scholarly journals Plasma levels of protein C pathway proteins and brain magnetic resonance imaging volumes in multiple sclerosis

2019 ◽  
Vol 27 (2) ◽  
pp. 235-243 ◽  
Author(s):  
N. Ziliotto ◽  
R. Zivadinov ◽  
M. Baroni ◽  
G. Marchetti ◽  
D. Jakimovski ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Plasma Levels ◽  
Protein C ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging

Weakness and Dysarthria After Radiosurgery

2021 ◽  
pp. 69-72
Author(s):  
Andrew McKeon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Arteriovenous Malformation ◽  
Motor Pattern ◽  
Brain Magnetic Resonance Imaging ◽  
Whole Brain Radiotherapy ◽  
Resonance Imaging ◽  
Brain Radiotherapy ◽  
Signal Abnormality

A 60-year-old woman with a history of Sjögren syndrome had an episode of painful left eye vision loss. Brain magnetic resonance imaging showed an arteriovenous malformation adjacent to the left ventricular atrium. Although this was considered an asymptomatic lesion, the patient underwent stereotactic radiosurgery to reduce the risk of future growth and hemorrhage. Within days of the surgery, speech disturbance and weakness of the right arm and leg developed. Examination indicated a subcortical language deficit and an upper motor pattern of paresis of right-sided limbs. Considered in the differential diagnosis were new hemorrhage from the arteriovenous malformation, ischemic stroke, radiation-induced necrosis, abscess, and demyelinating disease. Magnetic resonance imaging of the head with and without gadolinium contrast was used to evaluate for these possibilities. Brain magnetic resonance imaging after onset of speech and motor symptoms demonstrated new areas of confluent T2 signal abnormality in the brainstem and deep white matter of the left hemisphere, with some accompanying enhancement but without evidence of hemorrhage or acute stroke. Slow conduction was noted in the left optic nerve on visual evoked potentials. The patient was diagnosed with optic neuritis, with subsequent evolution to multiple sclerosis in the setting of radiosurgery. The patient received intravenous methylprednisolone with full recovery of language function and partial recovery of the hemiparesis, which improved with rehabilitation such that she could walk without a gait aid. Because the patient had more than 1 episode, she was treated with interferon beta-1a for further prevention of multiple sclerosis relapse. Chronic neurotoxicity leading to subcortical dementia occurs in approximately 25% of patients undergoing whole-brain radiotherapy. Histologically, demyelination, as well as necrosis, can be a prominent feature. Among patients with multiple sclerosis or a clinically isolated syndrome, the risk of demyelinating events appears to increase after brain radiotherapy, within the field of treatment.

scholarly journals Problem of differential diagnostics of neurodegenerative pathology

2019 ◽  
Vol 84 (3) ◽  
pp. 49-54
Author(s):  
M.E. Chernenko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Brain Magnetic Resonance Imaging ◽  
Dynamic Monitoring ◽  
Differential Diagnostics ◽  
Resonance Imaging ◽  
Adequate Treatment ◽  
Rate Of Increase

The differential diagnosis of multiple sclerosis and Wilson–Konovalov’s disease is an important clinical task, the timely appointment of adequate therapy depends on the correct solution of which. With the seemingly simple differential diagnosis of these diseases, in some cases, especially atypical, there are certain difficulties in making the correct diagnosis. Magnetic resonance imaging is a mandatory study in the structure of a comprehensive examination of patients with multiple sclerosis and Wilson–Konovalov’s disease. Conducting standardized magnetic resonance imaging scans performed on a high-field tomograph is mandatory in all cases of differential diagnosis in patients with demyelinating pathology of the central nervous system and neurodegenerative diseases. An analysis of the topography of focal changes in dynamics, an assessment of the rate of increase of atrophic changes is of great importance for the timely appointment of adequate treatment, which in turn directly affects the prognosis of the disease. The brain magnetic resonance imaging data from 30 patients with multiple sclerosis and 10 patients with Wilson–Konovalov’s disease who were treated at the GU INPN NAMS of Ukraine (Kharkov) were described. It is concluded that both multiple sclerosis and Wilson–Konovalov’s disease are chronic partially controlled diseases in which dynamic monitoring is extremely important, an integral part of which is the conduct of adequate neuroimaging. None of the methods for diagnosing multiple sclerosis and Wilson–Konovalov’s disease has independent diagnostic value, and diagnosis is possible only with a comprehensive analysis of clinical, laboratory, genetic and neuroimaging data.

scholarly journals Moyamoya Disease May Mimic Multiple Sclerosis?

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Ioanna Spanou ◽  
Maria-Eleftheria Evangelopoulos ◽  
Georgios Velonakis ◽  
Nikolaos Logiotatos ◽  
Achilleas Chatziioannou ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Moyamoya Disease ◽  
Cerebrovascular Disorders ◽  
Brain Magnetic Resonance Imaging ◽  
Left Middle Cerebral Artery ◽  
Resonance Imaging ◽  
Radiographic Findings ◽  
Wide Range

Introduction. A wide range of medical conditions may mimic multiple sclerosis. Among them, cerebrovascular diseases, including moyamoya disease, need to be excluded since they share common clinical features and radiographic findings with multiple sclerosis. Case Report. A 44-year-old woman experienced transient numbness of her right sided face and arm and was referred to our unit due to small brain lesions in magnetic resonance imaging, with a possible diagnosis of multiple sclerosis. Neurological examination was unremarkable except for plantar reflexes and jerky deep tendon reflexes. Brain magnetic resonance angiography revealed findings typically seen in moyamoya disease, confirmed with digital subtraction angiography. Antiplatelet therapy started, but few days later, she developed suddenly global aphasia and right hemiparesis (National Institutes of Health Stroke Scale/NIHSS 6). Brain magnetic resonance imaging revealed acute infarct in the distribution of the left middle cerebral artery. At her discharge, she was significantly improved (NIHSS 3). Conclusion. Diagnosis of multiple sclerosis is often challenging. In particular, in young patients with transient neurological symptoms and atypical white matter lesions in magnetic resonance imaging, cerebrovascular disorders such as moyamoya disease should be considered in the differential diagnosis. Detailed clinical and neuroimaging evaluation are mandatory for the correct diagnosis.

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