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1.
Int. j. clin. health psychol. (Internet) ; 23(1): 1-11, ene.-abr. 2023. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-213099

RESUMO

Background/Objective: Neuroimaging studies have shown brain abnormalities in Down syndrome (DS) but have not clarified the underlying mechanisms of dysfunction. Here, we investigated the degree centrality (DC) abnormalities found in the DS group compared with the control group, and we conducted seed-based functional connectivity (FC) with the significant clusters found in DC. Moreover, we used the significant clusters of DC and the seed-based FC to elucidate differences between brain networks in DS compared with controls.Method: The sample comprised 18 persons with DS (M = 28.67, SD = 4.18) and 18 controls (M = 28.56, SD = 4.26). Both samples underwent resting-state functional magnetic resonance imaging. Results: DC analysis showed increased DC in the DS in temporal and right frontal lobe, as well as in the left caudate and rectus and decreased DC in the DS in regions of the left frontal lobe. Regarding seed-based FC, DS showed increased and decreased FC. Significant differences were also found between networks using Yeo parcellations, showing both hyperconnectivity and hypoconnectivity between and within networks. Conclusions: DC, seed-based FC and brain networks seem altered in DS, finding hypo- and hyperconnectivity depending on the areas. Network analysis revealed between- and within-network differences, and these abnormalities shown in DS could be related to the characteristics of the population. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Síndrome de Down , Malformações do Sistema Nervoso , Cérebro , Espectroscopia de Ressonância Magnética , Sementes
4.
Medicine (Baltimore) ; 102(1): e32616, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36607853

RESUMO

RATIONALE: Meningioma and glioblastoma (GBM) are 2 common intracranial tumors with different pathophysiologies and prognoses. It is rare for these 2 kinds of tumors to occur in the same patient. Most of the similar cases reported in the literature have been treated with radiotherapy, while cases without radiotherapy are rare. In particular, GBM in the contralateral cerebral hemisphere after resection of meningioma has not been reported. PATIENT CONCERNS: We present a case of a 66-years-old man with GBM in the right temporal lobe after previous resection of a benign meningioma of the left frontal lobe without radiotherapy. DIAGNOSES: The patient was admitted to our hospital for the first time because of right upper limb weakness. Brain magnetic resonance imaging indicated a space-occupying lesion in the left frontal area. Surgical treatment was performed, and postoperative pathology confirmed a meningioma. The patient was readmitted to the hospital 3 years after surgery of the meningioma due to a new lesion of the right temporal lobe and underwent reoperation. The postoperative pathological results showed GBM. INTERVENTIONS: The patient underwent 2 operations, and the postoperative pathologies were meningioma and GBM. In addition, the patient received concurrent chemoradiotherapy and 2 cycles of temozolomide adjuvant chemotherapy. OUTCOMES: During the last 4 months of follow-up, the patient was in good condition with no recurrence of the tumor. LESSONS: The development of GBM without radiotherapy after meningioma surgery is very rare, especially at different sites, and it is necessary to accumulate relevant cases to reveal the causes of the disease and provide more evidence for the treatment of similar patients in the future.


Assuntos
Neoplasias Encefálicas , Cérebro , Glioblastoma , Neoplasias Meníngeas , Meningioma , Masculino , Humanos , Idoso , Feminino , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Meningioma/patologia , Glioblastoma/diagnóstico por imagem , Glioblastoma/cirurgia , Glioblastoma/patologia , Neoplasias Encefálicas/cirurgia , Neoplasias Encefálicas/patologia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Neoplasias Meníngeas/patologia
5.
Neurochem Int ; 162: 105462, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36509234

