bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of TCD in the Evaluation of Acute Stroke
Authors: Brunser Alejandro M. , Mansilla Eloy , Hoppe Arnold , Olavarría Verónica , Sujima Emi , Lavados Pablo M. 
Published: February 2016

ABSTRACTBACKGROUNDThe additional information that transcranial Doppler (TCD) can provide as part of a multimodal imaging stroke protocol in the setting of hyper acute strokes has not been evaluated.METHODSConsecutive patients admitted between December 2012 and January 2015 with ischemic stroke of less than 4.5 hours of onset were studied as soon as possible with a protocol consisting of noncontrast brain computed tomography, computed tomography angiography of supra‐aortic vessels, diffusion‐weighted magnetic resonance imaging, and TCD.RESULTSEighty‐six patients were included. The imaging protocol was performed 113.9 (±23) minutes after the stroke symptoms appeared and by TCD after 150.2 (±19) minutes. Sixty‐six (76.7%) patients were treated with revascularization therapies. TCD provided additional information in 49 cases (56.9.4%, 95 CI 46.4‐66.9). More than one piece of additional information was obtained in 17 patients. The most frequent additional information was collateral pathways, information related to patency of vessels, and active microembolization. Multivariate analysis demonstrated that, intracranial vessel occlusion (P <.001) and optimal sonographic windows (P <.004) were the variables associated with additional information. In 15 patients (17.4%; 95 CI 9.4‐25.5) the additional information changed the management. In 8 patients endovascular rescue was applied after the failure of intravenous thrombolysis; in 5 patients angiography was suspended and in 2 other cases aggressive neurocritical care was indicated.CONCLUSIONSTCD in the first 4.5 hours of acute ischemia can provide additional information to a multimodal acute ischemic stroke imaging protocol, and can induce changes in the management of a proportion of these patients.
Lateral Sinus Thrombosis: The Importance of the Unaffected Sinus
Authors: Glik Amir , Benkovich Elya , Kesler Anat , Ifergan Gal , Benifla Moni , Shelef Ilan 
Published: February 2016

ABSTRACTBACKGROUND AND PURPOSEIntracranial hypertension develops in only some patients with lateral sinus thrombosis (LST), for reasons that are unclear. The purpose of this study was to evaluate a possible association between patency of the unaffected sinus and clinical presentation of unilateral LST.METHODSA computerized search identified patients with LST, hospitalized in Soroka Medical Center. Patients with signs of increased intracranial pressure (iICP) and those with normal intracranial pressure (nICP) were compared. CT venography or MR venography confirmed the diagnosis, located the thrombosis, and determined the dominant lateral sinus (LS). Diameters of the right and left LSs (the occluded and unaffected) were compared to the diameter of the distal superior sagittal sinus (SSS).RESULTSOf the 50 patients identified, 30 had iICP and 20 nICP. The dominant LS was the right one in 39 (78%) and the left one in 8 (16%); 3 (6%) had equal LS dominance. The dominant sinus was affected in 32 (70%) and the non‐dominant in 15 (30%) patients. iICP was detected in 28/32 (81%) of patients with the dominant side affected, and 3/15 (20%) of those with non‐dominant thrombotic sinus (P = .002). The unaffected sinus was narrower in iICP patients (size relative to SSS diameter = 43% in iICP vs. 86% in nICP [P = .0002]; size grading, according to Farb's method was 1.86 in the iICP vs. 3.57 in the nICP group [P = .0001]).CONCLUSIONSThrombosis was more common in the dominant LS. Unaffected LS patency appears to be associated with the development of increased ICP.
Functional Imaging Predicts Cognitive Decline in Alzheimer's Disease
Authors: Jagust W. J. , Haan M. N. , Eberling J. L. , Wolfe N. , Reed B. R. 
Published: February 2016

AbstractEighteen patients with Alzheimer's disease were studied with positron emission tomographic measurements of regional cerebral metabolism of glucose. All patients were initially diagnosed and evaluated, underwent positron emission tomography, and then were followed with annual reevaluations, at which time the Mini‐Mental State Examination (MMSE) was performed. Patients were followed for an average of 2.5 years, and the rate of cognitive decline was calculated by determining the rate of change in the MMSE score defined as the MMSE score at the initial evaluation minus the MMSE score at the last examination, divided by the number of months between testing. The regional cerebral metabolic rates for glucose determined at the time of the first MMSE were then regressed on these changes in scores. Results showed that glucose metabolic rates in posterior temporal and primary visual cortex regions were significantly correlated with the subsequent rate of cognitive deterioration. These associations were not confounded by age, length of follow‐up, baseline MMSE score, or education. Stratification on gender suggested that these associations were much stronger in women than in men. These results replicate previous findings showing that functional brain imaging is predictive of the rate of cognitive decline in Alzheimer's disease.
The Spectrum of Neuroimaging Abnormalities in Solvent Abuse and Their Clinical Correlation
Authors: Caldemeyer Karen S. , Armstrong Sheri W. , George Kristi K. , Moran Catherine C. , Pascuzzi Robert M. 
Published: February 2016

