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1.
Adv Exp Med Biol ; 1131: 73-91, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31646507

RESUMO

Imaging techniques may overcome the limitations of electrode techniques to measure locally not only membrane potential changes, but also ionic currents. Here, we review a recently developed approach to image native neuronal Ca2+ currents from brain slices. The technique is based on combined fluorescence recordings using low-affinity Ca2+ indicators possibly in combination with voltage sensitive dyes. We illustrate how the kinetics of a Ca2+ current can be estimated from the Ca2+ fluorescence change and locally correlated with the change of membrane potential, calibrated on an absolute scale, from the voltage fluorescence change. We show some representative measurements from the dendrites of CA1 hippocampal pyramidal neurons, from olfactory bulb mitral cells and from cerebellar Purkinje neurons. We discuss the striking difference in data analysis and interpretation between Ca2+ current measurements obtained using classical electrode techniques and the physiological currents obtained using this novel approach. Finally, we show how important is the kinetic information on the native Ca2+ current to explore the potential molecular targets of the Ca2+ flux from each individual Ca2+ channel.


Assuntos
Canais de Cálcio , Neuroimagem , Animais , Cálcio/metabolismo , Canais de Cálcio/fisiologia , Dendritos/fisiologia , Humanos , Potenciais da Membrana/fisiologia , Imagem Óptica , Células Piramidais/fisiologia
2.
Estud. pesqui. psicol. (Impr.) ; 18(4): 1137-1154, out.-dez. 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-994979

RESUMO

Apresenta-se um panorama da Neuropsicologia brasileira, enfocando sua inserção no país, caracterizando o momento atual e desafios à sua consolidação. Aborda-se a trajetória da Neuropsicologia, traçando-se cinco períodos que a caracterizam, bem como sua trajetória nacional. A Neuropsicologia brasileira assiste à sofisticação da neuroimagem e ao avanço da pesquisa e interesse na área, à criação de entidades representativas, ao crescente número de publicações, grupos de pesquisa e de cursos de pós-graduação, ao desenvolvimento de instrumentos brasileiros e à ampliação da normatização e validação de instrumentos estrangeiros. Apesar desses avanços, ressalta-se a necessidade de constituir uma Neuropsicologia brasileira, sintonizada com os desafios de um país diverso, que contribua com políticas públicas, produza conhecimentos que atinjam diferentes populações e contribua para a diminuição das desigualdades sociais.(AU)


This paper aims to present an overview of Brazilian neuropsychology, focusing on the way the discipline was brought to Brazil, the present panorama of the discipline, and the challenges related to its consolidation. This article addresses the historical course of Neuropsychology, mapping the five distinct periods that characterized its history, as well as its national course. Brazilian neuropsychology is currently aided by the sophistication of neuroimaging techniques, the advancement in research and the interest in the area, as well as the creation of representative professional associations, the growing number of publications, research groups and graduate courses, the development of Brazilian instruments and the increase in standardization and validation of foreign instruments. Despite these advances, it is necessary to emphasize the need to make a Brazilian Neuropsychology, in tune with the challenges that come from a diverse country, one which contributes with public policies, produces knowledge that reaches different peoples and contributes towards reducing social inequalities.(AU)


Este artículo presenta un panorama de la Neuropsicología en Brasil, enfocándose en su inserción en el país, caracterizando el momento actual y los desafíos a su consolidación. Aborda la historia de la Neuropsicología, trazando los cinco períodos que la caracterizan y su trayectoria nacional. La Neuropsicología brasileña presencia la sofisticación de las técnicas de neuroimagen y el avance de la investigación y el interés de los estudiantes y profesionales, así como la creación de órganos representativos, el creciente número de grupos de investigación, cursos postgrado y publicaciones, el desarrollo de instrumentos brasileños de evaluación neuropsicológica y la estandarización de los procesos y validación de instrumentos extranjeros. A pesar de esos avances, se destaca la necesidad de establecer una Neuropsicología brasileña, en sintonía con desafíos y urgencias de un país diverso, que contribuya con políticas públicas, produzca y ponga en práctica conocimientos que alcancen diferentes poblaciones y contribuya con la reducción de las desigualdades sociales.(AU)


