scholarly journals Brain MRI findings in relation to clinical characteristics and outcome of tuberculous meningitis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241974
Author(s):  
Sofiati Dian ◽  
Robby Hermawan ◽  
Arjan van Laarhoven ◽  
Sofia Immaculata ◽  
Tri Hanggono Achmad ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
Brain Infarction ◽  
Brain Mri ◽  
Brain Lesion ◽  
Response To Treatment ◽  
P Value ◽  
Mri Findings ◽  
Meningeal Enhancement ◽  
Grade Ii ◽  
Magnetic Resonance Imaging Mri

Neuroradiological abnormalities in tuberculous meningitis (TBM) are common, but the exact relationship with clinical and inflammatory markers has not been well established. We performed magnetic resonance imaging (MRI) at baseline and after two months treatment to characterise neuroradiological patterns in a prospective cohort of adult TBM patients in Indonesia. We included 48 TBM patients (median age 30, 52% female, 8% HIV-infected), most of whom had grade II (90%), bacteriologically confirmed (71%) disease, without antituberculotic resistance. Most patients had more than one brain lesion (83%); baseline MRIs showed meningeal enhancement (89%), tuberculomas (77%), brain infarction (60%) and hydrocephalus (56%). We also performed an exploratory analysis associating MRI findings to clinical parameters, response to treatment, paradoxical reactions and survival. The presence of multiple brain lesion was associated with a lower Glasgow Coma Scale and more pronounced motor, lung, and CSF abnormalities (p-value <0.05). After two months, 33/37 patients (89%) showed worsening of MRI findings, mostly consisting of new or enlarged tuberculomas. Baseline and follow-up MRI findings and paradoxical responses showed no association with six-month mortality. Severe TBM is characterized by extensive MRI abnormalities at baseline, and frequent radiological worsening during treatment.

Relevance of hypointense brain MRI lesions for long-term worsening of clinical disability in relapsing multiple sclerosis

2013 ◽  
Vol 20 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Antonio Giorgio ◽  
Maria Laura Stromillo ◽  
Maria Letizia Bartolozzi ◽  
Francesca Rossi ◽  
Marco Battaglini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Mri ◽  
Univariate Analysis ◽  
Brain Lesion ◽  
Brain Magnetic Resonance Imaging ◽  
Stepwise Multiple Regression ◽  
Lesion Volume ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Remitting Multiple Sclerosis

Background: The accrual of brain focal pathology is considered a good substrate of disability in relapsing–remitting multiple sclerosis (RRMS). However, knowledge on long-term lesion evolution and its relationship with disability progression is poor. Objective: The objective of this paper is to evaluate in RRMS the long-term clinical relevance of brain lesion evolution. Methods: In 58 RRMS patients we acquired, using the same scanner and protocol, brain magnetic resonance imaging (MRI) at baseline and 10±0.5 years later. MRI data were correlated with disability changes as measured by the Expanded Disability Status Scale (EDSS). Results: The annualized 10-year lesion volume (LV) growth was +0.25±0.5 cm3 (+6.7±8.7%) for T2-weighted (T2-W) lesions and +0.20±0.31 cm3 (+11.5±12.3%) for T1-weighted (T1-W) lesions. The univariate analysis showed moderate correlations between baseline MRI measures and EDSS at 10 years ( p < 0.001). Also, 10-year EDSS worsening correlated with LV growth and the number of new/enlarging lesions measured over the same period ( p < 0.005). In the stepwise multiple regression analysis, EDSS worsening over 10 years was best correlated with the combination of baseline T1-W lesion count and increasing T1-W LV ( R = 0.61, p < 0.001). Conclusion: In RRMS patients, long-term brain lesion accrual is associated with worsening in clinical disability. This is particularly true for hypointense, destructive lesions.

scholarly journals Bilateral Medial Medullary Stroke: A Challenge in Early Diagnosis

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Amir M. Torabi
Keyword(s):  
Cervical Spine ◽  
Early Diagnosis ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Mri Findings ◽  
Rare Type ◽  
Abnormal Signal ◽  
Acute Vestibular Syndrome ◽  
Spine Mr ◽  
Magnetic Resonance Imaging Mri

