bluuebunny/crossref_metadata_2025_split huggingface dataset:
Focal Atrophy and Cerebrovascular Disease Increase Dementia Risk among Cognitively Normal Older Adults
Authors: Rosano Caterina , Aizenstein Howard J. , Wu Minjie , Newman Anne B. , Becker James T. , Lopez Oscar L. , Kuller Lewis H. 
Published: October 2009

ABSTRACT Background and Purpose. This study investigated the association of medial temporal lobe (MTL) atrophy and cerebrovascular disease (white matter hyperintensities [WMH], subclinical infarcts) with the risk of developing Alzheimer's disease (AD) among cognitively normal older adults. Methods. Risk of developing AD was examined for 155 cognitively normal older adults (77.4 years, 60% women, 81% white). The MTL volumes and the presence of WMH and of subclinical infarcts were determined from brain magnetic resonance imaging (MRI) at the beginning of the study. Follow‐up cognitive evaluations (average 4.3 years) identified those who developed AD. Results. The presence of either MTL atrophy or subclinical infarcts was independently and significantly associated with a greater risk to develop AD (OR [95% CI]: 4.4 [1.5, 12.3] and 2.7 [1.0, 7.1], respectively). In addition, those participants with both MTL atrophy and at least one brain infarct had a 7‐fold increase in the risk of developing AD (OR [95% CI]: 7.0 [1.5, 33.1]), compared to those who had neither of these conditions. Conclusions. In cognitively normal older adults, markers of neurodegeneration (as reflected by MTL atrophy) and of cerebrovascular disease (as reflected by infarcts on MRI) independently contribute to the risk to develop AD.
MR Findings of Intrathecal Chemotherapy‐Related Myelopathy in Two Cases: Mimicker of Subacute Combined Degeneration
Authors: Lu Chia‐Hung , Yao Ming , Liu Hon‐Man , Chen Ya‐Fang 
Published: October 2009

ABSTRACTWe report the findings of spinal magnetic resonance imaging (MRI) in 2 patients who had undergone intrathecal chemotherapy and presented with the subacute onset of ascending numbness and weakness. MRI revealed a symmetric hyperintensity at the posterior columns of the spinal cord from the lower cervical region down to the conus medullaris level on T2‐weighted images, and no abnormal enhancement. The imaging findings are similar to those seen in subacute combined degeneration (SCD), but the serum vitamin B12 levels were normal in these 2 cases.
Multislice Brain Myelin Water Fractions at 3T in Multiple Sclerosis
Authors: Oh Joonmi , Han Eric T. , Lee Michael C. , Nelson Sarah J. , Pelletier Daniel 
Published: October 2009

ABSTRACT Purpose. To evaluate a multislice nonlinearly‐spaced 12‐echo imaging sequence at 3T covering the supratentorial brain for the quantification of myelin water fraction (MWF) in multiple sclerosis (MS) patients. Methods. Eighty‐nine patients with, or at risk of, MS (69 relapsing remitting MS [RRMS], 7 secondary progressive MS [SPMS], 13 clinically isolated syndrome [CIS]) and 28 controls were studied. Twelve‐echo datasets were acquired using a multislice T2 prep spiral imaging sequence and were fitted using a nonnegative least squares algorithm. The mean MWF within normal appearing white matter (NAWM), contrast‐enhancing (CE), and nonenhancing T2 lesions were calculated. Results. Mean MWF in white matter for controls was 11.3%. Mean MWF was significantly reduced in NAWM of MS patients (10.6%, P= .004) relative to controls. SPMS/RRMS patients with disease duration >5 years (10.3%) had lower MWF compared to CIS/RRMS with disease duration ≤5 years (10.8%, P= .03). Mean MWF was reduced by 26% and 29% within both CE (P < .0001) and nonenhancing T2 lesions (P < .0001) relative to controls. Conclusions. Using a multicomponent T2 sequence at 3T, a significant decrease in the supratentorial MWF was observed in MS NAWM and lesions relative to controls. The method was sensitive to detect white matter changes early in the disease process.
Anomalous Origin of the Middle Meningeal Artery from the Basilar Artery: A Case Report
Authors: Shah Qaisar A. , Hurst Robert W. 
Published: October 2009

