropriately classify stimuli colors based on VEPs. Although further studies are needed to improve the classification performance of our approach, this opens new fields of applications for VEPs.

How lesions at different locations along the visual pathway influence pupillary reactions to chromatic stimuli

Purpose To examine systematically how prechiasmal, chiasmal, and postchiasmal lesions along the visual pathway affect the respective pupillary responses to specific local monochromatic stimuli. Methods Chromatic pupil campimetry (CPC) was performed in three patient groups (10 subjects with status after anterior ischemic optic neuropathy, 6 with chiasmal lesions, and 12 with optic tract or occipital lobe lesions (tumor, ischemia)) using red, low-intensity red, and blue local stimuli within the central 30° visual field. Affected areas - as determined by visual field defects revealed using conventional static perimetry - were compared with non-affected areas. Outcome parameters were the relative maximal constriction amplitude (relMCA) and the latency to constriction onset of the pupillary responses. Results A statistically significant relMCA reduction was observed in the affected areas of postchiasmal lesions with red (p = 0.004) and low-intensity red stimulation (p = 0.001). RelMCA reduction in the affected areas seemed more pronounced for low-intensity red stimulation (46.5% mean reduction compared to non-affected areas; 36% for red stimulation), however statistically not significant. In prechiasmal lesions, a statistically significant latency prolongation could be demonstrated in the affected areas with low-intensity red stimulation (p = 0.015). Conclusion Our results indicate that the choice of stimulus characteristics is relevant in detecting defects in the pupillary pathway of impairment along the visual pathway, favoring red stimuli of low intensity over blue stimuli. Such knowledge opens the door for further fundamental research in pupillary pathways and is important for future clinical application of pupillography in neuro-ophthalmologic patients.

A Multidimensional Examination of Psychopathy Traits and Gray Matter Volume in Adults

Uncovering the neurobiological abnormalities that may contribute to the manifestation of psychopathic traits is an important step towards understanding the etiology of this disorder. Although many studies have examined gray matter volume (GMV) in relation to psychopathy, few have examined how dimensions of psychopathic traits interactively relate to GMV, an approach that holds promise for parsing heterogeneity in neurobiological risk factors for this disorder. The aim of this study was to investigate the affective-interpersonal (Factor 1) and impulsive-antisocial (Factor 2) dimensions of psychopathy in relation to cortical surface and subcortical GMV in a mixed-gender, high-risk community sample with significant justice-system involvement (N = 156, 50.0% men). Cortex-wide analysis indicated that (i) the Factor 1 traits correlated negatively with GMV in two cortical clusters, one in the right rostral middle frontal region and one in the occipital lobe, and (ii) the interaction of the affective-interpersonal and impulsive-antisocial traits was negatively associated with GMV bilaterally in the parietal lobe, such that individuals high on both trait dimensions evidenced reduced GMV relative to individuals high on only one psychopathy factor. An interactive effect also emerged for bilateral amygdalar and hippocampal GMV, such that Factor 1 psychopathic traits were significantly negatively associated with GMV only at high (but not low) levels of Factor 2 traits. Results extend prior research by demonstrating the neurobiological correlates of psychopathy differ based on the presentation of Factor 1 and 2 traits.

Physiological and Psychological Effects of Visual Stimulation with Green Plant Types

This study was designed to assess the physiological and psychological benefits of visually looking at foliage plants in adults. This study involved 30 adults in their 20s (11 males, 19 females), and using a crossover design, participants looked at four different types of visual stimuli, namely, real plants, artificial plants, a photograph of plants, and no plants for 5 min. Brain waves were measured while viewing each type of plant, and a subjective evaluation of emotions was performed after each visual stimulus. Semantic differential methods (SDM) and Profile of Mood States (POMS) were used for the subjective evaluation. During the real plant visual stimulation, relative theta (RT) power spectrum was increased in the bilateral occipital lobes, while relative high beta (RHB) power spectrum was reduced in the left occipital lobe, indicating a reduction in stress, anxiety, and tension. The subjective survey results revealed that when looking at real plants, the participants exhibited significantly higher “comfort,” “natural,” and “relaxed” scores as well as an increase in positive mood conditions. In conclusion, among the four types of plants, visual stimulation with real plants induces physiological relaxation in adults and has a positive psychological effect.

