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At least 487 records · Page 27Linked to original sources
PubMed1999

Continuing decline of memory skills with significant recovery of intellectual function following severe carbon monoxide exposure: clinical, psychometric, and neuroimaging findings.

Extensive clinical, psychometric, and neuroimaging data are presented and interpreted with regard to a 35-year-old, White male college graduate who was exposed to severe carbon monoxide (CO) poisoning. The patient was comatose for 21 days following the exposure. Several other people, who were in the same room as the patient, died due to the toxic effects of the CO. The patient was employed premorbidly as a systems level lead computer programmer. The patient received medical and neuropsychological follow-up for 3 years post-CO exposure. Neuropsychological evaluations revealed a gradual, but incomplete recovery of general intellectual function. The patient continued to exhibit severe memory deficits with some evidence for small additional memory decline over time. Characteristic and permanent vestibular and gait disturbances were also noted, along with a variety of neuropsychological deficits that improved over time with the exception of memory function. The patient also experienced significant affective and personality changes. Neuroimaging studies reveal a generalized cortical atrophy as shown by significantly enlarged ventricles and a ventricle-to-brain ratio that exceeded 4 standard deviations above the norm. The observed atrophic changes are consistent with CO-induced anoxic type injury, which was also accompanied by bilateral lesions of the globus pallidus, caudate, and hippocampus. Despite obtaining average levels of general intellectual functioning over time, significant memory impairments, depression, and personality disturbances severely impaired the patients' vocational recovery and ability to return to work.

Journal Article↗
PubMedDate not supplied

[Intracranial tuberculoma in Africa, with no available neuroimaging. Case report and review of the literature].

The numerous extrapulmonary manifestations of tuberculosis have been well described. Intracranial localizations, including brain stem tuberculoma, are very rare. The authors report a case of brain tuberculoma in a patient with a history of primary pulmonary tuberculosis successfully treated more than twenty years earlier. The patient presented with signs of infection, although the fever disappeared temporarily after successive treatments for malaria (confirmed Plasmodium faiciparum), as well as neurological signs with left hemiparesis. Chest radiographs showed no signs of progressive pulmonary tuberculosis, and blood tests, cerebrospinal fluid testing, and HIV serology were all negative. Treatments for maxillary sinusitis, the malaria, bacterial meningitis, and cerebral abscess were equally ineffective. Brain stem tuberculoma was diagnosed only when the patient was transferred to a hospital equipped with neuroimaging equipment and was confirmed after histopathological examination of the intracranial lesion biopsies and the detection of mycobacterium DNA by polymerase chain reaction (PCR) in the cerebrospinal fluid. A review of 147 cases of intracranial tuberculoma reported in Africa between 1985 and 2001 points out the difficulties of both the differential diagnosis (tuberculoma or other intracranial space-occupying lesions) and treatment in African areas where neuroimaging is unavailable. Our patient's brainstem tuberculoma probably resulted from reactivation of latent tuberculosis.

Brain Stem↗
PubMed2004

Neuroimaging in autistic spectrum disorder (ASD).

Autistic spectrum disorder (ASD) is a lifelong developmental disorder characterized by impairment in socialization and communication. Neuroimaging research has shown abnormalities in the frontal lobes, limbic systems, and cerebella of individuals with ASD. Recently, abnormal developmental trajectories of brain growth have been reported, with increases in brain volume (in both gray and white matter) seen in younger rather than older individuals with this disorder. Despite 30 years of research, a reliable marker for ASD has not been identified. Therefore, routine neuroimaging for individuals with ASD is not recommended.

Autistic Disorder↗
PubMedDate not supplied

[Anoxic encephalopathy. Clinical description, prognosis and neuroimaging].

OBJECTIVES: To describe the clinical profile (neuropsychological, psychopathological, functional and neuroimaging), as well as the evolution of patients with anoxic encephalopathy. PATIENTS AND METHODS: Nine patients with anoxic encephalopathy attending our Service were included in the study. All patients were assessed with a broad range of neuropsychological tests, checklists of psychopathological symptoms, and several functional scales. A CT/MRI or a positron emission tomography (PET) were performed in five patients. Five patients were admitted to a multidisciplinary rehabilitation program. RESULTS: All patients showed problems in orientation, executive functions, verbal learning an immediate and long-term verbal memory, in association with diffuse cognitive changes in other functions. Psychopathologically, all patients showed apathy-indifference, and eight subjects showed anosognosia. All subjects have an important dependence in daily activities. CT/MRI were normal or showed subcortical changes whereas the PET showed a predominantly cortical hypometabolism with specific patterns. There were no significant improvements after rehabilitation in treated patients. CONCLUSION: In the absence of a unique clinical profile, our patients with anoxic encephalopathy showed similarities in their symptoms (diffuse cognitive deficits with predominance of amnesic and executive impairments; presence of apathy and anosognosia; complete functional dependence; and poor response to the rehabilitation). Functional neuroimaging could be a useful tool for a better understanding of these encephalopathies.

