MR imaging of colloid cysts of the third ventricle.
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Brain Diseases↗
Biomedical subjects
G Wilms
Publications and source records attributed to G Wilms.
Direct caroticocavernous fistula and traumatic dissection of the ipsilateral internal carotid artery: endovascular treatment.
After severe craniocerebral trauma a 14-year-old boy developed progressive exophthalmos with venous congestion and chemosis, due to a direct caroticocavernous fistula. Angiography revealed traumatic occlusion of the ipsilateral internal carotid artery and absence of the inferior petrosal sinus. After failure of an approach via the anterior and posterior communicating arteries, the cavernous sinus was successfully catheterised through the occluded internal carotid artery, and embolisation performed with coils.
Adolescent↗
Multiple small pseudoaneurysms complicating pancreatitis: angiographic diagnosis and transcatheter embolization.
We report a case of retroperitoneal hemorrhage due to multiple, small pseudoaneurysms complicating a chronic alcoholic pancreatitis. Cross-sectional imaging with CT and US could not clearly depict these vascular lesions. Selective arteriography of the superior mesenteric and gastroduodenal arteries clearly showed the small pseudoaneurysms and definitive treatment was performed by transcatheter embolization using coils. Eight months after successful embolization, the patient is asymptomatic without any recurrent bleeding.
Aneurysm, False↗
Predicting arm recovery following stroke: value of site of lesion.
OBJECTIVES: The aims of this study were to assess whether the site of lesion is predictive of upper limb recovery after stroke and to determine whether this information adds to the predictive ability of the clinical examination. MATERIAL AND METHODS: Forty-five patients were examined at entry to the study and at 2 and 12 months after stroke. The Brunnström-Fugl-Meyer test was used as outcome measurement. Predictor variables included clinical parameters and classifications of lesion site (obtained by CT/MRI). RESULTS: Correlation analysis revealed small to moderate relationships between lesions of subcortical structures and arm outcome at 2 months. In multiple regression analysis, the best model for predicting recovery at 2 months was found to be a combination of the clinical parameters with a purely subcortical lesion. Motor recovery at 12 months was best predicted by the clinical tests alone. The results further indicated that patients with subcortical damage tended to take longer to recover. CONCLUSIONS: Clinical assessment is most useful for determination of the prognosis of upper limb recovery after stroke. Neuroanatomical parameters measured by CT or MRI can only act as an adjunct.
Adult↗
Endovascular treatment of a ruptured paraclinoid aneurysm of the carotid syphon achieved using endovascular stent and endosaccular coil placement.
We herein report a case of a ruptured superior hypophyseal aneurysm of the left supraclinoid carotid artery that could not be treated with a Guglielmi detachable coil (GDC), even in combination with a supporting nondetachable balloon. After an unsuccessful attempt at surgical clipping, treatment consisted of the placement of a stent over the neck of the aneurysm, advancement of a microcatheter through the stent mesh, and endosaccular embolization with a GDC. The late clinical outcome was excellent.
Aneurysm↗
Diffusion-weighted MRI in sporadic Creutzfeldt-Jakob disease.
Diffusion-weighted MRI (DWI) was used in three patients with autopsy-proven sporadic Creutzfeldt-Jakob disease (CJD) to provide a rapid noninvasive way to make this sometimes confusing diagnosis. DWI prompted the diagnosis of CJD at an early stage and appears to be particularly useful for monitoring the progression of the disease. We suggest that patients with suspected CJD and no abnormalities on T2- and proton density-weighted images may have cortical involvement on DWI.
Aged↗
Acute posterior cerebral circulation syndrome accompanied by serious cardiac rhythm disturbances: a rare but reversible complication following bypass graft angiography.
Cerebral events are recognized, although infrequent, complications of cardiac catheterization. We report on an exceptional case of a posterior cerebral circulation syndrome comprising a confusional state, amnestic disturbances, aphasia, and cortical blindness, accompanied by life-threatening cardiac arrhythmia after left and right internal mammary artery graft angiography, with complete recovery over 5 days. The diagnostic potential of computed tomography, magnetic resonance, and SPECT imaging of the brain in diagnosing this rare but important complication is illustrated. The need for early continuous monitoring of patients with clinically important cerebrovascular events postangiography is emphasized. Cathet. Cardiovasc. Intervent. 48:397-401, 1999.
Acute Disease↗
Rostral vermian cortical dysplasia: MRI.
The MRI findings in rostral vermian dysplasia are described for the first time. Defective foliation and abnormal fissuration of the rostral vermis can clearly be depicted on coronal images. The abnormalities are limited to the anterior lobe of the vermis and its hemisphere extension. A hypothesis is put forward to explain the abnormalities. It is suggested that the vermian changes result from an intrauterine insult at the end of the first trimester. There appears to be a variable degree of expression and associated cerebellar and cerebral cortical abnormalities can be seen. The clinical significance of these findings remains incompletely understood but may be related to the severity of the abnormalities. It is also suggested that a mild degree of vermian rostral dysplasia may represent an incidental imaging finding.
Adolescent↗
Sciatica caused by a dilated epidural vein: MR findings.
