scholarly journals A Case of Congenital Brainstem Oligodendroglioma: Pathology Findings and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Stefan Kostadinov ◽  
Suzanne de la Monte
Keyword(s):  
White Matter ◽  
Survival Rates ◽  
Male Infant ◽  
Anaplastic Oligodendroglioma ◽  
Postnatal Life ◽  
Communicating Hydrocephalus ◽  
Progressive Dyspnea ◽  
Cerebellar Peduncles ◽  
Diffuse Pontine Glioma ◽  
Magnetic Resonance Imaging Mri

Congenital and perinatal primary brain neoplasms are extremely rare. Brainstem neoplasms in the perinatal and neonatal period are typically of high-grade nature and have poor prognoses with survival rates of less than 2 years from diagnosis. Herein, we report an unusual case of congenital anaplastic oligodendroglioma that arose in the pons and was detected as diffuse pontine glioma on in utero imaging studies during prenatal evaluation at 26 weeks’ gestation. A male infant was delivered at 36.4 weeks of gestation via Cesarean section who developed progressive dyspnea shortly after birth. Magnetic resonance imaging (MRI) studies of his head showed the expansile, poorly demarcated mass in the pons with minimal heterogeneous enhancement and severe communicating hydrocephalus. Despite aggressive management, including dexamethasone treatment, the infant expired on the third day of postnatal life. On postmortem examination cut sections through the brainstem and cerebellum disclosed the neoplasm that infiltrated the entire pons, extended into the midbrain, medulla, cerebellar peduncles, and caudal diencephalon. Histological sections demonstrated an anaplastic oligodendroglioma infiltrating the pons, 4th ventricle, midbrain, medulla, cerebellar white matter, posterior thalamus, and occipital white matter. The pathological features of the lesion distinguish it from previous reports in which spontaneous regression of pontine gliomas occurred and argue in favor of establishing a tissue diagnosis to plan for aggressive versus conservative management.

Another Piece of the Puzzle of Anomalous Connectivity in Joubert's Syndrome

2021 ◽  
Author(s):  
Avner Meoded ◽  
Marcia Kukreja ◽  
Gunes Orman ◽  
Eugen Boltshauser ◽  
Thierry A.G.M. Huisman
Keyword(s):  
White Matter ◽  
Diffusion Tensor ◽  
Three Dimensional ◽  
Axonal Guidance ◽  
Molar Tooth ◽  
Superior Cerebellar Peduncle ◽  
Corticospinal Tracts ◽  
Cerebellar Peduncles ◽  
Cerebellar Peduncle ◽  
Magnetic Resonance Imaging Mri

AbstractWe report on the conventional and diffusion tensor imaging (DTI) findings of a 2-year-old child with clinical presentation of Joubert's Syndrome (JS) and brainstem structural abnormalities as depicted by neuroimaging.Conventional magnetic resonance imaging (MRI) showed a “molar tooth” configuration of the brainstem. A band-like formation coursing in an apparent axial plane anterior to the interpeduncular fossa was noted and appeared to partially cover the interpeduncular fossa.DTI maps and three-dimensional (3D) tractography demonstrated a prominent red-encoded white matter bundle anterior to the midbrain. Probable aberrant course of the bilateral corticospinal tracts (CST) was also depicted. Absence of the decussation of the superior cerebellar peduncles and elongated thickened, horizontal superior cerebellar peduncle (SCP) reflecting the molar tooth sign were also shown.Our report and the review of the published cases suggest that DTI and tractography may be very helpful to differentiate between interpeduncular heterotopias and similarly located white matter bundles corroborating the underlying etiology of axonal guidance disorders in the complex group of ciliopathies including JS. Our case represents an important additional puzzle piece to explore the variability of these ciliopathies.

scholarly journals Prevalence of Cerebral Microbleeds in Thai Patients with Ischemic Stroke

2017 ◽  
Vol 08 (02) ◽  
pp. 216-220 ◽  
Author(s):  
Artit Potigumjon ◽  
Arvemas Watcharakorn ◽  
Pornpatr A. Dharmasaroja
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Magnetic Resonance ◽  
White Matter Lesions ◽  
Cerebral Microbleeds ◽  
National Institutes Of Health ◽  
Asian Origin ◽  
Chinese Study ◽  
Japanese Studies ◽  
Magnetic Resonance Imaging Mri

