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To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2007.00152.x Byline: Rose-Marie Marie (1), Catherine Lozza (1), Chantal Chavoix (1), Gilles Louis Defer (1), Jean-Claude Baron (1) Keywords: Parkinson's disease; functional MRI; executive functions; working memory Abstract: ABSTRACT BACKGROUND AND PURPOSE Over and above typical motor alterations, executive and working memory (WM) impairment can also occur in early idiopathic Parkinson's disease (PD). We aimed to investigate the compensatory neural processes involved in WM performance, as well as the networks involved in the long-term memory transfer from short-term stores in PD. METHODS Relative cerebral blood flow (rCBF) was mapped with [H.sub.2]O.sup.15-PET in eight treated nondemented PD patients while performing a WM verbal double-task (Brown-Peterson paradigm) using both short (6-second) and long (18-second) delays. RESULTS As compared to nine age-matched healthy subjects, performance of the PD group was only slightly reduced on the short-delay but markedly impaired on the long-delay task. Underlying the relatively preserved short-delay performance, the PD group exhibited overactivation of prefrontal and parietal areas involved in attention-demanding processes, suggestive of efficient compensatory processes. Further supporting this, significant positive correlations were found between short-delay performance and rCBF in the bilateral inferior parietal cortex. In contrast, the lack of overactivation with the long-delay task together with posterior cingulate hypoactivation would support the idea of functional disconnection impairing transfer of information from prefrontal onto (para)limbic areas. These findings suggest novel areas of investigation into early cognitive impairments in PD. Author Affiliation: (1)From the University of Caen, University Team 'Executive and Attentional Processes' and UPRES-EA 3917, Caen, France (R-MM, CL, CC, GLD); INSERM U320, Centre Cyceron, Caen, France (CL); Department of Clinical Neurosciences, University of Cambridge, UK (J-CB); CHU de Caen, Service de Neurologie, Caen, France (R-MM, GLD). Article History: Acceptance: Received December 15, 2006, and in revised form February 22, 2007. Accepted for publication March 10, 2007. Article note: Correspondence: Address correspondence to J.-C. Baron, MD, FMed Sci Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital Box 83, CB2 2QQ, Cambridge, UK. E-mail: jcb54@cam.ac.uk.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00045.x Byline: Liz Warburton (1), Jonathan Gillard (1) Keywords: Transient ischemic attack (TIA); carotid atheroma; position emission tomography (PET); magnetic resonance (MR) Abstract: ABSTRACT Atherosclerotic plaque rupture within the internal carotid artery is an important cause of transient ischemic attack (TIA) and stroke. Conventional imaging techniques such as ultrasound and angiography provide information about the structural consequences of such plaques in terms of luminal stenosis. Most clinical trials of carotid surgery and stenting and based on these imaging methods. Techniques aimed at imaging the biological 'functional' status of the plaque are now emerging. Most of these are based on the premise that inflammatory activity is an index of plaque stability. In this article we review potential imaging targets from the known molecular biological pathways of atherosclerosis. Both conventional imaging techniques and the newer methods are discussed. Recent data from position emission tomography (PET) imaging and from the use of superparamagnetic iron oxide particles with magnetic resonance (MR) imaging are shown. Author Affiliation: (1)From the Department of Clinical Neurosciences, Cambridge School of Clinical Medicine (LW); University Department of Radiology, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK (JG). Article History: Received January 6, 2006, and in revised form February 27, 2006 and March 23, 2006. Accepted for publication March 27, 2006. Article note: Address correspondence to Liz Warburton, MA, DM, MRCP, Department of Clinical Neurosciences, Cambridge School of Clinical Medicine, Addenbrooke's Hospital Cambridge CB2 2QQ, UK. E-mail: caw23@medschl.cam.ac.uk.