RESUMEN
We present a case of cerebral fat embolism (CFE) that demonstrated evidence of diffuse white matter cytotoxic edema on diffusion-weighted magnetic resonance imaging, in addition to punctate hyperintensities on T2-weighted and diffusion-weighted imaging. The case suggests that CFE represents a combination of occlusive arteriolar disease and secondary neurotoxicity.
Asunto(s)
Edema Encefálico/diagnóstico , Edema Encefálico/etiología , Imagen de Difusión por Resonancia Magnética , Embolia Grasa/complicaciones , Embolia Grasa/diagnóstico , Embolia Intracraneal/complicaciones , Embolia Intracraneal/diagnóstico , Adolescente , Femenino , HumanosRESUMEN
We report on the use of serial proton MR spectroscopy ((1)H MRS) to differentiate between glioma and tumefactive plaque in a known multiple sclerosis (MS) patient who developed a symptomatic cerebral space occupying lesion. Gliomas and acute MS plaques may have indistinguishable chemical resonance spectra, whereas that of chronic plaque is distinct. In our case (1)H MRS demonstrated elevated concentrations of choline, lactate and lipid, with reduced N-acetyl aspartate, a pattern consistent with either low grade glioma or acute demyelinating plaque. A repeat study 4 months later showed no change, this was felt to be incompatible with the natural history of an acute plaque and low grade glioma was diagnosed. Surgical removal of the lesion revealed an oligodendroglioma, confirming the imaging findings.
Asunto(s)
Neoplasias Encefálicas/diagnóstico , Glioma/diagnóstico , Esclerosis Múltiple/diagnóstico , Adulto , Corteza Cerebral , Diagnóstico Diferencial , Humanos , Espectroscopía de Resonancia Magnética/métodos , Masculino , ProtonesRESUMEN
Giant cell arteritis is a common condition that can result in permanent visual loss. It has traditionally been diagnosed by invasive temporal artery biopsy in cases of clinical suspicion. The findings of colour duplex ultrasound have recently been described. We report the use of duplex ultrasound to diagnose temporal arteritis, with clinicopathological correlation, and discuss the possible application of this non-invasive technique to the management of giant cell arteritis.
Asunto(s)
Arteritis de Células Gigantes/complicaciones , Arteritis de Células Gigantes/diagnóstico por imagen , Trastornos de la Visión/etiología , Anciano , Anciano de 80 o más Años , Femenino , Arteritis de Células Gigantes/patología , Humanos , Ultrasonografía Doppler en ColorAsunto(s)
Nervio Óptico/patología , Osteopetrosis/diagnóstico , Cráneo/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Nervio Óptico/diagnóstico por imagen , Enfermedades del Nervio Óptico/diagnóstico , Enfermedades del Nervio Óptico/etiología , Osteopetrosis/complicaciones , Osteopetrosis/diagnóstico por imagen , Cráneo/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Cervical spondylosis is an extremely common condition causing spinal cord compression, and yet it very rarely causes secondary syrinx formation. We report a case of cervical spondylosis with associated syringomyelia and review the possible pathogenesis of this condition.
Asunto(s)
Osteofitosis Vertebral/complicaciones , Siringomielia/etiología , Anciano , Humanos , Imagen por Resonancia Magnética , Masculino , Osteofitosis Vertebral/diagnóstico , Siringomielia/diagnósticoRESUMEN
We report MRI findings in a patient with familial hemiplegic migraine (FHM) with repeated episodes of hemiparesis. FHM is caused by a penetrant autosomal dominant genetic mutation; several mutations have been genotyped, involving brain-expressed ion channels. We found cerebral oedema, dilatation of intracerebral vessels and decreased water diffusion contralateral to the hemiparesis, not respecting vascular territories, with subsequent complete resolution of both clinical and imaging abnormalities. These results are thought to be consistent with an underlying primary neuronal pathology with secondary vascular effects, as opposed to the traditional, primarily vascular, model of migraine aetiology.