Assuntos
Humanos , Psicologia Aplicada , Neuropsicologia , Pesquisa , Brasil , Neuroimagem/psicologia , História
3.
J Assoc Physicians India ; 67(10): 90-91, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31571467

RESUMO

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is one of the most common heritable cerebral arteriopathy. Responsible for stroke and dementia in young adults and can be diagnosed by skin biopsy. We report a case of a 42 year old man with recurrent transient ischemic attacks (TIA). A detailed neurologic examination revealed poor score in MMSE (20/30) defect mainly seen in recall, repetitions. Executive dysfunction, memory and language impairment were also found. Motor system examination revealed grade 3 power in right upper and lower limb with more severe weakness of distal muscles in form of grip weakness and slippage of chappals. Neuroimaging and genetic analysis for Notch-3 confirmed the diagnosis. Imaging studies suggested greater involvement in the temporal and frontal lobes along with deep areas of the brain.


Assuntos
CADASIL , Adulto , Biópsia , Infarto Cerebral , Humanos , Masculino , Neuroimagem , Acidente Vascular Cerebral
4.
Radiol Clin North Am ; 57(6): 1083-1091, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582036

RESUMO

This article reviews the current state of imaging for acute ischemic stroke. Protocolized imaging acquisition using computed tomography in conjunction with coordinated stroke care allows for rapid diagnosis and prompt revascularization. Following the initial evidence to support endovascular therapy for large-vessel occlusion, published between 2014 and 2015, there are now guidelines supporting treatment up to 24 hours after time of onset of symptoms. Neuroimaging remains a central component in diagnosing acute stroke and potentially excluding patients from stroke treatment, as outlined in this article.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Angiografia por Ressonância Magnética/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Humanos , Neuroimagem/métodos
5.
Radiol Clin North Am ; 57(6): 1163-1175, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582042

RESUMO

Primary brain tumors are the most common solid malignancy of childhood and constitute the most common cause of cancer-related death in children. It is important for the radiologist to understand the differences between pediatric and adult brain tumors. For instance, tumor type varies significantly with age; many histologic subtypes occur exclusively in childhood. An anatomic approach to pediatric brain tumors helps narrow the differential diagnosis; however, information from this approach must be considered in conjunction with recent advances in molecular subtyping of these tumors. This article emphasizes relevant clinical, molecular, and imaging features that are unique to pediatric brain tumors.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Encéfalo/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Masculino , Neuroimagem/métodos , Tomografia Computadorizada por Raios X
7.
JAMA ; 322(16): 1589-1599, 2019 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-31638686

RESUMO

Importance: Worldwide, 47 million people live with dementia and, by 2050, the number is expected to increase to 131 million. Observations: Dementia is an acquired loss of cognition in multiple cognitive domains sufficiently severe to affect social or occupational function. In the United States, Alzheimer disease, one cause of dementia, affects 5.8 million people. Dementia is commonly associated with more than 1 neuropathology, usually Alzheimer disease with cerebrovascular pathology. Diagnosing dementia requires a history evaluating for cognitive decline and impairment in daily activities, with corroboration from a close friend or family member, in addition to a thorough mental status examination by a clinician to delineate impairments in memory, language, attention, visuospatial cognition such as spatial orientation, executive function, and mood. Brief cognitive impairment screening questionnaires can assist in initiating and organizing the cognitive assessment. However, if the assessment is inconclusive (eg, symptoms present, but normal examination findings), neuropsychological testing can help determine whether dementia is present. Physical examination may help identify the etiology of dementia. For example, focal neurologic abnormalities suggest stroke. Brain neuroimaging may demonstrate structural changes including, but not limited to, focal atrophy, infarcts, and tumor, that may not be identified on physical examination. Additional evaluation with cerebrospinal fluid assays or genetic testing may be considered in atypical dementia cases, such as age of onset younger than 65 years, rapid symptom onset, and/or impairment in multiple cognitive domains but not episodic memory. For treatment, patients may benefit from nonpharmacologic approaches, including cognitively engaging activities such as reading, physical exercise such as walking, and socialization such as family gatherings. Pharmacologic approaches can provide modest symptomatic relief. For Alzheimer disease, this includes an acetylcholinesterase inhibitor such as donepezil for mild to severe dementia, and memantine (used alone or as an add-on therapy) for moderate to severe dementia. Rivastigmine can be used to treat symptomatic Parkinson disease dementia. Conclusions and Relevance: Alzheimer disease currently affects 5.8 million persons in the United States and is a common cause of dementia, which is usually accompanied by other neuropathology, often cerebrovascular disease such as brain infarcts. Causes of dementia can be diagnosed by medical history, cognitive and physical examination, laboratory testing, and brain imaging. Management should include both nonpharmacologic and pharmacologic approaches, although efficacy of available treatments remains limited.


