Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Previous functional neuroimaging studies performed during transient global amnesia (TGA) have not answered the central question regarding the etiology of TGA, namely: whether the observed hypoperfusion in the mesial temporal lobe structures reflects a primarily ischemic process or whether it represents a secondary phenomenon resulting from locally decreased metabolism. The authors performed Tc 99-m-bicisate brain single photon-emission computed tomography (SPECT) scanning in a 66-year-old man during an episode of TGA, 24 hours after the episode and 3 months after the episode. To the authors' knowledge, this is the only reported study in which a follow-up SPECT scan was performed within 24 hours. ⋯ Resolution of the SPECT scan abnormalities correlated well with resolution of the memory loss. These findings agree with previously reported SPECT, positron-emission tomography (PET), and diffusion magnetic resonance imaging (MRI) studies that indicate the mesial temporal lobe structures as the major site of pathology in TGA. The authors suggest that a process causing decreased local metabolism, such as cortical spreading depression, constitutes the primary pathophysiologic mechanism in this case.
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Bell's palsy (idiopathic facial paralysis) is the most common cause of unilateral peripheral facial neuropathy. Bilateral involvement occurs in less than 10% of cases. The authors describe a 20-year-old man with bilateral idiopathic facial weakness. ⋯ There was no facial nerve swelling. Three months later he had improving residual bifacial weakness. To the authors' knowledge, this is the first report of abnormal MRI findings in bilateral Bell's palsy.
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Comparative Study
Imaging of dopamine transporters with technetium-99m TRODAT-1 and single photon emission computed tomography.
The authors wanted to evaluate the usefulness of 99Tcm-TRODAT-1 as an imaging agent for measuring changes in dopamine transporter concentrations in Parkinson disease (PD) and correlate the findings to the severity of the disease as measured by the Hoehn and Yahr scale (H/Y). Twenty-two healthy volunteers and 27 patients with PD of H/Y stage I-IV were evaluated. ⋯ Patients with PD showed a significant decrease in the striatal uptake of 99Tcm-TRODAT-1 compared to healthy volunteers, and the ST/CB ratios were closely related to the stage of PD. The present study demonstrates that it is possible to visualize and quantify changes in dopamine transporter in the striatum of patients with PD using 99Tcm-TRODAT-1 and SPECT with good correlation to H/Y stage and unified Parkinson's disease rating scale (UPDRS) scale.
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Acute effects of smoking on human cerebral blood flow: a transcranial Doppler ultrasonography study.
Middle cerebral artery (MCA) flow velocity was continuously monitored during smoking in an observational study (n = 14) using transcranial Doppler (TCD) ultrasonography. Cerebral autoregulatory vasodilator capacitance under inspired CO2 challenge was also measured before smoking and at peak smoking effect. ⋯ Gender subgroup analysis showed smoking acutely suppressed the CO2 vasodilator capacitance by 56% in men but only by 5% in women (p = 0.05). The magnitude of the acute smoking-induced increases in MCA flow velocities appeared to be independent of the estimated cigarette yields for nicotine, carbon monoxide, and "tar." Smoking in healthy subjects acutely increased MCA mean flow velocity, which may reflect a global increase in cerebral blood flow via complex influences on the cerebral autoregulation.