bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional Cerebral Blood Flow Abnormalities in Nondemented Patients With Memory Impairment
Authors: Tanaka Makoto , Fukuyama Hidenao , Yamauchi Hiroshi , Narita Minoru , Nabatame Hidehiko , Yokode Masayuki , Fujimoto Naoki , Kita Toru , Murakami Motonobu 
Published: November 2009

ABSTRACT Background. Patients with objective evidence of memory impairment have been considered to be at risk for developing Alzheimer's disease (AD). However, little is known about patterns of regional cerebral blood flow abnormalities and their prognostic significance in these patients. Methods. The authors retrospectively studied 28 nondemented subjects with memory loss and investigated patterns of blood flow abnormalities on single photon emission computed tomography (SPECT). Results. The patients were followed up for more than 2 years; during follow‐up, 14 patients (50%) developed AD. The onset of memory impairment in patients who progressed to AD was significantly earlier than in those who remained in a nondemented condition. SPECT data from the initial evaluation were analyzed by region of interest analysis and statistical parametric mapping. Interestingly, both groups of patients shared hypoperfusion in the medial temporal regions and the posterior cingulate. In addition to these regions, significant blood flow reduction in the parietal and anterior cingulate cortices was detected in patients who progressed to AD. Conclusions. These results demonstrate that (1) subjects with an earlier onset of memory loss have an increased risk for developing AD, (2) SPECT can be useful for distinguishing subjects with memory loss who will rapidly progress to AD from those who will not, and (3) perfusion impairment typical of AD was evident even in subjects with memory impairment who remained nondemented.
Magnetic Resonance Imaging in Patients Diagnosed With Papilledema: A Comparison of 6 Different High‐Resolution T1‐ and T2(*)‐Weighted 3‐Dimensional and 2‐Dimensional Sequences
Authors: Seitz Johannes , Held Paul , Strotzer Michael , Müller Michael , Völk Markus , Lenhart Markus , Djavidani Behrus , Feuerbach Stefan 
Published: November 2009

ABSTRACT Purpose. To evaluate visualization and signal characteristics of macroscopic changes in patients with ophthalmologically stated papilledema and to find a suitable high‐resolution magnetic resonance imaging (MRI) protocol. Method. Nine consecutive patients with 12 ophthalmologically stated papilledemas underwent MRI of the head and orbits, which consisted of the following high‐resolution sequences: 3‐dimensional (3D), T2*‐weighted (T2*w) constructive interference in steady‐state sequence (CISS); 3D, T1‐weighted (T1w) magnetization prepared‐rapid gradient echo sequence (MP‐RAGE) (with and without intravenous contrast medium); transverse 3D and 2‐dimensional (2D) (2mm), T2‐weighted (T2w) turbo spin echo (TSE); transverse 2D (2mm), contrast‐enhanced T1w TSE with fat‐suppression technique; and transverse 2D (5mm), T2w TSE. A quantitative and qualitative evaluation of the papilla, optic nerve, optic nerve sheath, optic chiasm, and the brain was performed. The 6 high‐resolution sequences were compared. Results. The elevation of the optic disc into the optic globe in ophthalmologically stated papilledema was best visualized in T2w, 3D CISS sequence. The pathological contrast enhancement was best seen in T1w contrast‐enhanced 2D TSE sequence with fat‐suppression technique. The mean width of the optic nerve sheath directly behind the globe was 7.54 mm (± 1.05 mm) in the pathological eyes, compared to 5.52 mm (± 1.11 mm) in the normal eyes. In all patients, the cerebral indices calculated showed no signs of increased intracranial pressure or other abnormalities changing the volume of the brain or ventricles. The contrast of the orbital fat versus the optic nerve sheath, the optic nerve sheath versus the surrounding cerebrospinal fluid (CSF), the surrounding CSF versus the optic nerve, the optic chiasm versus the CSF, and the optic papilla versus the optic globe were best visualized in the 3D, T2*w CISS sequence. An enhancement of the swollen optic nerve head was best seen in all 12 cases in the T1w contrast‐enhanced 2D TSE sequence with fat‐suppression technique. Conclusion. An MRI protocol consisting of a 5‐mm transverse T2w TSE sequence; a T2*w, 3D CISS sequence; a T1w, 3D MP‐RAGE sequence with and without contrast medium; and a transverse T1w, (2‐mm) 2D TSE sequence with fat‐suppression technique with intravenous contrast medium is suitable to visualize the macroscopic changes in papilledema. In addition, this combination is an excellent technique for the examination of the orbits and the brain.
Subclavian Steal and a Persistent Trigeminal Artery
Authors: Koch Sebastian , Romano Jose G. , Forteza Alejandro 
Published: November 2009

