Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Internal Capsule”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,063 records · Page 59Linked to original sources
PubMed2000

Simultaneous hypertensive intracerebral hematomas: two case reports.

We describe two patients (76- and 54-year-old females) with multiple hypertensive intracerebral hematomas occurring simultaneously. One patient had a right thalamic hematoma extending into the internal capsule and basal ganglia together with an other one in the left putamen. The other patient had two hematomas located ipsilaterally in the left putamen and thalamus. Their neurological examinations showed only unilateral deficits. Their magnetic resonance angiograms revealed no vascular malformations. Neuroradiological procedures are essential for the diagnosis of these multiple brain events.

Aged↗
PubMed2000

Crossed linguo-buccal reflex in post-stroke patients.

A pathological crossed orofacial reflex, called crossed linguo-buccal reflex in the present study, was observed in approximately 1/3 of post-stroke patients with central facial palsy. Stroking with pressure two or three times with a split wooden tongue-blade to the tongue or palate contralateral to the central facial palsy elicited a reflex movement consisting of retraction of the angle of mouth and medio-posterior withdrawal of the buccal mucosa on the paretic side. Seventy-seven patients with central hemifacial palsy caused by a unilateral cerebral lesion were examined clinically, electromyographically and by computed tomography (CT) and magnetic resonance imaging (MRI). In addition, three men with bilateral cerebral lesions and bilateral crossed linguo-buccal reflexes were electromyographically examined. Twenty-two patients with unilateral cerebral lesions had this reflex. It was found that this reflex was most frequently observed in patients with a capsulo-caudate lesion involving the head of the caudate nucleus, the anterior limb and genu of the internal capsule. The electromyogram of the reflex showed increased activity in the orbicularis oris, depressor anguli oris, risorius, zygomaticus major and buccinator muscles on the paretic side with a long latency (254-856 ms), and a prolonged after-discharge after the stimulation. Reciprocal inhibition was observed in patients with bilateral positive reflexes. These findings suggest that liberation of the polysynaptic brainstem reflex in the medulla oblongata and pons from the indirect corticobulbar inhibition may underlie the occurrence of the crossed linguo-buccal reflex in post-stroke patients.

Adult↗
PubMed2001

Citrullinemia type II in a 64-year-old man with fluctuating serum citrulline levels.

We describe a 64-year-old man with 'citrullinemia type II' whose serum citrulline levels fluctuated between normal and abnormally high during episodic manifesting periods. Elevations of the serum threonine/serine ratio and pancreatic secretory trypsin inhibitor level are very useful diagnostic markers. Our patient's cerebrospinal fluid citrulline level was also elevated, and T1-weighted magnetic resonance images revealed high-intensity signals at the bilateral internal capsule and the cerebral peduncles. Single-photon emission computed tomography of his brain showed reduced bilateral temporal lobar blood flow. Even if the serum citrulline level is within the normal range, citrullinemia should be considered in adult patients without primary liver dysfunction who show episodic consciousness disturbance, psychotic symptoms or both.

Ammonia↗
PubMed2002

Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study: a meta-analysis of 53 cases including four present cases.