Adolescent↗
PubMed2003

[Headache in patients with systemic lupus erythematosus: analysis of clinical EEG and neuroimaging studies].

The aim of the study was to evaluate the prevalence of headache in patients with systemic lupus erythematosus (SLE), its classification and estimation if they are the symptoms of central nervous system (CNS) involvement in patients with SLE causing any pathologies in EEG and neuroimaging methods like SPECT and MRI. We examined 83 patients with systemic lupus erythematosus (81 females and 2 males) aged between 19 and 71 years. All patients had neurological examination and EEG complemented with SPECt and MRI in some cases. 65 patients reported headache, 45 of them complained of idiopathic headache and 20--symptomatic one. The group with symptomatic headache had more frequently paroxymal changes in EEG while changes in background activity were more often notified in patients with idiopathic headache. Both SPECT and MRI showed more cerebral pathologies in patients with idiopathic headache. In SPECT the most common were multiple perfusion deficits and in MRI small hyperintensive lesions in white matter of cerebral hemispheres. Headache is the most common neurological complaint in SLE. Headache associated with pathological results of EEG or neuroimaging methods indicate the presence of central nervous involvement in patient with SLE.

Adult↗
PubMedDate not supplied

[Functional neuroimaging applied to the study of neuropsychological rehabilitation].

OBJECTIVE: We review the main aspects of functional recovery after brain injury as well as neuroimaging characteristics that make it relevant and useful to assess these changes. We also review some issues regarding recovery of motor and sensory functions, language and visuo spatial processes, and we discuss the methods used in this field, the difficulties found, and future implications. DEVELOPMENT: One of the main aspects in the study of the brain is the capacity to reorganize different functions in order to compensate for the deficits after a lesion in the central nervous system. The study of these adaptive processes is important in a clinical field as well as for basic research, as it is a clear example of brain plasticity. All the findings show how the study of the plastic phenomena or functional reorganization will allow us to better know how the brain works after a lesion. CONCLUSION: The use and combination of the new functional neuroimaging techniques gives the opportunity to register the reorganization of the brain with a high temporal and spatial resolution. It will give also an objective measure to assess the effectiveness of the rehabilitation programs. It will allow to identify different variables related to rehabilitation outcome and will guide effectively the selection of different rehabilitation approaches.

Brain Injuries↗
PubMed2003

Neural circuitry of anxiety: evidence from structural and functional neuroimaging studies.

Present understanding of the neural circuitry of anxiety has come from a variety of sources, including animal, clinical, and most recently, neuroimaging studies. Evidence from these sources has converged to form a translational bridge from animal models to human pathophysiology. In particular, the classical fear conditioning paradigm has served as a foundation for this bridge. Proposed models for the neural circuitry of normal anxiety as well as the anxiety disorders are discussed. A brief review of specific findings from neuroimaging studies of posttraumatic stress disorder, specific phobia, social phobia, obsessive-compulsive disorder, and generalized anxiety disorder is also provided.

Anxiety↗
PubMed2004

[Functional neuroimaging in adults].

A consensus has not been reached on the proper role of the different functional neuroimaging techniques available for the exploration of drug-resistant partial epilepsy, particularly in preparation for surgery. Several studies have suggested the potential contribution of positron emission tomography (PET) with [18F]-fluoro-deoxyglucose (FDG), [11C]-flumazenil (FMZ), or [11C]-alpha-methyl-tryptophane (AMT), single-photon emission computed tomography (SPECT) to measure ictal cerebral blood flow, magnetic resonance spectroscopy (MRS), and functional magnetic resonance imaging (fMRI) of language and memory functions, but to date there has been no impact study validating the clinical contribution of these different exploration techniques. The most robust data in the literature indicate that [18F]-FDG PET can help to predict surgical failures in patients with temporal lobe epilepsy. Studies with lesser power have suggested that SPECT measurement of ictal hyperperfusion blood flow, and [11C]-FMZ and [11C]-AMT PET can be useful in symptomatic neocortical epilepsy, particularly in patients with tuberous sclerosis explored with [11C]-AMT PET. Use of these different exploration techniques in epileptic patients with a normal MRI is warranted when complementary information could help in deciding on when and how to perform an invasive EEG, but there are significant risks of erroneous identification of the epileptogenic zone. Functional MRI assessment of language regions can be proposed as an alternative to the Wada test to determine hemispheric dominance in patients with temporal lobe epilepsy. Multicentric impact studies will be needed before evidence-based guidelines can be developed for the use of functional neuroimaging techniques in drug-resistant partial epilepsy.