ABSTRACTA persistent trigeminal artery (PTA) has been found in a number of cerebrovascular diseases. A 73‐year‐old asymptomatic woman was noted to have a left PTA and left subclavian steal by catheter angiography. Carotid duplex revealed a peak systolic flow velocity of 294 cm/s in the internal carotid artery (ICA) and an ICA to common carotid artery ratio >4, suggestive of a high‐grade stenosis. Only a low‐grade stenosis was identified by catheter angiography. The elevated flow velocities in the left ICA were attributed to increased collateral blood flow across the stenosis to the left PTA, which compensated for the subclavian steal. Transcranial Doppler found an alternating flow pattern in the basilar artery (mean flow velocity [MFV] = 18 cm/s) and left vertebral artery (MFV = 43 cm/s). During brachial hyperemia, the MFV increased by 178% in the basilar artery and 102% in the left vertebral artery. The data suggest that a PTA may compensate for subclavian steal and may have a protective hemodynamic role in this setting.
Focal Cortical Dysplasia: Improving Diagnosis and Localization With Magnetic Resonance Imaging Multiplanar and Curvilinear Reconstruction
Authors: Montenegro Maria Augusta , Min Li Li , Guerreiro Marilisa M. , Guerreiro Carlos A. M. , Cendes Fernando 
Published: November 2009

ABSTRACT Objective. To establish the contribution of multiplanar reconstruction (MPR) and curvilinear reformatting (CR) to the MRI investigation of focal cortical dysplasia (FCD). Methods. From a group of patients with intractable frontal lobe epilepsy, we selected patients with neuroimaging diagnosis of FCD. The diagnosis of FCD was based on the neuroimaging findings after a three step evaluation, always in the same order: (a) plain MRI films, (b) MPR, and (c) CR. After the selection of patients, the process of reviewing all the images in the three stages described above was performed by one of us, who did not take part on the selection of patients nor on the initial evaluation, and who was blind to the clinical and EEG findings of the patients. For data analysis, we first assessed the contribution of the additional findings of MPR analysis compared to the results of the evaluation using only plain MRI films, as is usually done in routine practice. Second, we assessed the contribution of CR to the findings of plain MRI films plus MPR. After completing the multistep evaluation, we all went back to review the plain MRI films with knowledge of lesion topography, in order to identify possible subtle features associated with FCD. Results. Seventeen patients met the inclusion criteria. Twelve had imaging diagnosis of FCD and were included in the second step of this project. Plain films of high resolution MRI showed the lesion in 6 (50%) of the 12 patients. By adding MPR to the plain MRI films, we identified lesions in all 12 patients. Furthermore, we found that MPR provided a better lesion localization and ascertainment of its relationship to other cerebral structures in 5 of 6 (83%) patients who had a lesion identified on plain films. By adding CR to the plain MRI films plus MPR analysis, we observed that (a) CR also allowed the identification of the dysplastic lesion in all patients, (b) CR improved lesion localization in one patient, and (c) CR provided a better visualization of the lesion extent in 4 patients (33%), showed a larger lesion in 3, and demonstrated that part of the area suspected as abnormal was more likely volume averaging in 2. Conclusion. MPR and CR analysis add to the neuroimaging evaluation of FCD by improving the lesion diagnosis and localization. CR helps to establish the extent of the lesion more precisely, allowing the visualization of some areas not shown on high resolution MRI and MPR. These techniques are complementary and do not replace the conventional wisdom of MRI analysis.
Transcranial Doppler Characteristics of Different Embolic Materials During In Vivo Testing
Authors: Rodriguez Rosendo A. , Giachino Allan , Hosking Martin , Nathan Howard J. 
Published: November 2009

