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2.
AJNR Am J Neuroradiol ; 37(1): 196-7, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26564445
3.
J Neuroradiol ; 33(4): 263-5, 2006 Oct.
Article in English | MEDLINE | ID: mdl-17041532

ABSTRACT

We report the case of a patient with bilateral and symmetrical T2 hyperintensities of the middle cerebellar peduncles. She had a history of left pontine infarction 8 months before. This was attributed to bilateral Wallerian degeneration. MR Spectroscopy showed decreased N-acetyl aspartate/Creatine (NAA/Cr) ratio in the cerebellar peduncles as well as in the whole cerebellum. We hypothesize that this could reflect neuronal degeneration following a stroke.


Subject(s)
Brain Stem Infarctions/complications , Cerebellopontine Angle , Mesencephalon , Wallerian Degeneration/etiology , Aged , Female , Humans
4.
J Neuroradiol ; 32(4): 278-80, 2005 Sep.
Article in French | MEDLINE | ID: mdl-16237368

ABSTRACT

Paraneoplastic limbic encephalitis is a rare clinical entity, most often associated with small cell lung cancer. We report a case of a 54-year-old man presenting status epilepticus, cognitive dysfunction and loss of short term memory associated with epidermoid lung carcinoma. CT scan was normal whereas MRI revealed hyperintensities on T2WI and FLAIR images in the temporolimbic regions. Treatment of the primary tumour was followed by neurological improvement.


Subject(s)
Carcinoma, Squamous Cell/complications , Limbic Encephalitis/etiology , Lung Neoplasms/complications , Humans , Male , Middle Aged
5.
J Radiol ; 86(9 Pt 2): 1091-101, 2005 Sep.
Article in French | MEDLINE | ID: mdl-16227905

ABSTRACT

Imaging of stroke has evolved with the development of stroke units and the CE approval of intravenous thrombolysis in the first three hours after stroke onset. The goal of imaging in the acute phase of stroke is: to make the diagnosis of stroke; to rule out other diagnosis (above all hemorrhagic strokes); to precise the location of the arterial occlusion; to assess the level of hypoperfusion; to evaluate the viability and reversibility of brain lesions; to understand the origin of the stroke by evaluating cervical arteries. Constraints of imaging in the acute phase of stroke are: the need to be performed as fast as possible to not delay IV thrombolysis (time is brain); machines must be available 24 hours a day, 7 days a week as close as possible to the stroke unit. The aim of imaging are: in routine practice to evaluate the likely benefits (provided by penumbra imaging) and risks of IV thrombolysis; in term of "evidence based medicine" to better evaluate new specific stroke therapies in randomized studies (IV thrombolysis between 3 to 4 hours, use of anti GpIIbIIIa, intra-arterial mechanical or chemical thrombolysis...). Magnetic resonance imaging is considered the goal standard of stroke imaging allowing to evaluate in a "one stop shopping" the level of arterial occlusion, hypoperfusion and brain viability. However, stroke management is a regional issue and performing MR in extreme emergency is almost impossible in all stroke units outside or even within university hospitals 24 hours a day. CT-perfusion and CT angiography are therefore an accurate alternative tool for acute stroke imaging. Multislice CT is indeed available in almost all stroke units. The examination is very time-saving and clinically relevant to make the decision for IV thrombolysis.


Subject(s)
Brain Ischemia/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Aged , Brain Ischemia/drug therapy , Cerebral Angiography/methods , Cerebral Infarction/diagnostic imaging , Cerebral Infarction/drug therapy , Cerebrovascular Circulation/physiology , Decision Making , Female , Fibrinolytic Agents/therapeutic use , Humans , Image Processing, Computer-Assisted/methods , Male , Platelet Glycoprotein GPIIb-IIIa Complex/therapeutic use , Risk Factors , Thrombolytic Therapy , Time Factors , Tissue Survival/physiology , Treatment Outcome
6.
J Radiol ; 85(11): 1943-6, 2004 Nov.
Article in French | MEDLINE | ID: mdl-15602417

ABSTRACT

Cervicothoracic syringomyelia is a frequent feature in Chiari I malformation. It can be symptomatic or not, and is well demonstrated by magnetic resonance imaging (MRI). Its spontaneous resolution is uncommon. The authors report a case of spontaneous resolution of a thoracic syrinx in an 18-year-old patient with a Chiari I malformation. MRI study performed 6 years previously because of worsening headaches demonstrated a Chiari I malformation associated with a syrinx cavity. The cavity disappearance was noted after improvement of the symptoms.


