Neonatal Respiratory Failure Caused by Congenital Diffuse Intrinsic Pontine Glioma

2017 ◽  
Vol 32 (6) ◽  
pp. 533-536 ◽  
Author(s):  
Katie M. Satrom ◽  
Rachel A. Phelan ◽  
Christopher L. Moertel ◽  
H. Brent Clark ◽  
Dana E. Johnson ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Postmortem Examination ◽  
Resonance Imaging ◽  
Pontine Glioma ◽  
Who Grade ◽  
The Family ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain ◽  
Who Grade Iii

The authors present a case of diffuse intrinsic pontine glioma presenting in a newborn with stridor and respiratory distress that progressed to respiratory failure. Magnetic resonance imaging (MRI) of the brain revealed findings compatible with the diagnosis of diffuse intrinsic pontine glioma. The family pursued palliative care and postmortem examination confirmed WHO grade III astrocytoma.

scholarly journals IMG-09. RESPONSE ASSESSMENT IN DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG): RECOMMENDATIONS FROM THE RESPONSE ASSESSMENT IN PEDIATRIC NEURO-ONCOLOGY COMMITTEE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii356-iii357
Author(s):  
Tabitha Cooney ◽  
Kenneth J Cohen ◽  
Carolina V Guimaraes ◽  
Girish Dhall ◽  
James Leach ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Clinical Trials ◽  
Response Duration ◽  
Response Assessment ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Pontine Glioma ◽  
Response Data ◽  
International Panel ◽  
Children And Young Adults ◽  
Magnetic Resonance Imaging Mri

Abstract Optimizing the conduct of clinical trials for diffuse intrinsic pontine glioma (DIPG) involves use of consistent, objective disease assessments and standardized response criteria. The Response Assessment in Pediatric Neuro-Oncology (RAPNO) committee, an international panel of pediatric and adult neuro-oncologists, clinicians, radiologists, radiation oncologists, and neurosurgeons, was established to address unique challenges in assessing response in children with CNS tumors. A subcommittee of RAPNO was formed to specifically address response assessment in children and young adults with DIPG and to develop a consensus on recommendations for response assessment. Distinct issues related to the response assessment of DIPG include its definition and recent molecular classifications, dearth of imaging response data, the phenomena of pseudoprogression, and measuring response in the era of focal drug delivery. The committee has recommended response be assessed using magnetic resonance imaging (MRI) of brain and spine, neurologic examination, and use of supportive medication, i.e. steroids and anti-angiogenic agents. Clinical imaging standards and imaging quality control are defined. Unique recommendations for DIPG response include an eight-week response duration, a twenty-five percent decrease for partial response, and the distinction of pontine and extra-pontine response for trials that use focal drug delivery. The recommendations presented here represent an initial effort to uniformly collect and evaluate response assessment criteria; these recommendations can now be incorporated into clinical trials to assess feasibility and corroboration with patient outcomes.

scholarly journals Cinematic rendering of a burst sagittal suture caused by an occipito-frontal gunshot wound

2021 ◽  
Author(s):  
Dominic Gascho ◽  
Michael J. Thali ◽  
Rosa M. Martinez ◽  
Stephan A. Bolliger
Keyword(s):  
Gunshot Wound ◽  
Three Dimensional ◽  
The Novel ◽  
Sagittal Suture ◽  
Resonance Imaging ◽  
Cinematic Rendering ◽  
Reconstruction Methods ◽  
Dimensional Reconstruction ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

AbstractThe computed tomography (CT) scan of a 19-year-old man who died from an occipito-frontal gunshot wound presented an impressive radiating fracture line where the entire sagittal suture burst due to the high intracranial pressure that arose from a near-contact shot from a 9 mm bullet fired from a Glock 17 pistol. Photorealistic depictions of the radiating fracture lines along the cranial bones were created using three-dimensional reconstruction methods, such as the novel cinematic rendering technique that simulates the propagation and interaction of light when it passes through volumetric data. Since the brain had collapsed, depiction of soft tissue was insufficient on CT images. An additional magnetic resonance imaging (MRI) examination was performed, which enabled the diagnostic assessment of cerebral injuries.