ABSTRACTAnomalous courses, anastomoses, and origins of the middle meningeal artery have often been described in the literature; however origin from the basilar artery or its branches is exceedingly rare with only five previous reports. We describe a middle meningeal artery originating from a large lateral pontine branch of the basilar artery. The lateral pontine branch also supplied most of the cerebellar hemispheric territory normally vascularized by both the anterior inferior cerebellar artery and posterior inferior cerebellar artery. We discuss the anatomy and possible embryological development of middle meningeal origin from the basilar artery.
Gliomatosis Cerebri Presenting as a Parkinsonian Syndrome
Authors: Asada Tomohiko , Takayama Yoshihiro , Tokuriki Yasuhiko , Fukuyama Hidenao 
Published: October 2009

ABSTRACTWe report a 70‐year‐old man who was hospitalized after a left‐sided partial seizure progressed to grand mal seizures. Three years before, the patient had presented with the main symptoms of bradykinesia and gait disturbance and was diagnosed with parkinsonism resistant to L‐dopa. At the latest admission, extensive diffuse white matter high‐intensity areas were present on T2‐weighted magnetic resonance imaging images, and stereotactic brain biopsy showed that these lesions were gliomatosis cerebri (GC). This is the first reported case in which extensive lesions in the bilateral white matter have been associated with parkinsonism as the main clinical feature; only one other case has been reported in which GC presented as parkinsonism, and this differed from the current case with respect to localization and symptoms. We speculate that damage to the thalamocortical projections and functional impairment due to demyelination could have caused parkinsonism in our patient, and we discuss the differential diagnosis.
Transbrachial Stent‐Assisted Coil Embolization of Right Posterior Inferior Cerebellar Artery Aneurysm: Technical Case Report
Authors: Zaidat Osama O. , Szeder Viktor , Alexander Michael J. 
Published: October 2009

ABSTRACTOBJECTIVE AND IMPORTANCEWe describe a case of stent‐assisted coil embolization of a wide neck right posterior inferior cerebellar artery (PICA) aneurysm via a transbrachial artery approach.CLINICAL PRESENTATIONA 73‐year‐old woman with a past medical history of hypertension, hyperlipidemia, colon cancer, and osteoporosis presented with a throbbing occipital area headache. Magnetic resonance angiography revealed a wide neck right PICA aneurysm. She presented for a planned endovascular stent‐assisted coil embolization.TECHNIQUEThe initial transfemoral approach was complicated by persistent guide catheter instability due to marked tortuosity of the right vertebral artery (VA). The left VA could not be accessed due to left subclavian occlusion with steal syndrome. Neuroform‐2 (Boston Scientific; Natick, MA) stent‐assisted Matrix (Boston Scientific; Natick, MA) coil embolization was successfully performed through a 6‐French guide catheter using a transbrachial approach.CONCLUSIONCurrent advances in technology produce neuroendovascular devices that are smaller with increased flexibility, allowing nonfemoral vascular access to the cerebral circulation via alternate arterial routes. This patient case demonstrates transbrachial access is a viable approach for endovascular aneurysm coil embolization, with or without stent assistance, in cases with an unstable guide catheter due to tortuous vessels or abnormal anatomy when femoral access is complicated or contraindicated.
Suitability of Temporal Bone Acoustic Window: Conventional TCD Versus Transcranial Color‐Coded Duplex Sonography
Authors: Krejza Jaroslaw , Swiat Maciej , Pawlak Mikolaj A. , Oszkinis Grzegorz , Weigele John , Hurst Robert W. , Kasner Scott 
Published: October 2009

ABSTRACTPURPOSE AND BACKGROUND To determine whether the proportion of patients with suitable temporal bone acoustic windows is different for conventional transcranial Doppler sonography (TCD) and transcranial color‐coded duplex sonography (TCCS), based on a head‐to‐head comparison in the same population of patients. SUBJECTS AND METHODS Ninety patients, age 22–88 years (mean 57.1 ± 11.7 years), 46 women and 44 men, 66 Caucasian, 19 African‐American, and five Hispanic, underwent routine conventional TCD and the TCCS examination close in time to each other. Suitability of temporal bone acoustic window was defined by ability to insonate the middle and posterior and/or anterior cerebral arteries, while partial suitability was defined by ability to detect the posterior cerebral artery but not the middle cerebral artery. To compare proportions of suitable temporal bone windows for both sonographic methods, exact sign test by Liddell was used. RESULTS. Bilateral absence of temporal bone acoustic window was reported in six patients when studied with both conventional TCD and TCCS, whereas at least unilateral absence was reported in 10 patients. Partial, at least unilateral, suitability was reported in 11 patients with conventional TCD, and in 7 with TCCS. All differences in proportions were not significant (two‐sided P>0.05). CONCLUSIONS: This study suggests that success rate of insonating the intracranial vessels through the temporal bone acoustic window is the same for conventional TCD and imaging TCCS.
Biologic Effects of 3 Tesla (T) MR Imaging Comparing Traditional 1.5 T and 0.6 T in 1023 Consecutive Outpatients
Authors: Weintraub Michael I. , Khoury André , Cole Steven P. 
Published: October 2009

