Psychogenic Unresponsiveness

2019 ◽  
pp. 291-304
Author(s):  
Jerome B. Posner ◽  
Clifford B. Saper ◽  
Nicholas D. Schiff ◽  
Jan Claassen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Tests ◽  
Epileptic Seizures ◽  
Tomographic Imaging ◽  
Factitious Disorder ◽  
Cerebellar Mutism ◽  
Conversion Reaction ◽  
Computed Tomographic ◽  
Psychogenic Seizures

Chapter 6 explores psychiatric causes of unresponsiveness, which must be differentiated from organic causes of stupor and coma. The chapter notes that several psychiatric disorders can result in psychogenic unresponsiveness. These include conversion reaction, catatonic stupor, a dissociative or “fugue” state, and factitious disorder or malingering. The chapter looks at these in turn. Various diagnostic tests are described in detail, including the electroencephalogram, magnetic resonance imaging, computed tomographic imaging, caloric testing, and the “Amytal interview.” Sections describes the diagnosis and treatment of catatonia, psychogenic seizures (which must be differentiated from epileptic seizures), and cerebellar mutism. The authors emphasize the importance of treating patients with psychiatric causes of unresponsiveness with compassion and understanding.

Neuroendoscopic Management of Symptomatic Septum Pellucidum Cysts

Neurosurgery ◽  
2006 ◽  
Vol 59 (2) ◽  
pp. 278-283 ◽  
Author(s):  
Hui Meng ◽  
Hua Feng ◽  
Fei Le ◽  
Jia Y. Lu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epileptic Seizures ◽  
Mass Effect ◽  
Septum Pellucidum ◽  
Common Symptom ◽  
Resonance Imaging ◽  
Computed Tomographic ◽  
Rigid Endoscope ◽  
Endoscopic Fenestration

Abstract OBJECTIVE: Ten rare cases of symptomatic septum pellucidum cysts in patients who underwent endoscopic fenestration are described. The approaches and techniques used in the management of these cysts and the endoscopic surgical indications are discussed. CLINICAL PRESENTATION: In the past 5 years, 10 patients (age range, 3–60 yr) with symptomatic septum pellucidum cysts underwent neuroendoscopic fenestration. The most common symptom was intermittent headache (seven patients) accompanied by dizziness, vomiting, and epileptic seizures. Two patients presented with epileptic seizures. One patient presented with abnormally increased head circumference. Magnetic resonance imaging scans of 10 patients showed septum pellucidum cysts, two with hydrocephalus, and two with pituitary microadenoma. INTERVENTION: All 10 patients underwent endoscopic fenestration with a rigid endoscope via a frontal approach. Eight cases were performed freehand. Two cases were assisted by a frameless neuronavigation system. Postoperatively, the mass effect of the cysts and the symptoms resolved immediately, and computed tomographic or magnetic resonance imaging scans showed significant decrease in the cyst size and no recurrence during follow-up. Ventricular sizes in the two patients with hydrocephalus were normal. CONCLUSION: Neuroendoscopic pellucidotomy could be an effective, safe, and convenient therapeutic method for symptomatic septum pellucidum cysts. This approach might provide communication between the cyst and the ventricular system, thus avoiding shunting or craniotomy. We consider that it is appropriate to use the rigid endoscope via the frontal approach. It is helpful to fill the ventricles with lactated Ringer's solution and leave an external drain after surgery.

ISOLATION OF THE BRAIN‐RELATED FACTOR OF THE ERROR BETWEEN INTENDED AND ACHIEVED POSITION OF DEEP BRAIN STIMULATION ELECTRODES IMPLANTED INTO THE SUBTHALAMIC NUCLEUS FOR THE TREATMENT OF PARKINSON'S DISEASE

2009 ◽  
Vol 64 (suppl_5) ◽  
pp. ons374-ons384 ◽  
Author(s):  
Slawomir Daniluk ◽  
Keith G. Davies ◽  
Peter Novak ◽  
Thai Vu ◽  
Jules M. Nazzaro ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Deep Brain Stimulation ◽  
Magnetic Resonance ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Related Factor ◽  
Technical Error ◽  
Resonance Imaging ◽  
Computed Tomographic ◽  
Deep Brain

Abstract OBJECTIVE Although a few studies have quantified errors in the implantation of deep brain stimulation electrodes into the subthalamic nucleus (STN), a significant trend in error direction has not been reported. We have previously found that an error in axial plane, which is of most concern because it cannot be compensated for during deep brain stimulation programming, had a posteromedial trend. We hypothesized that this trend results from a predominance of a directionally oriented error factor of brain origin. Accordingly, elimination of nonbrain (technical) error factors could augment this trend. Thus, implantation accuracy could be improved by anterolateral compensation during target planning. METHODS Surgical technique was revised to minimize technical error factors. During 22 implantations, targets were selected on axial magnetic resonance imaging scans up to 1.5 mm anterolateral from the STN center. Using fusion of postoperative computed tomographic and preoperative magnetic resonance imaging scans, implantation errors in the axial plane were obtained and compared with distances from the lead to the STN to evaluate the benefit of anterolateral compensation. RESULTS Twenty errors and the mean error had a posteromedial direction. The average distances from the lead to the target and to the STN were 1.7 mm (range, 0.8–3.1 mm) and 1.1 mm (range, 0.1–1.9 mm), respectively. The difference between the 2 distances was significant (paired t test, P < 0.0001). The lower parts of the lead were consistently bent in the posteromedial direction on postoperative scout computed tomographic scans, suggesting that a brain-related factor is responsible for the reported error. CONCLUSION Elimination of the technical factors of error during STN deep brain stimulation implantation can result in a consistent posteromedial error. Implantation accuracy may be improved by compensation for this error in advance.

