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1.
Medicine (Baltimore) ; 98(23): e15879, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169694

RESUMO

INTRODUCTION: Cases of isolated septum pellucidum infarction have not yet been reported. To date, there are only 2 stroke reports involving septum pellucidum infarction. The etiology of septum pellucidum infarction was subcallosal artery (ScA) injury. The abnormalities were strictly confined to the septum pellucidum and the right cingulated gyrus, making this the first case to report such confined abnormalities. PATIENT CONCERNS: In this report, we present a case of ischemic stroke confined to the septum pellucidum and cingulated gyrus in a 48-year-old male patient who presented with transient ischemic attack-like paroxysmal lower left limb weakness. DIAGNOSIS: Even no obvious abnormalities were revealed by an emergency computed tomography, the infarction in the combined territories of the septum pellucidum and the cingulate gyrus was detected on magnetic resonance imaging. INTERVENTIONS: Aspirin with clopidogrel was administered for 3 weeks as a secondary preventive drug. Clopidogrel was selected as a long-term antiplatelet drug based on a thromboelastogram. OUTCOMES: The patient showed no positive signs related to the nervous system in the hospital, and there was no recurrence during the 3-month follow-up. CONCLUSIONS: Infarction in the septum pellucidum and cingulate gyrus is rare and has atypical clinical manifestations. Physical examination may not yield obvious positive signs. False-negative computed tomography findings of the head may result in misdiagnosis. Thus, it is necessary to perform whole-brain magnetic resonance imaging in time. Moreover, ScA protection should be paid attention to during surgery for anterior communicating artery aneurysm.


Assuntos
Infarto Encefálico/patologia , Giro do Cíngulo/patologia , Septo Pelúcido/patologia , Acidente Vascular Cerebral/patologia , Anticoagulantes/uso terapêutico , Aspirina/uso terapêutico , Clopidogrel/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/tratamento farmacológico
3.
Adv Neurobiol ; 15: 383-400, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28674990

RESUMO

Although millions of individuals suffer a traumatic brain injury (TBI) worldwide each year, it is only recently that TBI has been recognized as a major public health problem. Beyond the acute clinical manifestations, there is growing recognition that a single severe TBI (sTBI) or repeated mild TBIs (rTBI) can also induce insidious neurodegenerative processes, which may be associated with early dementia, in particular chronic traumatic encephalopathy (CTE). Identified at autopsy examination in individuals with histories of exposure to sTBI or rTBI, CTE is recognized as a complex pathology featuring both macroscopic and microscopic abnormalities. These include cavum septum pellucidum, brain atrophy and ventricular dilation, together with pathologies in tau, TDP-43, and amyloid-ß. However, the establishment and characterization of CTE as a distinct disease entity is in its infancy. Moreover, the relative "dose" of TBI, such as the frequency and severity of injury, associated with risk of CTE remains unknown. As such, there is a clear and pressing need to improve the recognition and diagnosis of CTE and to identify mechanistic links between TBI and chronic neurodegeneration.


Assuntos
Encéfalo/fisiopatologia , Encefalopatia Traumática Crônica/fisiopatologia , Lesão Axonal Difusa/fisiopatologia , Peptídeos beta-Amiloides/metabolismo , Atrofia , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Encéfalo/patologia , Lesões Encefálicas Traumáticas/diagnóstico por imagem , Lesões Encefálicas Traumáticas/metabolismo , Lesões Encefálicas Traumáticas/patologia , Lesões Encefálicas Traumáticas/fisiopatologia , Ventrículos Cerebrais/diagnóstico por imagem , Ventrículos Cerebrais/patologia , Doença Crônica , Encefalopatia Traumática Crônica/diagnóstico por imagem , Encefalopatia Traumática Crônica/metabolismo , Encefalopatia Traumática Crônica/patologia , Proteínas de Ligação a DNA/metabolismo , Lesão Axonal Difusa/diagnóstico por imagem , Lesão Axonal Difusa/metabolismo , Lesão Axonal Difusa/patologia , Dilatação Patológica , Humanos , Doenças Neurodegenerativas/diagnóstico por imagem , Doenças Neurodegenerativas/metabolismo , Doenças Neurodegenerativas/patologia , Doenças Neurodegenerativas/fisiopatologia , Emaranhados Neurofibrilares/patologia , Septo Pelúcido/diagnóstico por imagem , Septo Pelúcido/metabolismo , Septo Pelúcido/patologia , Septo Pelúcido/fisiopatologia , Proteínas tau/metabolismo
4.
World Neurosurg ; 105: 1035.e5-1035.e10, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28619500