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 876 Disorders of the Brain Revealed by Magnetic Resonance Imaging (MRI) in Infants with Severe Congenital Cytomegaly

2010 ◽  
Vol 68 ◽  
pp. 440-440
Author(s):  
B Milewska-Bobula ◽  
B Lipka ◽  
J Zebrowska ◽  
E Jurkiewicz ◽  
I Pakula-Kosciesza ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

scholarly journals A Large-scale Comparison of Cortical and Subcortical Structural Segmentation Methods in Alzheimer’s Disease: a Statistical Approach

2020 ◽  
Author(s):  
Jafar Zamani ◽  
Ali Sadr ◽  
Amir-Homayoun Javadi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Large Scale ◽  
Automated Segmentation ◽  
Resonance Imaging ◽  
Brain Areas ◽  
Segmentation Methods ◽  
Magnetic Resonance Imaging Mri ◽  
Underlying Mechanisms ◽  
The Brain

AbstractBackgroundAlzheimer’s disease (AD) is a neurodegenerative disease that leads to anatomical atrophy, as evidenced by magnetic resonance imaging (MRI). Automated segmentation methods are developed to help with the segmentation of different brain areas. However, their reliability has yet to be fully investigated. To have a more comprehensive understanding of the distribution of changes in AD, as well as investigating the reliability of different segmentation methods, in this study we compared volumes of cortical and subcortical brain segments, using automated segmentation methods in more than 60 areas between AD and healthy controls (HC).MethodsA total of 44 MRI images (22 AD and 22 HC, 50% females) were taken from the minimal interval resonance imaging in Alzheimer’s disease (MIRIAD) dataset. HIPS, volBrain, CAT and BrainSuite segmentation methods were used for the subfields of hippocampus, and the rest of the brain.ResultsWhile HIPS, volBrain and CAT showed strong conformity with the past literature, BrainSuite misclassified several brain areas. Additionally, the volume of the brain areas that successfully discriminated between AD and HC showed a correlation with mini mental state examination (MMSE) scores. The two methods of volBrain and CAT showed a very strong correlation. These two methods, however, did not correlate with BrainSuite.ConclusionOur results showed that automated segmentation methods HIPS, volBrain and CAT can be used in the classification of AD and HC. This is an indication that such methods can be used to inform researchers and clinicians of underlying mechanisms and progression of AD.

scholarly journals Extended Cranial Ultrasound Views in Infants with Acute Brain Stem/Infratentorial Lesions: Diagnosis of a Progressive Midline Glioma in a 6-Week-Old Infant

2021 ◽  
Vol 11 (01) ◽  
pp. e262-e264
Author(s):  
Matthias Lange ◽  
Bernd Mitzlaff ◽  
Florian Beske ◽  
Holger Koester ◽  
Wiebke Aumann ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
World Health ◽  
Cranial Ultrasound ◽  
Anterior Fontanel ◽  
Resonance Imaging ◽  
Who Grade ◽  
Magnetic Resonance Imaging Mri ◽  
Health Organization ◽  
Mastoid Fontanelle ◽  
Diffuse Midline Glioma

AbstractCentral nervous system (CNS) tumors are the most common solid tumors in children and adolescents. However, in neonates and children aged younger than a year, they are very rare. Clinical presentation in neonates is often subtle and nonspecific. When neurological symptoms are apparent at this age, cranial ultrasound (CUS) is often done as the initial evaluation, with a standard approach through the anterior fontanel (AF), followed by further imaging, such as magnetic resonance imaging (MRI), if necessary. We report the first neonatal case of a rapidly progressive diffuse midline glioma positive for histone H3 K27M mutation (World Health Organization [WHO] grade IV) in which using extended (transmastoid) CUS studies through the mastoid fontanelle (MF) in the second month of life defined the lesion in the brainstem.