Bilateral medial medullary stroke is a very rare type of stroke, with catastrophic consequences. Early diagnosis is crucial. Here, I present a young patient with acute vertigo, progressive generalized weakness, dysarthria, and respiratory failure, who initially was misdiagnosed with acute vestibular syndrome. Initial brain magnetic resonance imaging (MRI) that was done in the acute phase was read as normal. Other possibilities were excluded by lumbar puncture and MRI of cervical spine. MR of C-spine showed lesion at medial medulla; therefore a second MRI of brain was requested, showed characteristic “heart appearance” shape at diffusion weighted (DWI), and confirmed bilateral medial medullary stroke. Retrospectively, a vague-defined hyperintense linear DWI signal at midline was noted in the first brain MRI. Because of the symmetric and midline pattern of this abnormal signal and similarity to an artifact, some radiologists or neurologists may miss this type of stroke. Radiologists and neurologists must recognize clinical and MRI findings of this rare type of stroke, which early treatment could make a difference in patient outcome. The abnormal DWI signal in early stages of this type of stroke may not be a typical “heart appearance” shape, and other variants such as small dot or linear DWI signal at midline must be recognized as early signs of stroke. Also, MRI of cervical spine may be helpful if there is attention to brainstem as well.

scholarly journals Unusual neurological manifestations of bilateral medial medullary infarction: A case report

Open Medicine ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. 119-123
Author(s):  
Ruizhi Zheng ◽  
Ting Zhang ◽  
Xianzhu Zeng ◽  
Miao Yu ◽  
Zhao Jin ◽  
...  
Keyword(s):  
Early Stage ◽  
Brain Mri ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Rare Type ◽  
Acute Ischemic Stroke Patient ◽  
Medial Medullary Infarction ◽  
Functional Consequences ◽  
Magnetic Resonance Imaging Mri ◽  
Medullary Infarction

Abstract Bilateral medial medullary infarction (BMMI) is an extremely rare type of cerebrovascular accident often resulting in poor functional consequences. “Heart appearance” on diffusion-weighted imaging (DWI) of magnetic resonance imaging (MRI) is the unique presentation of BMMI. In this article, we present an acute ischemic stroke patient whose brain MRI showed the atypical “heart appearance” sign, manifested unusual bilateral central facial paralysis concurrently. For an early diagnosis of BMMI, it is essential to recognize the characteristic clinical and MRI findings of this rare type of stroke. Abnormal small dot or linear DWI signal at the midline of the brainstem should not be ignored at the early stage of stroke.

scholarly journals Intracranial meningioma in a pet rat: MRI findings

2021 ◽  
Author(s):  
C Cococcetta ◽  
F Del Signore ◽  
I Cerasoli ◽  
G Di Guardo ◽  
M Baffoni ◽  
...  
Keyword(s):  
Brain Mri ◽  
Granular Cell ◽  
Intracranial Meningioma ◽  
Granular Cell Tumour ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Axial Mass ◽  
Brain Compression ◽  
Magnetic Resonance Imaging Mri ◽  
Well Differentiated

We herein report the magnetic resonance imaging (MRI) findings in a brain meningioma in a pet rat (Rattus norvegicus domestica). A 1.5-year-old pet rat was referred for depression, ataxia, tremors and bilateral nystagmus; a brain MRI was elected suspecting an intracranial neoplasia. The study was performed with a 0.25 T scanner. The MRI revealed a well-defined oval mass with a heterogeneous appearance, hyperintense in T1 and T2, and with extra-axial localisation and severe brain compression, the mass appeared strongly and diffusely contrast-enhancing. Euthanasia was elected, with the necropsy confirming the presence of a voluminous extra-axial mass. Histologically, a well-differentiated, benign meningotheliomatous meningioma was diagnosed, with the histochemical stains allowing one to exclude a granular cell tumour. To the best of our knowledge, this is the first report of MRI investigations on a pet rat intracranial meningioma.

scholarly journals Brain MRI in SARS-CoV-2 pneumonia patients with newly developed neurological manifestations suggestive of brain involvement

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Batil Alonazi ◽  
Ahmed M. Farghaly ◽  
Mohamed A. Mostafa ◽  
Jehad A. Al-Watban ◽  
Salah A. Zindani ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Magnetic Resonance Imaging ◽  
Neurological Manifestations ◽  
Rt Pcr ◽  
Significant Difference ◽  
Brain Involvement ◽  
Magnetic Resonance Imaging Mri ◽  
The Impact