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00027.x Byline: Xin Wang (1), Wynnie W. M. Lam (1), Yu Hua Fan (1), Colin A. Graham (1), Timothy H. Rainer (1), Ka Sing Wong (1) Keywords: Small subcortical infarcts; stroke; embolism; MCA stenosis; diffusion-weighted imaging Abstract: ABSTRACT Background and Purpose. Small subcortical infarcts (SSI, maximum lesion diameter [less than or equal to]2.0 cm) are usually considered as infarcts caused by small vessel disease. However, SSI can also be associated with large artery occlusive disease such as middle cerebral artery (MCA) stenosis. We performed a prospective study to investigate the relationship between MCA stenosis and SSI distribution and further to investigate the mechanism of SSI caused by MCA stenosis. Methods. Magnetic resonance angiography (MRA) and diffusion-weighed MRI (DWI) of consecutive acute ischemic stroke patients with recent SSI were studied. The distribution of acute infarcts on DWI was categorized as cortical infarct (CI), border zone infarct (BI), or perforating artery infarct (PAI). Results. Totally, 93 cases were recruited, among which 12 had single SSI with MCA stenosis (group 1) and 26 patients had multiple SSI with MCA stenosis (group 2), while 55 patients without MCA stenosis had single SSI (group 3). For patients with single SSI and MCA stenosis, 6 had BI and 6 had PAI; for patients with multiple SSI and MCA stenosis, 25 had BI, 4 had PAI and 9 had CI (compared with group1: P= .001); for patients with single SSI but without MCA stenosis, 20 had BI and 35 had PAI (compared with group1: P= .58). Conclusion. Multiple acute infarcts along the border zone are the commonest pattern in small infarcts with MCA stenosis, especially among those with multiple acute infarcts. Our data suggest that hemodynamic compromise and artery-to-artery embolism may be both important factors for infarcts in patients with MCA stenosis. Author Affiliation: (1)From the Department of Medicine and Therapeutics (XW, YHF, KSW); Department of Diagnostic Radiology & Organ Imaging (WWML); Accident & Emergency Medicine Academic Unit (CAG, THR), the Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; and Department of Neurology, the Qingdao Municipal Hospital, Qingdao, China (XW). Article History: Received July 13, 2005, and in revised form November 30, 2005. Accepted for publication December 7, 2005. Article note: Address correspondence to Dr Ka Sing Wong, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong, China. E-mail: ks-wong@cuhk.edu.hk.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00020.x Byline: Jeffrey J. Carlson (1), James M. Milburn (1), Gregg M. Barre (1) Keywords: Lhermitte-Duclos disease; dysplastic gangliocytoma of the cerebellum; Cowden's syndrome; posterior fossa mass Abstract: ABSTRACT Lhermitte-Duclos disease is a rare disorder with an unknown pathogenesis. A single report of a pathological proven case of Lhermitte-Duclos disease is presented with clinical, imaging, and histopathological findings. A brief review of the condition is provided with an emphasis on imaging description. Author Affiliation: (1)From the Department of Radiology (JJC, JMM) and the Department of Pathology (GMB), Ochsner Clinic Foundation, New Orleans, Louisiana. Article History: Received March 13, 2005, and in revised form July 20, 2005. Accepted for publication July 22, 2005. Article note: Address correspondence to Jeffrey J. Carlson, MD, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121. E-mail: jcarlson@ochsner.org.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1177/1051228405001528 Byline: Mustafa Efkan Colpan (1), Zeki Sekerci (1), Baki Hekimoglu (1), David Jeffrey Mogul (1) Keywords: Aneurysm; angiography; computerized tomography; magnetic resonance; reconstruction; thrombi Abstract: ABSTRACT Objective. Improved visualization of intraaneurysmal thrombi can contribute to understanding their impact on clinical courses and treatments. Digital subtraction angiography (DSA) demonstrates the hemodynamic portion of aneurysm domes and vasculature structures and has been considered by many to be the principal technique used for aneurysm diagnosis. An intraaneurysmal thrombus may be visualized as a filling defect on DSA, but DSA does not reliably indicate the presence of an intraaneurysmal thrombus or its details. Computerized tomography (CT) and magnetic resonance (MR) imaging may have advantages over DSA, particularly because of their capacity to visualize soft tissue. Hence, we investigated the reconstruction of MR and CT images and compared it to DSA for assessment of intraaneurysmal thrombi. Methods. Thirty-one patients with 34 aneurysms were enrolled. The entire group was examined with DSA. Sixteen cases were also examined with MR imaging; the remaining 15 were examined with CT imaging. Images of intraaneurysmal thrombi were rendered from corresponding MRI and soft tissue scans using CT. Intracranial vessels and aneurysms were defined from MR and CT angiography. Whole images were linked via imaging software for the reconstruction of vasculature structures. Images