Normal Variation of Focal T2 Hyperintensities in Anterior Parietal Periventricular white Matter: Another 'Terminal Zones of IV!yelination'

1994 ◽  
Vol 30 (5) ◽  
pp. 807
Author(s):  
Jong Hwa Lee ◽  
Jong Oag Park ◽  
Je Ho Woo ◽  
Tae Sung Ki ◽  
Don Young Lee
Keyword(s):  
White Matter ◽  
Periventricular White Matter ◽  
Normal Variation

scholarly journals White Matter Lesions as Possible Predictors of Audiological Performance in Adults after Cochlear Implantation

2021 ◽  
Vol 11 (5) ◽  
pp. 600
Author(s):  
Steffen Knopke ◽  
Hans-Christian Bauknecht ◽  
Stefan Gräbel ◽  
Sophia Marie Häußler ◽  
Agnieszka J. Szczepek ◽  
...  
Keyword(s):  
Speech Perception ◽  
White Matter ◽  
Cochlear Implantation ◽  
Age Groups ◽  
White Matter Lesions ◽  
Periventricular White Matter ◽  
Rehabilitation Outcomes ◽  
Hearing Ability ◽  
Structural Brain Damage ◽  
Oldenburg Sentence Test

The presented prospective study investigated whether structural brain damage, measured with the Fazekas score, could predict hearing rehabilitation outcomes with cochlear implantation (CI). With a follow-up period of 24 months, this study included 49 bilaterally, postlingually hearing impaired CI candidates for unilateral CI (67.3 ± 8.7 years; 20 men, 29 women) older than 50 at the time of implantation. The differences in the predictive value between two age groups, 50–70 year-olds (mid-age; n = 26) and over 70-year-olds (elderly; n = 23), were analyzed. The patients were evaluated using speech perception (SP) measured in quiet (Freiburg monosyllabic test; FMT) and noise (Oldenburg sentence test; OLSA). The subjective hearing ability was assessed using Oldenburg inventory (OI). The Fazekas PVWM score predicted postoperative speech perception two years after CI in the mid-age population. The periventricular white matter lesions (PVWM) could explain 27.4% of the speech perception (FMT) variance. Our findings support the hypothesis about the influence of pre-existing WMLs on CI outcome. We recommend the evaluation of Fazekas score as a predictive factor for post-implantation hearing ability.

The Clinical Value of Periventricular White Matter Hyperintensity on MRI in Sudden Sensorineural Hearing Loss

2021 ◽  
pp. 000348942110189
Author(s):  
Jung Woo Lee ◽  
Deoksu Kim ◽  
Seokhwan Lee ◽  
Sung-Won Choi ◽  
Soo-Keun Kong ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Multivariate Analysis ◽  
White Matter ◽  
Brain Mri ◽  
Sudden Sensorineural Hearing Loss ◽  
White Matter Hyperintensity ◽  
Control Group ◽  
Periventricular White Matter ◽  
Clinical Value ◽  
Hearing Gain

Objectives: To assess the clinical value of periventricular white matter hyperintensity (PWMH) found on brain magnetic resonance imaging (MRI) in patients with sudden sensorineural hearing loss (SSNHL). Methods: In this prospective study, 115 patients who were diagnosed with SSNHL aged between 55 and 75 years were analyzed. All subjects underwent brain MRI and were divided into a PWMH and control groups, depending on the presence of PWMH on MRI. PWMH was subdivided into 3 groups according to severity. Pure-tone average results and hearing gain were compared between the 2 groups before treatment and 2 months after treatment. Hearing improvement was assessed using Sigel’s criteria. Results: A total of 106 patients (43 in the PWMH group and 63 in the control group) finally completed the 2-month follow-up. Average hearing gain in the PWMH group was significantly higher than in the control group (34.8 ± 20.3 and 25.9 ± 20.3, respectively, P = .029). PWMH score 1 showed significantly better hearing levels and hearing gain compared to PWMH score 3 and the control group. Multivariate analysis revealed that younger age, better initial hearing level, and the presence of PVWM score 1 were associated with good recovery. Conclusions: The presence of PWMH score 1 on brain MRI in patients with SSNHL was associated with better treatment response and was a good prognostic factor in a multivariate analysis while the hearing recovery in more severe PWMH (scores 2, 3) was not different from the control group.

Predictive Value of Neonatal MR! as Compared to Ultrasound in Premature Infants with Mild Periventricular White Matter Changes

1999 ◽  
Vol 30 (05) ◽  
pp. 231-238 ◽  
Author(s):  
Gerda van Wezel-Meijler ◽  
M. van der Knaap ◽  
J. Oosting ◽  
L. Sie ◽  
L. de Groot ◽  
...  
Keyword(s):  
White Matter ◽  
Premature Infants ◽  
Predictive Value ◽  
Periventricular White Matter ◽  
White Matter Changes

Hemorrhagic Periventricular Leukomalacia: Diagnosis by Real Time Ultrasound and Correlation with Autopsy Findings

PEDIATRICS ◽  
1982 ◽  
Vol 69 (3) ◽  
pp. 282-284 ◽  
Author(s):  
Alan Hill ◽  
G. Leland Melson ◽  
H. Brent Clark ◽  
Joseph J. Volpe
Keyword(s):  
White Matter ◽  
Real Time ◽  
Intraventricular Hemorrhage ◽  
Periventricular Leukomalacia ◽  
Correct Diagnosis ◽  
Definitive Diagnosis ◽  
Periventricular White Matter ◽  
Ultrasound Scanning ◽  
Autopsy Findings ◽  
Hemorrhagic Lesion

Hemorrhage into areas of periventricular leukomalacia may occur and range in size from microscopic to massive. Hitherto, the definitive diagnosis has been made only at autopsy. A case is described in which the diagnosis of hemorrhagic periventricular leukomalacia was made antemortem by real-time ultrasound scanning and confirmed at autopsy. Periventricular/intraventricular hemorrhage, a more common hemorrhagic lesion, may extend into periventricular white matter in a location ventral and medial to hemorrhagic periventricular leukomalacia. Real-time ultrasound scanning is a safe and reliable means of defining the topography of these two hemorrhagic lesions and, thereby, of suggesting the correct diagnosis.

