Klüver-Bucy Syndrome in a Patient with Nasopharyngeal Carcinoma: A Late Complication of Radiation Brain Injury

1997 ◽  
Vol 10 (3) ◽  
pp. 111-113 ◽  
Author(s):  
Linda C.W. Lam ◽  
Helen F.K. Chiu
Keyword(s):  
Brain Injury ◽  
Nasopharyngeal Carcinoma ◽  
Computerized Tomography ◽  
Temporal Lobe ◽  
Late Complication ◽  
Delayed Effects ◽  
Effects Of Radiation ◽  
The Brain ◽  
Lobe Atrophy

We report a patient with dementia and Klüver-Bucy syndrome who presented 17 years after radiotherapy for nasopharyngeal carcinoma. Computerized tomography of the brain revealed bilateral temporal lobe atrophy. The possibility of delayed effects of radiation brain injury in causing the human Klüver-Bucy syndrome is discussed.

Abstract 13824: Computerized Tomography vs Ultrasound Imaging for Detecting Hypoxic-Ischemic Brain Injury

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Benjamin Karfunkle ◽  
Pavitra Kotini-shah ◽  
Richard Gordon ◽  
Jing Li ◽  
Misha Granado ◽  
...  
Keyword(s):  
Brain Injury ◽  
Hospital Discharge ◽  
Computerized Tomography ◽  
Point Of Care ◽  
Ischemic Injury ◽  
Ct Head ◽  
Ct Brain ◽  
Initial Imaging ◽  
The Brain ◽  
Hypoxic Ischemic Injury

Introduction: After an out-of-hospital cardiac arrest (OHCA), the resulting hypoxic-ischemic injury (HII) to the brain remains the main cause of mortality. Standardized approaches for measuring the extent of injury and monitoring of changes are lacking and continue to be a critical barrier to progress in improving neurological survival. Objective: We sought to characterize the prevalence of HII detected on computerized tomography of the brain and its correlation to point-of-care optic nerve sheath diameter (ONSD) measurements as an alternative modality for detecting brain injury. Methods: Adult OHCA patients at an urban academic ED were included in this study on a convenience sample basis from 2018-2019. The patients were grouped by findings of hypoxic-ischemic injury (HII) on both initial and subsequent CT brain imaging performed after ROSC in respective groups. CT Brain findings were compared to ONSD measurements as performed with point-of-care ultrasound by fellowship-trained emergency physicians within one hour of hospital arrival and at 6 hours, after return of spontaneous circulation (ROSC) and to cerebral performance category (CPC) at hospital discharge. Results: 76 patients enrolled in the study had a median age was 59, 49% were female, and 37% survived to hospital discharge. 58 patients had CT head performed, 40 had ONSD measured within one hour, and 27 patients had both. Of that 27, 9 (33%) had evidence of HII on initial imaging and 15 (55%) had evidence of HII on subsequent imaging for a total of 20 unique patients. The average ONSD within 1 hour of ROSC for those with no HII on any imaging was 0.59 cm, and for those without HII on initial imaging but with HII on subsequent imaging was 0.67 cm, and this difference was statistically significant (p< 0.05). Of the 20 patients with HI, 14 (70%) patients died and 6 (30%) survived with a CPC of 4. The average time to first CT head was 4 hours and 45 mins and the average time to subsequent imaging was 97 hours and 45 mins. Conclusion: After an OHCA, early time point ONSD measurements can potentially indicate brain injury within 1 hour of ROSC even in those without initial evidence of HII on CT imaging.

scholarly journals A-62Schelten et al. Ratings for Mesial Temporal Lobe Atrophy in the Social Outcomes of Brain Injury in Kids

