Neuroimaging of Children With Takayasu Arteritis

Objective: Takayasu arteritis is a rare granulomatous chronic vasculitis that affects the aorta and its main branches. Neurologic manifestations can accompany the disease; however, there is no study on neuroimaging in children with Takayasu arteritis. Therefore, we aimed to evaluate cranial magnetic resonance imaging (MRI) in pediatric Takayasu arteritis patients. Materials and Methods: Demographic, clinical, and laboratory data were obtained retrospectively. Results: The study included 15 pediatric Takayasu arteritis patients. All patients presented with constitutional symptoms. Additionally, 6 patients suffered from headache, 2 had syncope, 1 had loss of consciousness, and 1 had convulsion. All patients underwent cranial and diffusion MRI a median 12 months after diagnosis. Cranial MRI findings were normal in 12 patients, whereas 3 patients had abnormal findings, as follows: stenosis in the M1 and M2 segments of the left middle cerebral artery (n = 1); diffuse thinning of the right internal carotid, middle cerebral, and right vertebral and basilar artery (n = 1); as a sequela, areas of focal gliosis in both the lateral ventricular and posterior periventricular regions (n = 1). Among these 3 patients, 1 had no neurologic complaints. Conclusion: Abnormal MRI findings can be observed in pediatric Takayasu arteritis patients, even those that are asymptomatic; therefore, clinicians should carefully evaluate neurologic involvement in all pediatric Takayasu arteritis patients.

Download Full-text

Cerebral Proliferative Angiopathy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100006612 ◽

2009 ◽

Vol 36 (2) ◽

pp. 242-243 ◽

Cited By ~ 4

Author(s):

Muneer Eesa ◽

Pranshu Sharma ◽

Mayank Goyal

Keyword(s):

Emergency Room ◽

Cerebral Artery ◽

Left Middle Cerebral Artery ◽

Conventional Angiography ◽

Relative Paucity ◽

Signal Change ◽

Vascular Structures ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Left Middle

A 31-year-old male presented with transient numbness of the right hand, progressing to involve the forearm. The symptoms lasted for around 30 minutes without any associated weakness or positive motor phenomena. An evaluation in the emergency room revealed no focal deficits.Acomputer tomogram (CT) scan performed in the emergency room suggested a few abnormal vascular structures in relation to the left hemisphere, with no evidence of hemorrhage. The patient was referred for magnetic resonance imaging (MRI) and conventional angiography.The MRI showed a diffuse network of densely enhancing vascular spaces involving the left middle cerebral artery (MCA) and anterior cerebral artery (ACA) territories without a clear nidus or abnormal parenchymal signal change (Figure 1). There was no involvement of the basal ganglia or thalami. Given the size and extent of the abnormality, there was a relative paucity of draining vessels, which were only moderately enlarged.

Download Full-text

Intrasellar Intercarotid Communicating Artery Associated with Agenesis of the Right Internal Carotid Artery: Case Report

Neurosurgery ◽

10.1227/00006123-198812000-00019 ◽

1988 ◽

Vol 23 (6) ◽

pp. 770-773 ◽

Cited By ~ 6

Author(s):

Masahiko Udzura ◽

Hiroo Kobayashi ◽

Yoshio Taguchi ◽

Hiroaki Sekino

Keyword(s):

Magnetic Resonance Imaging ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Spatial Relationship ◽

Resonance Imaging ◽

Anomalous Artery ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Relationship Of

Abstract A 54-year-old man with a right hemiparesis was found to have an intrasellar intercarotid communicating artery associated with agenesis of the right internal carotid artery. Magnetic resonance imaging (MRI) studies demonstrated the spatial relationship of the anomalous artery to the surrounding structures, thus suggesting an embryonic enlargement of the capsular artery as a source of this anomalous artery.

Download Full-text

Longer T2relaxation time is a marker of hypothalamic gliosis in mice with diet-induced obesity

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00020.2013 ◽

2013 ◽

Vol 304 (11) ◽

pp. E1245-E1250 ◽

Cited By ~ 23

Author(s):

Donghoon Lee ◽

Joshua P. Thaler ◽

Kathryn E. Berkseth ◽

Susan J. Melhorn ◽

Michael W. Schwartz ◽

...

