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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical features of patients with hydrocephalus include generalized reductions in coordinated motor and cognitive functions. Although some group similarities have been noted, the outward manifestations of this dysfunction vary in degree and character, with some subjects revealing no overt signs of the underlying hydrocephalus. A retrospective review of subjects with MR criteria of hydrocephalus was undertaken to reevaluate the specific imaging correlates of the signs and symptoms associated with this pathologic process. Forty adults with hydrocephalus on MR evaluation were carefully scrutinized in an effort to elucidate specific clinicoradiologic patterns of abnormality. Spin-echo MR techniques were used with T1 and/or T2 weighting in three orthogonal planes. MR criteria of hydrocephalus encompassed dilated lateral ventricles to include the temporal horns, a pronounced upward elevation of the corpus callosum, and an outward expansion of the cerebral hemispheres at the expense of the subarachnoid space overlying the convexities. The significant related morphologic change on MR that has not been previously described in hydrocephalus was a localized dorsal flattening and thinning of the posterior body of the corpus callosum. Importantly, all but three of the 24 patients with this phenomenon manifested varying combinations of imbalance, gait disturbance, incontinence, short-term memory deficits, and global dementia. In the presence of hydrocephalus, but in the absence of this specific callosal configuration, only one of the remaining 16 subjects revealed symptoms that might suggest the presence of hydrocephalus (i.e., profound dementia). The structure responsible for this focal callosal flattening and thinning in hydrocephalus is the rigid free surface of the falx cerebri as it impinges on the caudal extent of the upwardly expanding corpus callosum and supracallosal hippocampal formation. This mechanical insult hypothetically causes variable axonal dysfunction, ranging from decreased to increased neurophysiologic activity. In summary, it is postulated that callosal impingement represents a dynamic partial hemispheric disconnection and accounts, in part, for the complex clinical state associated with hydrocephalus.
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PMID:Clinical manifestations of hydrocephalus caused by impingement of the corpus callosum on the falx: an MR study in 40 patients. 190 38

This study was undertaken to identify findings on magnetic resonance (MR) imaging that might possibly differentiate among several dementia states in the elderly or predict response to shunt therapy in patients with normal-pressure hydrocephalus (NPH). The MR findings were retrospectively reviewed in 54 patients who were divided into four clinical categories: NPH (17 patients), obstructive hydrocephalus (eight patients), Alzheimer disease (eight patients), and non-Alzheimer dementia (21 patients). Three MR findings were evaluated in each case: increased periventricular (PVS) and white matter (WMS) signal on T2-weighted images, CSF flow void sign (CFVS) in the aqueduct, and corpus callosum thinning. Neither the PVS/WMS nor corpus callosum thinning patterns were useful for distinguishing among the four clinical groups. At low field strength, the absence of a marked or moderate CFVS, however, may militate against a diagnosis of NPH. All 17 patients with NPH underwent a shunt procedure after the MR study. A better response to shunt therapy occurred in patients without WMS and with more severe PVS.
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PMID:MR findings in normal-pressure hydrocephalus: significance and comparison with other forms of dementia. 368 Jul 6

We report three patients with slowly progressive spastic paraplegia and dementia; MRI on these patients revealed hypoplasia of the corpus callosum. The mode of inheritance was supposed to be autosomal recessive. Patient 1 (26-year-old man) is an elder brother of patient 2 (21-year-old man). Their parents are first cousins. Patient 3 (woman), a sporadic case, died of pneumonia at the age of 44. Their motor development after the birth was normal, but patient 3 was mildly mentally retarded. Gait disturbance due to spastic paraplegia developed at the age of nine (patient 2), fifteen (patient 1) and nineteen (patient 3), respectively. They also showed slowly progressive mental deterioration. Patient 1 has also suffered from mild amyotrophy and sensory disturbance in the distal part of the extremities since the age of 25. Patient 3 was bed-ridden at the middle of her thirty's because of generalized amyotrophy and sensory disturbance in addition to spastic quadriplegia and profound dementia. Their MRI reveal the thinning of the corpus callosum. We think the thinning must be hypoplasia of the corpus callosum, because the cerebrum showed normal appearance on MRI in patient 1 and patient 2. These clinical findings and imaging studies are essentially similar to those of the cases reported by Iwabuchi et al (1991). We propose autosomal recessive HSP associated hypoplasia of the corpus callosum as a new type of HSP.
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PMID:[Three patients of complicated form of autosomal recessive hereditary spastic paraplegia associated with hypoplasia of the corpus callosum]. 782 9

