Search

This study aimed to evaluate whether there was a difference in functional magnetic resonance imaging (fMRI) findings in patients who were found having hyperalgesia or hypoesthesia according to Quantitative Sensory Tests (QST). Forty participants were included in the study: 20 with neuropathic pain (NP) due to cervical disc pathology (NP group) and 20 healthy volunteers. After obtaining the socio-demographic and clinical data of the participants, the painDETECT questionnaire was administered, followed by QST analysis to show the presence of hypoesthesia and/or hyperalgesia, and fMRI examinations, which included sensory stimulation of both extremities. Sensory threshold tests were found to be higher in the NP group compared with the healthy volunteers, and the heat pain threshold was found to be lower in the tests showing pain thresholds in the intergroup analyses (p < 0.05). The changes described were found in both painful and non-painful limbs. In the hypoesthetic NP group, a lower somatosensory cortex activity was found in non-painful limbs compared with the healthy volunteers (p < 0.05). In the unilateral hyperalgesic NP group, a lower somatosensory cortex activity was found on the painful side, and if the hyperalgesia was widespread, lower blood oxygen-level-dependent activity was also found in the operculum and insular cortex (p < 0.05). The patients with different phenotypes of NP had different activities in the areas related to the processing of pain, and were more prominent in patients with widespread hyperalgesia. Studies with larger numbers of patients are required for a definite statement., Ege University Research Projects Committee [TTU-2019-20708], This study was funded by Ege University Research Projects Committee (grant number: TTU-2019-20708).

OBJECTIVES: To obtain information from radiology departments throughout Europe regarding the practice of emergency radiology METHODS: A survey which comprised of 24 questions was developed and made available online. The questionnaire was sent to 1097 chairs of radiology departments throughout Europe using the ESR database. All data were collected and analyzed using IBM SPSS Statistics software, version 20 (IBM). RESULTS: A total of 1097 radiologists were asked to participate, 109 responded to our survey. The response rate was 10%. From our survey, 71.6% of the hospitals had more than 500 beds. Ninety-eight percent of hospitals have an active teaching affiliation. In large trauma centers, emergency radiology was considered a dedicated section. Fifty-three percent of institutions have dedicated emergency radiology sections. Less than 30% had all imaging modalities available. Seventy-nine percent of institutions have 24/7 coverage by staff radiologists. Emergency radiologists interpret cross-sectional body imaging, US scans, and basic CT/MRI neuroimaging in more than 50% of responding institutions. Cardiac imaging examinations/procedures are usually performed by cardiologist in 53% of institutions, while non-cardiac vascular procedures are largely performed and interpreted by interventional radiologists. Most people consider the European Diploma in Emergency Radiology an essential tool to advance the education and the dissemination of information within the specialty of emergency radiology. CONCLUSION: Emergency radiologists have an active role in the emergency medical team. Indeed, based upon our survey, they have to interact with emergency physicians and surgeons in the management of critically ill patients. A broad skillset from ultrasonography and basic neuroimaging is required. KEY POINTS: • At most major trauma centers in Europe, emergency imaging is currently performed by all radiologists in specific units who are designated in the emergency department. • Radiologists in the emergency section at present have a broad skillset, which includes cross-sectional body imaging, ultrasonography, and basic neuroimaging of the brain and spine. • A dedicated curriculum that certifies a subspecialty in emergency radiology with a diploma offered by the European Society of Emergency Radiology demonstrates a great interest by the vast majority of the respondents.

Introduction Neurogenic bladder with anorectal malformations (ARM) is a well-known yet understudied topic. Diffusion tensor imaging (DTI) is a special usage of MRI that can evaluate peripheric nerves. The aim of this study is to evaluate the lumbosacral plexuses of patients with ARM using DTI. Patients and methods Patients with ARM willing to participate were included. Patient files were reviewed, a questionnaire was made, and DTI was performed. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were computed for the right and left lumbosacral plexuses. Results There were 18 patients and 12 controls. Groups were similar in terms of sex (p = 0.232) and age (p = 0.853). There was a significant difference only for ADC of the left plexus. There was visible asymmetry in tractographies and DTI parameters of two patients with severely deformed pelvises (image 1) but also in another patient with a normal sacrum. In addition, despite asymmetry, FA and ADC were similar to controls also in these patients. Conclusion This is the first study presenting quantitative data about the lumbosacral plexus in ARM. We think the most interesting finding of this study was observing the normal values even in the patients with severely malformed sacrum which is yet to be validated with further studies., Aliye Uster Foundation (Izmir, Turkey) research scholarship; research activities in Ege University, This work was supported by Aliye Uster Foundation (Izmir, Turkey) research scholarship. This is an independent organization funding educational and research activities in Ege University. The authors have no conflict of interest regarding the study.

Emergency Radiology is a clinical practice and an academic discipline that has rapidly gained increasing global recognition among radiology and emergency/critical care departments and trauma services around the world. As with other subspecialties, Emergency Radiology practice has a unique scope and purpose and presents with its own unique challenges. There are several advantages of having a dedicated Emergency Radiology section, perhaps most important of which is the broad clinical skillset that Emergency Radiologists are known for. This multi-society paper, representing the views of Emergency Radiology societies in Canada and Europe, outlines several value-oriented contributions of Emergency Radiologists and briefly discusses the current state of Emergency Radiology as a subspecialty.

10th IEEE International Conference on Healthcare Informatics (IEEE ICHI) -- JUN 11-14, 2022 -- Rochester, MN, Pretrained language models elevated with in-domain corpora show impressive results in biomedicine and clinical NLP tasks in English. However, there is minimal work in low-resource languages. This work introduces the BioBERTurk family, three pretrained models in Turkish for biomedicine. To evaluate models, we also introduce a labeled dataset to classify radiology reports of CT exams. Our first model was initialized from BERTurk and pretrained with biomedical corpus. The second model again continues to pretrain the general BERT model with a corpus of Ph.D. theses on radiology to test the effect of the task-related text. The final model combines radiology and biomedicine corpora with the corpus of BERTurk and pretrained a BERT model from scratch. F-scores of our models in the radiology resort classification are 92.99, 92.75, and 89.49 respectively. As far as we know, this is the first model that evaluates the effect of small size in-domain corpus in pretraining from scratch., IEEE,Mayo Clin, Dept AI & Informat,Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Delivery,Mayo Clin Platform,NSF,IEEE Comp Soc Tech Comm Intelligent Informat,Journal Healthcare Informat Res,Hlth Data Sci, Tensorflow Research Cloud (TRC), We would like to acknowledge the support we received from the Tensorflow Research Cloud (TRC) team 4 in providing access to TPUv3 units.

