scholarly journals Sudden Death of a Young Man by Acute Hemorrhagic Leukoencephalitis

2017 ◽  
Vol 7 (3) ◽  
pp. 487-493 ◽  
Author(s):  
Raheem Peerani ◽  
Meredith Berggren ◽  
Jayantha C. Herath
Keyword(s):  
White Matter ◽  
Clinical History ◽  
Left Thigh ◽  
Singular Set ◽  
Fatal Complication ◽  
External Examination ◽  
Acute Hemorrhagic Leukoencephalitis ◽  
The Brain ◽  
Microscopic Findings ◽  
Gross Examination

We report a case of acute hemorrhagic leukoencephalitis in an adult man with a prodrome of “feeling unwell” two days prior to this death. At autopsy, external examination revealed minor external injuries including contusions on the scalp and left thigh and abrasions on the forehead and right eyebrow. Gross examination of the brain after coronal sectioning revealed multiple petechial hemorrhages in the white matter in the cerebral hemispheres, corpus callosum, basal ganglia, brainstem, and cerebellum. Microscopic examination of these lesions revealed demyelination, hemorrhage, and necrosis with fibrin exudation in a perivenular distribution with radial extension into the white matter. The remainder of the autopsy was unremarkable. This case highlights the death of a young man by a rare fatal complication of a natural disease only identified by a singular set of gross and microscopic findings at autopsy in circumstances that would otherwise suggest a nonnatural death. The case demonstrates the importance of a thorough autopsy in settings where the clinical history, scene, and circumstances may be misleading or absent.

Pediatric Acute Hemorrhagic Leukoencephalitis (Weston-Hurst syndrome): A Rare Entity

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S38-S38
Author(s):  
H Tomac Pavosevic ◽  
S Zaheer ◽  
G M Kleinman
Keyword(s):  
White Matter ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Biopsy ◽  
Acute Disseminated Encephalomyelitis ◽  
Small Vessel Vasculitis ◽  
Hyperintense Lesion ◽  
Acute Hemorrhagic Leukoencephalitis ◽  
Brain White Matter ◽  
The Brain

Abstract Introduction/Objective Acute hemorrhagic leukoencephalitis (Weston-Hurst syndrome) is a rare, fulminant inflammatory hemorrhagic demyelination of the brain white matter, and it is considered to be the most severe form of acute disseminated encephalomyelitis (ADEM). Herein we describe a case of 6-year-old boy presenting with elevated intracranial pressure and uncal herniation. Brain MRI showed a large right temporoparietal T2 hyperintense lesion with edema, abnormal perivascular enhancement and midline shift. Emergent decompressive craniotomy with brain biopsy was performed. Results H&E sections of the brain lesion revealed neutrophilic small vessel vasculitis with extravasation of blood and fibrin. Predominantly in a perivascular distribution were infiltrates of neutrophils and in areas foamy macrophages. Additionally, the white matter was studded with hemorrhages of varying size. Sections stained with Luxol Fast Blue for myelin and with a neurofilament immunostain for axons were compared to reveal selective perivascular loss of myelin with relative sparing of axons. Conclusion The constellation of acute hemorrhages, neutrophilic infiltration and selective loss of myelin with relative sparing of axons is characteristic of this exceptional, hyperacute variant of acute disseminated encephalomyelitis. Histomorphologic diagnosis is characteristic and may be crucial for timely decision for treatment of this often fatal disease.

scholarly journals Fungal pyogranulomatous encephalitis in a dog with leishmaniosis

2006 ◽  
Vol 36 (4) ◽  
pp. 1325-1327
Author(s):  
Gisele Fabrino Machado ◽  
Rosemeri de Oliveira Vasconcelos ◽  
Maria Cecília Rui Luvizotto ◽  
Terezinha Cristina Cândido
Keyword(s):  
White Matter ◽  
Frontal Cortex ◽  
Histopathological Examination ◽  
Giant Cells ◽  
Cortical Areas ◽  
One Year ◽  
The Right ◽  
The Brain ◽  
Cut Surface ◽  
Gross Examination

