To see the other types of publications on this topic, follow the link: Fluid; Volumes; Cerebral oedema.
Journal articles on the topic 'Fluid; Volumes; Cerebral oedema'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Fluid; Volumes; Cerebral oedema.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Bersot, Carlos Darcy, Rafael Linhares, Carolina Araujo Barbosa, and Jose Eduardo Pereira. "Peri-operative fluid management during neurosurgical procedures." Nepal Journal of Neuroscience 18, no. 2 (June 1, 2021): 9–14. http://dx.doi.org/10.3126/njn.v18i2.33373.
Full textAbstract:
The management of fluids and electrolytes in neurosurgical patients aims to reduce the risk of cerebral oedema, reduce ICP and at the same time maintain haemodynamic stability and cerebral perfusion. Neurosurgical patients commonly receive diuretics (mannitol and furosemide), developing complications such as bleeding and diabetes insipidus. These patients may require large volumes of intravenous fluids and even blood transfusions for volume resuscitation, treatment of cerebral vasospasm, correction of preoperative dehydration or maintenance of haemodynamic stability. Goal-oriented therapy is recommended in neurological patients, with the aim of maintaining circulating volume and tolerating the changes induced by anaesthesia (vasodilation and myocardial depression).
2
Fischer, R., C. Vollmar, M. Thiere, C. Born, M. Leitl, T. Pfluger, and RM Huber. "No Evidence of Cerebral Oedema in Severe Acute Mountain Sickness." Cephalalgia 24, no. 1 (January 2004): 66–71. http://dx.doi.org/10.1111/j.1468-2982.2004.00619.x.
Full textAbstract:
In a randomized, double-blind cross-over study 10 subjects were exposed to a simulated altitude of 4500 m for 10 h after administration of placebo, acetozolamide (250 mg bid) or theophylline (250 mg bid). T2-weighted magnetic resonances images (MRI) and diffusion weighted MRI were obtained directly after exposure to altitude under hypoxic conditions. Although eight of 10 subjects had moderate to severe acute mountain sickness (AMS), we found no evidence of cerebral oedema, irrespective of the medication taken. Almost all subjects showed a decrease in inner cerebrospinal fluid (iCSF) volumes (placebo −10.3%, P = 0.02; acetazolamide −13.2%, P = 0.008, theophylline −12.2%, n.s.). There was no correlation between AMS symptoms and fluid shift. However, we found a significantly positive correlation of large (>10 ml) iCSF volume and more severe AMS after administration of placebo ( r = 0.76, P = 0.01). Moderate to severe AMS after high altitude exposure for 10 h is associated with a decreased iCSF-volume independent of AMS severity or medication without signs of cerebral oedema.
3
Lin, Hung-Jung, Chia-Ti Wang, Ko-Chi Niu, Chungjin Gao, Zhuo Li, Mao-Tsun Lin, and Ching-Ping Chang. "Hypobaric hypoxia preconditioning attenuates acute lung injury during high-altitude exposure in rats via up-regulating heat-shock protein 70." Clinical Science 121, no. 5 (May 20, 2011): 223–31. http://dx.doi.org/10.1042/cs20100596.
Full textAbstract:
HHP (hypobaric hypoxia preconditioning) induces the overexpression of HSP70 (heat-shock protein 70), as well as tolerance to cerebral ischaemia. In the present study, we hypothesized that HHP would protect against HAE (high-altitude exposure)-induced acute lung injury and oedema via promoting the expression of HSP70 in lungs prior to the onset of HAE. At 2 weeks after the start of HHP, animals were exposed to a simulated HAE of 6000 m in a hypobaric chamber for 24 h. Immediately after being returned to ambient pressure, the non-HHP animals had higher scores of alveolar oedema, neutrophil infiltration and haemorrhage, acute pleurisy (e.g. increased exudate volume, increased numbers of polymorphonuclear cells and increased lung myeloperoxidase activity), increased pro-inflammatory cytokines [e.g. TNF-α (tumour necrosis factor-α), IL (interleukin)-1β and IL-6], and increased cellular ischaemia (i.e. glutamate and lactate/pyruvate ratio) and oxidative damage [glycerol, NOx (combined nitrate+nitrite) and 2,3-dihydroxybenzoic acid] markers in the BALF (bronchoalveolar fluid). HHP, in addition to inducing overexpression of HSP70 in the lungs, significantly attenuated HAE-induced pulmonary oedema, inflammation, and ischaemic and oxidative damage in the lungs. The beneficial effects of HHP in preventing the occurrence of HAE-induced pulmonary oedema, inflammation, and ischaemic and oxidative damage was reduced significantly by pretreatment with a neutralizing anti-HSP70 antibody. In conclusion, HHP may attenuate the occurrence of pulmonary oedema, inflammation, and ischaemic and oxidative damage caused by HAE in part via up-regulating HSP70 in the lungs.
4
Ahmed, Shahad W. "Life threatening water intoxication." Iraqi Journal of Veterinary Medicine 44, no. 2 (December 28, 2020): 71–77. http://dx.doi.org/10.30539/ijvm.v44i2.978.
Full textAbstract:
Water intoxication is a fatal disorder associated with disturbance in brain function, known as hypo-osmolar syndrome which resulting from an excessive water intake, with dilutional hypernatremia leads to a potentially fatal outcome. A change in the electrolyte equilibrium such as this sudden drop in serum sodium level and then subsequent mortality. With hyponatremia, the plasma osmolality decreased leading to water movement into the brain according to the osmotic gradient, resulting in hyponatremic encephalopathy and cerebral oedema. Increased water intake such as in Psychogenic polydipsia is followed by urination of high amount of diluted urine (polyuria) which are the main initial symptoms of water intoxication with headache, blurred vision, nausea, tremor, and deterioration in psychosis. Other serious symptoms involve muscle spasms, Early detection of seizures and coma are more serious outcomes, Untreated cases may lead to death, Risk factor for water intoxication are Marathon runners, military population and athletes and due to this endurance events, these behaviors encouraging heavy sweating that result in heat exhaustion and consume large volumes of fluid, then hyponatremia developed as a result of excessive fluid substitution. Child abuse is other pediatric clinical cases reported with water intoxication. Psychogenic polydipsia which is psychiatric disorder with obsessive water drinking leading to a serious self-induced water intoxication (SIWI), water is normally metabolized and excreted by different means and it is mainly by kidneys in urine, evaporation through the skin, by respiratory system through the respired water vapor and little quantity of water was lost from the gastrointestinal tract (GI).The LD50 of water is > 90 ml/kg orally in rats. The current review illustrates the Life threatening effects of water when it is aggressively consumed.
5
Foreman, J. H. "The effects of prolonged endurance exercise on the neurological system in horses." Comparative Exercise Physiology 8, no. 2 (January 1, 2012): 81–93. http://dx.doi.org/10.3920/cep11019.
Full textAbstract:
Horses compete routinely in endurance-type activities. Many of the various pathophysiological mechanisms which arise during endurance exercise have implications for the health and function of the neurological system. The development of centrally-mediated fatigue is a normal homeostatic physiological event with several possible mechanisms. Development of pathophysiological phenomena such as cerebral oedema may be near-terminal events during or after endurance exhaustion. Cellular damage resulting in cytotoxic cerebral oedema may result from decreases in circulating blood volume (dehydration), blood pressure, oxygen, and glucose, or increases in brain temperature. Vasogenic cerebral oedema arises from changes in cerebral vascular perfusion, tone, and permeability. Increased vascular permeability results from increased brain temperature, poor vascular integrity due to severe dehydration, disseminated intravascular coagulation due to hemoconcentration or endotoxemia, and iatrogenic overhydration during therapy. Clinical signs of intracranial disease after endurance exercise include staggering, shaking, ataxia, paresis, poor tongue tone, facial twitching, collapse, recumbency, seizures, and death. Treatment should include active and aggressive cooling, intravenous polyionic fluids, acid-base imbalance correction, intravenous glucose and calcium supplementation, non-steroidal anti-inflammatory agents once the patient is better hydrated, intra-nasal oxygen therapy if practicable, and achievement of a non-dependent head posture to prevent jugular venous hypertension and further increases in intracranial pressure. The prognosis for central fatigue is good with appropriate supportive care, but the prognosis for successful treatment of cerebral oedema must be considered guarded at best. Prevention is critical and must be through incorporation of mandatory rest stops with sufficient length and veterinary monitoring to allow prevention and detection of exhaustion, excessive dehydration, and neurological signs. Management flexibility in shortening or postponing rides in hot and humid conditions, mandated use of aggressive cooling techniques, and more restrictive entry criteria for upper level Fédération Equestre Internationale races should all be considered as viable options for optimising the safety of endurance horses.
6
Bracher, Alexia, Beat Knechtle, Markus Gnädinger, Jolanda Bürge, Christoph Alexander Rüst, Patrizia Knechtle, and Thomas Rosemann. "Fluid intake and changes in limb volumes in male ultra-marathoners: does fluid overload lead to peripheral oedema?" European Journal of Applied Physiology 112, no. 3 (July 1, 2011): 991–1003. http://dx.doi.org/10.1007/s00421-011-2056-3.
Full text
7
Brown, Mark A., Vivienne C. Zammit, and Sandra A. Lowe. "Capillary Permeability and Extracellular Fluid Volumes in Pregnancy-Induced Hypertension." Clinical Science 77, no. 6 (December 1, 1989): 599–604. http://dx.doi.org/10.1042/cs0770599.
Full textAbstract:
1. Capillary permeability was determined by the disappearance rate of Evans Blue dye from plasma in healthy non-pregnant women, normal third-trimester primigravidae and primigravidae with pregnancy-induced hypertension 2. Extracellular fluid volume was determined from the disappearance curves of injected mannitol in the same subjects and the plasma volume was measured by the Evans Blue dye dilution technique 3. In normal pregnancy capillary permeability was not altered from that of non-pregnant subjects. Although extracellular fluid volume and plasma volume were increased in normal pregnant compared with nonpregnant women, the distribution of fluid between plasma volume and interstitial fluid volume was unaltered 4. Women with established pregnancy-induced hypertension had a more rapid Evans Blue disappearance rate and a lower plasma volume than normal pregnant women, independent of the presence of proteinuria. Maternal plasma volume correlated positively and significantly with fetal birth weight in women with pregnancy-induced hypertension, emphasizing the important relationship between maternal plasma volume and fetal outcome 5. The increased capillary permeability in women with pregnancy-induced hypertension was associated with a reduction in the plasma volume/interstitial fluid volume ratio but a normal extracellular fluid volume, suggesting that the reduced plasma volume did not result from sodium loss but rather from a redistribution of the total extracellular fluid volume. These changes did not differ significantly in subgroups with and without oedema.
