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PubMed1986

Computerized tomography, magnetic resonance imaging, and positron emission tomography in the study of brain trauma. Preliminary observations.

Results of computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), xenon-133 measurement of cerebral blood flow (CBF), and neuropsychological assessments are described in three head-injured patients. The patients were selected because they presented with intracranial hemorrhage diagnosed by CT. Two of the patients were studied acutely and again approximately 6 months later. In the acute stage, MRI was superior to CT in identifying the precise location and extent of intracranial hemorrhage and associated edema. Small subdural hematomas diagnosed on MRI were missed with CT scanning. The extent of apparent encephalomalacia in the chronic stages of injury was also better defined with MRI. Positron emission tomography showed disturbances of glucose metabolism that extended beyond the structural abnormalities demonstrated by MRI and CT; anterior temporal lobe dysfunction was particularly evident in all three patients. Regional CBF studies failed to detect a number of the abnormalities seen on MRI and CT, and even ignored the metabolic dysfunction evident on PET that should have been accompanied by changes in regional CBF. The neuropsychological studies localized frontal lesions, but did not reveal abnormalities attributable to the structural lesions and the reduced metabolism in the anterior temporal lobes.

Adult↗
PubMed1995

Supratentorial-infraoccipital approach for posteromedial temporal lobe lesions.

The use of the supratentorial-infraoccipital approach is reported in seven patients with posteromedial temporal lobe lesions. No patient had permanent morbidity. Gross total resection of three low-grade gliomas and two gangliogliomas was achieved in five patients; one patient had subtotal resection of a low-grade glioma with adjacent gliosis, and one was initially thought to have a glioma but proved to have encephalomalacia on final pathological analysis. The patients ranged in age from 5 to 34 years. All seven patients presented with seizures, and four had uncontrolled seizures preoperatively. Six have been seizure-free since surgery (mean follow-up period 15 months), and one is well controlled on anticonvulsant medication. An anatomical study was performed to delineate the microsurgical anatomy relevant to operating on the medial temporal lobe through this posterior approach. A viewing wand intraoperative navigational system was utilized with this approach and proved helpful in gaining access as far anterior as the uncus through this occipital craniotomy. This approach is favorable in selected patients with posterior, medial, temporal lobe tumors because resection of otherwise difficult lesions may be accomplished without sacrificing lateral temporal lobe cortex or transecting the optic radiations.

Adolescent↗
PubMed2006

Effects of intravenous administration of human bone marrow stromal cells after intracerebral hemorrhage in rats.

OBJECT: The goal of this study was to investigate whether human bone marrow stromal cells (hBMSCs) administered by intravenous injection have a beneficial effect on outcome after intracerebral hemorrhage (ICH) in rats. METHODS: An ICH was induced in 54 adult male Wistar rats by a stereotactically guided injection of autologous blood into the right striatum. Intravenous infusion of the hBMSCs (3, 5, or 8 million cells) was performed 1 day after ICH, and for each dose group there was a control group that received injections of vehicle. Neurological function, which was evaluated using the Neurological Severity Score (NSS) and the corner turn test, was tested before and at 1, 7, and 14 days after ICH. After 14 days of survival, the area of encephalomalacia was calculated and histochemical labeling was performed. For all three groups, there were no statistical differences in either the NSS or corner turn tests after 1 day. After 7 and 14 days, however, the three groups that received the hBMSCs showed significant improvement in functional scores compared with the control group. In addition, after 14 days there was significantly more striatal tissue loss in the placebo groups compared with each of the three treatment groups. The region of injury in the treated animals demonstrated a significantly increased presence of hBMSCs, immature neurons, neuronal migration, synaptogenesis, and newly formed DNA. CONCLUSIONS: Intravenous administration of hBMSCs significantly improves neurological function in rats subjected to ICH. This improvement in the treated animals is associated with reduced tissue loss and increased local presence of the hBMSCs, mitotic activity, immature neurons, synaptogenesis, and neuronal migration.

