Neuroimaging Findings in Hemifacial Spasm: A Single-Center Experience

Introduction: In this study, we documented the demographic, etiological, clinical and radiological features of our patients with primary hemifacial spasm (HFS). We also wanted to emphasize that there may be an association between idiopathic intracranial hypertension (IIH) and HFS. Methods: Fifty-five patients diagnosed with HFS (28 women) who were followed up in the Movement Disorders Outpatient Clinics of the Department of Neurology University of Health Sciences Turkey, Istanbul Bagolar Training and Research Hospital between January 2017 and January 2022 were included in this study. Demographic, clinical, and radiological findings were retrospectively reviewed. Depending on radiological findings, patients were divided into three groups: a) Normal findings, b) Incidental findings that did not appear to be related to clinical findings, and c) vascular abnormalities at the level of the brainstem. Results: Only 23 patients had no atherosclerotic risk factors. While magnetic resonance imaging of the brain was normal in 23 patients, 19 patients had ischemic white matter changes, 5 patients had partial empty sella, 7 patients had dolichoectatic basilar artery, and 1 patient had a compression of the anterior segment of the left superior cerebellar artery to the 7th cranial nerve. Based on the history and clinical findings, lumbar puncture was performed in 4 patients, and 3 of them were diagnosed with idiopathic IIH with HIS, and they were treated with acetazolamide. fifty-one patients were treated with botulinum toxin injections only. Conclusion: Vascular compression is often noted on imaging of patients with primary HIS, but as in our case series, an empty sella finding in patients with chronic headache may be a sign of IIH and should not be overlooked. Also, HFS may be an uncommon presentation of IIH, and symptoms of HFS may improve with treatment of IIH. Additionally, the presence and history of Coronavirus disease-2019 infection should be questioned in newly admitted cases.

Adapting the UK Biobank Brain Imaging Protocol and Analysis Pipeline for the C-MORE Multi-Organ Study of COVID-19 Survivors.

SARS-CoV-2 infection has been shown to damage multiple organs, including the brain. Multiorgan MRI can provide further insight on the repercussions of COVID-19 on organ health but requires a balance between richness and quality of data acquisition and total scan duration. We adapted the UK Biobank brain MRI protocol to produce high-quality images while being suitable as part of a post-COVID-19 multiorgan MRI exam. The analysis pipeline, also adapted from UK Biobank, includes new imaging-derived phenotypes (IDPs) designed to assess the possible effects of COVID-19. A first application of the protocol and pipeline was performed in 51 COVID-19 patients post-hospital discharge and 25 controls participating in the Oxford C-MORE study. The protocol acquires high resolution T1, T2-FLAIR, diffusion weighted images, susceptibility weighted images, and arterial spin labelling data in 17 min. The automated imaging pipeline derives 1,575 IDPs, assessing brain anatomy (including olfactory bulb volume and intensity) and tissue perfusion, hyperintensities, diffusivity, and susceptibility. In the C-MORE data, IDPs related to atrophy, small vessel disease and olfactory bulbs were consistent with clinical radiology reports. Our exploratory analysis tentatively revealed some group differences between recovered COVID-19 patients and controls, across severity groups, but not across anosmia groups. Follow-up imaging in the C-MORE study is currently ongoing, and this protocol is now being used in other large-scale studies. The protocol, pipeline code and data are openly available and will further contribute to the understanding of the medium to long-term effects of COVID-19.

Coronavirus Disease 2019: Associated Multiple Organ Damage.

A 56-year-old man presented a particularly severe and multisystemic case of coronavirus disease 2019 (COVID-19). In addition to the common lung and quite common pulmonary embolism and kidney injuries, he presented ocular and intestinal injuries that, to our knowledge, have not been described in COVID-19 patients. Although it is difficult to make pathophysiological hypotheses about a single case, the multiplicity of injured organs argues for a systemic response to pulmonary infection. A better understanding of physiopathology should feed the discussion about therapeutic options in this type of multifocal damage related to severe acute respiratory syndrome coronavirus 2.