scholarly journals Atypical Reversible Leucoencephalopathy Syndrome after Bevacizumab/Folfox Regimen for Metastatic Colon Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Narimane Salmi ◽  
Ibrahim Elghissassi ◽  
Khadija Bellahammou ◽  
Asmaa Lakhdissi ◽  
Hind Mrabti ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Colon Cancer ◽  
White Matter ◽  
Intravenous Infusion ◽  
Symptomatic Treatment ◽  
Metastatic Colon Cancer ◽  
History Of ◽  
Occipital Lobes ◽  
The Brain ◽  
Visual Disturbances

We are reporting a case of multifocal reversible leucoencephalopathy syndrome induced by chemotherapy based on Folfox-Bevacizumab regimen. A 44-year-old female, with no history of hypertension, received a chemotherapy based on Folfox-Bevacizumab for her metastatic colon cancer (5 FU: 325 mg/m2 d1 by intravenous infusion, Oxaliplatin 80 mg/m2 d1, and Bevacizumab: 7.5 mg/Kg d1). During the fourth cure, she presented delirium, seizures, and visual disturbances. The computed tomography (CT) of the brain showed hypodense lesions of the white matter of frontal, parietal, and occipital lobes, which were bilateral and symmetrical. The clinical table was reversible under symptomatic treatment.

scholarly journals Diagnosing RCVS Without the CV

2015 ◽  
Vol 6 (3) ◽  
pp. NP1-NP4 ◽  
Author(s):  
Nuri Jacoby ◽  
Ulrike Kaunzner ◽  
Marc Dinkin ◽  
Joseph Safdieh
Keyword(s):  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Multiple Risk Factors ◽  
Mri Brain ◽  
Cerebral Vasoconstriction ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Occipital Lobes ◽  
The Brain

This is a case of a 52-year-old man with a past medical history of 2 episodes of coital thunderclap headaches as well as recent cocaine, marijuana, and pseudoephedrine use, who presented with sudden, sharp, posterior headache associated with photophobia and phonophobia. His initial magnetic resonance imaging (MRI) of the brain, magnetic resonance angiography (MRA) of the head, and magnetic resonance venography (MRV) of the head were all normal as well as a normal lumbar puncture. Given the multiple risk factors for reversible cerebral vasoconstriction syndrome (RCVS), the patient was treated for suspected RCVS, despite the normal imaging. Repeat MRI brain 3 days after hospital admission demonstrated confluent white matter T2 hyperintensities most prominent in the occipital lobes, typical of posterior reversible encephalopathy syndrome (PRES). Repeat MRA of the head 1 day after discharge and 4 days after the abnormal MRI brain showed multisegment narrowing of multiple arteries. This case demonstrates that RCVS may present with PRES on MRI brain and also exemplifies the need to treat suspected RCVS even if imaging is normal, as abnormalities in both the MRI and the MRA may be delayed.

scholarly journals Posterior reversible encephalopathy syndrome: A case report

2015 ◽  
Vol 72 (8) ◽  
pp. 735-739
Author(s):  
Dejan Kostic ◽  
Biljana Brkic-Georgievski ◽  
Aleksandar Jovanovski ◽  
Smiljana Kostic ◽  
Drazen Ivetic ◽  
...  
Keyword(s):  
Case Report ◽  
White Matter ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Impaired Consciousness ◽  
Posterior Reversible Encephalopathy ◽  
Neurological Signs ◽  
Appropriate Treatment ◽  
History Of ◽  
Reversible Encephalopathy ◽  
The Brain