BACKGROUND: Chorea associated with non-ketotic hyperglycemia and high signal intensity lesions on T1-weighted brain magnetic resonance images (C-H-BG) is recognized as a unique syndrome that affects elderly women exclusively. However, its overall clinical features are unclear. MATERIAL AND METHODS: The literature describing patients with C-H-BG from 1985 to 2001 was reviewed using MEDLINE. Their clinical features and those of four patients with C-H-BG at this hospital were analyzed. RESULTS: This study included 49 patients from the literature and four patients at this hospital. Their mean age at the onset was 71.1 years (range=22-92 years). Women were affected more frequently than men (men/women=17:30). The mean serum glucose level measured after the onset of chorea was 481.5 mg/dl (ranging from 169 to 1264), HbA1c level was 14.4% (ranging from 9.9 to 19.2), and the serum osmolarity was 305.9 mmol/kg (ranging from 291 to 335). Forty-seven patients developed hemichorea. Six patients developed bilateral chorea, and magnetic resonance imaging (MRI) showed bilateral basal ganglia lesions. MRI showed that putamen was involved in all cases (isolated putamen=31 patients, additional basal ganglia lesions=22 patients). None had lesions confined to the caudate nucleus or the globus pallidus. In all, except one, the anterior limb of the internal capsule was spared. Follow-up MRI studies were performed in 22 patients. In most, hemichorea improved along with the disappearance of the lesions. In 39 patients, chorea had ameliorated completely. The remaining 14 cases showed some improvement during the follow-up period. The chorea recurred in seven patients. CONCLUSION: C-H-BG is a benign disorder affecting the elderly. It affects men much more frequently than has been reported. The high signal intensity basal ganglia lesion on the T1-weighted brain MRI study was reversible, and correlated with the clinical improvement in chorea.

Adult↗
PubMed1997

Systemic lupus erythematosus with multiple perivascular spongy changes in the cerebral deep structures, midbrain and cerebellar white matter: a case report.

A 42-year-old woman with systemic lupus erythematosus developed an episode of tonic seizures and progressive disturbance of consciousness at the terminal stage. Neuropathological examination of the brain revealed a nearly symmetrical distribution of multiple spongy foci in the internal capsules, thalami, globus pallidus, mesencephalic tegmentum, cerebral peduncles and hilus of the dentate nuclei. The spongy lesions were obviously distributed along apparently intact medium-sized veins, and contained large numbers of macrophages, and axonal spheroids and a few reactive astrocytes, without inflammatory cell infiltration. In addition, the perivenous spongy lesions exhibited IgG immunoreactivity, so it is surmised that some neurotoxic factor(s) that exuded from the veins in the center of the perivenous lesions may have brought about such a unique pathology.

Adult↗
PubMed1997

A magnetization transfer study of white matter in siblings of multiple sclerosis patients.

In this study, we evaluated magnetization transfer ratio values in the brain white matter of siblings of multiple sclerosis (MS) patients and compared them to those obtained in sex- and age-matched normal controls. No statistically significant difference was found between the two groups for all the white matter areas studied (frontal and occipital lobes, centrum semiovale, periventricular white matter, internal capsule, genu and splenium of the corpus callosum).

Adult↗
PubMed1997

Selective involvement of basal ganglia and occipital cortex in a patient with acute endosulfan poisoning.

We report a teenage girl with acute endosulfan poisoning who developed psychosis, generalized tonic-clonic seizures, myoclonic jerks, cortical blindness and limb rigidity. Serial magnetic resonance imaging (MRI) showed bilateral reversible lesions localized to caudate nucleus, putamen and occipital cortex; internal capsule and thalamus were spared. This selective involvement may have a bearing on mechanisms underlying endosulfan toxicity.

Adolescent↗
PubMed1999

Acute disseminated encephalomyelitis: clinical and MRI study from South India.

Clinical and MRI appearances were reviewed in 25 cases of acute disseminated encephalomyelitis (ADEM) seen in a university hospital in South India. Specific viral infections and Semple antirabies vaccination together accounted for 56% of antecedent events. Clinical and MRI features were suggestive of diffuse/multifocal form in 15 patients. Of the 10 patients with clinically site restricted forms, two patients with dorsal myelitis and one patient with polyradiculitis had asymptomatic cerebral white matter lesions. MRI was essentially normal in all the four patients with acute ataxia following varicella infection. Of the 13 patients with multiple white matter lesions, lesions were asymmetrical in size and morphology in nine patients and symmetrical in four patients. Two of them had extensive destructive lesions and one patient had multiple discrete lesions. Lesions occurred at the corticomedullary junctions in seven patients. The distribution was subcortical and/or centrum semiovale in 10 patients. The regions affected include internal capsule(s), thalami, brainstem, cerebellar peduncles and cerebellum. No specific differences were observed in patients with ADEM following specific viral infections, Semple antirabies vaccination, and nonspecific upper respiratory tract infections. There was fairly good correlation between clinical and MRI findings in 81% of patients. Patients with incomplete recovery showed extensive and/or multifocal lesions.