RESUMO

BACKGROUND: Cavum septum pellucidum (CSP), which is often found incidentally in a few populations, occasionally becomes symptomatic if enlarged significantly. Wilson disease (WD) is an uncommon autosomal recessive inborn defect in copper metabolism characterized by abnormal accumulation of copper in various tissues, particularly in the liver and the brain. Seizure disorder, although rare both in CSP and WD, may happen in a few patients with either of the conditions. CASE DESCRIPTION: We report a case of 17-year-old boy, a patient with known WD, who developed intractable seizure for a year, which was not controlled with a large amount of antiepileptics. Magnetic resonance imaging showed enlargement of his preexisting CSP, which was small and asymptomatic at the time of diagnosis of WD. His WD was in a state of remission when he developed the seizure disorder. On endoscopic cyst fenestration, he was relieved of the seizure. CONCLUSIONS: Symptomatic CSP is a rare disorder, but the coexistence of WD is even rarer. Endoscopic cyst fenestration is a novel procedure that can be successful in properly selected cases. To the best of our knowledge, CSP associated with WD has not been reported in any English literature. We present this case for its rarity along with a relevant literature review.


Assuntos
Degeneração Hepatolenticular/complicações , Degeneração Hepatolenticular/patologia , Convulsões/etiologia , Septo Pelúcido/patologia , Adolescente , Endoscopia/métodos , Degeneração Hepatolenticular/diagnóstico por imagem , Degeneração Hepatolenticular/cirurgia , Humanos , Processamento de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Masculino , Convulsões/diagnóstico por imagem , Convulsões/cirurgia , Septo Pelúcido/diagnóstico por imagem
5.
PLoS One ; 12(5): e0177715, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28545119

RESUMO

OBJECTIVES: To investigate the prevalence and changes of cavum septum pellucidum (CSP) in first-episode psychosis (FEP) patients. METHODS: Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify eligible studies comparing FEP patients and healthy controls from inception to Feb 29, 2016. RESULTS: Ten cross-sectional studies and three longitudinal studies reported in ten articles met our criteria. Our meta-analysis found no significant differences in the prevalence of either "any CSP" (OR = 1.41; 95% CI 0.90-2.20; p = 0.13; I2 = 52.7%) or "large CSP" (OR = 1.10; 95% CI 0.77-1.58; p = 0.59; I2 = 24.1%) between FEP patients and healthy controls. However, the heterogeneity analysis of the prevalence of "any CSP" suggested bias in outcome reporting. CONCLUSIONS: The results based on current evidence suggest it is unclear whether "any CSP" is a risk factor for FEP due to the heterogeneity of the studies. There is insufficient evidence to support that "large CSP" is a possible risk factor for FEP.


Assuntos
Transtornos Psicóticos/diagnóstico , Septo Pelúcido/diagnóstico por imagem , Adulto , Estudos Transversais , Bases de Dados Factuais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Prevalência , Transtornos Psicóticos/epidemiologia , Septo Pelúcido/anatomia & histologia , Septo Pelúcido/patologia , Fatores Sexuais , Adulto Jovem
6.
J Ultrasound Med ; 36(8): 1657-1668, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28417514