Posterior reversible encephalopathy syndrome (PRES) is characterized by the following symptoms: seizures, impaired consciousness and/or vision, vomiting, nausea, and focal neurological signs. Diagnostic imaging includes examination by magnetic resonance (MR) and computed tomography (CT), where brain edema is visualized bi-laterally and symmetrically, predominantly posteriorly, parietally, and occipitally. Case report. We presented a 73-year-old patient with the years-long medical history of hipertension and renal insufficiency, who developed PRES with the symptomatology of the rear cranium. CT and MR verified changes in the white matter involving all lobes on both sides of the brain. After a two-week treatment (antihypertensive, hypolipemic and rehydration therapy) clinical improvement with no complications occurred, with complete resolution of changes in the white matter observed on CT and MR. Conclusion. PRES is a reversible syndrome in which the symptoms withdraw after several days to several weeks if early diagnosis is made and appropriate treatment started without delay.

scholarly journals Hepatic Encephalopathy in Two Goat Kids with Common Paternity

2008 ◽  
Vol 20 (6) ◽  
pp. 807-811 ◽  
Author(s):  
Gregory K. Wilkerson ◽  
Monali M. Bera ◽  
Timothy N. Holt ◽  
Robert J. Callan ◽  
Karamjeet Pandher
Keyword(s):  
Hepatic Encephalopathy ◽  
White Matter ◽  
Reference Interval ◽  
Laboratory Diagnostics ◽  
Cell Hyperplasia ◽  
Mental Deterioration ◽  
Mixed Breed ◽  
History Of ◽  
Portal Veins ◽  
The Brain

Two juvenile, intact, female mixed-breed goats from a common sire were presented for periodic neurologic deficits, seizures, and a generalized loss of body condition that occurred over a 4–6-week period. On physical examination, both goats were thin, obtunded, blind, and ataxic. Laboratory diagnostics revealed increased serum bile acids (95 μmol/l; reference interval: 0–50 μmol/l) in one of the goats. Both goats exhibited progressive physical and mental deterioration, and were eventually euthanized. Upon necropsy, no significant macroscopic lesions were noted. Microscopic examination, however, demonstrated hepatocellular atrophy and anomalies in the hepatic microvasculature, including duplication of hepatic arteries, small-to-indistinct portal veins, and oval cell hyperplasia. In addition, spongiform change was microscopically identified throughout the parenchyma of the brain, most notably within the white matter and along the junction of gray and white matter. The diagnosis of congenital portal vein hypoperfusion (suggestive of a portosystemic shunt) with resultant hepatic encephalopathy was proposed in each case based on the characteristic microscopic lesions in conjunction with the signalment and history of the goats. The observation that the affected kids were sired by the same buck suggests a hereditary basis for the condition in these animals as well.

scholarly journals Premature white matter microstructure in female children with a history of concussion

2021 ◽  
Author(s):  
Eman Nishat ◽  
Sonja Stojanovski ◽  
Shannon E Scratch ◽  
Stephanie H Ameis ◽  
Anne L Wheeler
Keyword(s):  
White Matter ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Large Population ◽  
Speed Test ◽  
Persistent Symptoms ◽  
Neurite Density ◽  
History Of ◽  
Brain Microstructure ◽  
The Brain

AbstractAs maturation of the brain continues throughout development, there is a risk of interference from concussions which are common in childhood. A concussion can cause widespread disruption to axons and inflammation in the brain and may influence emerging cognitive abilities. Females are more likely to experience persistent problems after a concussion, yet the sex-specific impact of concussions on brain microstructure in childhood is not well understood.In children from a large population sample, this study (1) investigated differences in white matter and cortical microstructure between children with and without a history of concussion, and (2) examined relationships between altered brain microstructure and cognitive performance.Neurite density measures from diffusion weighted magnetic resonance imaging were examined in 9-to 10-year-old children in the Adolescent Brain Cognitive Development Study with (n = 336) and without (n = 7368) a history of concussion. (1) Multivariate regression models were used to investigate the relationships between concussion history, sex, and age in the deep white matter, superficial white matter, subcortical structures, and cortex. (2) Principal component analysis was performed on neurite density, and components were examined in relation to performance on the Flanker Inhibitory Control and Attention Task and the Pattern Comparison Processing Speed Task to investigate the relationship between altered neurite density and cognitive performance.Neurite density in all tissue types demonstrated robust positive relationships with age reflecting maturation of brain microstructure. (1) Comparisons between children with and without a history of concussion revealed higher neurite density in deep and superficial white matter in females with concussion. No group differences were observed in subcortical or cortical neurite density. (2) Higher neurite density in superficial white matter beneath the frontal and temporal cortices was associated with lower scores on the processing speed test in females with concussion, and higher scores on the processing speed test in males with concussion.These findings suggest that concussion in childhood leads to premature white matter maturation in females and that this may be associated with slower processing speed. These sex-specific effects on the developing brain may contribute to the enhanced vulnerability to persistent symptoms after concussion in females.