Adolescent↗
PubMed1996

Acute cerebrovascular accident and lower urinary tract dysfunction: a prospective correlation of the site of brain injury with urodynamic findings.

PURPOSE: We evaluated the effects of an acute cerebrovascular accident on the lower urinary tract and correlated the site of cerebrovascular accident with findings on urodynamic study. MATERIALS AND METHODS: A total of 45 men and 15 women underwent a complete urodynamic study with electromyography within 72 hours of a cerebrovascular accident. Patients were divided into 5 different groups based on urodynamic findings. RESULTS: The majority of cortical and internal capsule lesions resulted in detrusor hyperreflexia. A total of 28 patients (47%) had urinary retention, mainly due to detrusor areflexia (75%). Of 20 patients with hemorrhagic infarcts 17 (85%) had areflexia, compared to only 4 of 40 (10%) with ischemic infarcts. All 6 patients with cerebellar infarction had detrusor areflexia. CONCLUSIONS: Our results confirm many previously reported findings. In addition, there was a specific correlation of cerebellar and hemorrhagic infarctions with detrusor areflexia.

Adult↗
PubMed2002

[Clinical study of 17 patients with cheiro-oral-pedal syndrome].

BACKGROUND: To characterize the clinical features, etiology and prognosis in cheiro-oral-pedal syndrome. PATIENTS AND METHOD: Descriptive study of 17 patients with cheiro-oral-pedal syndrome included in the Sagrat Cor Hospital of Barcelona Stroke Registry over a 11 year period. RESULTS: Cheiro-oral-pedal syndrome was present in 6 patients (35%), cheiro-oral syndrome in 10 (59%) and isolated oral syndrome in 1 (6%). Cheiro-oral-pedal syndrome was caused by a lacunar infarct in 88% of patients and by atherotrombotic infarcts in 12%. Cheiro-oral-pedal syndrome accounted for 0.7% of all acute strokes (n = 2.244), 1% of all cerebral infarcts (n = 1.649), 3.5% of all lacunar infarcts (n = 422) and 18.5% of all pure sensory lacunar infarcts (n = 80). Thalamus (n = 13), internal capsule (n = 2), striatocapsular involvement (n = 1) and fronto-parietal involvement (n = 1) were the cerebral topographies. Absence of in hospital mortality and absence or mild neurological deficit at discharge from the hospital were present in all the patients. CONCLUSIONS: Lacune hypothesis is present in cheiro-oral-pedal syndrome. Cheiro-oral-pedal syndrome was caused by a lacunar infarct in 88% of patients. The thalamic topography is the most frequent and the prognosis in cheiro-oral-pedal syndrome is good.

Adult↗
PubMed2004

Fou rire prodromique and history of pathological laughter in the XIXth and XXth centuries.

Fou rire prodromique (prodrome of crazy laughter) is a rarely described nosological entity. In 1903, Charles Féré, a French neurologist, introduced the term fou rire prodromique to describe pathological laughter heralding an apoplectic event. He was also among the first to describe gelastic epilepsy. His description was influenced by Edouard Brissaud, who supported the existence of a thalamic center for laughter regulation and suggested that spasmodic laughter and crying were due to lesions of the faisceau psychique (anterior internal capsule) or to irritation of the faisceau géniculé (corticobulbar tract). One hundred Years later, we review the evolution of the theories about pathological laughter and crying from Charles Bell in the early XIXth Century, up to the seminal works of Kinnier Wilson and James Papez and the era of modern neuroscience.

Crying↗
PubMed2005

[Parakinesia brachialis oscitans].