ABSTRACT Background: With the widespread use of magnetic resonance imaging (MRI), cerebral microbleeds (CMBs) are commonly detected. Ethnicity seems to play a role in the prevalence of CMB, with higher prevalence in participants from Asian origin. The purpose of the study is to look for the prevalence of CMBs and associated factors in Thai patients with ischemic stroke. Methods: Patients with acute ischemic stroke who had MRI and magnetic resonance angiography during January–August 2014 were included in the study. T2*-weighted gradient-recalled echo was used to define CMBs. Baseline characteristics, stroke subtypes, and severity of white matter lesions were compared between patients with and without CMBs. Results: Two hundred patients were included in the study. Mean age of the patients was 61-year-old. Mean National Institutes of Health Stroke Scale was 8. The prevalence of CMBs was 20% (39/200 patients). Hypertension (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.07–8.68, P = 0.037), and moderate-to-severe white matter lesions (Fazekas 2–3, OR 7.61, 95% CI 3.06–18.95, P < 0.001) were related to the presence of CMBs. Conclusions: CMBs were found in 20% of patients with ischemic stroke, which was lower than those reported from Japanese studies but comparable to a Chinese study. CMBs were associated with hypertension and severity of the white matter lesions.

scholarly journals Juxtacortical susceptibility changes in progressive multifocal leukoencephalopathy at the gray–white matter junction correlates with iron-enriched macrophages

2021 ◽  
pp. 135245852199965
Author(s):  
Kedar R Mahajan ◽  
Moein Amin ◽  
Matthew Poturalski ◽  
Jonathan Lee ◽  
Danielle Herman ◽  
...  
Keyword(s):  
White Matter ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Central Nervous System Lymphoma ◽  
Susceptibility Weighted Imaging ◽  
Resonance Imaging ◽  
Gradient Echo ◽  
Total N ◽  
Mri Brain ◽  
Fluid Attenuated Inversion Recovery ◽  
Magnetic Resonance Imaging Mri

Objective: Describe magnetic resonance imaging (MRI) susceptibility changes in progressive multifocal leukoencephalopathy (PML) and identify neuropathological correlates. Methods: PML cases and matched controls with primary central nervous system lymphoma (PCNSL) were retrospectively identified. MRI brain at 3 T and 7 T were reviewed. MRI-pathology correlations in fixed brain autopsy tissue were conducted in three subjects with confirmed PML. Results: With PML ( n = 26 total, n = 5 multiple sclerosis natalizumab-associated), juxtacortical changes on susceptibility-weighted imaging (SWI) or gradient echo (GRE) sequences were noted in 3/3 cases on 7 T MRI and 14/22 cases (63.6%) on 1.5 T or 8/22 (36.4%) 3 T MRI. Similar findings were only noted in 3/25 (12.0%) of PCNSL patients (odds ratio (OR) 12.83, 95% confidence interval (CI), 2.9–56.7, p < 0.001) on 1.5 or 3 T MRI. On susceptibility sequences available prior to diagnosis of PML, 7 (87.5%) had changes present on average 2.7 ± 1.8 months (mean ± SD) prior to diagnosis. Postmortem 7 T MRI showed SWI changes corresponded to areas of increased iron density along the gray–white matter (GM-WM) junction predominantly in macrophages. Conclusion: Susceptibility changes in PML along the GM-WM junction can precede noticeable fluid-attenuated inversion recovery (FLAIR) changes and correlates with iron accumulation in macrophages.

