Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Cerebral vasculitis is an unusual disorder with many causes. Infectious causes of cerebral vasculitis are predominantly bacterial or viral in nature. Purulent bacterial vasculitis is most often a complication of severe bacterial meningitis. ⋯ Shortly thereafter, an MRI examination revealed diffuse leptomeningeal enhancement and abscess and a right parietal subdural empyema. Infectious vasculitis secondary to purulent meningitis has a rapidly progressive course and presents with cranial nerve palsy with involvement of the cavernous sinus. Although the association of this disease with pregnancy has not been established, it should be recognized that the early imaging studies may be negative or discordant and follow-up imaging might be necessary.
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The authors investigate changes in brain metabolites among patients with amyotrophic lateral sclerosis (ALS). Twelve patients diagnosed with definite ALS (and 2 subgroups with either pronounced upper motoneuron signs or less obvious, probable upper motoneuron involvement) and 10 controls were examined. 1H studies were performed on a 1.5-T Siemens Magnetom Vision with single voxel (SV). A voxel (TR = 1500 ms, TE = 270 ms, 512 acquisitions, VOI = 8 cm3) was placed bilaterally in the precentral gyrus. In addition, chemical shift imaging (CSI) (VOI = 1 x 1 x 1.5 cm, TR = 1500 ms, TE = 135 ms) was performed. Ratios of peak integrals (N-acetyl-aspartate/choline, N-acetyl-aspartate/creatine, and creatine/choline) were determined. A Mann-Whitney U Test and a Wilcoxon Matched Pairs Test were applied. ⋯ The authors conclude that CSI is more effective at detecting lower N-acetyl-aspartate/choline levels among ALS patients than is SV.
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Case Reports
Intraosseous sacral myxopapillary ependymoma and the differential diagnosis of sacral tumors.
Although involvement of other regions of the spinal cord and brain stem is seen, myxopapillary ependymoma is most commonly found at the filum terminale or cauda equina. Less commonly, myxopapillary ependymoma may occur outside the central nervous system from direct metastatic extension of an intrathecal tumor, and rarely it may present as a primary tumor outside the thecal sac. ⋯ They then discuss the magnetic resonance imaging findings of this and other sacral tumors. Myxopapillary ependymoma should be considered in the differential diagnosis for a primary expansile sacral mass along with other lesions such as chordoma, aneurysmal bone cyst, and giant cell tumor.
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The effect of temporal lobe transection area, volume of postoperative gliosis, and surgical technique on patients' seizure-free outcome is unknown. The authors studied the effects of these variables on patients' seizure-free outcome. ⋯ The authors found no clear association between postoperative outcome and residual temporal lobe gliosis, the surgical technique, or the total area of temporal lobe transected by the scalpel.
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Case Reports
Cerebral vasculitis: diagnosis and follow-up with transcranial Doppler ultrasonography.
The authors report a patient with postpartum intracerebral hemorrhage associated with cerebral vasculitis. Cerebral circulation was assessed with transcranial Doppler (TCD) ultrasonography, magnetic resonance angiography, and conventional cerebral angiography. Initial TCD studies demonstrated bilateral patchy increased cerebral blood flow velocity (CBFV) in the anterior circulation with complete normalization during remission. This case report provides evidence that cerebral vasculitis leads to relevant CBFV changes and that the TCD technique may assist in diagnosis and follow-up of these patients.