ABSTRACT
Severe brain damage is often followed by serious complications. Quantitative measurements, such as regional volume and surface area under various conditions, are essential for understanding functional changes in the brain and assessing prognosis. The affected brain tissue is variable, hence traditional imaging methods are not always applicable and automatic methods may not be able to match the individual observer. Stereological techniques are alternative tools in the quantitative description of biological structures, and have been increasingly applied to the human brain. In the present study, we applied stereological techniques to representative CT and MRI brain scans from five patients to describe how stereological methods, when applied to scans of trauma patients, can provide a useful supplement to the estimation of structural brain changes in head injuries. The reliability of the estimates was tested by obtaining repeated intra- and interobserver estimates of selected subdivisions of the brain in patients with acute head injury, as well as in an MR phantom. The estimates of different subdivisions showed a coefficient of variation (CV) below 12% in the patients and below 7% for phantom estimation. The validity of phantom estimates was tested by the average deviation from the true geometric values, and was below 10%. The stereological methods were compared with more traditional region-based methods performed on medical imaging, which showed a CV below 7% and bias below 14%. It is concluded that the stereological estimates may be useful tools in head injury quantification.
Subject(s)
Brain Injuries/diagnosis , Brain/pathology , Image Interpretation, Computer-Assisted/methods , Subarachnoid Hemorrhage/diagnosis , Algorithms , Brain Injuries/etiology , Craniocerebral Trauma/complications , Humans , Magnetic Resonance Imaging/methods , Phantoms, Imaging , Reproducibility of Results , Subarachnoid Hemorrhage/etiology , Tomography, X-Ray Computed/methodsABSTRACT
We retrospectively evaluated the clinical value of Tc-99-HMPAO brain single photon emission tomography (SPECT) in 21 children with neurological disorders of varied aetiology. All 21 patients were examined with electroencephalograms (EEGs), 17 with computed tomography (CT) and ten with magnetic resonance imaging (MR). New relevant information was obtained from SPECT in all 21 cases and in four of these cases the investigation directly led to a change in diagnosis and better assessment of the prognosis. It is concluded that SPECT is an important investigational method in children with neurological symptoms of partly or completely unknown aetiology.
Subject(s)
Brain Diseases/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Adolescent , Age Factors , Cerebrovascular Circulation , Child , Evaluation Studies as Topic , Female , Humans , Male , PrognosisABSTRACT
Multifocal motor neuropathy (MMN) is a newly recognized disorder with a characteristic clinical picture. The diagnosis of MMN is established by the presence of a specific electrodiagnostic abnormality, conduction block confined to motor axons, and in some instances by the associated high titers of anti-GM1 antibodies. Clinical improvement may be achieved by treatment with intravenous immunoglobulin or cyclophosphamide, which underlines the importance of recognizing these patients. We present two patients with slowly progressive predominantly distal weakness and muscle wasting of an upper extremity characteristic of MMN. Extensive electrophysiological examinations are necessary to demonstrate conduction block of motor axons, which distinguishes patients with MMN from patients with motor neuron disease. Other diagnostic possibilities are discussed.
Subject(s)
Arm , Motor Neuron Disease/diagnosis , Arm/innervation , Arm/physiopathology , Diagnosis, Differential , Humans , Male , Middle Aged , Motor Neuron Disease/physiopathology , Motor Neuron Disease/therapyABSTRACT
During recent years chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) has been characterized on the basis of clinical and laboratory findings. Immune modifying treatment with glucocorticoids, plasma exchange and infusion of immune globulins has had a therapeutic effect in controlled studies. Decisive for increased therapeutic efforts against CIDP in Denmark is intensified electrophysiological search in patients with polyneuropathy with examination of several nerve segments for evidence of demyelination including conduction block, potential dispersion and reduction of conduction velocity by more than 40%.
Subject(s)
Demyelinating Diseases , Polyradiculoneuropathy , Chronic Disease , Demyelinating Diseases/diagnosis , Demyelinating Diseases/etiology , Demyelinating Diseases/therapy , Humans , Polyradiculoneuropathy/diagnosis , Polyradiculoneuropathy/etiology , Polyradiculoneuropathy/therapyABSTRACT
A 25-year-old man with myasthenia gravis and a non-Hodgkin lymphoma stage III B involving the thymus, is reported. The association myasthenia gravis and non-Hodgkin lymphoma has not been described previously. Treatment with chlormetin, vincristine, procarbazine, prednisone (MOPP) resulted in complete remission of both the myasthenic symptoms and the malignant lymphoma.