RESUMO

OBJECTIVES: To investigate fetal cases identified at our institution to determine whether an enlarged cavum septi pellucidi or cavum vergae is associated with other fetal abnormalities and whether its presence warrants more detailed investigation of the fetus. METHODS: In a retrospective study, 15 high- and low-risk patients undergoing prenatal sonography who had an enlarged cavum septi pellucidi or cavum vergae identified were reviewed. Data were collected for the sonographic study indication, gestation age at diagnosis of a prominent cavum, and associated anomalies. Follow-up outcome data regarding further imaging, karyotype, diagnosis of brain anomaly, and associated congenital abnormalities were obtained. RESULTS: Fifteen patients met the inclusion criteria. Nine patients were identified as having a prominent cavum septi pellucidi, and 6 were identified as having a prominent cavum vergae. The mean gestational age ± SD was 22.7 ± 5.9 weeks. Eleven patients made it to delivery. Of the 15 patients, 4 were thought to have trisomy 21, and 13 had congenital anomalies. Outcomes included 10 major adverse outcomes, 4 cases with normal development or minor abnormalities, and 1 lost to follow-up. An isolated dilated cavum on prenatal sonography was seen in 5 cases: 1 with lissencephaly on a neonatal examination, 3 premature deliveries (1 demise, 1 hospice, and 1 normal), and 1 unknown. CONCLUSIONS: Our cohort had many associated clinical anomalies: 3 confirmed trisomy 21 and 1 probable trisomy 21, 2 genetic disorders, and 10 major adverse outcomes, 5 of which were grave. Although we studied a small cohort, we conclude that an enlarged cavum septi pellucidi or cavum vergae warrants consideration of genetic counseling, which may include noninvasive prenatal testing (cell-free DNA), amniocentesis with microarray testing, or both.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Anormalidades Congênitas/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Adolescente , Adulto , Encéfalo/embriologia , Anormalidades Congênitas/patologia , Feminino , Seguimentos , Humanos , Tamanho do Órgão , Gravidez , Estudos Retrospectivos , Septo Pelúcido/diagnóstico por imagem , Septo Pelúcido/embriologia , Septo Pelúcido/patologia , Adulto Jovem
7.
J Clin Neurosci ; 34: 140-144, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27590863

RESUMO

We review our experience with four patients who presented to our Medical Center from 2005-2015 with adult idiopathic occlusion of the foramen of Monro (FM). All patients underwent CT scanning and MRI. Standard MRI was performed in each patient to rule out a secondary cause of obstruction (T1-weighted without- and with gadolinium, T2-weighted, fluid-attenuated inversion recovery [FLAIR] and diffusion-weighted imaging [DWI] protocols). When occlusion of the FM appeared to be idiopathic, further high-resolution MRI with multiplanar reconstructions for evaluation of stenosis or an occluding membrane at the level of the FM was performed (T1-weighted without- and with gadolinium, T2-weighted 3D turbo spin-echo). Occlusion of the FM was due to unilateral stenosis and septum pellucidum deviation in two patients, to an occluding membrane in one, and to bilateral stenosis in one patient. Urgent surgical intervention is mandatory when there are signs of increased intracranial pressure while asymptomatic patients may be managed conservatively. In this patient series, truly bilateral stenotic obstruction of the FM was best managed with ventriculoperitoneal shunt and patients with membranous obstruction or unilateral stenosis with septum deviation were treated endoscopically.


Assuntos
Ventrículos Cerebrais/patologia , Constrição Patológica/patologia , Adulto , Ventrículos Cerebrais/cirurgia , Constrição Patológica/cirurgia , Imagem de Difusão por Ressonância Magnética , Endoscopia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Neuroimagem , Septo Pelúcido/patologia , Septo Pelúcido/cirurgia , Tomografia Computadorizada por Raios X , Derivação Ventriculoperitoneal/efeitos adversos
8.
Am J Surg Pathol ; 40(6): 806-11, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26796505