The present study aimed at relating dementia, pseudo-neurasthenic and affective organic brain syndromes to underlying type of CSF flow disorder and to subsequent alteration of anatomy. T2*-weighted magnetic resonance imaging (MRI) in the midsagittal plane permitted an analysis of aqueductal CSF flow phenomena and hydrocephalus-induced elevation, thinning and dorsal impingement of the corpus callosum. Furthermore, the width of the third ventricle was measured on the transverse scout images. 72 patients with communicating hydrocephalus (increased aqueductal CSF pulsations) and 26 patients with aqueductal stenosis (absence of aqueductal flow phenomena) were compared with 22 controls. Dementia and affective disorders were distributed equally among both CSF flow subgroups whereas pseudo-neurasthenic syndromes were observed more frequently in non-communicating hydrocephalus (p < 0.03). Alzheimer-type and multiinfarct dementia syndromes were found more frequently in communicating hydrocephalus whereas non-classifiable dementia showed some predilection for non-communicating hydrocephalus. Callosal height, area and third ventricular width did not predict affective or pseudoneurasthenic disorder whereas third ventricular width (p < 0.01) and callosal area (p < 0.05) discriminated between demented and non-demented patients. Dorsal impingement of the corpus callosum by the falx was a non-specific finding.
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PMID:Disturbances of cerebrospinal fluid (CSF) circulation--neuropsychiatric symptoms and neuroradiological contribution. 857 10

Autosomal dominant, autosomal recessive and X-linked recessive varieties of spastic paraplegia have been recognized. Recently, Japanese patients with complicated form of autosomal recessive hereditary spastic paraplegia (HSP) associated with hypoplasia of the corpus callosum have been reported by Iwabuchi et al. We describe a patient with complicated HSP (Iwabuchi type) and cataracta. A 38-year-old man (his parents were a second cousin) was born uneventfully. His motor development was normal. Motor and mental dysfunctions were noticed during the lower classes of an elementary school. He could ride a bicycle at 18 years old but gradually developed galt disturbance and confined to wheelchair since 35 years. He was admitted to our hospital on February 25, 1994. A neurological examination showed mental retardation, dementia, cataracta, cerebellar ataxia, rigidity, spasticity, severe atrophy of the distal muscles of his extremities, paraparesis, hyperreflexia, positive Hoffmann reflexes and Babinski signs, pes cavus and hammer toes. Brain MRI showed thinning of corpus callosum. Clinical and laboratory findings did not support a diagnosis of metabolic disorders showing spastic paraparesis including adrenomyeloneuropathy, Globoid leukodystrophy, metachromatic leukodystrophy, cerebrotendinous xanthomatosis, Arginase deficiency. We considered that our patient was complicated form of HSP (Iwabuchi et al). However, cataract has not been found in Iwabuchi type of HSP. We discussed here other reports showing cataracta with spastic paraparesis.
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PMID:[A case of complicated form of hereditary spastic paraplegia associated with hypoplasia of the corpus callosum and cataracta]. 877 6

Dementias and other severe cognitive dysfunction states pose a daunting challenge to existing medical management strategies. An integrative, early intervention approach seems warranted. Whereas, allopathic treatment options are highly limited, nutritional and botanical therapies are available which have proven degrees of efficacy and generally favorable benefit-to-risk profiles. This review covers five such therapies: phosphatidylserine (PS), acetyl-l-carnitine (ALC), vinpocetine, Ginkgo biloba extract (GbE), and Bacopa monniera (Bacopa). PS is a phospholipid enriched in the brain, validated through double-blind trials for improving memory, learning, concentration, word recall, and mood in middle-aged and elderly subjects with dementia or age-related cognitive decline. PS has an excellent benefit-to-risk profile. ALC is an energizer and metabolic cofactor which also benefits various cognitive functions in the middle-aged and elderly, but with a slightly less favorable benefit-to-risk profile. Vinpocetine, found in the lesser periwinkle Vinca minor, is an excellent vasodilator and cerebral metabolic enhancer with proven benefits for vascular-based cognitive dysfunction. Two meta-analyses of GbE demonstrate the best preparations offer limited benefits for vascular insufficiencies and even more limited benefits for Alzheimer's, while "commodity" GbE products offer little benefit, if any at all. GbE (and probably also vinpocetine) is incompatible with blood-thinning drugs. Bacopa is an Ayurvedic botanical with apparent anti-anxiety, anti-fatigue, and memory-strengthening effects. These five substances offer interesting contributions to a personalized approach for restoring cognitive function, perhaps eventually in conjunction with the judicious application of growth factors.
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PMID:A review of nutrients and botanicals in the integrative management of cognitive dysfunction. 1038 79