scholarly journals THE POSSIBILITIES OF MR TRACTOGRAPHY IN DIAGNOSTICS OF SYMPTOMATIC EPILEPSY IN CHILDREN WITH DIFFERENT GENESIS

2015 ◽  
Vol 8 (2) ◽  
Author(s):  
Khabibulla Aminov
Keyword(s):  
White Matter ◽  
Diffusion Weighted Imaging ◽  
Opposite Hemisphere ◽  
Conventional Mri ◽  
Adc Values ◽  
Symptomatic Epilepsy ◽  
Subcortical Regions ◽  
Occipital Lobes ◽  
Transfer Of Information ◽  
The Brain

In this article the possibilities of MR tractography in symptomatic epilepsy patients have been presented. We determined the quantitative standards of numerical values of diffusion of white matter in children with symptomatic epilepsy of various etiology. In children with symptomatic epilepsy, the pathological changes of white matter were localized not only in the epileptogenic, but also in the opposite hemisphere. The regions with abnormal white matter FA and ADC values not only matched to limbic circle zones, but also to areas of intra- and interhemispheric connections uniting the frontal, temporal, parietal and occipital lobes of the brain. Determining the specific clusters of brain tracts in symptomatic epilepsy, regardless of etiology, is important to predict the prognosis of the disease and the likely possibility of cognitive impairment. The study proved that symptomatic epilepsy is characterized by a variety of changes in the white matter of the brain tracts that lead to the dissociation of certain regions of the brain, interrupting connections between cortical and subcortical regions and inhibiting the transfer of information. It can be concluded, that diffusion-weighted imaging are much more sensitive to the structural and metabolic changes occurring in the brain, in comparison with conventional MRI images.

scholarly journals A history of the path towards imaging of the brain: From skull radiography through cerebral angiography

2021 ◽  
Author(s):  
Haris Kamal ◽  
Edward J. Fine ◽  
Banafsheh Shakibajahromi ◽  
Ashkan Mowla
Keyword(s):  
Contrast Agent ◽  
Carotid Arteries ◽  
Cerebral Arteries ◽  
X Ray ◽  
Spinal Subarachnoid Space ◽  
Frontal Horn ◽  
History Of ◽  
The Right ◽  
Occipital Lobes ◽  
The Brain

This publication reviews the steps in the path towards obtaining a complete image of the brain. Up to the 1920s, plain X-ray films could demonstrate only calcified tumors, shifts in midline position of a calcified pineal gland due to a mass in the cranium, or foreign metallic objects within the skull. Walter Dandy reported in 1918 that he visualized cerebral ventricles by introducing air as a contrast agent through a trocar into one of the occipital lobes or the right frontal horn of the ventricular system. Dandy localized lesions that distorted or shifted the ventricles. In 1920, Dandy placed air by lumbar puncture into the spinal subarachnoid space that could visualize the brain and entire ventricles. Antonio Egas Moniz with the assistance of his neurosurgeon colleague, Almeida Lima, obtained X-ray images of cerebral arteries of dogs and decapitated human heads from corpses after injecting strontium bromide into their carotid arteries. Satisfied by these experiments, Moniz injected strontium bromide directly into carotid arteries of five patients which failed to show intracranial vessels. In the sixth patient, intracranial arteries were outlined but that patient died of cerebral thrombosis presumably due to the hyper- osmolality of that contrast agent. Finally, on June 18, 1927, Moniz injected 22% sodium iodine into a 20-year-old man and obtained clear visualization of his carotid artery and intracerebral branches after temporarily occluding the artery with a ligature. 

