Special Topics in Contact Sport Athletes and Others Who Have Had Multiple Concussions and Subconcussive Impacts

When to retire from contact sports? Help the patient, family, and peers think through the decision carefully. Educate them about the risk of serious and currently untreatable long-term problems, such as chronic traumatic encephalopathy. Discuss potential for a future professional sports career versus other career, interpersonal, and family aspirations. Does the patient have Chronic Traumatic Encephalopathy (CTE)? There is no way to tell for sure while the patient is alive. High-risk features may include progressive worsening over time, prominent mood and behavioral abnormalities, parkinsonism, and a cavum septum pellucidum on magnetic resonance imaging (MRI) scan. At present, treatment is entirely based on relieving symptoms and keeping the patient safe.

Special Topics in Contact Sport Athletes and Others with Multiple Concussions

Concussion Care Manual ◽

10.1093/med/9780199383863.003.0034 ◽

2014 ◽

pp. 131-132

Author(s):

David L Brody

Keyword(s):

High Risk ◽

Chronic Traumatic Encephalopathy ◽

Professional Sports ◽

Septum Pellucidum ◽

Mri Scan ◽

Cavum Septum Pellucidum ◽

Contact Sports ◽

Behavioral Abnormalities ◽

This chapter considers issues in patients with multiple concussions. These patients must consider when to retire from contact sports. Help the patient, family, and peers think through the decision carefully. Educate them about the risk of serious and currently untreatable long-term problems such as chronic traumatic encephalopathy (CTE). Discuss potential for a future professional sports career versus other career as well as interpersonal and family aspirations. Patients want to know if they have CTE. There is no way to tell for sure while they are alive. High-risk features may include progressive worsening over time, prominent mood and behavioral abnormalities, parkinsonism, and a cavum septum pellucidum on MRI scan. Treatment is entirely based on relieving symptoms and keeping the patient safe.

Cavum septum pellucidum in schizophrenia, affective disorder and healthy controls: a magnetic resonance imaging study

Psychological Medicine ◽

10.1017/s0033291700028403 ◽

1993 ◽

Vol 23 (2) ◽

pp. 319-322 ◽

Cited By ~ 43

Author(s):

George J. Jurjus ◽

Henry A. Nasrallah ◽

Stephen C. Olson ◽

Steven B. Schwarzkopf

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Imaging Study ◽

Septum Pellucidum ◽

Healthy Controls ◽

Resonance Imaging ◽

Cavum Septum Pellucidum ◽

Clinical Difference ◽

Mri Study

SynopsisMany structural brain abnormalities have been described in schizophrenia, consistent with a neurodevelopmental model for this disease. We report here a study of the cavum septum pellucidum (CSP) in schizophrenia compared to control groups, as well as the clinical correlates of this congenital anomaly in schizophrenia. We conducted a magnetic resonance imaging (MRI) study to compare rates of CSP in schizophrenia (N = 67) v. psychiatric controls (bipolar and schizoaffective, N = 60) and healthy controls (N = 37). Of the controls 18·9 %, and of all psychotic subjects 18·1 % had a CSP of any size and there was no difference in the frequency of large CSP among the groups. Males had higher rates of CSP than females (25% v. 9·7%, P = 0·01) in all groups. Schizophrenics had higher CSP rates than affective patients (25%, v. 10%, P = 0·02). No clinical difference was found between schizophrenics with or without CSP.

Morbidity and Volumetric Progression in Juvenile Nasopharyngeal Angiofibroma in a Long-Term Follow-Up

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1635255 ◽

2018 ◽

Vol 79 (06) ◽

pp. 533-537 ◽

Cited By ~ 1

Author(s):

Marc Mosimann ◽

Domenic Vital ◽

David Holzmann ◽

Lorenz Epprecht

Keyword(s):

