ABSTRACT
OBJECTIVE: Brain perfusion can be assessed non-invasively by modern arterial spin labeling MRI. The FAIR (flow-sensitive alternating inversion recovery)-TrueFISP (true fast imaging in steady precession) technique was applied for regional assessment of cerebral blood flow in brain areas close to the skull base, since this approach provides low sensitivity to magnetic susceptibility effects. The investigation of the rhinal cortex and the amygdala is a potentially important feature for the diagnosis and research on dementia in its early stages. MATERIALS AND METHODS: Twenty-three subjects with no structural or psychological impairment were investigated. FAIR-True-FISP quantitative perfusion data were evaluated in the amygdala on both sides and in the pons. A preparation of the radiofrequency FOCI (frequency offset corrected inversion) pulse was used for slice selective inversion. After a time delay of 1.2 sec, data acquisition began. Imaging slice thickness was 5 mm and inversion slab thickness for slice selective inversion was 12.5 mm. Image matrix size for perfusion images was 64 x 64 with a field of view of 256 x 256 mm, resulting in a spatial resolution of 4 x 4 x 5 mm. Repetition time was 4.8 ms; echo time was 2.4 ms. Acquisition time for the 50 sets of FAIR images was 6:56 min. Data were compared with perfusion data from the literature. RESULTS: Perfusion values in the right amygdala, left amygdala and pons were 65.2 (+/- 18.2) mL/100 g/minute, 64.6 (+/- 21.0) mL/100 g/minute, and 74.4 (+/- 19.3) mL/100 g/minute, respectively. These values were higher than formerly published data using continuous arterial spin labeling but similar to 15O-PET (oxygen-15 positron emission tomography) data. CONCLUSION: The FAIR-TrueFISP approach is feasible for the quantitative assessment of perfusion in the amygdala. Data are comparable with formerly published data from the literature. The applied technique provided excellent image quality, even for brain regions located at the skull base in the vicinity of marked susceptibility steps.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Amygdala/blood supply , Cerebrovascular Circulation , Dementia/diagnosis , Entorhinal Cortex/blood supply , Image Processing, Computer-Assisted , Magnetic Resonance Imaging/methods , Pons/blood supply , Reproducibility of Results , Spin LabelsABSTRACT
We report the case of a young man with anterior inferior cerebellar artery infarct causing unilateral deafness. Clinical features and audiometry suggested cochlear localization for deafness. MRI brain showed an infarct in the right AICA territory with involvement of pons. Involvement of the internal auditory artery explains the cochlear deafness.
Subject(s)
Adult , Arterial Occlusive Diseases/complications , Cerebellum/blood supply , Cerebral Angiography , Hearing Loss, Sudden/diagnosis , Hearing Loss, Unilateral/diagnosis , Humans , Infarction, Anterior Cerebral Artery/complications , Magnetic Resonance Imaging , Male , Pons/blood supplySubject(s)
Adult , Aged , Aged, 80 and over , Fatal Outcome , Female , Humans , Intracranial Hemorrhages/diagnosis , Middle Aged , Pons/blood supply , Recovery of FunctionABSTRACT
The combination of pure motor hemiplegia and horizontal gaze palsy is a rare but identifiable lacunar syndrome. Among horizontal gaze palsies, one-and-a-half syndrome and abducens nerve palsy are reported to be associated with pure motor hemiplegia in pontine lacunar infarction. Although conjugate lateral gaze palsy is also hypothesized, pure motor hemiplegia with conjugate lateral gaze palsy has never been reported. We present a 75-year-old man who showed right hemiparesis and impaired left horizontal conjugate eyeball movement. Both the findings of the brain CT scan and those of the MRI study were consistent with a small infarction in the left midpontine tegmentum. Magnetic resonance angiography revealed no stenotic narrowing of the vertebrobasilar artery. Radiological findings suggested that pure motor hemiplegia with conjugate lateral gaze palsy, in our patient, might have been produced by the occlusion of a single penetrating branch of the basilar artery.
Subject(s)
Aged , Humans , Male , Cerebral Infarction/complications , Hemiplegia/complications , Magnetic Resonance Imaging , Movement , Oculomotor Muscles , Paralysis/complications , Pons/blood supplyABSTRACT
O autor relata o caso de um paciente de sexo masculino de 54 anos com hematoma pontino que se manifestou por síndrome "one-and-a-half" e ataxia cerebelar mas sem sinais de acometimento do trato piramidal. A ausência de acometimento do trato piramidal é decorrente possivelmente de uma variaçäo da anatomia vascular do segmento pontino do tronco cerebral. Os achados clínicos do caso e os mecanismos fisiopatológicos da síndrome "one-and-a-half" säo discutidos
Subject(s)
Humans , Male , Middle Aged , Eye Movements/physiology , Hematoma/physiopathology , Ophthalmoplegia/physiopathology , Pons/blood supply , Cerebral Hemorrhage/diagnosis , Cerebral Hemorrhage/physiopathology , Hematoma/diagnosis , Hematoma/etiology , Magnetic Resonance Imaging , Ophthalmoplegia/diagnosis , Syndrome , Tomography, X-Ray ComputedABSTRACT
Two patients developed the locked-in state characterised by quadriplegia and mutism with an alert sensorium. Initially they had mild dysarthria and uncrossed hemisensory or hemimotor deficits involving the face and ipsilateral extremities. Both patients died. Rostral brainstem infarctions were found at autopsy in them. Acute onset of uncrossed hemisensory and hemimotor deficits with dysarthria may be caused by infarction of the pons which may predispose to locked-in state.
Subject(s)
Brain/pathology , Cerebral Infarction/pathology , Humans , Male , Middle Aged , Pons/blood supply , Pyramidal Tracts/pathology , Quadriplegia/pathologyABSTRACT
O autor relata um caso de lactente que com 50 dias de vida, de modo súbito, afebril, sem causa aparente, apresentou hemiplegia esquerda e paralisia nuclear dos nervos facial e abducente direitos. Nasceu de parto vaginal a termo, sem vícios ou deformaçöes, de peso, estatura, perímetro cefálico e torácico normais. Apgar 10, de pais näo consangüíneos. Na história heredofamilial, constatou-se que näo existe descendência de raça negra. A pesquisa de células falciformes foi negativa. Ausência de homocistinúria. A tomografia craniana computadorizada (TCC) näo revelou malformaçöes vasculares ou outras anomalias (Dr. Felicio Jahara). Atualmente (1984) com sete anos, anda paresicamente à esquerda, com mínima paresia facial periférica direita. Paralisia do abducente direito. Estuda. Deverá fazer nove TCC e potencial evocado
Subject(s)
Infant , Humans , Male , Cerebrovascular Disorders , Facial Paralysis , Hemiplegia , Pons/blood supply , Follow-Up Studies , Tomography, X-Ray ComputedABSTRACT
Relata-se um caso de hemorragia mesencéfalo-pontina alta direita, com oftalmoplegia extrínseca, permanecendo apenas a convergência bilateral, a abduçäo voluntária e automático-reflexa do olho esquerdo, e a aduçäo deste olho na pesquisa dos reflexos vestíbulo-oculares ("one-and-a-half syndrome") Ainda, havia dissociaçäo voluntária-automático da motricidade das pálpebras e dos movimentos conjugados verticais e, também, hemiplegia sensitivo-motora à esquerda e asterixis