Magnetic resonance in childhood white-matter disorders: The 2001 Ronnie Mac Keith Lecture

Object Resecting brain tumors involves the risk of damaging the descending motor pathway. Diffusion tensor (DT)–imaged fiber tracking is a noninvasive magnetic resonance (MR) technique that can delineate the subcortical course of the motor pathway. The goal of this study was to use intraoperative subcortical stimulation mapping of the motor tract and magnetic source imaging to validate the utility of DT-imaged fiber tracking as a tool for presurgical planning. Methods Diffusion tensor-imaged fiber tracks of the motor tract were generated preoperatively in nine patients with gliomas. A mask of the resultant fiber tracks was overlaid on high-resolution T1- and T2-weighted anatomical MR images and used for stereotactic surgical navigation. Magnetic source imaging was performed in seven of the patients to identify functional somatosensory cortices. During resection, subcortical stimulation mapping of the motor pathway was performed within the white matter using a bipolar electrode. Results A total of 16 subcortical motor stimulations were stereotactically identified in nine patients. The mean distance between the stimulation sites and the DT-imaged fiber tracks was 8.7 ±3.1 mm (±standard deviation). The measured distance between subcortical stimulation sites and DT-imaged fiber tracks combines tracking technique errors and all errors encountered with stereotactic navigation. Conclusions Fiber tracks delineated using DT imaging can be used to identify the motor tract in deep white matter and define a safety margin around the tract.

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Prevalence of Cerebral Microbleeds in Thai Patients with Ischemic Stroke

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.203836 ◽

2017 ◽

Vol 08 (02) ◽

pp. 216-220 ◽

Cited By ~ 4

Author(s):

Artit Potigumjon ◽

Arvemas Watcharakorn ◽

Pornpatr A. Dharmasaroja

Keyword(s):

Ischemic Stroke ◽

White Matter ◽

Magnetic Resonance ◽

White Matter Lesions ◽

Cerebral Microbleeds ◽

National Institutes Of Health ◽

Asian Origin ◽

Chinese Study ◽

Japanese Studies ◽

Magnetic Resonance Imaging Mri

ABSTRACT Background: With the widespread use of magnetic resonance imaging (MRI), cerebral microbleeds (CMBs) are commonly detected. Ethnicity seems to play a role in the prevalence of CMB, with higher prevalence in participants from Asian origin. The purpose of the study is to look for the prevalence of CMBs and associated factors in Thai patients with ischemic stroke. Methods: Patients with acute ischemic stroke who had MRI and magnetic resonance angiography during January–August 2014 were included in the study. T2*-weighted gradient-recalled echo was used to define CMBs. Baseline characteristics, stroke subtypes, and severity of white matter lesions were compared between patients with and without CMBs. Results: Two hundred patients were included in the study. Mean age of the patients was 61-year-old. Mean National Institutes of Health Stroke Scale was 8. The prevalence of CMBs was 20% (39/200 patients). Hypertension (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.07–8.68, P = 0.037), and moderate-to-severe white matter lesions (Fazekas 2–3, OR 7.61, 95% CI 3.06–18.95, P < 0.001) were related to the presence of CMBs. Conclusions: CMBs were found in 20% of patients with ischemic stroke, which was lower than those reported from Japanese studies but comparable to a Chinese study. CMBs were associated with hypertension and severity of the white matter lesions.

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Magnetic resonance imaging findings in children with Parry-Romberg syndrome and en coup de sabre

Pediatric Rheumatology ◽

10.1186/s12969-021-00512-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Harry Knights ◽

