Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Contrast neurotoxicity (CN) following exposure to iodinated contrast is uncommon, and usually presents as cortical blindness due to bilateral occipital lobe involvement. Unilateral cortical dysfunction due to CN could mimic an acute stroke and has been rarely described. We report the case of an 89-year-old female who developed a transient dense/complete left homonymous-hemianopsia and left-sided tactile extinction after undergoing a right internal carotid (ICA) artery rotational angiogram with a standard high-volume iodinated contrast injection for 3D visualization a 6×4-mm right posterior communicating artery aneurysm with a fetal posterior cerebral artery (PCA) incorporated in the neck. ⋯ The potential mechanism of CN in our case was the injection of a high volume of contrast in the ICA for the rotational angiogram. The presence of a right fetal PCA possibly allowed the contrast to reach the right occipital lobe. CN manifesting as an acute focal neurologic syndrome should be considered in the setting of recent iodinated contrast exposure.
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To report a novel endovascular coiling technique for ligation of aneurysms presenting with cranial neuropathy. ⋯ This technique may be considered in patients presenting with compressive cranial neuropathy and an aneurysm configuration that allows selective coiling of the inflow zone.
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Presentation of an interrupted aortic arch (IAA) in adulthood is extremely rare. Nonhemorrhagic stroke has not been reported previously in any adult with IAA. We, herein, describe a formerly asymptomatic 52-year-old male presenting with recurrent vertebrobasilar circulation ischemic strokes resulting from accelerated atherosclerotic arteriopathy secondary to IAA associated upper body hypertension. Surgical correction of IAA led to treatment of hypertension and cessation of ischemic attacks together with regression of collateral arterial networks as shown by computer tomography angiography.
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The pathological process of Huntington's disease (HD) preferentially targets spiny neurons in the striatum, with later involvement of the substantia nigra and other structures. The purpose of this study is to investigate the nigrostriatal dopaminergic system in a genetically confirmed HD family. ⋯ We showed that the postsynaptic part of the nigrostriatal pathway was involved. The presynaptic part is usually not affected but could occur in very advanced cases. Our findings suggest that SPECT imaging of D2 receptors is useful for diagnosing and monitoring HD.
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We present an interesting [18F]fluoro-2-deoxyglucose positron emission tomography (FDG-PET) imaging finding in a patient with ocular flutter and cerebellar ataxia as part of anti-Ma 1/2 antibody-mediated paraneoplastic syndrome associated with a testicular seminoma. He had a typical anterior mesial temporal hyperintensity on magnetic resonance imaging (MRI) without gadolinium enhancement. In addition, his FDG-PET images showed increased deep cerebellar and inferior rectus and superior oblique ocular muscles FDG uptake. This case is the first to visualize in vivo the possible underlying neuropathological mechanism of ocular flutter associated with cerebellar nuclei on functional imaging.