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Intracranial Lesions (intracranial + lesion)
Selected AbstractsPathological and epidemiological observations on rickettsiosis in cultured sea bass (Dicentrarchus labrax L.) from GreeceJOURNAL OF APPLIED ICHTHYOLOGY, Issue 6 2004F. Athanassopoulou Summary A systemic infection of a Rickettsia -like organism (RLO) in cultured sea bass is described for the first time. In hatcheries, clinical signs were lethargy, inappetence and discoloration. Twenty days after transfer to sea cages from hatcheries where the disease existed, fish showed erratic and abnormal swimming behaviour, loss of orientation, and lethargy. Cumulative mortality in colder months of the year reached 30% in hatcheries and 80% in cages. Surviving fish in cages did not show any clinical signs of RLO infection in the subsequent year. Evidence for a systemic distribution of RLO was supported by histolopathological lesions in both infected hatchery and caged fish, where the lesion profile included cranial sensory, central nervous, integumental and alimentary organ systems. Intracranial lesions were primarily characterized by an ascending histiocytic perineuritis and necrotizing congestive meningoencephalitis, with evidence for transfer of infective agents across the blood,brain barrier confirmed by the presence of RLOs within capillary endothelium and histiocytes in inflamed regions of the optic tectum and the cerebellum. In the most severe cases, infection spread to the statoacoustical (semicircular) canal system and the ependymal lining of ventricles, with marked rickettsial-laden histiocytic infiltration of the canal lumen. Integumental lesions were restricted to the oral submucosa, nares and integumental dermis of the cranium. Alimentary lesions were noted in both the liver parenchyma and mucosa/submucosa of the stomach. In all affected organs the RLOs were found by immunohistochemistry to be related to Piscirickettsia salmonis. [source] Visceral Kaposi's sarcoma with intracranial metastasis: A rare complication of renal transplantationPEDIATRIC TRANSPLANTATION, Issue 6 2002Elif Bahat Abstract: The incidence of Kaposi's sarcoma (KS) has increased in solid organ transplantation recipients. This type of KS tends to be aggressive, involving lymph nodes, mucosa and visceral organs in about half of patients, sometimes in the absence of skin lesions. Brain involvement of KS has rarely been reported. A 16-yr-old Turkish boy underwent renal transplantation from his mother. The immunosuppressive regimen included prednisolone, cyclosporin A and azathioprine. Fourteen months later the azathioprine was changed to cyclophosphamide (3 mg/kg/day) because of the development of a nephrotic syndrome. After 12 weeks, the cyclophosphamide was changed to mycophenolate mofetil (MMF) to control the nephrotic syndrome. At this time his serum creatinine level rose to 2.1 mg/dL. Polyclonal or monoclonal antibodies were never given. Multiple intra-abdominal lymphadenopathy was detected on abdominal tomography at the 32nd month after renal transplantation. Kaposi's sarcoma was diagnosed via laparotomy and biopsy. He had a generalized tonic and clonic seizure and contrast enhanced cranial tomography showed two intracranial masses which had an abundant vascular component which caused a mild shift. One of the masses was removed via a burr-hole with the aim of diagnosis and treatment of the shift. A pathologic examination of the intracranial lesion was also reported as Kaposi's sarcoma. Herpes virus-8 DNA was detected by PCR in the intracranial lesion. [source] Stereotactic biopsy and cytological diagnosis of solid and cystic intracranial lesionsCYTOPATHOLOGY, Issue 3 2003L. M. Collaço Cytological smears from 115 consecutive cases of stereotactic biopsies of intracranial lesions were reviewed. Ninety-five lesions were solid and 20 cystic. Material from 90 solid and 13 cystic lesions was sent both for cytological and histological examination. In 66 of the solid lesions, the cytological diagnosis was confirmed by histology (five were benign lesions and 61 malignant tumours: 56 primary brain tumours, three metastases and two lymphomas). In 24 cases with discrepant cytology and histology, the histology was inconclusive or insufficient in 14 cases, while cytology established the diagnosis of astrocytoma grade II (seven cases), metastases (two cases), gliosis (one case) and benign (four cases). Necrosis of tumour type was observed cytologically in six patients representing glioblastoma (two cases), anaplastic astrocytoma (one case), lymphoma (one case) and normal brain (two cases) histologically. Three cases reported cytologically as benign were primary brain tumour (two cases) and gliosis (one case). One smear of a glioblastoma was insufficient for cytological diagnosis. Cystic lesions were cytologically benign in 17 cases and malignant in three cases. Histology from the cyst wall confirmed the malignant diagnosis in three cases and showed tumour in six more cases, a benign process (two cases), changes induced by radiotherapy for arteriovenous malformation (one case) and insufficient material (one