Bolat, Gül Ünsel (Balikesir Author), Objective Arterial spin labeling (ASL) is a relatively new imaging modality in the field of the cognitive neuroscience. In the present study, we aimed to compare the dynamic regional cerebral blood flow alterations of children with ADHD and healthy controls during a neurocognitive task by using event-related ASL scanning. Methods The study comprised of 17 healthy controls and 20 children with ADHD. The study subjects were scanned on 3 Tesla MRI scanner to obtain ASL imaging data. Subjects performed go/no-go task during the ASL image acquisition. The image analyses were performed by FEAT (fMRI Expert Analysis Tool) Version 6. Results The mean age was 10.88 +/- 1.45 and 11 +/- 1.91 for the control and ADHD group, respectively (p = .112). The go/no-go task was utilized during the ASL scanning. The right anterior cingulate cortex (BA32) extending into the frontopolar and orbitofrontal cortices (BA10 and 11) displayed greater activation in ADHD children relative to the control counterparts (p < .001). With a lenient significance threshold, greater activation was revealed in the right-sided frontoparietal regions during the go session, and in the left precuneus during the no-go session. Conclusion These results indicate that children with ADHD needed to over-activate frontopolar cortex, anterior cingulate as well as the dorsal and ventral attention networks to compensate for the attention demanded in a given cognitive task., Ege University

The aim of this study is to investigate the pyramidal tract integrity with DTI in Behçet's and neuro-Behçet's cases. We performed this technique in two subgroups of neuro-Behçet's patients (parenchymal and vascular), and Behçet's cases without neurological involvement and control group. Totally, 28 patients were investigated. The control group was composed of 14 healthy people. Cranial MR and DTI were performed in three patient groups and the control group. At DTI, circular regions of interest (ROI) were symmetrically drawn on axial slices on the left and right sides along the pyramidal tract pathway at two levels: middle one third of the cerebral peduncle and posterior limb of the internal capsule. Fractional anisotropy (FA) values for each ROI were obtained by averaging all voxels within the ROI. Calculated FA values on both sides (left and right) of the posterior limb of the internal capsule and cerebral peduncle are significantly lower in all three patient groups when compared to the control group. But there is no any difference of FA values in the selected brain regions of three patient groups. FA values on the posterior limb of the internal capsule and cerebral peduncle do not show a statistically significant difference in parenchymal neuro-Behçet's cases. Our study demonstrates that DTI can detect subclinical pyramidal tract dysfunction in neuro-Behçet's and Behçet's patients. Detection of subclinical nervous system involvement is crucial for morbidity in Behçet's disease. For this reason, studies based on DTI, which include a large number of patients and explore different brain regions, are needed to guide clinicians.

Amaç: Hemofagositik lenfohistiyositoz (HLH) kontrolsüz immün yanıta yol açan hiperinflamasyonla karakterize klinik bir sendromdur. Etiyolojiye bağlı primer ve sekonder olarak sınıflanmaktadır. Klinik bulguları arasında ateş, splenomegali, hepatit yer almaktadır. Tanı doku örneklenmesi ile konulur. Familyal HLH’li hastaların santral sinir sistemi (SSS) tutulumu hastalığın prognozunu ve klinik gidişini olumsuz etkileyen bir faktördür. SSS tutulumunun bulguları; progresif ensefalopati, irritabilite, nöbet, kraniyal sinir paralizisi, ataksi, nistagmus, yürüme ve görme bozukluğu, psikomotor gelişim geriliğidir. Bu çalışmada, SSS tutulumu olan 6 olgunun radyolojik görüntüleme bulgularını sunmayı amaçladık.Gereç ve Yöntem: Bir-onbir yaş aralığında 6 hasta irritabilite, nöbet, ataksi, nistagmus, yürüme ve görme bozukluğu, psikomotor gelişim geriliği gibi nörolojik bulgularla hastanemize baş vurdu ve nörolojik muayene sonrasında kranyal manyetik rezonans görüntüleme (MRG) incelemesi gerçekleştirildi.Bulgular: Hastalarımıza klinik ve laboratuvar değerlendirmeleri sonrasında yapılan kemik iliği biyopsisi ile HLH tanısı konuldu. Hastalarımızın tamamında SSS tutulumunu gösteren kraniyal MRG bulguları saptandı. MRG incelemesinde T2 ağırlıklı ve FLAIR sekanslarında serebral hemisferlerde hiperintens odaklar ve postkontrast serilerde patolojik kontrastlanma ortak bulgular olarak belirlendi.Sonuç: HLH hastalığının santral sinir sistemi tutulumu yüksek mortalite ve morbidite ile seyretmektedir. Kraniyal MRG SSS tutulumunu göstermede önemli rol oynamaktadır., Aim: Hemophagocytic lymphohistiocytosis (HLH) is a clinical syndrome characterized by hyperinflammation causing uncontrolled immune response. It is classified as primary and secondary according to etiology. Fever, splenomegaly, hepatitis are among the clinical findings. The diagnosis is made with tissue sampling. The central nervous system (CNS) involvement of familial HLH patients is a factor that affects the prognosis and course of the disease. The findings of CNS involvement include progressive encephalopathy, irritability, attack, cranial nerve paralysis, ataxy, nistagmus, walking and visual impairment, psychomotor development deficiency. In this study, we aimed at presenting the radiologic imaging findings of 6 cases with CNS involvement.Materials and Methods: Six patients between the ages of 1-11 years applied to our hospital with neurological findings such as irritability, attack, cranial nerve paralysis, ataxy, nistagmus, walking and visual impairment, psychomotor development deficiency. Following the neurological examination, the cranial magnetic resonance imaging (MRI) examination was conducted.Results: HLH diagnosis was made through bone marrow biopsy after clinical and laboratory evaluations. Cranial MRI findings indicating CNS involvement were observed in all of our patients. Hyperintense foci in cerebral hemispheres and pathological contrast enhancement in postcontrast series were defined in T2 and FLAIR sequences in MRI examination.Conclusion: The central nervous system involvement of HLH disease is observed with high mortality and morbidity. Cranial MRI plays a significant role in revealing CNS involvement.

The calcification of the stylohyoid chain (SHC), elongated styloid process (SP), larger SP’ angle and its shortened distance of cervical internal carotid artery (CICA) are risk factors for bony compression and the stylocarotid syndrome. 3D-CTAs of 125 patients were analyzed in terms of the SP length, its angulations, type of the SHC and relationships of its proximity to the CICA. Elongated SP was observed frequently both in females (47%) and males (55%). The mean distance of the CICA to the SP was calculated as 8.2 ± 3.3 mm. This short distance between the CICA and the SP was observed more frequently in males (28.1%) and females (10.7%). The anterior and medial angulations of the SP were calculated as 71.2 ± 4.3°, and 57.3 ± 9.3°, respectively. In the present study, the SHC was determined as normal SP (54.2%), absence of the SP (1%), duplication of the SP (1%), elongated SP (26%), complete ossification of the SHC (1%), segmentation of the SHC (9%), fracture of ossification of the SHC (1.6%) and pseudo articulations of the SHC (5.6%). 3D-CTA was the most appropriate radiological investigation analyzing and measuring SHC (elongated, larger angle, shorter distances with CICA) and identifying types (duplicated, segmented, complete and fractured) resulting from pressures on the CICA. Our study also revealed the pressure on the artery not only arose from the tip of the SP but could also result from types stretching over the artery wall. In those specimens, there is a higher probability of formation of the stylocarotid syndrome due to the long-term pressure on the sympathetic chain around the CICA.