Animals↗
PubMed1985

Pathological changes associated with the feeding of soybean oil or oil extracted from different rapeseed cultivars to single comb white Leghorn cockerels.

A total of 384 Single Comb White Leghorn cockerels of the Hyline strain were fed either a basal (control) diet containing no added oil or a diet supplemented with 20% by weight of soybean oil, rapeseed oil from cultivars Tower, Candle, a mixture of Echo and Arlo high erucic acid rapeseed (HEAR), or R-500. Levels of erucic acid (22:1) in the rapeseed diets varied from .03 to 10.31%. Three birds from each unit were killed at 28, 56, 84, and 112 days and a wide range of tissues were examined histologically. A number of birds in all dietary groups had healed lesions of avian encephalomalacia. Two cockerels fed HEAR oil and 12 fed R-500 developed marked ascites, firm shrunken livers, hydropericardium, and cachectic muscular atrophy. Marked periacinar necrosis was present in birds dying with ascites. A significantly higher number of birds fed the rapeseed oils developed hepatic sinusoidal distention than birds fed the basal or soybean oil diets. Degenerative myocardial changes were seen only in R-500 and HEAR oil-fed birds. This, coupled with hepatic changes, producing shrunken firm livers, led to development of ascites, cachectic muscular atrophy, and periacinar hepatic necrosis. These changes were probably produced by the high erucic acid content of the HEAR and R-500 oils and the resultant grossly imbalanced diet.

Animals↗
PubMed2002

Plant poisonings and mycotoxicoses of importance in horses in southern Africa.

Well-known plant poisonings such as 'dunsiekte' (seneciosis) and 'jaagsiekte' (crotalariosis) of horses in southern Africa are briefly reviewed. Relatively unfamiliar mycotoxicoses such as stachybotryotoxicosis and perennial rye grass staggers and potentially occurring exotic intoxications such as equine nigropallidal encephalomalacia and ergot alkaloid poisoning are also discussed. This article is aimed at informing the southern African equine practitioner about probable poisonings that might occur locally in horses.

Africa, Southern↗
PubMed1997

Granulomatous amebic encephalitis due to Balamuthia mandrillaris (Leptomyxiidae): report of four cases from Mexico.

In this report, we describe four cases of granulomatous amebic encephalitis caused by Balamuthia (Leptomyxid ameba) in four previously healthy Mexican patients. All four cases were characterized by focal neurologic signs, increased intracranial pressure, and cerebral hyperdense lesions in computed tomography scans of the head. These patients underwent craniotomies for evaluation of mass lesions for possible brain tumors. Granulomatous chronic inflammatory reaction and amebic trophozoites were found in brain biopsies. At autopsy, areas of hemorrhagic encephalomalacia were located in both basal frontal lobes, right parieto-occipital lobes, and, less often, in the brainstem and cerebellum. Angiitis, necrotizing granulomatous encephalitis, and large numbers of amebic trophozoites in perivascular spaces were present. Amebic trophozoites were seen in the left adrenal gland in one of the cases. The amebas in all four cases were identified as Balamuthia mandrillaris (Leptomyxiidae) based on their reactivity with the anti-Balamuthia (Leptomyxiidae) serum in an immunofluorescence test.

Adolescent↗
PubMed1992

Probable herpesvirus infection in an eastern cottontail (Sylvilagus floridanus).

One wild eastern cottontail (Sylvilagus floridanus) from Milwaukee County, Wisconsin was necropsied. The lungs contained numerous multifocal, circumscribed, tan foci; the spleen was markedly enlarged and had a mottled reddish tan color; and the brain had a red to tan friable tract in the left hemisphere. Microscopically, the lung had a severe bronchiolitis and pneumonia. The bronchiolitis was characterized by epithelial cells containing eosinophilic intranuclear inclusion bodies. The encephalomalacia of the left cerebral cortex featured tissue disruption and astrocytes or neurons containing intranuclear inclusion bodies. Herpesvirus particles were found within the bronchiolar epithelial cells. Based on histopathological and ultrastructural findings, a herpesvirus seemed the most likely etiologic agent.