Adult↗
PubMed2004

Delayed encephalopathy after carbon monoxide intoxication--long-term prognosis and correlation of clinical manifestations and neuroimages.

In order to understand the correlation between the clinical and neuroimaging manifestations and the long-term prognosis in delayed encephalopathy after carbon monoxide (CO) intoxication, we retrospectively reviewed 12 patients who had delayed encephalopathy from 89 patients with CO intoxication. There were 8 men and 4 women, with a mean age of 54.4 +/- 17.2 years (range: 11-79 years). All patients had prominent consciousness disturbance in the acute stage and received high flow of O2 or hyperbaric oxygen therapy. All of them regained consciousness within 1-7 days, but subsequently developed delayed encephalopathy. The delayed encephalopathy occurred from 14 to 45 days after recovery from the acute stage. The clinical manifestations included cognitive impairment, akinetic mutism, sphincter incontinence, gait ataxia and extrapyramidal syndromes such as chorea, dystonia, and parkinsonism. Brain MRI revealed multiple lesions in the subcortical white matter and basal ganglia, mostly in the globus pallidus, and to a lesser degree in the putamen, and caudate. In the follow-up period, sphincter incontinence first disappeared. The cognitive impairment improved greatly in the following few months, but the involuntary movements were improved only slightly. Some patients had persistent neurological sequelae, such as dystonia. Similary, the follow-up brain MRI showed a steady improvement. In conclusion, the delayed encephalopathy usually developed 2 weeks to 1.5 months after the acute phase of CO intoxication. Globus pallidus and subcortical white matter were commonly involved. The neurological manifestations improved and correlated roughly with the neuroimaging changes.

Adolescent↗
PubMed2004

The roles of electroencephalography and neuroimaging in children with holoprosencephaly.

We analyze the respective roles of neuro-imaging and EEG in the assessment of 11 children with holoprosencephaly and epilepsy. Seizures were present in seven patients (64%); six were treated with antiepileptic drugs; five had intractable epilepsy. Two of the patients with intractable epilepsy became seizure-free under polytherapy. Fourteen EEG recordings were performed in eight patients. The abnormal EEG findings included slow waves, focal epileptiform discharges, slow spike-and-wave complexes, hypsarrhythmia, frontal fast activity, fronto-occipital gradients of amplitudes (posterior amplitude attenuation), lack of photic driving, periodic discharges, and extremely large amplitudes. A fronto-occipital gradient was found only in alobar and semilobar holoprosencephaly (HPE), while hypsarrhythmia only in lobar HPE. Lack of photic driving was found only in alobar HPE. All EEGs showed diffuse slow waves, and all patients had severe developmental delay. The Deep Gray Score(DGS) in neuroimaging studies, thought to predict clinical outcome, was irrelevant given the presence and intractability of the epilepsies. Patients with higher DGS, nonetheless, tended to have higher mortality rate. In conclusion, EEG evaluation provides additional functional information to neuroimaging studies in the assessment of neurological outcome in patients with HPE. With a more mature and well-formed cerebrum, as found in the lobar and semilobar types, the possibility of hypsarrhythmia and photic driving increased, while that of fronto-occipital gradients decreased.

Child↗
PubMed2004

Remembering the past: neuroimaging studies of human memory.

The ability to find our way around an environment and to remember the events that occur within it are fundamental to normal functioning in daily life. Impairment of these abilities are among the first symptoms to be reported in patients with pathologies such as Alzheimer's disease and anoxia that are linked to the hippocampus and other limbic structures. However, many questions remain unanswered regarding the nature and neural bases of these memories. Findings from functional neuroimaging studies offer insights into the anatomy of memory and the presentation of memory impairments. In particular, neuroimaging is well placed to inform about the functionality of residual brain tissue, and the plasticity of memory anatomy in the context of hippocampal damage, and normal ageing.

Brain↗
PubMed2004

Sensitivity of the neuroimaging techniques in ischemic stroke.