AbstractThe brain magnetic resonance (MR) images and medical records of 6 patients with a history of chronic toluene abuse were reviewed retrospectively. The imaging findings were correlated with clinical impairment. The major findings consisted of atrophy (6 patients), white matter T2 hyperintensity (6 patients), and T2 hypointensity involving the basal ganglia and thalami (5 patients). Also seen was focal enhancement, previously unreported for patients who abused toluene. This study showed a correlation between the degree of neurological impairment and extent of white matter disease. There was no correlation between the severity of white matter changes on MR images and the presence of T2 hypointensity or duration of toluene abuse. There was no definite clinical evidence of damage to the basal ganglia and thalami despite the MR imaging finding of T2 hypointensity. Temporal evidence against the theory that toluene accumulation causes the T2 hypointensity was found.
Distinctive Serial Magnetic Resonance Changes in a Young Woman with Rapidly Evolved Neurocysticercosis, with Positron Emission Tomography Results
Authors: Nagayama M. , Shinohara Y. , Nagakura K. , Izumi Y. , Takagi S. 
Published: February 2016

AbstractA woman aged 21 years noticed numbness of the left hand, dysarthria, and right hemiparesis. Magnetic resonance imaging (MRI) showed homogeneously enhanced lesions in the bilateral cerebral white matter; these enlarged within 2 weeks, showing ringlike enhancement, and then spontaneously decreased in size and enhancement. Neurocysticercosis was confirmed by repeated, significantly positive serology results and the dramatic response to praziquantel. Subsequently, positron emission tomography (PET) revealed persisting regions of possibly decreased cerebral uptake of [18F]2–fluoro–2–deoxyglucose. This is the first documentation of such distinctive serial MRI changes and the results of PET in neurocysticercosis.
Dislocation of the Third Ventricle Due to Space‐Occupying Stroke Evaluated by Transcranial Duplex Sonography
Authors: Seidel, G. , Gerriets T. , Kaps, M. , Missler, U. 
Published: February 2016

AbstractTranscranial color‐coded duplex sonography is a recently introduced method for visualizing (1) the blood flow velocity of the basal cerebral arteries and (2) the brain parenchyma as an acoustic impedance image. Dislocation of the third ventricle due to space‐occupying stroke is an important clinical marker. This study evaluated the dislocation of the third ventricle from the brain midline by transcranial duplex sonography in 10 healthy volunteers. The mean dislocation was 0.2 ± 0.3 mm. Eighteen stroke patients were investigated within 12 hours by both duplex sonography and computed tomography (CT) and the dislocation of the third ventricle was measured. Correlation between the two methods was high (r = 0.87, N = 27). Twelve stroke patients divided into three subgroups according to the extent of the space‐occupying effects of the lesion were followed for 3 weeks. The increase and decrease of the dislocation of the third ventricle over the time were monitored. In conclusion, transcranial duplex sonography is a reliable tool to monitor dislocation of the third ventricle due to space‐occupying stroke.
Neuroimaging Abnormalities with Hypoqlossal Nerve Palsies
Authors: Batchelor, Tracy T. , Krol, George S. , DeAngelis, Lisa M. 
Published: February 2016

AbstractSeven patients with acute or chronic unilateral hypoglossal nerve lesions were evaluated by magnetic resonance imaging and computed tomography. In patients with acute to subacute tongue paralysis, the base of the ipsilateral side of the tongue appeared expanded and showed increased signal intensity on T2‐weighted images. This appearance was suggestive of an infiltrative mass lesion within the tongue. These radiographic findings are due to the pathophysiological process of nerve injury and muscle denervation.
Acute Transverse Myelitis After Influenza Vaccination: Magnetic Resonance Imaging Findings
Authors: Bakshi Rohit , Mazziotta John C. 
Published: February 2016