Assuntos
Demência/diagnóstico , Demência/terapia , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/terapia , Inibidores da Colinesterase/efeitos adversos , Inibidores da Colinesterase/uso terapêutico , Antagonistas de Aminoácidos Excitatórios/efeitos adversos , Antagonistas de Aminoácidos Excitatórios/uso terapêutico , Humanos , Memantina/efeitos adversos , Memantina/uso terapêutico , Neuroimagem , Testes Neuropsicológicos
8.
Medicine (Baltimore) ; 98(38): e17211, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567974

RESUMO

This study aims to evaluate the feasibility and effectiveness of minimally invasive puncture treatment by positioning the simple bedside for spontaneous cerebellar hemorrhage.From January 2017 to March 2018, the investigators applied simple bedside positioning to perform the intracranial hematoma minimally invasive surgery for 21 patients with cerebellar hemorrhage.For these 21 patients, the bleeding amount and Glasgow Coma Scale (GCS) score before the operation were 18.5 ±â€Š5.0 cc and 9.5 ±â€Š3.3, respectively; 24 hours after the operation, the GCS score was 11.0 ±â€Š4.6. Five patients died within 7 days of the operation and the head computed tomography (CT) was re-examined. It was found that the average bleeding amount was 3.4 ±â€Š0.9 cc, the operation success rate was 76.2%, and the accurate puncture rate was 100%. Six months later, the Modified Rankin Scale (MRS) score was 2.5 ±â€Š2.0. The postoperative recovery was good. The situation shows that patients with favorable outcomes (MRS score 0-2) accounted for 38.1% (8/21), and the fatality rate was 33.3% (7/21).The efficacy of the intracranial hematoma minimally invasive surgery by positioning the simple bedside for spontaneous cerebellar hemorrhage with severe brainstem dysfunction is good.


Assuntos
Tronco Encefálico/fisiopatologia , Doenças Cerebelares/cirurgia , Hemorragia Cerebral/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Paracentese/métodos , Posicionamento do Paciente , Idoso , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/fisiopatologia , Feminino , Humanos , Masculino , Neuroimagem , Posicionamento do Paciente/métodos , Tomografia Computadorizada por Raios X
9.
Medicine (Baltimore) ; 98(38): e17249, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567992

RESUMO

RATIONALE: Diabetic striatopathy (DS) is an uncommon movement disorder among diabetic patients characterized by clinical hemichorea-hemiballism with neuroimage change of the striatum. Here, we report a case of DS with relapsed hemichorea-hemiballism attacks even during euglycemic period, and the MRI changes by volumetric analysis. PATIENT CONCERNS: A 69-year-old diabetic female suffered from a relapsed episode of hemichorea-hemiballism during her euglycemic period after the treatment of hyperglycemia. DIAGNOSES: To investigate the serial MRI changes in a case with diabetic striatopathy who had clinical hemichorea-hemiballism syndrome. INTERVENTIONS: Semi-quantitative volumetric analyses from T1 images of these brain MRIs were obtained during the disease course. OUTCOMES: Besides, the negative finding of the first brain MRI during her first hospital admission, three afterward MRI examinations disclosed a waxing-and-waning mode of volume change from high-signal T1 images in left striatum. The clinical symptoms paralleled with the neuroimage changes in striatum. The MR signal volume changes were valuable for the clinical course of the hemichorea-hemiballism caused by diabetic striatopathy LESSONS:: Serial MR images for the diabetic striatopathy presented as a key pathognomonic relationship with the clinical hemichorea-hemiballism syndrome, assessed by our simplied volumetric analysis. Clinical involuntary movements may relapse and persist even with euglycemic condition as our case.


