Quantitative phase-contrast MRI study of cerebrospinal fluid flow: a method for identifying patients with normal-pressure hydrocephalus.

OBJECTIVES: The aim of this study is to evaluate the use of phase-contrast MR imaging to diagnose normal pressure hydrocephalus (NPH) and differentiate it from other neurological disorders with similar clinical symptoms. METHODS: The study included 108 subjects, of whom 61 were healthy controls and 47, patients; in the patient group, 19 had cerebrovascular disease (CVD) and 28 had NPH. All patients underwent a phase-contrast MRI study and several CSF flow and velocity parameters were measured at the aqueduct of Sylvius. Discriminant analyses were performed to evaluate the classification capacity of both individual parameters and the combination of different parameters. RESULTS: Maximum diastolic velocity, mean flow, and stroke volume showed statistically significant differences that could be used to distinguish between NPH and CVD patients (P<.001). Stroke volume and mean flow showed no false positive results and successful classification rates of 86% and 79%, respectively. No other parameters or combination produced better results. CONCLUSIONS: Phase-contrast MR imaging is a useful tool for the early diagnosis of patients with NPH. CSF flow quantitative parameters, along with morphological features in a conventional MR study, enable us to differentiate between NPH and CVD patients.

Presence of plastic particles in waterbirds faeces collected in Spanish lakes.

Plastic intake by marine vertebrates has been widely reported, but information about its presence in continental waterfowl is scarce. Here we analyzed faeces of waterbirds species (European coot, Fulica atra, mallard, Anas platyrhynchos and shelduck, Tadorna tadorna) for plastic debris in five wetlands in Central Spain. We collected 89 faeces of shelduck distributed in four lakes, 43.8% of them presented plastic remnants. Sixty percent of 10 faeces of European coot and 45% of 40 faeces of mallard contained plastic debris. Plastic debris found was of two types, threads and fragments, and were identified as remnants of plastic objects used in agricultural fields surrounding the lakes. Differences in prevalence of plastic in faeces, number of plastic pieces per excrement and size of the plastic pieces were not statistically significant between waterfowl species. Thus, our results suggest that plastic may also be frequently ingested by waterfowl in continental waters, at least in our study area. Future studies should address this potential problem for waterbird conservation in other wetlands to evaluate the real impact of this pollutant on waterbirds living in inland water.

[Spontaneous dissection of the internal carotid artery. A report of two cases]. / Disección espontánea de la arteria carótida interna. Presentación de dos casos.

INTRODUCTION: Dissection of the internal carotid artery is a condition with a broad clinical spectrum. In absence of the classical triad of cervical pain, oculosympathetic ipsilateral paralysis and ischemic cerebral symptoms a considerable index of clinical suspicion is necessary to make a diagnosis. It is therefore considered to be probably underdiagnosed. The development of new techniques for neurovascular investigation, particularly ultrasound and magnetic angioresonance have improved the possibilities of diagnosis. CLINICAL CASES: In this paper we describe two cases of dissection of the internal carotid artery representing different clinical findings in the same condition. One patient presented with unilateral paralysis of the XI, X and XII cranial nerves and the other with transient ischemic cerebral accidents. In both cases the provisional diagnosis was made in function of the duplex findings of the supra-aortic trunks and confirmed by magnetic angioresonance studies. Both patients made satisfactory progress with complete recanalization of the vessels and no recurrence of symptoms after several months of follow-up. CONCLUSION: We discuss the different clinical characteristics and findings of the neurovascular examinations.

[Arterial hypertension and intracerebral hemorrhage]. / Hipertensión arterial y hemorragia intracerebral.

Intracerebral hemorrhage (ICH) is still a devastating stroke, with high mortality. Arterial hypertension (AHT) is the most common cause of primary ICH, causing changes in the wall of small vessels, leading to its rupture. Recent studies have attempted to understand the basic mechanisms of tissue damage around the hematoma. These days there is a debate regarding biochemical changes in this area, usually recognized as edema. Detection with the gradient-echo T2 weighted MRI of old and silent microhemorrhages in a patient with ICH as a radiological expression of a microangiopathy of small vessel poses questions regarding its predictive value of risk of bleeding recurrence. The object of our review is to analyze the present data that explains the interaction between chronic hypertension and primary ICH.