RESUMO

Diabetes exacerbates hemorrhagic transformation (HT) after stroke and worsens clinical outcomes. Female patients with diabetes are at a greater risk of stroke and worsened recovery. We have shown that activation of matrix metalloprotease 3 (MMP3) in hyperglycemic settings mediates HT in male rats. In light of our recent findings that diabetic female rats develop greater HT, the current study was designed to test the hypotheses that: 1) cerebral microvascular MMP3 activation contributes to poor functional outcomes and increased hemorrhagic transformations (HT) after ischemic stroke, and 2) MMP3 inhibition can improve functional outcomes in female diabetic rats. Female control and diabetic Wistar rats were subjected to 60 min of middle cerebral artery occlusion (MCAO). One cohort of diabetic animals received a single dose of MMP3 inhibitor (UK356618; 15 mg/kg; iv) or vehicle after reperfusion. Neurobehavioral outcomes, brain infarct size, edema, HT, and MMPs were measured in brain tissue. Diabetic rats had significant neurological deficits on Day 3 after stroke. MMP3 expression and enzyme activity were significantly increased in both micro and macro vessels of diabetic animals. MMP3 inhibition improved functional outcomes and reduced brain edema and HT scores. In conclusion, cerebral endothelial MMP3 activation to vascular injury in female diabetic rats. Our findings identify MMP3 as a potential therapeutic target in diabetic stroke.


Assuntos
Diabetes Mellitus Experimental , Infarto da Artéria Cerebral Média , Metaloproteinase 3 da Matriz , Microvasos , Acidente Vascular Cerebral , Lesões do Sistema Vascular , Animais , Feminino , Masculino , Ratos , Diabetes Mellitus Experimental/complicações , Modelos Animais de Doenças , Infarto da Artéria Cerebral Média/complicações , Metaloproteinase 3 da Matriz/metabolismo , Ratos Wistar , Acidente Vascular Cerebral/complicações , Lesões do Sistema Vascular/enzimologia , Lesões do Sistema Vascular/etiologia , Microvasos/enzimologia , Cérebro/irrigação sanguínea
6.
Zhonghua Bing Li Xue Za Zhi ; 51(11): 1129-1134, 2022 Nov 08.
Artigo em Chinês | MEDLINE | ID: mdl-36323542

RESUMO

Objective: To investigate clinicopathological features of multinodular and vacuolar neurodegenerative tumor (MVNT) of the cerebrum, and to investigate its immunophenotype, molecular characteristics and prognosis. Methods: Four cases were collected at the General Hospital of Southern Theater Command, Guangzhou, China and one case was collected at the First People's Hospital of Huizhou, China from 2013 to 2021. Clinical, histological, immunohistochemical and molecular characteristics of these five cases were analyzed. Follow-up was carried out to evaluate their prognoses. Results: There were four females and one male, with an average age of 42 years (range, 17 to 51 years). Four patients presented with seizures, while one presented with discomfort on the head. Pre-operative imaging demonstrated non-enhancing, T2-hyperintense multinodular lesions in the deep cortex and superficial white matter of the frontal (n=1) or temporal lobes (n=4). Microscopically, the tumor cells were mostly arranged in discrete and coalescent nodules primarily within the deep cortical ribbon and superficial subcortical white matter. The tumors were composed of large cells with ganglionic morphology, vesicular nuclei, prominent nucleoli and amphophilic or lightly basophilic cytoplasm. They exhibited varying degrees of matrix vacuolization. Vacuolated tumor cells did not show overt cellular atypia or any mitotic activities. Immunohistochemically, tumor cells exhibited widespread nuclear staining for the HuC/HuD neuronal antigens, SOX10 and Olig2. Expression of other neuronal markers, including synaptophysin, neurofilament and MAP2, was patchy to absent. The tumor cells were negative for NeuN, GFAP, p53, H3K27M, IDH1 R132H, ATRX, BRG1, INI1 and BRAF V600E. No aberrant molecular changes were identified in case 3 and case 5 using next-generation sequencing (including 131 genes related to diagnosis and prognosis of central nervous system tumors). All patients underwent complete or substantial tumor excision without adjuvant chemoradiotherapy. Post-operative follow-up information over intervals of 6 months to 8 years was available for five patients. All patients were free of recurrence. Conclusions: MVNT is an indolent tumor, mostly affecting adults, which supports classifying MVNT as WHO grade 1. There is no tumor recurrence even in the patients treated with subtotal surgical excision. MVNTs may be considered for observation or non-surgical treatments if they are asymptomatic.


