RESUMEN
Background: Diffusion Weighted Images (DWI) is conventionally used to identify acute ischemic lesions. It has now become a routine technique in the magnetic resonance protocols for the evaluation of stroke patients. The objective of the present study was to find the distribution of different cerebral lesions showing restriction on DWI and influence of ADC on them.Methods: This was single blinded prospective study. Evaluating the magnetic resonance imaging was blinded for the clinical data of the patient. This study was done at M.R.I. unit of Department of Radio Diagnosis, C.S.M. Medical University, Lucknow, during a period of one year from August 2008 to July 2009.Total 93 subjects with restricted diffusion with age range of (6 to 95 years) were found. Data were analyzed using statistical software package, STATA 9.2 and the difference was considered to be significant if ‘p’ value was found to be <0.05.Results: Ninety-three cases of diffusion restriction were seen of which 55 of infarcts (37 male and 18 female) with age range of 6 to 95 years. 10 cystic lesions which were showing restriction on DWI with low ADC value were found. Total 12 cases of encephalitis were found showing restriction on DWI. Most of the cases of encephalitis were found to have ADC value between 400 to 800 x 10-6 mm2/s that 75% of total encephalitis cases. Fluid-attenuated inversion recovery was superior to T2 sequencing in showing cortical lesions.Conclusions: MRI with DWI and ADC values are helpful in the earlier diagnosis of the encephalitis, infarcts and helpful in better differentiation of infarcts, abscesses and encephalitis in comparison to MRI without DWI and ADC value.
RESUMEN
Transcranial Doppler (TCD) sonography is emerging as a new ultrasonography technology to look at the interaction between the brain parenchyma and perfusion during cerebrovascular accident. Before TCD sonography the vasospasm following subarachnoid haemorrhage could only be diagnosed either clinically or by invasive method ie, angiography. TCD has been proved as a wonderful non-invasive, repeatable, beat-by-beat, non-expensive technique for detection and follow-up of vasospasm after subarachnoid haemorrhage. In the present series 12 patients suspected to have vasospasm after subarachnoid haemorrhage were confirmed and monitored with the help of TCD. Most of the patients were clinically presented with increasing headache and altered sensorium. It is noticed that vasospasm following subarachnoid haemorrhage has a typical course, which has increasing trend after 4th day of subarachnoid haemorrhage and declining trend after 14th day onwards. Six out of 12 patients were in moderate grade of vasospasm, 2 out of 12 were in severe grade and 4 out of 12 were mild grade of severity.