Assuntos
Corpo Estriado/diagnóstico por imagem , Complicações do Diabetes/diagnóstico por imagem , Transtornos dos Movimentos/etiologia , Idoso , Corpo Estriado/fisiopatologia , Complicações do Diabetes/diagnóstico , Complicações do Diabetes/fisiopatologia , Feminino , Humanos , Imagem por Ressonância Magnética , Transtornos dos Movimentos/diagnóstico por imagem , Transtornos dos Movimentos/fisiopatologia , Neuroimagem , Síndrome
10.
Medicine (Baltimore) ; 98(38): e17331, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31568020

RESUMO

RATIONALE: The regimen of the recombinant tissue plasminogen activator (rt-PA) is identical in every case where it is indicated in the treatment of cerebral infarction. We report a case of efficient recanalization of large arterial occlusion after rapid injection of rt-PA. PATIENT CONCERNS: A 78-year-old man was admitted with right-sided hemiplegia and global aphasia that occurred an hour ago. DIAGNOSES: His brain computed tomography (CT) revealed no hemorrhage, suggesting cerebral infarction. INTERVENTIONS: Ten percent of a total rt-PA dose was injected over 1 minute promptly. The remainder of rt-PA was designed to be infused for 60 minutes. Unexpectedly, during the study of CT angiography, administration of rt-PA was completed within 5 minutes. CT angiography showed occlusion from carotid bifurcation to the middle cerebral artery. OUTCOMES: After 2 hours of rt-PA administration, the patient began to regain strength in his right arm and leg. By the next day, he had only mild dysarthria and aphasia. Follow-up CT angiography revealed recanalized internal cervical artery and severe residual stenosis with a plaque. He was discharged without any neurologic symptoms. LESSONS: The infusion protocol of rt-PA administration is established in 1995 and has not changed. Successful recanalization of long segmental large vessel occlusion with only intravenous rt-PA is relatively low. In our case, a high concentration of rt-PA may have influenced the successful dissemination of large thrombus in the whole internal cervical artery. Our case is of significance as it raises the question of unanswered efficacy of diverse injection protocol according to thrombus size and bleeding risk.


Assuntos
Infarto Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tecidual/uso terapêutico , Idoso , Infarto Cerebral/diagnóstico por imagem , Humanos , Injeções Intravenosas/métodos , Masculino , Neuroimagem , Proteínas Recombinantes , Fatores de Tempo , Ativador de Plasminogênio Tecidual/administração & dosagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
J Comput Assist Tomogr ; 43(5): 690-696, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31490891

RESUMO

PURPOSE: The aim of the study was to refine and validate the NeuroImaging Radiological Interpretation System (NIRIS), which was developed to predict management and clinical outcome based on noncontrast head computerized tomography findings in patients suspected of acute traumatic brain injury (TBI). METHODS: We assessed the performance of the NIRIS score in a prospective, single-center cohort of patients suspected of TBI (n = 648) and compared the performance of NIRIS with that of the Marshall and Rotterdam scoring systems. We also revised components of the NIRIS scoring system using decision tree methodologies implemented on pooled data from the retrospective and prospective studies (N = 1190). RESULTS: The NIRIS performed similarly to the Marshall and Rotterdam scoring systems in predicting mortality and markedly better in terms of predicting more granular elements of disposition and management of TBI patients, such as admission, follow-up imaging, intensive care unit stay, and neurosurgical procedures. The revised NIRIS classification correctly predicted disposition and outcome in 91.2% (331/363) after excluding patients with other major extracranial traumatic injuries or intracranial nontraumatic injuries. CONCLUSIONS: The present study further demonstrates the predictive value of NIRIS in guiding standardized clinical management and decision-making regarding treatment options for TBI patients.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico por imagem , Neuroimagem/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Lesões Encefálicas Traumáticas/mortalidade , Lesões Encefálicas Traumáticas/terapia , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Índices de Gravidade do Trauma
12.
Zhonghua Wai Ke Za Zhi ; 57(8): 568-571, 2019 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-31422624