Assuntos
Neoplasias Encefálicas , Cérebro , Adulto , Feminino , Humanos , Masculino , Neoplasias Encefálicas/patologia , Cérebro/metabolismo , Cérebro/patologia , Neurônios/metabolismo , Convulsões , Lobo Temporal/patologia , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo
7.
Artigo em Russo | MEDLINE | ID: mdl-36440773

RESUMO

The article provides a literature review of the principles and the results of surgical treatment of giant tumors of the cerebral hemispheres in children. The article highlights the unsolved problems of modern neurosurgery of giant tumors.


Assuntos
Cérebro , Neoplasias , Neurocirurgia , Criança , Humanos , Procedimentos Neurocirúrgicos
8.
Int J Mol Sci ; 23(21)2022 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-36361987

RESUMO

In rodent models, leukemia inhibitory factor (LIF) is involved in cerebral development via the placenta, and maternal immune activation is linked to psychiatric disorders in the child. However, whether LIF acts directly on neural progenitor cells (NPCs) remains unclear. This study performed DNA microarray analysis and quantitative RT-PCR on the fetal cerebrum after maternal intraperitoneal or fetal intracerebral ventricular injection of LIF at day 14.5 (E14.5) and determined that the expression of insulin-like growth factors (IGF)-1 and -2 was induced by LIF. Physiological IGF-1 and IGF-2 levels in fetal cerebrospinal fluid (CSF) increased from E15.5 to E17.5, following the physiological surge of LIF levels in CSF at E15.5. Immunostaining showed that IGF-1 was expressed in the cerebrum at E15.5 to E19.5 and IGF-2 at E15.5 to E17.5 and that IGF-1 receptor and insulin receptor were co-expressed in NPCs. Further, LIF treatment enhanced cultured NPC proliferation, which was reduced by picropodophyllin, an IGF-1 receptor inhibitor, even under LIF supplementation. Our findings suggest that IGF expression and release from the NPCs of the fetal cerebrum in fetal CSF is induced by LIF, thus supporting the involvement of the LIF-IGF axis in cerebral cortical development in an autocrine/paracrine manner.


Assuntos
Cérebro , Fator Inibidor de Leucemia , Células-Tronco Neurais , Somatomedinas , Animais , Feminino , Gravidez , Ratos , Proliferação de Células , Cérebro/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Fator de Crescimento Insulin-Like II/metabolismo , Fator Inibidor de Leucemia/metabolismo , Células-Tronco Neurais/metabolismo , Receptor IGF Tipo 1/metabolismo
9.
eNeuro ; 9(6)2022.
Artigo em Inglês | MEDLINE | ID: mdl-36265904