8
Stoquart-ElSankari, Souraya, Olivier Balédent, Catherine Gondry-Jouet, Malek Makki, Olivier Godefroy, and Marc-Etienne Meyer. "Aging Effects on Cerebral Blood and Cerebrospinal Fluid Flows." Journal of Cerebral Blood Flow & Metabolism 27, no. 9 (February 21, 2007): 1563–72. http://dx.doi.org/10.1038/sj.jcbfm.9600462.
Full textAbstract:
Phase-contrast magnetic resonance imaging (PC-MRI) is a noninvasive reliable technique, which enables quantification of cerebrospinal fluid (CSF) and total cerebral blood flows (tCBF). Although it is used to study hydrodynamic cerebral disorders in the elderly group (hydrocephalus), there is no published evaluation of aging effects on both tCBF and CSF flows, and on their mechanical coupling. Nineteen young (mean age 27 ± 4 years) and 12 elderly (71 ± 9 years) healthy volunteers underwent cerebral MRI using 1.5 T scanner. Phase-contrast magnetic resonance imaging pulse sequence was performed at the aqueductal and cervical levels. Cerebrospinal fluid and blood flow curves were then calculated over the cardiac cycle, to extract the characteristic parameters: mean and peak flows, their latencies, and stroke volumes for CSF (cervical and aqueductal) and vascular flows. Total cerebral blood flow was ( P < 0.01) decreased significantly in the elderly group when compared with the young subjects with a linear correlation with age observed only in the elderly group ( R2 = 0.7; P = 0.05). Arteriovenous delay was preserved with aging. The CSF stroke volumes were significantly reduced in the elderly, at both aqueductal ( P < 0.01) and cervical ( P < 0.05) levels, whereas aqueduct/cervical proportion ( P = 0.9) was preserved. This is the first work to study aging effects on both CSF and vascular cerebral flows. Data showed (1) tCBF decrease, (2) proportional aqueductal and cervical CSF pulsations reduction as a result of arterial loss of pulsatility, and (3) preserved intracerebral compliance with aging. These results should be used as reference values, to help understand the pathophysiology of degenerative dementia and cerebral hydrodynamic disorders as hydrocephalus.
9
Gove, C. D., R. D. Hughes, and Roger Williams. "Importance of Fluid Replacement in a Rat Model of Cerebral Oedema Formation in Acute Liver Failure." Clinical Science 74, s18 (January 1, 1988): 52P. http://dx.doi.org/10.1042/cs074052pb.
Full text
10
Van Den Tooren, Harriet Kay, Viraj Bharambe, Nicholas Silver, and Benedict D. Michael. "Herpes simplex virus encephalitis in a patient receiving ustekinumab associated with extensive cerebral oedema and brainshift successfully treated by immunosuppression with dexamethasone." BMJ Case Reports 12, no. 8 (August 2019): e229468. http://dx.doi.org/10.1136/bcr-2019-229468.
Full textAbstract:
Herpes simplex virus (HSV) encephalitis affects 2–4 people per million/year. Immunocompomised patients can have atypical presentations of HSV encephalitis, including a lack of cerebrospinal fluid (CSF) pleocytosis. We present the case of a patient who was receiving ustekinumab therapy for psoriasis which inhibits interleukin (IL)-12 and IL-23 signalling pathways. The initial presentation was suggestive of encephalitis, but he was discharged prior to the reporting of HSV positivity due to the lack of CSF pleocytosis. On representation, he had worsening symptoms and imaging showed midline shift, indicating cerebral oedema despite the immunosupressant effects of ustekinumab. He required intensive care unit support and treatment with high dose aciclovir and dexamethasone; after a month of treatment he made a good recovery. This case is the first to report a link between ustekinumab and HSV encephalitis, and also emphasises that imunocompromised patients can lack CSF pleocytosis and develop significant cerebral oedema which responds to immune suppression.
11
Harvey, I., R. Persaud, M. A. Ron, G. Baker, and R. M. Murray. "Volumetric MRI measurements in bipolars compared with schizophrenics and healthy controls." Psychological Medicine 24, no. 3 (August 1994): 689–99. http://dx.doi.org/10.1017/s0033291700027847.
Full textAbstract:
SynopsisTwenty-six patients with RDC bipolar disorder were compared with a previously reported group of 48 RDC schizophrenics and 34 healthy controls, using volumetric MRI measurements of cerebral, cortical and sulcal volumes. The bipolar group appeared no different from the controls, and both of these groups had significantly larger cerebral and cortical volumes than the schizophrenics. Our previous report of a significantly reduced cortical volume in the schizophrenic group, with a corresponding increase in the volume of sulcal fluid is, therefore, not a generalized feature of psychotic illness but may be more specific to schizophrenia.
12
Goodman, R., L. R. Mantegna, C. L. McAIlister, E. Bruin, R. L. Dowling, H. George, W. Feeser, et al. "IL-1 and its role in rat carrageenan pleurisy." Mediators of Inflammation 2, no. 1 (1993): 33–39. http://dx.doi.org/10.1155/s0962935193000043.
Full textAbstract:
The carrageenan pleurisy model, which is characterized by cellular influx and oedema, has been used to examine the effects of anti-inflammatory compounds such as naproxen. Interleukin-1α and β (IL-1) are known to be pro-inflammatory mediators, and their roles in this model are unknown. Intrapleural injection of 1% viscarin carrageenan or saline was administered to male Lewis rats. Four to 24 h later, cell counts, fluid volumes and IL-1β levels (measured by ELISA) were determined in the pleural cavity. Serum corticosterone levels were measured only at 4 h. Significant increases in IL-1β levels precede cell influx suggesting IL-1β plays a role in the maintenance of cell accumulation in the pleural cavity. None of the drugs tested, including the IL-1 receptor antagonist, maintained pleural cell influx and IL-1β levels at control levels. When human IL-1α or β or rat IL-1β were injected individually into the pleural cavity, none of these cytokines were pro-inflammatory, as measured by increased cell influx and fluid extravasation. These results suggest that although IL-1β levels increase in the pleural cavity in response to carrageenan, IL-1 per se is not the initiator of the pro-inflammatory events of cell influx and oedema in this model.
13
Rugg-Gunn, Charlotte EM, Mark Deakin, and Daniel B. Hawcutt. "Update and harmonisation of guidance for the management of diabetic ketoacidosis in children and young people in the UK." BMJ Paediatrics Open 5, no. 1 (June 2021): e001079. http://dx.doi.org/10.1136/bmjpo-2021-001079.
Full textAbstract:
Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus. Careful and timely intervention is required to optimise glycaemic control and reduce the risk of mortality and devastating complications. Of these, cerebral oedema is the leading cause of death, with a mortality rate of approximately 25%. This article highlights the recent updates to UK fluid therapy guidelines for DKA and provides clinical context for the benefit of paediatricians and junior doctors in light of this new guidance.
14
Bader, Chaarani, Capel Cyrille, Zmudka Jadwiga, Daouk Joel, Anthony Fichten, Gondry-Jouet Catherine, Bouzerar Roger, and Balédent Olivier. "Estimation of the Lateral Ventricles Volumes from a 2D Image and Its Relationship with Cerebrospinal Fluid Flow." BioMed Research International 2013 (2013): 1–9. http://dx.doi.org/10.1155/2013/215989.
Full textAbstract:
Purpose. This work suggests a fast estimation method of the lateral ventricles volume from a 2D image and then determines if this volume is correlated with the cerebrospinal fluid flow at the aqueductal and cerebral levels in neurodegenerative diseases.Materials and Methods. FForty-five elderly patients suffering from Alzheimer’s disease (19), normal pressure hydrocephalus (13), and vascular dementia (13) were involved and underwent anatomical and phase contrast MRI scans. Lateral ventricles and stroke volumes were assessed on anatomical and phase contrast scans, respectively. A common reference plane was used to calculate the lateral ventricles’ area on 2D images.Results. The largest volumes were observed in hydrocephalus patients. The linear regression between volumes and areas was computed, and a strong positive correlation was detected (R2=0.9). A derived equation was determined to represent the volumes for any given area. On the other hand, no significant correlations were detected between ventricles and stroke volumes (R2≤0.15).Conclusion. Lateral ventricles volumes are significantly proportional to the 2D reference section area and could be used for patients’ follow-up even if 3D images are unavailable. The cerebrospinal fluid fluctuations in brain disorders may depend on many physiological parameters other than the ventricular morphology.
15
Van Os, Jim, Thomas A. Fahy, Peter Jones, Ian Harvey, Shôn Lewis, Maureen Williams, Brian Toone, and Robin Murray. "Increased Intracerebral Cerebrospinal Fluid Spaces Predict Unemployment and Negative Symptoms in Psychotic Illness a Prospective Study." British Journal of Psychiatry 166, no. 6 (June 1995): 750–58. http://dx.doi.org/10.1192/bjp.166.6.750.
Full textAbstract:
BackgroundIt has been suggested that the dimensions of cerebral ventricles are a risk factor for poor outcome in psychotic illness.MethodA cohort of 140 patients with functional psychoses of recent onset who had undergone CT scanning, were followed up for an average of 46 months and assessed on six dimensions of course and outcome of illness.ResultsLeft and right sylvian fissure volumes and, to a lesser extent, third ventricular volume predicted negative symptoms and unemployment over the course of follow-up, the latter association being mediated by poor cognitive functioning. There was a significant linear trend in risk over the distribution of sylvian fissure volumes in the cohort, and associations were especially evident in schizophrenic patients. No associations were found with global severity of illness, duration of hospital stay, homelessness, or affective symptoms.ConclusionsThese findings support the notion that dimensions of the cerebral ventricles are a continuous risk factor for some measures of outcome in the functional psychoses.
16
Das, Sayonee, Sidhartha Chattopadhyay, Kausik Munsi, and Sagar Basu. "Scrub typhus with cerebral venous sinus thrombosis: a rare presentation." BMJ Case Reports 14, no. 4 (April 2021): e241401. http://dx.doi.org/10.1136/bcr-2020-241401.
Full textAbstract:
This is a rare presentation of scrub typhus with cerebral venous thrombosis. A 32-year-old woman presented with signs of raised intracranial tension. Examination revealed maculopapular skin rashes and an ‘eschar’ over the right thigh. Nuchal rigidity and bilateral papilloedema were found. Scrub typhus was diagnosed by the presence of IgM antibody in serum. CT scan of the brain showed cerebral oedema. MRI of the brain was normal. Magnetic resonance venography of the brain showed thrombosis of several venous sinuses. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis with raised protein level. Other causes of prothrombotic states were ruled out by doing specific test results. There was no history of hormonal contraception and prolonged bed rest. A case of scrub typhus complicated with meningoencephalitis and cerebral venous thrombosis was diagnosed. She responded to treatment with doxycycline, anticoagulants, antipyrectics and intravenous saline. Early identification of such atypical neurological involvement in scrub typhus was helpful in satisfactory outcome.
