Publications by authors named "Felsberg G"

Imaging in the acute setting of suspected stroke is an important topic to all emergency physicians, neurologists, neurosurgeons and neuroradiologist. When it comes to imaging, the American College of Radiology (ACR) continually updates its guidelines for imaging pathways through the ACR Appropriateness Criteria.1,2 This article is a general review of the imaging modalities currently used to assess and help guide the treatment of strokes.

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Gliomatosis cerebri is a rare form of astrocytoma characterized by extreme infiltration of the brain structure in conjunction with a relative paucity of clinical findings. We describe the MRI findings in a patient with gliomatosis cerebri widely infiltrating the brain who presented with symptoms related to involvement of the optic nerves and chiasm. Contrast-enhanced MRI showed enlargement of the optic nerves and chiasm with pathological enhancement; T2-weighted images showed extensive infiltration of the brain by tumor.

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Leptomeningeal dissemination of childhood pilocytic astrocytoma (PA) is a rare event with little information available regarding therapy. We report here four children with disseminated PA whom we treated with high doses of cyclophosphamide with clinical benefit. The patients were aged 2.

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We aimed to determine the maximum tolerated dose (MTD) of 131I-labeled 81C6 in patients with leptomeningeal neoplasms or brain tumor resection cavities with subarachnoid communication and to identify any objective responses. 81C6 is a murine IgG monoclonal antibody that reacts with tenascin in gliomas/carcinomas but does not react with normal adult brain. 131I-labeled 81C6 delivers intrathecal (IT) radiation to these neoplasms.

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To assess the value of magnetic resonance imaging (MRI)-measured hippocampal volume in the detection of hippocampal sclerosis, we studied 28 patients undergoing anterior temporal lobectomy for medically intractable mesial temporal lobe epilepsy. Hippocampal volumetry and visual analysis of T2 signal change were performed using fast spin-echo T2-weighed MRI. Quantitative neuronal density measurements were performed in the resected hippocampal specimens.

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Thirteen patients with recurrent medulloblastoma were treated with cyclophosphamide in association with Sargramostim. Cyclophosphamide was given at doses ranging between 1.0-2.

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We present a case of a giant cell reparative granuloma of the frontoethmoidal region that had a large intracranial extraaxial component and was studied with MR. Although rare, giant cell reparative granuloma can be suggested in the correct clinical setting and when MR features suggest a fibrous lesion.

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We conducted a dose escalation trial of cyclophosphamide plus Sargramostim in the therapy of patients with newly diagnosed or recurrent central nervous system tumors. Cyclophosphamide was administered at doses ranging between 1.0 and 2.

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The MR images of a patient with cerebral amyloid angiopathy (a localized vascular deposition of amyloid without evidence of systemic amyloidosis) showed an extensive right temporoparietal lobe mass with frontal lobe extension that was slightly hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images. No contrast enhancement was identified on MR imaging.

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Purpose: To identify the extent of hippocampal sclerosis in temporal lobe epilepsy with fast spin-echo MR and correlate it with histopathologic findings and surgical outcome.

Methods: MR images of 30 patients with temporal lobe epilepsy and pathologically proved hippocampal sclerosis and 30 control subjects were obtained using a fast spin-echo technique with 4000/100/4 (repetition time/echo time/excitations), 16 echo train, 2- to 3-mm section thickness with interleave, 256 x 256 matrix, and 18-cm field of view. Criteria for MR diagnosis of hippocampal sclerosis included hippocampal atrophy diagnosed with MR volumetry and/or T2-weighted signal change.

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Purpose: To investigate the clinical significance of MR-defined asymmetry of the fornix and mamillary body for presurgical determination of the side of hippocampal sclerosis in patients with temporal lobe epilepsy.