RESUMO

Serotonin (5-HT) participates in the pathogenesis of amyotrophic lateral sclerosis (ALS), but its effects have not been completely clarified. Therefore, we observed the distribution features and potential effects of 5-HT in the cerebrum of G93A SOD1 transgenic (TG) and wild-type (WT) mice by fluorescence immunohistochemistry, Western blotting, ELISA, as well as motor function measurements. Both 5-HT and tryptophan hydroxylase-2 (TPH2) were mainly present in the limbic systems of the cerebrum, such as the glomerular layer of the olfactory bulb, nucleus accumbens, cingulate, fimbria of the hippocampus, mediodorsal thalamic nucleus, habenular nucleus, ventromedial hypothalamus nucleus, lateral hypothalamus area, dorsal raphe nucleus, and piriform cortex. TPH2 and 5-HT were expressed in cell bodies in the dorsal raphe nucleus and piriform cortex, while in other regions they were distributed as filaments and clump shapes in axons. The TPH2 distribution in the cerebrum of TG was significantly lower than that in WT in preset, onset, and progression stages. TPH2 expression in the fimbria of the hippocampus, mediodorsal thalamic nucleus, habenular nucleus, ventromedial hypothalamus nucleus and lateral hypothalamus area was increased in the onset stage and decreased in the progression stage, gradually decreased in the cingulate with disease progression and significantly decreased in the glomerular layer of the olfactory bulb and nucleus accumbens in the onset stage in TG. The number of mammalian achaete-scute homolog-1 in the subventricular zone (SVZ) in TG was significantly lower than that in WT, which was correlated with the TPH2 distribution. Double immunofluorescence staining showed that TPH2, mammalian achaete-scute homolog-1 and 5-HT were mainly expressed in neurons but rarely expressed in microglia or astrocytes in the piriform cortex. The relative fluorescence density of TPH2 in the cingulate region was negatively correlated with the disease severity. Our findings suggest that 5-HT plays a protective role in ALS, likely by regulating neural stem cells in the subventricular zone that might be involved in neuron development in the piriform cortex.


Assuntos
Esclerose Amiotrófica Lateral , Cérebro , Camundongos , Animais , Camundongos Transgênicos , Serotonina/metabolismo , Superóxido Dismutase-1/metabolismo , Esclerose Amiotrófica Lateral/metabolismo , Cérebro/metabolismo , Mamíferos/metabolismo
10.
Food Chem Toxicol ; 170: 113462, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36216167

RESUMO

Atrazine (ATR) is a widely used herbicide with biologically toxic effects that can lead to neurotoxicity. Lycopene (LYC) is an antioxidant with chemoprotective properties. However, little know about the mechanisms of preventative interventions about LYC alleviated ATR-induced neurotoxicity. Male mice were treated with distilled water (C), 5 mg/kg BW/day LYC (L), 50 and 200 mg/kg BW/day ATR (A1, A2), respectively and LYC + ATR (A1+L, A2+L). ATR promoted oxidative stress and inflammatory damage, as showed by the effects on MDA, H2O2, IL-6 and TNF-α accumulation, and IL-10, SOD, CAT and GSH depletion, which caused neuronal swelling and mitochondrial vacuolar degeneration. ATR disrupted the CYP450s balance via increasing contents of CYP450 and cytochrome B5, enhancing activities of NCR and ERND and activating NXRs and NXRs-related transcription factors. However, all these effects were reversed by LYC pretreatment. Collectively, these data indicated that LYC inhibited ATR-induced oxidative damage through modulating xenobiotic-sensing nuclear receptors and CYP450s.


Assuntos
Atrazina , Cérebro , Masculino , Camundongos , Animais , Atrazina/toxicidade , Licopeno/farmacologia , Xenobióticos/toxicidade , Peróxido de Hidrogênio/farmacologia , Receptores Citoplasmáticos e Nucleares , Sistema Enzimático do Citocromo P-450/metabolismo , Estresse Oxidativo , Cérebro/metabolismo
11.
Oper Neurosurg (Hagerstown) ; 23(5): 355-366, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36227194

RESUMO

BACKGROUND: An understanding of the anatomy of white matter tracts and their 3-dimensional (3D) relationship with each other is important for neurosurgical practice. The fiber dissection technique contributes to this understanding because it involves removing the brain's white matter tracts to reveal their anatomic organization. Using this technique, we built freely accessible 3D models and augmented and virtual reality simulations of white matter tracts. OBJECTIVE: To define the white matter tracts of cadaveric human brains through fiber dissection and to make 2-dimensional and 3D images of the white matter tracts and create 3D models and augmented and virtual reality simulations. METHODS: Twenty cadaveric brain specimens were prepared in accordance with the Klingler method. Brain hemispheres were dissected step-by-step from lateral-to-medial and medial-to-lateral directions. Three-dimensional models and augmented reality and virtual reality simulations were built with photogrammetry. RESULTS: High-resolution 3D models and augmented reality and virtual reality simulations of the white matter anatomy of the cerebrum were obtained. These models can be freely shifted and rotated on different planes, projected on any real surface, visualized from both front and back, and viewed from various angles at various magnifications. CONCLUSION: To our knowledge, this is the first detailed study integrating various technologies (3D modeling, augmented reality, and virtual reality) for high-resolution 3D visualization of dissected white matter fibers of the entire human cerebrum.