17
ÇOLAKOĞLU, EKREM ÇAĞATAY, ALI EVREN HAYDARDEDEOĞLU, HADI ALIHOSSEINI, and ECE AYDEMIR. "Cerebral hemorrhage in a dog with immune-mediated hemolytic anemia and concurrent thrombocytopenia – a case report." Medycyna Weterynaryjna 77, no. 07 (2021): 6547–2021. http://dx.doi.org/10.21521/mw.6547.
Full textAbstract:
The aim of this case report is to point out the neurological signs, long term management of the case and MRI lesions suggestive of cerebral haemorrhage in a dog with IMHA and concurrent thrombocytopenia. A 3.5-year-old intact female Cocker Spaniel dog was examined for anorexia, weakness, exercise intolerance and two collapse episodes. Based on the diagnostic procedures primary immune mediated hemolytic anaemia concurrent with severe thrombocytopenia were confirmed. The dog remained stable with prednisolone and fluid therapy for 6 weeks. The dog was later referred to emergency service with hemianopia, head tilt and epilepsy-like signs. Brain MRI lesions showed central line deviation, oedema and cerebral haemorrhage. Post-treatment MRI also provided clear evidence of resolution the cerebral haemorrhage. The dog was asymptomatic for 6 months after splenectomy. To the best our knowledge, this is the first fully documented report of cerebral haemorrhage in a dog with immune mediated hemolytic anaemia and thrombocytopenia.
18
Fang, Chengqing, Jianhua Mao, Yuwen Dai, Yonghui Xia, Haidong Fu, Yifang Chen, Yaping Wang, and Aimin Liu. "Fluid management of hypernatraemic dehydration to prevent cerebral oedema: A retrospective case control study of 97 children in China." Journal of Paediatrics and Child Health 46, no. 6 (April 16, 2010): 301–3. http://dx.doi.org/10.1111/j.1440-1754.2010.01712.x.
Full text
19
Edge, JA, and MS Hammersley. "The Management of Diabetic Ketoacidosis." Acute Medicine Journal 6, no. 1 (January 1, 2007): 3–8. http://dx.doi.org/10.52964/amja.0145.
Full textAbstract:
This article reviews the management of diabetic ketoacidosis (DKA) in adults with a focus on the three basic principles of treatment: intravenous fluid therapy, intravenous insulin administration and potassium replacement. The recommendations are modelled on the national guidance for the management of DKA in children. We highlight the importance of being alert to signs of life-threatening complications of the condition such as cerebral oedema and adult respiratory distress syndrome (ARDS). We also discuss the use of near-patient testing of capillary beta-hydroxybutyrate (b-OHB) using a ketone meter as an aid to managing and preventing DKA.
20
Salokangas, R. K. R., T. Cannon, T. Van Erp, T. Ilonen, T. Taiminen, H. Karlsson, H. Lauerma, et al. "Structural magnetic resonance imaging in patients with first-episode schizophrenia, psychotic and severe non-psychotic depression and healthy controls." British Journal of Psychiatry 181, S43 (September 2002): s58—s65. http://dx.doi.org/10.1192/bjp.181.43.s58.
Full textAbstract:
BackgroundStructural brain abnormalities are prevalent in patients with schizophrenia and affective disorders.AimsTo study how regional brain volumes and their ratios differ between patients with schizophrenia, psychotic depression, severe non-psychotic depression and healthy controls.MethodMagnetic resonance imaging scans of the brain on first-episode patients and on healthy controls.ResultsPatients with schizophrenia had a smaller left frontal grey matter volume than the other three groups. Patients with psychotic depression had larger ventricular and posterior sulcal cerebrospinal fluid (CSF) volumes than controls. Patients with depression had larger white matter volumes than the other patients.ConclusionsLeft frontal lobe, especially its grey matter volume, seems to be specifically reduced in first-episode schizophrenia. Enlarged cerebral ventricles and sulcal CSF volumes are prevalent in psychotic depression. Preserved or expanded white matter is typical of non-psychotic depression.
21
Noorveriandi, Henry, Matthew J. Parkes, Michael J. Callaghan, David T. Felson, Terence W. O'Neill, and Richard Hodgson. "Assessment of bone marrow oedema-like lesions using MRI in patellofemoral knee osteoarthritis: comparison of different MRI pulse sequences." British Journal of Radiology 94, no. 1124 (August 1, 2021): 20201367. http://dx.doi.org/10.1259/bjr.20201367.
Full textAbstract:
Objective: To compare bone marrow oedema-like lesion (BML) volume in subjects with symptomatic patellofemoral (PF) knee osteoarthritis (OA) using four different MRI sequences and to determine reliability of BML volume assessment using these sequences and their correlation with pain. Methods: 76 males and females (mean age 55.8 years) with symptomatic patellofemoral knee OA had 1.5 T MRI scans. PD fat suppressed (FS), STIR, contrast-enhanced (CE) T1W FS, and 3D T1W fast field echo (FFE) sequences were obtained. All sequences were assessed by one reader, including repeat assessment of 15 knees using manual segmentation and the measurements were compared. We used random-effects panel linear regression to look for differences in the log-transformed BML volume (due to positive skew in the BML volume distribution) between sequences and to determine associations between BML volumes and knee pain. Results: 58 subjects had PF BMLs present on at least one sequence. Median BML volume measured using T1W FFE sequence was significantly smaller (224.7 mm3, interquartile range [IQR] 82.50–607.95) than the other three sequences. BML volume was greatest on the CE sequence (1129.8 mm3, IQR 467.28–3166.02). Compared to CE sequence, BML volumes were slightly lower when assessed using PDFS (proportional difference = 0.79; 95% confidence interval [CI] 0.62, 1.01) and STIR sequences (proportional difference = 0.85; 95% CI 0.67, 1.08). There were strong correlations between BML volume on PDFS, STIR, and CE T1W FS sequences (ρs = 0.98). Correlations were lower between these three sequences and T1W FFE (ρs = 0.80–0.81). Intraclass correlation coefficients were excellent for proton density fat-suppressed, short-tau inversion recovery, and CE T1W FS sequences (0.991–0.995), while the ICC for T1W FFE was good at 0.88. We found no significant association between BML volumes assessed using any of the sequences and knee pain. Conclusion: T1W FFE sequences were less reliable and measured considerably smaller BML volume compared to other sequences. BML volume was larger when assessed using the contrast enhanced T1W FS though not statistically significantly different from BMLs when assessed using PDFS and STIR sequences. Advances in knowledge: This is the first study to assess BMLs by four different MRI pulse sequences on the same data set, including different fluid sensitive sequences and gradient echo type sequence.
22
Jiang, Hong, Wenjie Yang, Yuhao Sun, Fuhua Yan, Qingfang Sun, Hongjiang Wei, and Liu-Guan Bian. "Imaging cerebral microbleeds in Cushing’s disease evaluated by quantitative susceptibility mapping: an observational cross-sectional study." European Journal of Endocrinology 184, no. 4 (April 2021): 565–74. http://dx.doi.org/10.1530/eje-20-1139.
Full textAbstract:
Design Cushing’s disease (CD) is a rare clinical syndrome characterized by chronic exposure to hypercortisolism due to an adrenocorticotropic hormone-secreting pituitary adenoma. The adverse effects of chronic exposure to hypercortisolism on the human brain remain unclear. The purpose of this study was to assess the prevalence of cerebral microbleeds (CMBs) in CD patients and their associations with clinical characteristics. Methods In this study, 48 active CD patients, 39 remitted CD patients, and 52 healthy control (HC) subjects underwent MRI. CD patients also underwent neuropsychological testing and clinical examinations. The number, locations, and volumes of CMBs were assessed on quantitative susceptibility mapping (QSM) images and with the Microbleed Anatomical Rating Scale. The correlation between CMBs and clinical characteristics was explored. Results The prevalence of CMBs among active and remitted CD patients was higher than that among HCs (16.3%, 20.5%, and 3.3%, respectively). Moreover, the age of CD patients with CMBs were much younger than HCs with CMBs. Furthermore, the increased number of CMBs in active CD patients was associated with increased cerebrospinal fluid (CSF) volumes in remitted CD patients. Conclusions Chronic exposure to hypercortisolism may be relevant to CMBs and significantly correlated with altered brain volumes in CD.
23
Arbeille, P., K. A. Zuj, B. R. Macias, D. J. Ebert, S. S. Laurie, A. E. Sargsyan, D. S. Martin, et al. "Lower body negative pressure reduces jugular and portal vein volumes and counteracts the elevation of middle cerebral vein velocity during long-duration spaceflight." Journal of Applied Physiology 131, no. 3 (September 1, 2021): 1080–87. http://dx.doi.org/10.1152/japplphysiol.00231.2021.
Full textAbstract:
Microgravity-induced fluid shifts markedly enlarge jugular and portal veins and increase cerebral vein velocity. These findings demonstrate a marked flow engorgement at neck and splanchnic levels and may suggest compression of the cerebral veins by the brain tissue in space. LBNP (25 mmHg for 30 min) returns these changes to preflight levels and, thus, reduces the associated flow and tissue disturbances.
24
Slevin, Finbar, Sree Lakshmi Rodda, Mike Bosomworth, and David Bottomley. "Hyponatraemic seizures following prostate brachytherapy." Journal of Radiotherapy in Practice 13, no. 3 (June 11, 2014): 371–74. http://dx.doi.org/10.1017/s1460396914000235.
Full textAbstract:
AbstractAimTo demonstrate the importance of fluid management in the perioperative period by presenting a case of hyponatraemic seizures following prostate brachytherapy.CaseA 61-year-old gentleman, who had prostate cancer but was otherwise well, developed confusion and word-finding difficulties the day after prostate brachytherapy. This was followed by tonic–clonic seizures that necessitated treatment, intubation and ventilation, and admission to the intensive care unit. Investigations revealed serum sodium of 116 mmol/L. Fluid balance was inadequately recorded, but the patient had drank more than 3 L of water before he developed hyponatraemia.DiscussionPostoperative severe hyponatraemia and hyponatraemic encephalopathy develop because of anti-diuretic hormone release and hypotonic fluid administration. These are medical emergencies and should be managed in an intensive care unit. Symptoms range from headache, nausea and confusion to seizures, respiratory arrest and death, and are related to cerebral oedema. Treatment is done using hypertonic sodium chloride to increase the serum sodium to safe levels. Care should be taken to avoid overly rapid correction of serum sodium. Complete documentation of fluid balance is essential to allow proper assessment of fluid status. Patients should be advised on appropriate oral fluids in the postoperative period.
