Journal of neuroimaging : official journal of the American Society of Neuroimaging
-
In hepatic encephalopathy (HE), osmotic stressors promoting brain edema result in a compensatory drop in the astrocyte metabolite myo-inositol (mI). Identifying differences between nonalcoholic steatohepatitis (NASH) with and without HE and healthy controls using proton magnetic resonance spectroscopy (MRS) and evaluating hypoalbuminemia and hyperammonemia as osmotic stressors that predict the reduction of mI allow further understanding of mechanisms that promote brain edema in HE. The aim of this study was to assess brain edema in HE using characteristic MRS markers and serum albumin. ⋯ Low mI/tCr and increased Gln/tCr were characteristics of Crhs+HE. Low serum albumin was the strongest predictor of brain osmotic stress indicated by reduced mI/tCr, with no residual independent association seen for brain Gln/tCr concentration. This suggests that hypoalbuminemia in chronic liver disease may promote brain edema in HE.
-
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the name suggests was initially thought to only cause a respiratory illness. However, several reports have been published of patients with ischemic strokes in the setting of coronavirus disease 2019 (COVID-19). The mechanisms of how SARS-CoV-2 results in blood clots and large vessel strokes need to be defined as it has therapeutic implications. ⋯ As the blood-air barrier is breached, varying degrees of collateral damage occur. Although antiviral and immune therapies are studied, the role of blood thinners in the prevention, and management of blood clots in Covid-19 need evaluation. In addition to ventilators and blood thinners, continuous aspiration and clot retrieval devices (approved in Europe, cleared in the United States) or cyclical aspiration devices (approved in Europe) need to be considered for the emergent management of life-threatening clots including PE and large vessel strokes.
-
Neurological and neurodegenerative diseases can affect the spinal cord (SC) of pediatric patients. Magnetic resonance imaging (MRI) allows for in vivo quantification of SC atrophy via cross-sectional area (CSA). The study of CSA values in the general population is important to disentangle disease-related changes from intersubject variability. This study aimed at providing normative values for cervical CSA in children, extending our previous work performed with adults. ⋯ We present CSA normative values in a large cohort of children, reporting on sources of intersubject variability and how to reduce them applying normalization methods previously developed.
-
CT-Based Classification of Acute Cerebral Edema: Association with Intracranial Pressure and Outcome.
Brain edema after acute cerebral lesions may lead to raised intracranial pressure (ICP) and worsen outcome. Notwithstanding, no CT-based scoring system to quantify edema formation exists. This retrospective correlative analysis aimed to establish a valid and definite CT score quantifying brain edema after common acute cerebral lesions. ⋯ The proposed CT-based grading of extent of cerebral edema significantly correlated with ICP and outcome in TBI, SAH, and ICH patients and might be helpful for standardized description of CT-images and as parameter for clinical studies, for example, measuring effects of antiedematous therapies.
-
Microcystic meningiomas (MM) are a distinctive, rare subtype of Grade I meningiomas with limited radiological descriptions. We intend to identify unique imaging phenotypes and seek radiopathological correlations. ⋯ We have elucidated varied neuroimaging features and highlighted pathological substrates of crucial imaging findings of MM. MM ought to be considered as an imaging possibility in an extra-axial lesion with a marked hypodensity on noncontrast computed tomography, markedly T2-hyperintense/T1-hypointense signal, and a storiform/reticular pattern on T2W/GdT1w//DWI.