ABSTRACT Background. The recent use of high and ultra‐high magnetic field (MF) systems (3.0 T and above) have raised concerns about biologic effects and safety. Sensory symptoms (magnetophosphenes, dizziness/vertigo, headaches, metallic taste, pain changes, and cognitive effects) have been reported. We monitored 1023 consecutive outpatients undergoing MRI after recent introduction of a 3 T MR unit in our community. Methods/Design. Observational study utilizing a pretest and posttest symptom rating scale (0‐10) questionnaire presented to subjects undergoing MRI at three different facilities with five MRI machines, specifically a 3 T (Philips), three units with 1.5 T (GE, GE, Philips), and one 0.6 T (Fonar) unit to record symptoms before and after study. Results. 147 subjects (14%) experienced either new (N= 69; 6.7%) or changes (N= 78; 8%) in symptoms. New onset symptoms occurred predominantly with 3 T and female preponderance (75%) [P= .002]. Vertigo/dizziness (N= 28, 5.6%) [P= .001], headache (N= 8), spine pain (N= 11) occurred more frequently on 3 T, whereas magnetophosphenes (N= 8) and metallic mouth symptoms (N= 4) occurred principally in 1.5 T. Seventy‐eight subjects (8%) experienced pain symptoms ↑↓ with 75% occurring with 1.5 T. Females were 60%. Forty‐three percent of individuals had brain MRIs. Symptoms of vertigo/dizziness, headaches, and magnetophosphenes were more commonly seen in individuals undergoing brain MRIs but other body sites were also represented. Conclusions. Although no harmful effects were reported in 1023 cases, an unexpected high rate of 14% of individuals experienced sensory stimulation in both 3 T and 1.5 T units. Females appear to be more magnetically sensitive.
Central Pontine Signal Changes in Wilson's Disease: Distinct MRI Morphology and Sequential Changes with De‐Coppering Therapy
Authors: Sinha Sanjib , Taly Arun B. , Ravishankar Shivashankar , Prashanth Lingappa K. , Vasudev Mandapati K. 
Published: October 2009

ABSTRACTBACKGROUND AND PURPOSE Reports of central pontine myelinolysis (CPM)‐like changes in Wilson's disease (WD) and its sequential changes are exceptional. The aim was to study the MRI characteristics of CPM‐like changes in WD and the serial changes. METHODS Among the 121 patients of WD, twenty (M:F:9:11, age at onset: 14.2 ± 4.6 years) had features similar to CPM. All had progressive neuropsychiatric form of WD. All except five were on de‐coppering treatment. None had acute deterioration or hepatic failure. Ten patients underwent repeat studies. RESULTS Twenty patients with CPM‐like changes manifested with characteristic phenotype of WD. Three distinct patterns of CPM‐like changes were observed: (a) characteristic round shape ‐7, (b) “bisected” ‐9, and (c) “trisected” ‐4. Only one had signal changes suggesting extra‐pontine myelinolysis. All patients had contiguous involvement of midbrain. Serial MRI evaluation in 10 patients, at mean interval period of 17.4 ± 13.2 months, revealed complete reversal in one, partial improvement in five, and no change in three. Clinical and MRI improvement occurred pari passu, except in one. CONCLUSIONS CPM‐like changes in WD are perhaps under‐recognized and are distinct from the commonly known “osmotic demyelination.” It is potentially reversible similar to other MRI features of WD.
Magnetic Resonance Imaging of Idiopathic Herniation of the Cuneus Gyrus
Authors: Duarte Maddalena Pizzirusso , Maldjian T. Catherine , Tenner Michael , Adam Richard 
Published: October 2009

