scholarly journals Severe apathy due to injury of prefronto-caudate tract

2019 ◽  
Vol 10 (1) ◽  
pp. 157-159
Author(s):  
Sung Ho Jang ◽  
Hyeok Gyu Kwon
Keyword(s):  
Prefrontal Cortex ◽  
Caudate Nucleus ◽  
Attempted Suicide ◽  
Diffusion Tensor ◽  
Carbon Monoxide Poisoning ◽  
Brodmann Area ◽  
Ischemic Brain Injury ◽  
Mr Images ◽  
Ischemic Brain ◽  
Brain Mr Images

AbstractThe caudate nucleus, which is vulnerable to hypoxic–ischemic brain injury (HI-BI), is important to cognitive function because it is connected to the prefrontal cortex. Using diffusion tensor tractography (DTT), no study on injury of the prefronto-caudate tract in a patient with HI-BI has been reported so far. Here, we report a patient with severe apathy who showed injury of the prefronto-caudate tract following HI-BI, which was demonstrated by DTT. A 38-year-old female patient suffered HI-BI induced by carbon monoxide poisoning following attempted suicide for a period of approximately four hours. From the onset, the patient showed severe apathy (7 months after onset-the Apathy Scale score was 24 [full score: 42]). Brain MR images taken at seven months after onset showed no abnormality. On 7-month DTT, the neural connectivity of the caudate nucleus to the medial prefrontal cortex (Brodmann area: 10 and 12) and orbitofrontal cortex (Brodmann area: 11 and 13) was decreased in both hemispheres. Using DTT, injury of the prefronto-caudate tract was demonstrated in a patient who showed severe apathy following HI-BI. We believe that injury of the prefronto-caudate tract might be a pathogenetic mechanism of apathy in patients with HI-BI.

Neural tracts injuries in patients with hypoxic ischemic brain injury: Diffusion tensor imaging study

2012 ◽  
Vol 528 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Ah Young Lee ◽  
Dong-Gu Shin ◽  
Jong-Seon Park ◽  
Geu Ru Hong ◽  
Pyung-Hun Chang ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Brain Injury ◽  
Diffusion Tensor ◽  
Imaging Study ◽  
Ischemic Brain Injury ◽  
Ischemic Brain ◽  
Hypoxic Ischemic Brain Injury ◽  
Diffusion Tensor Imaging Study

scholarly journals Relationship Between Injured Cingulum and Impaired Consciousness in Patients with Hypoxic-Ischemic Brain Injury

2021 ◽  
Author(s):  
SungHO Jang ◽  
YOUSUNG SEO
Keyword(s):  
Brain Injury ◽  
Diffusion Tensor ◽  
Control Group ◽  
Ischemic Brain Injury ◽  
Impaired Consciousness ◽  
Ischemic Brain ◽  
Group A ◽  
Hypoxic Ischemic Brain Injury ◽  
Group B ◽  
The Relationship

Abstract Objectives We investigated the relationship between cingulum injury and impaired consciousness in patients with hypoxic-ischemic brain injury (HI-BI) by using diffusion tensor tractography (DTT). Methods We recruited 29 patients with HI-BI and 25 normal control subjects. The patients were classified as intact consciousness (group A, 13 patients) or impaired consciousness (group B, 16 patients). The DTT parameters of fractional anisotropy (FA) and tract volume (TV) were estimated for both cinguli. Glasgow Coma Scale (GCS) and Coma Recovery Scale-Revised (CRS-R) scores were also evaluated. Results The FA and TV values of the cinguli in groups A and B were lower than those of the control group (p < 0.05), and the FA and TV values of group B were lower than those of group A (p < 0.05). The FA and TV values of the cinguli in group A were not significantly correlated with GCS and CRS-R scores (p > 0.05); however, regarding the group B, the FA correlations with GCS (r = 0.457, p < 0.05) and CRS-R (r = 0.494, p < 0.05) and those of TV with GCS (r = 0.500, p < 0.05) and CRS-R (r = 0.491, p < 0.05) were moderately positive. Conclusions We found a significant relationship between injury of the cingulum and impaired consciousness in patients with HI-BI. Our results suggest that an injured cingulum could be an appropriate target for neurointervention or neurorehabilitation in patients with impaired consciousness following HI-BI.