AbstractThe increased frequency of neurological manifestations, including central nervous system (CNS) manifestations, in patients with coronavirus disease 2019 (COVID-19) pandemic is consistent with the virus's neurotropic nature. In most patients, brain magnetic resonance imaging (MRI) is a sensitive imaging modality in the diagnosis of viral encephalitides in the brain. The purpose of this study was to determine the frequency of brain lesion patterns on brain MRI in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia patients who developed focal and non-focal neurological manifestations. In addition, it will compare the impact of the Glasgow Coma Scale (GCS) as an index of deteriorating cerebral function on positive brain MRIs in both neurological manifestations. This retrospective study included an examination of SARS-CoV-2 pneumonia patients with real-time reverse transcription polymerase chain reaction (RT-PCR) confirmation, admitted with clinicoradiologic evidence of COVID-19 pneumonia, and who were candidates for brain MRI due to neurological manifestations suggesting brain involvement. Brain imaging acquired on a 3.0 T MRI system (Skyra; Siemens, Erlangen, Germany) with a 20-channel receive head coil. Brain MRI revealed lesions in 38 (82.6%) of the total 46 patients for analysis and was negative in the remaining eight (17.4%) of all finally enclosed patients with RT-PCR confirmed SARS-CoV-2 pneumonia. Twenty-nine (63%) patients had focal neurological manifestations, while the remaining 17 (37%) patients had non-focal neurological manifestations. The patients had a highly significant difference (p = 0.0006) in GCS, but no significant difference (p = 0.4) in the number of comorbidities they had. Brain MRI is a feasible and important imaging modality in patients with SARS-CoV-2 pneumonia who develop neurological manifestations suggestive of brain involvement, particularly in patients with non-focal manifestations and a decline in GCS.

scholarly journals Evaluation of Brain Magnetic Resonance Imaging (MRI) Findings of Neonates with Clinical Seizure Admitted to Yazd Shahid Sadoughi Hospital and its Effect on Diagnostic and Therapeutic Interventions of Newborns from 2015-2016

2020 ◽  
Author(s):  
Razieh Fallah ◽  
Mohammad Javad Asadi ◽  
Reza Nafisi Moghadam ◽  
Mohammad Hossein Ahrar Yazdi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Common Type ◽  
Therapeutic Interventions ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Clinical Seizure ◽  
Magnetic Resonance Imaging Mri ◽  
Abnormal Brain

Introduction: In neonatal period, brain magnetic resonance imaging (MRI) is the best neuroimaging to find etiology of seizure. The aim of this study was to evaluate brain MRI findings of neonates with clinical seizure and its effect on diagnostic and therapeutic interventions of newborn. Methods: In a retrospective study, medical records and brain MRI findings of neonates with clinical seizure admitted to Neonatal Intensive Care Unit or Pediatric Ward of Shahid Sadoughi Hospital, Yazd, Iran from September 2018 and before were evaluated. The data were analyzed using SPSS version 16 software , the required indicators and tables were prepared and Fisher exact test and Chi-square test were used to determine the relationship between qualitative variables and independent t-test was used to compare the means in the two groups Results: Twenty-five girls and 38 boys were studied. The cause of seizures was found in 94% and the most common cause of congenital hypoxia was in 22 infants (35%). The most common type of seizure was tonic in 23 infants (36.5%) and the most common type of generalized seizure was in 47 infants (75%). Brain MRI was abnormal in 19 neonates (30%). Based on the MRI results, there was a change in therapeutic interventions (brain surgery) in four infants (6.3%) and in diagnostic interventions (metabolic tests) in 19 infants (30%). Abnormal brain MRI was more frequent in neonates by cesarean section (46%)  than  normal vaginal delivery (19%), (p= 0.01) and also neonates with partial seizure (37.5%) had an abnormal MRI than  generalized seizure (21%), (p= 0.03). Mean of hospitalization days was longer in neonates with abnormal brain MRI (12.32±2.76 days) than neonates with normal MRI (8.57±2.82 days) (P = 0.02). Conclusion: Based on the results of this study, brain MRI might be useful in finding intracranial pathology that causes seizure in neonates by cesarean section to detect birth asphyxia and in newborns with partial seizure.  