AbstractDescriptions in the literature of magnetic resonance imaging (MRI) findings in postvaccination myelitis are scarce. Described here is a case of acute transverse myelitis that occurred after administration of an influenza vaccination. T1–weighted MRIs showed diffuse, fusiform spinal cord enlargement, extending from C–3 to rostral thoracic levels. Intramedullary lesions containing increased T2 signal were found in the areas of cord enlargement. The involvement on MRI was profound, extending far
Neuroimaging Findings in Rasmussen's Syndrome
Authors: Yacubian Elza M. T. , Marie Sueli K. N. , Valério Rosa M. F. , Jorge Carmen L. , Yamaga Liliam , Buchpiguel Carlos A. 
Published: February 2016

AbstractRasmussen's syndrome is a progressive childhood disease of unknown cause characterized by severe epilepsy, hemiparesis, mental deterioration, inflammation of one cerebral hemisphere, and brain atrophy. Computed tomography, single‐photon emission computed tomography (SPECT), and magnetic resonance (MR) neuroimaging findings of 8 patients with pathologically confirmed Rasmussen's syndrome were evaluated retrospectively. All patients showed a predominance of the atrophy in the temporo‐insular region and cerebral hemispheric alterations on MR images in a similar extension as seen on SPECT studies. Focal increase in regional cerebral blood flow was observed in the 4 patients presenting with epilepsia partialis continua at the time of hexamethyl‐propyleneamineoxime injection. Extensive cortical hypoperfusion was noted in the other 4 patients who received the injection during the interictal state. Cerebellar functional abnormalities were present in 6 patients, 2 of them with structural damage.
Ultrasonographic Assessment of the Prevalence of Fasciculations in Lesions of the Peripheral Nervous System
Authors: Scheel Alexander K. , Toepfer, Marcell , Kunkel, Mathias , Finkenstaedt, Michael , Reimers, Carl D. 
Published: February 2016

AbstractIn previous studies, ultrasonography was a very sensitive method in detecting fasciculations. The present study was intended to examine the prevalence of ultrasonographically visible fasciculations in patients with neuromuscular diseases affecting the lower extremities. Ultrasonography of 9 muscles (rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, sartorius, semitendinosus, tibialis anterior, gastrocnemius, and soleus muscles) was performed bilaterally in 70 adult healthy subjects and 172 patients with various neuromuscular diseases. Fasciculations were detected in 109 (63%) of 172 patients. The median value of affected muscles was 10 (range 1–18). Patients with spinal muscular atrophy (37/38, p < 0.001), hereditary motor and sensory neuropathy (24/25, p < 0.001), and lumbosacral radiculopathy with motor deficits (24/29, p < 0.001) exhibited fasciculations more frequently than did healthy volunteers. Radiculopathy with sensory deficits, lesions of either plexus or peripheral nerves, compartment syndrome, and myopathy were not associated with a significantly enhanced prevalence of fasciculations in the patient group compared to the control group. In summary, fasciculations are a frequent ultrasonographic sign in neuromuscular diseases. They are almost regularly found in patients with spinal muscular atrophy and those with hereditary motor and sensory neuropathy. Thus, the absence of fasciculations in ultrasonographic assessment should give cause for reconsidering these diagnoses.
Clinical and Diagnostic Findings in a Patient with Creutzfeldt‐Jakob Disease (Type Heidenhain)
Authors: Staffen W. , Trinka E. , Iglseder B. , Pilz P. , Homann N. , Ladurner G. 
Published: February 2016

AbstractA 61‐year‐old woman had Creutzfeldt‐Jakob disease, type Heidenhain, that progressed for 4 months until death, 3 of which she spent in a hospital. The diagnosis was verified by autopsy. Consecutive brain computed tomography, magnetic resonance imaging, blood flow measurements, electroencephalography (EEG), and routine laboratory tests were performed. All imaging techniques showed non‐specific pathological changes, whereas EEG revealed alterations indicative for Creutzfeldt‐Jakob disease.
Diagnostic Value of Three‐Dimensional Transcranial Contrast Duplex Sonography
Authors: Delcker, Andreas , Turowski B. 
Published: February 2016