APOE4 homozygosity has been associated with an increased risk of sporadic Alzheimer's disease through a mechanism, which has yet to be defined. Recent evidence has suggested that microvascular basement membrane injury may be a critical factor in the pathogenesis of AD-related dementia. In previous studies, we have shown that the synaptic organizing protein agrin can be found in neurons, and is a major component of the brain microvascular basement membrane. Here, we compare the basement membrane surface area of cortical microvasculature in AD brains by staining with an anti-agrin antibody. Quantitative morphometric analysis was used to determine the mean basement area (micro(2)) of prefrontal cortical microvessels. An average of 10 capillaries was measured in each of 35 cases of AD genotyped for APOE status. APOE4,4 homozygotes had smaller capillary basement membrane areas (17.4 micro(2))+/-6.2) than APOE3,3 homozygotes (26.9 micro(2)+/-6.5), p<0.001. The capillary basement membrane areas (CBMA) of heterozygotes APOE3,4 did not differ significantly from APOE3,3 or APOE4,4. Braak stage did not contribute significantly to CBMA. However, a preliminary analysis suggests an interaction between APOE4,4 and Braak V-VI producing smaller CBMA, a finding which needs to be confirmed with a larger sample. These data support the hypothesis that APOE4,4 is associated with thinning of the microvascular basement membrane in Alzheimer's disease.
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PMID:Effect of APOE genotype on microvascular basement membrane in Alzheimer's disease. 1241 81

Brain MRI is an important method for examining the diseases caused by various cerebral pathologies, and the measurement of temporal lobe volume is useful for identifying dementia and temporal lobe abnormalities. However, no segmentation algorithm for the temporal lobe on coronal MR images has been established. Such an algorithm is needed because the shape of the temporal lobe on coronal images varies from area to area. The purpose of this research was to develop a segmentation method for the posterior portion of the temporal lobe on coronal MR images. The subjects were 11 normal patients, whose coronal T(1)-weighted images were selected for this study. The preprocessing algorithm for segmentation consists of smoothing, binarization, and thinning. The first step of the segmentation process consists of recognition techniques for the temporal lobe region on thinning images. The next step is distance transformation on identified thinning images. Finally, the temporal lobe was segmented by using the original images and distance transformation images and employing the newly developed algorithm. The rate of accuracy of automated recognition was over 74% for all cases, while the average rate of accuracy was 83.2+/-4.0%. These results suggest that this segmentation method can clearly segment the temporal lobe and has potential for clinical use. Based on this study, although it included only 11 normal patients, we have started applying this segmentation method to many patients, with or without temporal lobe disease.
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PMID:[Development of automated segmentation method for the posterior portion of the temporal lobe on coronal MR images]. 1498 28

To elucidate MR imaging changes of the substantia innominata in Parkinson's disease (PD), using a 1.5-T superconductive MR unit, the thickness of the substantia innominata was measured on coronal thin-section images in 44 PD patients and 20 age-matched control subjects. We also evaluated the correlation between the thickness of the substantia innominata and mental status in PD patients. Mean thickness of the substantia innominata was 2.3 mm in PD patients, and 2.5 mm in control subjects. Thinning of the substantia innominata was statistically significant in PD patients compared with control subjects, although there were large overlaps. Among the PD patients, thinning was remarkable in cases with dementia. A positive correlation between thickness of substantia innominata and score of Mini-Mental-Status-Examination was also observed in PD patients. Atrophy of the substantia innominata was demonstrated, especially in PD patients with cognitive impairment, on coronal MR images, and this is compatible with the previous pathological reports.
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PMID:Substantia innominata: MR findings in Parkinson's disease. 1531 99

The hereditary spastic paraplegias (HSPs) are a group of rare disorders with the predominant clinical feature of progressive spastic paraplegia. They are subdivided into pure and complicated forms according to whether the disorder is associated with other neurological abnormalities. We report on two unrelated female Caucasian patients with complicated HSP, aged 16 and 24 years, who showed progressive gait disturbance with spasticity and ataxia as well as cognitive impairment. Onset of symptoms was at age 3 and 10 years, respectively. MRI revealed mild diffuse non-progressive T (2)-signal alterations of cerebral white matter and thinning of the body and genu of the corpus callosum. Some similarity of clinical symptoms and MRI patterns with the phenotype of Mast syndrome prompted a mutation analysis of the SPG21 gene, encoding maspardin, which revealed a wild-type sequence in both patients. Clinical and neuroradiological features in our patients are diagnostic for complicated autosomal recessive hereditary spastic paraplegia with thin corpus callosum (HSP-TCC, SPG11). This disorder, characterized by a typical MRI pattern and a progressive spastic paraplegia that may be associated with dementia and ataxia, may have an onset in early childhood and probably is one of the more common forms of complicated HSP.
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PMID:Complicated hereditary spastic paraplegia with thin corpus callosum (HSP-TCC) and childhood onset. 1613 54


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