EgeUn###, Purpose:Hinman syndrome is a rare disease with urodynamic findings and a clinical course resembling neuropathic bladder, without a neuropathic etiology. Diffusion tensor imaging is a special technique of magnetic resonance imaging that has recently been used to evaluate the peripheral nerves but has been demonstrated to be applicable for evaluation of the lumbosacral plexus. We examined the lumbosacral plexus using diffusion tensor imaging, which has not previously been reported in patients with Hinman syndrome.Materials and Methods:The study included 12 patients who fulfilled criteria for Hinman syndrome, with severe bladder dysfunction on urodynamics, renal scarring on scintigraphy and no pathological findings on magnetic resonance imaging. The 12 subjects serving as controls required pelvic or spinal magnetic resonance imaging for reasons other than spinal abnormalities. Evaluation was performed with a 3.0 Tesla magnetic resonance imaging system and 16-channel body coil. Tractography was done to examine the lumbosacral plexus. Fractional anisotropy and mean diffusivity were computed and compared between groups for the right and left plexuses.Results:Mean fractional anisotropy was 0.24 and 0.35 for the right plexus in patients and controls, respectively, and 0.24 and 0.36 for the left plexus. Mean diffusivity was 1.39 for the right and left plexuses in patients, and 1.28 for the right and left plexuses in controls (p, Aliye Uster Foundation (Izmir, Turkey), Supported by Aliye Uster Foundation (Izmir, Turkey) research scholarship.

Amaç: Wernicke ensefalopatisi (WE) tiamin (vitamin B1) eksikliğine bağlı olarak gelişen nöropsikiyatrik bir hastalıktır. Sıklıkla kronik alkolizme bağlı olarak görülmekle birlikte tiamin alım veya emilim eksikliğine neden olan her türlü durumda ortaya çıkabilir. Bu çalışmanın amacı tedavi edilmediği takdirde ölüme kadar giden ciddi sonuçlar doğurabilen bu hastalığın tanı ve izleminde manyetik rezonans görüntülemenin (MRG) önemini vurgulamaktır. Gereç ve Yöntem: Çalışmamıza kurumumuzda hospitalize edilen ve non-alkolik nedenlerle WE tanısı alan 10 hasta dahil edildi. Hastaların MRG tetkiklerinde tutulum yerlerinin lokalizasyonuna göre tipik ve atipik bulguların varlığı değerlendirildi. Ayrıca eşlik eden difüzyon kısıtlılığı varlığı araştırıldı. Bulgular: Kraniyal MRG’de tipik tutulum alanları 10 hastada bilateral talamus mediali, 8 hastada bilateral mamiller cisim, 7 hastada periakuaduktal alan/tektal plak olarak tespit edildi. Atipik tutulum alanları ise 5 hastada forniks, 4 hastada serebral korteks, 2 hastada putamen, 1 hastada ise serebellum tutulumu şeklinde idi. 8 hastada bu bulgulara difüzyon kısıtlılığı eşlik etmekteydi. Sonuç: Sunulan çalışmanın sonuçlarına göre, non-alkolik WE tanılı olgularda MRG’de, alkolik WE tanılı olgularla benzer bulgular gözlenmektedir. Bu hastaların tanı ve tedavilerinin gecikmemesi amacıyla MR görüntülemenin kullanımının önemli rol oynadığı sonucuna varılmıştır., Aim: Wernicke encephalopathy (WE) is a neuropsychiatric disease that develops due to the deficiency of thiamine (vitamin B1). It is often observed due to chronic alcoholism; however it can arise in any condition that causes deficiency in the intake or absorption of thiamine. The aim of this study is to emphasize the importance of magnetic resonance imaging (MRI) in the diagnosis and follow-up of this disease which can even lead to death when it is not treated. Materials and Methods: Ten patients, who had been hospitalized in our institution and diagnosed as WE due to non-alcoholic reasons, were included in our study. In the MRI examinations of the patients, typical and atypical findings were evaluated according to the localization of involvement areas. The existence of accompanying diffusion restriction was evaluated. Results: Typical involvement areas in cranial MRI were determined as bilateral medial thalamus in 10 patients, bilateral mammillary bodies in 8 patients, periaqueductal area/tectal plate in 7 patients. Atypical involvement areas were determined as fornix in 5 patients, cerebral cortex in 4 patients, putamen in 2 patients and cerebellum involvement in 1 patient. These findings were accompanied by diffusion restriction in 8 patients. Conclusion: According to the results of the presented study, cranial MRI has similar findings in alcoholic and nonalcoholic WE patients. We conclude that, the utilization of cranial MRI in these patients has an important role to prevent the latency of the diagnosis and treatment.

During the process of developing the DSM-5, a new phenotype of ADHD was proposed-the ADHD restrictive inattentive presentation (ADHD-RI), describing subjects with high endorsement of inattentive symptoms and a low level of hyperactivity. However, this phenotype was not included in the DSM-5 because of the lack of robust neurobiological data. We aimed to assess the specific neurobiological underpinnings of individuals presenting ADHD-RI. We compared a sample of 301 subjects (101 ADHD-Combined; 50 ADHD-RI; 50 ADHD predominantly inattentive type and 100 typically developing subjects) aged 8-15 years, using a complete neuropsychological battery, molecular genetic data (DRD4 and DAT1 most studied polymorphisms) and functional MRI during a Go-No/Go task. Subjects with ADHD-RI had a significantly different neuropsychological profile compared with the other groups, including lower psychomotor speeds, longer reaction times and the worst overall performance in the global neurocognitive index. The proportion of subjects with the presence of DRD4-7 repeat allele was significantly higher in ADHD-RI. The fMRI data suggested that more attention-related posterior brain regions (especially temporo-occipital areas) are activated in ADHD-RI during both Go and No-Go cues compared to TD controls and ADHD predominantly inattentive type. ADHD-RI may represent a different phenotype than other types of ADHD. In addition, our results suggest that reducing the phenotypic heterogeneity may aid in the search for the neurobiological underpinnings of ADHD.

Intravascular B cell lymphoma is rare and an agressive form of large B cell lymphoma which can affect central nervous system. Because of its varied clinical symptoms and the absence of lymphadenopathy, it is generally diagnosed postmortem. Cerebral infarction due to occlusion of arteries can be seen as a rare clinical form of central nervous system involvement. Large artery atherosclerosis, cardiyoembolism and small artery occlusion are the important causes of ischemic stroke but no any cause is detected in %15-40 of all cases. In this report, with the discussion of a case with ischemia like encephalopathy and multiple cerebral ischemic lesions at different stages in cranial MRI which was diagnosed by the help of brain biopsy as a intravascular B cell lymphoma, it is aimed to take attention intravascular lymphoma as a rare cause of ischemic stroke.