INTRODUCTION: In some cases of hemiplegia the onset of yawning is associated with an involuntary raising of the paralyzed arm. PATIENTS AND METHOD: Four observations of this movement, which is seldom described probably because it is mostly neglected, were made in the neurology unit of the University Hospital of Poitiers. The descriptions were compared with other cases that have been published in the medical literature of the last 150 years. Cerebral imagery shows a lesion that is most often localized on the internal capsule. After comparison with experimental models in cats, it is proposed that the section of the cortico-neocerebellum tract of the extra-pyramidal system disinhibits the spino-archeocerebellum tract, enabling a motor stimulation of the arm by the lateral reticular nucleus, which harmonises central respiratory and locomotor rhythms. RESULTS AND CONCLUSION: Some subcortical structures, that are phylogenetically more ancient, thus disinhibit regained autonomy in the homeostasis process associating the massive inspiration of yawning--a form of reflex behavior that stimulates vigilance--with a motor control that is active during locomotion. For this phenomenon we coined the term "parakinesia brachialis oscitans".

Adult↗
PubMed2005

[Acute tetraparesis of cerebral origin].

INTRODUCTION: Thrombolytic treatment in the early stage of ischemic cerebral attacks requires rapid confirmation of the diagnosis and topographic localization. Unusual clinical features can lead to misdiagnosis with the risk of delaying optimal therapeutic management. OBSERVATION: We report the cases of two patients who experienced acute tetraparesis without any associated encephalic sign, consistent with the diagnosis of spinal cord injury. Cervical magnetic resonance imaging (MRI) was normal. Conversely, cerebral MRI displayed in both cases bilateral hemispheric infarction. Two ischemic lesions were revealed in the territory of both anterior cerebral arteries in the first patient, while the second patient had a bilateral infarction in the posterior arms of both internal capsules. CONCLUSION: In case of tetraparesis, emergency spinal cord MRI should be performed to rule out neurosurgical etiologies and ischemia. If negative, cerebral MRI should be performed at the same time to look for early cerebral infarction in both hemispheres and determine the indication for thrombolysis.

Acute Disease↗
PubMed1987

Histopathology of the central nervous system in the acquired immunodeficiency syndrome.

Histopathologic findings in the central nervous system in 100 autopsy cases of the acquired immunodeficiency syndrome (AIDS) gave evidence of a variety of opportunistic infections and probably of infection by human immunodeficiency virus (HIV). Gliomesenchymal cell nodules (47 per cent of cases) and spongiform alterations with demyelination were common. Vasculitides (8 per cent) and lesions such as acute hemorrhagic leukoencephalitis may be attributable partly to hypersensitivity reactions. Multinucleated cells, including giant cells that could be a hallmark of HIV encephalitis, were common in normal neuropil, in gliomesenchymal cell nodules, near blood vessels, and in cavitating lesions. Degeneration in long tracts (13 per cent) included posterior column demyelination and spongiform change with or without corticospinal tract degeneration. Some long tract degeneration appeared to originate from bilateral degeneration of the internal capsule, and this may be part of the origin of subacute combined degeneration-like changes in AIDS vacuolar myelopathy. Prominent brainstem inflammatory infiltration suggests that the brainstem is a relatively prominent site of infection or immunopathologic activity. Early ependymal lesions in infants and frequent healed ependymal lesions in adults (16 per cent) could be related to the origin and pathogenesis of HIV lesions in the brain. Some characteristic lesions in AIDS encephalitis may result from immune-mediated responses to HIV antigens on neural cell receptors or from cross-reactivity occurring against epitopes common to neural constituents and to hematopoietic cells, with the latter being under direct antiviral attack.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Mossy-fibre sensory input to the cerebellum.

