Clinical and Radiological Profiles of COVID-19 Patients with Neurological Symptomatology: A Comparative Study

Patients with COVID-19 can require radiological examination, with chest CT being more frequent than neuro-imaging. The objective is to identify epidemiological, clinical and radiological factors considered as predictors of neurological involvement in patients with COVID-19 assessed by neuroimaging and to describe the neuroimaging findings. This retrospective study was performed with 232 consecutive confirmed COVID-19 patients, from two radiological units, which were divided into two groups: (1) those who underwent a brain CT/MRI scan (n = 35) versus (2) those who did not undergo the brain CT/MRI scan, but underwent only chest CT (n = 197). There was a statistically significant difference with associations regarding the COVID-19 brain scan group for: admission to ICU, greater severity of lung injuries, the use of a mechanical ventilator and sepsis. Statistical tendency was found for chronic renal failure and systemic arterial hypertension. Forty-percent of COVID-19 patients from the brain scan group were abnormal on brain CT and/or brain MRI (22.9% of the cases with bleeding or microbleeding, 8.6% with restricted diffusion lesions). One ischemic stroke case was associated with irregularity at the M1 segment of the right middle cerebral artery. There was a case of left facial nerve palsy with enhancement of the left geniculate ganglia. An analysis of the olfactory bulbs was possible in 12 brain MRIs and 100% had enhancement and/or microbleeding. In conclusion, a more severe COVID-19 disease from ICU, a more severe form of lung disease, the use of mechanical ventilator and sepsis were associated to the COVID-19 patients with neurological involvement who had undergone brain scans. Microvascular phenomenon was a frequent finding in the brain and olfactory bulbs evaluated by neuroimaging.

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Comparative Study - The Impact and Profile of COVID-19 Patients Who Are Indicated for Neuroimaging: Vascular Phenomena Are Been Found in the Brain and Olfactory Bulbs

10.1101/2020.12.28.20248957 ◽

2021 ◽

Author(s):

Maria de Fatima Viana Vasco Aragao ◽

Mariana de Carvalho Leal ◽

Ocelio Queiroga Cartaxo Filho ◽

Tatiana Moreira Fonseca ◽

Lucas Vasco Aragao ◽

...

Keyword(s):

Chest Ct ◽

Restricted Diffusion ◽

Mechanical Ventilator ◽

Olfactory Bulbs ◽

Brain Scans ◽

Brain Ct ◽

Significant Difference ◽

Brain Scan ◽

The Impact ◽

The Brain

AbstractObjectiveTo verify the impact and findings of the COVID-19 patients’ group that underwent brain scans in comparison to the group which only chest CT was performed.Method876 suspected COVID-19 patients and a subsample of 232 cases with confirmed COVID-19 who underwent brain CT/MRI scan (n=35) or only chest CT (n=197) in two radiology departments, were evaluated.Results5.59% of all suspected COVID-19 patients found had brain scans and 98.74% chest CT. There was a statistically significant difference with associations regarding the COVID-19 brain scan group for: admission to ICU, greater severity of lung injuries, the use of mechanical ventilator, seizure, sepsis, and stroke and statistical tendency for chronic renal failure and systemic arterial hypertension. 40.0% of COVID-19 patients from the brain scan group were abnormal on brain CT and/or brain MRI. 22.9% cases with any kind of bleeding or microbleeding, 8.6% with restricted diffusion lesions. One ischemic stroke case was associated with irregularity at M1 segment of the right middle cerebral artery. There was a case of left facial nerve palsy with enhancement of left geniculate ganglia. An analyse of the olfactory bulbs was possible in 12 brain MRIs and 100% had enhancement and/or microbleeding. There was no statistical difference regarding death (9.1% versus 5.2%).In conclusionthe COVID-19 patients group on which brain CT and/or MRI needed to be performed was statically associated with the more severe COVID-19 disease, an indication to ICU, a more severe form of lung disease, use of mechanical ventilator, seizure, sepsis and stroke. Less than half of patients had abnormal brain imaging scans with all of them showing vascular brain injury lesion, being more frequently microbleeding or bleeding, followed by restricted diffusion lesions. All the olfactory bulbs evaluated showed injury by vascular phenomenon, probably methahemoglobine by microbleeding or microthrombus and/or abnormal enhancement