RESUMO

Multi-modalities integration is important in improving the outcome of patients with neurovascular diseases.Based on hybrid operation, this mode also integrates modern intraoperative image and monitoring techniques such as neuronavigation and intraoperative electrophysiological monitoring, providing safe, effective and cost-efficient therapies to certain diseases with the cooperation of neurosurgery and neurology department, which has been becoming the direction of modern individualized precise neurosurgery development.


Assuntos
Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/cirurgia , Procedimentos Neurocirúrgicos/métodos , Transtornos Cerebrovasculares/diagnóstico , Terapia Combinada , Humanos , Monitorização Neurofisiológica Intraoperatória , Neuroimagem , Neuronavegação
13.
Br J Radiol ; 92(1101): 20190365, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31368776

RESUMO

There are numerous challenges to identifying, developing and implementing quantitative techniques for use in clinical radiology, suggesting the need for a common translational pathway. We developed the quantitative neuroradiology initiative (QNI), as a model framework for the technical and clinical validation necessary to embed automated segmentation and other image quantification software into the clinical neuroradiology workflow. We hypothesize that quantification will support reporters with clinically relevant measures contextualized with normative data, increase the precision of longitudinal comparisons, and generate more consistent reporting across levels of radiologists' experience. The QNI framework comprises the following steps: (1) establishing an area of clinical need and identifying the appropriate proven imaging biomarker(s) for the disease in question; (2) developing a method for automated analysis of these biomarkers, by designing an algorithm and compiling reference data; (3) communicating the results via an intuitive and accessible quantitative report; (4) technically and clinically validating the proposed tool pre-use; (5) integrating the developed analysis pipeline into the clinical reporting workflow; and (6) performing in-use evaluation. We will use current radiology practice in dementia as an example, where radiologists have established visual rating scales to describe the degree and pattern of atrophy they detect. These can be helpful, but are somewhat subjective and coarse classifiers, suffering from floor and ceiling limitations. Meanwhile, several imaging biomarkers relevant to dementia diagnosis and management have been proposed in the literature; some clinically approved radiology software tools exist but in general, these have not undergone rigorous clinical validation in high volume or in tertiary dementia centres. The QNI framework aims to address this need. Quantitative image analysis is developing apace within the research domain. Translating quantitative techniques into the clinical setting presents significant challenges, which must be addressed to meet the increasing demand for accurate, timely and impactful clinical imaging services.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Demência/diagnóstico , Demência/patologia , Imagem por Ressonância Magnética/métodos , Neuroimagem/métodos , Estudos de Avaliação como Assunto , Humanos
14.
Neuron ; 103(3): 367-379, 2019 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-31394062

