Intracranial vessel wall magnetic resonance imaging features of infectious vasculitis.

Vasculitis is a complication of several infectious diseases affecting the central nervous system, which may result in ischemic and/or hemorrhagic stroke, transient ischemic attack, and aneurysm formation. The infectious agent may directly infect the endothelium, causing vasculitis, or indirectly affect the vessel wall through an immunological mechanism. The clinical manifestations of these complications usually overlap with those of non-infectious vascular diseases, making diagnosis challenging.

Pediatric multiple sclerosis: from clinical basis to imaging spectrum and differential diagnosis.

Pediatric multiple sclerosis (MS) deserves special attention because of its impact on cognitive function and development. Although knowledge regarding pediatric MS has rapidly increased, understanding the peculiarities of this population remains crucial for disease management. There is limited expertise about the efficacy and safety of current disease-modifying agents.

Tips and tricks in the diagnosis of intracranial dural arteriovenous fistulas: A pictorial review.

Dural arteriovenous fistulas (DAVFs) are complex vascular abnormalities that account for 10-15% of intracranial vascular malformations. DAVFs are typically encountered in middle-aged adults, with a slightly female predominance. The causative factors are still uncertain; however, abnormal local hemodynamics and neoangiogenesis related to dural sinus or venous thrombosis can contribute to DAVF occurrence.

Neuromyelitis Optica Spectrum Disorders: Spectrum of MR Imaging Findings and Their Differential Diagnosis.

Neuromyelitis optica (NMO) is an autoimmune demyelinating disorder for which the aquaporin-4 (AQP4) water channels are the major target antigens. Advances in the understanding of NMO have clarified several points of its pathogenesis, clinical manifestations, and imaging patterns. A major advance was the discovery of the AQP4 antibody, which is highly specific for this disorder.

Dementia in motor neuron disease: Reviewing the role of MRI in diagnosis.

The superimposed clinical features of motor neuron disease (MND) and frontotemporal dementia (FTD) comprise a distinct, yet not fully understood, neurological overlap syndrome whose clinicopathological basis has recently been reviewed. Here, we present a review of the clinical, pathological and genetic basis of MND-FTD and the role of MRI in its diagnosis. In doing so, we discuss current techniques that depict the involvement of the selective corticospinal tract (CST) and temporal lobe in MND-FTD.

Contusion Contrast Extravasation Depicted on Multidetector Computed Tomography Angiography Predicts Growth and Mortality in Traumatic Brain Contusion.

Traumatic brain injury (TBI) is the main cause of death in trauma victims and causes high rates of disability and neurological sequelae. Approximately 38-65% of traumatic brain contusions (TBC) demonstrate hemorrhagic expansion on serial computed tomography (CT) scans. Thus far, however, no single variable can accurately predict the hemorrhage expansion of a TBC.

Midline brain-in-brain malformation associated with bilateral perirolandic cortical abnormalities: an image review of this rare disorder.

A midline brain-in-brain malformation was recently reported, but appropriate classification of this malformation remains uncertain. We describe a child with a complex brain malformation that was not restricted to the midline structures, enlarging the neuroanatomical spectrum of this pseudotumoral midline dysplasia associated with corpus callosum dysgenesis, azygos anterior cerebral artery, absent septum pellucidum and bilateral perirolandic cortical abnormalities. The spectrum of fusion of the cerebral hemispheres and associated brain hemispherical abnormalities is not completely understood.

Incidental demyelinating inflammatory lesions in asymptomatic patients: a Brazilian cohort with radiologically isolated syndrome and a critical review of current literature.

Despite the definition of specific diagnostic criteria to identify radiologically isolated syndrome (RIS) suggestive of multiple sclerosis, its natural history remains incompletely understood. We retrospectively analyzed a Brazilian cohort of 12 patients to clarify their features and to emphasize the role of imaging predictors in clinical conversion. We demonstrated that, although some individuals did not exhibit progression over a lengthy follow-up period (16.

Idiopathic inflammatory demyelinating disorders of the central nervous system in children.

Idiopathic inflammatory demyelinating disorders of the central nervous system usually present with a typical morphologic pattern in adults, with multiple sclerosis as the predominant disorder. However, the variety of disorders in children has an odd range of features that have piqued the interest of researchers. Information concerning this group of diseases, both in vivo and in different age groups, has particularly progressed with the advent of magnetic resonance imaging in the last few decades.

Diffusion MR imaging for monitoring treatment response.