The aim of this study was to investigate and compare the sensitivity and effectiveness of neuroimaging techniques in 190 patients with acute ischemic stroke. The first computed tomography (CT) scan for all patients was performed within the first 12 hours of the stroke symptoms onset. For each patient, between the third and fifth day of the hospitalization, at least one more neuroimaging procedure (CT and/or magnetic resonance imaging--MRI, and/or diffusion weighted imaging--DWI) was done. The CT scan in the first 12 hours of the stroke onset was positive in 32% of the patients; the highest number of the positive findings was in the patients with total anterior circulation infarct (52%). After 48 hours of the stroke onset second CT was positive in 85% (75/89), MRI in 93.5% (115/123), and DWI in 98.8% (79/80) patients. MRI was significantly more sensitive than CT in detection of ischemic lesion (88% vs. 72%, P=0.01), particularly in the patients with lacunar infarcts (75% vs. 50%, P=0.005). In detection of ischemic stroke 48 hours of the stroke onset the slightly higher number of strokes were detected on DWI in comparison with MRI (98.6% vs. 88.7%). According to our results, within the first 12 hours after the stroke onset, CT is reliable only for detection of considerable number of cortical ischemic strokes of the anterior cerebral circulation. After 48 hours from the stroke onset CT, MRI and DWI show high sensitivity in the detection of ischemic lesion of all clinical stroke subtypes. MRI is more sensitive in comparison with CT in detection of ischemic lesion, while DWI does not show dominance in comparison with MRI in identification of ischemic stroke after 48 hours of the symptoms onset.

Aged↗
PubMed2004

[Identifying distinct components in the cerebral treatment of visual sexual information through functional neuroimaging].

For now several years, the growing developement of neuroimaging techniques such as Positron Emission Tomography (PET) or functional Magnetic Resonance Imaging (fMRI) allowed a better understanding of neural processes involved in human emotions and goal-directed behaviors. In particular, several studies are now available on the neural correlates of male sexual arousal. A neurobehavioral model of neural processes involved in sexual arousal has been proposed (Redouté et al., 2000) comprising: i) a cognitive component; ii) an emotional component; iii) a motivational component and iv) an autonomic component. Among other regions, several cerebral areas have been found to be linked to: 1) the cognitive component which comprises: i) the orbitofrontal cortex involved in attentional processes directed toward the target and the superior parietal lobules; ii) the inferior parietal lobules involved in motor imagery processes; 2) the motivational component which involves the caudal part of the anterior cingulate cortex, related to motor preparation processes; 3) the autonomic component: concurrent measures of cerebral activations by functional neuroimaging and of erectile response by penile plethysmography allow the demonstration of the involvement of the hypothalamus, the insula, and the rostral part of the anterior cingulate cortex in this component.

Animals↗
PubMedDate not supplied

Sedation in pediatric neuroimaging: the science and the art.

Sedation of infants and children for neuroimaging is a "necessary evil" that will be with us for the foreseeable future. Sedation must be accompanied safely in all patients with a high frequency of success on the first attempt. A carefully-considered written sedation plan that addresses the issues raised in this review will assure maximum safety and success in sedating infants and children at each facility involved in pediatric neuroimaging. An affirmative approach and careful attention to both the science and the art of pediatric sedation by all concerned professionals will produce excellent results and facilitate application of current imaging technology in the diagnosis of pediatric neurologic disease.

Child↗
PubMed2005

The role of neuroimaging in the early diagnosis and evaluation of Parkinson's disease.

The development of imaging biomarkers which target specific sites in the brain represents a significant advance in neurodegenerative diseases and Parkinson's disease with the promise of new and improved approaches for the early and accurate diagnosis of disease as well as novel ways to monitor patients and assess treatment. The 3 major applications of imaging may play a role in Parkinson's disease include: 1) the use of neuroimaging as a biomarker of disease in order to improve the accuracy, timeliness, and reliability of diagnosis; 2) objective monitoring of the progression of disease to provide a molecular phenotype of Parkinson's disease which may illuminate some of the sources of clinical variability; 3) the evaluation of so-called ''disease-modifying'' treatments designed to retard the progression of disease by interfering with pathways thought implicated in the ongoing neuronal loss or replace dopamine-producing cells. Each of these areas has shown a numbers of critical clinical investigations which have better defined the utility of the imaging tools to these tasks. Nonetheless, current unresolved issues around the clinical role of neuroimaging in monitoring patients over time and validation of quantitative imaging measures of dopaminergic function are immediate issues for the field and the subject of current research efforts and the extension of the lessons learned in Parkinson's to other neurodegenerative diseases including Alzheimer's dementia.

Diagnostic Errors↗
PubMed2005

Sneddon's syndrome as a disorder of small arteries with endothelial cells proliferation: ultrastructural and neuroimaging study.