scholarly journals Patients With Chronic Migraine Without History of Medication Overuse Are Characterized by a Peculiar White Matter Fiber Bundle Profile

2020 ◽  
Author(s):  
Gianluca Coppola ◽  
Antonio Di Renzo ◽  
Emanuele Tinelli ◽  
Barbara Petolicchio ◽  
Cherubino Di Lorenzo ◽  
...  
Keyword(s):  
White Matter ◽  
Chronic Migraine ◽  
Diffusion Tensor ◽  
Internal Capsule ◽  
Posterior Limb ◽  
History Of ◽  
The Right ◽  
Normal White Matter ◽  
Microstructural Integrity ◽  
The Brain

Abstract Background: We investigated intracerebral fiber bundles using a tract-based spatial statistics (TBSS) analysis of diffusion tensor imaging (DTI) datato investigate microstructural integrity in patients with episodic (MO) and chronic migraine (CM).Methods: We performed DTI in 19 patients with MO within interictal periods, 18 patients with CM without any history of drug abuse, and 18 healthy controls (HCs) using a 3T magnetic resonance imaging scanner. We calculated diffusion metrics, including fractional anisotropy (FA), axial diffusion (AD), radial diffusion (RD), and mean diffusion (MD).Results: TBSS revealed no significant differences in the FA, MD, RD, and AD maps between the MO and HC groups. In comparison to the HC group, theCM group exhibited widespread increased RD (bilateral superior [SCR] and posterior corona radiata [PCR], bilateral genu of the corpus callosum [CC], bilateral posterior limb of internal capsule [IC], bilateral superior longitudinal fasciculus [LF]) and MD values (tracts of the right SCR and PCR, right superior LF, and right splenium of the CC). In comparison to theMO group, theCM group showed decreased FA (bilateral SCR and PCR, bilateral body of CC, right superior LF, right forceps minor) and increased MD values (bilateral SCR and right PCR, right body of CC, right superior LF, right splenium of CC, and right posterior limb of IC). Conclusion: Our results suggest that chronic migraine can be associated withthe widespread disruption of normal white matter integrity in the brain.

Postpartum Visual Disturbance

2017 ◽  
Author(s):  
M. Angela O’Neal
Keyword(s):  
White Matter ◽  
Pressure Control ◽  
Visual Disturbance ◽  
Organ System ◽  
Blood Pressures ◽  
Neurological Features ◽  
System Disorder ◽  
Reversible Encephalopathy ◽  
Occipital Lobes ◽  
The Brain

Preeclampsia (PE) is a multi-organ system disorder defined as hypertension with blood pressures greater than 140/90 on two occasions and proteinuria of more than 300 mg/24 hours. Eclampsia is defined as when seizures occur in a woman with preeclampsia. The pathophysiology of preeclampsia/eclampsia is felt to be related to incomplete penetration of the cytotrophoblasts of the placenta into the myometrium, leading to local ischemia, propagation of ischemic factors causing hypertension, resulting in endothelial dysfunction. The clinical features are related to which end organ is involved: in the kidney, proteinuria; in the liver, coagulopathy; and in the brain, posterior white matter dysfunction. The involvement of the parietal and occipital lobes explains the associated neurological features of confusion and visual changes. MRI reflects the white matter changes associated with eclampsia in posterior reversible encephalopathy syndrome (PRES). Eclampsia is treated with blood pressure control and magnesium to treat the seizures.

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