25
Álvarez, Patricia, Annette Wessmann, Mireia Pascual, Oriol Comas, Dolors Pi, and Martí Pumarola. "Cerebral gliosarcoma with perivascular involvement in a cat." Journal of Feline Medicine and Surgery Open Reports 5, no. 2 (July 2019): 205511691987978. http://dx.doi.org/10.1177/2055116919879783.
Full textAbstract:
Case summary A 5-year-old neutered male domestic shorthair cat presented with an 18-month history of facial tics, and progressive general ataxia, weakness, lethargy and anorexia of 2 weeks’ duration. MRI of the brain showed a well-defined heterogeneous hyperintense mass on T1-weighted and T2-weighted images, with central hypointensity in the rostral commissure and septum pellucidum, and perilesional hyperintensity in fluid-attenuated inversion recovery, suggestive of perilesional oedema. Gross examination in a transverse section of the brain at the level of the septum pellucidum revealed a 0.2 cm brown soft mass. Histopathological examination identified a biphasic neoplastic proliferation of mesenchymal and neuroepithelial cell populations. Fusiform cells were predominately distributed in bundles showing a high degree of anisocytosis and marked immune-positive reaction to vimentin immunochemistry, confirming a sarcomatous origin. Additionally, high numbers of astrocytic cells were identified by an intense immunopositive reaction to glial fibrillary acidic protein and negative reaction to oligodendrocyte transcription factor 2 immunochemistry. Vascular invasion of the neoplasia into the wall of a medium branch of the rostral cerebral artery was present (secondary Scherer structures). Based on these characteristics, the tumour was defined as a gliosarcoma. Gliosarcoma is a recognised astrocytoma grade IV anaplastic glial cell tumour with sarcomatous differentiation. Relevance and novel information To our knowledge, this is the first report describing a cerebral gliosarcoma in a cat including clinical, MRI, macroscopic and histopathological features and immunolabelling characteristics.
26
Elvevoll, Bjørg, Paul Husby, Venny L. Kvalheim, Lodve Stangeland, Arve Mongstad, and Øyvind S. Svendsen. "Microvascular fluid exchange during CPB with deep hypothermia circulatory arrest or low flow." Perfusion 32, no. 8 (June 16, 2017): 661–69. http://dx.doi.org/10.1177/0267659117715695.
Full textAbstract:
Objective: Use of deep hypothermic low-flow (DHLF) cardiopulmonary bypass (CPB) has been associated with higher fluid loading than the use of deep hypothermia circulatory arrest (DHCA). We evaluated whether these perfusion strategies influenced fluid extravasation rates and edema generation differently per-operatively. Materials and Methods: Twelve anesthetized pigs, randomly allocated to DHLF (n = 6) or DHCA (n = 6), underwent 2.5 hours CPB with cooling to 20°C for 30 minutes (min), followed by 30 min arrested circulation (DHCA) or 30 min low-flow circulation (DHLF) before 90 min rewarming to normothermia. Perfusion of tissues, fluid requirements, plasma volumes, colloid osmotic pressures and total tissue water contents were recorded and fluid extravasation rates calculated. During the experiments, cerebral microdialysis was performed in both groups. Results: Microvascular fluid homeostasis was similar in both groups, with no between-group differences, reflected by similar fluid extravasation rates, plasma colloid osmotic pressures and total tissue water contents. Although extravasation rates increased dramatically from 0.10 (0.11) ml/kg/min (mean with standard deviation in parentheses) and 0.16 (0.02) ml/kg/min to 1.28 (0.58) ml/kg/min and 1.06 (0.41) ml/kg/min (DHCA and DHLF, respectively) after the initiation of CPB, fluid filtrations during both cardiac arrest and low flow were modest and close to baseline values. Cerebral microdialysis indicated anaerobic metabolism and ischemic brain injury in the DHCA group. Conclusion: No differences in microvascular fluid exchange could be demonstrated as a direct effect of DHCA compared with DHLF. Thirty minutes of DHCA was associated with anaerobic cerebral metabolism and possible brain injury.
27
Stoquart-ElSankari, Souraya, Pierre Lehmann, Agnès Villette, Marek Czosnyka, Marc-Etienne Meyer, Hervé Deramond, and Olivier Balédent. "A Phase-Contrast MRI Study of Physiologic Cerebral Venous Flow." Journal of Cerebral Blood Flow & Metabolism 29, no. 6 (April 8, 2009): 1208–15. http://dx.doi.org/10.1038/jcbfm.2009.29.
Full textAbstract:
Although crucial in regulating intracranial hydrodynamics, the cerebral venous system has been rarely studied because of its structural complexity and individual variations. The purpose of our study was to evaluate the organization of cerebral venous system in healthy adults. Phase-contrast magnetic resonance imaging (PC-MRI) was performed in 18 healthy volunteers, in the supine position. Venous, arterial, and cerebrospinal fluid (CSF) flows were calculated. We found heterogeneous individual venous flows and variable side dominance in paired veins and sinuses. In some participants, the accessory epidural drainage preponderated over the habitually dominant jugular outflow. The PC-MRI enabled measurements of venous flows in superior sagittal (SSS), SRS (straight), and TS (transverse) sinuses with excellent detection rates. Pulsatility index for both intracranial (SSS) and cervical (mainly jugular) levels showed a significant increase in pulsatile blood flow in jugular veins as compared with that in SSS. Mean cervical and cerebral arterial blood flows were 714 ± 124 and 649 ± 178 mL/min, respectively. Cerebrospinal fluid aqueductal and cervical stroke volumes were 41 ± 22 and 460 ± 149 μL, respectively. Our results emphasize the variability of venous drainage for side dominance and jugular/epidural organization. The pulsatility of venous outflow and the role it plays in the regulation of intracranial pressure require further investigation.
28
Sagar, Ala Eddin S., Maria F. Landaeta, Andres M. Adrianza, Grecia L. Aldana, Leonardo Pozo, Aristides Armas-Villalba, Christian C. Toquica, et al. "Complications following symptom-limited thoracentesis using suction." European Respiratory Journal 56, no. 5 (June 4, 2020): 1902356. http://dx.doi.org/10.1183/13993003.02356-2019.
Full textAbstract:
BackgroundThoracentesis using suction is perceived to have increased risk of complications, including pneumothorax and re-expansion pulmonary oedema (REPO). Current guidelines recommend limiting drainage to 1.5 L to avoid REPO. Our purpose was to examine the incidence of complications with symptom-limited drainage of pleural fluid using suction and identify risk factors for REPO.MethodsA retrospective cohort study of all adult patients who underwent symptom-limited thoracentesis using suction at our institution between January 1, 2004 and August 31, 2018 was performed, and a total of 10 344 thoracenteses were included.ResultsPleural fluid ≥1.5 L was removed in 19% of the procedures. Thoracentesis was stopped due to chest discomfort (39%), complete drainage of fluid (37%) and persistent cough (13%). Pneumothorax based on chest radiography was detected in 3.98%, but only 0.28% required intervention. The incidence of REPO was 0.08%. The incidence of REPO increased with Eastern Cooperative Oncology Group performance status (ECOG PS) ≥3 compounded with ≥1.5 L (0.04–0.54%; 95% CI 0.13–2.06 L). Thoracentesis in those with ipsilateral mediastinal shift did not increase complications, but less fluid was removed (p<0.01).ConclusionsSymptom-limited thoracentesis using suction is safe even with large volumes. Pneumothorax requiring intervention and REPO are both rare. There were no increased procedural complications in those with ipsilateral mediastinal shift. REPO increased with poor ECOG PS and drainage ≥1.5 L. Symptom-limited drainage using suction without pleural manometry is safe.
29
Izadi, S., P. D. Karkos, R. Krishnan, J. Hsuan, and T. H. J. Lesser. "Papilloedema secondary to venous sinus thrombosis following glomus jugulare tumour surgery." Journal of Laryngology & Otology 123, no. 12 (May 20, 2009): 1393–95. http://dx.doi.org/10.1017/s0022215109005477.
Full textAbstract:
AbstractObjective:We present a case of a patient who had undergone embolisation and resection of a left glomus jugulare tumour, who presented three weeks post-operatively with magnetic resonance venography confirmed symptomatic cerebral venous sinus thrombosis.Method:We present a case report and a review of the world literature concerning glomus jugulare tumours and cerebral venous sinus thrombosis.Case report:A 42-year-old man presented with blurred vision and reduced Snellen visual acuity just three weeks after glomus jugulare tumour surgery. Fundoscopy revealed bilateral haemorrhagic optic disc oedema. Urgent magnetic resonance venography confirmed a left lateral venous sinus thrombosis. It was felt that this was responsible for inadequate cerebrospinal fluid drainage, resulting in raised intracranial pressure and papilloedema.Conclusion:To the authors' knowledge, this is the first account of a magnetic resonance venography confirmed venous sinus thrombosis and secondary papilloedema following glomus jugulare tumour surgery. Patients undergoing surgery involving resection or manipulation of the internal jugular vein may be at higher risk of developing thrombosis superior to the level of resection, and magnetic resonance venography ought to be considered an important diagnostic adjunct.
30
Caissie, M., T. Chenier, C. Gartley, E. Scholtz, R. Johnson, J. Hewson, and D. Bienzle. "95 N-Acetyl cysteine as a potential treatment for equine persistent breeding-induced endometritis." Reproduction, Fertility and Development 31, no. 1 (2019): 173. http://dx.doi.org/10.1071/rdv31n1ab95.
