Reversible cortical auditory dysfunction caused by cerebral vasospasm after ruptured aneurysmal subarachnoid hemorrhage and evaluated by perfusion magnetic resonance imaging

2007 ◽  
Vol 107 (1) ◽  
pp. 161-164 ◽  
Author(s):  
Sadaharu Tabuchi ◽  
Mitsutoshi Kadowaki ◽  
Takashi Watanabe
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Cerebral Vasospasm ◽  
Mean Transit Time ◽  
Auditory Brainstem Responses ◽  
Perfusion Magnetic Resonance Imaging ◽  
Mr Images ◽  
Auditory Dysfunction ◽  
The Right

✓ A 52-year-old woman developed subarachnoid hemorrhage (SAH) caused by a ruptured right internal carotid artery (ICA) aneurysm. Because of the aneurysm configuration, the authors decided to delay surgery and instead undertook serial imaging studies of the aneurysm. The patient remained alert but developed acute bilateral deafness on Day 7. Audiological examination and auditory brainstem responses suggested that the hearing disturbance was cortical in origin. Three-dimensional computed tomography (CT) angiography showed severe vasospasm in the right middle cerebral artery (MCA) and moderate vasospasm in the left ICA and MCA. Three-tesla magnetic resonance (MR) imaging was performed 2 days after the onset of symptoms. Diffusion-weighted and T2-weighted MR images showed an acute infarction in the right insular cortex caused by vasospasm. Perfusion-weighted MR imaging, particularly mean transit time mapping, revealed hypoperfusion in both temporal lobes including the auditory cortex and right auditory radiation. The vasospasm was treated with induction of mild hypertension and hypervolemia. Follow-up MR images, 3D CT angiograms, and audiometry performed 2 weeks after the first examination showed recovery of vasospasm and resolution of perfusion abnormality and hearing disturbance. On Day 26, the aneurysm was successfully occluded with clips and the patient was discharged with no deficits. To the authors' knowledge, this is the first reported case of reversible cortical auditory dysfunction purely due to bilateral cerebral vasospasm detected using perfusion MR imaging after SAH.

Partly reversible central auditory dysfunction induced by cerebral vasospasm after subarachnoid hemorrhage

2013 ◽  
Vol 119 (5) ◽  
pp. 1125-1128 ◽  
Author(s):  
Ester Ponzetto ◽  
Marco Vinetti ◽  
Cécile Grandin ◽  
Thierry Duprez ◽  
Vincent van Pesch ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Auditory Evoked Potentials ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Rare Complication ◽  
Brain Mri ◽  
Temporal Cortex ◽  
Intraarterial Infusion ◽  
Auditory Dysfunction ◽  
The Right

The authors describe a rare case of central auditory dysfunction induced by cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). A 55-year-old woman who was admitted after aneurysmal SAH developed cerebral vasospasm on Day 3 affecting mainly the right middle cerebral artery (MCA) and partly the left MCA. The vasospasm became refractory to conventional therapy and was ultimately improved by intraarterial infusion of nimodipine in the right MCA and angioplasty. Severe auditory dysfunction was apparent from Day 10 as the patient was not reactive to speech or environmental sounds. Brain MRI on Day 17 demonstrated infarcted areas mainly in the right hippocampus, medial occipital lobe, and thalamus. The patient underwent further examination using audiometry, speech testing, auditory evoked potentials, functional MRI, and cerebral PET. The initial diagnosis was extended nonverbal agnosia and total pure word deafness. The central auditory dysfunction improved over 6 months, with persisting hyperacusis, tinnitus, and amusia. Central auditory dysfunction is a rare complication after SAH. While cortical deafness may be associated with bilateral lesions of the temporal cortex, partly reversible central auditory dysfunction was observed in this patient after prominently unilateral right temporal lesions. The role of the interthalamic connections can be discussed, as well as the possibility that a less severe vasospasm on the left MCA could have transiently impaired the left thalamocortical auditory pathways.

