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Sequential MR imaging with gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) and sequential measurements of plasma Gd-DTPA concentration by inductively coupled plasma atomic emission spectroscopy (ICP-AES) were used to estimate the blood-to-tissue transport coefficient (Ki) in the 36B-10 rat glioma model. For these measurements, tissue Gd-DTPA concentration was estimated from tumor enhancement by correlation with calibration measurements obtained by ICP-AES analysis of tumor tissue. The 14 animals for which Ki was calculated can be grouped into those imaged at 11 days following tumor implantation, at 13-18 days, and at 20 days. The mean (+SEM) Ki values for these groups were 1.1 + 0.24, 9.2 + 0.8, and 13.4 + 1.7 ml/kg-min, respectively. These results correspond well with published data obtained by quantitative autoradiography. It is concluded that frequent sequential imaging and a graphical approach to Ki calculation are promising methods for determining the blood-to-tissue transport coefficient noninvasively by contrast-enhanced MRI.
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PMID:Measurement of blood-brain barrier permeability in a tumor model using magnetic resonance imaging with gadolinium-DTPA. 143 11

In 18 cases of temporal arachnoid cysts the etiology, clinical and radiographic findings, surgical treatment, and outcome are reviewed. Cysts of the middle cranial fossa are susceptible to trauma, which may cause bleeding either into the cyst or into the subdural space. CT or MRI scans are diagnostic in arachnoid cysts. In cases of intracranial mass lesion with displacement of the midline structures and increasing ICP, osteoplastic craniotomy is performed and the medial wall of the cyst is resected down to the tentorial notch, with opening into the basal cisterns. There were no operative or postoperative complications in 18 consecutive cases. However, one boy required a cystoperitoneal shunt 3 months later as a result of hydrocephalus following subdural hematoma and two other patients were also subsequently shunted. Asymptomatic arachnoid cysts are discussed with the respect to brain function and potential risks.
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PMID:Arachnoid cysts of the middle cranial fossa. 149 10

As a result of increased traffic and enlarged leisure offers the number of severe head injuries climbed significantly in the last years. Due to the improvement of preclinic care, including the transport of severe head injured patients to a neurosurgical clinic as well as the availability of modern neuroradiological techniques such as CT and MRI and the performance of ICP-monitoring at an early stage the prognosis of severe head injured patients was significantly improved.
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PMID:[Treatment of severe craniocerebral trauma]. 205 44

The authors report a rare case of a huge jugular foramen neurinoma extending to pharyngeal region in a 64 year-old woman who visited an otolaryngologist with complaints of dysphagia, hoarseness and headache in 1984. At that time a submucosal lump was noted in her left pharyngeal region. Biopsy of the tumor proved it to be neurinoma. A CT scan disclosed a dumbell shaped jugular foramen neurinoma and noncommunicating hydrocephalus. Because her symptoms slowly progressed and cerebellar signs as well as signs of increased intracranial pressure was noted, she was referred to our hospital in 1986. She had shown typical sings of left Vernet syndrome, VIIth, VIIIth cranial nerve impairment as well as cerebellar, long tract and increased ICP signs. A subtotal removal was performed from the extracranial and posterior fossa in one stage. The tumor seemed to originate from the Xth cranial nerve. The histological diagnosis of neurinoma was confirmed. Postoperatively, although her dysphagia increased for several weeks, a tracheostomy was not necessary. She was discharged 2 months later and returned to her usual occupation as a house wife. Slight dysphagia and hoarseness were her only chronic symptoms. So far, 88 cases of jugular foramen neurinoma have been reported, 15 of them including our case from Japan. Our case is probably the largest of these reported tumors. Tumors in jugular foramen often masquerade as an acoustic neurinoma or other tumor. However, recently this can usually be diagnosed preoperatively with a careful neurological examination and by means of neuroradiological investigations such as jugular venography, CT scan and MRI.
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PMID:[Huge jugular foramen neurinoma extending to the pharyngeal region: a case report]. 341 64