Full textAbstract:
Persistent breeding-induced endometritis (PBIE) is a major cause of infertility in mares. Transient uterine inflammation is a normal response to breeding; however, PBIE-susceptible mares do not clear this inflammation in a timely fashion. Uterine inflammation at the time of embryonic descent from the oviducts ultimately results in early embryonic death and is seen clinically as infertility. Several risk factors for PBIE have been identified and include age, parity, anatomical conformation, such as poor perineal conformation and cervical fibrosis, as well as other reproductive tract abnormalities. N-Acetyl cysteine (NAC), a mucolytic used to treat endometritis in mares, has anti-inflammatory properties, affects inflammatory cytokines, and is a mild inhibitor of nitric oxide synthase. Increased nitric oxide, causing smooth muscle relaxation and alterations in inflammatory cytokines, has been documented in PBIE mares. The objective of our study was to determine if NAC treatment would lower nitric oxide and inflammatory cytokine levels, thereby resolving PBIE. A randomised, blinded, crossover design clinical trial was performed utilising PBIE-susceptible mares (n=10). Mares were screened for bacterial endometritis before enrolment in the study and only mares that had negative bacterial cultures were used. No other treatments were given to mares while they were enrolled in the study. Intrauterine infusion of 180mL of 3.3% NAC was performed 12h before insemination, when a follicle >35mm was present. Mares were sampled for endometrial cytology and endometrial fluid to determine inflammatory cytokine (ELISA) and nitric oxide (colourimetric assay) levels at 12 and 72h post-insemination. Endometrial biopsies were taken at the same time points post-insemination to determine gene expression of inflammatory cytokines by qPCR. Clinical signs of endometrial oedema and intrauterine fluid volumes were assessed at 12 and then every 24h post-breeding. Statistical assessment of the data was performed using a repeated-measures ANOVA. Uterine inflammation, as determined by percent number of neutrophils on endometrial cytology (P=0.0006), and interleukin 6 gene expression (P=0.003) were highest at 12h. Uterine oedema was greatest at 12 and 24h (P=0.02) and uterine fluid volumes were highest at 24h (P=0.02). Interestingly, interleukin-6 protein levels were not in accordance with gene expression, and were highest at 72h. In this clinical trial, pre-breeding intrauterine treatment with NAC did not affect nitric oxide levels, cytokine gene expression, or clinical signs of PBIE. However, the pattern of inflammation noted in this study is consistent with that described in PBIE mares. Nevertheless, the assessment of inflammatory cytokines, both at the gene and protein level at different time points post-AI, in combination with clinical signs will add to the understanding of the alterations in inflammatory cytokine levels in mares susceptible to PBIE.
31
Xiao, Hao, Rahul Barmanray, Sarah Qian, Dilantha De Alwis, and Gerard Fennessy. "Survival Following Extreme Hypernatraemia Associated with Severe Dehydration and Undiagnosed Diabetes Mellitus." Case Reports in Endocrinology 2019 (December 12, 2019): 1–3. http://dx.doi.org/10.1155/2019/4174259.
Full textAbstract:
We report a case of a previously well 58-year-old man, who presented with delirium and low GCS, and was found to have extreme hypernatraemia (Na+ = 191 mmol/L) and hyperglycaemia (glucose = 31 mmol/L). This resulted in a corrected serum sodium of 202 mmol/L. He was treated with fluid and electrolyte replacement in the intensive care unit, and had returned to essentially normal function by hospital discharge. The aetiology was believed to be due to severe dehydration and a new diagnosis of diabetes mellitus. Extreme hypernatraemia (serum sodium level greater than 190 mmol/L) is rare and associated with a high mortality. The mainstay of treatment is careful fluid and electrolyte management. Most recommendations advise to reduce the serum sodium by 0.5 mmol/L/hour, due to concerns over cerebral oedema; however, there are reports that slower correction is associated with higher mortality. In this case, the initial corrected sodium of 202 mmol/L was steadily corrected to 160 mmol/L over 91 hours, at a rate of 0.46 mmol/L/hour. This demonstrates the safety of the recommended approach.
32
Auer, Ludwig M., and Michael Mokry. "Disturbed Cerebrospinal Fluid Circulation after Subarachnoid Hemorrhage and Acute Aneurysm Surgery." Neurosurgery 26, no. 5 (May 1, 1990): 804–9. http://dx.doi.org/10.1227/00006123-199005000-00012.
Full textAbstract:
Abstract In 138 patients with ruptured cerebral aneurysms operated on within 48 to 72 hours after subarachnoid hemorrhage, an external ventricular drainage catheter was inserted before craniotomy and was used intermittently during the first week after surgery. In 51 patients, intracranial pressure (ICP) was measured intraoperatively. The majority of patients showed increased ICP intraoperatively irrespective of the preoperative Hunt and Hess grade and the amount of subarachnoid blood accumulation or intraventricular blood clot. Intraoperative drainage of cerebrospinal fluid allowed easy access for aneurysm dissection by making the brain slack in more than 90% of patients. Postoperative ICP measurements revealed that significant brain swelling did not occur in the majority of patients, In 7 patients, persistently elevated ICP (>20 mm Hg) was recorded. Nine patients (8%) developed shunt-dependent hydrocephalus; all of these patients had suffered an intraventricular hemorrhage. Measurements of the volumes of cerebrospinal fluid drained did not allow prediction of shunt-dependent hydrocephalus.
33
Latif, Azka, Aheli Arce Gastelum, Akshat Sood, and Joseph Thilumala Reddy. "Euglycaemic diabetic ketoacidosis in a 43-year-old woman with type 2 diabetes mellitus on SGLT-2 inhibitor (empagliflozin)." BMJ Case Reports 13, no. 6 (June 2020): e235117. http://dx.doi.org/10.1136/bcr-2020-235117.
Full textAbstract:
We report a case of euglycaemic diabetic ketoacidosis (EDKA) in a 43-year-old woman with type 2 diabetes mellitus who presented to the emergency department with problems of vomiting, cough, shortness of breath and generalised weakness after following a ketogenic diet for 2 weeks. Therapy with sodium glucose transport protein-2 empagliflozin had been started 2 months prior. Initial evaluation revealed high anion gap metabolic acidosis with blood glucose level of 169 mg/dL. Treatment for EDKA with fluid resuscitation, intravenous insulin and dextrose resolved her acidosis and symptoms in less than 24 hours. Empaglifozin was discontinued on discharge. This entity represents a diagnostic challenge since the differential diagnosis is broad with a potentially misleading clinical presentation that can result in delayed diagnosis and adverse outcomes including acute kidney injury, multiple electrolyte abnormalities, cerebral oedema, acute respiratory distress syndrome, shock and death.
34
Ziai, Wendy C., Adrian R. Parry-Jones, Carol B. Thompson, Lauren H. Sansing, Michael T. Mullen, Santosh B. Murthy, Andrew Mould, Saman Nekoovaght-Tak, and Daniel F. Hanley. "Early Inflammatory Cytokine Expression in Cerebrospinal Fluid of Patients with Spontaneous Intraventricular Hemorrhage." Biomolecules 11, no. 8 (July 30, 2021): 1123. http://dx.doi.org/10.3390/biom11081123.
Full textAbstract:
We investigated cerebrospinal fluid (CSF) expression of inflammatory cytokines and their relationship with spontaneous intracerebral and intraventricular hemorrhage (ICH, IVH) and perihematomal edema (PHE) volumes in patients with acute IVH. Twenty-eight adults with IVH requiring external ventricular drainage for obstructive hydrocephalus had cerebrospinal fluid (CSF) collected for up to 10 days and had levels of interleukin-1α (IL-1α), IL-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNFα), and C-C motif chemokine ligand CCL2 measured using enzyme-linked immunosorbent assay. Median [IQR] ICH and IVH volumes at baseline (T0) were 19.8 [5.8–48.8] and 14.3 [5.3–38] mL respectively. Mean levels of IL-1β, IL-6, IL-10, TNF-α, and CCL2 peaked early compared to day 9–10 (p < 0.05) and decreased across subsequent time periods. Levels of IL-1β, IL-6, IL-8, IL-10, and CCL2 had positive correlations with IVH volume at days 3–8 whereas positive correlations with ICH volume occurred earlier at day 1–2. Significant correlations were found with PHE volume for IL-6, IL-10 and CCL2 at day 1–2 and with relative PHE at days 7–8 or 9–10 for IL-1β, IL-6, IL-8, and IL-10. Time trends of CSF cytokines support experimental data suggesting association of cerebral inflammatory responses with ICH/IVH severity. Pro-inflammatory markers are potential targets for injury reduction.
35
Andescavage, Nickie N., Adre DuPlessis, Robert McCarter, Gilbert Vezina, Richard Robertson, and Catherine Limperopoulos. "Cerebrospinal Fluid and Parenchymal Brain Development and Growth in the Healthy Fetus." Developmental Neuroscience 38, no. 6 (2016): 420–29. http://dx.doi.org/10.1159/000456711.
Full textAbstract:
Objective: The objective of this study was to apply quantitative magnetic resonance imaging to characterize absolute cerebrospinal fluid (CSF) development, as well as its relative development to fetal brain parenchyma in the healthy human fetus. Design: We created three-dimensional high-resolution reconstructions of the developing brain for healthy fetuses between 18 and 40 weeks' gestation, segmented the parenchymal and CSF spaces, and calculated the volumes for the lateral, third, and fourth ventricles; extra-axial CSF space; and the cerebrum, cerebellum, and brainstem. From these data, we constructed normograms of the resulting volumes according to gestational age and described the relative development of CSF to fetal brain parenchyma. Results: Each CSF space demonstrated major increases in volumetric growth during the second half of gestation: third ventricle (23-fold), extra-axial CSF (11-fold), fourth ventricle (8-fold), and lateral ventricle (2-fold). Total CSF volume was related to total brain volume (p < 0.01), as was lateral ventricle to cerebral volume (p < 0.01); however, the fourth ventricle was not related to cerebellar or brainstem volume (p = 0.18-0.19). Relevance: Abnormalities of the CSF spaces are the most common anomalies of neurologic development detected on fetal screening using neurosonography. Normative values of absolute CSF volume, as well as relative growth in comparison to intracranial parenchyma, provide valuable insight into normal fetal neurodevelopment. These data may provide important biomarkers of early deviations from normal growth, better distinguish between benign variants and early disease, and serve as reference standards for postnatal growth and development in the premature infant.
36
Mehrnahad, Mehrsad, Sara Rostami, Farnaz Kimia, Reza Kord, Morteza Sanei Taheri, Hamidreza Saligheh Rad, Hamidreza Haghighatkhah, Afshin Moradi, and Ali Kord. "Differentiating glioblastoma multiforme from cerebral lymphoma: application of advanced texture analysis of quantitative apparent diffusion coefficients." Neuroradiology Journal 33, no. 5 (July 6, 2020): 428–36. http://dx.doi.org/10.1177/1971400920937382.
