scholarly journals Ischemic Stroke of the Artery of Percheron with Normal Initial MRI: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Guillaume Cassourret ◽  
Bertrand Prunet ◽  
Fabrice Sbardella ◽  
Julien Bordes ◽  
Olga Maurin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Brain Magnetic Resonance Imaging ◽  
Symptomatic Patient ◽  
Resonance Imaging ◽  
Complex Anatomy ◽  
Artery Of Percheron ◽  
Thalamic Infarct ◽  
Head Computed Tomography

The artery of Percheron is a solitary trunk representing an uncommon anatomic variant that provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The clinical diagnosis is difficult because the complex anatomy causes large clinical variability. We report a case of a comatose patient with normal early head-computed tomography and magnetic resonance imaging. A bilateral paramedian thalamic infarct due to an occlusion of the artery of Percheron was revealed two days later by a new head computed tomography. To our knowledge, this is the first report in the literature of a symptomatic patient presenting an acute Percheron stroke with normal early brain magnetic resonance imaging. Our case indicates that a normal initial magnetic resonance imaging cannot formally eliminate the diagnosis of acute stroke of the artery of Percheron. We discuss the causes of noncontributive brain magnetic resonance imaging at the onset of this acute Percheron stroke and the alternative diagnosis and therapy methods.

scholarly journals Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report

2016 ◽  
Vol 29 (9) ◽  
pp. 567 ◽  
Author(s):  
Vítor Magno Pereira ◽  
Luís Marote Correia ◽  
Tiago Rodrigues ◽  
Gorete Serrão Faria
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Emergency Department ◽  
Magnetic Resonance ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Epigastric Pain ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours. His physical examination was remarkable for a blood pressure of 190/100 mmHg and tenderness in epigastrium. His analytical results revealed emphasis on amylase 193 U/L and lipase 934 U/L. During the observation in the emergency department,he presented a generalized tonic-clonic seizure. Abdominal ultrasonography was performed and suggestive of pancreatitis withoutgallstones signals. Head computed tomography showed subarachnoid haemorrhage and a small right frontal cortical haemorrhage. The brain magnetic resonance imaging done one week after admission showed areas of a bilateral and symmetrical T2 / FLAIR hyperintensities in the subcortical white matter of the parietal and superior frontal regions, suggesting a diagnosis of posterior reversible encephalopathy syndrome. Abdominal computed tomography (10 days after admission) demonstrated a thickened pancreas in connection with inflammation and two small hypodense foci in the anterior part of the pancreas body, translating small foci of necrosis. The investigation of a thrombophilic defect revealed a heterozygous G20210A prothrombin gene mutation. The patient was discharged without neurological sequelae and asymptomatic. The follow-up brain magnetic resonance imaging confirmed the reversal of the lesions, confirming the diagnosis.

scholarly journals Emerging Utility of Applied Magnetic Resonance Imaging in the Management of Traumatic Brain Injury

2021 ◽  
Vol 9 (1) ◽  
pp. 10
Author(s):  
Jeffrey Nadel ◽  
Joseph Scott McNally ◽  
Anthony DiGiorgio ◽  
Ramesh Grandhi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Magnetic Resonance ◽  
Diffusion Tensor ◽  
Brain Magnetic Resonance Imaging ◽  
Scientific Basis ◽  
Resonance Imaging ◽  
Noncontrast Computed Tomography

Traumatic brain injury (TBI) is a widespread and expensive problem globally. The standard diagnostic workup for new TBI includes obtaining a noncontrast computed tomography image of the head, which provides quick information on operative pathologies. However, given the limited sensitivity of computed tomography for identifying subtle but meaningful changes in the brain, magnetic resonance imaging (MRI) has shown better utility for ongoing management and prognostication after TBI. In recent years, advanced applications of MRI have been further studied and are being implemented as clinical tools to help guide care. These include functional MRI, diffusion tensor imaging, MR perfusion, and MR spectroscopy. In this review, we discuss the scientific basis of each of the above techniques, the literature supporting their use in TBI, and how they may be clinically implemented to improve the care of TBI patients.

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