Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Case Reports
Hemodynamic effects of innominate artery occlusive disease on anterior cerebral artery.
Stenoses of the innominate artery (IA) may affect flow conditions in the carotid arteries. However, alternating flow in ipsilateral anterior cerebral artery (ACA) due to IA stenosis is extremely rare. ⋯ Magnetic resonance angiography demonstrated tight stenosis of the right IA. For a thorough study of the hemodynamic effects of IA stenosis, a combination of duplex and transcranial Doppler examination is required.
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Case Reports
Isolated pontine progressive multifocal leukoencephalopathy: unusual magnetic resonance imaging features.
Progressive multifocal leukoencephalopathy (PML) is an uncommon opportunistic infection that causes focal or multifocal demyelination predominantly in the subcortical white matter. The authors describe the clinical and radiographic features in 2 unusual cases of PML that were initially isolated to the pons. One patient presented clinically with only an isolated sixth cranial nerve palsy.
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Abnormally increased 18F-fluorodeoxyglucose uptake in the basal ganglia was noted by positron emission tomography (PET) in a 37-year-old bone marrow transplant patient who had severe intention tremors of his hands and a progressive psychiatric change with social withdrawal and flat affect. This is the first PET report on metabolic abnormalities in cyclosporine neurotoxicity. It emphasizes the need for more research to understand the pathophysiology of these changes.
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Cognitive decline has recently been found to be associated with microemboli in cerebral vessels in patients with artificial heart valves. The authors sought to determine the nature of such microemboli, that is, whether they are gaseous or solid, by comparing their characteristics to those of artificially generated air emboli in patients with patent foramen ovale (PFO). ⋯ No difference in intensity, duration, or relative velocity of microemboli was found between groups. The authors conclude that microemboli generated from artificial heart valves are generally gaseous and not solid.
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The authors report on a 32-year-old man with common variable immunodeficiency and high signal intensity in basal ganglia on T1-weighted images. No signal alteration on T2-weighted and postcontrast images was observed. The patient had elevated levels of manganese in the serum. The authors conclude that the unusual hyperintensity in the basal ganglia area on T1-weighted images resulted from manganese deposition due to liver dysfunction.