Journal of neuroimaging : official journal of the American Society of Neuroimaging
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To evaluate the time periods of Wallerian degeneration (WD) in which the diffusion parameters of ipsilateral corticalspinal tract (CST) can be used to predict the motor function outcome after brain infarction. ⋯ The rFA and ipsilateral FA values after 2 weeks of stroke onset correlate with the motor function outcome.
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The second most frequently affected organ in mitochondrial disorders (MIDs) is the central nervous system (CNS). One of the most frequent CNS abnormalities on imaging is the affection of the white matter (WMLs) for which the term, leukoencephalopathies in mitochondrial disorders (LEM), is proposed. The morphology of LEM on imaging is quite variable even within the same type of MID and the same family. ⋯ WMLs in MIDs frequently give rise to misinterpretation, particularly if the mitochondrial defect is not evident in organs other than the CNS or if the presence of WMLs does not induce consideration of a MID as a differential. The diagnosis of a LEM requires the diagnosis of an MID, the detection of WMLs on imaging, and the exclusion of all possible differentials. Because the presence of LEM has an impact on the prognosis of an MID, all MID patients should undergo cerebral imaging even in the absence of clinical CNS manifestations.
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Case Reports
Potential role of PMD-TCD monitoring in the management of hemodynamically unstable intracranial stenosis.
A 54-year-old woman started to loose vision 2 days prior to admission and also experienced left-sided headache, nausea, emesis, and disorientation. Magnetic resonance imaging (MRI) revealed bilateral posterior cerebral artery and cerebellar infarctions. Transcranial power motion Doppler (PMD-TCD) showed blunted flow signal in the proximal basilar artery (BA) suggestive for a high-grade stenosis also seen on magnetic resonance angiography (MRA). ⋯ PMD-TCD findings were suggestive for an intraluminal thrombus that moved from the proximal to the distal basilar artery, presumably further contributing to brain stem hypoperfusion and neurological deterioration. To achieve a compromise between lower blood pressure and maintenance of brain perfusion, hypervolemic hemodilution with intravenous dextran-40 was initiated. Patient's symptoms resolved to baseline and MRI showed no new parenchymal lesions.
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Though routine neuroimaging is usually normal in essential tremor (ET) there is clinical evidence of widespread involvement of central nervous system. This study aimed at determining morphological changes in brain of patients with ET using voxel-based morphometry (VBM) analysis and also compare the subtypes of ET. ⋯ Patients with ET showed widespread areas of atrophy in both cerebellum and cerebral GM, which supports the current concept of the progressive and diffuse nature of ET. Patients with additional head tremor may represent a distinct subgroup of ET.
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We attempt to evaluate objectively the regional cerebral blood flow (rCBF) changes during long-term donepezil therapy and the relationship between the clinical response and rCBF change in patients with Alzheimer's disease (AD). ⋯ The progression of cognitive deterioration may be related to rCBF affected by the neuropathologic changes of AD.