Intracranial lipomas: clinical and imaging findings.

PURPOSE: Intracranial lipomas are rare congenital malformations. The most common location of intracranial lipoma is the midline cerebral structures. The most frequently seen symptoms are headaches, seizures, psychomotor retardation and cranial nerve deficits. This study aimed to evaluate the clinical and radiological findings of 14 patients with intracranial lipoma. MATERIALS AND METHODS: The study comprised 14 patients diagnosed with intracranial lipoma from computed tomography and magnetic resonance imaging taken after presentation at our hospital with headaches or seizures between January 2008 and April 2012. The cranial CT and MR images were evaluated by two experienced specialist radiologists. The lipoma localisation, size, morphology, any concomitant anomalies and findings of compression were recorded. RESULTS: The study comprised 14 patients diagnosed with intracranial lipoma. The lipoma was observed to be located pericallosal, adjacent to the mamillary body and the optic chiasm, interhemispheric, in the quadrigeminal cistern and sylvian fissure. 3 patients had a history of seizures. The others had headaches. CONCLUSIONS: If there are no concomitant central nervous system (CNS) anomalies, there are no significant clinical or neurological findings apart from headaches.

Assessment of arterial stiffness in chronic obstructive pulmonary disease by a novel method: cardio-ankle vascular index.

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular morbidity and mortality. Increased arterial stiffness is associated with the presence and severity of cardiovascular disease. The cardio-ankle vascular index (CAVI) is a new method for assessment of arterial stiffness that is not influenced by blood pressure at the time of measurement and is significantly correlated with the presence and severity of cardiovascular disease. The aim of the present study was to evaluate whether there is an association between the spirometric severity of COPD, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, with arterial stiffness as assessed by CAVI. METHODS: We enrolled 123 patients with COPD (102 men) followed up by the chest medicine outpatient clinics and 35 healthy subjects (26 men). All patients were assessed with spirometry, CAVI, and clinical history. RESULTS: Patients with COPD had significantly increased CAVI values compared with control subjects (10.37 ± 2.26 vs. 6.74 ± 1.42, p < 0.001). CAVI was correlated with FEV1 % predicted, FEV1/FVC, and COPD stage (r: - 0.54, p < 0.001; r: - 0.58, p < 0.001 and r: 0.78, p < 0.001, respectively). Multivariate regression analysis showed that CAVI was independently associated with GOLD stages (p < 0.001). CONCLUSION: In this study, we have shown that increased arterial stiffness assessed by CAVI is associated with the spirometric severity of COPD.

Optimal wrist position for long and short axis ultrasound guided radial artery cannulation.

BACKGROUND: The radial artery is the most common site for arterial cannulation. Procedures for improving radial artery cannulation have involved direct visualization of the vessel with ultrasonography (US). The aim of this study evaluate the short axis and long axis radial artery measurements at 0º, 45º, 60º wrist joint angle and find out the optimal wrist joint angle for long and short axis US guided radial artery cannulation. MATERIALS AND METHODS: This study was approved by the Institutional Ethical Committee and the study was performed in accordance with the ethical principles for human investigations, as outlined by the Second Declaration of Helsinki. One hundred fifty-two (90 men and 62 women, 18-48 years of age, mean age: 32.9 ± 6.1) healthy volunteers were recruited. The radial artery distance between skin and height, width, area in short axis and radial artery distance between skin and height was measured in long axis at 0º, 45º, 60º wrist joint angle were measured. Results. Short axis radial artery distance between skin, width, height, area and long axis radial artery distance between skin, height were statistically significantly different among 0º, 45º, 60º (p< 0.05; for all comparisons). Short axis width was statistically significantly increased at 45º compared to at 0º (p< 0.001;). Short axis radial artery distance between skin and height at 45º were statistically significantly decreased than at 0º (p< 0.001; for all comparisons) and long axis skin distance and height at 45º were also statistically significantly decreased than at 0º (p< 0.001; for both comparisons). Short axis radial artery skin distance and area at 60º is statistically significantly decreased than at 45º (p< 0.001; for both comparisons) and also long axis height of radial artery at 60º is statistically significantly decreased than at 45º (p< 0.001;). CONCLUSIONS: Angle increment up to 45º might help clinicians for radial artery cannulation in short axis plane whereas this angle increment maneuver decreased the arterial height in long axis which might be a potential disadvantage for cannulation.

Examining cerebral metabolic abnormalities in chronic obstructive pulmonary disease (COPD) patients by localized proton magnetic resonance spectroscopy (MRS).

PURPOSE: The study was planned based on the hypothesis that cerebral metabolism is impaired in chronic obstructive pulmonary disease (COPD) by using localized in vivo proton magnetic resonance spectroscopy. MATERIALS AND METHODS: The study comprised 30 male patients, aged 45-70 years, with moderate level COPD and an aged matched group of 30 healthy males as the control group. Cerebral metabolism was investigated with proton magnetic resonance spectroscopy (MRS) using multivoxel technique. Data normal distribution conformity was evaluated by the One Sample Kolmogorov Smirnov Test and homogeneity by the One-Way ANOVA test. For both the COPD and control group, data were obtained as mean, standard deviations, minimum and maximum values. Independent sample t-test was used for the comparison of means between the two groups. RESULTS: The frontal and parietal white matter in patients with COPD showed an overall reduction in cerebral metabolites. The NAA (N-acetylaspartate)/Cr (Creatinine), Cho (Choline)/Cr ratios of the cerebral frontal and parietal white matter regions in the COPD group were significantly lower than the control group. CONCLUSIONS: The findings of this study through the use of MRS confirmed that most patients with symptomatic COPD have cerebral metabolic abnormalities.

Cerebral venous thrombosis initially considered as a complication of spinal-epidural anaesthesia.

Cerebral venous thrombosis is an unusual condition characterized by headache, nausea, vomiting, focal deficits and epileptic seizures. In this case report we describe a patient who presented with headache and focal motor deficits after an uneventful Caesarean section, performed using combined spinal-epidural anaesthesia. Magnetic resonance imaging was performed because of the pronounced neurological symptoms, and a diagnosis of cerebral venous thrombosis was made. The patient was treated with anticoagulant agents and made a complete recovery. This case emphasizes the importance of considering cerebral venous thrombosis in the differential diagnosis of headache in the post-partum period prior to instituting conventional therapy.