RESUMO

Traumatic brain injury (TBI) is one the most common human afflictions, contributing to long-term disability in survivors. Emerging data indicate that functional improvement or deterioration can occur years after TBI. In this regard, TBI is recognized as risk factor for late-life neurodegenerative disorders. TBI encompasses a heterogeneous disease process in which diverse injury subtypes and multiple molecular mechanisms overlap. To develop precision medicine approaches where specific pathobiological processes are targeted by mechanistically appropriate therapies, techniques to identify and measure these subtypes are needed. Traumatic microvascular injury is a common but relatively understudied TBI endophenotype. In this review, we describe evidence of microvascular dysfunction in human and animal TBI, explore the role of vascular dysfunction in neurodegenerative disease, and discuss potential opportunities for vascular-directed therapies in ameliorating TBI-related neurodegeneration. We discuss the therapeutic potential of vascular-directed therapies in TBI and the use and limitations of preclinical models to explore these therapies.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Circulação Cerebrovascular , Microvasos/patologia , Doenças Neurodegenerativas/etiologia , Acoplamento Neurovascular , Animais , Barreira Hematoencefálica , Lesões Encefálicas Traumáticas/fisiopatologia , Isquemia Encefálica/etiologia , Progressão da Doença , Endotélio Vascular/fisiopatologia , Humanos , Microcirculação , Micronutrientes/farmacocinética , Modelos Animais , Proteínas do Tecido Nervoso/metabolismo , Doenças Neurodegenerativas/patologia , Doenças Neurodegenerativas/fisiopatologia , Doenças Neurodegenerativas/prevenção & controle , Neuroimagem
15.
Artigo em Russo | MEDLINE | ID: mdl-31407694

RESUMO

Dementia in Parkinson's disease (D-PD) worsens the course of PD, and it is associated with a decrease in the quality of life of patients and caregivers, as well as with elevated costs for patient care, and, as a consequence, leads to a significant cost increase in the health management. Early detection of the risk of dementia in patients with PD is one of the challenges of modern clinical neurology. Various methods for the detection of morphologic and functional changes associated with D-PD risk (prognostic biomarkers) were suggested. The aim of this article is a brief review of current achievements in the search for and evaluation of the effectiveness of such biomarkers. The review included the following methods: clinical examination, neuroimaging, examination of biological fluids, genetic analysis, neurophysiological methods and combined methods. Biomarkers of D-PD can contribute to optimization of the selection of pharmacological or non-pharmacological methods of preventing cognitive impairment at early stages of PD, and, therefore, to potential improvement of the overall clinical outcomes.


Assuntos
Disfunção Cognitiva , Demência , Doença de Parkinson , Demência/etiologia , Humanos , Neuroimagem , Doença de Parkinson/complicações , Qualidade de Vida
17.
Brain Nerve ; 71(7): 733-748, 2019 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-31289247

RESUMO

Artificial intelligence (AI) shows promises in terms of diagnostic support on neuroimaging. We developed a software that predicts Alzheimer's disease (AD) using support vector machines (SVM) through three-dimensional brain MR images. Here, we will explain the general idea of voxel-based morphometry and SVM. We used the Alzheimer's Disease Neuroimaging Initiative (ADNI) database for SVM training and tested it on the Australian Imaging Biomarkers and Lifestyle Study of Ageing (AIBL) and the Japanese ADNI database. AI shows higher accuracy for predicting AD than a method of conventional statistical analysis, indicating potential clinical use for diagnostic support.


Assuntos
Doença de Alzheimer/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Neuroimagem , Máquina de Vetores de Suporte , Humanos
18.
Artigo em Russo | MEDLINE | ID: mdl-31339493

RESUMO

Diffuse axonal injury (DAI) is one of the most severe traumatic brain injuries. The availability of neuroimaging biomarkers for monitoring expansion of traumatic brain injury in vivo is a topical issue. PURPOSE: To evaluate novel neuroimaging biomarkers for monitoring brain injury using diffusion kurtosis imaging (DKI) in patients with severe diffuse axonal injury. MATERIAL AND METHODS: DKI data of 12 patients with severe DAI (11 patients with a Glasgow Coma Scale (GCS) score of ≤ 8 and 1 patient with a GCS score of 9) and 8 healthy volunteers (control group) were compared. MRI examination was performed 5 to 19 days after injury; 7 of the 12 patients underwent repeated MRI examinations. We assessed the following parameters: mean, axial, and radial kurtosis (MK, AK, RK, respectively) and kurtosis anisotropy (KA) of the white and gray matter; fractional anisotropy (FA), axonal water fraction (AWF), axial and radial extra-axonal diffusion (AxEAD and RadEAD, respectively), and tortuosity (TORT) of the extra-axonal space) of the white matter. Regions of interest (ROIs) were set bilaterally in the centrum semiovale, genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, putamen, thalamus, midbrain, and pons. RESULTS: A significant reduction in KA (p<0.05) in most of ROIs set on the white matter was revealed. AK was increased (p<0.05) not only in the white matter but also in the putamen and thalamus. A significant reduction in MK with time was observed when the first and second DKI data were compared. AWF was reduced in the centrum semiovale and peduncles. The TORT parameter was decreased (p<0.05) in the majority of ROIs in the white matter, with the most pronounced changes occurring in the genu and splenium of the corpus callosum. CONCLUSION: DKI provides novel data about microstructural injury in DAI and improves our knowledge of brain trauma pathophysiology. DKI parameters should be considered as potential biomarkers of brain injury and potential predictors of the outcome.