Increased MRI-based cortical grey/white-matter contrast in sensory and motor regions in schizophrenia and bipolar disorder

2016 ◽  
Vol 46 (9) ◽  
pp. 1971-1985 ◽  
Author(s):  
K. N. Jørgensen ◽  
S. Nerland ◽  
L. B. Norbom ◽  
N. T. Doan ◽  
R. Nesvåg ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Linear Models ◽  
Subcortical White Matter ◽  
Precentral Gyrus ◽  
Average Group ◽  
Medication Dose ◽  
Weighted Magnetic Resonance Imaging ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

BackgroundSchizophrenia and bipolar disorder share genetic risk factors and one possible illness mechanism is abnormal myelination. T1-weighted magnetic resonance imaging (MRI) tissue intensities are sensitive to myelin content. Therefore, the contrast between grey- and white-matter intensities may reflect myelination along the cortical surface.MethodMRI images were obtained from patients with schizophrenia (n = 214), bipolar disorder (n = 185), and healthy controls (n = 278) and processed in FreeSurfer. The grey/white-matter contrast was computed at each vertex as the difference between average grey-matter intensity (sampled 0–60% into the cortical ribbon) and average white-matter intensity (sampled 0–1.5 mm into subcortical white matter), normalized by their average. Group differences were tested using linear models covarying for age and sex.ResultsPatients with schizophrenia had increased contrast compared to controls bilaterally in the post- and precentral gyri, the transverse temporal gyri and posterior insulae, and in parieto-occipital regions. In bipolar disorder, increased contrast was primarily localized in the left precentral gyrus. There were no significant differences between schizophrenia and bipolar disorder. Findings of increased contrast remained after adjusting for cortical area, thickness, and gyrification. We found no association with antipsychotic medication dose.ConclusionsIncreased contrast was found in highly myelinated low-level sensory and motor regions in schizophrenia, and to a lesser extent in bipolar disorder. We propose that these findings indicate reduced intracortical myelin. In accordance with the corollary discharge hypothesis, this could cause disinhibition of sensory input, resulting in distorted perceptual processing leading to the characteristic positive symptoms of schizophrenia.

scholarly journals White matter differences between essential tremor and Parkinson disease

Neurology ◽  
2018 ◽  
Vol 92 (1) ◽  
pp. e30-e39 ◽  
Author(s):  
Meher R. Juttukonda ◽  
Giulia Franco ◽  
Dario J. Englot ◽  
Ya-Chen Lin ◽  
Kalen J. Petersen ◽  
...  
Keyword(s):  
White Matter ◽  
Parkinson Disease ◽  
Essential Tremor ◽  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Superior Cerebellar Peduncle ◽  
Radial Diffusivity ◽  
Cerebellar Peduncles ◽  
Cerebellar Peduncle

ObjectiveTo assess white matter integrity in patients with essential tremor (ET) and Parkinson disease (PD) with moderate to severe motor impairment.MethodsSedated participants with ET (n = 57) or PD (n = 99) underwent diffusion tensor imaging (DTI) and fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity values were computed. White matter tracts were defined using 3 well-described atlases. To determine candidate white matter regions that differ between ET and PD groups, a bootstrapping analysis was applied using the least absolute shrinkage and selection operator. Linear regression was applied to assess magnitude and direction of differences in DTI metrics between ET and PD populations in the candidate regions.ResultsFractional anisotropy values that differentiate ET from PD localize primarily to thalamic and visual-related pathways, while diffusivity differences localized to the cerebellar peduncles. Patients with ET exhibited lower fractional anisotropy values than patients with PD in the lateral geniculate body (p < 0.01), sagittal stratum (p = 0.01), forceps major (p = 0.02), pontine crossing tract (p = 0.03), and retrolenticular internal capsule (p = 0.04). Patients with ET exhibited greater radial diffusivity values than patients with PD in the superior cerebellar peduncle (p < 0.01), middle cerebellar peduncle (p = 0.05), and inferior cerebellar peduncle (p = 0.05).ConclusionsRegionally, distinctive white matter microstructural values in patients with ET localize to the cerebellar peduncles and thalamo-cortical visual pathways. These findings complement recent functional imaging studies in ET but also extend our understanding of putative physiologic features that account for distinctions between ET and PD.

scholarly journals Protrusion of ventriculoperitoneal shunt catheter tip through anus with silence abdomen

2021 ◽  
Author(s):  
See Liang Lim ◽  
Mohd Shahrulsalam Mohd Shah ◽  
Norsuhana Omar
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Clinical Symptoms ◽  
Simple Procedure ◽  
Bowel Perforation ◽  
Male Infant ◽  
Distal Portion ◽  
Communicating Hydrocephalus ◽  
Abdominal Incision ◽  
Abdominal Complication ◽  
Shunt Procedure