Full textAbstract:
Purpose The purpose of this study was to differentiate glioblastoma multiforme from primary central nervous system lymphoma using the customised first and second-order histogram features derived from apparent diffusion coefficients. Methods and materials: A total of 82 patients (57 with glioblastoma multiforme and 25 with primary central nervous system lymphoma) were included in this study. The axial T1 post-contrast and fluid-attenuated inversion recovery magnetic resonance images were used to delineate regions of interest for the tumour and peritumoral oedema. The regions of interest were then co-registered with the apparent diffusion coefficient maps, and the first and second-order histogram features were extracted and compared between glioblastoma multiforme and primary central nervous system lymphoma groups. Receiver operating characteristic curve analysis was performed to calculate a cut-off value and its sensitivity and specificity to differentiate glioblastoma multiforme from primary central nervous system lymphoma. Results Based on the tumour regions of interest, apparent diffusion coefficient mean, maximum, median, uniformity and entropy were higher in the glioblastoma multiforme group than the primary central nervous system lymphoma group ( P ≤ 0.001). The most sensitive first and second-order histogram feature to differentiate glioblastoma multiforme from primary central nervous system lymphoma was the maximum of 2.026 or less (95% confidence interval (CI) 75.1–99.9%), and the most specific first and second-order histogram feature was smoothness of 1.28 or greater (84.0% CI 70.9–92.8%). Based on the oedema regions of interest, most of the first and second-order histogram features were higher in the glioblastoma multiforme group compared to the primary central nervous system lymphoma group ( P ≤ 0.015). The most sensitive first and second-order histogram feature to differentiate glioblastoma multiforme from primary central nervous system lymphoma was the 25th percentile of 0.675 or less (100% CI 83.2–100%) and the most specific first and second-order histogram feature was the median of 1.28 or less (85.9% CI 66.3–95.8%). Conclusions Texture analysis using first and second-order histogram features derived from apparent diffusion coefficient maps may be helpful in differentiating glioblastoma multiforme from primary central nervous system lymphoma.
37
Sagoo, Ravjit S., Charles E. Hutchinson, Alex Wright, Charles Handford, Helen Parsons, Victoria Sherwood, Sarah Wayte, et al. "Magnetic Resonance investigation into the mechanisms involved in the development of high-altitude cerebral edema." Journal of Cerebral Blood Flow & Metabolism 37, no. 1 (July 20, 2016): 319–31. http://dx.doi.org/10.1177/0271678x15625350.
Full textAbstract:
Rapid ascent to high altitude commonly results in acute mountain sickness, and on occasion potentially fatal high-altitude cerebral edema. The exact pathophysiological mechanisms behind these syndromes remain to be determined. We report a study in which 12 subjects were exposed to a FiO2 = 0.12 for 22 h and underwent serial magnetic resonance imaging sequences to enable measurement of middle cerebral artery velocity, flow and diameter, and brain parenchymal, cerebrospinal fluid and cerebral venous volumes. Ten subjects completed 22 h and most developed symptoms of acute mountain sickness (mean Lake Louise Score 5.4; p < 0.001 vs. baseline). Cerebral oxygen delivery was maintained by an increase in middle cerebral artery velocity and diameter (first 6 h). There appeared to be venocompression at the level of the small, deep cerebral veins (116 cm3 at 2 h to 97 cm3 at 22 h; p < 0.05). Brain white matter volume increased over the 22-h period (574 ml to 587 ml; p < 0.001) and correlated with cumulative Lake Louise scores at 22 h ( p < 0.05). We conclude that cerebral oxygen delivery was maintained by increased arterial inflow and this preceded the development of cerebral edema. Venous outflow restriction appeared to play a contributory role in the formation of cerebral edema, a novel feature that has not been observed previously.
38
Nguyen, Tung T., Yashdip S. Pannu, Cynthia Sung, Robert L. Dedrick, Stuart Walbridge, Martin W. Brechbiel, Kayhan Garmestani, Markus Beitzel, Alexander T. Yordanov, and Edward H. Oldfield. "Convective distribution of macromolecules in the primate brain demonstrated using computerized tomography and magnetic resonance imaging." Journal of Neurosurgery 98, no. 3 (March 2003): 584–90. http://dx.doi.org/10.3171/jns.2003.98.3.0584.
Full textAbstract:
Object. Convection-enhanced delivery (CED), the delivery and distribution of drugs by the slow bulk movement of fluid in the extracellular space, allows delivery of therapeutic agents to large volumes of the brain at relatively uniform concentrations. This mode of drug delivery offers great potential for the treatment of many neurological disorders, including brain tumors, neurodegenerative diseases, and seizure disorders. An analysis of the treatment efficacy and toxicity of this approach requires confirmation that the infusion is distributed to the targeted region and that the drug concentrations are in the therapeutic range. Methods. To confirm accurate delivery of therapeutic agents during CED and to monitor the extent of infusion in real time, albumin-linked surrogate tracers that are visible on images obtained using noninvasive techniques (iopanoic acid [IPA] for computerized tomography [CT] and Gd—diethylenetriamine pentaacetic acid for magnetic resonance [MR] imaging) were developed and investigated for their usefulness as surrogate tracers during convective distribution of a macromolecule. The authors infused albumin-linked tracers into the cerebral hemispheres of monkeys and measured the volumes of distribution by using CT and MR imaging. The distribution volumes measured by imaging were compared with tissue volumes measured using quantitative autoradiography with [14C]bovine serum albumin coinfused with the surrogate tracer. For in vivo determination of tracer concentration, the authors examined the correlation between the concentration of the tracer in brain homogenate standards and CT Hounsfield units. They also investigated the long-term effects of the surrogate tracer for CT scanning, IPA-albumin, on animal behavior, the histological characteristics of the tissue, and parenchymal toxicity after cerebral infusion. Conclusions. Distribution of a macromolecule to clinically significant volumes in the brain is possible using convection. The spatial dimensions of the tissue distribution can be accurately defined in vivo during infusion by using surrogate tracers and conventional imaging techniques, and it is expected that it will be possible to determine local concentrations of surrogate tracers in voxels of tissue in vivo by using CT scanning. Use of imaging surrogate tracers is a practical, safe, and essential tool for establishing treatment volumes during high-flow interstitial microinfusion of the central nervous system.
39
de Groot, Martijn J., Paul E. Sijens, Dirk-Jan Reijngoud, Anne M. Paans, and Francjan J. van Spronsen. "Phenylketonuria: Brain Phenylalanine Concentrations Relate Inversely to Cerebral Protein Synthesis." Journal of Cerebral Blood Flow & Metabolism 35, no. 2 (October 29, 2014): 200–205. http://dx.doi.org/10.1038/jcbfm.2014.183.
Full textAbstract:
In phenylketonuria, elevated plasma phenylalanine concentrations may disturb blood-to-brain large neutral amino acid (LNAA) transport and cerebral protein synthesis (CPS). We investigated the associations between these processes, using data obtained by positron emission tomography with l-[1-11C]-tyrosine (11C-Tyr) as a tracer. Blood-to-brain transport of non-Phe LNAAs was modeled by the rate constant for 11C-Tyr transport from arterial plasma to brain tissue (K1), while CPS was modeled by the rate constant for 11C-Tyr incorporation into cerebral protein (k3). Brain phenylalanine concentrations were measured by magnetic resonance spectroscopy in three volumes of interest (VOIs): supraventricular brain tissue (VOI 1), ventricular brain tissue (VOI 2), and fluid-containing ventricular voxels (VOI 3). The associations between k3 and each predictor variable were analyzed by multiple linear regression. The rate constant k3 was inversely associated with brain phenylalanine concentrations in VOIs 2 and 3 (adjusted R2=0.826, F=19.936, P=0.021). Since brain phenylalanine concentrations in these VOIs highly correlated with each other, the specific associations of each predictor with k3 could not be determined. The associations between k3 and plasma phenylalanine concentration, K1, and brain phenylalanine concentrations in VOI 1 were nonsignificant. In conclusion, our study shows an inverse association between k3 and increased brain phenylalanine concentrations.
40
Kravets, O. V. "IMPACT OF RESTRICTIVE REGIMEN OF INFUSION THERAPY ON THE PERIOPERATIVE PERIOD IN PATIENTS WITH URGENT ABDOMINAL PATHOLOGY." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 19, no. 2 (July 19, 2019): 35–38. http://dx.doi.org/10.31718/2077-1096.19.2.35.
Full textAbstract:
One of the leading pathogenetic processes that is specific for emergency abdominal pathology is hypovolemia. The primary method of its treatment is infusion therapy. The purpose of the study is to evaluate the effectiveness of the restrictive regimen of infusion therapy in patients with emergency abdominal pathology.
Materials and methods. We examined 50 patients who were performed on emergency laparotomy. Perioperative infusion therapy in all patients was carried out in a restrictive regimen with balanced crystalloid solutions. We studied the indicators of water metabolism: daily and cumulative water balances, the percentage of fluid excess. We determined water sectors of the body by the method of non-invasive bioelectric rheography. Results. The study has found out the presence of the initial depletion of the extracellular fluid volume due to a decrease in both interstitial and intravascular volumes in patients with urgent abdominal pathology. Intravascular deficiency was due to a decrease in plasma volume. Replenishment of extracellular deficiency by restrictive regimen of infusion therapy restored the plasma volume to normal values since one day after surgery; interstitial volume started restoring on the 7th days of observation, compared to the normal intracellular volume on the 3 days of the postoperative period. Conclusions: restrictive infusion therapy regimen enables to completely and safely restore extracellular volume depletion on the 7 days of the preoperative period by correcting plasma deficiency since the 1 day of the post-operative period; to replenish interstitial volume on the 7 days and to prevent the development of oedema during “zero” daily water balance, as well as to slightly increase the cumulative water balance and the percentage of excess fluid.
41
Tan, X. R., I. C. C. Low, M. C. Stephenson, T. Kok, H. W. Nolte, T. W. Soong, and J. K. W. Lee. "Altered brain structure with preserved cortical motor activity after exertional hypohydration: a MRI study." Journal of Applied Physiology 127, no. 1 (July 1, 2019): 157–67. http://dx.doi.org/10.1152/japplphysiol.00081.2019.
