ABSTRACT
We report a patient diagnosed with neuro-Behcet's disease showing multiple enhancing lesions on a brain MRI that were confined to the cerebral cortex without any involvement of other brain regions. The patient, a 30-year-old man, was admitted because of seizure attacks. He had the symptom triad of recurrent oral ulcer, genital ulcer, and uveitis. Neurologic symptoms included ataxia, dysarthria, and dementia which had progressed over several years. During the hospital course, he underwent a right hemicolectomy due to bowel perforation. A pathological examination showed multiple discrete ulcerations from the cecum to the mid-transverse colon, consistent with Behcet's colitis. A brain MRI revealed multiple small enhancing lesions distributed over wide areas of the cerebral cortex. To our knowledge, this pattern of lesion distribution has not yet been reported in neuro-Behcet's disease.
Subject(s)
Adult , Humans , Ataxia , Brain , Cecum , Cerebral Cortex , Colitis , Colon , Dementia , Dysarthria , Magnetic Resonance Imaging , Neurologic Manifestations , Oral Ulcer , Seizures , Ulcer , UveitisABSTRACT
PURPOSE: To assess the embolization effect of dural arteriovenous fistula(DAVF). MATERIALS AND METHODS: Weevaluated 23 patients with DAVF who were diagnosed using digital subtraction angiography and treated bytransarterial and/or transvenous emobolization. The locations of DAVFs, as seen on angiography were as follows: 16in the cavernous sinus, four in the major dural sinuses, two in the jugular bulb, one in the torcula Herophili,and one in the tentorium cerebelli. On the basis of venous drainage patterns, Cognard's classification of DAVF wasused. Among our 23 patients, 13 underwent transarterial embolization, six underwent transvenous embolization, andfour underwent both. After embolization, three patients underwent other treatment: surgery, one ; gammairradiation, one ; and both. One. Polyvinyl alcohol particles or glue was used in transarterial embolization, andtungsten, platinum, or Guglielmi detachable coils in transvenous embolization. To analyse the residual lesion inDAF, we compared pre- and post-treatment angiograms ; patients were followed up for 2 to 48 months, and theircondition was assessed as cured, improved, not changed, or aggravated. RESULTS: Nine patients were found to beCognard type I, two were IIa, four were IIa+b, and eight were type III. Of our 23 patients, 12 were cured, tenimproved, and one was aggravated ; of the 13 who underwent transarterial embolization, four were cured, eightimproved, and one was aggravated ; of the six who underwent transvenous embolization, five were cured and oneimproved. The condition of a patient with a lesion in the torcular herophili was aggravated despite surgery andgamma irradiation after embolization. CONCLUSION: DAVF can be managed successfully with endovascular treatment.The outcome of the transvenous approach appears to be better than that of the transarterial approach alone. In acase involving a lesion in the torcular herophili, the outcome was poor and more aggressive treatment wasrequired.
Subject(s)
Humans , Adhesives , Angiography , Angiography, Digital Subtraction , Arteriovenous Fistula , Cavernous Sinus , Central Nervous System Vascular Malformations , Classification , Drainage , Platinum , Polyvinyl AlcoholABSTRACT
No abstract available.
ABSTRACT
Spontaneous spinal subarachnoid hemorrhage is unusual, accounting for less than 1% of all cases of subarachnoid hemorrhge. Very rare cases have been reported that they had no definitive etiology of spontaneuos spinal subarachnoid hemorrhage. One patient with spontaneous spinal subarachnoid hemorrhage is presented to emphasize the clinical and radiological features of this uncommon illness. The patient had severe back pain at the onset and was unable to walk. The s!mtoms improved slowly with conservative treatments. Complete blood work up CSF culture and spinal angiogrphy failed to reveal a cause for the hemorrhage. This is believed to be the first case report of spontaneous spinal subarachnoid hemorrhage of unknown cause in Korea.
Subject(s)
Humans , Back Pain , Hemorrhage , Korea , Subarachnoid HemorrhageABSTRACT
This study was performed to evaluate, in complex partial seizure, the incidence and nature of MRI abnormality and the correlation between MRI and interictal nasopharyngeal EEG findings. MRI findings were also correlated with age of seizure onset, duration and clinical response to anticonvulsants. For this study, high field MR imaging and interictal nasopharyngeal EEG were performed in 122 patients with complex partial seizures. The patients were distributed in all age groups(mean age:26 years) and include 64 males and 58 females. The average duration of seizure disorder was 10.8 years. Abnormal MRI findings were discovered in 74 of 122 patients, in which mesial temporal sclerosis was most common(58.1%). And other abnormalities were neuroglial tumor(l3.5%), infectious lesion (10.8%), vascular lesion (6.8%), hemiatrophy (4.19@), cystic mass (2.7%) and others (4.1%). There were only slight difference in seizure duration(p0.1).
Subject(s)
Female , Humans , Male , Age of Onset , Anticonvulsants , Electroencephalography , Epilepsies, Partial , Epilepsy , Incidence , Magnetic Resonance Imaging , Sclerosis , SeizuresABSTRACT
No abstract available.