Magnetic resonance imaging of primary cerebral gliosarcoma: a report of 15 cases

2008 ◽  
Vol 49 (9) ◽  
pp. 1058-1067 ◽  
Author(s):  
L. Han ◽  
X. Zhang ◽  
S. Qiu ◽  
X. Li ◽  
W. Xiong ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Information ◽  
Cerebellar Hemisphere ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mr Images ◽  
Peripheral Location ◽  
Pathology Reports ◽  
The Right ◽  
Radiologic Features

Background: Gliosarcomas are rare tumors with mixed glial and mesenchymal components. Many of their radiologic features resemble those of other primary brain malignancies. Purpose: To investigate the magnetic resonance (MR) imaging features of gliosarcomas. Material and Methods: We retrospectively reviewed the MR images, pathology reports, and clinical information of 11 male and four female patients aged 15–71 years to evaluate the location, morphology, enhancement, and other features of their pathologically confirmed gliosarcomas. Results: Apart from one tumor in the right cerebellar hemisphere, all were supratentorial. Two tumors were intraventricular, and four involved the corpus callosum. The tumors were well demarcated, with an inhomogeneous or cystic appearance and moderate-to-extensive surrounding edema. Thick walls with strong rim and ring-like enhancement were observed in 13 (87%). Seven (47%) showed intratumoral paliform enhancement. Conclusion: Gliosarcoma demonstrates certain characteristic MR features, such as supratentorial and peripheral location, well-demarcated, abutting a dural surface, uneven and thick-walled rim-like or ring enhancement, as well as intratumoral strip enhancement. These findings, combined with patient age, can aid the differential diagnosis of gliosarcomas from more common primary brain tumors.

Accelerated spondylotic changes adjacent to the fused segment following central cervical corpectomy: magnetic resonance imaging study evidence

2004 ◽  
Vol 100 (1) ◽  
pp. 2-6 ◽  
Author(s):  
Vaijayantee Kulkarni ◽  
Vedantam Rajshekhar ◽  
Lakshminarayan Raghuram
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Imaging Study ◽  
Degenerative Changes ◽  
Adjacent Segment ◽  
Mr Images ◽  
Short Term ◽  
Content Type ◽  
Fine Print

Object. The authors studied whether cervical spine motion segments adjacent to a fused segment exhibit accelerated degenerative changes on short-term follow-up magnetic resonance (MR) imaging. Methods. Preoperative and short-term follow-up (mean duration 17.5 months, range 10–48 months) cervical MR images obtained in 44 patients who had undergone one- or two-level corpectomy for cervical spondylotic myelopathy were evaluated qualitatively and quantitatively. The motion segment adjacent to the fused segment and a segment remote from the fused segment were evaluated for indentation of the thecal sac, disc height, and sagittal functional diameter of the spinal canal on midsagittal T2-weighted MR images. Thecal sac indentations were classifed as mild, moderate, and severe. New indentations of the thecal sac of varying severity (mild in 17 patients [38.6%], moderate in 10 [22.7%], and severe in six [13.6%]) had developed at the adjacent segments in 33 (75%) of 44 patients. The degenerative changes were seen at the superior level in 11 patients, inferior level in 10 patients, and at both levels in 12 patients and resulted from both anterior and posterior element degeneration in the majority (23 [69.6%]) of patients. The remote segments showed mild thecal sac indentations in seven patients and moderate indentations in two patients (nine [20.5%] of 44). Compared with the changes at the remote segment, the canal size was significantly decreased at the superior adjacent segment by 0.9 mm (p = 0.007). No patient sustained a new neurological deficit due to adjacent-segment changes. Conclusions. On short-term follow-up MR imaging, levels adjacent to the fused segment exhibited more pronounced degenerative changes (compared with remote levels) in 75% of patients who had undergone one- or two-level central corpectomy.

scholarly journals Atypical, polyarticular lipoma arborescens in a child

2016 ◽  
Vol 144 (11-12) ◽  
pp. 650-653
Author(s):  
Robert Semnic ◽  
Radoje Simic ◽  
Slavisa Djuricic ◽  
Oto Adjic ◽  
Filip Vanhoenacker
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Open Surgery ◽  
Literature Search ◽  
Histological Analysis ◽  
Rare Tumor ◽  
Rare Entity ◽  
Lipoma Arborescens ◽  
Diagnostic Protocol ◽  
The Right