ABSTRACT Purpose. The authors investigated whether ultrasonic characteristics of embolic signals could be used to differentiate embolic composition. Materials and Methods. The authors analyzed high‐intensity transient signals (HITS) from 3 patients with patent foramen ovale during the bubble contrast test and during total joint replacement surgery. In 3 anesthetized dogs, latex microspheres, fat particles, and air bubbles were injected into the internal carotid artery and HITS were identified in the cerebral circulation. The area under the receiver operating characteristic curve quantified the usefulness of each measure to distinguish embolic composition. Results. In humans, HITS intensity (area: 0.80) and frequency (area: 0.73) but not duration (area: 0.32) were useful to distinguish air bubbles from presumed solid emboli. In animals, intensity distinguished micro‐spheres from air (area: 0.94) and microspheres from fat (area: 0.94) but was less useful for fat and air (area: 0.64). The duration (area: 0.54–0.76) and frequency (area: 0.54–0.63) were poor discriminators. Conclusion. The HITS intensity best distinguished embolic composition. Particle size should be taken into account in future research.
Diffusion‐Weighted Magnetic Resonance Imaging in Superior Sagittal Sinus Thrombosis
Authors: Wasay Mohammad , Bakshi Rohit , Bobustuc George , Dubey Neeraj , Cheema Zahid , Dai Alper 
Published: November 2009

ABSTRACT Background and Purpose. Diffusion‐weighted imaging (DWI) has shown high sensitivity in the diagnosis of acute arterial strokes. The pathophysiology of cerebral venous thrombosis with associated venous stroke appears to differ from that of arterial strokes. The purpose of this study was to describe DWI findings in venous strokes. Methods. The authors reviewed 3 adults with superior sagittal sinus thrombosis who underwent DWI and magnetic resonance imaging within 24 hours of symptom onset. DWI was obtained at 1.5 T using the multishot echo planar technique (TR = 8000, TE = 97, field of view = 30 ?19 cm, slice thickness = 6.0 mm, interslice gap = 0.5 mm, matrix 128 ?128, NEX = 1). The diffusion gradients were applied in 3 orthogonal directions with 3 increasing b values (0–1000 s/mm2) to create average (trace) DWI images. Apparent diffusion coefficient (ADC) values were calculated on a pixel‐by‐pixel basis and displayed as ADC maps. Results. DWI showed hyperintensities in patients 1 and 2 and hypointensity in patient 3 in corresponding to parenchymal lesions on conventional images. As compared to the homologous uninvolved location in the contralateral hemisphere, ADC values were decreased (0.53 ?10−3 mm2/s [patient 1] and 0.68 −3 mm2/s [patient 2]) and increased (1.1 ?10−3 mm2/s [patient 3]). The ADC ratio of the lesion in the involved to uninvolved side was 88% (patient 1), 81% (patient 2), and 120% (patient 3). Conclusion. Acute cerebral venous strokes may contain cytotoxic edema and/or vasogenic edema on DWI scans. DWI may be helpful in diagnosing cerebral venous thrombosis in cases with cryptic presentations.
Transient Focal Leptomeningeal Enhancement in Sturge‐Weber Syndrome
Authors: Shin Robert K. , Moonis Gul , Imbesi Steven G. 
Published: November 2009