Visualization of Hidden Structure and Shape in Ct Image via Non-Linear Perspective Foreground and Back Ground Projection

The neurologist analyse the brain images to diagnose the disease via structure and shape of the part in the scanned Medical images such as CT, MRI, and PET.The Medical image segmentation perform less in the regions where no or little contrast,artefacts over the different boundary regions. The manual process of segmentation show poor boundary differentiation dueto discernibility in shape and location, intra and inter observer reliability. In this paper, we propose a dyadic Cat optimization (DCO) algorithm to segment the regions in the brain from CT and MRI image via Non- linear perspective Foreground and Back Ground projection. The DCO algorithm remove the artefacts in the boundary regions and provide the exact structure and shape of the brain regions. The DCO algorithm show the region boundary such as plerygomaxillary fissure, occipital lobe, vaginal process zygomatic arch, maxilla and piriform aperture with high visibility in the regions of inadequately visible boundary and distinguish the deformable shape. The DCO algorithm show the increased SSIM and 90 percent accuracy.

Role of the parietooccipital fissure and its implications in the pathophysiology of posterior medial temporal gliomas

OBJECTIVE The parietooccipital fissure is an anatomical landmark that divides the temporal, occipital, and parietal lobes. More than 40% of gliomas are located in these three lobes, and the temporal lobe is the most common location. The parietooccipital fissure is located just posterior to the medial temporal lobe, but little is known about the clinical significance of this fissure in gliomas. The authors investigated the anatomical correlations between the parietooccipital fissure and posterior medial temporal gliomas to reveal the radiological features and unique invasion patterns of these gliomas. METHODS The authors retrospectively reviewed records of all posterior medial temporal glioma patients treated at their institutions and examined the parietooccipital fissure. To clarify how the surrounding structures were invaded in each case, the authors categorized tumor invasion as being toward the parietal lobe, occipital lobe, isthmus of the cingulate gyrus, insula/basal ganglia, or splenium of the corpus callosum. DSI Studio was used to visualize the fiber tractography running through the posterior medial temporal lobe. RESULTS Twenty-four patients with posterior medial temporal gliomas were identified. All patients presented with a parietooccipital fissure as an uninterrupted straight sulcus and as the posterior border of the tumor. Invasion direction was toward the parietal lobe in 13 patients, the occipital lobe in 4 patients, the isthmus of the cingulate gyrus in 19 patients, the insula/basal ganglia in 3 patients, and the splenium of the corpus callosum in 8 patients. Although the isthmus of the cingulate gyrus and the occipital lobe are located just posterior to the posterior medial temporal lobe, there was a significantly greater preponderance of invasion toward the isthmus of the cingulate gyrus than toward the occipital lobe (p = 0.00030, McNemar test). Based on Schramm’s classification for the medial temporal tumors, 4 patients had type A and 20 patients had type D tumors. The parietooccipital fissure determined the posterior border of the tumors, resulting in a unique and identical radiological feature. Diffusion spectrum imaging (DSI) tractography indicated that the fibers running through the posterior medial temporal lobe toward the occipital lobe had to detour laterally around the bottom of the parietooccipital fissure. CONCLUSIONS Posterior medial temporal gliomas present identical invasion patterns, resulting in unique radiological features that are strongly affected by the parietooccipital fissure. The parietooccipital fissure is a key anatomical landmark for understanding the complex infiltrating architecture of posterior medial temporal gliomas.

Predicting multilingual effects on executive function and individual connectomes in children: An ABCD study

While there is a substantial amount of work studying multilingualism’s effect on cognitive functions, little is known about how the multilingual experience modulates the brain as a whole. In this study, we analyzed data of over 1,000 children from the Adolescent Brain Cognitive Development (ABCD) Study to examine whether monolinguals and multilinguals differ in executive function, functional brain connectivity, and brain–behavior associations. We observed significantly better performance from multilingual children than monolinguals in working-memory tasks. In one finding, we were able to classify multilinguals from monolinguals using only their whole-brain functional connectome at rest and during an emotional n-back task. Compared to monolinguals, the multilingual group had different functional connectivity mainly in the occipital lobe and subcortical areas during the emotional n-back task and in the occipital lobe and prefrontal cortex at rest. In contrast, we did not find any differences in behavioral performance and functional connectivity when performing a stop-signal task. As a second finding, we investigated the degree to which behavior is reflected in the brain by implementing a connectome-based behavior prediction approach. The multilingual group showed a significant correlation between observed and connectome-predicted individual working-memory performance scores, while the monolingual group did not show any correlations. Overall, our observations suggest that multilingualism enhances executive function and reliably modulates the corresponding brain functional connectome, distinguishing multilinguals from monolinguals even at the developmental stage.