Assuntos
Cérebro , Realidade Virtual , Substância Branca , Cadáver , Cérebro/anatomia & histologia , Dissecação/métodos , Humanos , Substância Branca/anatomia & histologia
12.
Medicina (Kaunas) ; 58(10)2022 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-36295526

RESUMO

(1) Background: The anterior cerebral artery (ACA) has a precommunicating A1 segment, followed by a postcommunicating A2 segment. Anatomically, after it sends off from the callosomarginal artery (CMA), it continues as the pericallosal artery (PCalA). A detailed pattern of the anatomical variations of the PCalA are needed for practical reasons. (2) Methods: There were 45 retrospectively documented Computed Tomography Angiograms of 32 males and 13 females. (3) Results: In 90 sides, eleven different types of PCalA were documented: type 1: normal origin, above the genu of the corpus callosum (CC) (51.11%); type 2: low origin, below the rostrum of the CC (8.88%); type 3: late origin, above the body of the CC (3.33%); type 4, initial transcallosal course (3.33%); type 5, duplicated PCalA (1.11%); type 6, azygos PCalA (2.22%); type 7, absent PCalA (CMA type of ACA) (7.78%); type 8: CMA continued as PCalA (5.56%); type 9: PCalA continued as the cingular branch (1.11%); type 10: PCalA type of ACA, absent CMA (14.44%); type 11: triple PCalA, with an added median artery of the CC (1.11%). Different types of CMA were also documented: type 0, absent CMA (17.78%); type 1, CMA with frontoparietal distribution (45.56%); type 2, CMA with parietal distribution (22.22%); type 3, low origin of CMA, either from A1, or from A2 (8.88%); type 4, CMA continued as PCalA (5.56%). Ipsilateral combinations of PCalA and CMA types were classified as types A-P. In 33/45 cases (73.3%), the bilateral asymmetry of the combined anatomical patterns of PCalA and CMA was documented. Additional rare variations were found: (a) huge fenestration of A2; (b) bihemispheric ACAs (6/45 cases); (c) twisted arteries within the interhemispheric fissure. (4) Conclusions: The PCalA and CMA are anatomically diverse and unpredictable. Therefore, they should be documented on a case-by-case basis before surgical or endovascular approaches.


Assuntos
Artéria Cerebral Anterior , Cérebro , Masculino , Feminino , Humanos , Artéria Cerebral Anterior/diagnóstico por imagem , Artéria Cerebral Anterior/cirurgia , Estudos Retrospectivos
15.
Psicosom. psiquiatr ; (23): 60-62, Oct-Dic. 2022.
Artigo em Inglês, Espanhol | IBECS | ID: ibc-214152

RESUMO

El artículo presenta la definición actual y comprehensible de la Esquizofrenia, incluyendo todos los aspectos que involucran al concepto.(AU)


The article present the current comprehensive definition of Schizophrenia, including all the aspects involves in the concept.(AU)


Assuntos
Humanos , Esquizofrenia , Cérebro , Encefalopatias , Sintomas Psíquicos , Medicina Psicossomática , Psiquiatria
17.
Leg Med (Tokyo) ; 59: 102144, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36088752