Introduction: Ventriculoperitoneal shunt (VPS) is most commonly performed surgical treatment for hydrocephalus by draining excessive cerebrospinal fluid (CSF) in ventricles to peritoneal cavity. Despite significant improvement in shunt procedure and being a relatively simple procedure, shunt complications remain common. Aim: The aim of this paper is to report a case of perforated bowel presented with silence abdomen following VPS insertion. Case study: We report a case of protrusion of distal VPS catheter through anus with silent abdomen, managed successfully with minimal intervention. Patient, 11-months-old male infant, diagnosed with congenital communicating hydrocephalus and VPS placement was done at 6 months of life, presented with tip of VPS protruding from anus after 4 months of VPS insertion. Patient was scheduled for removal of VPS, where shunt was disconnected through superficial abdominal incision, distal portion removed through anus without resistance. Postoperative patient recovers well without abdominal complication. Results and discussion: Perforation of bowel by distal peritoneal catheter is rare and only accounts for 0.1%–0.7% of complication. The exact pathogenesis for spontaneous bowel perforation is unclear. Management of bowel perforation secondary to VPS is highly individualized, mainly depending on its clinical symptoms and signs. Conclusions: Although bowel perforation following VPS insertion is rare, it carries high mortality up to 15% especially if unrecognized and delayed in treatment. Early detection and appropriate management are key in reducing VPS related morbidity and mortality.

scholarly journals Body mass index, time of day, and genetics affect perivascular spaces in the white matter

2020 ◽  
Author(s):  
Giuseppe Barisano ◽  
Farshid Sepehrband ◽  
Nasim Sheikh-Bahaei ◽  
Meng Law ◽  
Arthur W. Toga
Keyword(s):  
Body Mass Index ◽  
White Matter ◽  
Body Mass ◽  
Structural Changes ◽  
Large Population ◽  
Time Of Day ◽  
Perivascular Spaces ◽  
Healthy Human ◽  
Magnetic Resonance Imaging Mri

AbstractThe analysis of cerebral perivascular spaces (PVS) using magnetic resonance imaging (MRI) allows to explore in vivo their contributions to neurological disorders. To date the normal amount and distribution of PVS in healthy human brains are not known, thus hampering our ability to define with confidence pathogenic alterations. Furthermore, it is unclear which biological factors can influence the presence and size of PVS on MRI. We performed exploratory data analysis of PVS volume and distribution in a large population of healthy individuals (n = 897, age = 28.8 ± 3.7). Here we describe the global and regional amount of PVS in the white matter, which can be used as a reference for clinicians and researchers investigating PVS and may help the interpretation of the structural changes affecting PVS in pathological states. We found a relatively high inter-subject variability in the PVS amount in this population of healthy adults (range: 1.31-14.49 cm3). We then identified body mass index, time of day, and genetics as new elements significantly affecting PVS in vivo under physiological conditions, offering a valuable foundation to future studies aimed at understanding the physiology of perivascular flow.

scholarly journals Leukoencephalopathy with brainstem and spinal cord involvement and high brain lactate: report of three brazilian patients

2007 ◽  
Vol 65 (2b) ◽  
pp. 506-511 ◽  
Author(s):  
Daniel Gurgel Fernandes Távora ◽  
Mauro Nakayama ◽  
Rômulo Lopes Gama ◽  
Thereza Cristina de Lara Alvim ◽  
Dalton Portugal ◽  
...  
Keyword(s):  
Spinal Cord ◽  
White Matter ◽  
Magnetic Resonance ◽  
Autosomal Recessive Disorder ◽  
Dorsal Column ◽  
Resonance Spectroscopy ◽  
Motor Neuropathy ◽  
Spinal Cord Involvement ◽  
Spinal Cord Dorsal ◽  
Magnetic Resonance Imaging Mri

A novel leukoencephalopathy was recently identified based on magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (¹H-MRS) findings. Leukoencephalopathy with brainstem and spinal cord involvement and high lactate (LBSL) is an autosomal recessive disorder characterized by early onset of symptoms and slowly progressive cerebellar, pyramidal and spinal cord dorsal column dysfunction. MRI and ¹H-MRS typically show abnormalities within cerebral and cerebellar white matter, a characteristic involvement of brainstem and spinal cord tracts and elevated lactate in the abnormal white matter. We present three cases with characteristic clinical and neuroimaging findings of this disorder. Some additional unique findings of our patients are discussed, like distal motor neuropathy and elevated creatine kinase in the serum.