Subject(s)
Arnold-Chiari Malformation/complications , Syringomyelia/etiology , Adolescent , Child , Female , Follow-Up Studies , Humans , Remission, Spontaneous
7.
Neuroradiology ; 45(11): 812-7, 2003 Nov.
Article in English | MEDLINE | ID: mdl-14517703

ABSTRACT

Inflammatory myofibroblastic tumours (IMT), also called inflammatory pseudotumours, nodular lymphoid hyperplasia, plasma-cell granuloma and fibrous xanthoma, are rare soft-tissue lesions characterised by inflammatory cells and a fibrous stroma. Clinically and radiologically, they may look like malignant tumours. They rarely affect the central nervous system and are very rare in the spinal cord. We report an IMT of the spinal cord in a 22-year-old woman presenting with spinal cord compression and a cauda equina syndrome. MRI showed a lesion at T9 with extramedullary and intramedullary components giving low signal on T2-weighted images and enhancing homogeneously. Pial lesions on the lumbar enlargement and thoracic spinal were present 11 months after surgery, when the lesion recurred. We present the radiological, operative and pathological findings and review the literature.


Subject(s)
Granuloma, Plasma Cell , Magnetic Resonance Imaging , Spinal Cord Diseases , Adult , Cauda Equina , Female , Granuloma, Plasma Cell/complications , Granuloma, Plasma Cell/epidemiology , Granuloma, Plasma Cell/pathology , Granuloma, Plasma Cell/surgery , Humans , Nerve Compression Syndromes/etiology , Recurrence , Reoperation , Spinal Cord Diseases/complications , Spinal Cord Diseases/epidemiology , Spinal Cord Diseases/pathology , Spinal Cord Diseases/surgery
8.
J Neurol Sci ; 206(2): 139-44, 2003 Feb 15.
Article in English | MEDLINE | ID: mdl-12559501

ABSTRACT

Conventional MRI techniques are sensitive to detect MS lesions and their change overtime. In relapsing-remitting MS correlations with clinical measures are weak suggesting a pathological heterogeneity of these lesions. There are less data available in secondary progressive phase of the disease. The best source for clinical MRI correlations analysis is the placebo arm of the published interferon beta trials. This review presents the main clinical-MRI findings from these trials then focuses on recent promising observations obtained with non conventional MRI techniques in SP MS patients.


Subject(s)
Magnetic Resonance Imaging , Multiple Sclerosis, Chronic Progressive/diagnosis , Clinical Trials as Topic , Disease Progression , Humans , Interferon-beta/therapeutic use , Multiple Sclerosis, Chronic Progressive/pathology , Multiple Sclerosis, Chronic Progressive/therapy , Reproducibility of Results , Sensitivity and Specificity
9.
J Radiol ; 83(12 Pt 1): 1850-2, 2002 Dec.
Article in French | MEDLINE | ID: mdl-12511842

ABSTRACT

Superficial siderosis of the central nervous system is secondary to chronic subarachnoid bleeding. However, the underlying etiology is not always detected. Superficial siderosis can be diagnosed at MRI by the presence of a hypointense rim along the brain surface on gradient echo T2W images. The authors report a case of superficial cerebral siderosis where the underlying etiology remained undiagnosed in spite of extensive neuroradiological work up.


Subject(s)
Central Nervous System Diseases/diagnosis , Magnetic Resonance Imaging/methods , Siderosis/diagnosis , Central Nervous System Diseases/drug therapy , Central Nervous System Diseases/etiology , Cerebral Angiography , Chelating Agents/therapeutic use , Chronic Disease , Female , Hearing Loss, Bilateral/etiology , Humans , Middle Aged , Siderosis/drug therapy , Siderosis/etiology , Subarachnoid Hemorrhage/complications , Trientine/therapeutic use
10.
Rev Laryngol Otol Rhinol (Bord) ; 122(2): 81-4, 2001.
Article in French | MEDLINE | ID: mdl-11715265

