Search PubMed⌕ Search

Biomedical subjects

P Demaerel

Publications and source records attributed to P Demaerel.

At least 73 records · Page 4Linked to original sources

Congenital scalp defect, distal limb reduction anomalies, right spastic hemiplegia and hypoplasia of the left arteria cerebri media. Further evidence that interruption of early embryonic blood supply may result in Adams-Oliver (plus) syndrome.

In this report we describe a male patient with the interesting combination of a large congenital scalp defect, distal limb reduction anomalies, right spastic hemiplegia and hypoplasia of the left arteria cerebri media. Follow-up data from birth up to the age of 18 years revealed positive evolution with low to normal intelligence. The findings in the present patient, i.e. an Adams-Oliver syndrome associated with a severe neurological deficit, are best explained as resulting from interruption of the early embryonic blood supply.

Abnormalities, Multiple↗

Orbital fat edema in anorexia nervosa: a reversible finding.

Orbital fat edema was found in a patient with long-standing severe anorexia nervosa. The changes disappeared after the patient gained weight. The underlying mechanisms remains unexplained, but the changes most likely coincide with the disappearance of fat tissue and the appearance of edema following disturbance of the electrolyte/fluid balance.

Adipose Tissue↗

Aggressive pituitary macroadenoma: CT and MR appearances.

Two cases of aggressive pituitary macroadenoma (prolactinoma) with diffuse invasion of the skull base are described. Clinical signs usually appear late. CT shows the bone destruction, whereas MRI accurately delineates the extension of the tumor and involvement of the surrounding neurovascular structures. Histopathology and immunohistochemical staining are necessary for a definitive diagnosis differentiating prolactimonas from a wide range of skull base tumours and for deciding on additional therapy and prognosis. Aggressive pituitary macroadenoma is a large and diffuse tumor which is difficult to treat; therapy usually consists of extensive surgery, radiotherapy and pharmacotherapy with dopaminergic agents.

Adult↗

Characterisation of intracranial aneurysms with MR angiography.

The purpose of this study was to compare the accuracy of 3D time-of-flight (TOF) acquisitions in the characterisation of intracranial aneurysms. Fourteen patients with aneurysms proven on intra-arterial angiography were first studied with a 3D TOF acquisition. When the aneurysms were incompletely demonstrated, additional MR angiography (MRA) acquisitions were performed, including black-blood MRA, 2D TOF, phase-contrast and contrast-enhanced TOF.3D TOF MRA was sufficient for detection of the aneurysm in 13 of 14 cases and characterisation of the aneurysm was possible in 6. All the initial shortcomings of the TOF technique could be analysed and explained by means of additional MRA techniques. This study suggests that the combination of different MRA techniques offers new possibilities for noninvasive investigation of intracranial aneurysms.

Adult↗

Magnetic resonance angiography of supratentorial tumours: comparison with selective digital subtraction angiography.

We compared magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (IADSA) in the study of brain tumours and assessed the utility of gadolinium-enhanced MRA. We studied 17 patients with supratentorial brain tumors. The entire brain was imaged with multiple overlapping thin volume acquisitions. After IV injection of gadolinium-DTPA, a single thick-slab MRA acquisition was performed. Standard three-dimensional (3D-TOF) acquisitions (in six patients) and 3D-TOF with magnetization transfer prepulse and tilted optimisation nonsaturing radiofrequency excitation pulses (in 11 patients) were used. Displacement of the anterior cerebral artery, main stem and insular branches of the middle cerebral artery was seen well on unenhanced and contrast-enhanced MRA. Displacement of the lenticulostriate and anterior choroidal arteries was seen only once, after Gadolinium. Tumour encasement of the middle cerebral artery was demonstrated in one patient. Tumour vessels were seen in 2 of 8 cases before and 3 of 8 after gadolinium; Tumour hypervascularity was seen only after gadolinium, in 3 of 8 cases. Study of the veins was possible only on gadolinium-enhanced MRA. Displacement of the venous angle was seen in 4 of 7 patients in the frontal, and in all of 8 patients on the lateral projections. Early venous drainage was not seen. Patency of the dural venous sinuses was demonstrated in all patients, but in one neoplastic occlusion of a cortical vein was recognized.

Adult↗

Uncommon posterior cranial fossa anomalies: MRI with clinical correlation.