We report the MR imaging findings in a 41-year-old woman presenting with sudden low back pain and sciatica. At surgery a dilated epidural vein was found compressing the nerve root. The MR findings may suggest the diagnosis. Magnetic resonance imaging of a dilated epidural vein or varix causing sciatica has not been reported until now.
Adult↗
MRI of non-ischemic vascular disease: aneurysms and vascular malformations.
Due to flow-void phenomena, MRI is of great value in the demonstration of cerebral aneurysms and vascular malformations as well as of related parenchymal changes and hemorrhagic complications. Magnetic resonance angiography can produce vascular images which are of importance in the diagnosis and follow-up of the lesions.
Brain↗
Transcatheter embolization of hepatic arteriovenous fistulas in Rendu-Osler-Weber disease: a case report and review of the literature.
A patient with hereditary hemorrhagic telangiectasia and diffuse intrahepatic arteriovenous fistulas developed secondary high-output ventricular failure and pulmonary hypertension. A serial staged hepatic arterial coil embolization was performed with long-term resultant haemodynamic and clinical improvement. The methods of this procedure and related complications are discussed.
Angiography↗
Fast FLAIR MRI in childhood white-matter abnormalities.
We compared a fast fluid-attenuated inversion recovery (FLAIR) pulse sequence with a dual-echo short tau fast inversion-recovery (DESTTIR) sequence in 20 children with white matter abnormalities. Although the overall image quality of DESTTIR images was better, the lesion-to-background contrast was significantly higher with the fast FLAIR pulse sequence and lesion detection was more accurate.
Adolescent↗
Spinal epidural abscess complicating epidural infiltration: CT and MR findings.
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Abscess↗
Cranial CT revisited: do we really need contrast enhancement?
The aim of this study was to define guidelines for intravenous contrast administration in cranial CT, as currently there are no recent guidelines based on a large series of patients. In 1900 consecutive patients (1480 adults and 420 children) pre- and post-contrast scan was analysed in order to assess the contribution of contrast enhancement to the diagnosis. The findings were grouped according to whether abnormalities were seen on the pre- and/or post-contrast scan, or whether no abnormalities were seen at all. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of a pre-contrast scan were used to determine validity. Intravenous contrast enhancement only contributes to the diagnosis if a suspicious abnormality is seen on the unenhanced scan or in the appropriate clinical setting (33.6%). In the remaining patients (65.6%) there is no diagnostic contribution, except for a small number of abnormalities (0.8%). These are often anatomical variants and have no therapeutic impact. The number of contrast-enhanced cranial CT examinations can significantly be reduced by using four general guidelines for contrast administration resulting in considerable cost savings without affecting the quality of service to the patient. These guidelines are defined by the clinical findings/presentation or by the findings on the unenhanced scan. The number of contrast-related complications will be reduced, which may have medicolegal implications. These guidelines can be applied in any radiology department.
Adolescent↗
Functional MRI of the brain: localisation of eloquent cortex in focal brain lesion therapy.
The aim of this study was to assess the feasibility of functional MRI (fMRI) in a clinical environment on a large patient group, and to evaluate the pretherapeutic value of localisation of eloquent cortex. Forty patients with focal brain lesions of different origin were studied using fMRI. Functional information was obtained using motor, somatosensory, auditory and phonological stimuli depending on the localisation of the lesions. To obtain information about the spatial accuracy of fMRI, the results were compared with postoperative electrocortical stimulation. Two patients with secondary trigeminal neuralgia were scanned using a motor protocol and were implanted with an extradural plate electrode. Imaging was successful in 40 of 42 patients (including the 2 with trigeminal neuralgia). These patients were analysed for strength of activation, the relation of the lesion to activation sites and the presence of mass effect. The correlation between these data and surgical findings provided significant additional clinical information. Functional MRI can be accurately performed in patients with focal brain lesions using a dedicated approach. Functional MRI offers important clinical information as a contribution to a decrease in posttherapeutic morbidity. The accuracy of the technique can be confirmed by other modalities, including invasive cortical electrostimulation.
Adolescent↗
Functional magnetic resonance imaging (fMRI) visualises the brain at work.
Functional Magnetic Resonance Imaging (fMRI) is a recent MRI technique capable of visualising neuronal activity in humans in a non-invase way. The technique visualises the physiological changes in oxy- and deoxyhemoglobin concentration changes in small cortical blood vessels upon neuronal activation without the need for radiation or the administration of contrast media or radioactive tracers. The spatial accuracy of the technique is of the order of millimeters and the temporal resolution of the order of one second. The concept has captured the interest of neuroradiologists as well as neuroscientists, who now have a means to visualise their theories in human volunteers. In the clinical environment the non-invasive studies should aid neurosurgeons in adopting a safe course into the brain and assist neurologists in unraveling neurological hypotheses. This report describes the technical principals of fMRI and presents some of our clinical results on the mapping of several cortical functions, such as motor, auditory and language functions, in a large group of patients.
Brain↗
Prospects with renal artery stenting.
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Humans↗
CT and MRI of amyloidoma of the CNS.
We present a case of cerebral amyloidoma in a 71-year-old woman. The clinical presentation and the radiological features were both highly suggestive for a brain tumor.
Aged↗