ABSTRACT

The goal of this study was to assess the reliability of CT-Scan in the cases of conductive hearing losses with normal tympanic membrane. A computed tomography of the temporal bone (CT-Scan) has been performed in a prospective manner in all patients who underwent surgery for a conductive hearing loss with a normal tympanic membrane in our department. Out of 474 cases, 437 cases (92.2%) presented with otosclerosis. In 25 cases a minor malformation (5.3%) was found at surgery, and in 12 cases (2.5%), another diagnosis was made. Sensitivity of CT-Scan was 91.3% in otosclerosis and 57% in minor malformations. In 8.7% of cases, a superficial and beginning surgical focus was put in evidence whereas CT-Scan was normal. Theses cases represent infra-radiological cases of otosclerosis. In case of radiological otosclerosis, fenestral otosclerosis was found in 83.5% of the cases. CT-Scan was found specific on the operated and deaf side, but in 11.3% of the cases, a radiologic focus did not have a clinical consequence on the controlateral side. A radiological focus is not systematically responsible for a hearing loss. Finally, CT-Scan remains a reliable, sensitive and specific exam in the diagnosis of cases of conductive hearing losses with normal tympanic membrane.


Subject(s)
Hearing Loss, Conductive/diagnostic imaging , Otosclerosis/diagnostic imaging , Temporal Bone/diagnostic imaging , Tomography, X-Ray Computed , Audiometry , Diagnosis, Differential , Follow-Up Studies , Humans , Prospective Studies , Sensitivity and Specificity , Time Factors
11.
Rev Neurol (Paris) ; 157(8-9 Pt 1): 769-76, 2001 Sep.
Article in French | MEDLINE | ID: mdl-11677397

ABSTRACT

Early imaging investigations in multiple sclerosis (MS) described focal signs. Technological progress now suggests this concept should be revisited as more diffuse anomalies of the central nervous system are described, sometimes involving regions that appear normal with conventional imaging techniques. This integrative concept results largely from the contribution of magnetic resonance imaging techniques recently broadened to in vivo investigations. Technical developments in MRI now provide new contrast images (magnetization transfer, diffusion, anisotropic diffusion, functional MRI using the BOLD method) as well as new variants of conventional sequences designed to demonstrate specific aspects of the MS lesions: FLAIR sequence (a T2-weighted sequence), black holes (a particular aspect on T1-weighted images), cord atrophy (quantification of the axial section of the cord on T1-weighted sequences). Together these new methods should improve diagnostic sensitivity (FLAIR) or provide prognosis information not provided by conventional sequences (T2 or T2 weighted images with or without gadolinium injection).


Subject(s)
Image Enhancement , Image Processing, Computer-Assisted , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy/methods , Multiple Sclerosis/diagnosis , Brain/pathology , Follow-Up Studies , Humans , Sensitivity and Specificity , Spinal Cord/pathology
12.
Neuroradiology ; 43(6): 485-8, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11465762

ABSTRACT

We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case.


Subject(s)
Borrelia burgdorferi/isolation & purification , Lyme Disease/pathology , Myelitis/etiology , Myelitis/pathology , Adult , Borrelia burgdorferi/pathogenicity , Diagnosis, Differential , Humans , Immunoglobulin M/analysis , Lyme Disease/diagnosis , Magnetic Resonance Imaging , Male , Serologic Tests
13.
J Cereb Blood Flow Metab ; 21(5): 592-607, 2001 May.
Article in English | MEDLINE | ID: mdl-11333370

