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OBJECTIVE: Chronic subdural hematoma (CSDH) is a common intracranial hemorrhage that is associated with significant morbidity. Bilateral lesions are occasionally found in neurosurgical practice. The purpose of this study is to analyze clinical characteristics of bilateral CSDH compared with unilateral CSDH. METHODS: Between January 2005 and January 2013, the authors treated 114 surgical patients with CSDH. Clinical presentations, precipitating factors, computed tomography (CT) findings, postoperative complications, and outcomes of patients were retrospectively analyzed in the bilateral and unilateral CSDH groups. RESULTS: Bilateral CSDH was identified in 28 (24.6%) of the 114 CSDH patients. The mean age was 77.85 years in the bilateral CSDH group. The frequency of altered consciousness as a presenting symptom was significantly higher in the bilateral CSDH, and that of hemiparesis was significantly higher in the unilateral CSDH (p=0.015). Diabetes mellitus was more common in the bilateral CSDH (p=0.001). CT scans revealed significant differences in the degree of midline shift (p=0.001). The mean modified Rankin scale at discharge was 1.5 in the bilateral CSDH group and 0.6 in the unilateral group (p=0.019). CONCLUSION: Bilateral CSDH showed different clinical characteristics from unilateral CSDH. Bilateral CSDH is prone to occurrence in the patient of old and diabetics. The patients of bilateral CSDH seem to reveal worse mental status and neurologic sign than unilateral CSDH in both baseline and postoperative state.
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Humanos , Encéfalo , Estado de Conciencia , Diabetes Mellitus , Hematoma , Hematoma Subdural Crónico , Hemorragias Intracraneales , Manifestaciones Neurológicas , Paresia , Complicaciones Posoperatorias , Factores Desencadenantes , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND AND PURPOSE: The functional outcome of traumatic brain injury (TBI) varies widely. The aim of this study was to identify the factors predicting outcome following TBI. METHODS: We prospectively enrolled acute TBI patients, and assessed them clinically and radiologically using brain magnetic resonance imaging (MRI). Functional outcome was measured using the Glasgow Outcome Scale (GOS) at 3 months after TBI. A GOS score of < or =4 was regarded as an unfavorable outcome. We performed multivariate analysis to investigate the association between clinicoradiological variables and outcome. RESULTS: Forty-two patients completed the clinical evaluation in the acute phase and outcome measurement at 3 months. Motorcycle accident was associated with unfavorable outcome [odds ratio (OR)=38.3, p=0.022]. If the patients were the victims of the accident, they were more likely to have an unfavorable outcome (OR=21.3, p=0.037). All seven patients with a low Glasgow Coma Scale (GCS) score (i.e., < or =8) at 24 or 48 h after TBI were also found to have an unfavorable outcome. The presence of diffuse axonal injury (DAI) was a significant predicting factor of an unfavorable outcome (OR=8.48, p=0.042). CONCLUSIONS: Motorcycle accident, being an accident victim, and a lower GCS score at 24 hours or more after the accident were found to be unfavorable prognostic variables. DAI was the only radiologic variable predicting an unfavorable outcome. Thus, it is important to identify DAI by applying MRI in the acute phase.
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Humanos , Encéfalo , Lesiones Encefálicas , Lesión Axonal Difusa , Escala de Coma de Glasgow , Escala de Consecuencias de Glasgow , Imagen por Resonancia Magnética , Motocicletas , Análisis Multivariante , Neuroimagen , Estudios ProspectivosRESUMEN
Atomic force microscopy (AFM) is an emerging technique for a variety of uses involving the analysis of cells. AFM is widely applied to obtain information about both cellular structural and subcellular events. In particular, a variety of investigations into membrane proteins and microfilaments were performed with AFM. Here, we introduce applications of AFM to molecular imaging of membrane proteins, and various approaches for observation and identification of intracellular microfilaments at the molecular level. These approaches can contribute to many applications of AFM in cell imaging.
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Membrana Celular/ultraestructura , Proteínas de la Membrana/fisiología , Citoesqueleto de Actina/fisiología , Microscopía de Fuerza Atómica , Imagen Molecular/métodosRESUMEN
Cerebral fat embolism (CFE) is a rare, albeit potentially lethal complication of long-bone fractures. All trauma patients who are initially lucid and subsequently experience mental status deterioration should undergo immediate evaluation of possible CFE. In the present case, magnetic resonance imaging (MRI) was the most sensitive technique for the diagnosis of CFE, particularly the use of diffusion-weighted images (DWI). The authors present this case to report a pathophysiology-based interpretation of the MR characteristics and treatment of CFE.
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Humanos , Embolia , Embolia Grasa , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Magnetismo , ImanesRESUMEN
Cerebral fat embolism (CFE) is a rare, albeit potentially lethal complication of long-bone fractures. All trauma patients who are initially lucid and subsequently experience mental status deterioration should undergo immediate evaluation of possible CFE. In the present case, magnetic resonance imaging (MRI) was the most sensitive technique for the diagnosis of CFE, particularly the use of diffusion-weighted images (DWI). The authors present this case to report a pathophysiology-based interpretation of the MR characteristics and treatment of CFE.
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Humanos , Embolia , Embolia Grasa , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Magnetismo , ImanesRESUMEN
OBJECTIVE: Although gadolinium enhancement of compression fractures is well known, the enhancement pattern of the acute stage of a fracture is not completely understood. Here, we investigated the enhancement pattern of acute vertebral compression fractures (VCFs). METHODS: We conducted a retrospective study of patients with acute osteoporotic VCFs admitted to hospital between January 2004 and December 2005. The demographic details, stage of the fracture, management data, and results were analyzed. There were nine men and 22 women, and the mean age was 71 years (range, 53-92 years). According to the onset of pain, patients were divided into the following four groups : Group I (less than 3 days), Group II (4-7 days), Group III (8-14 days), and Group IV (14-30 days). RESULTS: All patients had central low-signal intensity of the nonenhancing part of vertebral bodies on T1 images. Enhancing box sign (EBS) was seen 7 days of VCF development. After 7 days of onset (Groups III and IV), patch or Kummell's enhancements occurred. EBS has been statistically correlated with stage of compression fracture (Pearson's correlation = -0.774). However, EBS had no statistically significant correlation with prognosis in our study (Pearson's correlation = 0.059). CONCLUSION: EBS represents a characteristic sign 7 days of VCF development.
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Femenino , Humanos , Masculino , Fracturas por Compresión , Gadolinio , Imagen por Resonancia Magnética , Pronóstico , Estudios RetrospectivosRESUMEN
We present two cases of deep cerebral venous thrombosis(DCVT) with the totally occluded straight sinus. A 42-year-old female received with altered mentality . She has taken antihistamine for six years to treat the paranasal sinusitis. Another 34-year-old female who used the oral contraceptive for 11 months presented with acute behavior change . Both of these patients were diagnosed by computed tomography(CT), magnetic resonance(MR) imaging, and cerebral angiography. They were fully recovered with systemic urokinase thrombolysis followed by heparin therapy. We report that the intravenous thrombolysis was potentially effective management strategy in our cases of DCVT with the totally occluded straight sinus.