Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Transcranial Doppler (TCD) is an invaluable tool allowing real-time monitoring of physiologic blood flow velocity changes. We present a case where TCD monitoring for vasospasm after subarachnoid hemorrhage identified blood flow velocity changes consistent with sudden increased intracranial pressure (ICP) due to a malfunctioning extraventricular drain. ⋯ Serial TCD monitoring allowed identification of an imminently fatal complication in time to allow a life saving intervention. TCD is a portable, inexpensive, real-time tool providing important physiologic data regarding blood flow velocities and intracranial pressure that is crucial to the care of critically ill patients.
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Review Case Reports
Acute Marchiafava-Bignami disease with extensive diffusion restriction and early recovery: case report and review of the literature.
Marchiafava-Bignami disease (MBD) is a neurological disorder that has been found to be associated with chronic alcoholism and malnutrition. MBD classically results in acute edema and demyelination of the corpus callosum. ⋯ We present an acute onset of MBD with diffusion restriction of the complete corpus callosum and symmetric bilateral extension into the semioval center, that almost completely resolved clinically as well as in MRI only 3 days later. With early detection and treatment, the prognosis of MBD may be good even in cases with severe diffusion restriction of the complete corpus callosum.
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Patients with amnestic mild cognitive impairment (aMCI) are at risk of developing Alzheimer's disease (AD). It is therefore important to identify biomarkers of conversion to AD. This study examined whether the integrity of white matter can predict this conversion. ⋯ Those aMCI subjects with lower than normal FA values in the CF were more likely to convert to AD. The connectivity of the hippocampus and cingulate bundles may be affected in the early stage of AD. Impairment of white matter and fiber bundles was more severe at the AD stage than the aMCI stage.
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Bilateral paramedian thalamic infarction is a rare subtype of stroke the etiology of which still remains undetermined in many patients. ⋯ Vascular imaging is useful to determine underlying vascular pathologies and may support the diagnosis of small vessel disease in those patients with isolated bilateral paramedian thalamic infarction, hypoplastic/absent P1 segment of the PCA, and lack of vascular pathology.