Assuntos
Lesão Axonal Difusa , Substância Branca , Anisotropia , Lesão Axonal Difusa/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Imagem de Tensor de Difusão , Humanos , Neuroimagem
19.
Artigo em Russo | MEDLINE | ID: mdl-31339500

RESUMO

Intraventricular meningiomas are rare and account for approximately 0.5 to 3% of all meningiomas and 9.8 to 14% of all intraventricular tumors. Most rarely, intraventricular meningomas occur in the third and fourth ventricles. The article reviews the literature devoted to meningiomas of a rare localization, in the fourth ventricle. On the basis of published surgical procedures and neuroimaging data, we divided posterior cranial fossa meningiomas into tumors completely located in the fourth ventricle cavity and those with a partial intraventricular component, which are not associated with any structures outside the ventricle. The reason for this study was our own clinical observation.


Assuntos
Neoplasias do Ventrículo Cerebral , Neoplasias Meníngeas , Meningioma , Neoplasias do Ventrículo Cerebral/diagnóstico , Neoplasias do Ventrículo Cerebral/cirurgia , Quarto Ventrículo , Humanos , Meningioma/diagnóstico , Meningioma/cirurgia , Neuroimagem
20.
Medicine (Baltimore) ; 98(28): e16320, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305419

RESUMO

To investigate the use of neuroimaging in children and adolescents with minor brain injury in pediatric and non-pediatric departments.In this observational cohort study data were extracted from a large German statutory health insurance (AOK Plus Dresden ∼3.1 million clients) in a 7-year period (2010-2016). All patients with International Classification of Diseases (ICD) code S06.0 (concussion; minor brain injury; commotio cerebri) aged ≤ 18 years were included. Demographic and clinical data were analyzed by logistic regression analysis for associations with the use of CT and MRI (independent variables: gender, age, length of stay, pediatric vs non-pediatric department, university vs non-university hospital).A total of 14,805 children with minor brain injuries (mean age 6.0 ±â€Š5.6; 45.5% females) were included. Treatment was provided by different medical departments: Pediatrics (N = 8717; 59%), Pediatric Surgery (N = 3582, 24%), General Surgery (N = 2197, 15%), Orthopedic Trauma Surgery (N = 309, 2.1%). Patients admitted to pediatric departments (Pediatrics and Pediatric Surgery) underwent head CT-imaging significantly less frequently (3.8%) compared to patients treated in non-pediatric departments (18.5%; P < .001; General Surgery: 15.6%; Orthopedic Trauma Surgery: 39.2%). Logistic regression confirmed a significantly higher odds ratio (OR) for the use of cranial CT by the non-pediatric departments (OR: 3.2 [95-%-CI: 2.72-3.76]).CT was significantly less frequently used in pediatric departments. Educational efforts and quality improvement initiatives on physicians, especially in non-pediatric departments may be an effective approach to decreasing rates of CT after minor traumatic brain injuries.


Assuntos
Lesões Encefálicas/diagnóstico por imagem , Assistência à Saúde , Neuroimagem , Adolescente , Lesões Encefálicas/terapia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Utilização de Procedimentos e Técnicas , Tomografia Computadorizada por Raios X
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