Neuroradiology 0028-3940

Faro, S.; Vinitski, S.; Ortega, H.; Mohamed, F.; Chen, C.; Flanders, A.; Gonzales, C.; Zimmerman, R.

doi: 10.1007/BF00607262pmid: 8837080

234 38 38 5 5 S. H. Faro S. Vinitski H. V. Ortega F. B. Mohamed C. Y. Chen A. E. Flanders C. F. Gonzales R. A. Zimmerman Department of Radiologic Sciences Medical College of Pennsylvania 3300 Henry Avenue 19129 Philadelphia PA USA Department of Radiology Thomas Jefferson University Hospital and Jefferson Medical College Philadelphia Pennsylvania USA Department of Radiology Tri-Service General Hospital Taipei Taiwan Republic of China Department of Pediatric Neuroradiology Childrens Hospital Philadelphia Pennsylvania USA Neuro-MRI/MRA Physics Research Group Philadelphia Pennsylvania USA Abstract Magnetic resonance angiography (MRA) hs inherent artifacts due to variation in velocity and direction of flowing blood in the carotid bulb and regions of stenosis. We examined the efficiency of dual 3-inch surface coils to delineate carotid artery flow better. Carotid MRA was performed on ten healthy volunteers and six patients, on a 1.5 T system. A special adapter was constructed to use with 3-inch (receive-only) coils, which were placed over the carotid bifurcations. Routine anterior neck coils were also used. Contiguous axial two-dimensional (45/8.7, 1.5 mm, flip angle 60°) time-of-flight sequences were used. Image matrix was 256×256 with two signals averaged and acquisition time 6–10 min. These images were postprocessed and reformatted into angiographic views using a maximum intensity projection algorithm. Computer simulation of carotid artery blood flow through-out the cardiac cycle based on vessel contours derived from digital subtraction angiography was carried out by finite element analysis. Improved definition of vessel margin, particularly at the carotid bifurcation, and substantially increased signal-to-background ratio of flowing blood were obtained with 3-inchcoils. Apparent loss of signal in the carotid bulb was diminished. In one patient, contiguous flow throughout a high-grade stenosis was well defined, with the surface coil method, while drop-off of signal was observed with routine neck coil imaging.

Kandeel, A.; Zimmerman, R.; Ohene-Frempong, K.

doi: 10.1007/BF00607263pmid: 8837081

234 38 38 5 5 A. Y. Kandeel R. A. Zimmerman K. Ohene-Frempong Department of Radiology Mansoura University Hospital Mansoura Egypt Department of Radiology The Children's Hospital of Philadelphia 34th Street and Civic Center Boulevard 19104 Philadelphia PA USA Division of Hematology The Children's Hospital of Philadelphia Philadelphia Pennsylvania USA Abstract We retrospectively reviewed the medical records and conventional angiograms of 21 patients with known sickle cell disease, who underwent a total of 50 magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) studies. MRA and conventional angiography were assessed separately for evidence of stenosis or occlusion. Follow up MRI/MRA studies were also assessed for evidence of progression, regression or stability of the disease in these patients. In the carotid circulation, MRA made the correct diagnosis in 85% of the vessels evaluated with a sensitivity of 80.5% and a specificity of 94%. MRA was also found to show evidence of disease progression, more often than did MRI or the clinical condition of the patients.

Brassel, F.; Weissenborn, K.; Rückert, N.; Hussein, S.; Becker, H.

doi: 10.1007/BF00607264pmid: 8837082

234 38 38 5 5 F. Brassel K. Weissenborn N. Rückert S. Hussein H. Becker Abteilung Neuroradiologie Klinikum der Ernst-Moritz-Arndt-Universität Greifswald Friedrich-Loeffler-Strasse 23 D-17487 Greifswald Germany Neurologische Klinik mit Klinischer Neurophysiologie Medizinische Hochschule Hannover Hannover Germany Abteilung Neuroradiologie Medizinische Hochschule Hannover Hannover Germany Neurochirurgische Klinik Medizinische Hochschule Hannover Hannover Germany Abstract We describe the angioarchitecture of the medial temporal region as a basis for modified superselective Wada tests in patients with temporal lobe epilepsy. Possible functional deficits following the injection of amytal, depending on the superselective placement of the microcatheter in the medial temporal arteries, are discussed. The individual blood supply in each patient determines the ideal super-selective positioning of the micro-catheter.

Weissenborn, K.; Rückert, N.; Brassel, E.; Becker, H.; Dietz, H.

doi: 10.1007/BF00607265pmid: 8837083

234 38 38 5 5 K. Weissenborn N. Rückert E. Brassel H. Becker H. Dietz Neurologische Klinik mit Klinischer Neurophysiologie Medizinische Hochschule Hannover D-30623 Hannover Germany Neurochirurgische Klinik Medizinische Hochschule Hannover Hannover Germany Abteilung für Neuroradiologie Medizinische Hochschule Hannover Hannover Germany Abstract We report experience with a modification of the Wada test used before temporal lobe resection in patients with drug-resistant epilepsy. Our procedure consists of injection of amytal via a microcatheter into the anterior choroidal artery or the P2 segment of the posterior cerebral artery and simultaneous presentation of verbal and figural memory test material before, during and after the injection. Pros and cons of the modification and inherent shortcomings of the amytal test are discussed on the basis of the results in ten patients.

