Acta neurologica Belgica
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Acta neurologica Belgica · Jun 2011
ReviewThe role of magnetic resonance imaging in the study of multiple sclerosis: diagnosis, prognosis and understanding disease pathophysiology.
Magnetic resonance imaging (MRI) has become an established tool to diagnose multiple sclerosis (MS) and to monitor its evolution. In patients at presentation with clinically isolated syndromes suggestive of MS, MRI criteria for MS diagnosis have been proposed and are updated on a regular basis. In addition, MRI "red flags" useful for the differential diagnosis from other neurological conditions which can mimic MS have been identified. ⋯ The use of these techniques has allowed to grade in vivo the heterogeneity of MS pathology not only in focal lesions, but also in the normal-appearing white matter and grey matter. Combined with the use of functional MRI, this is ameliorating progressively our understanding of the factors associated to MS evolution. This review summarizes how MRI has improved our ability to diagnose MS and to predict its course, as well as how it is changing our understanding of the factors associated with the accumulation of irreversible disability in this condition.
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Acta neurologica Belgica · Jun 2011
Case ReportsPost operative delirium with hyponatriemia after transurethral resection of the prostate: a case of transurethral resection syndrome?
Postoperative delirium is one of the most spectacular, frightening and misdiagnosed postoperative complications of surgery. We describe the case of a caucasian 77-year-old male patient, who developed a severe postoperative delirium after combined transurethral resection of the prostate and cystolithotripsy. ⋯ Because of the heterogeneous clinical presentation diagnosis can be difficult. In a patient who develops alterations of consciousness with evidence of hypervolemia and hyponatremia after endoscopic surgery, transurethral resection syndrome must be considered.