The measurement of NMRD profiles of water protons of excised tissues containing paramagnetic metal ions is one of the few ways of determining the biochemical and biophysical state of these ions in vivo. It is of critical importance, for example, to verify that Gd, injected as Gd(DTPA) to enhance contrast in MRI, remains chelated, since free Gd ions are highly toxic. We have investigated this in the renal medulla of rabbits. Fitting the magnetization data at each field of the dispersion to a single exponential shows that Gd accumulates predominantly in the renal medulla, from which it is cleared within 18 hours, and that Gd(DTPA) introduced intravenously into rabbits is excreted as Gd(DTPA) in the urine as rotationally mobile as in neat water. Taking a larger data set at each field and fitting it to the sum of two exponentials, since the errors of the single exponential analysis were larger than for other tissues, shows that the relaxation behavior of the renal medulla, free of contrast agent, can be well-described by a single relaxation rate at 37 degrees C. For increasing concentrations of Gd in the medulla, as determined by ICP analysis, two relaxation rates are required to account for the data, due to compartmentalization of tissue water and inhomogeneous distribution of Gd. These results, and similar data after mild mechanical disruption of renal structures, show unequivocally that the Gd in the renal medulla remains the chelate complex Gd(DTPA) and rotationally mobile, for dosages up to 300 mumoles/kg injected.
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PMID:Magnetic field dependence (NMRD profile) of 1/T1 of rabbit kidney medulla and urine after intravenous injection of Gd(DTPA). 377 Nov 56

The authors present the policy they have worked out for hydrocephalus patients with special reference to the pressure measurement and test methods and to rCBF, SPECT and transcranial Doppler sonography (TDC) studies. For diagnosis, the protocol proposed by Gjerris and Borgesen was followed in 75 cases: besides other methods (CT, radionuclide cisternography, MRI) the intracranial pressure waves routinely recorded and analyzed by means of ventricular catheters for 24 h. The patients were roughly divided into groups in terms of diagnosis, baseline pressure, compliance, results of infusion tests and of surgery. In 13 patients the investigations were supplemented by rCBF SPECT and in 42 patients by TCD studies before and after CSF shunting or withdrawal to analyze the acute effects on cerebral circulation. Clinical follow-up shows that need for shunting was indicated fairly well by the common results of baseline ICP, compliance and infusion loading. The rCBF SPECT studies revealed a significant increase of the cerebral perfusion at the basal ganglia after shunting while, on the basis of CBF velocity changes three types of vasoregulatory response could be defined with TCD. In our hands, monitoring of the pressure and craniospinal capacity has proved to be a valuable aid in decisions on surgery; however, for a more precise (and beneficial) appreciation of whether surgery is indicated the vasoregulatory responses should also be taken into account in future.
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PMID:Our policy in diagnosis and treatment of hydrocephalus. 775 7