RESUMO

A male in his late 50s had been complaining of headaches and dizziness for 25 years. He also had episodes of losing consciousness, but had not sought treatment because of financial hardship. He was found in the ocean. Autopsy revealed foamy liquid leaking from his nose and mouth, and pleural effusions. The trachea and bronchi contained the same foamy liquid. The lungs were swollen and edematous, and leaked a large amount of foamy liquid. His cause of death was diagnosed as drowning. In the brain, the veins on the frontal lobe and the temporal pole, each on the right cerebral hemisphere, were dilated. A vascular lesion measuring 5 × 5 × 8 cm was found on the bottom of the right frontal lobe, and was located between the right middle cerebral artery and those veins. This vascular lesion extended to the brain parenchyma, and the basal ganglia of the right cerebrum was displaced outward and upward. The vascular lesions in the brain showed blood vessels of various sizes and shapes, and some of the vessel walls were thickened. The vascular lesion on the right frontal lobe was diagnosed as an arteriovenous malformation (AVM). According to the police investigation, the harbor where his body was found was a place he often came for fishing and walking. The possibility of suicide cannot be ruled out. Moreover, it was considered that his AVM might have rendered him unconscious, causing him to fall into the ocean.


Assuntos
Cérebro , Afogamento , Malformações Arteriovenosas Intracranianas , Humanos , Masculino , Malformações Arteriovenosas Intracranianas/complicações , Malformações Arteriovenosas Intracranianas/patologia , Malformações Arteriovenosas Intracranianas/terapia , Convulsões , Cérebro/patologia , Lobo Frontal
18.
Life Sci ; 308: 120958, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36108767

RESUMO

Neurodegenerative diseases are one of the major complications of type 1 diabetes mellitus (T1DM). The effect of insulin monotherapy on controlling blood glucose and neurodegeneration associated with diabetes is unsatisfactory. It is revealed that oxidative stress is a key element in T1DM. Therefore, N-acetylcysteine (NAC) was used together with insulin to investigate the therapeutic effect on neuronal damage in T1DM in this study. A total of 40 beagles were randomly divided into 5 groups (control group, DM group, insulin monotherapy group, NAC combined with insulin group, and NAC monotherapy group) to explore the effects of NAC on alleviating the oxidative damage in cerebrum. Our results showed that the contents of H2O2, 8-OHdg and MDA were apparently increased in DM group, while DNA and lipid oxidative damage was alleviated by the treatment of NAC and insulin. Histopathology revealed the sparse of neurofibrils and vacuolar degeneration in DM group. Additionally, compared with the control group, the mRNA expression levels of HO-1, nqo1, GCLC and GSTM1 were significantly decreased in DM group, while the opposite trend could be shown under NAC combined with insulin treatment. Meanwhile, the tight junction proteins of ZO-1, occludin and Claudin-1 were up-regulated with the treatment of NAC combined with insulin. Additionally, NAC further alleviated oxidative damage by enhancing the activity of GSH, Trx and TrxR and reducing the activity of catalase, GSSG and Grx to maintain redox homeostasis. These results demonstrated that NAC combined with insulin exerted protective effects against T1DM-induced cerebral injury via maintaining cerebral redox homeostasis.


Assuntos
Cérebro , Diabetes Mellitus Tipo 1 , Acetilcisteína/uso terapêutico , Animais , Antioxidantes/farmacologia , Glicemia , Catalase/metabolismo , Cérebro/metabolismo , Claudina-1/metabolismo , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/tratamento farmacológico , Cães , Dissulfeto de Glutationa/metabolismo , Dissulfeto de Glutationa/farmacologia , Homeostase , Peróxido de Hidrogênio/farmacologia , Insulina/metabolismo , Lipídeos/farmacologia , Ocludina/metabolismo , Oxirredução , Estresse Oxidativo , RNA Mensageiro/metabolismo
19.
Curr Biol ; 32(18): R957-R960, 2022 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-36167045

RESUMO

Hemispheric differences speak to the functional organisation of the human brain. A new study causally demonstrates such differences are present in bilateral motion-selective areas that are early in the visual cortical hierarchy.


