Orbital Venous Varices: A Rare Bilateral Asymptomatic Presentation.

This report illustrates a case of asymptomatic bilateral orbital varices in a 64-year-old Caucasian male. The orbital varices were incidentally discovered while investigating the patient's initial presentation of bilateral chorioretinal scars and optic nerve head drusen. Magnetic resonance imaging (MRI) of the brain and orbits with contrast confirmed the presence of bilateral varices of the inferior ophthalmic veins and pterygoid plexuses. The occurrence of bilateral orbital varices is quite rare, and few asymptomatic cases have been described in the literature.

Functional MR imaging study of language-related differences in bilingual cerebellar activation.

BACKGROUND AND PURPOSE: Reports in the monolingual literature suggest that the cerebellum has an important role in language processing. The purpose of this study was to determine whether bilingual cerebellar functional MR imaging (fMRI) activation differs during the performance of comparable tasks in subjects' primary and secondary languages. METHODS: Eight bilingual, right-handed individuals underwent echo-planar fMRI at 1.5 T. They performed semantic (noun-verb association) and phonological (rhyming) tasks in Spanish (primary language) and English (secondary language). Individual and group functional datasets were analyzed using Statistical Parametric Mapping software (SPM99; P <.001 with a 10-voxel spatial extent threshold) and overlaid on T1-weighted anatomic images normalized to a standard (Montreal Neurologic Institute) space. Analysis of variance was performed on laterality indices derived from voxel counts in cerebellar regions of interest (ROIs). Subtraction of group-averaged normalized results from the combined Spanish tasks from the combined English tasks was also performed within SPM99 (P <.001 activation threshold). RESULTS: Significantly greater lateralilty indices were noted in the English tasks than in the Spanish tasks (mean Spanish LI, 0.3286; mean English LI, 0.5141 [P =.0143]). Overall, more robust activation was seen in the English tasks than in the Spanish tasks. Areas of significantly greater activation existed in the English tasks as compared with the Spanish tasks; these areas were more prominent in the left cerebellar hemisphere. CONCLUSION: Although both English and Spanish language tasks demonstrate left cerebellar dominance, English tasks demonstrate greater left hemispheric lateralization.

Mineralization of the basal ganglia: implications for neuropsychiatry, pathology and neuroimaging.

This article examines the evidence for and against the existence of basal ganglia mineralization as a defined clinico-pathological entity. In reviewing the literature on basal ganglia mineralization, this article emphasizes evidence derived from different neuroimaging modalities, genetics, metabolic studies, postmortem series and their possible neuropsychiatric correlates. Relevant articles were collected through Medline and Index Medicus searches. Researchers have encountered multiple difficulties in accepting basal ganglia mineralization as a distinct entity. This syndrome lacks set clinical criteria or a unique etiology; not surprisingly, numerous articles have applied varied definitions. Because many of the reported cases have not been examined postmortem, both the extent and nature of their mineralization remains uncertain. Furthermore, researchers have considered small foci of basal ganglia mineralization a normal phenomenon of aging. However, when brain deposits are extensive, they are associated with a set of age-dependent, progressive clinical symptoms. They include cognitive impairment, extrapyramidal symptoms and psychosis. Most cases are related to abnormalities of calcium metabolism, but rare familial cases of idiopathic origin have been reported. Overabundant mineralization of the brain is judged pathological based on its amount, distribution and accompanying clinical symptoms. Although its relation with calcium dysregulation is well known, modern studies have emphasized abnormalities of iron and dopamine metabolism. The authors suggest that these metabolic abnormalities may link basal ganglia mineralization to psychotic symptomatology.

Reduced brain size and gyrification in the brains of dyslexic patients.

Dyslexia is a specific learning disability that affects the way in which a person acquires reading skills. The pathologic substrate of the condition has been debated in the literature. Conclusions from postmortem studies remain controversial because series have been based on few and often ill-characterized cases. The present article expands on one of the reported neuropathologic findings in dyslexia, that is, wider minicolumns. Measurements were made of magnetic resonance images in a series of 16 dyslexic and 14 age- and sex-matched controls. Dyslexic patients had significantly smaller total cerebral volume (P = .014) and reduced gyrification index (P = .021). No changes were noted in cortical thickness, the ratio of gray to white matter, or the cross-sectional areas of the corpus callosum and medulla oblongata. The findings, although not conclusive, are in keeping with a minicolumnar defect in dyslexia. The decreased gyrification and preserved cortical thickness can alter the information processing capacity of the brain by providing a greater degree of cortical integration at the expense of a slower response time. The article also emphasizes the contrast between findings in dyslexia and in autism.

Functional MRI study of semantic and phonological language processing in bilingual subjects: preliminary findings.

The objective of the study was to explore differences in regional fMRI activation topography and lateralization between semantic and phonological tasks performed in English and Spanish in bilingual individuals. Eight bilingual (primary Spanish and secondary English-speaking) individuals performed fMRI noun-verb association and rhyming tasks in both Spanish and English. Functional dataset analysis within Statistical Parametric Mapping (SPM99) with overlay on T1-weighted anatomic images was performed. Significantly higher laterality indices were noted in the semantic tasks as compared with the phonological tasks in the anterior regions of interest comprising the frontal and superior temporal lobes. A task subtraction analysis demonstrated right hemispheric (inferior frontal gyrus and supramarginal gyrus) foci of significantly increased activation in the combined language phonological tasks compared to the combined language semantic tasks; similarly prominent right hemispheric activation was seen in the English phonological-English semantic subtraction, but the analogous Spanish task subtraction revealed no task-related differences. This divergence in activation topography between semantic and phonological tasks performed in the nonnative language, but not in the primary language, suggests that neural networks utilized for phonological and semantic language processing in the nonnative language may not be as similar as those in the primary language.

Compromiso pulmonar en esclerosis tuberosa

La esclerosis tuberosa (ET) es una rara enfermedad hereditaria caracterizada por el desarrollo de nódulos hamartomatosos en casi todos los órganos. El pulmón está comprometido en menos del 1 por ciento de estos pacientes. Se presenta un caso de ET con compromiso pulmonar

Neuroimagen de la toxoplasmosis en el paciente con Sida / Tomographic images in patient with AIDS and neurologic syptoms

Se realiza la revisión de la literatura del compromiso del SNC en el paciente con SIDA, ilustrando los casos con imágenes de pacientes atendidos en el HSJD. Se propone un árbol de decisiones en pacientes con sintomatología neurológica y diagnóstico de SIDA