Residual Tumor ◽

Open Approach ◽

Nasopharyngeal Angiofibroma ◽

Symptomatic Recurrence ◽

Long Term Follow Up ◽

Mean Time ◽

Objective We compare the open and transnasal approaches for the excision of juvenile nasopharyngeal angiofibromas regarding the rate of morbidity, and residual tumor and its symptomatic recurrence over time. In addition, we present volumetric measurements of juvenile nasopharyngeal angiofibromas over time. Methods All surgically treated patients of our institution were reviewed back to 1969 for type of surgery, residual tumor by magnetic resonance imaging (MRI)-based volumetry, recurrence, and morbidity. We performed a prospective clinical and radiological follow-up on reachable patients. Results In total, 40 patients were retrievable from our records. We were able to follow up on 13 patients after a mean of 15.7 years since surgery (range: 1–47 years). Patients operated by the open approach had a higher rate of postoperative complications and thus a higher morbidity than endoscopic patients (4/4 vs 3/9; p = 0.007), although tumor sizes were equal among groups (p = 0.12). Persisting tumor was noted in 3/4 and 4/9 (p = 0.56) patients, respectively. The corresponding mean volumes of residual tumors were 16.2 ± 14.4 cm3 and 10.8 ± 6.6 cm3 (p = 0.27). No progression could be noted in endoscopically treated patients (p = 0.24, mean time between scans 2 years). Conclusions Our analysis shows that the endoscopic approach results in less morbidity. The open approach does not guarantee freedom from persisting tumor tissue. Age seems to be a most important risk factor for the conversion of an asymptomatic persistence into a symptomatic recurrence.

Cavum Septum Pellucidum Epidermoid- An Extremely rare occurrence

Nepal Journal of Neuroscience ◽

10.3126/njn.v15i1.20026 ◽

2018 ◽

Vol 15 (1) ◽

pp. 32-34

Author(s):

Dwarakanath Srinivas ◽

Raghavendra Chalikwar ◽

Anita Mahadevan ◽

Sampath Somanna

Keyword(s):

Emergency Services ◽

Septum Pellucidum ◽

Mass Lesion ◽

Cranial Computed Tomography ◽

Extensive Literature ◽

Resonance Imaging ◽

Cavum Septum Pellucidum ◽

Transcallosal Approach ◽

History Of ◽

Magnetic Resonance Imaging Mri

Supratentorialintraventricularepidermoids are very rare and midline septal pellucidal epidermoids are even more uncommon with only one case being reported in available literature. A 42-year-old lady with no previous complaints was admitted to the emergency services with history of intermittent headache, vomiting and giddiness of 3 months duration. A cranial computed tomography (CT) revealed a hypodense, non-enhancing intraventricular mass lesion and cranial magnetic resonance imaging (MRI) demonstrated a non-enhancing mass lesion in the septum pellucidum suggestive of an epidermoid. She underwent endoscopic-assisted surgery via an interhemispheric transcallosal approach. Intra-operatively, the lesion was located in the enlarged cavum septum pellucidum and was removed totally. An extensive literature review unearthed only 10 cases of intraventricular epidermoids and one in the septum pellucidum. We present only the second case of a midline septum pellucidum epidermoid and reflect on the paucity of supratentorial intraventricular midline epidermoids.Nepal Journal of Neuroscience 15:32-34, 2018

Magnetic Resonance Spectroscopy in Children With Developmental Delay: Time to Look Beyond Conventional Magnetic Resonance Imaging (MRI)

Journal of Child Neurology ◽

10.1177/0883073820978006 ◽

2020 ◽

pp. 088307382097800

Author(s):

Nikhil Rajvanshi ◽

Rahul Bhakat ◽

Sudhir Saxena ◽

Jitendra Rohilla ◽

Sriparna Basu ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Developmental Delay ◽

Visual Assessment ◽

Resonance Spectroscopy ◽

Resonance Imaging ◽

Behavioral Abnormalities ◽

Magnetic Resonance Imaging Mri

Developmental delay (DD) is an important long-term neuromorbidity owing to various insults to the developing brain and neuroimaging plays a key role in evaluating these children. Magnetic resonance spectroscopy (MRS) is the only noninvasive method to determine the levels of various metabolites in the brain which aids in delineating the underlying abnormalities. A total of 48 children aged between 6 months to 6 years with developmental delay were included and evaluated with neuroimaging in our study. Sensitivity of MRS in children with DD and DD plus (DD along with seizures, abnormal motor findings, behavior, brainstem evoked response audiometry, visual assessment, and microcephaly) was 81.2% and 89.6% respectively. 86.6% of children with microcephaly had abnormal MRS. MRS detected abnormalities in two-thirds of children with normal magnetic resonance imaging (MRI). Children with behavioral abnormalities had significantly lower N-acetyl aspartate (NAA)–creatine and NAA-choline ratios on MRS. Thus, MRS is additive to MRI in delineating the underlying pathophysiology in children with DD.