The objective of this article was to emphasize the use of diffusion-weighted imaging in the diagnosis and follow-up of several major disease contexts, as established in recent literature. In some of these diseases the diffusion changes are correlated with the clinical deficit and are potentially useful for early diagnosis and longitudinal evaluation, as well as in the context of pharmacologic trials. Diffusion magnetic resonance is a major advance in the continuing evolution of MR imaging.

Hippocampal sclerosis and status epilepticus: cause or consequence? A MRI study.

Background: Transient imaging abnormalities, including changes on diffusion-weighted imaging (DWI), may be seen in status epilepticus. These abnormalities can be followed by hippocampal sclerosis.

Case Report: We report a 15-year-old lady with focal non convulsive status epilepticus (NCSE) and focal slowing on EEG.

Spinal cord compression secondary to epidural bilharzioma: case report.

A case of an epidural granuloma due to Schistosoma mansoni compressing the spinal cord at T7-T9 is presented. The patient, a 35-year-old Brazilian man, started complaining of recurrent back pain since 2003. A magnetic resonance imaging (MRI) scan showed a large epidural mass extending from T7 to T9 and causing mild spinal cord compression.

Differentiation of Parkinson's disease and progressive supranuclear palsy with magnetic resonance imaging: the first Brazilian experience.

Background: The objective of this study is to differentiate PSP from Parkinson's disease through magnetic resonance imaging.

Methods: We included 14 consecutive patients with PD (9) or PSP (5). These measures included the third ventricle, midbrain diameter, quadrigeminal plate, brainstem volumetry, and interpeduncular angle.

Pyramidal tract degeneration in multiple system atrophy: the relevance of magnetization transfer imaging.

The clinical features of multiple system atrophy (MSA) include four domains: autonomic failure/urinary dysfunction, Parkinsonism, cerebellar ataxia, and corticospinal tract dysfunction. Although the diagnosis of definite MSA requires pathological confirmation, magnetic resonance imaging (MRI) studies have been shown to contribute to the diagnosis of MSA. Although pyramidal tract dysfunction is frequent in MSA patients, signs of pyramidal tract involvement are controversially demonstrated by MRI.

Focal transient lesion in the splenium of the corpus callosum in three non-epileptic patients.

Introduction: We analyzed the imaging features of transient focal lesions in the splenium of the corpus callosum (SCC) in non-epileptic patients receiving antiepileptic drugs (AEDs).

Methods: We identified signal abnormalities in the SCC in three non-epileptic patients, all of them receiving AEDs. We examined two of these patients with multiplanar magnetic resonance (MR) imaging using 1.

Granulomatous diseases of the central nervous system.

Infectious diseases of the central nervous system (CNS), particularly those accompanied by the formation of granulomas, are a constant diagnostic challenge in some specific regions of the world, above all in developing countries. The pattern of image seen on CT or MR scan is the result of the inter-relations between the individual characteristics of the infectious agent and the capacity of each host to mount an appropriate inflammatory response to that specific type of aggression, inside one particular compartment of the CNS. Taking these parameters into account we will discuss the several patterns of image found in parasitic, bacterial, and fungal granulomatous infections.

Comparative analysis of MR sequences to detect structural brain lesions in tuberous sclerosis.

Background: Tuberous sclerosis (TS) is a neurocutaneous genetically inherited disease with variable penetrance characterized by dysplasias and hamartomas affecting multiple organs. MR is the imaging method of choice to demonstrate structural brain lesions in TS.

Objective: To compare MR sequences and determine which is most useful for the demonstration of each type of brain lesion in TS patients.

MR cerebral blood volume maps correlated with vascular endothelial growth factor expression and tumor grade in nonenhancing gliomas.

Background And Purpose: Relative cerebral blood volume (rCBV) measurements derived from perfusion-weighted imaging (PWI) may be useful to evaluate angiogenesis and preoperatively estimate the grade of a glioma. We hypothesized that rCBV is correlated with vascular endothelial growth factor (VEGF) expression as marker of the angiogenic stimulus in presumed supratentorial low-grade gliomas (LGGs).

Methods: From February 2001 to February 2004, we examined 20 adults (16 men, four women; mean age 36 years; range, 23-60 years) with suspected (nonenhancing) supratentorial LGG on conventional MR imaging.

Evidence of acute ischemic tissue change in transient global amnesia in magnetic resonance imaging: case report and literature review.

Transient global amnesia is a benign syndrome of sudden-onset alteration of behavior with temporary dysfunction of anterograde and recent retrograde memory. Its neural substrates remain uncertain. Possible causes include ischemia, migraine, and epilepsy.