Keyword(s):

Relaxation Time ◽

High Field ◽

Relaxation Times ◽

Quantitative Mri ◽

Human Studies ◽

Mri Findings ◽

Diet Induced Obesity ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Mr Brain

A hallmark of brain injury from infection, vascular, neurodegenerative, and other disorders is the development of gliosis, which can be detected by magnetic resonance imaging (MRI). In rodent models of diet-induced obesity (DIO), high-fat diet (HFD) consumption rapidly induces inflammation and gliosis in energy-regulating regions of the mediobasal hypothalamus (MBH), and recently we reported MRI findings suggestive of MBH gliosis in obese humans. Thus, noninvasive imaging may obviate the need to assess MBH gliosis using histopathological end points, an obvious limitation to human studies. To investigate whether quantitative MRI is a valid tool with which to measure MBH gliosis, we performed analyses, including measurement of T2relaxation time from high-field MR brain imaging of mice fed HFD and chow-fed controls. Mean bilateral T2relaxation time was prolonged significantly in the MBH, but not in the thalamus or cortex, of HFD-fed mice compared with chow-fed controls. Histological analysis confirmed evidence of increased astrocytosis and microglial accumulation in the MBH of HFD-fed mice compared with controls, and T2relaxation times in the right MBH correlated positively with mean intensity of glial fibrillary acidic protein staining (a marker of astrocytes) in HFD-fed animals. Our findings indicate that T2relaxation time obtained from high-field MRI is a useful noninvasive measurement of HFD-induced gliosis in the mouse hypothalamus with potential for translation to human studies.

Download Full-text

Cerebral Hemispheric and Contralateral Cerebellar Hypoperfusion during a Transient Ischemic Attack

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.1987.95 ◽

1987 ◽

Vol 7 (4) ◽

pp. 507-509 ◽

Cited By ~ 23

Author(s):

Daniela Perani ◽

Paolo Gerundini ◽

Gian Luigi Lenzi

Keyword(s):

Single Photon ◽

Photon Emission ◽

Complete Recovery ◽

Emission Computed Tomography ◽

Left Middle Cerebral Artery ◽

Single Photon Emission Computed ◽

Ischemic Attack ◽

The Right ◽

Photon Emission Computed Tomography ◽

Left Middle

We studied a 79-year-old woman within 3 h of the onset of a motor aphasia and a right hemiparesis. Single photon emission computed tomography (SPECT) showed a 24% decrease in the perfusion of the left middle cerebral artery territory and a 16% reduction in the perfusion of the right cerebellum. A mild naming difficulty was the neurological deficit at the end of the SPECT examination, and complete recovery was achieved within 24 h. Repeated SPECT study 10 days later was normal. This is the first report of focal hemispheric and contralateral cerebellar hypoperfusion in transient cerebral ischemia.

Download Full-text

Altered microstructure integrity of the amygdala in schizophrenia: a bimodal MRI and DWI study

Psychological Medicine ◽

10.1017/s0033291710000875 ◽

2010 ◽

Vol 41 (2) ◽

pp. 301-311 ◽

Cited By ~ 10

Author(s):

B. Tomasino ◽

M. Bellani ◽

C. Perlini ◽

G. Rambaldelli ◽

R. Cerini ◽

...

Keyword(s):

Emotional Processing ◽

Structural Magnetic Resonance Imaging ◽

Apparent Diffusion Coefficients ◽

Tissue Organization ◽

Water Diffusivity ◽

Apparent Diffusion ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

And Diffusion

BackgroundThe amygdala plays a central role in the fronto-limbic network involved in the processing of emotions. Structural and functional abnormalities of the amygdala have recently been found in schizophrenia, although there are still contradictory results about its reduced or preserved volumes.MethodIn order to address these contradictory findings and to further elucidate the possibly underlying pathophysiological process of the amygdala, we employed structural magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI), exploring amygdalar volume and microstructural changes in 69 patients with schizophrenia and 72 matched healthy subjects, relating these indices to psychopathological measures.ResultsMeasuring water diffusivity, the apparent diffusion coefficients (ADCs) for the right amygdala were found to be significantly greater in patients with schizophrenia compared with healthy controls, with a trend for abnormally reduced volumes. Also, significant correlations between mood symptoms and amygdalar volumes were found in schizophrenia.ConclusionsWe therefore provide evidence that schizophrenia is associated with disrupted tissue organization of the right amygdala, despite partially preserved size, which may ultimately lead to abnormal emotional processing in schizophrenia. This result confirms the major role of the amygdala in the pathophysiology of schizophrenia and is discussed with respect to amygdalar structural and functional abnormalities found in patients suffering from this illness.

