-
Arquivos de neuro-psiquiatria 12/2011; 69(6):998. · 0.55 Impact Factor
-
Arquivos de neuro-psiquiatria 07/2009; 67(2A):305-7. · 0.55 Impact Factor
-
Arquivos de neuro-psiquiatria 04/2009; 67(1):115-6. · 0.55 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate with 1H-magnetic resonance spectroscopy (MRS) the metabolites rations of the foramen of Monro's region in patients with tuberous sclerosis complex (TSC).
Twelve patients with TSC and an age and gender-matched control group underwent MR imaging at a 1.5T scanner, and 1H-MRS at the foramen of Monro level with a multivoxel acquisition. Similar volumes of interest were selected in each side of the foramen of Monro and in the basal ganglia (lentiform nuclei). The obtained N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) peak amplitude values and ratios were studied. The statistical analysis was performed and p<0.05 was considered statically significant.
There was no significant difference between the NAA/Cr and Cho/Cr ratios near to the foramen of Monro and basal ganglia of the TSC patients compared with the controls (p>0.05).
The NAA/Cr and Cho/Cr ratios near to the foramen of Monro and basal ganglia of TSC patients are similar to the rations obtained in the control group.
Arquivos de Neuro-Psiquiatria 06/2008; 66(2B):303-7. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A 17-year-old boy presented with somnolence and mental confusion. Physical examination demonstrated motor disturbances. Laboratory investigation showed elevated levels of alpha-fetoprotein in serum and cerebrospinal fluid. The CT scan revealed a heterogeneous mass at the pineal region. At the MRI, this lesion was hypointense on T1 and hyperintense on T2-weighted images, enhancing after contrast administration. The patient underwent a surgical biopsy, which defined the diagnosis of yolk sac tumor. We emphasize the correlation of neuroimaging and pathological findings of this rare pineal region tumor.
Arquivos de Neuro-Psiquiatria 07/2007; 65(2A):283-5. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To describe the CT scan findings of 21 thrombocytopenic patients with central nervous system (CNS) hemorrhage.
Retrospective study of the computed tomography (CT) of 21 platelet-depleted patients with CNS hemorrhage. One patient presented two episodes of hemorrhagic episode with different intervals. The clinical data were obtained by the review of the medical records. Two radiologists analyzed the films and reached the decisions by consensus. The following findings were studied: type of bleeding, number of lesions, topography, laterality, size and associated findings.
Intraparenchymal hemorrhage (IPH) was the most common findings, found in 20 cases, being six of them associated with subarachnoid and intraventricular hemorrhages. The size of the lesions varied between 1.8 and 10.5 cm. The parietal lobes were more commonly affected (n=11, 50%), followed by the temporal (n=7, 31.8%), frontal (n=7, 31.8%) and occipital (n=2, 9.09%) lobes. In 15 cases (68.2%) there was a single area of hemorrhage and in the remaining cases there were multiple hemorrhages. Associated findings were found in 20 cases. The most prevalent were edema (n=17, 77.3%), hydrocephalus (10, 45.4%) and midline shift (n=9, 41%).
The most frequent CT scan findings in thrombocytopenic patients with CNS hemorrhage are single IPH, located mostly in the parietal, temporal and frontal lobes, with varied sizes and associated with edema, hydrocephalus and midline shift.
Arquivos de Neuro-Psiquiatria 07/2007; 65(2A):268-72. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To present the imaging findings of a patient with diffuse brain injury secondary to intoxication with oral hypoglycemics.
A nine years-old boy presented with generalized tonic-clonic convulsions and decreased consciousness. Laboratory investigation demonstrated blood glucose level of 21 mg/dL. The magnetic resonance imaging showed cortical and subcortical temporo-parieto-occipital areas of high signal on T2 and low signal on T1, with high signal on the diffusion-weighted images and low signal on apparent diffusion coefficient maps.
Cortical and subcortical temporal, parietal and occipital ischemic lesions may be seen in patients with intoxication by oral hypoglycemics.
Arquivos de Neuro-Psiquiatria 01/2007; 64(4):1036-8. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To report a case of childhood cerebral X-linked adrenoleukodystrophy (X-ADL), emphasizing the magnetic resonance imaging (MRI) findings at initial evaluation and at the follow-up.