Ağır afaziye rağmen şarkı söyleme yeteneğinin korunabildiği uzun yıllardır bilinmektedir. Lezyon çalışmalarına dayanarak özellikle melodi üretiminde sağ hemisferin daha baskın olduğu öne sürülmüştür. Bu çalışmada akut sol hemisferik infarkta bağlı akıcı olmayan afazisi olan, şarkı sözlerini konuşma dilinde söyleyemez iken, melodinin ilk bölümü söylendiğinde bildiği şarkıyı müzikal hatasız söyleyebilen 50 yaşında bayan olgu sunulmuştur. Olgunun bildiği bir şarkıyı söylerken uygulanan fonksiyonel manyetik rezonans görüntüleme (fMRG) çalışmasında bilateral anterior temporal, mezensefalik ve sağ derin temporal aktivasyon gözlendi. Müziksel işlevler sırasında hemisferik baskınlık ve serebral ağlar, olgumuzdaki radyolojik bulgu ve son nörogörüntüleme çalışmaları ışığında tartışılmıştır. Afazik olguların müzikal tedavi ile iyileşmelerinin hızlanabileceği ayrıca vurgulanmıştır. ( Nöropsikiyatri Arşivi 2013; 50: 189-192 ), Preservation of ability to sing in the presence of severe expressive aphasia has been known for a long time. Based on lesion studies, it is generally proposed that the right hemisphere is dominant especially for melody production. We present a 50-year-old woman with non-fluent aphasia due to left hemisphere acute infarction. If the first part of the melody was given by the examiner, she was able to sing a familiar song with text words without any musical error, where she was unable to speak the same words. 3T functional magnetic resonance imaging showed bilateral anterior temporal, bilateral mesencephalic and right deep temporal activation during the task of singing a familiar song. Hemispheric domain specificity and cerebral network in musical processing will be discussed on the basis of our findings and recent neuroimaging studies. We also emphasize that music therapies may facilitate recovery in such non-fluent aphasic patients. ( Archives of Neuropsychiatry 2013; 50: 189-192)

Introduction An evolving literature suggests a volume reduction and a loss of functional integrity of prefrontal cortex in depressed patients. Interhemispheric prefrontal functional integrity is mediated via the anterior portion of the corpus callosum. Until recently interhemispheric fibers connecting prefrontal cortex have not been well defined. In this study, we compared the corpus callosum area of depressed patients with controls using a novel schema proposed by Hofer and Frahm (2006) which defined a specific anterior callosal area for prefrontal interhemispheric fibers. We further investigated the correlation between callosal area and prefrontal cortical volume. Methods Thirty-six patients with major depressive disorder and thirty-three healthy controls were recruited. All subjects were psychotropic medication-free and right-handed. The imaging was performed on a 1.5 T MR unit (Magnetom Vision Siemens). The images obtained from 3D MP-RAGE sequence were used for analyses. Medical Image Processing, Analyzing and Visualization (MIPAV) software was used for callosal and prefrontal measurements. Results Depressed patients had reduced prefrontal cortical volume and a loss of the normal callosal/gray matter correlation, but normal white matter volume and normal callosal areas. Limitations It is not known if the observed changes were preexisting or acquired. Conclusion Our results indicate that the normal structural relationship between anterior callosal area and prefrontal cortical volume is disrupted in major depressive disorder and that the disruption is due to reduced cortical volume rather than to changes in interhemispheric connections.

WOS: 000422853200006, Background: The aim of this study was to evaluate the recurrence patterns and the times of recurrence after temozolomide-based radiochemotherapy for high grade gliomas. Methods: Magnetic resonance imaging (MRI), diffusion MRI, perfusion MRI, and MRI spectroscopy scans of 30 patients who were treated with radiotherapy concurrently with temozolomide chemotherapy between June 2009 and April 2012 were retrospectively evaluated. Central, in-field, marginal, and distant recurrences of progression were defined related to radiation therapy dose distribution (90% isodose line). Results: The overall survival (OS) rates of central recurrences at 1 year and 2 years were 78% and 25%, respectively (at a median of 16 months). The OS rate of in-field, marginal and distant recurrences at 1 year and 2 years were 100% and 40%, respectively (at a median of 24 months). The progression-free survival (PFS) rate of central recurrences at 1 year and 2 years were 21% and 0%, respectively (at a median of 5 months). The PFS rate of in-field, marginal and distant recurrences at 1 year and 2 years were 36% and 27%, respectively (at a median of 11 months). The PFS rate of pseudoprogression at 1 year and 2 years were 87% and 43% (range, 7-31 months). Conclusions: The survival of new in-field, marginal and distant recurrences are longer and these new lesions develop at a later time compared with central recurrences. Pseudoprogression predicts better response to temozolomide-based radiochemotherapy. Finally, the location of recurrence is determined as one of the prognostic factors for OS and PFS.

Maple syrup urine disease (MSUD) is a rare inherited metabolic disorder resulting from the defective activity of branched-chain 2-ketoacid dehydrogenase complex. Routine screening of newborn with tandem mass spectroscopy on the third day of life may detect elevated branched-chain amino acids in blood before the appearance of encephalopathic symptoms in MSUD cases. If undiagnosed by such a routine screening test, patients often present with encephalopathy and seizures. Clinical neurologic examination is supplemented by electroencephalography and imaging. Here, we report abnormal amplitude-integrated electroencephalography, electroencephalography, magnetic resonance imaging, and magnetic resonance imaging spectroscopy findings in a neurologically asymptomatic male newborn who was diagnosed with MSUD at the third week of life. These neurologic disturbances disappeared at the fourth month of life with appropriate special diet. Therefore, even in already asymptomatic cases, early neurologic deterioration of brain metabolism and structure can be detected with these early laboratory findings, indicating the importance of early diagnosis and management. Patients may also benefit from these investigations during the follow-up period.