Download Full-text

Metronidazole-Induced Encephalopathy: Case Report and Review of MRI Findings

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100011951 ◽

2011 ◽

Vol 38 (3) ◽

pp. 512-513 ◽

Cited By ~ 5

Author(s):

Jamsheed A. Desai ◽

Jessica Dobson ◽

Michel Melanson ◽

Giovanna Pari ◽

Albert Yongwon Jin

Keyword(s):

Imaging Finding ◽

Sensory Loss ◽

Mri Findings ◽

Axonal Polyneuropathy ◽

Large Fibre ◽

History Of ◽

Impaired Balance ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Vibration Threshold

A 74-year-old man presented with a four week history of behavioural disturbances, upper and lower extremity numbness and impaired balance. He had been treated with metronidazole for six months for osteomyelitis of the right hallux. Examination revealed encephalopathy, and glove-and-stocking sensory loss to pinprick with reduced vibration threshold at the toe. The gait was wide based and ataxic. Nerve conduction studies showed a large fibre sensory-motor axonal polyneuropathy. Magnetic resonance imaging (MRI) revealed a solitary restricted diffusion lesion in the splenium of the corpus callosum (Figure A, B) with subtle prolongation of T2 (Figure C). The radiographic differential diagnosis included hypoglycaemia, viral encephalitis, antiepileptic drug toxicity/withdrawal and metronidazole toxicity. The combination of the imaging finding with the history of prolonged metronidazole use suggested metronidazole induced encephalopathy.

Download Full-text

Unilateral Fixed Dilation of the Pupil as a False-localizing Sign with Intracranial Hemorrhage: Case Report and Literature Review

Neurosurgery ◽

10.1097/00006123-200111000-00045 ◽

2001 ◽

Vol 49 (5) ◽

pp. 1251-1256 ◽

Cited By ~ 1

Author(s):

Laurence A.G. Marshman ◽

Charles E. Polkey ◽

Christopher C. Penney

Keyword(s):

Artery Aneurysm ◽

Mass Effect ◽

Left Middle Cerebral Artery ◽

Eye Opening ◽

The Right ◽

False Localizing Sign ◽

Mass Lesions ◽

Cerebral Artery Aneurysm ◽

Supratentorial Mass ◽

Left Middle

ABSTRACT OBJECTIVE AND IMPORTANCE Although other focal signs may prove “false localizing,” it is a neurosurgical axiom that unilateral fixed dilation of the pupil occurs ipsilateral to a supratentorial mass. CLINICAL PRESENTATION A 25-year-old man collapsed with a dense right hemiplegia and a Glasgow Coma Scale score of 6 (eye opening, 1; motor, 4; verbal, 1) after rupture of a left middle cerebral artery aneurysm associated with an intrasylvian hematoma. Initially, both pupils had remained equal-sized and reactive: however, within hours, the right (contralateral) pupil became fixed and dilated (i.e., false localizing). For some time, the left (ipsilateral) pupil remained small and reactive; at emergency craniotomy, this also became fixed and equally dilated. INTERVENTION After evacuation of the clot and wrapping of the aneurysm, both pupils rapidly became equal-sized and reactive. Twenty-four hours later, concurrent with massive left hemispheric swelling and a midline shift, the left (ipsilateral) pupil became unilaterally fixed and dilated (i.e., false localizing). Eventually, the right (contralateral) pupil also became fixed and dilated, concurrent with cardiovascular collapse. Death occurred within 10 hours. CONCLUSION Unilateral fixed dilation of the pupil in patients with hemispheric mass lesions may be false localizing. Furthermore, disparate “herniating mechanisms” can arise despite mass effect emanating from the same side. Because such mechanisms cannot be witnessed, their nature remains speculative. An extensive review is contained in this article.

Download Full-text

Therapeutic challenges after successful thrombectomy in a patient with an antiphospholipid syndrome associated M1-occlusion: A case report

Interventional Neuroradiology ◽

10.1177/1591019915590371 ◽

2015 ◽

Vol 21 (5) ◽

pp. 598-602 ◽

Cited By ~ 8

Author(s):

Katharina Stadler ◽

Johannes S Mutzenbach ◽

Gudrun Kalss ◽

Johann Sellner ◽

Abdul R Al-Schameri ◽

...

Keyword(s):