ABSTRACT A 65‐year‐old woman presenting with chronic headaches and without overt visual symptomatology was found to have herniation of the cuneus gyrus into the superior cerebellar cistern. Only one prior case of idiopathic brain herniation has been described, in which the parahippocampal gyrus herniated into the ambient cistern. In that case a biopsy was performed as the herniation was mistaken for a tumor. We describe the features of idiopathic brain herniation that would mitigate the necessity for undergoing brain biopsy.
CTA Quantification of Internal Carotid Artery Stenosis: Application of Luminal Area vs. Luminal Diameter Measurements and Assessment of Inter‐observer Variability
Authors: Bucek Robert A. , Puchner Stefan , Haumer Markus , Reiter Markus , Minar Erich , Lammer Johannes 
Published: October 2009

ABSTRACT Background and Purpose. In contrast to digital subtraction angiography (DSAdia), computed tomography angiography (CTA) provides exact delineation of the perfused lumen in the axial plane, thus allowing luminal (CTAdia) as well as cross‐sectional area (CTAarea) internal carotid artery stenosis (ICAS) assessment. The purposes of the present study were to correlate CTAdia and CTAarea with DSAdia and to assess the inter‐observer variabilities of both CTA techniques. Methods. In a retrospective analysis, CTA images were reviewed by two observers and ICAS was assessed according to North American Symptomatic Carotid Endarterectomy Trial applying CTAdia and CTAarea. DSAdia was assessed by a third observer. Results. Based on 54 consecutive patients (40 males [74.1%] and 14 females [25.9%]; median age 73.3 years), ICAS percentages of CTAdia and CTAarea revealed significant correlations with DSAdia (r= 0.79‐0.87, all P<.001) with median differences in the range of +8% to –6%. Inter‐observer agreement was moderate for CTAdia (κ= 0.60) and excellent for CTAarea (κ= 0.86). Sensitivity of CTAarea for the detection of ICAS >70% was 100% for both observers, corresponding results for CTAdia were 97.1% and 71.4%, respectively, using DSAdia as the gold standard. Conclusion. CTAarea assessment of ICAS correlates well with the results of DSAdia and provides an excellent sensitivity for the detection of ICAS >70% with superior inter‐observer agreement compared to CTAdia.
Subacute Combined Degeneration Due to Copper Deficiency
Authors: Ferrara Joseph M. , Skeen Mark B. , Edwards Nancy J. , Gray Linda , Massey E. Wayne 
Published: October 2009

ABSTRACT There is growing clinical evidence supporting a connection between copper deficiency and subacute combined degeneration. While nearly half of patients with copper deficiency myelopathy exhibit MRI abnormalities, signal changes are often ill‐defined in distribution. We report a patient with sensory ataxia and spastic paraplegia from copper deficiency whose MRI demonstrates abnormal signal restricted to the dorsal and lateral columns, providing clear radiological support of an association between hypocupremia and combined system degeneration.
Measuring Brain Atrophy in Multiple Sclerosis
Authors: De Stefano Nicola , Battaglini Marco , Smith Stephen M. 
Published: October 2009

ABSTRACTThe last decade has seen the development of methods that use conventional magnetic resonance imaging (MRI) to provide sensitive and reproducible assessments of brain volumes. This has increased the interest in brain atrophy measurement as a reliable indicator of disease progression in many neurological disorders, including multiple sclerosis (MS). After a brief introduction in which we discuss the most commonly used methods for assessing brain atrophy, we will review the most relevant MS studies that have used MRI‐based quantitative measures of brain atrophy, the clinical importance of these results, and the potential for future application of these measures to understand MS pathology and progression. Despite the number of issues that still need to be solved, the measurement of brain atrophy by MRI is sufficiently precise and accurate. It represents one of most promising in vivo measures of neuroaxonal degeneration in MS, and it should be used extensively in the future to assess and monitor pathological evolution and treatment efficacy in this disease.
T1‐ and T2‐Based MRI Measures of Diffuse Gray Matter and White Matter Damage in Patients with Multiple Sclerosis
Authors: Neema Mohit , Stankiewicz James , Arora Ashish , Dandamudi Venkata S.R. , Batt Courtney E. , Guss Zachary D. , Al‐Sabbagh Ali , Bakshi Rohit 
Published: October 2009