RESUMO

Dysembryoplastic neuroepithelial tumors (DNTs) are one of the most common epilepsy-associated low-grade glioneuronal tumors of the central nervous system. Although most DNTs occur in the cerebral cortex, DNT-like tumors with unusual intraventricular or periventricular localizations have been reported. Most of them involve the septum pellucidum and the foramen of Monro. In this study, we have described the neuroradiologic, histopathologic, and molecular features of 7 cases (4 female and 3 male; patient age range, 3 to 34 y; mean age, 16.7 y). The tumors, all localized near the supratentorial midline structures in proximity to the foramen of Monro and septum pellucidum, appeared in magnetic resonance imaging as well-delimited cystic lesions with cerebrospinal fluid-like signal on T1-weighted and T2-weighted images, some of them with typical fluid-attenuated inversion recovery ring sign. Histologically, they shared features with classic cortical DNTs but did not display aspects of multinodularity. From a molecular point of view the cases investigated did not show KIAA1549-BRAF fusions or FGFR1 mutations, alterations otherwise observed in pilocytic astrocytomas, or MYB and MYBL1 alterations that have been identified in a large group of pediatric low-grade gliomas. Moreover, BRAF mutations, which so far represent the most common molecular alteration found in cortical DNTs, were absent in this group of rare periventricular tumors.


Assuntos
Neoplasias Neuroepiteliomatosas/patologia , Septo Pelúcido/patologia , Neoplasias Supratentoriais/patologia , Teratoma/patologia , Adolescente , Adulto , Biomarcadores Tumorais/análise , Criança , Pré-Escolar , Análise Mutacional de DNA , Feminino , Humanos , Imuno-Histoquímica , Imagem por Ressonância Magnética , Masculino , Reação em Cadeia da Polimerase Multiplex , Neoplasias Neuroepiteliomatosas/genética , Neoplasias Supratentoriais/genética , Teratoma/genética , Adulto Jovem
9.
Childs Nerv Syst ; 32(2): 327-35, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26597681

RESUMO

BACKGROUND: The 9p deletion syndrome is a rare condition, which associates trigonocephaly, facial dysmorphism and developmental delay. The neuroradiological aspects of this syndrome have not yet been described. The purpose of this article is to identify the clinical and neuroradiological features, that should be recognized by all specialists treating these children, for a proper and early diagnosis. METHODS: Among patients with trigonocephaly treated at our institution, we retrospectively analyzed the clinical and neuroradiological aspects of children with genetically confirmed 9p deletion syndrome. RESULTS: 6 patients were identified. Beside trigonocephaly, the most frequent clinical findings were small ears, long philtrum, upslanting palpebral fissures, flat nasal bridge and variable psycho-motor delay. Hypertelorism was present in 4 of 6 patient, which is opposite to the hypotelorism typical of non-syndromic trigonocephaly. Among neuroradiological findings, large, anteriorly rotated sylvian cisterns and altered shape of the septum pellucidum were found in all patients, as well as the compression of the frontal cortex due to the metopic synostosis (MS). A thin or dysmorphic corpus callosum and a diffuse white matter hypoplasia were present in more than half of the cases. Futhermore we compared these MRI findings with those of a control group of 30 non-syndromic trigonocephalies. CONCLUSIONS: Some recurrent neuroradiological alterations can be found in 9p deletion syndrome. The presence of these signs on MRI of a trigonocephalic patient should raise the suspicion of an underlying chromosomal alteration, such as the 9p deletion syndrome and prompt genetic investigations.


Assuntos
Agenesia do Corpo Caloso/patologia , Encéfalo/anormalidades , Deleção Cromossômica , Anormalidades Craniofaciais/patologia , Craniossinostoses/patologia , Deficiências do Desenvolvimento/patologia , Encéfalo/patologia , Estudos de Casos e Controles , Cromossomos Humanos Par 9 , Corpo Caloso/patologia , Humanos , Lactente , Imagem por Ressonância Magnética , Estudos Retrospectivos , Septo Pelúcido/anormalidades , Septo Pelúcido/patologia , Substância Branca/anormalidades , Substância Branca/patologia
10.
J Neurotrauma ; 33(4): 346-53, 2016 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-26414478

RESUMO

Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p < 0.0001; septum length: rho = 0.93; ICC 0.96; p < 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p < 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall, p = 0.04) and decreased test scores on a measure of estimate verbal intelligence (Wide Range Achievement Test Fourth Edition Reading Test, p = 0.02). Given the high prevalence of CSP in neuropathologically confirmed CTE in addition to the results of this study, CSP may serve as a potential early in vivo imaging marker to identify those at high risk for CTE. Future research is needed to investigate the pathomechanism underlying the development of CSP after repetitive head impacts, and its potential association with neuropathologically confirmed CTE.


