ABSTRACT
The Detection of neurologic signs for topographical disorders in central nerves system can prevent unnecessary neuroimaging techniques such as MRI. This study was performed to determine the diagnostic value of physical examination for topographic detection of infratentorial lesions in patients with cerebrovascular syndromes. This descriptive study was done on 200 patients with cerebrovascular syndrome in Qaem Hospital in Mashhad, north-east Iran during 2011. Regarding to topographic physical examination, sensitivity, specificity, positive and negative predictive value and accuracy of signs of syndromes were compared to MRI as gold standard method. The accuracy of tetraparesis and crossed syndromes for localization of brain lesion in brainstem was 79% and 83%, respectively. The accuracy of hemiataxia for localization of brain lesion in ipsilateral cerebellar hemisphere was 98%. The accuracy of Wallenberg syndrome for localization of brain lesion in posterolateral medulla was 98%. Using clinical neuro-examination skills and accurate topographic physical examination can prevent unwanted MRI technique for the diagnoses of cerebrovascular syndromes
ABSTRACT
Diastematomyelia is one of the uncomon and occult spinal dysraphisms. The term is derived from two latin word: diastemato means split and myelous means cord. The pathological characteristics consist of longitudinal cleft in the spinal cord of the lower thoracic and upper lumbar spinal column in children and rarely in adults. This report has encountered with 4 cases during one year [2003-2004] in M.R.I, centers of university and private clinic that MRI showing a midline dimple shape and hemicord appearance. This study and article found that patient diagnosis with MRI is more reliable and more accurate than other radiological techniques specially CT scanning, because of multisectional and multiplanners for a better view of the lesion. In this study most of patients are a female infant with a majority of clinical neurologic findings including motor and sensory loss in the lower extremities and bladder dysfunction