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Extricating Brain Tumor in MRI Images with the aid of MATLAB software

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.35578 ◽

2021 ◽

Vol 9 (VII) ◽

pp. 502-506

Author(s):

Shivam Kumar Mittal

Keyword(s):

Image Processing ◽

Brain Tumor ◽

Image Quality ◽

Brain Mri ◽

Medical Science ◽

Noise Removal ◽

Mri Scan ◽

Matlab Software ◽

The Brain ◽

Mri Image

In the current era of Medical Science, Image Processing is the most evolving and inspiring technique. This technique consolidates some noise removal functions, segmentation, and morphological activities which are the fundamental ideas of image processing. Initially preprocessing of an MRI image is done to ensure the image quality for further processing/output. Our paper portrays the methodology to extricate and diagnose the brain tumor with the help of an affected person’s MRI scan pictures of the brain. MRI pictures are taken into account to recognize and extricate the tumor from the brain with the aid of MATLAB software.

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Apgar Scores at 10 Minutes and Outcomes in Term and Late Preterm Neonates with Hypoxic-Ischemic Encephalopathy in the Cooling Era

American Journal of Perinatology ◽

10.1055/s-0038-1670637 ◽

2018 ◽

Vol 36 (05) ◽

pp. 545-554 ◽

Cited By ~ 2

Author(s):

Marina Ayrapetyan ◽

Kiran Talekar ◽

Kathleen Schwabenbauer ◽

David Carola ◽

Kolawole Solarin ◽

...

Keyword(s):

Therapeutic Hypothermia ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Hypoxic Ischemic Encephalopathy ◽

Preterm Neonates ◽

Short Term ◽

Apgar Scores ◽

Significant Difference ◽

The Brain ◽

Ischemic Encephalopathy

Objective To determine the short-term outcomes (abnormal brain magnetic resonance imaging [MRI]/death) in infants born with a 10-minute Apgar score of 0 who received therapeutic hypothermia and compare them with infants with higher scores. Study Design This is a retrospective review of 293 neonates (gestational age ≥ 35 weeks) born between November 2006 and October 2015 admitted with hypoxic-ischemic encephalopathy who received therapeutic hypothermia. Results of brain MRIs were assessed by the basal ganglia/watershed scoring system. Short-term outcomes were compared between infants with Apgar scores of 0, 1 to 4, and ≥5 at 10 minutes. Results Eight of 17 infants (47%) with an Apgar of 0 at 10 minutes survived, having 4 (24%) without abnormalities on the brain MRI and 7 (41%) without severe abnormalities. There was no significant difference in the combined outcomes of “death/abnormal MRI” and “death/severe abnormalities on the MRI” between infants with Apgar scores of 0 and 1 to 4. Follow-up data were available for six of eight surviving infants, and none had moderate or severe neurodevelopmental impairment. Conclusion In the cooling era, 47% of infants with no audible heart rate at 10 minutes and who were admitted to the neonatal intensive care unit survived; 24% without abnormalities on the brain MRI and 41% without severe abnormalities.

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MRI Brain Documentation

Austin Journal of Radiology ◽

10.26420/austinjradiol.2021.1124 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Alahmari A ◽

Keyword(s):