2015 ◽  
Vol 30 (6) ◽  
pp. 508.1-508
Author(s):  
Y Tsui-Caldwell ◽  
Z Christensen ◽  
D Oleson ◽  
R Leete ◽  
J Gonzales ◽  
...  
Keyword(s):  
Brain Injury ◽  
Temporal Lobe ◽  
Social Outcomes ◽  
The Social ◽  
Mesial Temporal Lobe ◽  
Lobe Atrophy

scholarly journals Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Shan Li ◽  
Qin Zhou ◽  
Liang-Fang Shen ◽  
Huan Li ◽  
Zhan-Zhan Li ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Optic Nerve ◽  
Nasopharyngeal Carcinoma ◽  
Temporal Lobe ◽  
Volumetric Modulated Arc Therapy ◽  
Optic Chiasm ◽  
Delivery Time ◽  
T Stage ◽  
Arc Therapy ◽  
The Brain

Purpose. To compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) in treating early T-stage nasopharyngeal carcinoma (NPC). Method. Ten patients with early T-stage NPC who received tomotherapy using simultaneously integrated boost (SIB) strategies were replanned with VMAT (RapidArc of Varian, dual-arc). Dosimetric comparisons between the RapidArc plan and the HT plan included the following: (1) D98, homogeneity, and conformity of PTVs; (2) sparing of organs at risk (OARs); (3) delivery time and monitor units (MUs). Results. (1) Compared with RapidArc, HT achieved better dose conformity (CI of PGTVnx + nd: 0.861 versus 0.818, P = 0.004). (2) In terms of OAR protection, RapidArc exhibited significant superiority in sparing ipsilateral optic nerve (Dmax: 27.5Gy versus 49.1Gy, P < 0.001; D2: 23.5Gy versus 48.2Gy, P < 0.001), contralateral optic nerve (Dmax: 30.4Gy versus 49.2Gy, P < 0.001; D2: 26.2Gy versus 48.1Gy, P < 0.001), and optic chiasm (Dmax: 32.8Gy versus 48.3Gy, P < 0.001; D2: 30Gy versus 47.6Gy, P < 0.001). HT demonstrated a superior ability to protect the brain stem (D1cc: 43.0Gy versus 45.2Gy, P = 0.012), ipsilateral temporal lobe (Dmax 64.5Gy versus 66.4 Gy, P = 0.015), contralateral temporal lobe (Dmax: 62.8Gy versus 65.1Gy, P = 0.001), ipsilateral lens (Dmax: 4.27Gy versus 5.24Gy, P = 0.009; D2: 4.00Gy versus 5.05Gy, P = 0.002; Dmean: 2.99Gy versus 4.31Gy, P < 0.001), contralateral lens (Dmax: 4.25Gy versus 5.09Gy, P = 0.047; D2: 3.91Gy versus 4.92Gy, P = 0.005; Dmean: 2.91Gy versus 4.18Gy, P < 0.001), ipsilateral parotid (Dmean: 36.4Gy versus 41.1Gy, P = 0.002; V30Gy: 54.8% versus 70.4%, P = 0.009), and contralateral parotid (Dmean: 33.4Gy versus 39.1Gy, P < 0.001; V30Gy: 48.2% versus 67.3%, P = 0.005). There were no statistically significant differences in spinal cord or pituitary protection between the RapidArc plan and the HT plan. (3) RapidArc achieved a much shorter delivery time (3.8 min versus 7.5 min, P < 0.001) and a lower MU (618MUs versus 5646MUs, P < 0.001). Conclusion. Our results show that RapidArc and HT are comparable in D98, dose homogeneity, and protection of the spinal cord and pituitary gland. RapidArc performs better in shortening delivery time, lowering MUs, and sparing the optic nerve and optic chiasm. HT is superior in dose conformity and protection of the brain stem, temporal lobe, lens, and parotid.

scholarly journals Determining Correlation of Food Intake and Satiety Related Hormones with the Findings of Brain Computerized Tomography (CT) Scans and Psychological Disorders in Children with Mild to Moderate Traumatic Brain Injury