Assuntos
Atletas , Encefalopatia Traumática Crônica/diagnóstico , Futebol Americano/lesões , Septo Pelúcido/patologia , Adulto , Idoso , Concussão Encefálica/diagnóstico , Concussão Encefálica/epidemiologia , Encefalopatia Traumática Crônica/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade
11.
J Neurotrauma ; 33(1): 157-61, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-25970145

RESUMO

Previous studies report that cavum septum pellucidum (CSP) is frequent among athletes with a history of repeated traumatic brain injury (TBI), such as boxers. Few studies of CSP in athletes, however, have assessed detailed features of the septum pellucidum in a case-control fashion. This is important because prevalence of CSP in the general population varies widely (2% to 85%) between studies. Further, rates of CSP among American pro-football players have not been described previously. We sought to characterize MRI features of the septum pellucidum in a series of retired pro-football players with a history of repeated concussive/subconcussive head traumas compared with controls. We retrospectively assessed retired American pro-football players presenting to our memory clinic with cognitive/behavioral symptoms in whom structural MRI was available with slice thickness ≤2 mm (n=17). Each player was matched to a memory clinic control patient with no history of TBI. Scans were interpreted by raters blinded to clinical information and TBI/football history, who measured CSP grade (0-absent, 1-equivocal, 2-mild, 3-moderate, 4-severe) and length according to a standard protocol. Sixteen of 17 (94%) players had a CSP graded ≥2 compared with 3 of 17 (18%) controls. CSP was significantly higher grade (p<0.001) and longer in players than controls (mean length±standard deviation: 10.6 mm±5.4 vs. 1.1 mm±1.3, p<0.001). Among patients presenting to a memory clinic, long high-grade CSP was more frequent in retired pro-football players compared with patients without a history of TBI.


Assuntos
Traumatismos em Atletas/patologia , Concussão Encefálica/patologia , Futebol Americano , Septo Pelúcido/patologia , Adulto , Estudos de Casos e Controles , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Estados Unidos
12.
Rev. Asoc. Esp. Neuropsiquiatr ; 35(128): 831-835, oct.-dic. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-146287

RESUMO

El cavum septum pellucidum (CSP) es una alteración morfológica del septum pellucidum que debe desaparecer entre los tres y los seis meses de vida. Los CSP que persisten después de esa fecha y los de tipo no comunicante se consideran una alteración del neurodesarrollo y se han relacionado con la esquizofrenia y otros trastornos psicóticos, especialmente los de gran tamaño. La prevalencia es variable en función del método de medida, de modo que encontramos cifras que oscilan entre el 0,1% a 85% en la población general y entre el 15 a 44,8% en la esquizofrenia. En los pacientes con trastornos psicóticos y CSP grandes se han observado una serie de características clínicas tales como, mayor presencia de síntomas negativos, alteraciones cognitivas del aprendizaje verbal y de la comprensión de frases, entre otras. Presentamos el caso clínico de una paciente de 19 años diagnosticada de esquizofrenia hebefrénica en la que se halló mediante tomografía computerizada (TC) un CSP de tamaño gigante (2,6 cm) y en la que destaca la importante presencia de síntomas negativos, el deterioro cognitivo, las alteraciones del aprendizaje verbal y de la comprensión de frases e importantes trastornos de conducta (AU)