Full textAbstract:
Hypohydration exceeding 2% body mass can impair endurance capacity. It is postulated that the brain could be perturbed by hypohydration, leading to impaired motor performance. We investigated the neural effects of hypohydration with magnetic resonance imaging (MRI). Ten men were dehydrated to approximately −3% body mass by running on a treadmill at 65% maximal oxygen consumption (V̇o2max) before drinking to replace either 100% [euhydration (EU)] or 0% [hypohydration (HH)] of fluid losses. MRI was performed before start of trial (baseline) and after rehydration phase (post) to evaluate brain structure, cerebral perfusion, and functional activity. Endurance capacity assessed with a time-to-exhaustion run at 75% V̇o2max was reduced with hypohydration (EU: 45.2 ± 9.3 min, HH: 38.4 ± 10.7 min; P = 0.033). Mean heart rates were comparable between trials (EU: 162 ± 5 beats/min, HH: 162 ± 4 beats/min; P = 0.605), but the rate of rise in rectal temperature was higher in HH trials (EU: 0.06 ± 0.01°C/min, HH: 0.07 ± 0.02°C/min; P < 0.01). In HH trials, a reduction in total brain volume (EU: +0.7 ± 0.6%, HH: −0.7 ± 0.9%) with expansion of ventricles (EU: −2.7 ± 1.6%, HH: +3.7 ± 3.3%) was observed, and vice versa in EU trials. Global and regional cerebral perfusion remained unchanged between conditions. Functional activation in the primary motor cortex in left hemisphere during a plantar-flexion task was similar between conditions (EU: +0.10 ± 1.30%, HH: −0.11 ± 0.31%; P = 0.637). Our findings demonstrate that with exertional hypohydration, brain volumes were altered but the motor-related functional activity was unperturbed. NEW & NOTEWORTHY Dehydration occurs rapidly during prolonged or intensive physical activity, leading to hypohydration if fluid replenishment is insufficient to replace sweat losses. Altered hydration status poses an osmotic challenge for the brain, leading to transient fluctuations in brain tissue and ventricle volumes. Therefore, the amount of fluid ingestion during exercise plays a critical role in preserving the integrity of brain architecture. These structural changes, however, did not translate directly to motor functional deficits in a simple motor task.
42
Seifman, Marc A., Alexios A. Adamides, Phuong N. Nguyen, Shirley A. Vallance, David James Cooper, Thomas Kossmann, Jeffrey V. Rosenfeld, and M. Cristina Morganti-Kossmann. "Endogenous Melatonin Increases in Cerebrospinal Fluid of Patients after Severe Traumatic Brain Injury and Correlates with Oxidative Stress and Metabolic Disarray." Journal of Cerebral Blood Flow & Metabolism 28, no. 4 (January 9, 2008): 684–96. http://dx.doi.org/10.1038/sj.jcbfm.9600603.
Full textAbstract:
Oxidative stress plays a significant role in secondary damage after severe traumatic brain injury (TBI); and melatonin exhibits both direct and indirect antioxidant effects. Melatonin deficiency is deleterious in TBI animal models, and its administration confers neuroprotection, reducing cerebral oedema, and improving neurobehavioural outcome. This study aimed to measure the endogenous cerebrospinal fluid (CSF) and serum melatonin levels post-TBI in humans and to identify relationships with markers of oxidative stress via 8-isoprostaglandin-F2α (isoprostane), brain metabolism and neurologic outcome. Cerebrospinal fluid and serum samples of 39 TBI patients were assessed for melatonin, isoprostane, and various metabolites. Cerebrospinal fluid but not serum melatonin levels were markedly elevated (7.28±0.92 versus 1.47±0.35 pg/mL, P<0.0005). Isoprostane levels also increased in both CSF (127.62±16.85 versus 18.28±4.88 pg/mL, P<0.0005) and serum (562.46±50.78 versus 126.15±40.08 pg/mL ( P<0.0005). A strong correlation between CSF melatonin and CSF isoprostane on day 1 after injury ( r=0.563, P=0.002) suggests that melatonin production increases in conjunction with lipid peroxidation in TBI. Relationships between CSF melatonin and pyruvate ( r=0.369, P=0.049) and glutamate ( r=0.373, P=0.046) indicate that melatonin production increases with metabolic disarray. In conclusion, endogenous CSF melatonin levels increase after TBI, whereas serum levels do not. This elevation is likely to represent a response to oxidative stress and metabolic disarray, although further studies are required to elucidate these relationships.
43
Millar, W. S., O. Klinghammer, M. S. Durkin, P. K. Tulipano, H. O. Peitgen, and H. K. Hahn. "A Reliable and Efficient Method for Cerebral Ventricular Volumetry in Pediatric Neuroimaging." Methods of Information in Medicine 43, no. 04 (2004): 376–82. http://dx.doi.org/10.1055/s-0038-1633881.
Full textAbstract:
Summary Objectives: Cerebral ventricular volume has the potential to become an important parameter in quantitative neurological diagnosis. However, no accepted methodology for routine clinical use exists to date. We sought a robust, reproducible, and fast technique to evaluate cerebral ventricular volume in young children. Methods: We describe a novel volumetric methodology to segment and visualize intracerebral fluid spaces and to quantify ventricular volumes. The method is based on broadly available T1 weighted volumetric magnetic resonance (MR) imaging, an interactive watershed transform, and a fully automated histogram analysis. We evaluated this volumetric methodology with 34 clinical volumetric MR datasets from non-sedated children (age 6-7 y) with a history of prematurity and low birth weight (≤ 1500 g) obtained during a prospective study. Results: The methodology, with adaptation for small ventricular size, was capable of evaluating all 34 of the pediatric datasets for cerebral ventricular volume. The method was a) robust for normal and pathological anatomy, b) reproducible, c) fast with less than five minutes for image analysis, and d) equally applicable to children and adults. Conclusions: Clinical brain ventricular volume calculations in non-sedated children can be performed using routine MR imaging besides efficient three-dimensional segmentation and histogram analysis with results that are robust and reproducible.
44
Petrovic, Branko, Djordje Radak, Vladimir Kostic, Nadezda Sternic-Covickovic, Jovo Kolar, and Nebojsa Tasic. "Posterior reversibile encephalopathic syndrom: case report and review of literature." Srpski arhiv za celokupno lekarstvo 131, no. 11-12 (2003): 461–66. http://dx.doi.org/10.2298/sarh0312461p.
Full textAbstract:
INTRODUCTION Reversible Posterior Leukoencephalopathy Syndrome was introduced into clinical practice in 1996 in order to describe unique syndrome, clinically expressed during hypertensive and uremic encephalopathy, eclampsia and during immunosuppressive therapy [1 ]. First clinical investigations showed that leucoencephalopathy is major characteristic of the syndrome, but further investigations showed no significant destruction in white cerebral tissue [2, 3,4]. In majority of cases changes are localize in posterior irrigation area of the brain and in the most severe cases anterior region is also involved. Taking into consideration all above mentioned facts, the suggested term was Posterior Reversible Encephalopathy Syndrome (PRES) for the syndrome clinically expressed by neurological manifestations derived from cortical and subcortical changes localized in posterior regions of cerebral hemispheres cerebral trunk and cerebellum [5]. CASE REPORT Patient, aged 53 years, was re-hospitalized in Cardiovascular Institute "Dedinje" two months after succesfull aorto-coronary bypass performed in June 2001 due to the chest bone infection. During the treatment of the infection (according to the antibiogram) in September 2001, patient in evening hours developed headache and blurred vision. The recorded blood pressure was 210/120 mmHg so antihypertensive treatment was applied (Nifedipin and Furosemid). After this therapy there was no improvement and intensive headache with fatigue and loss of vision developed. Neurological examination revealed cortical blindness and left hemiparesis. Manitol (20%, 60 ccm every 3 hours) and iv. Nytroglicerin (high blood pressure). Brain CT revealed oedema of parieto-occipital regions of both hemispheres, more emphasized on the right. (Figure 1 a, b, c). There was no sign of focal ischemia even in deeper sections (Figure 1d, e, f). Following three days enormous high blood pressure values were registered. On the fourth day the significant clinical improvement occurred with lowering of blood pressure, better mental state and better vision. There was no sign of left hemiparesis on the 7th day. On the 9th day there were no symptoms or sign of disease. Control brain CT (15th day) was normal. ETHIOPATHOGENESIS Most common causes of PRES are hypertensive encephalopathy [6-8], pre-eclampsia/eclampsia [9-12] cyklosporin A administration [13-22] and uremic encephalopathy [23]. There are several theories about the mechanism for PRES in hypertensive encephalopathy (reversible vasospasm and hyperperfusion) and administration of cyclosporin A (neurotoxic effect). CLINICAL PICTURE Most common symptoms are headache, nausea, vomiting, confusion, behavioural changes, changes of conciousnes (from somnolencia to stupor), vision disturbances (blurred vision, haemianopsia, cortical blindness) and epileptic manifestations (mostly focal attacs with secondary generalization). Mental functions are characterised with decreased activity and reactivity, confusion, loss of concentration and mild type of amnesia. Lethargy is often initial sign, sometimes accompanied with phases of agitation. Stupor and coma rarely occurred. DIAGNOSIS In patients with hypertensive ecephalopathy and eclampsia high blood pressure is registered. Neurological examination revealed vision changes and damages of mental function as well as increased reflex activity. Today, brain MRI and CT are considered the most important diagnostic method for the diagnosis and follow-up of patients with PRES [6]. Brain MRI better detects smaller focal parenhim abnormalities than brain CT.The most often neuroradiological finding is relatively symetrical oedema of white cerebral tissue in parieto-occipital regions of both cerebral hemispheres. Gray cerebral tissue is sometimes involved, usually in mild form of disease. Diagnosis of this "cortical" form of PRES is possible by MR FLAIR (Fluid-Attenuated Inversion Recovery) technique [5]. TREATMENT Therapeutic strategy depends on the cause of PRES and clinical picture. Most important are blood pressure regulation (labetalol, nitroprusid, diuretici), control of epileptic attacs (phenytoin), anti-oedema therapy. (Manitol), induction of vaginal delivery in eclampsia and discontinuation of cyclosporin therapy. In most cases there are no neurological manifestations after the 7th day but some studies showed normalization of clinical finding after one year and more.
45
Cancelliere, Nicole M., Mehdi Najafi, Olivier Brina, Pierre Bouillot, Maria I. Vargas, Karl-Olof Lovblad, Timo Krings, Vitor M. Pereira, and David A. Steinman. "4D-CT angiography versus 3D-rotational angiography as the imaging modality for computational fluid dynamics of cerebral aneurysms." Journal of NeuroInterventional Surgery 12, no. 6 (November 26, 2019): 626–30. http://dx.doi.org/10.1136/neurintsurg-2019-015389.