Animals↗
PubMed1970

Two viruses isolated from rodents (Clethrionomys gapperi and Microtus pennsvlvanicus) trapped in St. Lawrence County, New York.

Four strains of C. gapperi virus were isolated from 3 Clethrionomys gapperi and 47 strains of Microtus virus from 15 Microtus pennsylvanicus and 1 Mus musculus. One of the Microtus strains was isolated from a pool of 20 mites while the others were from rodent tissues. These agehts were insensitive to ether and sodium desoxycholate, withstood freezing at -70 C for 3 years and lyophilization without loss of titer, and were not killed when heated at 60 C for 1 hour. Their size as determined by filtration was less than 50 mg and greater than 20-35 mmicro. The strains within each group appear to be similar. The illness induced in suckling mice by the C. gapperi agents had a 5-day incubation period followed by prostration and death with a histologic picture of extensive encephalomalacia. The incubation period in mice for the Microtus agents was 9 to 11 days followed by convulsions and death. Histopathology showed meningeal infiltration and necrosis of the molecular layer. No antigenic similarity was detected between the C. gapperi and Microtus viruses by cross complement-fixation test.

Animals↗
PubMed1976

[Comparative study of infectious and atypical encephalomyelitis in birds].

Studied were morphologically a total of 234 birds for infectious encephalomyelitis (IE) and atypic encephalomyelitis (AE) of which 70 were experimentally infected with standard reference strains of IE (Calnek 1143-42 birds, and Van Roeckel 28 birds), 32 were infected with a brain suspension of affected with AE birds, and 110 were spontaneously affected with AE. Those of the birds that were infected with the standard strains of IE as well as with the brain suspension exhibited changes in the central nervous system in the form of a non-suppurative encephalomyelitis, and in the viscera--lymphoidcell proliferations. These alterations proved analogous with those observed in birds spontaneously affected with AE. The changes in CNS in the case of IE were localized in the brain and the spinal cord, while the lesions in the case of AE were found chiefly in the brain. In AE there were perivascular lymphoidcell were groupings along the peripheral nerves. It was concluded that the histologic changes established may well serve to differentiate IE from AE in Marek's disease, the transitional paralysis, the Newcastle disease, and the alimentary encephalomalacia.

Animals↗
PubMedDate not supplied

[Subcortical infarcts (caudate nucleus) in a case of bilateral anterior cerebral artery occlusion].

The authors describe a patient with bilateral anterior cerebral artery (ACA) occlusion. CT and MRI revealed bilateral encephalomalacia in the regions supplied by Heubner arteries and/or by perforating branches of ACA. The patient presented mainly with frontal symptomatology resulting from caudate nuclei lesion. Frontal symptomatology due to caudate impairment is discussed in the sense of frontal-subcortical circuits: lateral orbitofrontal and anterior cingulate ones. We emphasise a similarity of behavioural and cognitive disorders in early Huntington's disease and in frontal lobe lesion.

Arterial Occlusive Diseases↗
PubMedDate not supplied

Associated brain abnormalities in patients with corpus callosum anomalies.

Forty-nine patients with corpus callosum (CC) anomalies were evaluated in terms of the clinical features and magnetic resonance imaging (MRI) findings. CC anomalies were classified as CC agenesis: 6 (12%), CC hypogenesis: 5 (10%), and CC hypoplasia: 38 (78%). In the CC hypoplasia group the mean value of the genu thickness of the CC was 0.29 +/- 0.1 cm, which was less than the normal value of the age-matched normal children (normal range: 0.6-1.2 cm). The associated brain abnormalities were in five distinct groups: gray matter abnormalities, white matter abnormalities, midline brain structure defects, cortical atrophy, and encephalomalacia. There was no uniformity for the clinical spectrum of CC anomalies. Microcephaly, developmental delay and seizures were the prominent findings in patients. The clinical features were more severe in cases with associated brain anomalies.

Abnormalities, Multiple↗
PubMedDate not supplied

Chicken embryo lethality assay for determining the virulence of avian Escherichia coli isolates.

