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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report 9 patients with an isolated infarct of the anterior part of the rostral cerebellum, ie, the territory of the lateral branch of the superior cerebellar artery. Clinicoanatomic correlations are based on CT, MRI, or both in 8 patients and on pathologic data in the ninth. The main clinical features were ipsilateral dysmetria and axial lateropulsion, dysarthria, and unsteadiness. In 1 patient, the clinical presentation mimicked a lacunar stroke (dysarthria and clumsy hand syndrome). There were no edematous cerebellar infarcts with signs of brainstem compression, and all patients spontaneously improved without significant sequellae. Angiography in 2 patients and pathologic examination of arteries in 1 patient disclosed no occlusion in the vertebrobasilar system. Six patients had a cardiac source of emboli. In conclusion, infarcts of the anterior part of the rostral cerebellum can be regarded as a benign condition in which there is, frequently, a cardiac source of emboli.
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PMID:Infarction in the anterior rostral cerebellum (the territory of the lateral branch of the superior cerebellar artery). 199 70

Quantitative interpretation of functional images (PET or SPECT) is hampered by poor spatial resolution, low counting statistics, and, for many tracers, low contrast between different brain structures of interest. Furthermore, normal tracer distributions can be severely disrupted by such gross pathologies as stroke, tumor, and dementia. Hence, the complementary anatomical information provided by CT or MRI is essential for accurate and reproducible regional analysis of functional data. We have developed methods for the simultaneous three-dimensional display and analysis of image volumes from MRI and PET. A general algorithm for defining the affine transformation between two equivalent point ensembles has been adapted for the purpose of registering MRI and PET image volumes by means of a simple fiducial arrangement. In addition, we have extended previous MRI-based computerized atlas methodology to three dimensions. The native atlas planes were spaced at 2 mm intervals, sufficient axial sampling to permit the generation of oblique planar sections through the atlas space. This will allow for an infinite number of angulations and axial offsets in two-dimensional region-of-interest (ROI) templates, all derived from the same master three-dimensional volume-of-interest (VOI) atlas and therefore maintaining topographical consistency throughout. These ROI templates may be selected to match the image orientation for conventional two-dimensional segmentation and data extraction.
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PMID:MRI-PET correlation in three dimensions using a volume-of-interest (VOI) atlas. 199 91

The authors report a case of a patient with a pituitary tumor, in which pituitary apoplexy occurred only in the suprasellar part of the tumor. A 26-year-old woman suffered from abrupt worsening of vision and headache. A CT scan showed a dumb-bell-shaped tumor extending to the suprasellar region, in which an irregularly shaped low density area suggesting a liquidized hematoma was seen. The rapid worsening of her symptoms was highly indicative of pituitary apoplexy. The first operation was performed through the transsphenoidal route. There was no evidence of intratumoral hematoma in the intrasellar tumor, which could be removed successfully. However, the suprasellar mass could not be reached because of the hardness of the diaphragma sellae and the presence of a normal pituitary gland. MRI and CT cisternography after this first operation showed a narrow opening of the diaphragma sellae. The second operation using right frontotemporal craniotomy disclosed a suprasellar mass, which consisted of an old hematoma and a necrotic tumor. The tumor was sub-totally removed. The patient's visual acuity improved after the second operation. Although transsphenoidal surgery is the treatment of choice in patients with pituitary apoplexy, the selection of the surgical route should be made only after careful neuroradiological evaluation with regard to the extrasellar extension of the tumor.
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PMID:[Pituitary apoplexy with localized hematoma in the suprasellar region]. 203 17

Two promising advances in MRI have recently evolved. Water proton directional "diffusion" as well as "perfusion" processes can be imaged in a rapid (on the order of milliseconds) and accurate manner. MR diffusion imaging is shown to effectively allow determination of the presence of anisotropic water diffusion in animal and human cerebral and spinal white matter and in peripheral nerves. In another important application, the measured apparent water proton diffusion is observed to be significantly slowed in cerebral gray matter within the first minutes following experimental stroke suggesting that MRI could be useful in rapid initial assessments of ischemic damage. MR contrast media can cause regional changes due to either magnetic susceptibility-induced T2* shortening or to paramagnetic-induced T1 shortening. The passage of a contrast bolus through the microcirculation can be monitored using high-speed MRI and can provide significant contrast enhancement in ischemic and normally perfused tissues.
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PMID:Magnetic resonance imaging of diffusion and perfusion. 205 98

Two patients with bilateral thalamo-mesencephalic infarct in the paramedian territory developed vertical gaze dysfunction and marked behavioural changes, in the absence of significant motor inability and formal neuropsychological impairment. While they were physically and emotionally active before stroke, they became apathetic, aspontaneous, indifferent, and seemed to have lost motor and affectic drive, as well as the need itself for any psychic activity. However, this mental and motor inertia was reversible when the patients were repeatedly stimulated by another person. This need for constant external programming, together with a lack of emotional reactivity, made the patients resemble robots. CT and MRI suggested involvement of the dorsomedial and midline nuclei of the thalamus, and SPECT showed remote frontomesial hypoperfusion. A disturbance of the striatal-ventral pallidal-thalamic-frontomesial limbic loop is suggested by previous reports of a similar "loss of psychic self-activation", "pure psychic akinesia", or "athymhormia" with bipallidal, bistriatal, or subcortical bifrontal lesions.
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PMID:Loss of psychic self-activation with bithalamic infarction. Neurobehavioural, CT, MRI and SPECT correlates. 206 54