The role of the spinal and vestibular afferents to the cerebellum in the control of movement first began to be recognized towards the end of the 19th century. By the middle of the present century it was clear that visual and auditory information are also relayed to the cerebellum from the cerebral cortex and brainstem by way of the pontine nuclei. Pontine cells project to the cerebellar cortex where they terminate as mossy fibres. The corticopontine projection arises from cells in lamina V of the cerebral cortex. Cells in the rat primary somatosensory cortex also provide an input to the basal ganglia, but the two populations are largely segregated in distinct sub-laminae. In monkeys, and probably in humans, the cortical visual input to the pontine nuclei arises from the dorsal stream of extrastriate visual areas. Experimental and clinical evidence suggest that damage to this pathway at the cortical level, or interruption of its corticopontine fibres within the internal capsule produce profound disturbance in visuomotor guidance. One of the major pathways through the brain for the visual guidance of movement is relayed from the dorsal stream of extrastriate areas to the cerebellum by way of the pontine nuclei.

Animals↗
PubMed2000

Dissecting aneurysm of the anterior choroidal artery: angiographical and MR imaging findings.

BACKGROUND: Intracranial dissecting aneurysms are relatively rare. We present a rare case of a dissecting aneurysm originating from the anterior choroidal artery; this is the first reported case. CASE DESCRIPTION: A 42-year-old man suffered sudden onset of right hemiparesis and dysarthria. Computed tomography on admission revealed a small low density area in the posterior limb of the internal capsule. MR imaging revealed aneurysmal dilatation of the anterior choroidal artery, and angiography revealed aneurysmal dilatation and stasis of dye in the venous phase at the anterior choroidal artery, which resolved in the chronic stage. CONCLUSION: We describe a rare case of a dissecting aneurysm of the anterior choroidal artery. The radiological findings were characteristic of dissecting aneurysms in spite of the rare location.

Adult↗
PubMed1997

Stereotactic transsylvian, transinsular approach for deep-seated lesions.

BACKGROUND: Lesions located deep within the frontal and parietal lobes adjacent to the internal capsule are often considered surgically inaccessible. We have used intraoperative stereotactic lesion localization in conjunction with microsurgical dissection of the lateral sylvian fissure to accurately and atraumatically approach such lesions through the insular cortex. METHODS: When possible, the sylvian fissure is widely opened using standard microsurgical technique. However, exploration through a precisely placed exposure no more than 1.0 cm in length is still feasible. Repeated intraoperative lesion localization employing ultrasound, frame-based or frameless stereotaxis was used to guide dissection deep to the Insular cortex. RESULTS: Using this approach we have resected five cavernous angiomas, three plexiform AVMs and 2 low-grade gliomas. There was a single case of transient dysphasia in seven dominant hemisphere explorations and a single case of transient somatosensory impairment. Otherwise, there were no new transient or permanent postoperative neurologic deficits. In two cases, hemiparesis present prior to surgery improved following resection of a cavernous angioma. CONCLUSIONS: The transsylvian, transinsular approach can be employed to safely expose lesions deep within the cerebral hemisphere. Anatomic considerations, surgical technical refinements, and clinical results are the subject of this report.

Adolescent↗
PubMed2006

[MRI findings in neuro-Behcet's disease].

PURPOSE: Describe the patterns and location of lesions seen on MR imaging in neuro-Behçet's disease. OBSERVATIONS: 33 patients with neuro-Behçet's disease (mean age: 27 years) imaged by MRI were reviewed. Most common neurologic symptoms included headaches and pyramidal signs. MRI examinations (Siemens Magnetom Impact 1 Tesla) included the following sequences: T1wi, T2wi, Flair, MPR-3D and MRA sequences. RESULTS: Parenchymal lesions were identified in 21 patients. Brainstem, internal capsule, cerebral white matter, basal ganglia were involved respectively in 14, 10, 7, and 5 cases. Vascular thrombosis (venous: n=7; arterial: n=1) were observed in eight. MRI was normal in four patients. CONCLUSION: This study shows the value of MR imaging for the exploration of parenchymal lesions of neuro-Behçet's and confirms the frequency of brainstem involvement.

Adolescent↗