Multiple isolates of Escherichia coli from clinical cases of colibacillosis and E. coli from the intestinal tracts of normal broilers at slaughter were assayed by the embryo lethality test to determine their virulence. The assay was repeated five times in order to establish reproducibility and determine the statistical parameters of the test. This study showed that the inoculation of approximately 100 colony-forming units in the allantoic cavity of 12-day-old embryos discriminated between virulent and avirulent E. coli isolates. Gross lesions included cranial and skin hemorrhages in addition to encephalomalacia in embryos inoculated with virulent isolates. Abnormalities were observed by microscopic examination of the heart, brain, and liver in embryos inoculated with virulent isolates. Analysis of data indicated that the length of the test should be 4 days. In the virulent group, day 2 postinoculation had the most significant death patterns. Sample size calculations indicated that 11 embryos are sufficient for the assay. On the basis of death rates, isolates considered to be avirulent had an embryo death rate of <10%, moderately or secondary pathogens had a 10%-29% death rate, and virulent isolates had a death rate of >29%. An important aspect of this assay is the accessibility of good-quality fertile embryonated eggs.

Animals↗
PubMedDate not supplied

Infants of twin pregnancies with one twin demise in the uterus: a retrospective study.

Many papers have reported that twin pregnancies with one twin demise in the uterus can cause complications in the surviving twin. We retrospectively reviewed charts from 1988 to 1997 at our hospital and found 17 of 302 twin deliveries with one twin intrauterine fetal death. The incidence of intrauterine death of a single twin was 5.7%. Six of the surviving twin (35.3%) had renal function impairment. One died due to acute renal failure. The other five patients recovered normal serum creatinine level. Five patients (29.4%) had abnormal brain imaging findings. One had multicystic encephalomalacia and microcephaly. Three of the five patients were complicated with cerebral palsy. After dividing the patients into complicated (n = 8, 47.1%) and non-complicated (n = 9, 52.9%) groups, we found that the patients with complication had lower Apgar score at 5 minutes and those with monochorionic diamniotic placenta had higher incidences of complication (62.5% vs 12.5%). We conclude that twin pregnancies with one fetal demise in the uterus do result in a higher incidence of complication in the surviving twin, especially if placentation type is monochorionic diamniotic. In managing the surviving twin of the monozygous twin pregnancies with one fetal demise in the uterus, we must be careful to monitor these patients. If complication was suspected, we should arrange the brain and kidney ultrasonography and manage these patients appropriately to decrease the complication risk.

Delivery, Obstetric↗
PubMed2000

Clinics in diagnostic imaging (51). Multiloculated cerebral abscesses due to paradoxical cardiac emboli.

A 19-year-old woman with congenital cyanotic heart disease (Epstein anomaly and ventricular septal defect) had persistent headaches and intermittent fever for five weeks. Physical examination revealed central cyanosis, finger clubbing and fever. The leucocyte count was elevated. Cerebral MR imaging showed the characteristic features of brain abscesses in the right frontal lobe, including multiloculation with adjacent satellite lesions, ring enhancement, T1-hyperintense and T2-hypointense signal areas within the abscess rim, as well as hypointense internal concentric rings on T2-weighted images. The diagnosis of brain abscesses was confirmed by craniotomy and pus drainage. She made a good recovery with a combination of antibiotics and surgery. Follow-up CT scans showed only changes of encephalomalacia at the healed abscess site. The aetiology, clinical features, and the role of CT and MR imaging in the diagnosis and management of brain abscess are discussed.

Adult↗
PubMed2001

Clinics in diagnostic imaging (58). Chronic cerebral paragonimiasis.

A 36-year-old Korean man presented with a history of epilepsy. MR imaging of the brain revealed multiple conglomerated round nodules that were hypointense on both T1-and-T2 weighted images. These were located at the left temporal and occipital lobes and had surrounding encephalomalacia. CT scan confirmed the presence of large calcified nodules in the corresponding regions. These imaging findings were typical of chronic cerebral paragonimiasis. The clinical, CT and MR features of cerebral paragonimiasis are reviewed.