Full textAbstract:
Background and purposeComputational fluid dynamics (CFD) can provide valuable information regarding intracranial hemodynamics. Patient-specific models can be segmented from various imaging modalities, which may influence the geometric output and thus hemodynamic results. This study aims to compare CFD results from aneurysm models segmented from three-dimensional rotational angiography (3D-RA) versus novel four-dimensional CT angiography (4D-CTA).MethodsFourteen patients with 16 cerebral aneurysms underwent novel 4D-CTA followed by 3D-RA. Endoluminal geometries were segmented from each modality using an identical workflow, blinded to the other modality, to produce 28 'original' models. Each was then minimally edited a second time to match length of branches, producing 28 additional 'matched' models. CFD simulations were performed using estimated flow rates for 'original' models (representing real-world experience) and patient-specific flow rates from 4D-CTA for 'matched' models (to control for influence of modality alone).ResultsOverall, geometric and hemodynamic results were consistent between models segmented from 3D-RA and 4D-CTA, with correlations improving after matching to control for operator-introduced variability. Despite smaller 4D-CTA parent artery diameters (3.49±0.97 mm vs 3.78±0.92 mm for 3D-RA; p=0.005) and sac volumes (157 (37–750 mm3) vs 173 (53–770 mm3) for 3D-RA; p=0.0002), sac averages of time-averaged wall shear stress (TAWSS), oscillatory shear (OSI), and high frequency fluctuations (measured by spectral power index, SPI) were well correlated between 3D-RA and 4D-CTA 'matched' control models (TAWSS, R2=0.91; OSI, R2=0.79; SPI, R2=0.90).ConclusionsOur study shows that CFD performed using 4D-CTA models produces reliable geometric and hemodynamic information in the intracranial circulation. 4D-CTA may be considered as a follow-up imaging tool for hemodynamic assessment of cerebral aneurysms.
46
Zhou, Ying, Qingqing Li, Ruiting Zhang, Wenhua Zhang, Shenqiang Yan, Jinjin Xu, Shuyue Wang, Minming Zhang, and Min Lou. "Role of deep medullary veins in pathogenesis of lacunes: Longitudinal observations from the CIRCLE study." Journal of Cerebral Blood Flow & Metabolism 40, no. 9 (October 16, 2019): 1797–805. http://dx.doi.org/10.1177/0271678x19882918.
Full textAbstract:
Our purpose is to assess the role of deep medullary veins in pathogenesis of lacunes in patients with cerebral small vessel disease (cSVD). We included patients with baseline and 2.5-year follow-up MRI in CIRCLE study. Susceptibility Weighted Imaging-Phase images were used to evaluate deep medullary veins based on a brain region-based visual score, and T2-Fluid-Attenuated-Inversion-Recovery images were used to evaluate lacunes. Cerebral blood flow and microstructural parameters in white matter hyperintensities and normal appearing white matter were also analyzed. A total of 203 cSVD patients were analyzed and 101 (49.8%) patients had baseline lacunes. Among them, 64 patients had follow-up MRI, including 16 (25.0%) with new lacunes. The patients’ deep medullary veins median score was 9 (7–12). At baseline, high deep medullary veins score was independently associated with the presence of lacunes after adjusting for age, diabetes mellitus, white matter hyperintensities volume and cerebral blood flow or white matter microstructural parameters (all p < 0.001). Longitudinally, high deep medullary veins score was independently associated with new lacunes after adjusting for gender ( p < 0.001). The association was also independent of white matter hyperintensities volumes, cerebral blood flow or white matter microstructural parameters (all p < 0.05). Our results suggest that deep medullary veins disruption might be involved in pathogenesis of lacunes.
47
Rava, Ryan A., Kenneth V. Snyder, Maxim Mokin, Muhammad Waqas, Ariana B. Allman, Jillian L. Senko, Alexander R. Podgorsak, et al. "Effect of computed tomography perfusion post-processing algorithms on optimal threshold selection for final infarct volume prediction." Neuroradiology Journal 33, no. 4 (June 23, 2020): 273–85. http://dx.doi.org/10.1177/1971400920934122.
Full textAbstract:
In acute ischemic stroke (AIS) patients, eligibility for endovascular intervention is commonly determined through computed tomography perfusion (CTP) analysis by quantifying ischemic tissue using perfusion parameter thresholds. However, thresholds are not uniform across all analysis methods due to dependencies on patient demographics and computational algorithms. This study aimed to investigate optimal perfusion thresholds for quantifying infarct and penumbra volumes using two post-processing CTP algorithms: Vitrea Bayesian and singular value decomposition plus (SVD+). We utilized 107 AIS patients (67 non-intervention patients and 40 successful reperfusion of thrombolysis in cerebral infarction (2b/3) patients). Infarct volumes were predicted for both post-processing algorithms through contralateral hemisphere comparisons using absolute time-to-peak (TTP) and relative regional cerebral blood volume (rCBV) thresholds ranging from +2.8 seconds to +9.3 seconds and –0.23 to –0.56 respectively. Optimal thresholds were determined by minimizing differences between predicted CTP and 24-hour fluid-attenuation inversion recovery magnetic resonance imaging infarct. Optimal thresholds were tested on 60 validation patients (30 intervention and 30 non-intervention) and compared using RAPID CTP software. Among the 67 non-intervention and 40 intervention patients, the following optimal thresholds were determined: intervention Bayesian: TTP = +4.8 seconds, rCBV = –0.29; intervention SVD+: TTP = +5.8 seconds, rCBV = –0.29; non-intervention Bayesian: TTP = +5.3 seconds, rCBV = –0.32; non-intervention SVD+: TTP = +6.3 seconds, rCBV = –0.26. When comparing SVD+ and Bayesian post-processing algorithms, optimal thresholds for TTP were significantly different for intervention and non-intervention patients. rCBV optimal thresholds were equal for intervention patients and significantly different for non-intervention patients. Comparison with commercially utilized software indicated similar performance.
48
Siepmann, Timo, Henry Boardman, Amy Bilderbeck, Ludovica Griffanti, Yvonne Kenworthy, Charlotte Zwager, David McKean, et al. "Long-term cerebral white and gray matter changes after preeclampsia." Neurology 88, no. 13 (February 24, 2017): 1256–64. http://dx.doi.org/10.1212/wnl.0000000000003765.
Full textAbstract:
Objective:To determine whether changes in cerebral structure are present after preeclampsia that may explain increased cerebrovascular risk in these women.Methods:We conducted a case control study in women between 5 and 15 years after either a preeclamptic or normotensive pregnancy. Brain MRI was performed. Analysis of white matter structure was undertaken using voxel-based segmentation of fluid-attenuation inversion recovery sequences to assess white matter lesion volume and diffusion tensor imaging to measure microstructural integrity. Voxel-based analysis of gray matter volumes was performed with adjustment for skull size.Results:Thirty-four previously preeclamptic women (aged 42.8 ± 5.1 years) and 49 controls were included. Previously preeclamptic women had reduced cortical gray matter volume (523.2 ± 30.1 vs 544.4 ± 44.7 mL, p < 0.05) and, although both groups displayed white matter lesions, changes were more extensive in previously preeclamptic women. They displayed increased temporal lobe white matter disease (lesion volume: 23.2 ± 24.9 vs 10.9 ± 15.0 μL, p < 0.05) and altered microstructural integrity (radial diffusivity: 538 ± 19 vs 526 ± 18 × 10−6 mm2/s, p < 0.01), which also extended to occipital and parietal lobes. The degree of temporal lobe white matter change in previously preeclamptic women was independent of their current cardiovascular risk profile (p < 0.05) and increased with time from index pregnancy (p < 0.05).Conclusion:A history of preeclampsia is associated with temporal lobe white matter changes and reduced cortical volume in young women, which is out of proportion to their classic cardiovascular risk profile. The severity of changes is proportional to time since pregnancy, which would be consistent with continued accumulation of damage after pregnancy.
49
Scott, Emmi P., Anne Sorrell, and Andreana Benitez. "Psychometric Properties of the NIH Toolbox Cognition Battery in Healthy Older Adults: Reliability, Validity, and Agreement with Standard Neuropsychological Tests." Journal of the International Neuropsychological Society 25, no. 08 (July 1, 2019): 857–67. http://dx.doi.org/10.1017/s1355617719000614.
Full textAbstract:
AbstractObjective:Few independent studies have examined the psychometric properties of the NIH Toolbox Cognition Battery (NIHTB-CB) in older adults, despite growing interest in its use for clinical purposes. In this paper we report the test–retest reliability and construct validity of the NIHTB-CB, as well as its agreement or concordance with traditional neuropsychological tests of the same construct to determine whether tests could be used interchangeably.Methods:Sixty-one cognitively healthy adults ages 60–80 completed “gold standard” (GS) neuropsychological tests, NIHTB-CB, and brain MRI. Test–retest reliability, convergent/discriminant validity, and agreement statistics were calculated using Pearson’s correlations, concordance correlation coefficients (CCC), and root mean square deviations.Results:Test–retest reliability was acceptable (CCC = .73 Fluid; CCC = .85 Crystallized). The NIHTB-CB Fluid Composite correlated significantly with cerebral volumes (r’s = |.35−.41|), and both composites correlated highly with their respective GS composites (r’s = .58−.84), although this was more variable for individual tests. Absolute agreement was generally lower (CCC = .55 Fluid; CCC = .70 Crystallized) due to lower precision in fluid scores and systematic overestimation of crystallized composite scores on the NIHTB-CB.Conclusions:These results support the reliability and validity of the NIHTB-CB in healthy older adults and suggest that the fluid composite tests are at least as sensitive as standard neuropsychological tests to medial temporal atrophy and ventricular expansion. However, the NIHTB-CB may generate different estimates of performance and should not be treated as interchangeable with established neuropsychological tests.
50
Beard, Daniel J., Caitlin L. Logan, Damian D. McLeod, Rebecca J. Hood, Debbie Pepperall, Lucy A. Murtha, and Neil J. Spratt. "Ischemic penumbra as a trigger for intracranial pressure rise – A potential cause for collateral failure and infarct progression?" Journal of Cerebral Blood Flow & Metabolism 36, no. 5 (January 12, 2016): 917–27. http://dx.doi.org/10.1177/0271678x15625578.
Full textAbstract:
We have recently shown that intracranial pressure (ICP) increases dramatically 24 h after minor intraluminal thread occlusion with reperfusion, independent of edema. Some of the largest ICP rises were observed in rats with the smallest final infarcts. A possible alternate mechanism for this ICP rise is an increase of cerebrospinal fluid (CSF) volume secondary to choroid plexus damage (a known complication of the intraluminal stroke model used). Alternatively, submaximal injury may be needed to induce ICP elevation. Therefore, we aimed to determine (a) if choroid plexus damage contributes to the ICP elevation, (b) if varying the patency of an important internal collateral supply to the middle cerebral artery (MCA), the anterior choroidal artery (AChA), produces different volumes of ischemic penumbra and (c) if presence of ischemic penumbra (submaximal injury) is associated with ICP elevation. We found (a) no association between choroid plexus damage and ICP elevation, (b) animals with a good internal collateral supply through the AChA during MCAo had significantly larger penumbra volumes and (c) ICP elevation at ≈24 h post-stroke only occurred in rats with submaximal injury, shown in two different stroke models. We conclude that active cellular processes within the ischemic penumbra may be required for edema-independent ICP elevation.