ABSTRACT
Magnetic resonance (MR) imaging and localized proton MR spectroscopy of the occipital lobes were performed in a patient with cortical blindness following brain trauma. Computed tomography (CT) scans and MR images of the visual cortex were normal in the acute stage. Six weeks after the trauma, MR images showed cortical lesions in both occipital lobes, while the spectra showed elevated lactate and decreased N-acetyl aspartate levels relative to those of healthy volunteers. One year later, visual acuity had improved and follow-up studies revealed an increase in the ratios of N-acetyl aspartate to choline and creatine. These results demonstrate that parenchymal lesions may develop in brain regions that appear normal at CT and MR imaging during the acute stage after trauma. Metabolic changes can be observed in these areas by means of localized proton MR spectroscopy.
Subject(s)
Blindness/etiology , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Occipital Lobe/injuries , Occipital Lobe/pathology , Aspartic Acid/analogs & derivatives , Aspartic Acid/analysis , Brain Chemistry , Brain Injuries/complications , Brain Injuries/diagnosis , Brain Injuries/metabolism , Child , Choline/analysis , Creatine/analysis , Humans , Lactates/analysis , Lactic Acid , Male , Photic StimulationABSTRACT
A case of orbital involvement in Waldenström's macroglobulinemia is presented. Orbital echography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed and revealed a retrobulbar mass of the right orbit. Ultrasonography suggested a lymphoid orbital tumor. A CT scan was nonspecific, but helpful in exactly locating the tumor and excluding bony lesions. Signal intensity patterns of MRI were characterized by a low intensity on T1- and T2-weighted images. A marked enhancement of the tumor was evident after intravenous injection of a paramagnetic contrast agent (gadolinium-DTPA). Although the definite diagnosis could only be established by means of an ultrasound-guided fine-needle aspiration biopsy, MRI in connection with the history of our patient strongly suggested a diagnosis of orbital lymphoma in Waldenström's disease.
Subject(s)
Lymphoma, Non-Hodgkin/diagnosis , Magnetic Resonance Imaging , Orbital Neoplasms/diagnosis , Waldenstrom Macroglobulinemia/diagnosis , Aged , Gadolinium DTPA , Humans , Lymphoma, Non-Hodgkin/diagnostic imaging , Male , Orbital Neoplasms/diagnostic imaging , Organometallic Compounds , Pentetic Acid , Tomography, X-Ray Computed , Ultrasonography , Waldenstrom Macroglobulinemia/diagnostic imagingABSTRACT
We report on a patient, who regularly developed reversible corneal edema of the right eye after cold stress. Cycling tours in cold weather and windy conditions seemed to precipitate the edema. After a provocation test, we also observed transient, corneal edema. A few reports in the literature suggested that Raynaud's disease or trigeminal neuropathy might be responsible for cold-induced corneal opacification. None of these conditions was present in our patient, as proved by laboratory tests and magnetic resonance imaging. We found that contact lenses were an effective prophylaxis against corneal edema.