Pontine Tegmentum Lesions Accompanying Myelitis During an Enterovirus Outbreak: Differential Diagnosis and Outcome

2020 ◽  
Vol 35 (8) ◽  
pp. 501-508
Author(s):  
Mehmet Bastemur ◽  
Rahsan Gocmen ◽  
Safak Parlak ◽  
Deniz Yuksel ◽  
Elif Acar Arslan ◽  
...  
Keyword(s):  
Brain Mri ◽  
Prognostic Significance ◽  
Mri Findings ◽  
Acute Flaccid Myelitis ◽  
Pontine Tegmentum ◽  
Etiologic Agents ◽  
Spinal Mri ◽  
Polymerase Chain ◽  
Magnetic Resonance Imaging Mri

Aim: To investigate etiology and prognostic significance of pontine tegmentum lesions accompanying a cluster of acute flaccid myelitis. Method: We retrospectively examined patients from 6 centers in Turkey who manifested encephalitis or myelitis associated with dorsal pontine lesions on magnetic resonance imaging (MRI) between July 2018 and February 2019. Results: Twenty-two patients were evaluated. Ten of 22 (45%) presented with acute paralysis and 12 of 22 (55%) with brainstem symptoms only. Reverse transcription polymerase chain reaction for enterovirus was positive in 2 patients’ respiratory tract. Other etiologic factors were detected in 10 cases. On follow-up, patients presenting with symptoms of myelitis developed motor sequalae although spinal cord lesions on MRI resolved in 5 of 9 (55%). Encephalitic symptoms, present in 17 cases, recovered in 13 (76%), and brain MRI showed complete or near-complete resolution in 11 of 14 (78%). Conclusion: Various etiologic agents can be detected in patients with pontine involvement, even in a series collected during an outbreak of EV-D68. Encephalitis has a fair outcome but clinical recovery is slow and motor sequalae are frequent in spinal involvement, irrespective of follow-up spinal MRI findings.

scholarly journals Congenital Oligodendroglioma: Clinicopathologic and Molecular Assessment with Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Hope Richard ◽  
Kimberly Stogner-Underwood ◽  
Christine Fuller
Keyword(s):  
Male Infant ◽  
Low Grade ◽  
Mri Findings ◽  
Isocitrate Dehydrogenase 1 ◽  
Who Grade ◽  
Microscopic Appearance ◽  
Grade Ii ◽  
Molecular Assessment ◽  
Magnetic Resonance Imaging Mri

Oligodendroglioma is an infiltrating glial neoplasm frequently seen in adults. Pediatric oligodendrogliomas are rare, with very few cases presenting in infancy and only rare congenital examples. In contrast to adult oligodendrogliomas, pediatric cases typically lack 1p/19q codeletion. Herein we report a case of WHO grade II oligodendroglioma diagnosed in a 7-month-old male infant. The patient initially presented at 3 months of age with symptoms suspicious for seizure. Initial workup including electroencephalography (EEG), electrocardiogram (EKG), and computed tomography (CT) of the head was negative. His symptoms persisted, and subsequent magnetic resonance imaging (MRI) performed at age of 7 months revealed a 2 cm contrast-enhancing left temporal lobe mass. The mass was excised and the microscopic appearance was that of a classic low grade oligodendroglioma composed of cells with uniformly round nuclei, perinuclear halos, delicate branching capillaries, and an absence of high grade features. Mutant specific (R132H) isocitrate dehydrogenase-1 (IDH1) immunohistochemistry was negative, and the tumor lacked detectable 1p or 19q deletions by fluorescent in situ hybridization (FISH). The onset of neurological symptoms in early infancy followed by the positive MRI findings suggests that this case represents a rare example of congenital oligodendroglioma.

