Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Internal carotid artery (ICA) elongation (coiling and kinking) has been suggested as a risk factor for carotid dissection. Since vasomotion is known to be impaired in spontaneous cervical vessel dissection, we investigated whether endothelial-dependent vasodilation in subjects with carotid coiling and kinking is compromised. ⋯ Among subjects with carotid elongation, those with severe kinking have an impaired endothelial-dependent vasodilation and might be prone to carotid dissection.
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Evidence from animal models and examination of human epilepsy surgery specimens indicates that inflammation plays an important role in epilepsy. Positron emission tomography (PET) using [C11]PK11195, a marker of activated microglia, provides a means to visualize neuroinflammation in vivo in humans. We hypothesize that in patients with active epilepsy, [C11]PK11195 PET (PK-PET) may be able to identify areas of focally increased inflammation corresponding to the seizure onset zone. ⋯ PK-PET can identify neuroinflammation associated with subtle focal cortical dysplasia, and may therefore have a clinical role in guiding epilepsy surgery for patients with difficult-to-localize seizure foci.
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Cerebral coenurosis due to Taenia multiceps is a rare infection with no case reports from India. A 55-year-old male patient had presented with progressive symptoms of hemiparesis of 1-year duration. Magnetic resonance imaging (MRI) with magnetic resonance spectroscopy (MRS) of the lesion was performed that showed a septated cystic lesion in left parieto-occipital lobe. ⋯ MRS showed mildly elevated choline (Cho), depressed creatine (Cr), and N-acetyl aspartate (NAA), a large peak of lactate, pyruvate, and acetate peaks. To best of our knowledge, there has been no reported case of in vivo proton MRS finding ever reported. We present MRS findings in this operatively proven case of T. multiceps cyst of the brain.
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Reversible cerebral vasoconstriction syndrome (RCVS) is an increasingly recognized acute cerebrovascular condition that may produce myriad transient and sustained neurologic deficits as well as a host of radiologic features. We report the case of a woman with RCVS and a severe clinical syndrome with bilateral basal ganglia hemorrhages, cerebral infarctions, and marked vascular abnormalities. The patient made a near complete clinical recovery, representing an extreme and illustrative form of RCVS.
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Case Reports
Acute stroke, catheter related venous thrombosis, and paradoxical cerebral embolism: report of two cases.
Patent foramen ovale (PFO) has been associated with cryptogenic stroke, particularly in young adults. However, the source of particles leading to cerebral embolism remains frequently unknown despite comprehensive evaluation. ⋯ PFO associated with large venous access site thrombosis was the most likely mechanism of stroke in both cases. Local thrombosis at sites of large venous access may be an overlooked source of paradoxical embolism in patients with PFO as well as a preventable cause of stroke in critically ill patients.