Structural MRI profiles and tau correlates of atrophy in autopsy-confirmed CTE

Alzheimer s Research & Therapy ◽

10.1186/s13195-021-00928-y ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Michael L. Alosco ◽

Asim Z. Mian ◽

Karen Buch ◽

Chad W. Farris ◽

Madeline Uretsky ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Imaging Finding ◽

Chronic Traumatic Encephalopathy ◽

Magnetic Resonance Imaging Finding ◽

Microvascular Disease ◽

Septum Pellucidum ◽

Imaging Features ◽

Resonance Imaging ◽

Cavum Septum Pellucidum

Abstract Background Chronic traumatic encephalopathy (CTE), a neurodegenerative tauopathy, cannot currently be diagnosed during life. Atrophy patterns on magnetic resonance imaging could be an effective in vivo biomarker of CTE, but have not been characterized. Mechanisms of neurodegeneration in CTE are unknown. Here, we characterized macrostructural magnetic resonance imaging features of brain donors with autopsy-confirmed CTE. The association between hyperphosphorylated tau (p-tau) and atrophy on magnetic resonance imaging was examined. Methods Magnetic resonance imaging scans were obtained by medical record requests for 55 deceased symptomatic men with autopsy-confirmed CTE and 31 men (n = 11 deceased) with normal cognition at the time of the scan, all >60 years Three neuroradiologists visually rated regional atrophy and microvascular disease (0 [none]–4 [severe]), microbleeds, and cavum septum pellucidum presence. Neuropathologists rated tau severity and atrophy at autopsy using semi-quantitative scales. Results Compared to unimpaired males, donors with CTE (45/55=stage III/IV) had greater atrophy of the orbital-frontal (mean diff.=1.29), dorsolateral frontal (mean diff.=1.31), superior frontal (mean diff.=1.05), anterior temporal (mean diff.=1.57), and medial temporal lobes (mean diff.=1.60), and larger lateral (mean diff.=1.72) and third (mean diff.=0.80) ventricles, controlling for age at scan (ps<0.05). There were no effects for posterior atrophy or microvascular disease. Donors with CTE had increased odds of a cavum septum pellucidum (OR = 6.7, p < 0.05). Among donors with CTE, greater tau severity across 14 regions corresponded to greater atrophy on magnetic resonance imaging (beta = 0.68, p < 0.01). Conclusions These findings support frontal-temporal atrophy as a magnetic resonance imaging finding of CTE and show p-tau accumulation is associated with atrophy in CTE.

Cavum septum pellucidum and adhesio interthalamica in schizophrenia: an MRI study

European Psychiatry ◽

10.1016/j.eurpsy.2005.09.010 ◽

2006 ◽

Vol 21 (5) ◽

pp. 291-299 ◽

Cited By ~ 30

Author(s):

José Alexandre de Souza Crippa ◽

Antonio Waldo Zuardi ◽

Geraldo F. Busatto ◽

Rafael Faria Sanches ◽

Antonio Carlos Santos ◽

...

Keyword(s):

Case Series ◽

Septum Pellucidum ◽

Group Differences ◽

Resonance Imaging ◽

Brain Abnormalities ◽

Cavum Septum Pellucidum ◽

Neurodevelopmental Model ◽

Male Patients ◽

Mri Study

AbstractSeveral studies have independently suggested that patients with schizophrenia are more likely to have an enlarged cavum septum pellucidum (CSP) and an absent adhesio interthalamica (AI), respectively. However, neither finding has been consistently replicated and it is unclear whether there is an association between these two midline brain abnormalities. Thus, we compared the prevalence of absent AI and the prevalence, size and volume of CSP in 38 patients with schizophrenia and 38 healthy controls using magnetic resonance imaging (MRI). There were no between group differences in the presence or volume of CSP; however, an enlarged CSP was commoner among patients than controls. There was also a positive correlation between CSP ratings and volumes. No differences in the presence or absence of the AI were found between patients and controls; however, an absent AI was commoner in male patients with schizophrenia than females. There was absolutely no overlap between the presence of a large CSP and an absence of AI. In conclusion, our findings are in line with several case series and other MRI investigations that have shown a higher incidence of putatively developmental brain abnormalities in patients with schizophrenia, particularly in males, and support the neurodevelopmental model of this disorder.