Background: The impact of poststroke seizures on the neurological deficits related to ischemic stroke is not well known. It has been reported that following poststroke epilepsy, transient or long-lasting worsening of the poststroke sequelae may develop, but the underlying mechanism of deficit worsening has not been systematically studied by magnetic resonance diffusion-weighted imaging (MRI-DWI). Methods: From 2008 to 2009, 1,010 ischemic stroke patients were admitted to our stroke unit at the Ege University Hospital with first-time strokes. Of these, 76 (7.5%) patients developed delayed seizures in a follow-up period of 18 months. We extracted the clinical and imaging data of the patients from our Stroke Registry databases and other medical records, and evaluated brain MRI, including spin-echo DWI with apparent diffusion coefficient (ADC) maps, FLAIR and T2-weighted images. Results: There were 15 (20%) patients who had long-lasting worsening of the previous neurological sequelae, which we called long-lasting neurological worsening (LLW); 38 (50%) had transient neurological worsening (TNW) and 23 (30%) were without neurological worsening (WNW) after poststroke seizures. DWI findings were present in 3/23 (13%) patients with simple partial-type seizure, in 4/17 (29%) patients with complex partial-type seizure, and in 7/13 (54%) patients with generalized toni-clonic type seizure (p = 0.002). Patients with LLW showed more frequent changes on DWI than those with TNW (53 vs. 16%; p = 0.009). Forty percent of patients with LLW and 5% of those with TNW had ADC decrease (p = 0.004). Patients with LLW had DWI changes in the occipital region more frequently than those with TNW (57 vs. 18%; p = 0.05). Correlation analysis found a significant association between LLW and DWI changes, multiple DWI lesions, ADC decrease, and recurrent seizures. In the control MRI-DWI 1 month after the poststroke seizure, no signal abnormalities were detected in neuroimaging studies of all patients. Despite no functional outcome differences between the groups before the seizure, the functional scales 1 week after the seizure (National Institutes of Health Stroke Scale, Modified Rankin Scale and Barthel Index) showed significantly worse neurological functional statements in the patients with LLW than those with TNW and WNW (p = 0.001). Conclusions: Poststroke seizures may affect poststroke sequelae transiently, which we see more often, but some seizure types may prolong the duration of deficits. Multiple DWI changes and LLW following recurrent and longer poststroke seizures were strongly associated, and this may be due to the effect of seizures causing additional metabolical changes.

Background and purpose: The clinical spectrum of different neuroradiological features of cerebral sinus–venous thrombosis (CSVT) varies considerably. We sought the relationship between different neuroradiological aspects and clinical presentations in these patients. Methods: The diagnosis of cerebral sinus–venous thrombosis has been confirmed by conventional angiography, MRI combined with MR venography following established diagnostic criteria. We analyzed clinical data, symptoms and signs, imaging findings, location and extent of the thrombus, and parenchymal lesions, retrospectively. Results: There were 220 consecutive patients with cerebral sinus–venous thrombosis; 98 (45%) had non-lesional sinus–venous thrombosis (NL CSVT), 51 (23%) had non-hemorrhagic infarct (NHI), 45 (20%) had hemorrhagic infarct (HI), and 26 (12%) had intracerebral hemorrhage (ICH). In patients with hemorrhagic lesion (HI+ICH), advanced age, headache (99%), behavioral disturbances (55%), consciousness disturbances (35%), seizures (41%), and language deficits (42%) were significantly higher than the other patients (NL+NHI) (P

A 55-year-old patient was admitted to the hospital with severe acute back pain. Thoracolumbar magnetic resonance (MR) imaging showed hemorrhage in subarachnoidal-subdural space. On cranial MR imaging and MR angiography, an aneurysm was suspected in the V4 segment of the right vertebral artery. Angiography showed a fusiform dissecting aneurysm in the V4 segment of right vertebral artery. The final diagnosis was ruptured V4 segment aneurysm with subsequent symptomatic migration of hemorrhage into the spinal subarachnoidal-subdural space. The patient was treated endovascularly by coil occlusion of both the aneurysm and vertebral artery. This rare cause and possible mechanisms for spinal migration of intracranial hemorrhage after aneurysmal rupture is discussed.

Posterior reversible encephalopathy syndrome, a serious neurotoxicity, may develop rarely in patients receiving tacrolimus. Because the underlying etiology of posterior reversible encephalopathy syndrome is vasogenic edema, it is generally accepted to be a reversible neurologic condition. Cranial magnetic resonance imaging techniques enable detection of the type of edema, and they are widely used in the differential diagnosis and prognostic prediction of posterior reversible encephalopathy syndrome. Presented here is a case of posterior reversible encephalopathy syndrome in which the patient recovered completely, despite radiologic findings indicating the coexistence of vasogenic and cytotoxic edema secondary to tacrolimus therapy after liver transplantation.

Objective We aimed to detect the frequency of restricted diffusion in intracerebral metastases and to find whether there is correlation between the primary tumor pathology and diffusion-weighted MR imaging (DWI) findings of these metastases. Material and methods 87 patients with intracerebral metastases were examined with routine MR imaging and DWI. 11 hemorrhagic metastatic lesions were excluded. The routine MR imaging included three plans before and after contrast enhancement. The DWI was performed with spin–echo EPI sequence with three b values (0, 500 and 1000), and ADC maps were calculated. 76 patients with metastases were grouped according to primary tumor histology and the ratios of restricted diffusion were calculated according to these groups. ADCmin values were measured within the solid components of the tumors and the ratio of metastases with restricted diffusion to that which do not show restricted diffusion were calculated. Fisher's exact and Mann–Whitney U tests were used for the statistical analysis. Results Restricted diffusion was observed in a total of 15 metastatic lesions (19, 7%). Primary malignancy was lung carcinoma in 10 of these cases (66, 6%) (5 small cell carcinoma, 5 non-small cell carcinoma), and breast carcinoma in three cases (20%). Colon carcinoma and testicular teratocarcinoma were the other two primary tumors in which restricted diffusion in metastasis was detected. There was no statistical significant difference between the primary pathology groups which showed restricted diffusion ( p > 0.05). ADCmin values of solid components of the metastasis with restricted diffusion and other metastasis without restricted diffusion also showed no significant statistical difference (0.72 ± 0.16 × 10 −3 mm 2 /s and 0.78 ± 21 × 10 −3 mm 2 /s respectively) ( p = 0.325). Conclusion Detection of restricted diffusion on DWI in intracerebral metastasis is not rare, particularly if the primary tumor is lung or breast cancer. However we found that there is no correlation between the metastasis showing restricted diffusion and primary pathology. Prospective studies with larger groups and more information are necessary regarding the correlation between the primary tumor histopathology and the ADC values of metastasis with restricted diffusion.

Wernicke's Encephalopathy is an acute neuropsychiatric syndrome that can be seen in both alcohol abusers and non-alcoholic population as a result of thiamine deficiency. We herein report a non-alcoholic patient with typical clinical presentations but atypical MRI findings. Early clinical suspicion of WE is especially important in non-alcoholic patients with atypical MRI findings. The diagnosis of this group is more difficult to make and the prognosis of the syndrome mostly depends on early initiation of thiamine supplementation.

This study aimed to provide novel insights into the white matter (WM) microstructural properties of Attention Deficit/Hyperactivity Disorder (ADHD) subtypes by recruiting a relatively large sample of stimulant-naive children and adolescents who had no comorbidity other than Oppositional Defiant Disorder and were homogenous according to the DAT1 gene polymorphism. A sample of 72 ADHD subjects and 24 controls aged 8-15 years were enrolled in the study. We applied tract-based spatial statistics to the DTI measures for obtaining fractional anisotropy (FA) and axial, radial diffusivity (AD, RD) measures to explore ADHD type-related differences in WM for the whole brain. Comparing ADHD-Combined group (ADHD-C) with the ADHD predominantly inattentive group (ADHD-I) we detected increased RD in several bilateral brain area and increased AD mostly in left side of the brain, including the body and splenium of the corpus callosum; the anterior and posteriors limbs of the internal capsule; the superior, anterior and posterior corona radiata; the posterior thalamic radiation; and the superior longitudinal fasciculus. Likewise, mostly in the overlapping brain areas, the ADHD-C group presented increased AD values than ADHD-RI. Significant differences among ADHD types could be a preliminary evidence that they have distinct microstructural properties. There were no significant differences in diffusivity between controls and both the ADHD group as whole or any ADHD subgroups.