ABSTRACTThe authors describe a 36‐year‐old man with Sturge‐Weber syndrome who presented with focal seizures and subsequently developed a temporary post‐ictal hemianopia. Magnetic resonance imaging of the brain demonstrated focal leptomeningeal enhancement, which subsequently resolved.
A Case of Adult Influenza A Virus–Associated Encephalitis: Magnetic Resonance Imaging Findings
Authors: Iijima Hiroyuki , Wakasugi Kyoko , Ayabe Mitsuyoshi , Shoji Hiroshi , Abe Toshi 
Published: November 2009

ABSTRACTA 27‐year‐old man presented with fever, convulsive seizure, and sudden impairment of consciousness. Magnetic resonance imaging (MRI) abnormalities were found in the bilateral thalami, including the brain stem and white matter. The possibility of a previous influenza A virus infection was considered, and cerebrospinal fluid cells and interleukin‐6 were elevated. The MRI findings closely resembled those found in cases of childhood acute necrotizing encephalopathy (ANE). The present case suggests that adult influenza A virus‐associated encephalitis/encephalopathy or ANE can occur during winter influenza epidemics.
Is Cerebral Microembolism in Mechanical Prosthetic Heart Valves Clinically Relevant?
Authors: Nadareishvili Zurab G. , Beletsky Vadim , Black Sandra E. , Fremes Stephen E. , Freedman Morris , Kurzman David , Leach Larry , Norris John W. 
Published: November 2009

ABSTRACT Background and Purpose. High‐intensity transient signals (HITS) are frequently detected by transcranial Doppler (TCD) ultra‐sound in patients with mechanical prosthetic heart valves (PHVs), but published data about their clinical relevance are controversial. This study was undertaken to determine the clinical relevance of HITS in patients with mechanical PHVs. Methods. The authors prospectively studied patients with mechanical PHVs using TCD monitoring for microemboli detection with and without O2 inhalation. The cognitive testing of patients included the Mini‐Mental State Examination, the Dementia Rating Scale, and MicroCog. Results. The authors studied 36 patients (20 women, aged 58 ±13 years). HITS were detected in 72% of patients, with a nonsignificant increase of HITS rate in the aortic valve group (P= .07). There was no significant difference in HITS rate between asymptomatic and symptomatic patients. In a multiple linear regression model, HITS rate was predicted only by younger age (P= .024). No correlation was found between HITS rate and the cognitive performance of patients. There was a significant decrease in HITS rate after 100%O2 inhalation compared to baseline levels (32.8 ±40.2 vs 6.1 ±11.3, P= .011). Subgroup analysis in asymptomatic patients confirmed this finding (P= .017), but in symptomatic patients, decreased HITS rate was not statistically significant (P= .18). Conclusion. Only age was a significant predictor of HITS in patients with mechanical PHVs. The lack of association between HITS, clinical symptoms, and cognitive functioning suggests that most of these signals represent harmless epiphenomena, and only HITS detected after O2 inhalation have any clinical relevance.
Comparison of Striatal Dopamine D2 Receptors in Parkinson's Disease and Progressive Supranuclear Palsy Patients Using [123I] Iodobenzofuran Single‐Photon Emission Computed Tomography
Authors: Oyanagi Chisako , Katsumi Yukinori , Hanakawa Takashi , Hayashi Takuya , Thuy Din ha Duy , Hashikawa Kazuo , Nagahama Yasuhiro , Fukuyama Hidenao , Shibasaki Hiroshi 
Published: November 2009