Introduction. Lipoma arborescens is a rare, tumor-like lesion commonly involving synovial joints and less commonly bursae and synovial tendon sheaths. Case Outline. We report a case of a 12-year-old boy with symmetric involvement of the bicipitoradial bursae, synovial sheaths of extensor compartments of both hands and medial ankles. The diagnosis of polyarticular lipoma arborescens was proposed on magnetic resonance (MR) imaging and this diagnosis was histologically proven after biopsy of the bursae and later by open surgery of the synovial sheath of the right ankle tendons. Literature search was performed and twelve cases with polyarticular involvement were analyzed. Lipoma arborescens commonly involves suprapatellar recess of the knee and very rarely other joints or bursae. Histological analysis revealed an accompanying non-necrotizing granulomatous synovial inflammation. Conclusion. Polyarticular lipoma arborescens is a rare entity and symmetrical involvement of the joints other than the knees is exceedingly rare. MR imaging plays a significant role in the diagnostic protocol, and the characteristic fatty signal on MR imaging is highly suggestive of lipoma arborescens.

Lack of agreement between direct magnetic resonance imaging and statistical determination of a subthalamic target: the role of electrophysiological guidance

2002 ◽  
Vol 97 (3) ◽  
pp. 591-597 ◽  
Author(s):  
Emmanuel Cuny ◽  
Dominique Guehl ◽  
Pierre Burbaud ◽  
Christian Gross ◽  
Vincent Dousset ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Functional Response ◽  
Anterior Commissure ◽  
Surgical Techniques ◽  
High Frequency Stimulation ◽  
Mr Images ◽  
Posterior Commissure ◽  
Content Type ◽  
Fine Print

Object. The goal of this study was to determine the most suitable procedure(s) to localize the optimal site for high-frequency stimulation of the subthalamic nucleus (STN) for the treatment of advanced Parkinson disease. Methods. Stereotactic coordinates of the STN were determined in 14 patients by using three different methods: direct identification of the STN on coronal and axial T2-weighted magnetic resonance (MR) images and indirect targeting in which the STN coordinates are referred to the anterior commissure—posterior commissure (AC—PC) line, which, itself, is determined either by using stereotactic ventriculography or reconstruction from three-dimensional (3D) MR images. During the surgical procedure, electrode implantation was guided by single-unit microrecordings on multiple parallel trajectories and by clinical assessment of stimulations. The site where the optimal functional response was obtained was considered to be the best target. Computerized tomography scanning was performed 3 days later and the scans were combined with preoperative 3D MR images to transfer the position of the best target to the same system of stereotactic coordinates. An algorithm was designed to convert individual stereotactic coordinates into an all-purpose PC-referenced system for comparing the respective accuracy of each method of targeting, according to the position of the best target. Conclusions. The target that is directly identified by MR imaging is more remote (mainly in the lateral axis) from the site of the optimal functional response than targets obtained using other procedures, and the variability of this method in the lateral and superoinferior axes is greater. In contrast, the target defined by 3D MR imaging is closest to the target of optimal functional response and the variability of this method is the least great. Thus, 3D reconstruction adjusted to the AC—PC line is the most accurate technique for STN targeting, whereas direct visualization of the STN on MR images is the least effective. Electrophysiological guidance makes it possible to correct the inherent inaccuracy of the imaging and surgical techniques and is not designed to modify the initial targeting.

Magnetic resonance imaging for primary breast cancer management: current role and new applications.

2002 ◽  
pp. 141-153 ◽  
Author(s):  
L Esserman ◽  
D Wolverton ◽  
N Hylton
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Mr Images ◽  
Cancer Management ◽  
The Past ◽  
Breast Cancer Management ◽  
Clinical Breast ◽  
Unnecessary Procedures ◽  
New Applications

Techniques for magnetic resonance (MR) imaging of the breast have been evolving over the past decade. The opportunities for integration of MR imaging into clinical breast cancer management and clinical research are increasing. In this paper, we will review the principles behind the creation of standard and MR images and use this as a platform to evaluate clinical studies and indications for the use and study of MR. In particular, we will focus on those areas where MR has the capability of changing care and/or improving our understanding of the biology of breast cancer. In addition, we will address areas where MR is not yet capable of adding value or where MR may lead to unnecessary procedures.