Five year-old boy, who was asymptomatic, presented with diagnosis of X-ADL for MRI evaluation. The initial brain MRI showed a focal area of enhancement at the splenium of the corpus calosum. One year later, the follow-up MRI showed a progression of the corpus calosus lesion, as well as other lesions in the parietal and occipital lobes.
The brain MRI follow-up of patients with X-ADL is important to show the progression of the lesions.
Arquivos de Neuro-Psiquiatria 01/2007; 64(4):1033-5. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To report a case of subependymal giant cell astrocytoma (SEGA) in a patient with tuberous sclerosis, emphasizing the proton MR spectroscopy (MRS) findings.
A three year-old boy with tuberous sclerosis presented with a 3-month history of mild headache. The physical examination showed discrete mental retardation and multiple hypomelanic macules in the legs and back. MRI showed many cortical tubers and subependymal nodules. At the left foramen of Monro, there was a 15 mm nodule, with heterogeneous signal on T1 and T2-weighted images, and strong enhancement after contrast administration. MRS study (multi-voxel PRESS, TE=144ms) showed the following ratios: a) left foramen of Monro nodule N-acetylaspartate (NAA)/creatine (Cr)=0.93 and Choline (Cho)/Cr=1.6 and b) at the right Monro foramen NAA/Cr=1.56 and Cho/Cr=1.29.
The MRS performed at the SEGA may show high Cho/Cr and low NAA/Cr ratios, similar to the other brain neoplasms. As a consequence, MRS may be a valuable tool for the early detection of neoplastic transformation of subependymal nodules near the foramina of Monro in patients with tuberous sclerosis.
Arquivos de Neuro-Psiquiatria 10/2006; 64(3B):877-80. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To describe the MRI findings of two pediatric patients with sudden sensorineural hearing loss (SSHL).
Two male patients (two-year and three-months-old, and one year and four-months-old) presented with sudden dumbness. Physical and neurological examinations were unremarkable besides bilateral hypoacusia. All the laboratory investigation was negative, and brain stem auditory evoked potentials showed deep bilateral deafness in both cases. MRI studies revealed normal inner ears and multifocal white matter areas of slight low signal on T1-weighted images and high signal on FLAIR images. The follow-up MRI studies and neurological examinations did not demonstrate alterations in the previous findings.
Pediatric patients with SSHL may present cerebral white matter signal abnormalities at the MRI as the only finding. Further studies with larger casuistics need to be conducted to elucidate these findings.
Arquivos de Neuro-Psiquiatria 01/2006; 63(4):969-71. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The cerebral lesions are uncommon in patients with histoplasmosis, occurring more frequently in the disseminated form of the disease. Rarely, the disease may present as a histoplasmoma, simulating a neoplastic lesion. The histoplasmoma as the only manifestation of this infection in immunocompetent patients is even rarer. This case report describes a 13 year-old male patient with headache, vomit, low visual acuity and auditive deficit on the left, and paresis on the right. The magnetic resonance image showed an expansible lesion in the thalamic, hypothalamic, and chiasmatic regions, which showed ring enhancement. The stereotactic biopsy was performed and the histological diagnosis of histoplasmosis was defined. The treatment was initiated with fluconazole. The patient showed important clinical improvement after 6 months.
Arquivos de Neuro-Psiquiatria 10/2005; 63(3A):689-92. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which has the pulmonary form as the most common presentation. Dissemination of the disease is common in immunocompromised patients, but immunodeficiency related to pregnancy severe enough to cause dissemination of the Mycobacteria is exceedingly rare. When dissemination occurs, any organ may be affected and in central nervous system, the infection presents as meningitis and single brain parenchyma tuberculomas. We report the case of a 17 year-old woman at the 34th week of pregnancy with respiratory and high intracranial pressure symptoms. On the day before admission she had a sudden onset of paraparesis and urinary retention and ten hours after the delivery she presented with paraplegia. The chest X-ray and CT scan were compatible with miliary tuberculosis. The cranial CT scan revealed numerous rounded hypodense lesions located at cerebral and cerebellar hemispheres, which presented ring-like enhancement after contrast injection. The patient underwent a craniotomy with biopsy of the lesions confirming the diagnosis of brain tuberculomas. The three-drug regimen was started and the cranial CT scan performed a year after diagnosis showed no brain lesions. We emphasize the aggressive dissemination of the disease in this case associated with pregnancy and the importance of early diagnosis and institution of therapy resulting in regression of the lesions.