Cavum septum pellucidum (CSP) is a morphological alteration of the septum pellucidum that should disappear at 3-6 months of age. CSPs that persist for longer, and non-communicating CSP, are classified as a neurodevelopmental disorders and have been associated with schizophrenia and other psychotic disorders, especially in cases with large CSPs. Prevalence rates vary according to the measurement method, and the figures range from 0,1% to 85% in the general population and from 15% to 44,8% in schizophrenia. A series of clinical features such as cognitive disorders, more negative symptoms and verbal learning and sentence comprehension disorders has been found in patients with psychotic disorders and large CSP. We present the clinical case of a 19-year old patient diagnosed with hebephrenic schizophrenia in which a CT scan revealed a giant CSP (2,6 cm) and who presented significant negative symptoms, cognitive deterioration, verbal learning and sentence comprehension disorders and important behavioural disorders (AU)


Assuntos
Adulto , Feminino , Humanos , Septo Pelúcido/patologia , Esquizofrenia/complicações , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Dissonância Cognitiva , Transtornos Psicóticos/complicações , Transtornos Psicóticos/psicologia , Terapia Cognitivo-Comportamental , Transtornos do Desenvolvimento da Linguagem/patologia , Transtornos do Desenvolvimento da Linguagem/psicologia , Transtornos da Linguagem/patologia , Transtornos da Linguagem/psicologia , Competência Mental/psicologia , Septo Pelúcido
13.
J Neurosurg Pediatr ; 16(3): 283-6, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26090550

RESUMO

Cavum septum pellucidum (CSP) cysts are relatively rare. The most common presenting symptom is headache, which is thought to be secondary to elevated intracranial pressure. Many CSP cysts are treated surgically; conservative treatment is seldom recommended. The authors describe 3 cases of pediatric CSP cysts that were managed without surgery. The patients ranged in age from 5 months to 8 years old. Two presented with headaches, which were associated with mild ventricular enlargement in 1 case. Over the course of 5-15 months, 2 cysts became markedly reduced in size, and in one of these 2 cases a substantial reduction in ventricle size was also observed. At last follow-up, all 3 children were asymptomatic. The authors note that CSP cysts are often associated with headaches. In the absence of hydrocephalus, they recommend conservative management with clinical and radiological follow-up.


Assuntos
Cistos do Sistema Nervoso Central/patologia , Cistos do Sistema Nervoso Central/terapia , Septo Pelúcido , Cistos do Sistema Nervoso Central/complicações , Cistos do Sistema Nervoso Central/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Hidrocefalia/etiologia , Lactente , Hipertensão Intracraniana/etiologia , Imagem por Ressonância Magnética , Masculino , Septo Pelúcido/patologia , Ventriculostomia
14.
Asian J Psychiatr ; 15: 21-4, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26001900

RESUMO

Like prevalence of abnormal cavum septum pellucidum in patients of schizophrenia remains controversial, its role in clinical outcome, duration of illness and effect on treatment remains less understood as well. Our study examined clinical correlates of enlarged cavum septum pellucidum in schizophrenia. A total of 139 patients diagnosed with schizophrenia during the year 2012 and 2013 were taken for the study. We compared them in respect to the presence and absence of enlarged cavum septum pellucidum. We found 16 patients with enlarged cavum septum pellucidum and were compared with those without enlarged cavum septum pellucidum for socio-demographic and clinical variables. We also correlated these clinical variables with dimension of cavum septum pellucidum. We found statistically significant increased current age and duration of illness in patients with enlarged cavum septum pellucidum. The implications of these findings are discussed with possible confounding effect of current age on neuroimaging. No meaningful correlation was found. No difference in clinical variables was found. Retrospective design and use of computed tomography were limitation of our study.