A case of pyogranulomatous micotic encephalitis in a one-year old, female, Fila Brasileiro dog is reported. Gross examination of the cerebrum revealed a softened haemorrhagic area in the right frontal cortex and on the cut surface of the left hemisphere, which affected the white matter and deep cortical areas. The diagnosis of multifocal mycotic pyogranulomatous encephalitis was obtained by the histopathological examination, which showed the presence of macrophages, giant cells, haemorrhage and brownish septate hyphae diffusely distributed within the tissue and invading vessel lumina. Identification of amastigotes forms in popliteus lymphonode imprint confirmed infection by Leishmania sp. Mycotic infection in the brain of this dog was related to a concurrent leishmaniosis, an immunosuppressive disease.

scholarly journals Cautery Disbudding Iron Application Time and Brain Injury in Goat Kids: A Pilot Study

2021 ◽  
Vol 7 ◽  
Author(s):  
Melissa N. Hempstead ◽  
Jan K. Shearer ◽  
Mhairi A. Sutherland ◽  
Jennifer L. Fowler ◽  
Joseph S. Smith ◽  
...  
Keyword(s):  
Brain Injury ◽  
White Matter ◽  
Pilot Study ◽  
Primary Concern ◽  
State University ◽  
Application Time ◽  
Mr Images ◽  
Iowa State University ◽  
The Brain ◽  
Gross Examination

Cautery disbudding is a painful procedure performed on goat kids to prevent horn growth that may result in brain injury. Thermal damage to the cerebral cortex of the brain and subsequent neurologic disease is a primary concern. Cautery iron application time may affect transmission of heat to the brain; however, research in this area is scarce. Therefore, the objective of this pilot study was to evaluate the effect of iron application time on brain injury of goat kids. A total of six buck and doe kids <9 days of age were obtained from a commercial dairy and transported to an Iowa State University research facility. Kids received a different randomly assigned application time (5, 10, 15, or 20s) on each horn bud. Kids were disbudded using an electric cautery iron (under isoflurane general anesthesia). After a 5-day observation period, the kids were euthanized, and magnetic resonance (MR) images were acquired to evaluate brain injury. Additionally, four of the six kids were presented for gross examination and two kids were selected for histopathologic examination. From the MR images, white matter edema was observed subjacent to four treated areas, representing application times of 5 s (one horn bud), 15 s (one horn bud), and 20 s (two horn buds). With the exception of the horn bud that received 5 s, which had white matter edema restricted to a single gyrus, the remaining three groups had a branching region of edema. No bone abnormalities were identified on any kids. Gross evidence of discoloration and hemorrhage on the cerebral hemispheres was observed on two horn buds that received 20 s, two horn buds that received 15 s, and one horn bud that received 10 s. Microscopic lesions consisting of leptomeningeal and cerebrocortical necrosis were observed in sections of brain from all groups. Lesions were most severe with 20 s. In conclusion, all application times used in this study resulted in some level of brain injury; however, using 15 s or more resulted in more severe and consistent brain injury. These results indicate that extended iron application time may increase the risk of brain injury in cautery disbudded kids.

Characterization of Ischemic Stroke in CT Images using Image Processing

2017 ◽  
Vol 7 (9) ◽  
pp. 18
Author(s):  
Amal Alzain ◽  
Suhaib Alameen ◽  
Rani Elmaki ◽  
Mohamed E. M. Gar-Elnabi
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Classification Accuracy ◽  
Ct Images ◽  
Gray Level ◽  
Level Variation ◽  
Interactive Data ◽  
The Brain ◽  
Brain Tissues

This study concern to characterize the brain tissues to ischemic stroke, gray matter, white matter and CSF using texture analysisto extract classification features from CT images. The First Order Statistic techniques included sevenfeatures. To find the gray level variation in CT images it complements the FOS features extracted from CT images withgray level in pixels and estimate the variation of thesubpatterns. analyzing the image with Interactive Data Language IDL software to measure the grey level of images. The results show that the Gray Level variation and   features give classification accuracy of ischemic stroke 97.6%, gray matter95.2%, white matter 97.3% and the CSF classification accuracy 98.0%. The overall classification accuracy of brain tissues 97.0%.These relationships are stored in a Texture Dictionary that can be later used to automatically annotate new CT images with the appropriate brain tissues names.