Background – Cortical and/or deep vein thrombosis (CDVT) without dural sinus involvement is uncommon and presents diagnostic difficulty for many reasons. Our aim is to determine the relationship between magnetic resonance imaging (MRI) findings and clinical findings in patients with CDVT. Methods – Forty-six patients with venous stroke proved on MRI included in our Registry, corresponding to 0.1% of 4650 patients with stroke, were studied. Magnetic resonance angiography (MRA) was performed in all patients, and 18 of them had follow-up MRA. Outcome was evaluated by using the Glasgow Outcome Scale at the time of discharge and during follow-up. Results – Thirty-two patients presented cortical venous stroke; 21 of them had involvement of the dorsomedial venous system, six had a defect in the posteroinferior venous group, and five had a defect in the anteroinferior venous group. Thirteen patients presented simultaneous involvement of the superficial and deep venous system; seven with a defect in the parietal and internal cerebral veins (three with involvement of vein of Gallen), four with a defect in the temporooccipital (vein of Labbe) and basal vein of Rosenthal, two with a deficit in the anterior frontotemporal and uncal-pterygoid venous system. One patient had deep venous thrombosis primarily localized to the thalami bilaterally and the basal ganglia on the right because of occlusion of the thalamostriate veins. The main presenting symptoms of CDVT were headache, focal neurologic signs, partial complex or secondary generalized seizures, and consciousness disturbances in those with deep venous thrombosis, presented alone or in combination at onset. CDVT was more than twofold more frequent in women than in men. Pregnancy, puerperium, oral contraceptive use, and infections were the most common predisposing factors. Conclusion – Computerized tomography, conventional MRI and diffusion-weighted imaging showing ischemic and/or hemorrhagic lesion that does not follow the boundary of classical arterial boundaries without signs of sinus thrombosis, and partial or generalized seizures followed by focal neurologic signs may predict CDVT. The outcome of patients with cortical venous stroke was good, but not in those with cortical plus deep venous infarction.

This case report demonstrates the importance of the CISS sequence, a fast imaging technique in MRI, in case of suspected nerve root avulsion. We present a case of traumatic pseudomeningoceles at T1-T2 root levels with right T2 ventral root avulsion without associated skeletal fracture diagnosed by MRI using the three dimensional CISS technique. A 28-year-old man presented to the Emergency Department following a motorcycle accident. Clinical examination revealed paresis in intrinsic muscles of the right hand. Traumatic pseudomeningoceles at T1-T2 root levels bilaterally with right T2 ventral root avulsion without associated skeletal fracture were diagnosed by three dimensional cervicothoracic MRI with CISS technique.

Common contrast-enhancing malignant tumors of the brain are glioblastoma multiforme (GBMs), anaplastic astrocytomas (AAs), metastases, and lymphomas, all of which have sometimes similar conventional MRI findings. Our aim was to evaluate the role of perfusion MR imaging (PWI) and diffusion-weighted imaging (DWI) in the differentiation of these contrast-enhancing malignant cerebral tumors.Forty-eight patients with contrast-enhancing and histologically proven brain tumors, 14 AAs, 17 GBMs, nine metastases, and eight lymphomas, were included in the study. All patients have undergone routine MR examination where DWI and PWI were performed in the same session. DWI was performed with b values of 0, 500, and 1000 mm(2)/s. Minimum ADC values (ADC(min)) of each tumor was later calculated from ADC map images. PWI was applied using dynamic susceptibility contrast technique and maximum relative cerebral blood volume (rCBV(max)) was calculated from each tumor, given in ratio with contralateral normal white matter. Comparisons of ADC(min) and rCBV(max) values with the histological types of the enhancing tumors were made with a one-way analysis of variance and Bonferroni test. A P value less than 0.05 indicated a statistically significant difference.The ADC(min) values (mean+/-S.D.) in GBMs, AAs, lymphomas, and metastases were 0.79+/-0.21 (x10(-3)mm(2)/s), 0.75+/-0.21 (x10(-3)mm(2)/s), 0.51+/-0.09 (x10(-3)mm(2)/s), and 0.68+/-0.11 (x10(-3)mm(2)/s), respectively. The difference in ADC(min) values were statistically significant between lymphomas and GBMs (P0.05). It was also statistically significant between lymphomas and AAs (P0.03). However, there were no differences between lymphomas and metastasis, and between GBMs, AAs, and metastasis. The rCBV(max) ratio (mean+/-S.D.) in GBMs were 6.33+/-2.03, whereas it was 3.66+/-1.79 in AAs, 2.33+/-0.68 in lymphomas, and 4.45+/-1.87 in metastases. These values were statistically different between GBMs and AAs (P0.001), GBMs and lymphoma (P0.0001). Although there seemed to be difference between GBMs and metastases, it was not statistically significant (P0.083).Combination of DWI and PWI, with ADC(min) and rCBV(max) calculations, may aid routine MR imaging in the differentiation of common cerebral contrast-enhancing malignant tumors.

To determine whether diffusion-weighted imaging by using minimum apparent diffusion coefficient (ADC(min)) values could differentiate various brain tumors including gliomas, metastases, and lymphomas.We examined 65 patients with histologically or clinically diagnosed brain tumors (12 low-grade gliomas, 31 high-grade gliomas, 14 metastatic tumors, and 8 lymphomas) using a 1.5 T MR unit. On diffusion-weighted imaging, the ADC(min) values were measured within the tumors and mean values were evaluated regarding statistical differences between groups.The ADC(min) values of low-grade gliomas (1.09+/-0.20 x 10(-3)mm(2)/s) were significantly higher (p.001) than those of other tumors. There were no statistical significant differences between glioblastomas (0.70+/-0.16 mm(2)/s), anaplastic astrocytomas (0.77+/-0.21 mm(2)/s), metastases (0.78+/-0.21 mm(2)/s), and lymphomas. But, lymphomas had lower mean ADC(min) values (0.54+/-0.10mm(2)/s) than high-grade gliomas and metastases.The ADC measurements may help to differentiate low-grade gliomas from high-grade gliomas, metastases, and lymphomas. Although there is no statistical difference, lymphomas seem to have marked restriction in diffusion coefficients.