Assuntos
Esquizofrenia/patologia , Septo Pelúcido/patologia , Adulto , Fatores Etários , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Tamanho do Órgão , Estudos Retrospectivos , Esquizofrenia/diagnóstico por imagem , Septo Pelúcido/diagnóstico por imagem , Tomografia Computadorizada por Raios X
16.
Neurol India ; 63(1): 68-71, 2015 Jan-Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25751472

RESUMO

A rare case of cavernoma in the region of the septum pellucidum is reported. A 35-year-old female patient presented with chronic headaches. Her neurological exam was normal. Her magnetic resonance (MR) imaging showed a lesion within the inferior aspect of the septum pellucidum extending into the anterior third ventricular region, blocking the foramen of Monro, resulting in moderate supratentorial asymmetrical hydrocephalus. A central neurocytoma or subependymoma was suspected on imaging. Complete excision of the septum pellucidum cavernoma was performed using microneurosurgical techniques through an interhemispheric transcallosal route. The patient had an excellent outcome and is cured. Although rare, septum pellucidum cavernomas should be considered in the differential diagnosis of anterior third ventricular lesions in the region of foramen of Monro. The unusual location, atypical radiological features, differential diagnosis as well as surgical nuances in the management of a cavernoma in the septum pellucidum and anterior third ventricular region are discussed in the light of current literature.


Assuntos
Ependimoma/diagnóstico , Neurocitoma/diagnóstico , Septo Pelúcido/patologia , Adulto , Diagnóstico Diferencial , Ependimoma/cirurgia , Feminino , Humanos , Neurocitoma/cirurgia
18.
Ultrasound Obstet Gynecol ; 46(5): 595-9, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25586942

RESUMO

OBJECTIVE: To describe and assess the presence of a new indirect sign of partial agenesis of the corpus callosum (pACC): an abnormally shaped cavum septi pellucidi (CSP). METHODS: We analyzed retrospectively images from all 71 cases of pACC seen at two referral centers between September 2006 and April 2014. Abnormally shaped CSP was diagnosed when its lateral dimension was greater than its anteroposterior dimension in the axial transthalamic plane, and the incidence of this sign was assessed. We also examined the following variables: gestational age at referral, indication for referral, which (if any) of the four corpus callosal segments were abnormal, presence of other, previously established, indirect signs of callosal agenesis (ACC) and presence of additional cerebral or extracerebral anomalies. RESULTS: In 56 of the 71 (79%) cases, the CSP was measurable; it was abnormally shaped in 19 (34%) of these cases, 15 (79%) of which had no other indirect signs of pACC. Of 23 cases with isolated pACC and no other indirect signs, 12 (52%) had an abnormally shaped CSP. CONCLUSIONS: In a significant proportion of cases of pACC detected prenatally, the shape of the CSP is abnormal. This should be considered an additional indirect sign of pACC, and is frequently the only clue to the diagnosis. When observing this sign in a screening context, pACC should be considered, and an attempt to visualize the corpus callosum directly in the midsagittal plane is suggested.


Assuntos
Agenesia do Corpo Caloso/diagnóstico , Corpo Caloso/patologia , Imagem por Ressonância Magnética , Diagnóstico Pré-Natal , Adulto , Agenesia do Corpo Caloso/embriologia , Agenesia do Corpo Caloso/epidemiologia , Corpo Caloso/embriologia , Feminino , França/epidemiologia , Idade Gestacional , Humanos , Israel/epidemiologia , Gravidez , Estudos Retrospectivos , Septo Pelúcido/anormalidades , Septo Pelúcido/embriologia , Septo Pelúcido/patologia
19.
Pomeranian J Life Sci ; 61(1): 12-33, 2015.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-27116851