What Has Direct Cortical and Subcortical Electrostimulation Taught Us about Neurolinguistics?

2019 ◽  
pp. 185-211
Author(s):  
Hugues Duffau
Keyword(s):  
White Matter ◽  
Large Scale ◽  
Functional Neuroimaging ◽  
Great Accuracy ◽  
Subcortical White Matter ◽  
Cerebral Lesions ◽  
Physiological Basis ◽  
Postoperative Mri ◽  
The Brain

Investigating the neural and physiological basis of language is one of the most important challenges in neurosciences. Direct electrical stimulation (DES), usually performed in awake patients during surgery for cerebral lesions, is a reliable tool for detecting both cortical and subcortical (white matter and deep grey nuclei) regions crucial for cognitive functions, especially language. DES transiently interacts locally with a small cortical or axonal site, but also nonlocally, as the focal perturbation will disrupt the entire subnetwork sustaining a given function. Thus, in contrast to functional neuroimaging, DES represents a unique opportunity to identify with great accuracy and reproducibility, in vivo in humans, the structures that are actually indispensable to the function, by inducing a transient virtual lesion based on the inhibition of a subcircuit lasting a few seconds. Currently, this is the sole technique that is able to directly investigate the functional role of white matter tracts in humans. Thus, combining transient disturbances elicited by DES with the anatomical data provided by pre- and postoperative MRI enables to achieve reliable anatomo-functional correlations, supporting a network organization of the brain, and leading to the reappraisal of models of language representation. Finally, combining serial peri-operative functional neuroimaging and online intraoperative DES allows the study of mechanisms underlying neuroplasticity. This chapter critically reviews the basic principles of DES, its advantages and limitations, and what DES can reveal about the neural foundations of language, that is, the large-scale distribution of language areas in the brain, their connectivity, and their ability to reorganize.

THE METABOLISM OF NORMAL BRAIN AND HUMAN GLIOMAS IN RELATION TO CELL TYPE AND DENSITY

1955 ◽  
Vol 33 (3) ◽  
pp. 395-403 ◽  
Author(s):  
Irving H. Heller ◽  
K. A. C. Elliott
Keyword(s):  
Cerebral Cortex ◽  
White Matter ◽  
Brain Tumors ◽  
Corpus Callosum ◽  
Oxygen Uptake ◽  
Glial Cells ◽  
Cerebellar Cortex ◽  
Unit Weight ◽  
Uptake Rates ◽  
The Brain

Per unit weight, cerebral and cerebellar cortex respire much more actively than corpus callosum. The rate per cell nucleus is highest in cerebral cortex, lower in corpus callosum, and still lower in cerebellar cortex. The oxygen uptake rates of the brain tumors studied, with the exception of an oligodendroglioma, were about the same as that of white matter on the weight basis but lower than that of cerebral cortex or white matter on the cell basis. In agreement with previous work, an oligodendroglioma respired much more actively than the other tumors. The rates of glycolysis of the brain tumors per unit weight were low but, relative to their respiration rate, glycolysis was higher than in normal gray or white matter. Consideration of the figures obtained leads to the following tentative conclusions: Glial cells of corpus callosum respire more actively than the neurons of the cerebellar cortex. Neurons of the cerebral cortex respire on the average much more actively than neurons of the cerebellar cortex or glial cells. Considerably more than 70% of the oxygen uptake by cerebral cortex is due to neurons. The oxygen uptake rates of normal oligodendroglia and astrocytes are probably about the same as the rates found per nucleus in an oligodendroglioma and in astrocytomas; oligodendroglia respire much more actively than astrocytes.