case). In conclusion, cytology from solid brain lesion allows an accurate diagnosis and subtyping of tumours in a majority of cases, and can thus be used to choose type of therapy. In cystic brain tumours, however, examination of the cystic fluid, is often inconclusive and a biopsy from the cyst wall should be performed if there is clinical or radiological suspicion of tumour. [source] Coma after spinal anaesthesia in a patient with an unknown intracerebral tumourACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2010T. METTERLEIN Spinal anaesthesia is contraindicated in patients with elevated intracranial pressure or space-occupying intracranial lesions. Drainage of the lumbar cerebrospinal fluid (CSF) can increase the pressure gradient between the spinal, supratentorial and infratentorial compartments. This can result in rapid herniation of the brain stem or occluding hydrocephalus. We present a case of a female patient with an occult brain tumour who received a spinal anaesthesia for an orthopaedic procedure. The primary course of anaesthesia was uneventful. Several hours after surgery, the patient became increasingly disoriented and agitated. The next day, she was found comatose. A computed tomogram of the head revealed herniation of the brain stem, resulting in an occluding hydrocephalus due to a prior not known infratentorial mass. By acute relieving of the intracranial pressure by external CSF drainage, the mass was removed 2 days later. The further post-operative course was uneventful and the patient was discharged from the hospital without neurological deficit 3 weeks after the primary surgery. [source] Improved bolus arrival time and arterial input function estimation for tracer kinetic analysis in DCE-MRIJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 1 2009Anup Singh PhD Abstract Purpose To develop a methodology for improved estimation of bolus arrival time (BAT) and arterial input function (AIF) which are prerequisites for tracer kinetic analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data and to verify the applicability of the same in the case of intracranial lesions (brain tumor and tuberculoma). Materials and Methods A continuous piecewise linear (PL) model (with BAT as one of the free parameters) is proposed for concentration time curve C(t) in T1 -weighted DCE-MRI. The resulting improved procedure suggested for automatic extraction of AIF is compared with earlier methods. The accuracy of BAT and other estimated parameters is tested over simulated as well as experimental data. Results The proposed PL model provides a good approximation of C(t) trends of interest and fit parameters show their significance in a better understanding and classification of different tissues. BAT was correctly estimated. The automatic and robust estimation of AIF obtained using the proposed methodology also corrects for partial volume effects. The accuracy of tracer kinetic analysis is improved and the proposed methodology also reduces the time complexity of the computations. Conclusion The PL model parameters along with AIF measured by the proposed procedure can be used for an improved tracer kinetic analysis of DCE-MRI data. J. Magn. Reson. Imaging 2009;29:166,176. © 2008 Wiley-Liss, Inc. [source] Time-resolved contrast-enhanced MR angiography of intracranial lesionsJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2008Zhitong Zou MD Abstract Purpose To determine if contrast-enhanced (CE) MRI of intracranial lesions benefits from time-resolved MR angiography (MRA) during contrast agent injection. Materials and Methods For 126 patients with suspected intracranial lesions undergoing routine CE MRI at 3.0T (N = 88) or 1.5T (N = 38), time-resolved CE MRA (three-dimensional [3D] time-resolved imaging of contrast kinetics [TRICKS]) was performed during injection of the routine gadolinium (Gd) dose of 0.1 mmol/kg. Time to peak (TTP) enhancement of lesions as well as time to internal carotid artery (ICA), middle cerebral artery (MCA), superior sagittal sinus (SSS), and jugular vein enhancement were measured. Source and maximum intensity projection (MIP) images were reviewed to delineate the spatial relationship of lesions and the vasculature. Results In 61 patients (48%), additional important findings were detected on time-resolved MRA that were not seen on the routine CE protocol, including aneurysms (N = 6), arteriovenous malformations (N = 7), ICA stenoses (N = 2), vascular anomalies (N = 18), and relationships between lesions and vessels (N = 28). In addition, tumor TTP correlated with glioma grade (r = 0.87) and discriminated epithelial from nonepithelial meningiomas (P = 2.6 × 10,5). MRA added eight minutes to the total exam time. Conclusion Time-resolved MRA performed during contrast agent injection adds information to the routine brain CE MRI examination of intracranial lesions with only a small time penalty and no additional risk to the patient. J. Magn. Reson. Imaging 2008. © 2008 Wiley-Liss, Inc. [source] Update of radiosurgery at the Royal Adelaide HospitalJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 2 2006DE Roos Summary This is an update of