Case Report ◽

Antiphospholipid Syndrome ◽

Stent Implantation ◽

New Left ◽

Anticoagulation Therapy ◽

Blood Parameters ◽

Left Middle Cerebral Artery ◽

Systemic Thrombolysis ◽

Magnetic Resonance Imaging Mri ◽

The Right

Backround Stroke is a frequent disorder in patients with an antiphospholipid syndrome (APS). Due to a high risk for further thromboembolic events, appropriate anticoagulation therapy in patients with an APS-associated stroke seems mandatory but drug eluting and duration is a matter of debate. Case A 48-year-old female patient presented with Broca’s aphasia and mild hemiparesis on the right side. Diagnostic work-up revealed left middle cerebral artery (MCA) occlusion yet without diffusion-weighted lesions. Due to a thrombocytopenia (67.00 g/l) systemic thrombolysis was not indicated and endovascular treatment was initiated 150 min after symptom onset. After successful clot retrieval, recurrent re-occlusions lead to the necessity of stent implantation and anticoagulation, respectively. On day 5 she developed a new severe right-sided hemiparesis. The magnetic resonance imaging (MRI) showed a subtotal restenosis of the left MCA despite the regular anticoagulation regime leading to a new left MCA ischaemic stroke. In the meantime, the unknown aetiology, the patients’ age and the thrombocytopenia let to further diagnostic workup. Elevated blood parameters such as lupus anticoagulant (LA)-1, LA-ratio, positive anti-nuclear antibody (ANA), p-anti-neutrophil cytoplasmic antibodies (ANCA), c-ANCA confirmed the diagnosis of APS. Conclusion This case report showed the feasibility of mechanical clot retrieval and stent implantation in patients with APS. Due to the elevated risk of in-stent thrombosis a prolonged therapy with glycoprotein (GP)IIb/IIIa receptor antagonists in the initial postoperative period and further anticoagulation with coumarin derivate might be needed.

Download Full-text

Unusual MRI Findings in a Polio Survivor

Case Reports in Orthopedics ◽

10.1155/2016/3179621 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

Masaaki Sakamoto ◽

Hitoshi Watanabe ◽

Hitoshi Kubosawa ◽

Takeshi Ishii

Keyword(s):

Acute Inflammation ◽

Gluteus Medius ◽

Joint Space ◽

Mri Findings ◽

Musculoskeletal Tumor ◽

Hip Instability ◽

Gluteus Medius Muscle ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Polio Survivors

A 63-year-old male consulted our institution due to worsening of right hip pain for approximately one month. The patient had no apparent functional disorders besides rigidity of the right ankle secondary to childhood poliomyelitis. Plain radiographs demonstrated narrowing of the right hip joint space. Magnetic resonance imaging (MRI) showed unusual findings in the right gluteus medius muscle, suspecting a malignant musculoskeletal tumor. Further examinations clarified acute inflammation caused byStaphylococcus aureuswith no atypia. After treatment, serum inflammatory markers normalized and MRI showed homogeneous fat signal intensity in the muscle, which was consistent with poliomyelitis. Total hip arthroplasty was performed due to progression of osteoarthritis. Intraoperative findings showed flaccidity of the gluteus medius muscle, and histological examination of the specimen also was compatible with poliomyelitis. Postoperatively there was no hip instability and the patient has been able to resume his previous physical activity. To our knowledge, this is the first report regarding polio survivors combined with septic arthritis, and sole MRI examination was unable to lead to the diagnosis. The current patient demonstrates the possibility that the involved muscles in poliomyelitis exist even in asymptomatic regions, which will be helpful for accurate diagnosis and life guidance in polio survivors.

Download Full-text

Identifying Changepoints in Biomarkers During the Preclinical Phase of AD

10.1101/508820 ◽

2018 ◽

Author(s):

Laurent Younes ◽

Marilyn Albert ◽

Abhay Moghekar ◽

Anja Soldan ◽

Corinne Pettigrew ◽

...

Keyword(s):

Symptom Onset ◽

Medial Temporal Lobe ◽

Cognitive Testing ◽

Mri Findings ◽

Single Measure ◽

Cognitively Normal ◽

Preclinical Phase ◽

Normal Individuals ◽

Magnetic Resonance Imaging Mri ◽

The Right

Objective: Several models have been proposed for the evolution of Alzheimer's disease (AD) biomarkers. The aim of this study was to identify changepoints in a range of biomarkers during the preclinical phase of AD. Methods: We examined nine measures based on cerebrospinal fluid (CSF), magnetic resonance imaging (MRI) and cognitive testing, obtained from 306 cognitively normal individuals, a subset of whom subsequently progressed to the symptomatic phase of AD. A changepoint model was used to determine which of the measures had a significant change in slope in relation to clinical symptom onset. Results: All nine measures had significant changepoints, all of which preceded symptom onset, however the timing of these changepoints varied considerably. A single measure, CSF-tau, had an early changepoint (40 years prior to symptom onset). A group of measures, including the remaining CSF measures (CSF-Abeta and phosphorylated tau) and all cognitive tests had changepoints 10-15 years prior to symptom onset. A second group is formed by medial temporal lobe shape composite measures, with a five-year time difference between the right and left side (respectively nine and three years prior to symptom onset). Conclusions: These findings highlight the long period of time prior to symptom onset during which AD pathology is accumulating in the brain. There are several significant findings, including the early changes in cognition and the laterality of the MRI findings. Additional work is needed to clarify their significance.

Download Full-text