Sprodiamide Injection (S-043 Injection, Nycomed Salutar; WIN 59080, Sterling Winthrop) is a magnetic susceptibility-based MRI contrast agent which contains 500 mM dysprosium diethylenetriaminepentaacetic acid bis(methylamide) (DyDTPA-BMA), and 25 mM caldiamide sodium (CaNaDTPA-BMA). A study was conducted to evaluate clearance of drug in cynomolgus monkeys. Eighteen cynomolgus monkeys, divided into three groups of six animals each, were administered Sprodiamide Injection intravenously at dose levels of 0.25, 0.5 and 2.5 mmol kg-1, respectively. The concentration of dysprosium in serum was determined in a monkey serum-hydrochloric acid matrix by inductively-coupled plasma atomic emission spectrometry (ICP-AES). The ICP-AES method was demonstrated to be valid for sensitivity, precision, accuracy, and specificity. The dynamic range was linear from 0 to 50 micrograms ml-1 and the limit of quantification was 24 ng ml-1. The measured dysprosium concentration in monkey serum ranged from 0 to 339 micrograms ml-1 for the 0.25 mmol kg-1 Sprodiamide Injection dose group, from 0 to 633 micrograms ml-1 for the 0.5 mmol kg-1 and from 0 to 2920 micrograms ml-1 for 2.5 mmol kg-1 dose groups. Dysprosium was not detected after 480 min in any of the serum samples from the 0.25 and 0.5 mmol kg-1 dose groups after the administration of Sprodiamide Injection. All the monkeys in the 2.5 mmol kg-1 dose group, with one exception, required 720 min for clearance of the drug from the serum. The drug was completely cleared from serum in all monkeys within 24 h.
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PMID:Determination of dysprosium in monkey serum by inductively-coupled plasma atomic emission spectrometry (ICP-AES) after the administration of Sprodiamide Injection, a new contrast medium for magnetic resonance imaging. 812 24

Cerebrovascular disease may be secondary to various disorders including hypothyroidism, sepsis, neoplasia, hypertension, vascular malformation, and coagulopathy. Brain infarction or hemorrhage should be suspected in an animal with a sudden onset of a focal brain lesion. The recent availability of CT and MRI has improved our ability to diagnose cerebrovascular disease in animals. Treatment is directed at maintaining adequate oxygenation of the brain, controlling elevations of ICP, treating seizures, and identifying and treating any underlying disease. With appropriate care, many animals can recover.
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PMID:Cerebrovascular disease. 881 57

Within 27 months 122 patients with severe head injury were treated at our clinic. Of these patients twelve (9.8%) were categorized as having a primary brain stem lesion (9 male and 3 female, mean age 28.3 years (17 to 73 years). Their injuries were caused primarily by traffic accidents. Initial and follow-up CT ruled out mass lesions or other causes for transtentorial herniation, supporting the diagnosis of primary brain stem lesion. Respiratory insufficiency and control of vegetative function demanded artificial ventilation and analog-sedation for up to 32 days (mean 18 days) on our Intensive Care Unit. In all patients we performed initial and follow-up CT scans, ICP monitoring, evoked potentials (AEP, SSEP) and TCD. MRI was carried out in four patients. One patient died during the acute hospital phase, 7 were transferred in poor and four in good condition. During rehabilitation one patient died, two, one in a vegetative state and one in poor condition were transferred to a caring facility. Eight patients with a good or moderate recovery were dismissed home, subsequently regaining their prior social function. The primary traumatic brain stem lesion presents as a dramatic clinical picture. As shown in our series the prognosis is good independent of the duration of coma. The important prognostic factors were the primary neurological state according to the Gerstenbrand and Luecking classification, the degree of the brain stem lesion in CT scan and MRI, and normal evoked potentials, indicating a favourable outcome.
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PMID:[Primary traumatic midbrain syndrome--follow-up and prognosis of acute primary brain stem damage]. 902 54

Leptomeningeal cyst as a rare complication of skull fracture in children is well documented. Most cases occur months or years after the original skull fracture, with characteristic roentgenogram findings. The authors report two cases of leptomeningeal cysts in children less than two years old. The association of hygroma, severe brain injury, increased ICP, and early development of leptomeningeal cyst are discussed. Both patients sustained parietal diastatic skull fracture and developed external brain herniation within 10 days after motor vehicle accidents. Clinically they presented with seizure, hemiparesis, and an enlarging subgaleal mass over the skull fracture. MRI demonstrated severe underlying brain contusion, hygroma around the fracture site, and brain herniation through the skull fracture. Surgical repair of dural laceration and cranioplasty produced good results. The development of hygroma and increased intracranial pressure might account for the early development of leptomeningeal cysts in these two cases.
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PMID:Early onset of leptomeningeal cyst with severe brain herniation: report of two cases. 926 58


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