Adult↗
PubMed2000

[Morphologic and clinical sequelae of focal ischemic lesions].

The diseases of vessels, mainly of those in brain are one of the most serious problems of the medical practice. The encephalomalacia or cerebral infarctions are usually caused by transient or permanent obstruction of the brain arteries lumen. Beside local dysfunction of vessels the obstructions could be based on embolic events originating in the heart. Such an obstructions are resulting in global and focal cerebral ischaemias. Arterial occlusion results in cerebral ischaemia and the lack of oxygen (anoxia) which leads to reversible or irreversible injury of the nervous cells in the ischaemic region. The local cell injury or cell death causes attraction of macrophages invading into the devitalized tissue within 72-96 hours after the beginning of the ischaemia. The aim of this study was to find out the correlation between asymptomatic or symptomatic course regarding localisation of the ischaemic lesions in the cerebral tissue. Our anatomical findings were collected from 318 autopsies, and reports on postmortem examinations during the period between September-December 1998. The grossing of the brain was carried out by using of Virchow's method. Atherosclerosis, hypertension, and diabetes mellitus were found to be the main risk factors for the production of focal cerebral ischaemia. Of those patients with focal cerebral ischaemia atherosclerosis had 87.5%, 44.3% were suffering from hypertension, and 25% from diabetes mellitus. The focal ischaemia analysed in this study originated from arterial stenosis or thromboembolic obstructions. We divided the lesions into 3 groups according to their size. The most frequently apparent lesions (72%) were the small cysts (0-10 mm in diameter)-lacunae. The majority of them (90%) was found in the basal ganglia. The second group consisted of postmalatic pseudocysts (10-30 mm in diameter), and the third group was represented by encephalomalatic lesions which were larger than 30 mm. Cerebral ischaemic lesions were present in 27.8% of the studied cases. Nevertheless, more than the half (56.8%) of the affected brains (postmalatic pseudocysts, lacunae and malaciae) belongs to the group of patients who were clinically asymptomatic. The asymptomatic lesions, having negative results in the patient's history, and the clinical course were localised mainly in the basal ganglia of both sides and in the frontal part of the right (nondominant) hemisphere.

Adult↗
PubMed1989

Brain Magnetic Resonance Imaging in Elderly Depressed Patients Receiving Electroconvulsive Therapy.

The authors review their experience with brain magnetic resonance (MR) imaging in elderly patients with depression referred for electroconvulsive therapy (ECT). A variety of brain changes were identified on the pre-ECT MR scans of these patients, including cortical atrophy, subcortical encephalomalacia, lateral ventricular enlargement, and lesions of the pons. The authors examine the effects of these preexisting brain changes on the therapeutic outcome and side effects from ECT. Pilot data suggest that these brain findings do not change during a course of ECT. The potential relationship of these brain changes to the development of affective disorder in the elderly is discussed and areas for future research are suggested.

Journal Article↗
PubMed2003

Complications induced by decompressive craniectomies after traumatic brain injury.

OBJECTIVE: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. METHODS: 68 patients who underwent external decompression after traumatic brain injury were admitted into Tianjin Medical University General Hospital for cranioplasty from 1995 to 2001. Complications were retrospectively investigated and analyzed in all patients. The findings were compared between the patients who accepted the decompressive craniectomy in our hospital and in local hospitals. chi(2)-test was employed for statistical analysis and complication evaluation. RESULTS: Large craniectomy definitely caused some side effects to patients. Among various complications, several of them showed significantly high incidence (P<0.05) in patients who underwent the decompressive operation in local hospitals such as shunt-dependent hydrocephalous, subdural fluid collection, and CSF leakage from scalp incision. The rest of the complications had no remarkable difference (P<0.05) between the two groups including dilation or/and migration of lateral ventricle underlying the cranial defect, skin flap concavity, encephalomalacia of the decompressive area, seizure and infection. CONCLUSIONS: To reduce the incidence of iatrogenic side effects, surgical craniectomy should be performed according to the strict indication and standard and any abuse should be avoided.

Adolescent↗