Background and Purpose: The clinical, etiological and stroke mechanisms are defined well before but the detailed clinical and etiologic mechanisms regarding to all clinical spectrum of posterior inferior cerebellar artery (PICA) infarcts were not systematically studied by diffusion-weighted imaging (DWI). Methods: Seventy-four patients with PICA territory ischemic lesion proved by DWI with decreased apparent diffusion coefficient and FLAIR (fluid attenuation inversion recovery) included in our Registry, corresponding to 2% of 3,650 patients with ischemic stroke, were studied. The presence of steno-occlusive lesions in the posterior circulation were sought by magnetic resonance angiography, and reviewed with a three-dimensional rotating cineangiographic method. Results: We found six subgroups of PICA territory infarcts according clinico-topographical relationship: (1) 9 patients with lesion in the territory lateral branch of PICA; (2) 23 patients with an infarct in the territory of medial branch of PICA; (3) 9 patients with a lesion involving both medial and lateral branches of the PICA; (4) 9 patients with cortical infarcts at the boundary zones either between medial and lateral branches of the PICA or between PICA and m/l superior cerebellar artery (SCA); (5) 10 patients with a lesion at the deep boundary zones either between medial and lateral PICA, or between PICA and medial/lateral SCA; (6)14 patients with concomitant multiple lesions in the PICA and in other vertebrobasilar artery territories. The main cause of PICA infarcts was extracranial large-artery disease in 30 patients (41%) patients, cardioembolism and in situ branch disease in 15 patients (20%) each. Conclusions: Multiple PICA territory lesions on DWI were not uncommon and could be caused by multiple emboli originating from break-up of atherosclerotic plaque in the subclavian/innominate-vertebral arterial system. DWI findings of single or multiple small lesions could account for some cases with transient and subtle cerebellar symptoms which have been considered before as ‘vertebrobasilar insufficiency’ without morphologic lesion. Different clinical-DWI correlations allow us to determine better definition of the topographical and etiological spectrum of acute PICA territory lesions, which was previously defined by pathological and conventional MRI studies.

In this report the diffusion-weighted imaging (DWI) findings and ADC values of leukoaraiosis (LA) and associated periventricular ischemic lesions were assessed. Seventy-eight patients with LA were examined with magnetic resonance imaging (MRI) and DWI. Twenty one patients (28%) were found to have focal acute white matter infarction on DWI which could not be detected and discriminated on the basis of MRI findings alone. LA and acute white matter infarction both showed hyperintensity on standard T2W MRI, whereas acute infarction revealed focal hyperintensity on DWI. Thirteen patients (16%) had chronic lacunar infarctions in the white matter. ADC values of LA, acute and chronic white matter infarctions were calculated and found to be significantly different from each other (p

We present five new cases of van der Knaap's leukoencephalopathy, which is a rare abnormality characterized by infantile-onset white matter disease with swelling and mild clinical course. Based on the very rare histopathological data, this disease is considered a vacuolating myelinopathy with peripherally located intralamellar vacuoli. Although approximately 70 cases have so far been published, there are very limited data in the literature regarding diffusion-weighted imaging (DWI) findings of this recently discovered entity. In this paper, in addition to MRI, MRS and DWI findings in three patients are shown, apparent diffusion coefficient (ADC) maps are calculated, and ADC measurements made from various regions of interest are documented. MRI showed diffuse swelling and areas of T2 high signal in supratentorial white matter, sparing the cortex and central gray matter structures. MRS findings indicated some degree of neuronal loss. DWI and ADC maps showed increased diffusion rates, suggesting a different type of tissue damage than that would be expected in vacuolating myelinopathies. We believe that DWI and ADC mapping would be of help in providing a baseline for monitoring the progression of the disease.

PURPOSE: Pseudoprogression is defined among the glioblastoma (GBM) patients as clinical deterioration and/or radiological enlargement and contrast enhancement after radiochemotherapy which resolves during the follow-up. It is typically detected within 3 months after radiochemotherapy. Late pseudoprogression is not common and not clearly defined yet. We analyzed 33 patients who were reoperated for clinical/radiological progression after chemoradiotherapy and compared the clinicopathologic characteristics of the patients without any histologic evidence of tumor with those having real tumor progression. MATERIAL AND METHODS: We identified histologically verified GBM patients who underwent a second tumor resection after radiochemotherapy due to clinical deterioration and/ or radiologically progression between January 2010- October 2013. All pathological specimens were evaluated in our center and were separated in two groups; GroupA: real recurrence of GBM, Group B:late pseudo progression, either no evidence of tumor, complete necrosis or treatment related changes reminding tumor regression. We determined survival after primary surgery and re-resection with regard to pathological results using Kaplan-Meier estimates. RESULTS: 33 patients were included in this study. Median age was 51 (range:17-72), male/female ratio was 2.3/1. After the radiochemotherapy, clinical deterioration and/ or radiologically progression was detected median 10 months later (range: 4-22months).After the secondary surgery, 18 patients (55%) showed late pseudoprogression but 15 patients (45%) experienced real tumor recurrence in the pathological evaluation. From the diagnosis, 2-year survival rate was 26.3% in whole group. 2-year survival rate was 36% in patients who had late pseudoprogression and 16.7% in patients who had real tumor progression (p:0,45). After the secondary surgery, 2 year survival rate was 11% in cases with late pseudoprogression and median survival was 9 months (range:4-28 months). In patients who experienced real tumor recurrence, 2-year survival after secondary surgery was%0 and median survival was 4 months (range: 2-12 months) . Median time to recurrence was 9 months (range :5-22 months) in patients with late pseudoprogression but 11 months (range:4-18 months) in patients experienced real tumor recurrence. CONCLUSION: GBM patients occasionally undergone reoperation due to clinical deterioration or radiological progression, however no evidence of tumor is found in some cases which may be defined as late pseudoprogression. The survival of these patients are better than the cases with tumor progression.

A case of hypertrophic cranial pachymeningitis with an unusual and misleading manifestation is reported. CT detected calcified tentorium and superior sagittal sinus. MR imaging and MR angiography depicted tentorial thickening as well as occlusion of all major dural sinuses. Fibrocalcific occlusion of dural sinuses showed interestingly signal-void appearance on spin-echo images which could readily be interpreted as being patent sinuses.

WOS: 000236154900020, PubMed ID: 16459088, Apart from calvarial infiltration, intracranial involvement in multiple myeloma is uncommon. Diffuse leptomeningeal invasion with or without parenchymal involvement is most common. Dural infiltration without involvement of the parenchyma, leptomeninges or skull is rare. The differential diagnosis of a dural plasmacytoma includes meningioma, which has a similar MRI appearance, metastasis, lymphoma and sarcoma of the dura mater. We present a patient with multiple myeloma presenting with an intracerebral mass mimicking a meningioma on MRI. Multiple myeloma had been diagnosed seven years previously. The patient presented with headache and speech disturbance 12 months after autologous peripheral stem cell transplantation for recurrence of multiple myeloma. MRI revealed a left temporal extra-axial mass with a dural tail mimicking meningioma. Histopathological examination of the mass after excision showed multiple myeloma immunopositive for IgG, kappa light chain and CD38. There was no recurrence after postoperative radiotherapy. Plasmacytoma should be considered in the differential diagnosis of a solitary dural mass., particularly in a patient with multiple myeloma. (c) 2006 Published by Elsevier Ltd.