were superimposed to produce visualizations of thrombi situated in aneurysmal bodies. Results. Reconstruction of the MR and CT images clearly demonstrated the presence and details of intraaneurysmal thrombi in 9 (26.4 %) of 34 aneurysms. DSA detected only 4 (11.7 %) of the cases as a filling defect. Significant differences in thrombus visualization were observed between DSA used alone or in conjunction with either MRA (P= .02) or CTA (P= .04) images. Mean volume of thrombosed aneurysms was 3.2 [+ or -] 0.84 mL (mean [+ or -] SEM) and thrombosis volume was 0.9 [+ or -] 0.31 mL. Aneurysm and nested thrombus volumes were highly correlated (r= 0.987; P < .001). Conclusion. Intraaneurysmal thrombi were clearly visualized by computerized MR and CT image reconstruction. MR and CT were superior to DSA alone in demonstrating the presence of intra-aneurysmal thrombi. Computer-assisted 3-D visualization can be invaluable in understanding the shape and volume of intraaneurysmal thrombi, which may contribute to more accurate assessment and effective treatment of aneurysms cases. Author Affiliation: (1)From the Department of Neurosurgery, SSK Ankara Education and Research Hospital, Ankara, Turkey (MEC, ZS); Pritzker Institute of Biomedical Science & Engineering; Illinois Institute of Technology, Chicago, Illinois, USA (MEC, DM); and Department of Radiology, SSK Ankara Education and Research Hospital, Ankara, Turkey (BH). Article History: Received April 13, 2005, and in revised form August 19, 2005. Accepted for publication August 30, 2005. Article note: Address correspondence to Mustafa Efkan Colpan, MD, Pritzker Institute of Biomedical Science and Engineering, 10 West 32nd Street, E1-116, Chicago, IL, 60616. E-mail: colpan@iit.edu.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1177/1051228405280646 Byline: Eva Bartels (1) Keywords: Vertebral artery; dissection; duplex scanning; ultrasonics; noninvasive diagnosis Abstract: ABSTRACT Dissection of cervical arteries causes ischemic stroke in young adults. This reports the clinical, ultrasonographic, and neuroradiological findings in 24 patients with 28 vertebral artery dissections in the neck (4 occurring bilaterally). In 20 patients (83%), the dissection was temporally related to trauma. No patients had an underlying vascular disease, for example, atherosclerosis or fibromuscular dysplasia. In all, the major initial manifestation was pain in the occipital or neck region. The next most common symptoms were vertigo and nausea (in 17 patients). Clinical manifestations were vertebrobasilar transient ischemic attack (TIA) (5 patients: in 2 patients vestibulocerebellar TIA, in 1 patient visual TIA, in 1 patient motor TIA, and in 1 patient brain stem TIA with perioral paresthesia), cerebellar infarction (10 patients, in 4 patients bilateral), brainstem infarction (5 patients), posterior cerebral artery territory infarction (1 patient), and multiple vertebrobasilar ischemic lesions (3 patients). Typical angiographic findings were irregular narrowing of the vessel lumen or a tapering stenosis with distal occlusion. Magnetic resonance imaging showed a thickened vessel wall with hematoma signal at the site of the dissection. Duplex color-flow imaging was valuable for the early diagnosis of extracranial vertebral artery dissection and for follow-up examinations. The distal V1- and the proximal V2-segment (at the level of C6 vertebra) was the most frequent localization of dissections (in 43%). The outcome was favorable except for 2 patients with basilar artery occlusion. Embolism to the basilar artery may be avoided by early administration of anticoagulants. Author Affiliation: (1)From the Department of Clinical Neurophysiology, Georg-August-University Gottingen, Germany. Article History: Received April 21, 2005, and in revised form June 16, 2005. Accepted for publication June 20, 2005. Article note: Address correspondence to Eva Bartels, MD, PhD, Department of Clinical Neurophysiology, Georg-August-University Gottingen, Robert-Koch-Str. 40, D 37075 Gottingen, Germany. E-mail: Bartels.Eva@t-online.de.