Choroid Plexus Enlargement and Allostatic Load in Schizophrenia.

Although schizophrenia is a brain disorder, increasing evidence suggests that there may be body-wide involvement in this illness. However, direct evidence of brain structures involved in the presumed peripheral-central interaction in schizophrenia is still unclear. Seventy-nine previously treatment-naïve first-episode schizophrenia patients who were within 2-week antipsychotics initial stabilization, and 41 age- and sex-matched healthy controls were enrolled in the study. Group differences in subcortical brain regional structures measured by MRI and the subclinical cardiovascular, metabolic, immune, and neuroendocrine biomarkers as indexed by allostatic load, and their associations were explored. Compared with controls, patients with schizophrenia had significantly higher allostatic load (P = .001). Lateral ventricle (P < .001), choroid plexus (P < .001), and thalamus volumes (P < .001) were significantly larger, whereas amygdala volume (P = .001) was significantly smaller in patients. The choroid plexus alone was significantly correlated with higher allostatic load after age, sex, education level, and the total intracranial volume were taken into account (t = 3.60, P < .001). Allostatic load was also significantly correlated with PANSS positive (r = 0.28, P = .016) and negative (r = -0.31, P = .008) symptoms, but in opposite directions. The peripheral multisystemic and central nervous system abnormalities in schizophrenia may interact through the choroid plexus during the early stage of the illness. The choroid plexus might provide a sensitive structural biomarker to study the treatment and prevention of brain-periphery interaction abnormalities in schizophrenia.

Bilateral Thalamic Edema from Coexisting Choroid Plexus Arteriovenous Malformation and Sinus Thrombosis: Case Report.

Bilateral thalamic dysfunction secondary to venous congestion may result from either venous sinus thrombosis or high flow arteriovenous malformations or a combination of both. We present a case of bilateral thalamic edema resulting from concomitant choroid plexus arteriovenous malformation (AVM) and straight sinus thrombosis and describe our treatment approach. The patient presented with several weeks of progressive confusion and memory deficits. Magnetic resonance imaging and venography (MRI/ MRV) showed bilateral thalamic T2 hyperintensities and straight sinus thrombosis. Subsequent cerebral angiography revealed a choroid plexus AVM within the right lateral ventricle. The patient underwent surgical resection of the AVM resulting in postoperative resolution of bilateral thalamic edema on MRI and improvement of his confusion and memory deficits. This case demonstrates a rare example of reversible bilateral thalamic edema secondary to venous hypertension from both an AVM and sinus occlusion after appropriate treatment of the AVM.

Rapid high dose (RHD) contrast cranial computed tomography: a concise review of normal anatomy.

This study illustrates detailed cerebral anatomy that can be consistently visualized on computed tomography scans after a rapid high dose of contrast substance has been infused. A thorough knowledge of anatomy is required not only to detect and precisely localize lesions but to avoid ascribing pathological significance to normal, contrast enhanced structures.

Sustained tumour opacification in infants during cerebral angiography.

Total body opacification in infants following the intravenous injection of a large dose of water soluble contrast medium has long been recognised, but no example of increased radiodensity of abdominal or intracranial tumours has been reported using this technique. This paper reports the sustained opacification of intracranial tumours in three infants during cerebral angiography. Two of the tumours were papillomas of the choroid plexus of the lateral ventricle and the third a medulloblastoma of the fourth ventricle. Three possible explanations of this phenomenon are briefly considered: 1. That the amount of contrast medium was sufficient to cause total body opacification and the visibility of the tumours was due to a combination of their vascularity and the iodine concentration in the circulation blood. 2. That the observed phenomenon is peculiar to these tumours. 3. That the sustained opacity of these these tumours is due to the same cause or causes as the density enhancement of some intracranial tumours demonstrated by computerised tomography after intravenous injection of contrast medium.