ABSTRACT Background and Purpose. To investigate the clinical applicability and validity of [123I] iodobenzofuran (IBF) single‐photon emission computed tomography (SPECT), the authors analyzed the changes in striatal dopamine D2 receptor binding among 7 patients with Parkinson's disease (PD), 6 patients with progressive supranuclear palsy (PSP) (Hoehn and Yahr stage II to IV), and 8 normal controls. Methods. SPECT data were acquired every 1 minute for 60 minutes postinjection of 167 MBq [123I] IBF. The binding potential (BP) of the striatum was evaluated by 2 methods: region‐of‐interest (ROI) analysis by the nonlinear least squares method using blood sampling and time‐series brain radioactivities in normal controls and a voxel‐by‐voxel method based on a region model that provided parametric images of BP without blood sampling. Results. Statistical parametric mapping indicated that BP in the striatum of PSP patients was significantly lower than that of PD patients and normal controls (P <.005, uncorrected), and there was no significant difference between PD patients and normal controls, even in patients with PD at an advanced stage. Data derived from the ROI method and a simplified reference region model showed good correlations in normal controls, indicating the validity of the latter model. Conclusions. The results predict that [123I] IBF SPECT, especially voxel‐by‐voxel BP parametric imaging, can discriminate among extrapyramidal diseases such as PD and PSP and may be applicable for clinical use.
The Radial Width of the Temporal Horn in Mild Cognitive Impairment
Authors: Frisoni Giovanni B. , Rossi Roberta , Beltramello Alberto 
Published: November 2009

ABSTRACT Background and purpose. The diagnosis of preclinical Alzheimer's disease (AD) (or mild cognitive impairment [MCI]) is loaded with a high degree of uncertainty. The aim was to test the accuracy of a computed tomography‐based (CT‐based) marker of medial temporal lobe atrophy, the radial width of the temporal horn (rWTH), in MCI. Methods. Ten MCI and 42 AD patients and 29 nondemented controls underwent brain CT on the temporal lobe plane (slice thickness = 2 mm). The rWTH was taken on CT films with a precision caliper placed at the tip of the temporal horn radial to the curvature of the hippocampal head region. Results. When specificity was fixed at 95%, the sensitivity for the detection of AD was 39/42 (93%) and that for the detection of MCI was 8/10 (80%). Conclusion. The rWTH is a measure sensitive to the regional brain atrophy common in early AD.
Decreased Cerebral Blood Flow in Neuro‐Behcet's Syndrome Patients With Neuropsychiatric Manifestations and Normal Magnetic Resonance Imaging—A Preliminary Report
Authors: Huang Wei‐Shih , Chiu Pai‐Yi , Kao Albert , Tsai Chon‐Haw , Lee Cheng‐Chun 
Published: November 2009

ABSTRACTInvolvement of the brain is one of the most important complications of Behcet's disease, but its diagnosis is difficult because of the lack of effective imaging tools. Therefore, technetium‐99m ethyl cysteinate dimer (Tc‐99m ECD) single‐photon emission computed tomography (SPECT) of the brain was used to detect abnormal regional cerebral blood flow in patients with neuro‐Behcet's syndrome (NBS). Tc‐99m ECD brain SPECT was per‐formed to detect hypoperfusion areas of the brain in 10 NBS patients with definite neuropsychiatric symptoms or signs and normal brain magnetic resonance imaging (MRI) findings. Tc‐99m ECD brain SPECT demonstrated hypoperfusion areas of the brain in all of the 10 NBS patients. The parietal lobes were the most common areas with hypoperfusion lesions. Tc‐99m ECD brain SPECT is a more sensitive and useful tool than brain MRI for detecting hypoperfusion areas of the brain in NBS patients.
Diffusion Magnetic Resonance Imaging in Intermediate Form of Maple Syrup Urine Disease
Authors: Sener R. N. 
Published: November 2009

ABSTRACTAn 8‐year‐old boy with the intermediate variant of maple syrup urine disease is reported. On b= 1000 s/mm2 (heavily diffusion weighted) images of diffusion magnetic resonance imaging, there was symmetric high signal in the globus pallidus, mesencephalon, dorsal pons, and nucleus dentatus, consistent with restriction of the mobility of water molecules. Apparent diffusion coefficient (ADC) maps revealed low ADC values ranging from 0.42 to 0.56 ?10−3mm2/s in these regions, compared to those of apparently unaffected regions in the brain parenchyma ranging from 0.63 to 0.97 ?10−3 mm 2/s. It is suggested that the areas of increased signal (and low ADC values) are the result of dysmyelination as a reflection of disorganized tissue integrity.
Cerebral and Systemic Hemodynamics Changes During Upright Tilt in Chronic Fatigue Syndrome
Authors: Razumovsky Alexander Y. , DeBusk Karen , Calkins Hugh , Snader Sally , Lucas Katherine E. , Vyas Pranav , Hanley Daniel F. , Rowe Peter C. 
Published: November 2009