Prevalence of cavum septum pellucidum detected by MRI in patients with bipolar disorder, major depression and schizophrenia

Psychological Medicine ◽

10.1017/s0033291700034838 ◽

1996 ◽

Vol 26 (2) ◽

pp. 431-434 ◽

Cited By ~ 41

Author(s):

T. Shioiri ◽

Y. Oshitani ◽

T. Kato ◽

J. Murashita ◽

H. Hamakawa ◽

...

Keyword(s):

Bipolar Disorder ◽

Major Depression ◽

Sex Education ◽

Clinical Importance ◽

Septum Pellucidum ◽

Cavum Septum Pellucidum ◽

Control Subjects ◽

Total Prevalence ◽

Schizophrenic Patients ◽

Magnetic Resonance Imaging Mri

SynopsisThe incidence of cavum septum pellucidum (CSP), which has been widely regarded as a developmental anomaly of little clinical importance in neuropathology, was examined in 113 patients with affective disorders (69 with bipolar disorder and 44 with major depression), 40 schizophrenic patients, and 92 control subjects by magnetic resonance imaging (MRI). Significantly higher incidence of Grade 3–4 CSP (moderate to large) compared with the controls was found only in the schizophrenics. When a broader interpretation of CSP, including indeterminant (Grade 1) and small (Grade 2) CSP was used, three additional patients with bipolar disorder were found to have Grade 1–2 CSP, and the total prevalence of Grade 1–4 CSP in the patients with bipolar disorder was significantly higher than that in the control subjects but slightly lower than that in the schizophrenic patients. CSP was not observed in any patient with major depression. There were no differences between the patients with and without CSP in age, sex, education, or the duration of illness. These findings are consistent with the hypothesis that neurodevelopmental abnormality may be present in schizophrenia, and such an abnormality may also be present in some patients with bipolar disorder.

New normal range of fetal cavum septum pellucidum in the second trimester of gestation

10.21516/2413-1458-2020-19-1-21-24 ◽

2020 ◽

Author(s):

M.V. Medvedev, O.I. Kozlova, À.Yu. Romanova

Keyword(s):

Brain Development ◽

Reference Range ◽

Fetal Brain ◽

Septum Pellucidum ◽

Second Trimester ◽

Normal Range ◽

Cavum Septum Pellucidum ◽

New Normal ◽

Biparietal Diameter ◽

Fetal Brain Development

Fetal brain was retrospectively evaluated in 418 normal fetuses at 16–28 weeks of gestation. The multiplanar mode to obtain the axial cerebral plane and measured the width of the cavum septum pellucidum (CSP) and biparietal diameter (BD). All measurements of CSP were done from as the widest diameter across both borders in an inter-to inter fashion. The CSP width is increasing at second trimester of gestation. Normal range plotted on the reference range (mean, 5th and 95th percentiles) of fetal width CSP by measuring of its size may be useful for assessment of fetal brain development in the second trimester of gestation.

Enhancing community welfare through improved water quality: a case for applying staggered pollution charges in the river Musi sub-basin of Andhra Pradesh, India

Water Policy ◽

10.2166/wp.2005.0028 ◽

2005 ◽

Vol 7 (5) ◽

pp. 469-483

Author(s):

Tishya Chatterjee

Keyword(s):

Andhra Pradesh ◽

Relevant Literature ◽

Pollution Prevention ◽

Economic Benefits ◽

Environmental Damage ◽

Marginal Costs ◽

Community Acceptance ◽

Level Data ◽

In conditions of severe water-pollution and dormant community acceptance of accumulating environmental damage, the regulator's role goes beyond pollution prevention and more towards remediation and solutions based on the community's long-term expectations of economic benefits from clean water. This paper suggests a method to enable these benefits to become perceptible progressively, through participatory clean-up operations, supported by staggered pollution charges. It analyses the relevant literature on pollution prevention and applies a cost-based “willingness to pay” model, using primary basin-level data of total marginal costs. It develops a replicable demand-side approach imposing charge-standard targets over time in urban-industrial basins of developing countries.