ABSTRACT
Objective To search MRI features of patients with HIV-negative cryptococcus meningoencephalitis (CM)and evaluate the value in judging the prognosis of CM.Methods The findings of cranial MRI and prognosis were retrospectively analyzed in 19 cases with India-ink capsule staining-proved HIV-negative CM in our department.The prognosis was evaluated by Glasgow Outcome Scale:score 1=death,score 2=persistent vegetative state,score 3=severe disability,score 4=moderate disability,score 5=good recovery. The patients with score 1-3 were classified as the group of poor prognosis,while those with score 4,5 as good prognosis.Results Abnormal manifestations on cranial MRI were observed in 84.2%(1 6/1 9)cases,meninges enhanced in 84.2% (1 6/1 9),brain edema in 31.6%(6/1 9),brain parenchyma lesion in 47.4% (9/1 9 ),vasculitis in 5.2% (1/1 9 ).The mean duration of follow-up was 3.5 years,The prognosis of 5/9(44.4%)cases with brain parenchyma lesion confirmed by cranial MR was poor.Conclusion The MRI manifestation of HIV-negative CM is diverse,and brain parenchyma lesion confirmed by cranial MRI may associated with poor prognosis.
ABSTRACT
Objective To study the clinical and neuroimaging features of top of the basilar artery syndrome(TOBS).Methods The clinical and neuroimaging features of 63 cases with TOBS were analyzed retrospectively.Results Main causes of TOBS were atherosclerosis and embolisms.Vertigo and disturbance of consciousness and movement of the eye-ball,abnormality of pupils,partial blindness were the main clinical features.The most important imageologic feature of TOBS was infarction of thalami or midbrain,which was frequently complicating with infarction in other locations.Conclusion TOBS has simultaneously more than two infarction lesions,either superior or inferior tentorium of cerebellum with many complications and poor prognosis.MRI is more sensitive than CT.Early MRI examination,systemic and comprehansive treatment may improve the prognosis of the TOBS patients.