ABSTRACT

The aim of the current study was to assess the reproducibility of functional magnetic resonance imaging (fMRI) brain activation signals in a sensorimotor task in healthy subjects. Because random or systematic changes are likely to happen when movements are repeated over time, the authors searched for time-dependent changes in the fMRI signal intensity and the extent of activation within and between sessions. Reproducibility was studied on a sensorimotor task called "the active task" that includes a motor output and a sensory feedback, and also on a sensory stimulation called "the passive task" that assessed the sensory input alone. The active task consisted of flexion and extension of the right hand. The subjects had performed it several times before fMRI scanning so that it was well learned. The passive task consisted of a calibrated passive flexion and extension of the right wrist. Tasks were 1 Hz-paced. The control state was rest. Subjects naïve to the MRI environment and non--MRI-naïve subjects were studied. Twelve MRI-naïve subjects underwent 3 fMRI sessions separated by 5 hours and 49 days, respectively. During MRI scanning, they performed the active task. Six MRI-naïve subjects underwent 2 fMRI sessions with the passive task 1 month apart. Three non--MRI-naïve subjects performed twice an active 2-Hz self-paced task. The data were analyzed with SPM96 software. For within-session comparison, for active or passive tasks, good reproducibility of fMRI signal activation was found within a session (intra-and interrun reproducibility) whether it was the first, second, or third session. Therefore, no within-session habituation was found with a passive or a well-learned active task. For between-session comparison, for MRI-naïve or non--MRI-naïve subjects, and with the active or the passive task, activation was increased in the contralateral premotor cortex and in ispsilateral anterior cerebellar cortex but was decreased in the primary sensorimotor cortex, parietal cortex, and posterior supplementary motor area at the second session. The lower cortical signal was characterized by reduced activated areas with no change in maximum peak intensity in most cases. Changes were partially reversed at the third session. Part of the test-retest effect may come from habituation of the MRI experiment context. Less attention and stress at the second and third sessions may be components of the inhibition of cortical activity. Because the changes became reversed, the authors suggest that, beyond the habituation process, a learning process occurred that had nothing to do with procedural learning, because the tasks were well learned or passive. A long-term memory representation of the sensorimotor task, not only with its characteristics (for example, amplitude, frequency) but also with its context (fMRI), can become integrated into the motor system along the sessions. Furthermore, the pattern observed in the fMRI signal changes might evoke a consolidation process.


Subject(s)
Cerebral Cortex/physiology , Magnetic Resonance Imaging , Adult , Analysis of Variance , Cerebellum/physiology , Female , Frontal Lobe/physiology , Hand , Humans , Longitudinal Studies , Male , Middle Aged , Motor Activity/physiology , Movement , Parietal Lobe/physiology , Reproducibility of Results , Time Factors , Wrist
14.
Radiology ; 219(1): 95-100, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11274542

ABSTRACT

PURPOSE: To assess the capability of computed tomography (CT) in the prediction of irreversible ischemic brain damage and its association with the clinical course within 6 hours of stroke onset. MATERIALS AND METHODS: Serial CT scans obtained within 6 hours of stroke onset, at 22-96 hours (median, 1 day), and at 2-36 days (median, 7 days) after symptom onset in 786 patients with ischemic stroke were prospectively studied, and follow-up CT scans were used as the reference. Clinical variables were assessed prospectively and independently of CT evaluation. RESULTS: The specificity and positive predictive value of ischemic edema at baseline CT for brain infarcts were 85% (95% CI: 77%, 91%) and 96% (95% CI: 94%, 98%), respectively. Sensitivity and negative predictive values were 64% (95% CI: 60%, 67%) and 27% (95% CI: 23%, 32%), respectively. Patients without early CT findings were less severely affected (P<.001), developed smaller infarcts (P<.001), had fewer intracranial bleeding events (P<.001), and had a better clinical outcome at 90 days (P<.001) compared with patients with hypoattenuating brain tissue at early CT. CONCLUSION: After ischemic stroke, x-ray hypoattenuation at CT is highly specific for irreversible ischemic brain damage if detection occurs within the first 6 hours. Patients without hypoattenuating brain tissue have a more favorable clinical course.


Subject(s)
Brain Damage, Chronic/diagnostic imaging , Cerebral Infarction/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Aged, 80 and over , Brain Damage, Chronic/drug therapy , Cerebral Infarction/drug therapy , Double-Blind Method , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neurologic Examination , Prospective Studies , Sensitivity and Specificity , Tissue Plasminogen Activator/therapeutic use
15.
J Radiol ; 82(1): 63-6, 2001 Jan.
Article in French | MEDLINE | ID: mdl-11223632

ABSTRACT

Septic arthritis of the lumbar facet joint is rare, probably underdiagnosed, often associated with complications such as epidural abscess and paraspinal muscles abscess. Diagnosis is based on imaging evaluation. Plain radiographs of the lumbar spine are not helpful because often nomal. Bone scintigraphy is very sensitive but non-specific. CT scan can confirm the diagnosis and guide the needle biopsy. MRI is the preferred imaging modality for diagnosis. MRI shows early bone and joint involvement and it is helpful in detecting epidural and paravertebral soft tissue lesions.


