Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Review Case Reports
Acute Marchiafava-Bignami disease with extensive diffusion restriction and early recovery: case report and review of the literature.
Marchiafava-Bignami disease (MBD) is a neurological disorder that has been found to be associated with chronic alcoholism and malnutrition. MBD classically results in acute edema and demyelination of the corpus callosum. ⋯ We present an acute onset of MBD with diffusion restriction of the complete corpus callosum and symmetric bilateral extension into the semioval center, that almost completely resolved clinically as well as in MRI only 3 days later. With early detection and treatment, the prognosis of MBD may be good even in cases with severe diffusion restriction of the complete corpus callosum.
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To evaluate the variability of determining eligibility for intravenous thrombolysis (IV t-PA) by a stroke team interpretation of computed tomographic (CT) scan of the head versus review of the radiology interpretation (presented in final report) in patients with acute ischemic stroke. ⋯ Our study demonstrates that administering IV t-PA to patients based on the stroke team's interpretation of the CT scan versus review of the radiology interpretation does not lead to significant differences in clinical outcome, aICH, or sICH.
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To determine whether voxel-based morphometry of the cerebrospinal fluid (CSF) space can accurately differentiate iNPH from other related neurological disorders. ⋯ The VBM-based CSF space analysis can detect disproportionate changes in CSF space and differentiate iNPH patients from those with AD or PD and healthy elderlies accurately.
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Residual giant-cystic craniopharyngiomas are amenable to intracavitary bleomycin treatment. Radiologic identification of potential cyst leaks is of paramount for treatment decisions. ⋯ In one case, whose previous water-soluble iodinated contrast-enhanced CT cystography was negative for leaks, intracystic Gd-enhanced MR showed intraventricular Gd enhancement. We conclude that MR imaging after intracystic administration of Gd-based contrast paramagnetic agents is useful in the detection of potential leaks in cases of giant residual craniopharyngiomas.
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Artery-to-artery embolism generally occurs in patients with not only moderate to severe arterial stenosis but also plaque vulnerability. Two unique cases with free-floating thrombi at the distal side of the small plaque in the internal carotid artery without stenosis are presented and its clinical implications are discussed. ⋯ In these two cases, duplex ultrasonography revealed free-floating thrombi developed at the distal region of small plaques. Aggressive treatment should be considered in a patient with thromboembolic stroke who has the small plaque presenting "snake fang" sign even if there is no stenosis or plaque vulnerability.