Brain Mri ◽

Normal Brain ◽

Neurological Abnormality ◽

Mri Scan ◽

Medical File ◽

Mri Brain ◽

Picture Archiving ◽

Neurological Event ◽

Mri Study ◽

The Brain

In many clinical cases, a patient may come to the hospital with a neurological abnormality. This patient happen to have a normal brain MRI study that is recorded on the Picture Archiving and Communicating system (PACs) of that hospital. The previous normal study will help in identifying any pathology take place in the future easily. What if all the patients did have a previous studies for the brain as some kind of documentation? It will help a lot. The aim of this paper is to propose a new idea that required for all the citizens in a country to have a normal brain MRI study recorded on their medical file and this MRI study updated every five years by undertaking an MRI scan. The usefulness of this idea can be imply in different ways. For example; when a patient affected by any type of neurological issue, we have a morphological documentation for the brain prior to that neurological event took a place. As well, this is will provide a database for researchers to find pre and post neurological event documentation. Furthermore, it will help in detecting and documenting senile atrophic changes over the time. Sometime patients will have a “silent stroke” which has no symptoms which can be detected by the brain MRI scan.

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Cladophialophora bantianaCerebral Phaeohyphomycosis Complicated by Pulmonary Nocardiosis: A Tale of Two Infections

Case Reports in Infectious Diseases ◽

10.1155/2019/4352040 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Muhammad Farhan Khaliq ◽

Rayan E. Ihle ◽

Christopher P. Schirtzinger

Keyword(s):

Multidisciplinary Approach ◽

Brain Mri ◽

Brain Biopsy ◽

Term Treatment ◽

Chest Ct ◽

Long Term Treatment ◽

History Of ◽

The Brain ◽

Neurosurgical Intervention

Cladophialophora bantiana, a melanized neurotropic fungus, is the most commonly reported agent of cerebral phaeohyphomycosis. We present a case of cerebral phaeohyphomycosis due toC. bantianawith a concomitantNocardiainfection in the lung. The patient was a 64-year-old male who presented with one-week history of productive cough, confusion, and staggering gait. Brain MRI showed multiple enhancing masses, and chest CT demonstrated multifocal consolidation. To confirm diagnosis, brain biopsy was performed that showedCladophialophora bantiana. Bronchoscopic lung biopsy confirmed infection withNocardia araoensis. The patient was treated with trimethoprim-sulfamethoxazole, meropenem, voriconazole, and liposomal amphotericin in addition to partial resection of the brain mass. After several weeks in the hospital and deteriorating status with poor prognosis, medical care was withdrawn.Cladophialophora bantianainfection is rare and requires multidisciplinary approach for accurate diagnostic confirmation. Aggressive and long-term treatment with voriconazole along with early neurosurgical intervention may offer an improved chance of survival in these patients.

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Intracranial anti-tumor activity of lazertinib in patients with advanced NSCLC who progressed after prior EGFR TKI therapy: Data from a phase I/II study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.9571 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 9571-9571

Author(s):

Sang-We Kim ◽

Myung-Ju Ahn ◽

Ji-Youn Han ◽

Ki Hyeong Lee ◽

Eun Kyung Cho ◽

...

Keyword(s):

Brain Metastasis ◽

Phase I ◽

Advanced Nsclc ◽

Brain Mri ◽

T790m Mutation ◽

Brain Scan ◽

Full Analysis ◽

Anti Tumor Activity ◽

The Brain ◽

Egfr Tki

9571 Background: Lazertinib (YH25448) is a highly mutant-selective, irreversible 3rd-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that targets the activating EGFR mutations (Del19 and L858R), as well as the T790M mutation, while sparing wild type. Brain metastasis (BM) are common in patients (pts) with advanced NSCLC. Lazertinib showed a high blood-brain barrier penetration profile in preclinical studies. We report intracranial response data in pts with advanced NSCLC from a Phase I/II study of lazertinib (NCT03046992). Methods: Pts with advanced NSCLC, who had progressed after prior EGFR-TKI therapy, were enrolled in an open-label, multicenter, phase I/II study with dose-escalation, dose-expansion and dose-extension phases. Brain MRI was done in all pts at baseline. Pts with asymptomatic BM were eligible for enrollment. Intracranial anti-tumor activity of lazertinib was analysed in pts with BM present on baseline brain scan. Pre-defined intracranial endpoints included objective intracranial response rate (OIRR) and intracranial progression-free survival (IPFS) by independent central review (ICR). The brain metastasis full analysis population included pts with measurable and/or non-measurable BM lesion present on baseline brain scan; the brain metastasis population evaluable for response included only pts with measurable BM lesion. Results: As of 30 Sep 2019, a total of 181 pts received at least one dose of lazertinib 20-320 mg across 7 dose levels. Of those, 64 pts (56% female, median age 63, 86% T790M mutation positive by central testing) were included in the brain metastasis full analysis population; Intracranial disease control rate (IDCR) was 90.6% (58/64; 95% CI 83.5, 97.8) and median IPFS was not reached (95% CI 14.0, NR). In the brain metastasis population evaluable for response, a total of 22 pts were included; OIRR and IDCR were 54.5% (12/22; 95% CI 33.7, 75.4) and 90.9% (20/22; 95% CI 78.9, 100), respectively. In 13 pts (7.2%) out of 181 pts, brain was the first site of disease progression by existing and/or new lesions. Conclusions: Lazertinib demonstrated clinically meaningful activity against BM, aligned with preclinical data. Clinical trial information: NCT03046992 .