Spinal cord grey matter lesions in multiple sclerosis detected by post-mortem high field MR imaging

2008 ◽  
Vol 15 (2) ◽  
pp. 180-188 ◽  
Author(s):  
CP Gilmore ◽  
JJG Geurts ◽  
N Evangelou ◽  
JCJ Bot ◽  
RA van Schijndel ◽  
...  
Keyword(s):  
Spinal Cord ◽  
White Matter ◽  
Mr Imaging ◽  
High Field ◽  
Grey Matter ◽  
Great Majority ◽  
Proton Density ◽  
Post Mortem ◽  
Mr Images ◽  
The Brain

Background Post-mortem studies demonstrate extensive grey matter demyelination in MS, both in the brain and in the spinal cord. However the clinical significance of these plaques is unclear, largely because they are grossly underestimated by MR imaging at conventional field strengths. Indeed post-mortem MR studies suggest the great majority of lesions in the cerebral cortex go undetected, even when performed at high field. Similar studies have not been performed using post-mortem spinal cord material. Aim To assess the sensitivity of high field post-mortem MRI for detecting grey matter lesions in the spinal cord in MS. Methods Autopsy material was obtained from 11 MS cases and 2 controls. Proton Density-weighted images of this formalin-fixed material were acquired at 4.7Tesla before the tissue was sectioned and stained for Myelin Basic Protein. Both the tissue sections and the MR images were scored for grey matter and white matter plaques, with the readers of the MR images being blinded to the histopathology results. Results Our results indicate that post-mortem imaging at 4.7Tesla is highly sensitive for cord lesions, detecting 87% of white matter lesions and 73% of grey matter lesions. The MR changes were highly specific for demyelination, with all lesions scored on MRI corresponding to areas of demyelination. Conclusion Our work suggests that spinal cord grey matter lesions may be detected on MRI more readily than GM lesions in the brain, making the cord a promising site to study the functional consequences of grey matter demyelination in MS.

Abstract MP16: Excessive White Matter Hyperintensity Burden and Functional Outcomes After Acute Ischemic Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Sungmin Hong ◽  
Anne-katrin Giese ◽  
Markus D Schirmer ◽  
Adrian V Dalca ◽  
Anna Bonkhoff ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Life Time ◽  
Stroke Recovery ◽  
White Matter Hyperintensity ◽  
Brain Health ◽  
Stroke Outcomes ◽  
The Brain

Objective: Ability of the brain to recover after an acute ischemic stroke (AIS) is linked to the pre-stroke burden of white matter hyperintensity (WMH), a radiographic marker of brain health. We sought to determine the excessive WMH burden in an AIS population and investigate its association with 3-month stroke outcomes. Data: We used 2,435 subjects from the MRI-GENIE study. Three-month functional outcomes of 872 subjects among those subjects were measured by 90-day modified Ranking Scale (mRS). Methods: We automatically quantified WMH volume (WMHv) on FLAIR images and adjusted for a brain volume. We modeled a trend using the factor analysis (FA) log-linear regression using age, sex, atrial fibrillation, diabetes, hypertension, coronary artery disease and smoking as input variables. We categorized three WMH burden groups based on the conditional probability given by the model (LOW: lower 33%, MED: middle 34%, and HIGH: upper 33%). The subgroups were compared with respect to mRS (median and dichotomized odds ratio (OR) (good/poor: mRS 0-2/3-6)). Results: Five FA components out of seven with significant relationship to WMHv (p<0.001) were used for the regression modeling (R 2 =0.359). The HIGH group showed higher median (median=2, IQR=2) mRS score than LOW (median=1, IQR=1) and MED (median=1, IQR=1). The odds (OR) of good AIS outcome for LOW and MED were 1.8 (p=0.0001) and 1.6 (p=0.006) times higher than HIGH, respectively. Conclusion: Once accounted for clinical covariates, the excessive WMHv was associated with worse 3-month stroke outcomes. These data suggest that a life-time of injury to the white matter reflected in WMH is an important factor for stroke recovery and an indicator of the brain health.

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