AbstractThis study evaluated intracranial cerebral arteries using a new data acquisition system for transcranial three‒dimensional (3D) ultrasonography with and without an echo contrast agent, with confirmation by cerebral angiography. Ten patients, studied with diagnostic cerebral angiography, were examined without knowledge of the angiographic results. Data acquisition through the transtemporal acoustic window was performed using a magnetic sensor system to track the spatial orientation of the ultrasound probe while scanning the volume of interest. A color transcranial duplex system with a power Doppler mode was used, and 3D data sets were acquired before and after the injection of transpulmonary‒stable ultrasound contrast medium. Ipsilateral to the transducer, the anterior cerebral artery (ACA) in 90%, middle cerebral artery (MCA) in 60%, all three or more branches of the MCA in 60%, posterior cerebral artery (PCA) in 60%, and posterior communicating artery (PCoA) in 60% were successfully imaged without the echo contrast agent. With the contrast agent, the ACA, MCA, three or more branches of the MCA, PCA, and PCoA were visible in 100%. The anterior communicating artery was visualized in 40% without contrast enhancement and in 90% with contrast enhancement. Contralateral to the transducer, the ACA (60%), MCA (30%), all three or more branches of the MCA (10%), PCA (20%), and PCoA (20%) were successfully imaged without contrast. Contrast enhancement improved the imaging success rate for the ACA (90%), MCA (80%), three or more branches of the MCA (80%), PCA (100%), and PCoA (100%). A transpulmonary‒stable ultrasound contrast agent used in combination with 3D transcranial duplex ultrasonography can significantly improve the success rate for transcranial color duplex imaging of intracranial arteries.
A 66‐Year‐Old Woman with a Rapidly Progressing Dementia and Basal Ganglia Involvement
Authors: Gold, Michael , Rojiani, Amyn , Murtaugh, Reed 
Published: February 2016

AbstractA 66‐year‐old woman presented with a rapidly progressive dementia initially characterized by an auditory agnosia. She experienced a rapid progression of her aphasia and developed ataxia and myoclonus. An initial neurological evaluation suggested a left parieto‐temporal lesion, however, neuroimaging did not reveal any. An MRI of her brain demonstrated highly focal T2 hyperintensities in her basal ganglia. The patient was diagnosed with Creutzfeldt‐Jacob Disease (CJD) on the basis of the presence of two proteins in the CSF that are highly sensitive and specific for CJD. Pathological examination confirmed the diagnosis. The differential diagnosis and utility of MRI in patients with CJD is discussed.
An Approach to Imaging the Dizzy Patient
Authors: MacDonald C. Bruce , Melhem Elias R. 
Published: February 2016

AbstractDisease of the vestibular system involves a lengthy differential diagnosis, from the relatively trivial to potentially life–threatening conditions. As a definitive specific diagnosis is often difficult to make, imaging may be used simply to “rule out” serious pathology. In this context, suboptimal imaging choices may be unnecessarily expensive and may fail to document the pathology. In contrast, an orderly investigation includes appropriate audiometric and vestibular tests, which when reviewed in the clinical context, indicate the most pertinent imaging modalities. This enables the clinician to plan a cost–effective, definitive imaging strategy. This review considers the role of imaging in an integrated approach to investigating the dizzy patient. A discussion of vestibular pathology is presented to assist in the review, and several cases are provided as examples.
Transcranial Power–Mode Duplex Ultrasound in Two Patients with Moyamoya Syndrome
Authors: Morgenstern C. , Griewing B. , Müller–Esch G. , Zeller J. A. , Kessler Ch. 
Published: February 2016

AbstractMoyamoya syndrome is characterized by the reticulated collateralization of the intracranial vasculature distal to an occlusion of proximal intracranial vessels. In the present study this pathology was visualized in 2 patients, aged 29 and 32 years, using
Microemboli on Transcranial Doppler in Patients with Spontaneous Carotid Artery Dissection
Authors: Koennecke Hans-Christian , Trocio Samuel H. , Mast Henning , Mohr J. P. 
Published: February 2016

AbstractHigh‐intensity transient signals on transcranial Doppler sonography (TCD) are associated with atherosclerotic stenosis of the internal carotid artery. Few data exist regarding the detection of high‐intensity transient signals in dissected carotid arteries. In the present study, 6 patients with spontaneous carotid dissection, defined by magnetic resonance techniques and duplex sonography, were examined by TCD. Both middle cerebral arteries were monitored simultaneously for 30 minutes. Four of the patients had ipsilateral cerebral ischemia, while 2 presented with other symptoms. High‐intensity transient signals were detected in the middle cerebral artery ipsilateral to the dissection in 3 of the 4 patients with cerebral ischemia and in none of the patients with other presenting symptoms. No microemboli were found contralateral to the dissected arteries. Microemboli can be detected distally from dissected carotid arteries. The present findings support the assumption that embolism is a major cause of stroke in patients with carotid dissection, and suggest that high‐intensity transient signals are more common among patients with cerebral ischemia secondary to dissection.
Diffusion‐Weighted Magnetic Resonance Imaging Characteristics of Hemorrhagic Transformation in Experimental Embolic Stroke
Authors: Yenari, Midori A. , Beaulieu, Christian , Steinberg, Gary K. , Moseley, Michael E. 
Published: February 2016