Neurological manifestations of tuberous sclerosis in children (own observations)

2021 ◽  
Vol 1 (223) ◽  
pp. 15-21
Author(s):  
Aigerim Balykbayeva ◽  
◽  
Dina Bakrayeva ◽  
Gaukhar Ospanova ◽  
Yekaterina Talipova ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Ultrasound Examination ◽  
Resonance Imaging ◽  
Laboratory Examination ◽  
Internal Organs ◽  
Cortical Dysgenesis ◽  
Symptomatic Epilepsy ◽  
Magnetic Resonance Imaging Mri ◽  
The University ◽  
The Brain

Tuberous sclerosis (Pringle-Burneville disease) is a polysystemic genetic disease and occurs in the population with a frequency of 1:50000. Objective of the study. To study neuropsychic status and dynamics of tuberous sclerosis development in children. Material and Methods. Have been examined 33 children aged from 1 to 14 years, who were observed in the neurological pediatric department of the University Clinic ("Aksay") of Asfendiyarov KazNMU. All children had apigmented spots and coffee-milk stains on the torso and extremities, not protruding above the skin level. All children showed characteristic neuroimaging changes in the brain by magnetic resonance imaging (MRI) and computed tomography (CT) - areas of dyshinesia cortically and subcortically, i.e. tubercles. As well as changes in internal organs (hamartoma variants). All children underwent a complete laboratory examination (general blood count, standard biochemical parameters), electroencephalography of the brain (EEG), as well as ultrasound examination of internal organs. Results and conclusions. As a result of our study, it was revealed that the main symptom confirming the diagnosis of tuberous sclerosis is the presence of tubers (95-100% of patients). Moreover, there is a topographical relationship between tubers detected during MRI examination and the presence of foci on the EEG. Thus, a particular manifestation of the disease in patients is symptomatic epilepsy with onset in the first months of life (96% of patients). Keywords: tuberous sclerosis, epilepsy, children, hamartomas, pigmented spots, cortical dysgenesis, tubers.

scholarly journals Characterization of the Blood–Brain Barrier Integrity and the Brain Transport of SN-38 in an Orthotopic Xenograft Rat Model of Diffuse Intrinsic Pontine Glioma

Pharmaceutics ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 399 ◽  
Author(s):  
Catarina Chaves ◽  
Xavier Declèves ◽  
Meryam Taghi ◽  
Marie-Claude Menet ◽  
Joelle Lacombe ◽  
...  
Keyword(s):  
Blood Brain Barrier ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Brain Barrier ◽  
Brain Delivery ◽  
Pontine Glioma ◽  
Anticancer Drug Delivery ◽  
Blood Brain ◽  
The Brain

The blood–brain barrier (BBB) hinders the brain delivery of many anticancer drugs. In pediatric patients, diffuse intrinsic pontine glioma (DIPG) represents the main cause of brain cancer mortality lacking effective drug therapy. Using sham and DIPG-bearing rats, we analyzed (1) the brain distribution of 3-kDa-Texas red-dextran (TRD) or [14C]-sucrose as measures of BBB integrity, and (2) the role of major ATP-binding cassette (ABC) transporters at the BBB on the efflux of the irinotecan metabolite [3H]-SN-38. The unaffected [14C]-sucrose or TRD distribution in the cerebrum, cerebellum, and brainstem regions in DIPG-bearing animals suggests an intact BBB. Targeted proteomics retrieved no change in P-glycoprotein (P-gp), BCRP, MRP1, and MRP4 levels in the analyzed regions of DIPG rats. In vitro, DIPG cells express BCRP but not P-gp, MRP1, or MRP4. Dual inhibition of P-gp/Bcrp, or Mrp showed a significant increase on SN-38 BBB transport: Cerebrum (8.3-fold and 3-fold, respectively), cerebellum (4.2-fold and 2.8-fold), and brainstem (2.6-fold and 2.2-fold). Elacridar increased [3H]-SN-38 brain delivery beyond a P-gp/Bcrp inhibitor effect alone, emphasizing the role of another unidentified transporter in BBB efflux of SN-38. These results confirm a well-preserved BBB in DIPG-bearing rats, along with functional ABC-transporter expression. The development of chemotherapeutic strategies to circumvent ABC-mediated BBB efflux are needed to improve anticancer drug delivery against DIPG.