We report a 18-year-old female patient with livedo reticularis and neurological disturbances. CT scan showed two big ischemic focuses in the pons, moreover MRI revealed small disseminated ischemic focuses in the pons and deep structures of both brain hemispheres. MRA demonstrated no changes in the big extracranial and intracranial arteries. Since the clinical data and neuroimaging results suggested Sneddon's syndrome, the skin and skeletal muscle biopsy was taken to examine. The immunohistochemical and ultrastructural investigations of the skin biopsy revealed a significant reduction of the lumen of the capillaries and small to medium-sized arteries. Cells surrounding the vascular lumen, frequently with multilayer arrangement and their nuclei placed perpendicularly to the lumen, were CD31, CD34, and sporadically SMA positive. At the ultrastructural level, these proliferating cells showed typical features of endothelial cells: abundant intermediate filaments and Weibel-Palade bodies. Between the endothelial cells some junctions were detached as well in the capillaries as in the small arteries. The smooth muscle cells of the small arteries were electron denser than usual and their cytoplasmic protrusions penetrated to the endothelial cells. The ultrastructural picture of some vessels with a considerably narrow lumen was typical of vessels newly formed during angiogenesis. Neuroimaging including TC, MRI, MRA besides histological, immunohistochemical and ultrastructural evaluation may be useful for diagnosis of Sneddon's syndrome.

Adolescent↗
PubMed2006

Insight into management of dementias from neuroimaging.

Structural and functional neuroimagings are the most powerful tools for differential diagnosis and early diagnosis of dementia. Besides clinical use, they also contribute to neuroscience and to testing efficacy as surrogate measures in clinical trial. This paper, focusing on two different models beyond the therapeutic nihilism, discusses the roles of neuroimaging in relation to treatment of dementias; 1) treatable "incurable dementia" - Alzheimer's disease (AD) and 2) untreated "curable dementia" - idiopathic normal pressure hydrocephalus (INPH).

Alzheimer Disease↗
PubMed2006

[Incontinentia pigmenti: clinical and neuroimaging findings in a series of 12 patients].

OBJECTIVE: To describe the clinical, neuroimaging 51 with magnetic resonance imaging (MRI) and evolutive findings in 12 patients with incontinentia pigmenti (IP). Five patients show cutaneous and neurological lesions and seven only show cutaneous lesions without neurologic or/ and ophthalmologic abnormalities. MATERIAL AND METHODS: Five mothers and seven daughters from four families were studied and followed between 1965 and 2004. The studies consisted of detailed clinical history since birth, physical examination, family history, EEG recordings and MRI studies. In some patients, at least three MRI studies were performed during our follow-up. All patients were followed-up since their first visit until 2004. Including four patients since birth or early infancy. Skin biopsies were obtained from two infants for histological study. RESULTS: MRI studies revealed brain abnormalities in five girls who had neurologic signs associated with the cutaneous lesions of IP. Brain lesions were bilateral in four and unilateral in one. Cerebellar changes were observed only in one case who also showed severe cerebral lesions. The lesions involved cortex, subcortical and deep white matter, ependymal and subependymal zones of one or both cerebral hemispheres. Lesions usually were localized and extended radially to involve all the cerebral parenchyma between ependyma and cortex. Affected areas did not correspond to territories vascularized by any determined artery. The corpus callosum showed generalized or localized atrophy in the five patients who had cerebral hemispheric lesions. Although parenchymal changes were seen in both the T1 and T2 weighted images, these were most evident in the latter. Parenchymal abnormalities were most severe in patients with neonatal severe cutaneous lesions, especially if these were located in the scalp. Cerebral lesions were present from birth or the first months of life and changed little thereafter. The acute appearance and distribution of cerebral lesions always during the neonatal period, associated with scalp lesions in stage 1, suggest an acute inflammatory origin of unknown etiology and of nonprogressive course. Ocular lesions were directly related with cerebral abnormalities. Patients who only had cutaneous lesions without neurologic symptoms showed no MRI abnormalities. CONCLUSIONS: Neuroimaging studies reveals brain lesions only in patients with neurologic disease in this serie. The brain lesions may involve one or both cerebral hemispheres, corpus callosum, and cerebellum. The brain lesions correlate with the neonatal scalp lesions in stage 1, suggests an inflammatory process of unknown etiology and non-progressive course. The appearance and distribution of the cerebral lesions do not follow the territories vascularized by specific arteries. Ocular lesions are observed only in patients with severe cerebral changes. Early onset of cerebral lesions may be the most reasonable explanation for the progressive microcephaly within the first year of life in IP.

Abnormalities, Multiple↗