scholarly journals Central tegmental tract T2 hyperintensity

2021 ◽  
Author(s):  
Ali Alsmair
Keyword(s):  
Central Tegmental Tract ◽  
T2 Hyperintensity

scholarly journals Transaxonal degenerations of cerebellar connections: the value of anatomical knowledge

2020 ◽  
Vol 78 (5) ◽  
pp. 301-306
Author(s):  
Mariana Trombetta de Lima RAEDER ◽  
Eduardo Pontes REIS ◽  
Brunno Machado CAMPOS ◽  
Igor Aloísio Garcez ZAMILUTE ◽  
Marcondes Cavalcante FRANÇA JÚNIOR ◽  
...  
Keyword(s):  
Dentate Nucleus ◽  
Demyelinating Disease ◽  
Clinical Manifestations ◽  
Imaging Findings ◽  
Middle Cerebellar Peduncle ◽  
Imaging Characteristics ◽  
Central Tegmental Tract ◽  
Clinical Correlations ◽  
Cerebellar Peduncle ◽  
T2 Hyperintensity

ABSTRACT Transaxonal degenerations result from neuronal death or the interruption of synaptic connections among neuronal structures. These degenerations are not common but may be recognized by conventional magnetic resonance imaging. Objective: The learning objectives of this review include recognition of the imaging characteristics of transaxonal degenerations involving cerebellar connections, the identification of potential encephalic lesions that can lead to these degenerations and correlation of the clinical manifestations with imaging findings that reflect this involvement. Methods: In this report, we review the neuroanatomical knowledge that provides a basis for identifying potential lesions that can result in these degenerations involving cerebellar structures. Results: Hypertrophic olivary degeneration results from an injury that interrupts any of the components of the Guillain-Mollaret triangle. In this work, we describe cases of lesions in the dentate nucleus and central tegmental tract. The crossed cerebellar diaschisis presents specific imaging findings and clinical correlations associated with its acute and chronic phases. The Wallerian degeneration of the middle cerebellar peduncle is illustrated by fiber injury of the pontine cerebellar tracts. A T2-hyperintensity in the dentate nucleus due to a thalamic acute lesion (in ventral lateral nuclei) is also described. Each condition described here is documented by MRI images and is accompanied by teaching points and an anatomical review of the pathways involved. Conclusion: Neurologists and radiologists need to become familiar with the diagnosis of these conditions since their presentations are peculiar and often subtle, and can easily be misdiagnosed as ischemic events, degenerative disease, demyelinating disease or even tumors.

scholarly journals New-Onset Seizure With Possible Limbic Encephalitis in a Patient With COVID-19 Infection: A Case Report and Review

2021 ◽  
Vol 9 ◽  
pp. 232470962098630
Author(s):  
Riwaj Bhagat ◽  
Barbara Kwiecinska ◽  
Nolan Smith ◽  
Matthew Peters ◽  
Christopher Shafer ◽  
...  
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Nasopharyngeal Swab ◽  
Onset Seizure ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Global Pandemic ◽  
Elevated Protein ◽  
T2 Hyperintensity ◽  
Elevated Protein Level ◽  
New Onset

With the outbreak of COVID-19 (coronavirus disease 2019) as a global pandemic, various of its neurological manifestations have been reported. We report a case of a 54-year-old male with new-onset seizure who tested positive for severe acute respiratory syndrome coronavirus 2 from a nasopharyngeal swab sample. Investigative findings, which included contrast-enhancing right posterior temporal lobe T2-hyperintensity on brain magnetic resonance imaging, right-sided lateralized periodic discharges on the electroencephalogram, and elevated protein level on cerebrospinal fluid analysis, supported the diagnosis of possible encephalitis from COVID-19 infection. The findings in this case are placed in the context of the existing literature.

scholarly journals Utility of MRI Enhancement Pattern in Myelopathies with Longitudinally-extensive T2-lesions

2021 ◽  
pp. 10.1212/CPJ.0000000000001036
Author(s):  
Rafid Mustafa ◽  
Theodore J. Passe ◽  
Alfonso S. Lopez-Chiriboga ◽  
Brian G. Weinshenker ◽  
Karl N. Krecke ◽  
...  
Keyword(s):  
Excellent Agreement ◽  
Correct Diagnosis ◽  
Kappa Coefficient ◽  
Poor Agreement ◽  
Enhancement Pattern ◽  
Gadolinium Enhancement ◽  
Specific Diagnosis ◽  
T2 Lesions ◽  
Image Characteristics ◽  
T2 Hyperintensity

ABSTRACTObjectiveTo determine if MRI gadolinium enhancement patterns in myelopathies with longitudinally-extensive T2-lesions can be reliably distinguished and assist in diagnosis.MethodsWe retrospectively identified 74 Mayo Clinic patients (1/1/1996–12/31/2019) fulfilling the following criteria: 1) Clinical myelopathy; 2) MRI spine available; 3) Longitudinally-extensive T2-hyperintensity (≥3 vertebral segments); and 4) Characteristic gadolinium enhancement pattern associated with a specific myelopathy etiology. Thirty-nine cases with alternative myelopathy etiologies, without previously described enhancement patterns, were included as controls. Two independent readers, educated on enhancement patterns, reviewed T2-weighted and post-gadolinium T1-weighted images and selected the diagnosis based on this knowledge. These were compared to the true diagnoses and agreement was measured with Kappa coefficient.ResultsAmong all cases and controls (n=113), there was excellent agreement for diagnosis using post-gadolinium images (Kappa, 0.76) but poor agreement with T2-weighted characteristics alone (Kappa, 0.25). A correct diagnosis was more likely when assessing post-gadolinium image characteristics than with T2-weighted images alone (Rater 1: 100/113 [88%] vs 61/113 [54%] correct, p<0.0001; Rater 2: 95/113 [84%] vs 68/113 [60%] correct, p<0.0001). Of the 74 with characteristic enhancement patterns, 55 (74%) were assigned an alternative incorrect or non-specific diagnosis when originally evaluated in clinical practice, 12 (16%) received immunotherapy for non-inflammatory myelopathies, and 2 (3%) underwent unnecessary spinal cord biopsy.ConclusionsMisdiagnosis of myelopathies is common. The gadolinium enhancement patterns characteristic of specific diagnoses can be identified with excellent agreement between raters educated on this topic. This study highlights the potential diagnostic utility of enhancement patterns in myelopathies with longitudinally-extensive T2-lesions.