Abstract W P158: Permeability as a Biomarker of Cavernous Malformations

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Abdul Ghani Mikati ◽  
Luying Li ◽  
Robert Shenkar ◽  
Lingjao Zhang ◽  
Xiaodong Guo ◽  
...  
Keyword(s):  
White Matter ◽  
Disease Activity ◽  
Grey Matter ◽  
Response To Treatment ◽  
Cavernous Malformations ◽  
Familial Cases ◽  
Coefficients Of Variation ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Over Time

Introduction: Vascular hyperpermeability in lesions and nonlesional brain is a cardinal feature of cerebral cavernous malformation (CCM) pathogenesis. Thus we implemented a novel magnetic resonance imaging (MRI) technique in order to quantitate vascular permeability in CCMs and non-CCM brain tissue in humans. We hypothesize that permeability of lesions and background brain will differ between familial and sporadic patients and measurements will be consistent between observers and over time. Method: We used a T 1 -weighted dynamic contrast-enhanced quantitative perfusion (DCEQP) protocol in 30 patients (13 sporadic, 12 familial, and 5 non-CCM cases) in conjunction with routine MRI scans. Regions of interest (ROIs) for permeability measurement included the entire lesion and areas of 12.9 mm 2 (16 pixels) of grey and white matter near and far from the lesion. Measurements were repeated by two observers and at two time points on a subset of patients. Results: For each ROI category except white matter near lesions, the mean permeability was higher in the familial than in the sporadic patients with p-values of 0.04, 0.005, 0.05, and 0.007 for CCM lesions, grey matter near, grey matter far (GMF), and white matter far (WMF) from lesions respectively. No difference was seen between sporadic and non-CCM cases, however familial WMF had higher permeability than both those groups (p0.05) except GMF with p=0.04. The intrapatient coefficients of variation between measurements were 0.74 and 0.63 and interpatient coefficients of variation were 1.36 and 1.56 for sporadic and familial cases respectively. Lastly, it was found that 3 of 4 patients with two scans had stable background (WMF) brain permeability over time. Conclusion: Results show the higher lesional and background brain permeability of familial cases, corroborating previous findings in mice. We also demonstrate the feasibility of DCEQP in CCM disease and the potential of permeability as a biomarker of disease activity or response to treatment. It also highlights the need for further investigation into clinical factors that may impact disease activity and permeability measures.

scholarly journals Volume of white matter hyperintensities increases with blood pressure in patients with hypertension

2019 ◽  
Vol 47 (8) ◽  
pp. 3681-3689 ◽  
Author(s):  
Yu Zhao ◽  
Zunyu Ke ◽  
Wenbo He ◽  
Zhiyou Cai
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Clinical Analysis ◽  
Primary Diagnosis ◽  
Mri Findings ◽  
Scale Scores ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Fazekas Scale

Objective Hypertension is a risk factor for development of white matter hyperintensities (WMHs). However, the relationship between hypertension and WMHs remains obscure. We sought to clarify this relationship using clinical data from different regions of China. Methods We analyzed the data of 333 patients with WMHs in this study. All included patients underwent conventional magnetic resonance imaging (MRI) examination. A primary diagnosis of WMHs was made according to MRI findings. The volume burden of WMHs was investigated using the Fazekas scale, which is widely used to rate the degree of WMHs. We conducted retrospective clinical analysis of the data in this study. Results Our findings showed that WMHs in patients with hypertension were associated with diabetes, cardiovascular diseases, history of cerebral infarct, and plasma glucose and triglyceride levels. Fazekas scale scores for WMHs increased with increased blood pressure values in patients with hypertension. Conclusion This analysis indicates that hypertension is an independent contributor to the prevalence and severity of WMHs.

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