ABSTRACT Background and Purpose. During head‐up tilt (HUT), patients with chronic fatigue syndrome (CFS) have higher rates of neurally mediated hypotension (NMH) and postural tachycardia syndrome (POTS) than healthy controls. The authors studied whether patients with CFS were also more likely to have abnormal cerebral blood flow velocity (CBFV) compared with controls in response to orthostatic stress. Methods. Transcranial Doppler monitoring of middle cerebral artery (MCA) CBFV was performed during 3‐stage HUT prospectively in 26 patients with CFS and 23 healthy controls. At the same time, continuous monitoring of arterial blood pressure (BP), heart rate (HR), end‐tidal CO2 (ET‐CO2) were performed. Results are reported as mean ± SD. Results. NMH developed in 21 patients with CFS and in 14 controls (P = .22). POTS was present in 9 CFS patients and 7 controls (P = .76). Supine HR was higher in CFS patients, but all other hemodynamics and CBFV measures were similar at baseline. The median time to hypotension did not differ, but the median time to onset of orthostatic symptoms was shorter in those with CFS (P < .001). The CBFV did not differ between groups in the supine posture, at 1 or 5 minutes after upright tilt, at 5 or 1 minute before the end of the test, or at termination of the test. Mean CBFV fell at termination of tilt testing in those with CFS and controls. ET‐CO2 was lower at termination of the test in those with CFS versus controls (P = .002). Conclusions. The results of this study are not consistent with the hypothesis that patients with CFS have a distinctive pattern of MCA CBFV changes in response to orthostatic stress.
Residual Hippocampal Atrophy in Asphyxiated Term Neonates
Authors: Mañ;eru Cristina , Serra‐Grabulosa Josep M. , Junqué Carme , Salgado‐Pineda Pilar , Bargalló Núria , Olondo Miren , Botet‐Mussons Francesc , Tallada Mercé , Mercader Josep Maria 
Published: November 2009

ABSTRACT Background and Purpose. Previous studies have shown the hippocampus and basal ganglia to be highly sensitive to hypoxic‐ischemic insult. The authors' aim was to evaluate the long‐term effects of perinatal asphyxia (PA) on the hippocampus and caudate nucleus in a group of participants born at term and who met the criteria for hypoxic‐ischemic encephalopathy (HIE). Additionally, the authors looked for damage in other brain regions using voxel‐based morphometry (VBM). Methods. The sample consisted of 13 participants (8 boys and 5 girls) with a mean age at study of 16.23 years (± 2.89) with antecedents of perinatal asphyxia, diagnosed as moderate hypoxic‐ischemic encephalopathy. A group of 13 healthy adolescents matched for age, sex, educational level, and social background were recruited as a comparison group. MR scans were acquired on a 1.5T Signa (General Electric, Milwaukee, WI) to evaluate hippocampal and caudate volumes and to perform VBM analysis. Finally, Rey's Auditory Verbal Learning Test was administered to evaluate verbal long‐term memory. Results. HIE participants were found to have bilateral hippocampal atrophy (P = .015) and gray matter damage in temporal and frontal lobes. The caudate nucleus showed no atrophic changes in PA participants, and VBM analysis did not reveal other consistent brain abnormalities. Verbal long‐term memory was slightly worse in HIE participants. Conclusions. These findings indicate that PA produces hippocampal and other nonspecific long‐term damage, which cannot be compensated for by plasticity mechanisms. However, this damage does not preclude normal development and scholarship.