Methods: Fast spin-echo MR images were evaluated for evidence of an asymmetrically small fornix and mamillary body in 33 patients with pathologically proved hippocampal sclerosis (presurgical hippocampal sclerosis group), 7 patients who had undergone anterior temporal lobectomy (mean, 3 years from surgery) because of hippocampal sclerosis (postsurgical hippocampal sclerosis group), and 34 healthy subjects (control group). Fast spin-echo hippocampal volumetry was performed in each patient.

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Purpose: To describe imaging findings in the hippocampus in status epilepticus with fast spin-echo (SE) magnetic resonance (MR) imaging.

Materials And Methods: Five patients with status epilepticus were examined with fast SE MR imaging, and the findings were correlated with neuropathologic observations of status epilepticus.

Results: One patient with diffuse bilateral hippocampal and amygdalal abnormal hyperintensity died.

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We evaluated the utility of MR imaging in pediatric patients with acute and subacute spinal cord injuries. MR imaging of 22 pediatric patients with suspected traumatic spinal cord injuries was reviewed. MR findings were correlated with physical examination and compared to available radiographs and CT examinations performed at time of presentation.

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Objective: Measurements of the volume of the hippocampus have been used preoperatively to determine the side of the hippocampus involved in patients with intractable temporal lobe epilepsy. However, the method used is time consuming and requires special training. The purpose of this study was to determine the validity of using measurements of the volume of the hippocampal body as a substitute for measurements of the volume of the whole hippocampus in patients with temporal lobe epilepsy.

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Contrast angiography is the standard means of diagnosing spinal dural arteriovenous fistulas. We present a patient in whom a spinal dural arteriovenous fistula was demonstrated on phase contrast MR angiography.

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The limbic system refers to the part of the brain that is involved in emotional expression and in cognitive and somatomotor control systems; it most likely also has a significant role in the pathogenesis of certain dementias, neuropsychiatric disturbances, and seizure disorders. This system, as originally defined, has no clear anatomic boundaries. Limbic regions of the telencephalon include a continuous medial zone of cortical regions, including the hippocampal formation; a perihippocampal zone, including the cingulate gyrus, prefrontal region, and perirhinal region; along with subcortical areas, including the septum pellucidum and the amygdala.

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Lesions of the central skull base, most notably the sphenoid bone, commonly originate from the endocranial soft tissues. Although most commonly identified with pituitary macroadenomas, skull base erosion, destruction, and remodeling may be seen with a variety of congenital, neoplastic, cystic, vascular, and inflammatory lesions involving the sellar and parasellar soft tissues.

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Objective: The purpose of this study was to evaluate the usefulness of diffusion-weighted echoplanar MR imaging in the examination of high-grade brain gliomas compared with that of conventional spin-echo (SE) or fast spin-echo (FSE) MR imaging. We hypothesize that diffusion-weighted MR imaging may enable us to differentiate various tumor components on the basis of differences in the diffusion of water.

Subjects And Methods: Conventional SE and FSE MR images were obtained in 10 patients with high-grade brain glioma.

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Objective: With the increased survival of patients with severe immunosuppression, it has become more important to recognize the various forms of cerebral and craniofacial aspergillosis. Currently, only small series of patients with this infection have been described; the radiographic diagnosis of cerebral and craniofacial aspergillosis has varied and has been relatively nonspecific. The purpose of our study was to identify neuroimaging patterns in patients with cerebral and craniofacial aspergillosis.

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Purpose: This study was performed to determine the sensitivity and specificity of fast spin-echo (FSE) magnetic resonance (MR) imaging in detecting mesial temporal sclerosis.

Materials And Methods: Twenty-one patients with a diagnosis of complex partial seizures were studied. Criteria for abnormality included visual detection of hippocampal MR signal abnormality and atrophy or significantly decreased hippocampal volume determined by using MR morphometric techniques.

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Current methods of neuroimaging have revolutionized the examination of patients with dementia. Clinical examination of these patients has identified cortical and subcortical patterns of dementia. Each of these patterns can be caused by various diseases.

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