In vivo magnetic resonance imaging of fetal cat neural tissue transplants in the adult cat spinal cord

1992 ◽  
Vol 76 (2) ◽  
pp. 261-274 ◽  
Author(s):  
Edward D. Wirth ◽  
Daniel P. Theele ◽  
Thomas H. Mareci ◽  
Douglas K. Anderson ◽  
Stacey A. Brown ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Neural Tissue ◽  
Injured Spinal Cord ◽  
Mr Images ◽  
Compression Injury ◽  
Content Type ◽  
Graft Tissue ◽  
Fine Print

✓ Magnetic resonance (MR) imaging was evaluated for its possible diagnostic application in determining the survival of fetal central nervous system tissue grafts in the injured spinal cord. Hemisection cavities were made at the T11—L1 level of eight adult female cats. Immediately thereafter, several pieces of tissue, either obtained from the fetal cat brain stem on embryonic Day 37 (E-37), from the fetal neocortex on E-37, or from the fetal spinal cord on E-23, were implanted into the cavities made in seven cats. The eighth cat served as a control for the effect of the lesion only. In another group of four animals, a static-load compression injury was made at the L-2 level. Seven weeks later, the lesion was resected in three cases and fragments of either fetal brainstem or spinal cord tissue were introduced. A small cyst was observed in a fourth cat in the compression injury group and a suspension of dissociated E-23 brain-stem cells was injected into this region of cavitation without disturbing the surrounding leptomeninges. Five months to 2 years posttransplantation, MR imaging was performed with a 2.0-tesla VIS imaging spectrometer by acquiring multislice spin-echo images (TR 1000 msec, TE 30 msec) in both the transverse and sagittal planes. Collectively, these intermediate-weighted images revealed homogeneous, slightly hyperintense signals at the graft site relative to the neighboring host tissue in seven of the 11 graft recipients. Two of the remaining four cats exhibited signals from the graft site that were approximately isointense with the adjacent host spinal cord, and the final two cats and the lesion-only control presented with very hypointense transplant/resection regions. The hyperintense and isointense images were tentatively interpreted as representing viable graft tissue, whereas the hypointense transplant/resection sites were considered to be indicative of a lack of transplant survival or the absence of tissue in the lesion-only control animal. Postmortem gross inspection of fixed specimens and light microscopy verified the MR findings in the control animal in 10 of the 11 graft recipients by showing either transplants and/or cysts corresponding to the MR images obtained. In one cat in the hemisection group, histological analysis revealed a very small piece of graft tissue that was not detected on the MR images. Therefore, it is suggested that within certain spatial- and contrast-resolution limits, MR imaging can reliably detect the presence of transplanted neural tissue in both the hemisected and compression-injured spinal cord of living animals. Thus, MR imaging can serve as an important adjunct to histological, electrophysiological, and long-term behavioral analyses of graft-mediated anatomical and functional repair of the injured spinal cord. It is further suggested that this noninvasive diagnostic approach offers many advantages in terms of the judicious and optimum use of valuable animal models, and that these findings address an important prerequisite (in situ verification of transplant survival) for any future clinical trials involving these or equivalent neural tissue grafting approaches, when such are warranted.

scholarly journals Intracranial Malignant Glioma Presenting as Subarachnoid Hemorrhage

2003 ◽  
Vol 30 (1) ◽  
pp. 63-66 ◽  
Author(s):  
Stephen Hentschel ◽  
Brian Toyota
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Magnetic Resonance ◽  
Magnetic Resonance Image ◽  
Clinical Presentation ◽  
Cerebral Aneurysms ◽  
Short List ◽  
Metastatic Lesions ◽  
The Right ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Cerebral Neoplasms