The clinical and MRI findings in two cases of rhombencephalosynapsis (RS) and two of tectocerebellar dysraphia (TCD) with an associated occipital encephalocele were studied to elucidate the clinical picture and embryogenesis of these rare anomalies. To our knowledge, only one case of TCD [1] and four of RS [2, 3] examined by MRI during life have been reported. The clinical picture in the cases of RS was rather constant and there were similarities with TCD. Consideration of the embryogenesis of the neural tube suggests a temporal proximity of the abnormalities, with TCD arising at a slightly earlier time.

Cerebellum↗

Childhood neuroborreliosis: clinicoradiological correlation.

We report the cranial CT and MRI findings in three children with Lyme disease (neuroborreliosis). The neuroimaging findings in children have been rarely reported. We found cranial MRI far superior to cranial CT. Ring-enhancing lesions have been described in acute disseminating encephalomyelitis and multiple sclerosis but not in neuroborreliosis. Although other infectious and inflammatory diseases cannot be excluded, Lyme disease should be included in the differential diagnosis and put forward as being the most likely diagnosis in the appropriate clinical setting. Gadopentetate dimeglumine is helpful in assessing the response to antibiotic treatment.

Brain↗

Chordoma of the lower cervical spine.

Vertebral chordomas are rather rare tumours, especially in the lower cervical region. We present a patient with a C7 vertebral body chordoma and a discussion of pertinent literature is given. Only three C7 chordomas have been reported previously. Diagnosis is sometimes difficult to establish and is based on radiological examinations. Once the histological diagnosis is available, one should aim at a total resection. If this is not possible, adjuvant radiotherapy should be given. For limited cervical lesions, we advise a corporectomy with fusion by an iliac crest graft and osteosynthetic plate stabilisation.

Cervical Vertebrae↗

Neurofibromatosis type 1 in childhood: correlation of MRI findings with intelligence.

In a group of 28 children with neurofibromatosis type 1 aged between 4 and 16 years, neuroradiological findings were correlated with intelligence as measured by the Wechsler scales. The presence or specific location in the brain of T2 weighted prolonged signals on MRI was not associated with cognitive problems. No other physical characteristics associated with neurofibromatosis type 1 were found to correlate significantly with IQ. At the present these T2 weighted hyper-intense spots should not be used to predict neurofibromatosis type 1 associated cognitive problems.

Analysis of Variance↗

Neurocysticercosis: a poorly understood disease.

A 22-year-old male patient of Indian origin presented with generalized seizures. Brain magnetic resonance imaging (MRI) showed two cystic lesions. Extensive screening only revealed positive skin tests for tuberculosis. Immunoassays for cysticerosis were negative in serum and cerebrospinal fluid. Biopsy of the temporal lesion revealed a cysticercus. Although neurocysticercosis is a common cause of seizures in patients from countries where cysticercosis is endemic, the diagnosis can be difficult in a patient with evidence of multiple infections or in whom serological evidence is lacking, as is illustrated by the present case. Furthermore, because the pathogenic factors determining the activity of the disease are poorly understood, its management represents a similar problem as it depends upon the activity of the disease as estimated by clinical, radiological and laboratory tests. The present case report illustrates these difficulties.

Adult↗

Gadodiamide injection at 0.1 and 0.3 mmol/kg body weight: a phase III double-blind, parallel, randomised clinical investigation of known or suspected central nervous system lesions at 1.5 T.

We studied 78 patients with clinically suspected central nervous system abnormalities (66 intracranial, 12 spinal) by MRI before and after administration of the nonionic contrast medium gadodiamide injection. A parallel, double-blind, randomised design was followed. Two dosages were used: 38 patients underwent studies with 0.1 mmol/kg body weight (b.w.) and 40 with 0.3 mmol/kg b.w. MRI showed abnormalities in 36 of the 38 patients receiving the lower dose and 39 of the 40 patients receiving the higher dose. In 3 patients from each group more lesions were seen following injection than before. The contrast medium improved the delineation of abnormal structures and assessment of tumour size and increased their signal intensity indices in both groups, but especially at the higher dose. Administration of gadodiamide injection provided more diagnostic information in about 75% of the patients, independently of the dose. There were no reports of discomfort, but 7 patients reported adverse events considered unrelated to the gadodiamide injection. The two doses were found to be equally safe and efficient for diagnosis.

Central Nervous System Diseases↗