AbstractDiffusion‐weighted magnetic resonance imaging (MRI) can detect ischemia within minutes of onset, but its ability to reliably detect hyperacute cerebral hemorrhage is unknown. The present study characterized diffusion‐weighted, T2‐weighted, and contrast‐enhanced T1‐weighted MRI appearances of hemorrhagic transformation within 5 hours of onset in experimental embolic stroke. Apparent diffusion coefficients and MRI signal characteristics were noted within corresponding regions of hemorrhage observed on gross pathology. Apparent diffusion coefficients were significantly increased within hemorrhagic lesions, but were still within the expected range for bland ischemia. The appearance of the hemorrhagic lesions on diffusion‐weighted MRI was also very heterogeneous and not very useful for clinical screening. Other MRI modalities should be investigated, but computed tomography remains the only widely available clinical method of reliably detecting cerebral hemorrhage.
Algorithm on the Clinical Evaluation of Epilepsy
Authors: Ho, Susan S. , Kuzniecky, Ruben I. 
Published: February 2016

AbstractEpilepsy is an important public health problem because of its prevalence in the community and the economic disadvantage associated with its chronic morbidity. Uncontrolled seizures are potentially life‐threatening and have adverse psychosocial consequences. Surgery is an effective but underutilized therapy for some patients with medically refractory seizures. However, this form of treatment demands precise localization of the epileptogenic zone. In recent years there have been major advances in the development of various imaging techniques for seizure localization. The best combination of diagnostic testing with regard to cost‐benefit has been debated. A rational strategy for the deployment of these techniques is discussed.
Spinal Leptomeningeal Hemangioblastomatosis in von Hippel‐Lindau Disease: Magnetic Resonance and Pathological Findings
Authors: Bakshi Rohit , Mechtler Laszlo L. , Patel Malti J. , Lindsay Bret D. , Messinger Sol , Gibbons Kevin J. 
Published: February 2016

AbstractA 55–year–old man with von Hippel–Lindau disease presented with quadriparesis. Muitiple enhancing cervical and thoracic spinal masses were seen on magnetic resonance imaging (MRI). A rim of diffuse, nodular enhancement linking all of the discrete masses was apparent on the surface of the cervical and thoracic regions of the cord. Surgical exploration revealed multiple extramedullary–intradural and intramedullary masses, extending to and infiltrating the cord; the leptomeninges contained numerous small tumor seeds at several levels. The excised spinal masses were diagnosed as capillary hemangioblastomas, which infiltrated the pia mater. Diffuse, intense, spinal leptomeningeal enhancement on MRI associated with multiple hemangioblastomas has not been previously reported and may be referred to as spinal “leptomeningeal hemangioblastomatosis.”
Memory Processes in Depressed Geriatric Patients With and Without Subcortical Hyperintensities on MRI
Authors: Jenkins Melissa , Malloy Paul , Salloway Stephen , Cohen Ronald , Rogg Jeffrey , Tung Glenn , Kohn Robert , Westlake Robert , Johnson Eileen Gillard , Richardson Emily 
Published: February 2016

AbstractIn this study, 12 patients over age 60 with depression with moderate to severe subcortical hyperintensities (SH) localized to the periventricular white matter were identified by quantitative MRI. Using the California Verbal Learning Test, they were compared with 12 age‐, education‐, and severity‐matched patients with depression with minimal white matter changes on specific aspects of memory performance. Patients with cortical lesions, neurologic or systemic illness affecting cognition, and history of substance abuse were excluded. Patients in the group with high SH showed reduced use of semantic encoding strategies (p < 0.05), reduced learning efficiency (p < 0.05), and a greater discrepancy between free recall and recognition discriminability (p < 0.05) than their low SH counterparts. This pattern of performance on memory tasks is similar to that found in previous studies to be associated with subcortical degenerative disorders such as Huntington's and Parkinson's diseases. Geriatric patients with depression with SH may represent a subgroup with greater subcortical involvement, with associated cognitive and functional decline.