Assuntos
Cérebro , Percepção de Movimento , Córtex Visual , Encéfalo , Mapeamento Encefálico , Lateralidade Funcional , Humanos
20.
Radiología (Madr., Ed. impr.) ; 64(5): 415-421, Sep.-Oct. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-209917

RESUMO

Introducción: El uso de anestesia general en niños pequeños conlleva riesgos, a corto y largo plazo. El objetivo de este estudio fue evaluar la eficacia de la técnica de resonancia magnética (RM) cerebral sin anestesia mediante fijación con colchón en niños menores de 3 meses. Pacientes y métodos: Estudio prospectivo de casos y controles realizado en el año 2019. Los casos fueron pacientes menores de 3 meses con indicación de RM craneal, estables y sin soporte ventilatorio; las resonancias se realizaron usando la técnica de dar de comer y dormir y un colchón inmovilizador. Los controles fueron pacientes de la misma edad y sexo, inestables clínicamente, derivados para realizar RM craneal con anestesia general. Tres radiólogos pediátricos evaluaron el éxito de la RM (si respondía a la pregunta clínica), si era necesario repetirla y calificaron la presencia de artefactos de movimiento en una escala del 1 al 4. Resultados: 47 casos fueron incluidos en este estudio (28 niños, 19 niñas; media: 31 días de vida), de los cuales (89%) 42 RM fueron llevadas a cabo de manera exitosa. Los estudios realizados de manera ambulatoria se asociaron a mayor posibilidad de fallo de la técnica que los realizados a ingresados (valor de p 0,02). El 60% de las RM de los casos realizados tuvieron calidad óptima y el 30%, subóptima (artefacto de movimiento en una o dos secuencias). No se detectaron problemas de seguridad con esta técnica. La media de duración de los estudios fue de 16,6 minutos (rango 6-30 minutos). El 100% de las RM de los controles bajo anestesia general se llevaron a cabo con éxito, con una calidad óptima en el 89% y subóptima en el 11% restante. En el primer año de experiencia con esta técnica, de 47 RM realizadas, se evitó el uso de anestesia general a 42 recién nacidos. Conclusión: La técnica de dar de comer y dormir y fijación con colchón neumático para realizar RM sin anestesia puede realizarse de forma eficaz y segura en niños menores de 3 meses.(AU)


Introduction: The use of general anesthesia in infants involves both short-term and long-term risks. The aim of this study is to evaluate the efficacy of brain MRI without anesthesia in infants younger than 3-month-old immobilized with a pillow. Patients and methods: This prospective case-control study was done in 2019. Cases were stable patients less than 3 months old who did not require ventilatory support for whom brain MRI was indicated. Patients were fed so they would fall asleep and placed in the scanner with an immobilizing pillow. Controls were clinically unstable patients matched for age and sex referred for brain MRI under general anesthesia. Three pediatric radiologists evaluated the success of the MRI study (whether it answered the clinical question), recorded whether it was necessary to repeat the study, and rated the presence of motion artifacts on a scale ranging from 1 to 4. Results: A total of 47 cases were included (28 boys and 19 girls; mean age, 31 days). Of these, 42 (89%) MRI studies were considered successful. The proportion of successful MRI studies was lower in outpatients than in inpatients (p=0.02). The quality of MRI in cases was considered optimal in 60% and suboptimal (motion artifacts in one or two sequences) in 30%. No safety issues related with the technique were detected. The mean duration of the studies was 16.6minutes (range, 6-30minutes). All of the MRI studies in controls were considered successful; quality was considered optimal in 89% and suboptimal in 11%. In the first year in which we used this technique, we avoided the use of general anesthesia in 47 MRI studies in 42 newborns. Conclusion: Brain MRI using the feed and sleep technique in infants younger than 3-month-old immobilized with a pillow can be done safely and efficaciously without general anesthesia.(AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Espectroscopia de Ressonância Magnética , Cérebro/diagnóstico por imagem , Anestesia Geral , Crânio , Neonatologia , Radiologia , Estudos de Casos e Controles , Estudos Prospectivos , Serviço Hospitalar de Radiologia
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