Elizabeth Minas ◽

Faraan Khan ◽

Lindsay Shaw ◽

Muthana Al Obaidi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

White Matter ◽

Magnetic Resonance ◽

Brain Imaging ◽

Case Series ◽

Dystrophic Calcification ◽

Resonance Imaging ◽

Cutaneous Manifestations ◽

Street Hospital ◽

Parry Romberg Syndrome

Abstract Background The aim of this study was to: (i) describe the abnormalities seen on brain imaging in a group of children with en coup de sabre (EDCS) with/without Parry-Romberg syndrome (PRS); and (ii) identify clinical predictors of brain imaging abnormalities. Methods This was a single centre (Great Ormond Street Hospital, London) retrospective case series of patients with ECDS/PRS seen from 2000 to 2018. We identified patients with cutaneous manifestations consistent with the clinical descriptions of ECDS/PRS. Presenting clinical, laboratory, and radiological brain findings are described. Results are expressed as medians and ranges or frequencies and percentages. Fisher’s exact test was used to identify clinical associations with magnetic resonance imaging (MRI) abnormalities. Results Fourteen patients were studied: 6 males and 8 females; median age 14 years (range 3–20). We observed neuroimaging abnormalities in 2/6 ECDS and 5/8 ECDS/PRS patients. White matter signal abnormality, dystrophic calcification, leptomeningeal enhancement, and sulcal crowding were the typical findings on brain imaging. A total of 50% of patients had no MRI abnormality despite some of these patients having neurological symptoms. The presence of seizures was significantly associated with ipsilateral enhanced white matter signalling on MRI (p < 0.05). Conclusions In summary, we observed several distinct radiographic patterns associated with ECDS/PRS. Seizure disorder was strongly associated with the presence of ipsilateral enhanced white matter signalling. Improved neuroimaging techniques that combine morphological with functional imaging may improve the detection rate of brain involvement in children with ECDS/PRS in the future.

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Maturation of white matter in the human brain: a review of magnetic resonance studies

Brain Research Bulletin ◽

10.1016/s0361-9230(00)00434-2 ◽

2001 ◽

Vol 54 (3) ◽

pp. 255-266 ◽

Cited By ~ 575

Author(s):

T Paus ◽

D.L Collins ◽

A.C Evans ◽

G Leonard ◽

B Pike ◽

...

Keyword(s):

White Matter ◽

Magnetic Resonance ◽

Human Brain ◽

Magnetic Resonance Studies

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ASPREE-NEURO study protocol: A randomized controlled trial to determine the effect of low-dose aspirin on cerebral microbleeds, white matter hyperintensities, cognition, and stroke in the healthy elderly

International Journal of Stroke ◽

10.1177/1747493016669848 ◽

2016 ◽

Vol 12 (1) ◽

pp. 108-113 ◽

Cited By ~ 18

Author(s):

Stephanie A Ward ◽

Parnesh Raniga ◽

Nicholas J Ferris ◽

Robyn L Woods ◽

Elsdon Storey ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

White Matter ◽

Primary Prevention ◽

Magnetic Resonance ◽

Controlled Trial ◽

Brain Magnetic Resonance Imaging ◽

Cerebral Microbleeds ◽

Resonance Imaging ◽

Healthy Elderly ◽

Cerebral Microbleed

Rationale Cerebral microbleeds seen on brain magnetic resonance imaging are markers of small vessel disease, linked to cognitive dysfunction and increased ischemic and hemorrhagic stroke risk. Observational studies suggest that aspirin use may induce cerebral microbleeds, and associated overt intracranial hemorrhage, but this has not been definitively resolved. Aims ASPREE-NEURO will determine the effect of aspirin on cerebral microbleed development over three years in healthy adults aged 70 years and over, participating in the larger ‘ASPirin in Reducing Events in the Elderly (ASPREE)’ primary prevention study of aspirin. Sample size Five hundred and fifty-nine participants provide 75% power (two-sided p value of 0.05) to determine an average difference of 0.5 cerebral microbleed per person after three years. Methods and design A multi-center, randomized placebo-controlled trial of 100 mg daily aspirin in participants who have brain magnetic resonance imaging at study entry, one and three years after randomization and who undergo cognitive testing at the same time points. Study outcomes The primary outcome is the number of new cerebral microbleeds on magnetic resonance imaging after three years. Secondary outcomes are the number of new cerebral microbleeds after one year, change in volume of white matter hyperintensity, cognitive function, and stroke. Discussion ASPREE-NEURO will resolve whether aspirin affects the presence and number of cerebral microbleeds, their relationship with cognitive performance, and indicate whether consideration of cerebral microbleeds alters the risk-benefit profile of aspirin in primary prevention for older people. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613001313729.

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