Subject(s)
Arthritis, Infectious/diagnosis , Epidural Abscess/diagnosis , Lumbar Vertebrae , Staphylococcal Infections/diagnosis , Aged , Arthritis, Infectious/complications , Epidural Abscess/complications , Humans , Magnetic Resonance Imaging , Male , Staphylococcal Infections/complications , Tomography, X-Ray Computed
16.
Ann Neurol ; 50(6): 718-29, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11761469

ABSTRACT

In order to determine the influence of a single dose of fluoxetine on the cerebral motor activation of lacunar stroke patients in the early phase of recovery, we conducted a prospective, double-blind, crossover, placebo-controlled study on 8 patients with pure motor hemiparesia. Each patient underwent two functional magnetic resonance imaging (fMRI) examinations: one under fluoxetine and one under placebo. The first was performed 2 weeks after stroke onset and the second a week later. During the two fMRI examinations, patients performed an active controlled motor task with the affected hand and a passive one conducted by the examiner with the same hand. Motor performance was evaluated by motor tests under placebo and under fluoxetine immediately before the examinations to investigate the effect of fluoxetine on motor function. Under fluoxetine, during the active motor task, hyperactivation in the ipsilesional primary motor cortex was found. Moreover, fluoxetine significantly improved motor skills of the affected side. We found that a single dose of fluoxetine was enough to modulate cerebral sensory-motor activation in patients. This redistribution of activation toward the motor cortex output activation was associated with an enhancement of motor performance.


Subject(s)
Brain Infarction/drug therapy , Brain/physiology , Fluoxetine/therapeutic use , Magnetic Resonance Imaging , Motor Skills/drug effects , Recovery of Function/physiology , Adult , Aged , Brain/pathology , Brain Infarction/physiopathology , Cross-Over Studies , Double-Blind Method , Female , Fluoxetine/pharmacology , Humans , Male , Middle Aged , Placebos , Prospective Studies , Selective Serotonin Reuptake Inhibitors/pharmacology , Selective Serotonin Reuptake Inhibitors/therapeutic use
17.
Neuroradiology ; 42(9): 657-61, 2000 Sep.
Article in English | MEDLINE | ID: mdl-11071438

ABSTRACT

A suprasellar location of a benign choroid plexus papilloma is reported. Local recurrence within the fourth ventricle was also present, 8 years after apparently complete removal. Imaging and histological findings were similar to those of the initial lesion. At surgery, the suprasellar lesion had no connection with the ventricular system. Seeding of choroid plexus papillomas is discussed, and the pertinent literature reviewed.


Subject(s)
Fourth Ventricle/pathology , Neoplasm Recurrence, Local/pathology , Neoplasm Seeding , Papilloma, Choroid Plexus/pathology , Sella Turcica/pathology , Female , Fourth Ventricle/diagnostic imaging , Fourth Ventricle/surgery , Humans , Magnetic Resonance Imaging , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Neurosurgical Procedures , Papilloma, Choroid Plexus/diagnosis , Papilloma, Choroid Plexus/surgery , Sella Turcica/diagnostic imaging , Sella Turcica/surgery , Tomography, X-Ray Computed
18.
Neuroradiology ; 42(9): 703-6, 2000 Sep.
Article in English | MEDLINE | ID: mdl-11071448

ABSTRACT

We present a neonate with a cervicofacial haemangioma complicated by the Kasabach-Merritt syndrome, respiratory distress due to airway compression and high-output heart failure. This haemangioma and intravascular disseminated coagulation, treated initially by aspirin, ticlopidine and corticosteroids, required more invasive treatment with superselective embolisation and interferon alpha-2a. The clinical outcome was good.


Subject(s)
Blood Coagulation Disorders/complications , Facial Neoplasms/complications , Facial Neoplasms/diagnosis , Hemangioma/complications , Hemangioma/diagnosis , Thrombocytopenia/complications , Cerebral Angiography , Facial Neoplasms/therapy , Female , Hemangioma/therapy , Humans , Infant, Newborn , Syndrome , Treatment Outcome
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