Hasuo, K.; Mizushima, A.; Matsumoto, S.; Mihara, F.; Yoshiura, T.; Umezu, Y.; Masuda, K.

doi: 10.1007/BF00607266pmid: 8837084

234 38 38 5 5 K. Hasuo A. Mizushima S. Matsumoto F. Mihara T. Yoshiura Y. Umezu K. Masuda Department of Radiology, Faculty of Medicine Kyushu University 3-1-1 Maidashi Higashi-ku 812 Fukuoka Japan Abstract A stereoscopic biplane digital subtraction angiography (DSA) system was developed, capable of obtaining frontal and lateral projections simultaneously during a single injection of contrast medium. This new system combines the advantages of both biplane and stereoscopic single-plane DSA, and permits high-quality neuroangiography.

Hyogo, T.; Nakagawara, J.; Nakamura, J.; Suematsu, K.

doi: 10.1007/BF00607267pmid: 8837085

234 38 38 5 5 T. Hyogo J. Nakagawara J. Nakamura K. Suematsu Department of Surgical Neuroangiography Nakamura Memorial Hospital S-1, W-14 Chuouku 060 Sapporo Japan Neurosurgery, Nakamura Memorial Hospital Hokkaido Brain Research Foundation Hokkaido Japan Abstract A case of multiple segmental agenesis of the cerebral arteries is presented. Cerebral angiography demonstrated bilateral socalled carotid rete mirabile, a similar “rete” of the right vertebral artery and intradural duplication of the left vertebral artery. These abnormalities are thought to be caused by multiple segmental agenesis of the cerebral arteries as they penetrate the dura mater, the embryological and anatomical significance of these findings is discussed.

Kamei, S.; Takasu, T.; Mori, N.; Yoshihashi, K.; Shikata, E.

doi: 10.1007/BF00607268pmid: 8837086

234 38 38 5 5 S. Kamei T. Takasu N. Mori K. Yoshihashi E. Shikata Department of Neurology Nihon University School of Medicine 30-1 Oyaguchi-kamimachi, Itabashi-ku 173 Tokyo Japan Abstract Bilateral striatal necrosis in acute encephalopathy has been reported in a small number of adults with methanol or cyanide intoxication, hypoxic encephalopathy or haemolytic-uraemic syndrome. Acute encephalopathy with bilateral striatal necrosis has been reported in infants and children. However, the pathogenesis of the necrosis remains unclear. This is the first report of serial imaging from the very early to chronic stage in two acute encephalopathic adults with bilateral striatal necrosis. A clinicoradiological study is presented for clarification of the pathological process and pathogenesis. Striatal lesions were not detected in the very early stages, but only thereafter. Serial studies suggested that the lesions were caused by delayed neuronal death. These patients had severe lactic acidosis, near the limit for survival. There have been few reports of adults with acute encephalopathy and bilateral striatal necrosis in whom arterial pH was described; all these exhibited marked acidosis. The common pathophysiological condition among these encephalopathies with bilateral striatal necrosis could be lactic acidosis elicited by impairment of ATP generation through the Krebs cycle. The striatum might represent one of the target areas of Krebs-cycle blockade.

Kawata, Y.; Suzuki, T.; Kagaya, H.; Omi, R.; Shiroto, H.; Ebina, K.

doi: 10.1007/BF00607269pmid: 8837087

234 38 38 5 5 Y. Kawata T. Suzuki H. Kagaya R. Omi H. Shiroto K. Ebina Department of Radiology Nakadori Hospital 3-15 Misono-cho 010 Minami-dori, Akita Japan Department of Neurology Nakadori Hospital Akita Japan Department of Neurosurgery Nakadori Hospital Akita Japan Abstract We describe the relations between primary brain stem or cerebellar infarct or haemorrhage and secondary inferior olivary pseudohypertrophy (OPH). We identified 17 patients (43.6%) among 39 with brain stem or cerebellar vascular disease who had MRI follow-up more than 3 months after their ictus, with OPH. The primary lesions in the 22 cases without OPH were 11 haemorrhages, including 8 medial cerebellar and 3 brain stem lesions, and 11 infarcts: 4 brain stem lesions without accompanying cerebellar involvement, 2 cerebellar infarcts with brain stem extension, and 5 cerebellar lesions without a brain stem infarct. The causative lesion in the 17 patients with OPH included 5 brain stem and 7 cerebellar haemorrhages and 5 brain stem infarcts; no cerebellar infarcts without brain stem involvement were found to cause OPH. Primary involvement of the tegmentum of the brain stem was closely related to secondary OPH, but we could not characterise MRI differences in the cerebellar lesions between the patients with or without OPH.

Pyhtinen, J.; Pääkkö, E.

doi: 10.1007/BF00607270pmid: 8837088

234 38 38 5 5 J. Pyhtinen E. Pääkkö Department of Diagnostic Radiology University of Oulu Kajaanintie 50 FIN-90220 Oulu Finland Abstract Gliomatosis cerebri, a rare condition, requires clinical, radiological and pathological correlation for diagnosis. Mental and personality changes are the most common presenting symptoms with or without focal neurological signs. The widespread nature of the disease is revealed by CT or MRI. The shape of the brain may be maintained and pathological gross examination may be unremarkable or show hypertrophy without evident tumour. Microscopic examination reveals infiltration of the brain by variably differentiated neoplastic glial cells. We present a patient with gliomatosis cerebri in whom we experienced difficulties with diagnosis. The literature is reviewed and the diagnostic features summarised.

Hadley, D.

doi: 10.1007/BF00607271pmid: N/A