The MELAS syndrome (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) can be difficult to identify. We report MRI abnormalities that we believe are specific to this disorder in three patients with complete or partial MELAS syndrome. The patients all showed an unusual pattern on T2-weighted MRI with multifocal areas of hyperintense signal confined to the cortex of the cerebrum, cerebellum, and adjacent white matter. Some images suggested selective cortical involvement of deeper layers only. Deep white matter was relatively spared, distinguishing this from usual cerebrovascular disease or the edema after status epilepticus. Specificity of these findings is further suggested by a good correlation of these findings with the previously described unique postmortem brain pathology of MELAS.
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PMID:Magnetic resonance imaging shows specific abnormalities in the MELAS syndrome. 206 32

A cerebral metabolic activator was administered to patients with cerebrovascular dementia to treat urinary incontinence or pollakisuria. The results are of interest as discussed in this paper. This study was carried out on 35 patients (15 males and 20 females) with cerebrovascular dementia with the chief complaint of incontinence or pollakisuria averaging in age 78.1 years with a range of 65 to 92. The underlying disease was cerebral hemorrhage in 4 cases, cerebral embolism in 21 cases and sequelae of cerebral apoplexy in 10 cases. ADL was assessed in all cases by cerebral CT or MRI and Hasegawa's test, a simple test for dementia. Bladder function was evaluated by determining urodynamic tests (CMG, UFM, UPP) before and after medical treatment. Test drug was bifemelane hydrochloride, a cerebrovascular metabolic activator. It was administered at a dose of 150 mg/day for periods of 2 months or more. As a result, bladder symptoms improved in 16/35 patients (45.7%), and mental symptoms in 21/35 (60%). Urine voiding and holding as bladder functions determined by urodynamics tests were not affected at all. The effect of this drug on bladder symptoms is secondary to improvement of mental symptoms, and its most pronounced clinical effect was on dementia.
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PMID:[Effect of the cerebro-metabolism activator (bifemelane hydrochloride) on urinary incontinence and pollakisuria associated with cerebrovascular dementia]. 206 5

We examined 46 patients with angiographically documented regurgitant lesions (26 patients with mitral regurgitation, 20 patients with aortic regurgitation) using an 0.5 Tesla magnet. In each patient a multislice-multiphase spinecho sequence in sagittal-coronal double angulated plane was performed to assess left and right ventricular volumes, ejection fraction and regurgitant fraction. Additionally a blood flow sensitive gradient echo technique was done to visualize direction and extension of the regurgitant jet. MRI data were compared with quantitative and qualitative assessment of regurgitation by angiography and echocardiography. Using the gradient echo technique MRI could demonstrate the regurgitant jet in all patients. A linear correlation for volume parameters by MRI and angio was found with best correlation for the left ventricular stroke volume (r = 0.82, p less than 0.0001). Furthermore MRI regurgitant fraction correlated with angiographically determined regurgitant fraction in patients with aortic regurgitation (r = 0.91, p less than 0.0001) and mitral regurgitation (r = 0.67, p less than 0.001), respectively. Semiquantitative assessment of regurgitation by gradient echo technique showed an agreement with angiographic grading by Sellers in 70% of mitral and 75% of aortic regurgitation, respectively. The comparison of MRI and color Doppler sonography showed only moderate correlation of r = 0.72 (p less than 0.01).
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PMID:Quantification of regurgitant lesions by MRI. 209 4

To clarify the significance of periventricular hyperintensity (PVH) on MRI-T2 images in stroke patients, clinical and experimental studies were performed. MRI (1.5 Tesla) was obtained in 153 patients with ischemic stroke. The PVH was observed in all the patients, although severe PVH was found only in 22% of the cases. Severe PVH was observed mainly in hypertensive elderly patients with multiple infarctions and impaired cognitive function. Regional cerebral blood flow was reduced in majority of these patients. The absence of aqueductal signal flow void, remarkable ventricular enlargement and abnormal RI cisternography+ were observed in 20% of the patients with severe PVH. In Wistar rats and gerbils, chronic low perfusion state was induced by occlusion or narrowing of both common carotid arteries, and histological studies were performed at 1 week, 1 month or 3 months after the surgery. Multiple infarctions, white matter changes and ventricular enlargement were observed in these animals. The results suggest that chronic low perfusion in the brain and/or abnormal cerebrospinal fluid circulation play a role in the development of PVH.
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PMID:[Significance of periventricular hyperintensity on magnetic resonance images in stroke patients]. 209 80

1H MRI permits detection of edema in the brain. In a middle cerebral artery stroke model in the cat, we found a significant correlation between an edema index based on MRI and a sensitive metabolic index of ischemia, the in vivo oxidation status of mitochondrial cytochrome aa3 determined by near-infrared reflectance spectrophotometry (r = -0.70, alpha = 0.001). This result suggests that a simple, noninvasive study using MRI can provide an index of the extent of ischemic damage in an experimental acute stroke model.
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PMID:MRI quantitation of edema in focal cerebral ischemia in cats: correlation with cytochrome aa3 oxidation state. 215 26


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