Abstract T P362: Prevalence and Clinicoradiological Profile of Japanese Patients with Alzheimer Disease Coexisting Multiple Microbleeds

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Ken Ikeda ◽  
Takehisa Hirayama ◽  
Takanori Takazawa ◽  
Testuhito Kiyozuka ◽  
Masaru Yanagihashi ◽  
...  
Keyword(s):  
White Matter ◽  
Brain Mri ◽  
Japanese Patients ◽  
Brain Parenchyma ◽  
Rapid Progression ◽  
Amyloid Angiopathy ◽  
Mri Findings ◽  
Age Related ◽  
Magnetic Resonance Imaging Mri ◽  
Severe Degree

Background: Pathological findings of cerebral amyloid angiopathy (CAA) and Alzheimer’s disease (AD) coexist frequently. Both diseases are associated with β-amyloid deposition and dementia. We aimed to evaluate frequency and clinicoradiological profile of AD patients with multiple microbleeds (MBs) Methods: We reviewed clinical charts and magnetic resonance imaging (MRI) findings in patients with probable AD from 2009 to 2012, according to the DSM-IV. Brain MRI was performed at 1.5 T using protocols, including T2*-weighted gradient-echo or susceptibility-weighted imaging. MBs were defined as rounded, hypointense foci ≤ 10 mm in size in the brain parenchyma. MBs topography was divided into the lobar (L) and the deep/infratentorial (D/I) region. Multiple MBs were defined as the number ≥ 8 in the L or the D/I territory. White matter hyperintensities (WMH) were assessed using the age-related white matter changes scale. Clinicoradiological findings were examined for ≥ 1 year. Prevalence and clinicoradiological profiles were studied in patients with multiple L MBs or multiple D/I MBs. Results: Five hundred fifty patients (238 men and 312 women) were participated in the present study. Mean age (SD) was 78.4 (7.7) years, 78.3 (8.1) in men and 78.6 (7.5) in woman. A total of 132 patients (55 men and 78 women) had at least MB. Prevalence of total MBs was 24.0%, 23.1 in men and 25.0 in women. Multiple L MBs existed in 49 patients (8.9%), 15 men (6.3) and 34 women (10.9). Multiple D/I MBs were found in 44 patients (8.0%), 23 men (9.7) and 21 women (6.7). Clinical profiles of multiple L MBs revealed sudden deterioration, rapid progression, non-hypertension, higher rates of symptomatic subcortical hemorrhage and onset of CAA-associated leukoencephalopathy. Radiological hallmarks exhibited increased number and size of MBs, high score of WMH and asymptomatic subcortical hemorrhage. Clinicoradiological features of multiple D/I MBs exhibited higher rates of hypertension and variable degrees of WMH. Conclusions: The present study indicated that prevalence of multiple MBs was 16.9% in Japanese patients with AD. The clinicoradiological profile suggested severe degree of CAA in patients with multiple L MBs (8.9%) and hypertensive changes in patients with multiple D/I MBs (8.0%).

scholarly journals Discontinuing prophylactic transfusions increases the risk of silent brain infarction in children with sickle cell disease: data from STOP II

Blood ◽  
2011 ◽  
Vol 118 (4) ◽  
pp. 894-898 ◽  
Author(s):  
Miguel R. Abboud ◽  
Eunsil Yim ◽  
Khaled M. Musallam ◽  
Robert J. Adams ◽  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Brain Infarction ◽  
Brain Mri ◽  
High Rate ◽  
Study Entry ◽  
Normal Brain ◽  
Cell Disease ◽  
Silent Brain Infarction ◽  
Magnetic Resonance Imaging Mri

Abstract In the STOP II trial, discontinuation of prophylactic transfusions in high risk children with sickle cell disease (SCD) resulted in a high rate of reversion to abnormal blood-flow velocities on transcranial Doppler (TCD) ultrasonography and strokes. We analyzed data from STOP II to determine the effect of discontinuing transfusions on the development or progression of silent brain infarcts on magnetic resonance imaging (MRI). At study entry, 21 of 79 (27%) patients had evidence of silent infarcts. There were no statistically significant differences in baseline characteristics between patients with normal brain MRI or silent infarcts at study entry. At study end, 3 of 37 (8.1%) patients in the continued-transfusion group developed new brain MRI lesions compared with 11 of 40 (27.5%) in the transfusion-halted group (P = .03). The total number of lesions remained essentially unchanged decreasing from 25 to 24 in the continued-transfusion group while increasing from 27 to 45 in transfusion-halted patients. Thus, discontinuation of transfusions in children with SCD and abnormal TCD who revert to low-risk increases the risk of silent brain infarction. Together with data from STOP, these findings demonstrate that transfusions prevent the development of silent infarcts in patients with SCD and abnormal TCD but normal MRA.

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