scholarly journals Symmetrical central tegmental tract hyperintensities on magnetic resonance imaging

2015 ◽  
Vol 10 (3) ◽  
pp. 235
Author(s):  
Paramdeep Singh ◽  
Amarpreet Kaur ◽  
Rupinderjeet Kaur ◽  
Simmi Aggarwal ◽  
Ramandeep Singh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Central Tegmental Tract

Subacute Cognitive Decline in an 86-Year-Old Woman With Prior Lobar Intracerebral Hemorrhage

2021 ◽  
pp. 192-194
Author(s):  
Stephen W. English ◽  
James P. Klaas
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cognitive Decline ◽  
Temporal Lobe ◽  
Cerebral Amyloid Angiopathy ◽  
Mass Effect ◽  
Amyloid Angiopathy ◽  
Left Temporal Lobe ◽  
Epileptiform Discharges ◽  
Cerebral Amyloid ◽  
T2 Hyperintensity

An 86-year-old woman with a history of hypertension, hyperlipidemia, coronary artery disease, and hypothyroidism sought care for subacute, progressive cognitive decline. Five months earlier, she was hospitalized for a small, left temporal, lobar, intracerebral hemorrhage with associated receptive aphasia. Over the next several months, she had a precipitous cognitive decline. She was prescribed memantine by her primary physician because of concern for dementia. One month before seeking care, she was found unconscious in her bathroom, which was believed to be an unwitnessed seizure. Brain magnetic resonance imaging 1 month before the current evaluation showed a prior, small, left temporal hemorrhage and diffuse lobar microhemorrhages on gradient echo imaging, focal leptomeningeal gadolinium enhancement in the left temporal lobe, and multifocal T2 hyperintensity with mass effect, maximal in the left temporal lobe. Electroencephalography showed multifocal, independent epileptiform discharges. She underwent open biopsy of the left temporal lobe, which indicated focal granulomatous inflammation causing vascular destruction, with β‎-amyloid plaques within the cortical and leptomeningeal vessels. The findings were consistent with a diagnosis of amyloid-β‎-related angiitis in the setting of severe cerebral amyloid angiopathy. Because of concern for subclinical seizures and epileptiform discharges on electroencephalography, the patient was started on levetiracetam without substantial change in her mental status. After the biopsy findings demonstrated inflammatory changes consistent with amyloid-β‎-related angiitis, she was started on intravenous methylprednisolone, followed by transition to prednisone. After 6 months of treatment, she had significant clinical and radiographic improvement. Follow-up magnetic resonance imaging at that time showed interval improvement in the T2 hyperintensity and mass effect in the left temporal lobe. She was again independent with her activities of daily living, and memantine was discontinued. Cerebral amyloid angiopathy encompasses a heterogeneous group of diseases characterized by amyloid-β‎ peptide deposition. The most common clinical manifestation of cerebral amyloid angiopathy is lobar intracerebral hemorrhage, which can be multifocal and recurrent but can also result in cerebral ischemia and ischemic leukoencephalopathy.

Correlation of MRI with the Neuropathologic Changes in Two Cats with Bromethalin Intoxication

2019 ◽  
Vol 55 (3) ◽  
Author(s):  
Marc Kent ◽  
Eric N. Glass ◽  
Lindsay Boozer ◽  
Rachel B. Song ◽  
Elyshia J. Hankin ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
White Matter ◽  
Cervical Spinal Cord ◽  
Spongy Degeneration ◽  
Intramyelinic Edema ◽  
Apparent Diffusion ◽  
The Central Nervous System ◽  
Uncoupling Of Oxidative Phosphorylation ◽  
T2 Hyperintensity

ABSTRACT Two cats were presented with multifocal neurological signs. One cat’s signs progressed over 2 wk; the other cat progressed over 5 days. Examinations were consistent with a process involving the prosencephalon, vestibular system, and general proprioceptive/upper motor neuron systems. MRI of the brain and cervical spinal cord reveal widespread T2 hyperintensity of the white matter. Affected areas included the cerebrum, cerebral peduncles, corticospinal tracts of the pons and medulla, and the cerebellum. T2 hyperintensity was present in all funiculi of the spinal cord. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps were consistent with cytotoxic or intramyelinic edema. Differential diagnosis included toxic or metabolic/degenerative leukoencephalopathies. Necropsies revealed widespread spongy degeneration of the central nervous system white matter. Toxicologic assays of liver specimens revealed desmethylbromethalin, a metabolite of bromethalin. Bromethalin is a rodenticide that causes uncoupling of oxidative phosphorylation. Antemortem diagnosis is challenging. DWI and ADC maps were instrumental in narrowing the differential diagnosis and raised the index of suspicion for bromethalin. Bromethalin intoxication should be considered in all animals with a progressive course of multifocal neurologic deficits. MRI, specifically, DWI and ADC maps, may serve as a biomarker of cytotoxic or intramyelinic edema associated with spongiform leukoencephalomyelopathy.

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