Automatic Segmentation of the Caudate Nucleus From Human Brain MR Images

2007 ◽  
Vol 26 (4) ◽  
pp. 509-517 ◽  
Author(s):  
Yan Xia ◽  
Keith Bettinger ◽  
Lin Shen ◽  
Allan L. Reiss
Keyword(s):  
Human Brain ◽  
Caudate Nucleus ◽  
Automatic Segmentation ◽  
Mr Images ◽  
Brain Mr Images

scholarly journals Near-hanging with outliving period: Pathoforensic aspects

2012 ◽  
Vol 140 (3-4) ◽  
pp. 198-203
Author(s):  
Vladimir Zivkovic ◽  
Slobodan Nikolic
Keyword(s):  
Prognostic Factors ◽  
Causes Of Death ◽  
Attempted Suicide ◽  
Cardiopulmonary Arrest ◽  
Deep Coma ◽  
Ischemic Brain Injury ◽  
Autopsy Study ◽  
Ischemic Brain ◽  
Police Reports ◽  
Hard Structures

Introduction. Hanging usually ends in death, and about 80% of victims are found dead at the scene of the hanging. However, sometimes the hanging victims overlive for some time, and sometimes even survive the hanging. Objective. The aim was to determine the causes of death in nearhanging cases, in people who have been outliving hanging for some time, to explain the pathophysiological mechanisms leading to death, and to identify prognostic factors for this outcome. Methods. Retrospective autopsy study was performed for a twelve-year period. There were only seven cases of near hanging. The sample was analyzed according to gender, age, circumstances of death, and autopsy findings of all observed subjects. The relevant data were collected from autopsy records, police reports and heteroanamnestic interviews. Results. The sample consisted of five men and two women, average age 48.3?19.9 years (29-81 years). The average outliving period was 3.8?2.6 days (from 7 hours to 7 days). Six people were admitted to hospital in the state of deep coma. In six cases cardiopulmonary arrest occurred after the hanging attempt and all were reanimated for a shorter or longer time until admission at hospital. Conclusion. Survival after attempted suicide by hanging occurs extremely rarely. In all the cases, the immediate cause of death after attempted hanging was ischemic brain injury, with a significant and pronounced oedema. In all the cases observed, regardless of the presence or absence of injuries of soft and hard structures of the neck, there was a ligature mark on the neck skin. Acute hemorrhagic gastritis with melaena was present in a significant number of reported cases of near-hanging.

Normal cerebral ventricular volume growth in childhood

2020 ◽  
Vol 26 (5) ◽  
pp. 517-524
Author(s):  
Noah S. Cutler ◽  
Sudharsan Srinivasan ◽  
Bryan L. Aaron ◽  
Sharath Kumar Anand ◽  
Michael S. Kang ◽  
...  
Keyword(s):  
Brain Mri ◽  
Volume Growth ◽  
Ventricular Volume ◽  
Growth Patterns ◽  
Diagnostic Process ◽  
Growth Charts ◽  
Normal Brain ◽  
Mr Images ◽  
Ventricular Volumes ◽  
Brain Mr Images

OBJECTIVENormal percentile growth charts for head circumference, length, and weight are well-established tools for clinicians to detect abnormal growth patterns. Currently, no standard exists for evaluating normal size or growth of cerebral ventricular volume. The current standard practice relies on clinical experience for a subjective assessment of cerebral ventricular size to determine whether a patient is outside the normal volume range. An improved definition of normal ventricular volumes would facilitate a more data-driven diagnostic process. The authors sought to develop a growth curve of cerebral ventricular volumes using a large number of normal pediatric brain MR images.METHODSThe authors performed a retrospective analysis of patients aged 0 to 18 years, who were evaluated at their institution between 2009 and 2016 with brain MRI performed for headaches, convulsions, or head injury. Patients were excluded for diagnoses of hydrocephalus, congenital brain malformations, intracranial hemorrhage, meningitis, or intracranial mass lesions established at any time during a 3- to 10-year follow-up. The volume of the cerebral ventricles for each T2-weighted MRI sequence was calculated with a custom semiautomated segmentation program written in MATLAB. Normal percentile curves were calculated using the lambda-mu-sigma smoothing method.RESULTSVentricular volume was calculated for 687 normal brain MR images obtained in 617 different patients. A chart with standardized growth curves was developed from this set of normal ventricular volumes representing the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles. The charted data were binned by age at scan date by 3-month intervals for ages 0–1 year, 6-month intervals for ages 1–3 years, and 12-month intervals for ages 3–18 years. Additional percentile values were calculated for boys only and girls only.CONCLUSIONSThe authors developed centile estimation growth charts of normal 3D ventricular volumes measured on brain MRI for pediatric patients. These charts may serve as a quantitative clinical reference to help discern normal variance from pathologic ventriculomegaly.

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