Primary Intrasellar Microgerminoma Detected by Magnetic Resonance Imaging: Case Report

Neurosurgery ◽  
1989 ◽  
Vol 25 (3) ◽  
pp. 458-462 ◽  
Author(s):  
Mariko Oishi ◽  
Takaharu Iida ◽  
Misako Koide ◽  
Yoshiharu Akazawa ◽  
Yoshie Azuma ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Sella Turcica ◽  
Posterior Lobe ◽  
Resonance Imaging ◽  
Pituitary Fossa ◽  
Computed Tomographic ◽  
Initial Symptoms

Abstract A case of primary intrasellar germinoma in a 24-year-old woman is presented. Her initial symptoms were diabetes insipidus and headaches. The neurological examination found no abnormalities, but the endocrinological examination disclosed a deficiency in growth hormone secretion. Her skull x-ray revealed a normal sella turcica, and a computed tomographic scan revealed no abnormal mass in the pituitary fossa, but a slightly enlarged stalk. Magnetic resonance imaging revealed a small tumor in the posterior lobe. Transsphenoidal exploration revealed a germinoma in the posterior pituitary lobe. Six cases of primary intrasellar germinoma, including our case, were reviewed. Our case is considered to be the smallest intrasellar germinoma yet reported.

Ultrasonographic, computed tomographic and magnetic resonance imaging anatomy of the normal canine stifle joint

2007 ◽  
Vol 174 (2) ◽  
pp. 351-361 ◽  
Author(s):  
Marta Soler ◽  
José Murciano ◽  
Rafael Latorre ◽  
Eliseo Belda ◽  
Maria J. Rodrı´guez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Computed Tomographic ◽  
Stifle Joint ◽  
Canine Stifle

scholarly journals Integrated magnetic resonance imaging and [ 11 C]‐PBR28 positron emission tomographic imaging in amyotrophic lateral sclerosis

2018 ◽  
Vol 83 (6) ◽  
pp. 1186-1197 ◽  
Author(s):  
Mohamad J. Alshikho ◽  
Nicole R. Zürcher ◽  
Marco L. Loggia ◽  
Paul Cernasov ◽  
Beverly Reynolds ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Amyotrophic Lateral Sclerosis ◽  
Magnetic Resonance ◽  
Tomographic Imaging ◽  
Positron Emission Tomographic ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Lateral Sclerosis

Case Study of a Rare Incidence of a Leiomyosarcoma Mass Occluding the Distal Femoral Vein

2021 ◽  
pp. 875647932110440
Author(s):  
Tammy Perkins ◽  
Kelly McDonald ◽  
Douglas Clem
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lower Extremity ◽  
Femoral Artery ◽  
Femoral Vein ◽  
Lower Leg ◽  
Resonance Imaging ◽  
Computed Tomographic ◽  
Magnetic Resonance Imaging Mri

This is a case study of a 47-year-old Caucasian male whose chief concern was left lower leg swelling for 1 month. A unilateral lower extremity venous duplex examination was performed. The results concluded that the distal femoral vein was occluded to the distal popliteal vein. Incidentally, a hypoechoic region in the distal thigh near the distal femoral artery was noted by the technologist. The patient was placed on anticoagulation and was told to return for further examination if there was no relief. Three months later, the patient continued to experience lower left leg swelling and returned for another sonogram. The hypoechoic region was seen again in the distal thigh and remained occluded. A computed tomographic arterial (CT-A) and magnetic resonance imaging (MRI) were ordered for further investigation of the hypoechoic area. The CT-A and the MRI revealed the presence of a mass in the distal thigh. The mass was biopsied and diagnosed as a leiomyosarcoma, grade 1. The mass caused the compression and occlusion of the distal femoral vein. The mass was removed, along with a portion of the distal femoral artery due to involvement of the artery within the mass. The artery was repaired with a graft.

Magnetic Resonance Versus Computed Tomographic Imaging in Acute Stroke

Stroke ◽  
1995 ◽  
Vol 26 (5) ◽  
pp. 807-812 ◽  
Author(s):  
J. P. Mohr ◽  
J. Biller ◽  
S. K. Hilal ◽  
W. T. C. Yuh ◽  
T. K. Tatemichi ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Acute Stroke ◽  
Tomographic Imaging ◽  
Computed Tomographic ◽  
Computed Tomographic Imaging
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