RESUMO

INTRODUCTION: The cavum of the septum pellucidum occurs in up to 15% of adults and is considered as an anatomical variant. How- ever, some patients reveal symptoms which are associated with the evolution from the cavum in the form of a cyst of the septum pelludum. Cyst incidence is much lower. The pathomechanism and risk factors of such changes are not fully understood. Among the theories for the formation of the cyst, most attention is given to the hypothesis of the mechanism of the valve in the flow of cerebrospinal fluid. However, this statement can be validated only on the basis of direct observation, which can be made in vivo only with the help of the endoscopic method. The aim of this study was to describe the clinical and radiological features coexisting with the expanding cysts of the septum pellucidum. The research also included considerations on the pathogenesis of the expanding cysts of the septum pellucidum, as well as the evaluation of the intraoperative endoscopic image. MATERIAL AND METHODS: The study included 27 patients of the Department of Neurosurgery Pomeranian Medical University in Szczecin, diagnosed with an expanding cyst of the septum pellucidum, who underwent neurosurgery treatment. The patients' clinical and radiological symptoms were evaluated before and after surgical intervention. Analysis of the intraoperative endoscopic images was also performed. RESULTS: The most common clinical symptoms in patients before surgery were similar: headache, dizziness, nausea and vomiting, advanced nervous functions disorders, and visual defects. In most cases the symptoms resolved after surgical treatment, which proves their association with the occurrence of cysts. Significant differences in radiographic measurements before and after surgery where also noted, which allowed the determination of clinical and radiological criteria for the diagnosis of expanding cysts of the septum pellucidum, and intravital intraoperative findings allowed direct proof of the cyst's filling mechanism. The obtained results allowed us to prove the hypothesis of the valve mechanism as the main factor causing the symptoms in patients with expanding cysts of the septum pellucidum, and to determine the components of the syndrome of the septum pellucidum cyst. They confirmed the validity of the selection of surgical treatment using an endoscope. Furthermore, changes in the geometry of the structures of the central nervous system observed in the analysis of radiological images before and after surgery made further research on the dynamics of this anatomical area in patients with expanding cysts of the septum pellucidum reasonable.


Assuntos
Cistos do Sistema Nervoso Central/diagnóstico por imagem , Cistos do Sistema Nervoso Central/cirurgia , Septo Pelúcido/diagnóstico por imagem , Septo Pelúcido/cirurgia , Adolescente , Adulto , Cistos do Sistema Nervoso Central/complicações , Criança , Endoscopia/métodos , Epilepsia/etiologia , Feminino , Cefaleia/etiologia , Humanos , Hidrocefalia/etiologia , Masculino , Pessoa de Meia-Idade , Papiledema/etiologia , Polônia , Hemorragia Pós-Operatória/etiologia , Septo Pelúcido/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
20.
Eur J Pain ; 19(8): 1071-4, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25487523

RESUMO

BACKGROUND: Primary dysmenorrhoea (PDM) is inexorably common. PDM women suffer from cramping pain in the lower abdomen that starts with menstruation and lasts for 24-72 h. Up to 90% of adolescent girls and more than 50% of menstruating women worldwide report suffering from it. Ten to 20% of PDM women describe their suffering as severe and distressing. However, nothing is known regarding the association of PDM with possible brain anomalies or abnormalities. METHODS: High-resolution T1-weighted anatomical brain magnetic resonance images (MRI) were acquired for each subject and inspected for incidental findings (normal variants and abnormalities) as a routine procedure in our PDM-related multimodal neuroimaging studies. Altogether, 330 right-handed young women [otherwise healthy PDMs = 163; non-PDM healthy controls (HCs) = 167] were enrolled during the period of 2006-2014. Binomial proportion test was performed for between-group comparisons. RESULTS: PDMs demonstrated significantly higher prevalence of overall incidental brain MRI findings (PDMs: n = 18, 11.0%; HCs: n = 6, 3.6%; p = 0.005) that should be ascribed to a preponderance of normal variants (PDMs: n = 16, 9.8%; HCs: n = 3, 1.8%; p = 0.001), especially cavum septum pellucidum. No significant between-group difference of abnormal findings was found (PDMs: n = 2, 1.2%; HCs: n = 3, 1.8%; p = 0.336). CONCLUSIONS: We report here that otherwise healthy PDMs are associated with high prevalence of normal variants but not brain abnormalities. Our observations invite further epidemiological and neuroscientific studies.


Assuntos
Encéfalo/patologia , Dismenorreia/complicações , Achados Incidentais , Adolescente , Adulto , Feminino , Humanos , Imagem por Ressonância Magnética , Neuroimagem , Prevalência , Septo Pelúcido/patologia , Adulto Jovem
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