Arquivos de Neuro-Psiquiatria 10/2003; 61(3B):855-8. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: pineal region tumors are uncommon, and comprise more frequently three categories: germ cell, parenchymal cell and glial tumors. Most pineal gliomas are low-grade astrocytomas. Glioblastoma multiforme, the most aggressive and common brain tumor, is extremely rare at this location with only few cases reported.
a 29-year-old woman with a two month history of headache, nuchal pain, fever, nausea and seizures and physical examination showing nuchal rigidity, generalized hypotony, hypotrophy and hyper-reflexia, Babinski sign and left VI cranial par palsy. CT scan examination revealed a ill-defined hypodense lesion at the pineal region with heterogeneous contrast enhancement. MRI showed a lesion at the pineal region infiltrating the right thalamic region. The patient underwent a right craniotomy with partial resection of the mass. The histological examination of paraffin-embedded material defined the diagnosis of glioblastoma multiforme. Post-operative radiotherapy was indicated but the patient refused the treatment and died two months afterwards.
in spite of its rarity at this location, glioblastoma multiforme should be considered in the differential diagnosis of aggressive lesions at the pineal region.
Arquivos de Neuro-Psiquiatria 07/2003; 61(2B):468-72. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Medulloblastoma is a brain tumor of neuroepithelial origin, which represents 15 to 30% of all pediatric brain tumors, and less than 1% of CNS adult neoplasms. We report the imaging findings of 8 adult patients with medulloblastoma. The mean age was 35 years, ranging from 20 to 65 years, and the male:female rate was 3:5. The tumors were predominantly lateral (63%), hyperdense on CT scans (83%), and on the MRI, hypointense on T1 (100%) and hyperintense on T2 (80%) weighted images. It was seen intratumoral necrosis and cysts in six cases and calcifications in three. Hydrocephalus was observed in 5 cases and brain stem invasion in four. The imaging findings of medulloblastomas in adults are different of those in child, and also nonspecific. Although these tumors are uncommon in adults, they must be considered in the differential diagnosis of cerebellar masses in the posterior fossa of this age group.
Arquivos de Neuro-Psiquiatria 07/2003; 61(2A):199-203. · 0.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We present the case of an 11-year-old female patient with tuberous sclerosis who had a right nasal mass. CT examination revealed fibrous dysplasia involving the frontal, ethmoid, sphenoid, and vomer bones. Biopsy findings of the mass confirmed this diagnosis, and follow-up revealed marked expansion of these lesions. The authors emphasize the association of bone abnormalities and tuberous sclerosis and discuss the consideration of fibrous dysplasia as a component of this syndrome.
American Journal of Neuroradiology 06/2003; 24(5):835-7. · 2.93 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To quantify the imaging findings of 17 patients with central nervous system (CNS) paracoccidioidomycosis.
Retrospective analysis of the clinical data, films, and laboratory findings of 17 patients with CNS paracoccidioidomycosis. The clinical data were obtained by medical records review. Plain chest films, cranial computed tomography scans (CT), and serum and liquor analysis were evaluated.
All the patients were male, with a mean age of 46.5 years. Headache and hemiparesis were the most frequent symptoms. The head CT scans revealed two or more granulomas in 53% of the cases, frequently confined to the parietal lobes (35%) and cerebellar hemispheres (35%). The lesions were hypodense (53%) and irregular (76%) and showed ring-like contrast enhancement (94%). Perilesional edema was seen in 82% of the patients, and hydrocephalus was seen in 41%.
Although CNS paracoccidioidomycosis might represent a suspicious lesion pattern on CT scan examination, correlation of the CT scan findings, clinical data, plain chest films, and laboratory results is necessary to define the diagnosis of this uncommon entity.
Journal of Computer Assisted Tomography 27(1):12-7. · 1.22 Impact Factor