Objective:Cerebral aneurysms are the predominant cause of spontaneous subarachnoid hemorrhage (SAH). However, if an aneurysmal cause has been excluded, there remains but a short list of other potential etiologies. Cerebral neoplasms are clearly on this list but are most commonly meningiomas or metastatic lesions. This article details a case of a neoplasm that presented exclusively with SAH.Clinical Presentation:A 40-year-old male presented with a SAH with normal cerebral angiography. The initial magnetic resonance image revealed a lesion in the right insula thought to be resolving hemorrhage. Subsequent images, however, revealed the mass to be enlarging.Intervention:Craniotomy and resection of the lesion established a diagnosis of a malignant oligodendroglioma.Conclusion:An affirmation is made that patients experiencing ’angiographically-negative’ SAH should undergo MRI, occasionally on a serial basis, to exclude other etiologies for hemorrhage, including neoplasia.

Extracerebral fluid collections in infancy: role of magnetic resonance imaging in differentiation between subdural effusion and subarachnoid space enlargement

1994 ◽  
Vol 81 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Nobuhiko Aoki
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Subdural Effusion ◽  
Mr Images ◽  
Content Type ◽  
Vascular Flow ◽  
Flow Void ◽  
Subarachnoid Spaces ◽  
Fluid Collections ◽  
Fine Print

✓ The pathological process of extracerebral fluid collections in infancy includes subdural effusion and enlargement of the subarachnoid spaces. Both conditions have traditionally been investigated as a single clinical entity, because of difficulty in differentiating between them. The prognosis of subdural effusion is not as benign as that of enlargement of subarachnoid spaces, requiring differential diagnosis between these disorders. The present study was conducted to elucidate whether this differentiation could be made on magnetic resonance (MR) images. The series consisted of 16 infants aged 10 months or younger, including eight with verified subdural effusion and eight in whom a diagnosis of enlargement of the subarachnoid spaces was achieved by neuroimaging studies other than MR imaging. In all eight patients with subdural effusion, the intensity of the fluid was greater than that of cerebrospinal fluid (CSF) in at least one of the sequences using T1-weighted, proton-density, and T2-weighted MR images. The flow-void sign, indicating vessels in the fluid spaces, was not seen in any of these eight patients. On the other hand, in all eight patients with enlargement of the subarachnoid spaces, the fluid was isointense in relation to CSF, and vascular flow-void areas were seen in at least one of the MR imaging sequences. Based on these observations, it is concluded that differentiation between subdural effusion and enlargement of the subarachnoid spaces can be established by focusing on two aspects of MR imaging findings: 1) the intensity of the fluid, which is either iso- or hyperintense relative to CSF, and 2) the presence or absence of vascular flow-void areas in the fluid spaces.

scholarly journals Magnetic Resonance Appearance of Pulmonary Type of Primary Small Cell Carcinoma of the Ovary: A Case Report and Literature Review

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Xuechao Du ◽  
Pengtao Sun ◽  
Yuan Zhao ◽  
Yuchang Yan ◽  
Zhenyu Pan
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Small Cell ◽  
Imaging Features ◽  
The Right ◽  
Carcinoma Of The Ovary

: The pulmonary type of primary small cell carcinoma of the ovary (SCCOPT) is a rare aggressive malignancy with a poor prognosis, usually occurring in postmenopausal women. Few literatures have emphasized on the magnetic resonance (MR) imaging features. In this paper, we analyze its MR imaging findings in combination with pathological manifestations. We report a case of a 51-year-old woman who presented with abdominal pain and distension. Several tumor markers were elevated. MR scan of the pelvis was performed. It revealed a heterogeneous lobulated mass with solid and cystic components originating from the right adnexa. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histology showed a tumor comprising areas of classical small-cell carcinoma, and SCCOPT was diagnosed based on histopathology and immunohistochemistry. SCCOPT is a rare aggressive malignancy with certain characteristic imaging features. The solid component exhibits slightly higher signal on T2-weighted imaging with fat suppression, restricted diffusion on diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps, and honeycomb-like persistent enhancement. More data are needed to better understand its specific imaging manifestations.

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