the Royal Adelaide Hospital radiosurgery experience between November 1993 and December 2004 comprising 165 patients with 168 intracranial lesions. Including re-treatment, there were 175 treatment episodes (163 radiosurgery and 12 stereotactic radiotherapy) at an average of 1.3 per month. The commonest lesions were acoustic neuroma (65), arteriovenous malformation (58), solitary brain metastasis (23) and meningioma (14). The clinical features, treatment details and outcome are described. Our results continue to be well within the range reported in the published work. Radiosurgery provides an elegant, non-invasive alternative to neurosurgery and conventional external beam radiotherapy for many benign and malignant brain tumours. [source] Combined Use of F-18 Fluorocholine Positron Emission Tomography and Magnetic Resonance Spectroscopy for Brain Tumor EvaluationJOURNAL OF NEUROIMAGING, Issue 3 2004Sandi A. Kwee MD ABSTRACT Background. Choline metabolism is often abnormal in malignant brain tumors.Methods. Brain positron emission tomography (PET) imaging with F-18 fluorocholine (FCH) was performed on 2 patients with intracranial lesions suspected to be high-grade malignant gliomas on the basis of magnetic resonance (MR) imaging and multivoxel 1H-MR spectroscopic imaging (MRSI) findings. Standardized uptake value (SUV) measurements on PET were compared with measurements of choline/creatine metabolite ratio on MRSI in corresponding regions. Brain biopsy revealed glioblastoma multiforme (GBM) in one case and demyelinating disease in the other.Results. In the case of GBM, the tumor demonstrated increased FCH uptake on PET. The mean and maximum SUV in areas of the tumor correlated with regional choline/ creatine ratio measurements (r= 0.76,P < .001;r= 0.83,P < .001, respectively). In the case of tumefactive demyelinating lesions, the lesion demonstrated low FCH uptake, which did not correlate with choline/ creatine ratio measurements.Conclusions. Assessments of choline metabolism may aid in evaluating intracranial mass lesions. [source] Cerebrospinal fluid opening pressure measurements in acute headache patients and in patients with either chronic or no painACTA NEUROLOGICA SCANDINAVICA, Issue 2010S. H. Bø Bø SH, Davidsen EM, Benth J,, Gulbrandsen P, Dietrichs E. Cerebrospinal fluid opening pressure measurements in acute headache patients and in patients with either chronic or no pain. Acta Neurol Scand: 2010: 122 (Suppl. 190): 6,11. © 2010 John Wiley & Sons A/S. Objective,,, To observe cerebrospinal fluid opening pressure (CSFOP) in different clinical settings and in patients with acute, chronic and no pain and to observe possible differences because of age and sex. Method,,, In this prospective study, CSFOP was measured in lumbar puncture in three different settings of clinical investigations; patients with acute headache investigated for subarachnoidal haemorrhage (n = 222), patients with sciatica undergoing myelography (n = 61), and patients in an outpatient neurological clinic (n = 65). Results,,, The mean CSFOP in cm H2O was 17.3 for the myelography patients, 19.1 for the outpatients, 19.3 for the primary headache patients and 22.4 for the patients with secondary headache. Large proportions of patients in all groups had CSFOP above 20 cm H2O. The female patients in all groups had lower mean CSFOP than the male patients. Conclusion,,, The CSFOP levels found in clinical practice among patients without intracranial lesions or infectious conditions were broader than expected. Measurement of CSFOP is of limited value as diagnostic procedure if not closely linked to clinical symptoms and finds. [source] Neuroprotein s-100B , a useful parameter in paediatric patients with mild traumatic brain injury?ACTA PAEDIATRICA, Issue 10 2009C Castellani Abstract Aims:, To examine the correlation of S-100B to cranial computerized tomography (CCT) scan results in children after mild traumatic brain injury (MTBI). Methods:, One hundred and nine paediatric patients (0,18 years) with MTBI were included in this prospective single-centre study. Serum was collected within 6 h of trauma for determination of serum S-100B. The upper reference of S-100B was set to 0.16 ,g/L. A CCT scan was performed in all patients and the results were correlated to the S-100B values. Results:, Computerized tomography was abnormal in 36 patients showing intracerebral haemorrhages and/or skull fractures. Serum S-100B level was significantly higher in patients with a pathological condition as shown in CT scan results (p = 0.003). There were no false negative, but 42 false positive test results for S-100B. This resulted in a sensitivity of 1.00, specificity of 0.42, positive predictive value of 0.46 and negative predictive value of 1.00. An area under the receiver operating curve of 0.68 was calculated. Conclusion:, S-100B is a valuable tool to rule out patients with pathological CCT findings in a collective of paediatric patients with MTBI. Elevations of S-100B do not necessarily lead to a pathological finding in the CT scan, but values below the cut-off safely rule out the evidence of intracranial lesions. [source] | ||||||||||