Abstract P329: White Matter Score Does Not Predict Post-tPA Hemorrhage in Elderly Patients Evaluated Acutely via Telestroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Muhammad Bilal Tariq ◽  
Shekhar Khanpara ◽  
Eliana Bonfante Mejia ◽  
Liang Zhu ◽  
Christy T Ankrom ◽  
...  
Keyword(s):  
White Matter ◽  
Elderly Patients ◽  
The Elderly ◽  
Periventricular White Matter ◽  
Severe Stroke ◽  
Age Related ◽  
Increased Risk ◽  
Symptomatic Intracranial Hemorrhage ◽  
Relationship Of ◽  
Patient Presentation

Background: While tPA may be safe in the elderly, increasing age appears to augment risk of post-tPA symptomatic intracranial hemorrhage (sICH). Age-related white matter changes (ARWMC) are associated with increased sICH. Patients evaluated for acute ischemic stroke (AIS) via telestroke (TS) may not have access to MRI to allow incorporation of microbleeds in tPA decisions. We assessed if increased CT-based ARWMC was associated with increased sICH in elderly patients. Methods: Patients 80 years and older who received tPA for AIS at spoke hospitals were selected from our TS network registry from 9/2015 to 12/2018. TS spoke CT scans from patient presentation were reviewed by three of the authors for periventricular white matter (PWMC) and deep white matter (DWMC) changes. Total ARWMC score, based on the Fazekas score, was collected. Total ARWMC score was either mild (0-2), moderate (3-4), or severe (5-6). PWMC and DWMC were either mild (0-1) or moderate-severe (2-3). Logistic regression adjusted for age, sex, race, ethnicity, NIHSS and premorbid mRS was used to analyze relationship of ARWMC scores with sICH and patient-outcomes. Results: Of 241 patients, median age overall was 86 years (IQR 83-90), and 66% were female. The overall median ARWMC score was 3 (IQR 2-5). Regression analysis showed that more severe ARWMC scores did not lead to higher frequency of post-tPA ICH (moderate OR 0.57, CI 0.19-1.71; severe OR 1.32, CI 0.48-3.65) including sICH (moderate OR 0.78, CI 0.21-2.94; severe OR 2.09, CI 0.62-7.02). Similarly, severe PWMC and DWMC were not associated with increased risk of post-tPA ICH (PWMC OR 1.31, CI 0.51-3.38; DWMC OR 1.25, CI 0.52-3.01), including sICH (PWMC OR 1.61, CI 0.51-5.08; DWMC OR 1.81, CI 0.65-5.01). In our cohort, older patients had no difference in hemorrhage (ICH OR 0.93 CI 0.85-1.00: sICH OR 0.95 CI 0.86-1.04), and patients with less severe stroke were more likely to have hemorrhage (ICH OR 1.06 CI 1.02-1.10; sICH OR 1.08 CI 1.03-1.13). IRR among the CT scan readers was moderate (k=0.504). Conclusions: ARWMC scores were not associated with post-tPA ICH in the elderly. Our analysis lends support for the use of tPA despite severity of white matter disease. ARWMC should not be used to assist in tPA decision-making in elderly patients via telestroke.

scholarly journals Peak ependymal cell stretch overlaps with the onset location of periventricular white matter lesions

2021 ◽  
Author(s):  
Valery Visser ◽  
Henry Rusinek ◽  
Johannes Weickenmeier
Keyword(s):  
White Matter ◽  
Ependymal Cell ◽  
White Matter Lesions ◽  
Magnetic Resonance Images ◽  
Ependymal Cells ◽  
Periventricular White Matter ◽  
Ventricular Wall ◽  
Imaging Data ◽  
Lateral Ventricles ◽  
Cell Stretch

Abstract Deep and periventricular white matter hyperintensities (dWMH/pvWMH) are bright appearing white matter tissue lesions in T2-weighted fluid attenuated inversion recovery magnetic resonance images and are frequent observations in the aging human brain. While early stages of these white matter lesions are only weakly associated with cognitive impairment, their progressive growth is a strong indicator for long-term functional decline. DWMHs are typically associated with vascular degeneration in diffuse white matter locations; for pvWMHs, however, no unifying theory exists to explain their consistent onset around the horns of the lateral ventricles. We use patient imaging data to create anatomically accurate finite element models of the lateral ventricles, white and gray matter, and cerebrospinal fluid, as well as to reconstruct their WMH volumes. We simulated the mechanical loading of the ependymal cells forming the primary brain-fluid interface, the ventricular wall, and its surrounding tissues at peak ventricular pressure during the hemodynamic cycle. We observe that both the maximum principal tissue strain and the largest ependymal cell stretch consistently localize in the anterior and posterior horns. Our simulations show that ependymal cells experience a loading state that causes the ventricular wall to be stretched thin. Moreover, we show that maximum wall loading coincides with the pvWMH locations observed in our patient scans. These results warrant further analysis of white matter pathology in the periventricular zone that includes a mechanics-driven deterioration model for the ventricular wall.

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