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Primary central nervous system lymphoma (PCNSL) is a rare,extranodal form of non-Hodgkin lymphoma that is confined to the central nervous system.It mainly involves the deep brain white matter,the lateral ventricle and the corpus callosum.A decline in cognitive function and headache are the typical clinical manifestations of the disease.We report a patient with PCNSL in bilateral middle cerebellar peduncles,whose clinical manifestations were only dizziness and unstable walking.Brain MRI manifestations were not typical in early time,with symmetrical hypointensity lesions on T1-weighted imaging,hyperintensity lesions on T2-weighted imaging,and edema zone around on FLAIR imaging.Enhanced scan showed marginal contrast enhancement,but no significant occupying effect.These changes were similar to the multiple characteristics of multiple sclerosis.The history of autoimmune diseases and cerebrospinal fluid examination highly indicated demyelinating disease.The differences of clinical manifestations,MRI characteristics,diagnosis,treatment and prognosis between PCNSL in bilateral middle cerebellar peduncles and multiple sclerosis were analyzed to imorove the understanding of the disease in clinical practice.
RESUMO
Objective To investigate the clinical manifestations and diagnosis of patients with abnormal signal of bilateral pontine brachium on magnetic resonance imaging (MRI),in order to improve the understanding of diseases involving bilateral middle cerebellar peduncles.Methods Combined with auxiliary examination,we compared the clinical manifestations of five patients and analyzed the characteristics of diseases involving bilateral middle cerebellar peduncles.Results MRI was similar in all five patients.Symmetrical T2-weighted,FLAIR-weighted images of bilateral middle cerebellar peduncles were seen on MRI,with corresponding hypointensity on T1 WI of all five patients.No obvious enhancement has been showed.But there were different clinical manifestations and diagnosis of them.The first patient manifested as dizziness,visual rotation,slurred speech and inactivity of right limb.She was diagnosed with acute cerebral infarction.The second patient only manifested as dizziness.Combined with the history of cerebral infarction,he was diagnosed as Wallerian degeneration.The third patient manifested as blindness in the left eye,vision blurred in right eye and numbness of limbs.She was diagnosed with neuromyelitis optica.The forth patient manifested as lisp,walking instability,talk rubbish and hyperspaamia.She took heroin for dozens of times,and was diagnosed with heroin encephalopathy finally.The final patient manifested as ataxia,slurred speech,choking,dysphagia,less facial expression and urinary retention.He was diagnosed with olivopontocerebellar atrophy.Conclusions The etiology of bilateral pontine brachium lesion is complex.Cerebrovascular diseases,demyelinating diseases,infectious and toxic diseases,and neurodegenerative diseases can be involved.The mechanism of bilateral pontine brachium lesions is not very clear and needs to be further explored.
RESUMO
Objective To investigate the changes of expression of N-methyl-D-aspartate receptor(NMDAR)and mitogen activated protein kinase(MAPK)in Alzheimer disease(AD)rat model. Methods AD rat model was established by injection of amyloid-beta protein 1-40 1?l(10 g/L)into hippocampus of rat.NMDAR-mRNA and MAPK protein were immunostained by in situ hybradization histochemistry and immunohistochemistry respectively.Learning and memory ability,LTP were determined by Morris water maze and electrophysiological methods respectively. Results The escape latent was prolongated in Alzheimer rats two weeks after injection of A? than in control rats and in rats before the injection of A?(P