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1177/1051228405001474 Byline: Thilo Deckersbach (1), Darin D. Dougherty (1), Scott L. Rauch (1) Keywords: neuroimaging; cognitive neuroscience; affective neuroscience; functional magnetic resonance imaging; position emission tomography; mood disorders; anxiety disorders Abstract: ABSTRACT Neuroimaging research has emerged as a valuable tool in shaping our understanding of the pathophysiology of psychiatric disorders. We review functional neuroimaging findings pertaining to mood disorders (major depression, bipolar disorders) as well as selected anxiety disorders (posttraumatic stress disorder [PTSD] and obsessive-compulsive disorder [OCD]). Author Affiliation: (1)From the Department of Psychiatry, Massachusetts General Hospital; and Harvard Medical School, Boston, Massachusetts. Article History: Received October 21, 2004, and in revised form August 4, 2004. Accepted for publication August 10, 2005. Article note: Address correspondence to Dr Thilo Deckersbach, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Bldg 149, 13th Street, 2nd floor, Charlestown, MA 02129. E-mail: tdeckersbach@partners.org.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2007.00084.x Keywords: Abscess; brain subdural empyema; cranial subdural empyema; spinal subdural empyema; Streptococcus intermedius; subdural collection Abstract: ABSTRACT BACKGROUND AND PURPOSE Subdural empyema represents a loculated infection between the dura and the arachnoid. It has been described either intracranially or in the spinal canal, the latter localization being quite rare. While treatment guidelines for a single (either brain or spinal) localization of a subdural empyema are more or less established, its management when a massive involvement of CNS is evident represents a challenge. METHODS The authors describe a unique case of a 65-year-old woman having a massive involvement of the entire CNS with multiple localizations, both intracranial and spinal. Early diagnosis was obtained through brain CT scans followed by cranio-spinal contrast enhanced MRI scans. Patient was treated with external ventricular drainage and suboccipital craniectomy, while on antibiotic therapy. RESULTS Patient's neurological condition gradually improved. By the end of the eighth hospital week, she was discharged without any neurological deficit. CONCLUSIONS Spinal subdural empyema and brain subdural empyema are not always, as in our case, two different entities. Prompt diagnosis and treatment constitute the major variables affecting outcome. Author Affiliation: (1)From the Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy (AP, PDB, GS, CA, AM); Institute of Infectious Diseases, Catholic University School of Medicine, Rome, Italy (GF); Institute of Radiology, Catholic University School of Medicine, Rome, Italy (MM). Article History: Acceptance: Received September 30, 2006, and in revised form September 30, 2006. Accepted for publication October 19, 2006. Article note: Correspondence: Address correspondence to Pasquale De Bonis, MD, Institute of Neurosurgery, Catholic University School of Medicine, l.go A. Gemelli, 8 00168 Rome Italy. E-mail: debonisvox@gmail.com.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00018.x Keywords: Neuroimaging; amygdala calcifications; lipoid proteinosis; Urbach-Wiethe disease Abstract: ABSTRACT Objectives. To describe imaging findings of central nervous system involvement in patients with lipoid proteinosis. Methods. Patients with lipoid proteinosis followed in the dermatology and neurology departments of the State University of Campinas between 2002 and 2004 were evaluated using high-resolution MRI and computerized tomography (CT). Results. We reviewed the charts of three patients (two women) with lipoid proteinosis with, ages ranging from 5 to 44 years. Symptomatic disease duration ranged from 2 to 39 years. MRI scans showed hypointense signal in FLAIR and T2 images in the amygdalae in two of three patients. Brain CT scans from two patients showed that MRI findings were calcifications. The calcification was more evident in patients with longer disease duration. Epilepsy was identified in one patient with longer disease duration. No other epileptogenic lesion was identified on MRI in this patient. Conclusion. Lipoid proteinosis is associated with bilateral amygdalae calcification. These findings were more evident in patients with longer disease duration. Epilepsy, when present, may be related to these calcifications. Patients with lipoid proteinosis should be followed with MRI/CT in order to identify these abnormalities. Author Affiliation: (1)From the Neuroimaging Lab (SA, EC, FC, LML); Department of Neurology (EC, FC, LML); Dermatology Unit, Department of Internal Medicine (PV, EMS); Department of Radiology, State University of Campinas, UNICAMP (VZA), Cidade Universitaria Zeferino Vaz CEP, 13083970 Campinas-SP, Brazil. Article History: Received March 28, 2005, and in revised form July 11, 2005. Accepted for publication July 20, 2005. Article note: Address correspondence to Dr Li M. Li, Department of Neurology, State University of Campinas (UNICAMP), Cidade Universitaria Zeferino Vaz CEP 13083970 Campinas-SP, Brazil. E-mail: limin@fcm.unicamp.br.