Manganese-enhanced magnetic resonance imaging (MEMRI) has been used to detect brain activity based on the ability of active neurons to take up manganese ions through calcium channels. Kainic acid (KA), an analog of excitotoxic glutamate, can elicit selective neuronal death in the brains of rodents, of which the pathological changes partially mimic neurodegeneration in the central nervous system. We used in vivo MEMRI to evaluate neurodegenerative changes in an excitotoxicity model induced by KA in rats.Adult Sprague-Dawley rats (220-250 g) were injected with either KA or saline into the right lateral ventricle. Precontrast and postcontrast MEMRI sessions were obtained. Region of interest (ROI) analyses were performed on both injected (saline and KA) and contralateral (normal) sites in the hippocampal area. All brains were evaluated histologically following MEMRI.Analysis of percentage change in ROI intensities of T1-weighted fluid-attenuated inversion-recovery MR images in the hippocampal area revealed a significant difference between the KA-injected (ipsilateral) and contralateral sites (P = 0.008), whereas no significant difference was observed between the saline-injected and contralateral sites. Furthermore, there was a significant difference between ipsilateral sites of the saline-treated and KA-treated groups (P = 0.026). The histological results supported these findings.MEMRI is a simple and useful in vivo method for detecting neurodegenerative changes due to excitotoxicity in the rat brain. The development of a manganese-based contrast agent that can be safely used in humans is warranted to investigate neurological disorders.

Purpose Manganese-enhanced magnetic resonance imaging (MEMRI) has been used to detect brain activity based on the ability of active neurons to take up manganese ions through calcium channels. Kainic acid (KA), an analog of excitotoxic glutamate, can elicit selective neuronal death in the brains of rodents, of which the pathological changes partially mimic neurodegeneration in the central nervous system. We used in vivo MEMRI to evaluate neurodegenerative changes in an excitotoxicity model induced by KA in rats. Materials and methods Adult Sprague-Dawley rats (220-250 g) were injected with either KA or saline into the right lateral ventricle. Precontrast and postcontrast MEMRI sessions were obtained. Region of interest (ROI) analyses were performed on both injected (saline and KA) and contralateral (normal) sites in the hippocampal area. All brains were evaluated histologically following MEMRI. Results Analysis of percentage change in ROI intensities of T1-weighted fluid-attenuated inversion-recovery MR images in the hippocampal area revealed a significant difference between the KA-injected (ipsilateral) and contralateral sites (P = 0.008), whereas no significant difference was observed between the saline-injected and contralateral sites. Furthermore, there was a significant difference between ipsilateral sites of the saline-treated and KA-treated groups (P = 0.026). The histological results supported these findings. Conclusion MEMRI is a simple and useful in vivo method for detecting neurodegenerative changes due to excitotoxicity in the rat brain. The development of a manganese-based contrast agent that can be safely used in humans is warranted to investigate neurological disorders.

Brucellosis is a multisystem infection with a broad spectrum of clinical presentations. Its nervous system involvement is known as neurobrucellosis. Neurobrucellosis (NB) has neither a typical clinical picture nor specific cerebrospinal fluid (CSF) findings. Its diagnosis is based on the existence of a neurologic picture not explained by any other neurologic disease, evidenced by systemic brucellar infection and the presence of inflammatory alteration in CSF. Imaging findings of NB is divided into four categories: (1) normal, (2) inflammation (recognized by granulomas, abnormal enhancement of the meninges, perivascular space, or lumbar nerve roots), (3) white matter changes, and (4) vascular changes.

A patient is presented with widespread primary hydatid cysts in spinal-paraspinal locations, secondary to Echinococcus granulosus. An alternative mechanism to explain how the embryos gained access to the body is proposed: The embryos penetrated the intestinal muscle and may have directly entered into the inferior vena cava system through small venous connections between this system and portal circulation. Various conditions in daily life associated with Valsalva maneuver might have caused such an atypical passage of the embryos to the inferior caval system toward the retroperitoneum and spinal-paraspinal structures via lumber epidural venous plexuses.

Developmental venous anomalies (DVAs) are common congenital venous drainage anomalies. Although they typically have a benign clinical course and a low symptomatic rate, thrombosis of a drainage vein may occur, leading to potentially debilitating complications. We report imaging findings of posterior fossa DVA with a thrombosed drainage vein in a patient with nonhemorrhagic cerebellar infarct. We also review the relevant literature on the subject. © 2009 by the American Society of Neuroimaging.

In this retrospective study, we evaluated the contribution and role of diffusion-weighted imaging (DWI) in differentiating acute and chronic forms of brucellar spondylodiscitis. We also describe the characteristics and some indistinguishable features of brucellar spondylodiscitis on magnetic resonance imaging (MRI) to emphasise the importance and limitations of MRI.MRI examinations of 25 patients with brucellar spondylodiscitis were retrospectively reviewed and analysed by two experienced radiologists. Signal and morphological changes were assessed. The imaging characteristics of acute and chronic forms of spondylodiscitis were compared. Both discriminative imaging findings of brucellar spondylodiscitis and some uncommon findings were interpreted.Of 25 patients with spinal brucellosis, eight had thoracic, ten had lumbar, five had both thoracic and lumbar and two had both lumbar and sacral vertebral involvement. We detected posterior longitudinal ligament elevation in 11 patients, epidural abscess formation in 11 and paravertebral abscess formation in nine. Ten patients had cord compression and eight had root compression. Three patients had facet-joint involvement, and one had erector spinae muscle involvement. Eight patients (32%) were in the acute stage, six (24%) in the subacute stage and 11 (44%) in the chronic stage. Vertebral bodies, vertebral end plates and intervertebral disc spaces were hypointense and hyperintense in the acute stage, whereas they were hypointense and heterogeneous in the subacute and chronic stages on T1- and T2-weighted images, respectively. In the acute stage on the DWI series, vertebral bodies, end plates and discs were all hyperintense but hypointense in the chronic stage.Although conventional MRI has several advantages over other imaging modalities and is very useful in the differential diagnosis between brucellar spondylodiscitis and other spinal pathologies, it has some difficulties in discriminating acute and chronic forms of spondylodiscitis. DWI is a sensitive, fast sequence that has the potential for differentiating acute and chronic forms of spondylodiscitis, which makes it crucial in spinal imaging.

Computed tomography (CT) is very sensitive for detection and localization of intracranial calcifications. We reviewed in this pictorial essay the diseases associated with intracranial calcifications and emphasized the utility of CT for the differential diagnosis.

We report a patient with rhinocerebral mucormycosis whose initial central nervous system involvement was isolated pontine infarction due to basilar arteritis caused by the fungus. The patient was diagnosed and followed by MRI and CT and basilar arteritis was demonstrated well on MRI studies. Involvement of the skull base was shown on CT in the later stage of the disease. The unusual initial presentation of the infection is discussed.