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Unintended Pulmonary Artery Ligation during PDA Ligation

The Heart Surgery Forum ◽

10.1532/hsf.1449 ◽

2016 ◽

Vol 19 (4) ◽

pp. 187 ◽

Cited By ~ 2

Author(s):

Dohun Kim ◽

Si-Wook Kim ◽

Hong-Ju Shin ◽

Jong-Myeon Hong ◽

Ji Hyuk Lee ◽

...

Keyword(s):

Pulmonary Artery ◽

Ductus Arteriosus ◽

Left Lung ◽

Left Pulmonary Artery ◽

Chest Ct ◽

Mechanical Ventilator ◽

Artery Ligation ◽

Ventilator Support ◽

Surgical Ligation ◽

Emergent Operation

A 10-day-old boy was transferred to our hospital due to tachypnea. Patent ductus arteriosus (PDA), 4.8 mm in diameter, with small ASD was diagnosed on echocardiography. Surgical ligation of the ductus was performed after failure of three cycles of ibuprofen. However, the ductus remained open on routine postoperative echocardiography on the second postoperative day, and chest CT revealed inadvertent ligation of the left pulmonary artery (LPA) rather than the PDA. Emergent operation successfully reopened the clipped LPA and ligated the ductus on the same (second postoperative) day.<br />Mechanical ventilator support was weaned on postoperative day 21, and the baby was discharged on postoperative day 47 with a normal left lung shadow.

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The ”true me”—one or many?

10.31234/osf.io/tkur5 ◽

2019 ◽

Author(s):

Iris Berent ◽

Melanie Platt

Keyword(s):

Free Will ◽

Optimality Theory ◽

The Self ◽

True Self ◽

Behavioral Test ◽

Brain Scan ◽

Moral Behaviors ◽

The Brain ◽

Constraint Ranking

Recent results suggest that people hold a notion of the true self, distinct from the self. Here, we seek to further elucidate the “true me”—whether it is good or bad, material or immaterial. Critically, we ask whether the true self is unitary. To address these questions, we invited participants to reason about John—a character who simultaneously exhibits both positive and negative moral behaviors. John’s character was gauged via two tests--a brain scan and a behavioral test, whose results invariably diverged (i.e., one test indicated that John’s moral core is positive and another negative). Participants assessed John’s true self along two questions: (a) Did John commit his acts (positive and negative) freely? and (b) What is John’s essence really? Responses to the two questions diverged. When asked to evaluate John’s moral core explicitly (by reasoning about his free will), people invariably descried John’s true self as good. But when John’s moral core was assessed implicitly (by considering his essence), people sided with the outcomes of the brain test. These results demonstrate that people hold conflicting notions of the true self. We formally support this proposal by presenting a grammar of the true self, couched within Optimality Theory. We show that the constraint ranking necessary to capture explicit and implicit view of the true self are distinct. Our intuitive belief in a true unitary “me” is thus illusory.