ABSTRACTMagnetic resonance imaging (MRI) has emerged as a powerful noninvasive tool to assist in the diagnosis and monitoring of multiple sclerosis (MS). In addition, investigators have used MRI metrics as supportive outcome measures to explore drug efficacy in clinical trials. Conventional MRI surrogates provide information at the macroscopic level but lack sensitivity and specificity in identifying the full extent of underlying MS pathology. They also show relatively weak relationships to clinical status such as predictive strength for clinical change. Advanced MRI techniques involving quantitative measures of diffuse damage in normal appearing (NA) white matter (WM) and gray matter (GM) may help in resolving this apparent clinical MRI paradox. T2 hypointensity has been described in the GM of patients with MS and has been linked to physical disability, cognitive dysfunction, and brain atrophy. While this T2 hypointensity is thought to represent iron deposition, this awaits pathologic confirmation. Advanced MRI measures of iron deposition such as R2, R2*, R2' relaxometry, 3T imaging and other new approaches are beginning to be applied to studies of MS and should yield interesting information. Both T1 and T2 relaxometry have a role in detecting damage in NA brain tissue that escapes detection by conventional MRI lesion measures. For example, T2 mapping may allow an assessment of myelin content in NAWM. In this review, we will focus on MRI advances in the last 10 years pertaining to T1 and T2 measures of diffuse GM and WM damage.
Functional MRI in Multiple Sclerosis
Authors: Rocca Maria A. , Filippi Massimo 
Published: October 2009

ABSTRACTThere is increasing evidence that the severity of the clinical manifestations of multiple sclerosis (MS) does not simply depend on the extent of tissue destruction, but rather represents a complex balance among tissue damage, tissue repair, and cortical reorganization. Functional magnetic resonance imaging (fMRI) provides information about the extent and nature of brain plasticity, which follows MS structural injury and might have the potential to limit the clinical manifestations of the disease. An altered recruitment of regions normally devoted to the performance of a given task and/or the recruitment of additional areas, which are not typically activated by healthy people for performing that given task, have been described in patients with MS, independent of their clinical phenotype when investigating the visual, cognitive, and motor systems. These functional changes have been related to the extent and severity of brain damage within and outside T2‐visible lesions and to the involvement of specific central nervous system (CNS) structures, including the spinal cord and the optic nerve. Brain functional changes have been shown to be dynamic over time, not only after an acute relapse, but also in clinically stable patients. An increased recruitment of the cerebral networks might represent a first step of cortical reorganization with the potential to maintain a normal level of function in the course of MS. The progressive failure of these mechanisms might, on the one hand, result in the activation of previously silent “second‐order” compensatory areas, and, on the other, contribute to the clinical manifestations of the disease.
Optic Nerve Imaging in Multiple Sclerosis
Authors: Hickman Simon J. 
Published: October 2009

ABSTRACTIn this article I review the last 10 years of progress in the imaging of the optic nerve with a particular focus on applications to multiple sclerosis (MS). Development of magnetic resonance imaging (MRI) of the optic nerve has lagged behind imaging of other parts of the CNS. These limitations are due to technical challenges related to the small size and mobility of the optic nerves and artefacts caused by surrounding cerebrospinal fluid, orbital fat, and air‐bone interfaces. Nonetheless the last 10 years has seen significant progress with regard to detecting optic nerve atrophy following optic neuritis, the use of fat‐ and CSF‐suppressed high resolution imaging, the ability to measure magnetization transfer ratio and diffusivity in the optic nerve, and the emergence of SPIR‐FLAIR for increasing sensitivity to inflammatory demyelination. Remaining challenges include further reduction of movement artifacts, testing ultra‐high field MRI systems and dedicated surface coils, and developing automated segmentation techniques to improve the reproducibility of quantitative measurements. Finally the role of optic coherence tomography as a marker of retinal damage needs to be clarified further through correlations with MRI, clinical, and electrophysiologic data.
Diffusion Tensor and Functional Magnetic Resonance Imaging of Diffuse Axonal Injury and Resulting Language Impairment
Authors: Mao Hui , Polensek Sharon H. , Goldstein Felicia C. , Holder Chad A. , Ni Chunchun 
Published: October 2009

ABSTRACT Diffuse axonal injury (DAI) is a common aftermath of brain trauma. The diagnosis of DAI is often difficult using conventional magnetic resonance imaging (MRI). We report a diffusion tensor imaging (DTI) study of a patient who sustained DAI presenting with language impairment. Fractional anisotropy (FA) and DTI tractography revealed a reduction of white matter integrity in the left frontal and medial temporal areas. White matter damage identified by DTI was correlated with the patient's language impairment as assessed by functional MRI (fMRI) and a neuropsychological exam. The findings demonstrate the utility of DTI for identifying white matter changes secondary to traumatic brain injury (TBI).