Cerebral schistosomiasis: MRI features with pathological correlation

2020 ◽  
pp. 028418512093447
Author(s):  
Chun-yan Lu ◽  
Sha Zhao ◽  
Yi Wei
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Area ◽  
Pathological Findings ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Mri Features ◽  
Cerebral Involvement ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain ◽  
Radiology And Pathology

Background Neuroschistosomiasis is not commonly encountered and is probably underrecognized. We hope these findings can help clinicians and radiologists to raise awareness of this disabling disorder. Purpose To demonstrate the magnetic resonance imaging (MRI) findings of cerebral schistosomiasis and correlate it with pathological findings. Material and Methods We identified seven patients with cerebral schistosomiasis from radiology and pathology archives of our hospital. Of the seven patients, six were pathologically confirmed. The remaining patient had pathologically confirmed spinal schistosomiasis with MRI findings of cerebral involvement. MRI and pathological findings of these patients were analyzed and correlated. Results Multiple enhancing nodules at varying size were found in all patients. Prominent leptomeningeal or choroidal veins were found in six patients, four at the center of the foci and two at the periphery. Hemorrhage was identified in two patients. Histology revealed granulomas around ova in six patients. A prominent vein with ova in the lumen and wall of a vein was found in one patient and perivascular ova deposition was found in one patient. Conclusion Multiple enhancing nodules with central or peripheral veins in a circumscribed brain area are important signs to the diagnosis of cerebral schistosomiasis. The inflamed veins involved may be the route taken by the ova to spread to the brain tissue.

scholarly journals ABC Transporter Inhibition Plus Dexamethasone Enhances the Efficacy of Convection Enhanced Delivery in H3.3K27M Mutant Diffuse Intrinsic Pontine Glioma

Neurosurgery ◽  
2019 ◽  
Vol 86 (5) ◽  
pp. 742-751 ◽  
Author(s):  
Vadim Tsvankin ◽  
Rintaro Hashizume ◽  
Hiroaki Katagi ◽  
James E Herndon ◽  
Christopher Lascola ◽  
...  
Keyword(s):  
Abc Transporter ◽  
Kinase Inhibitor ◽  
Mutant Cell ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Pontine Glioma ◽  
Convection Enhanced Delivery ◽  
P Glycoprotein ◽  
Magnetic Resonance Imaging Mri

Abstract BACKGROUND An impermeable blood–brain barrier and drug efflux via ATP-binding cassette (ABC) transporters such as p-glycoprotein may contribute to underwhelming efficacy of peripherally delivered agents to treat diffuse intrinsic pontine glioma (DIPG). OBJECTIVE To explore the pharmacological augmentation of convection-enhanced delivery (CED) infusate for DIPG. METHODS The efficacy of CED dasatinib, a tyrosine kinase inhibitor, in a transgenic H3.3K27M mutant murine model was assessed. mRNA expression of ABCB1 (p-glycoprotein) was analyzed in 14 tumor types in 274 children. In Vitro viability studies of dasatinib, the p-glycoprotein inhibitor, tariquidar, and dexamethasone were performed in 2 H3.3K27M mutant cell lines. Magnetic resonance imaging (MRI) was used to evaluate CED infusate (gadolinium/dasatinib) distribution in animals pretreated with tariquidar and dexamethasone. Histological assessment of apoptosis was performed. RESULTS Continuous delivery CED dasatinib improved median overall survival (OS) of animals harboring DIPG in comparison to vehicle (39.5 and 28.5 d, respectively; P = .0139). Mean ABCB1 expression was highest in K27M gliomas. In Vitro, the addition of tariquidar and dexamethasone further enhanced the efficacy of dasatinib (P < .001). In Vivo, MRI demonstrated no difference in infusion dispersion between animals pretreated with dexamethasone plus tariquidar prior to CED dasatinib compared to the CED dasatinib. However, tumor apoptosis was the highest in the pretreatment group (P < .001). Correspondingly, median OS was longer in the pretreatment group (49 d) than the dasatinib alone group (39 d) and no treatment controls (31.5 d, P = .0305). CONCLUSION ABC transporter inhibition plus dexamethasone enhances the efficacy of CED dasatinib, resulting in enhanced tumor cellular apoptosis and improved survival in H3.3K27M mutant DIPG.

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