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Serum Vitamin D and Cingulate Cortex Thickness in Older Adults: Quantitative MRI of the Brain

Current Alzheimer Research ◽

10.2174/1567205016666191113124356 ◽

2019 ◽

Vol 16 (11) ◽

pp. 1063-1071 ◽

Cited By ~ 1

Author(s):

Gonzague Foucault ◽

Guillaume T Duval ◽

Romain Simon ◽

Olivier Beauchet ◽

Mickael Dinomais ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Brain Mri ◽

Serum Vitamin ◽

Cingulate Cortex ◽

Posterior Cingulate Cortex ◽

Vitamin D Insufficiency ◽

Anterior Cingulate ◽

Posterior Cingulate ◽

Significant Difference

Background: Vitamin D insufficiency is associated with brain changes, and cognitive and mobility declines in older adults. Method: Two hundred and fifteen Caucasian older community-dwellers (mean±SD, 72.1±5.5years; 40% female) received a blood test and brain MRI. The thickness of perigenual anterior cingulate cortex, midcingulate cortex and posterior cingulate cortex was measured using FreeSurfer from T1-weighted MR images. Age, gender, education, BMI, mean arterial pressure, comorbidities, use of vitamin D supplements or anti-vascular drugs, MMSE, GDS, IADL, serum calcium and vitamin B9 concentrations, creatinine clearance were used as covariables. Results: Participants with vitamin D insufficiency (n=80) had thinner total cingulate thickness than the others (24.6±1.9mm versus 25.3±1.4mm, P=0.001); a significant difference found for all 3 regions. Vitamin D insufficiency was cross-sectionally associated with a decreased total cingulate thickness (β=- 0.49, P=0.028). Serum 25OHD concentration correlated positively with the thickness of perigenual anterior (P=0.011), midcingulate (P=0.013) and posterior cingulate cortex (P=0.021). Conclusion: Vitamin D insufficiency was associated with thinner cingulate cortex in the studied sample of older adults. These findings provide insight into the pathophysiology of cognitive and mobility declines in older adults with vitamin D insufficiency.

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Content-Based Estimation of Brain MRI Tilt in Three Orthogonal Directions

Journal of Digital Imaging ◽

10.1007/s10278-020-00400-7 ◽

2021 ◽

Author(s):

Pooja Prabhu ◽

A. K. Karunakar ◽

Sanjib Sinha ◽

N. Mariyappa ◽

G. K. Bhargava ◽

...

Keyword(s):

Large Scale ◽

Brain Mri ◽

Similarity Measures ◽

Principal Component ◽

Brain Anatomy ◽

Morphological Operations ◽

Mr Images ◽

Tilt Correction ◽

Brain Mr Images ◽

The Brain

AbstractIn a general scenario, the brain images acquired from magnetic resonance imaging (MRI) may experience tilt, distorting brain MR images. The tilt experienced by the brain MR images may result in misalignment during image registration for medical applications. Manually correcting (or estimating) the tilt on a large scale is time-consuming, expensive, and needs brain anatomy expertise. Thus, there is a need for an automatic way of performing tilt correction in three orthogonal directions (X, Y, Z). The proposed work aims to correct the tilt automatically by measuring the pitch angle, yaw angle, and roll angle in X-axis, Z-axis, and Y-axis, respectively. For correction of the tilt around the Z-axis (pointing to the superior direction), image processing techniques, principal component analysis, and similarity measures are used. Also, for correction of the tilt around the X-axis (pointing to the right direction), morphological operations, and tilt correction around the Y-axis (pointing to the anterior direction), orthogonal regression is used. The proposed approach was applied to adjust the tilt observed in the T1- and T2-weighted MR images. The simulation study with the proposed algorithm yielded an error of 0.40 ± 0.09°, and it outperformed the other existing studies. The tilt angle (in degrees) obtained is ranged from 6.2 ± 3.94, 2.35 ± 2.61, and 5 ± 4.36 in X-, Z-, and Y-directions, respectively, by using the proposed algorithm. The proposed work corrects the tilt more accurately and robustly when compared with existing studies.

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