2020 ◽  
Author(s):  
Shabnam Bagheri ◽  
Mohammad Sadegh Masoudi ◽  
Maryam Ekramzadeh
Keyword(s):  
Brain Injury ◽  
Food Intake ◽  
Ct Scan ◽  
Frontal Lobe ◽  
Energy Intake ◽  
Temporal Lobe ◽  
Calorie Intake ◽  
Appetite Control ◽  
Daily Energy ◽  
The Brain

Abstract Background: Traumatic brain injury (TBI) is an impairment with high prevalence amongst the pediatric population. Central nervous system (CNS) regulates food intake and each region of the brain can be responsible for appetite control network. It seems that TBI might affect appetite control system which could result in overeating or reduced food intake. Hence, the aim of this study was to determine, if there is a relationship between daily energy intake and satiety related hormones with computerized tomography scan (CT scan) findings in children with mild to moderate TBI.Methods: In this cross sectional study, 50 pediatrics with mild to moderate TBI were recruited and the following steps were performed for each patient: Completing the demographic information (age, gender, medical disorders, etc.), dietary intake assessment, taking blood samples for biochemical evaluations, and evaluating psychological disorders using the “Rutter Children Behavior Questionnaire”. The patient's CT scan was also used to determine the main area of brain injury. Results: The results showed that in comparison with the Reference Dietary Allowance (RDA) values, calorie intake was inadequate in 32% of the patients, while 32% had excess calorie intake. Comparison of the mean daily energy intake and serum levels of satiety hormones in different categorical CT scan findings showed that there was a significant relationship between energy intake and the site of injury. Post- hoc analysis showed that energy intake in patients with temporal lobe injury was significantly higher than in patients with frontal lobe injury or injuries to other sites of the brain. The results also showed that mean serum Ghrelin and Orexin levels in patients with temporal lobe injury were higher than patients with frontal lobe injury but no significant relationship was found regarding leptin and site of injury. Moreover, it was shown that children with frontal lobe injury had significantly more behavioral disorders.Conclusions: It seems that frontal lobe injuries might be associated with anorexia while temporal lobe injury can be associated with increased food intake. Future studies are recommended to determine, if there is a relationship between satiety related hormones with other site of injury in TBI patients.

scholarly journals “The Mind Is Its Own Place”: Amelioration of Claustrophobia in Semantic Dementia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Camilla N. Clark ◽  
Laura E. Downey ◽  
Hannah L. Golden ◽  
Phillip D. Fletcher ◽  
Rajith de Silva ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Brain Network ◽  
Semantic Dementia ◽  
Everyday Lives ◽  
The Mind ◽  
The Brain ◽  
Cognitive Meaning ◽  
Lobe Atrophy

Phobias are among the few intensely fearful experiences we regularly have in our everyday lives, yet the brain basis of phobic responses remains incompletely understood. Here we describe the case of a 71-year-old patient with a typical clinicoanatomical syndrome of semantic dementia led by selective (predominantly right-sided) temporal lobe atrophy, who showed striking amelioration of previously disabling claustrophobia following onset of her cognitive syndrome. We interpret our patient’s newfound fearlessness as an interaction of damaged limbic and autonomic responsivity with loss of the cognitive meaning of previously threatening situations. This case has implications for our understanding of brain network disintegration in semantic dementia and the neurocognitive basis of phobias more generally.

Confronting the grey zone after severe brain injury

2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen
Keyword(s):  
Brain Injury ◽  
Ethical Issues ◽  
Vegetative State ◽  
Clinical Care ◽  
Grey Zone ◽  
Severe Brain Injury ◽  
New Methods ◽  
Legal Decision Making ◽  
Technological Developments ◽  
The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy
Keyword(s):  
College Students ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sense Of Self ◽  
Scientific Evidence ◽  
Sudden Onset ◽  
Lessons Learned ◽  
Speech Language Pathologists ◽  
The Brain ◽  
Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

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