Intracranial calcifications on CT

Computed tomography (CT) is very sensitive for detection and localization of intracranial calcifications. We reviewed in this pictorial essay the diseases associated with intracranial calcifications and emphasized the utility of CT for the differential diagnosis. © Turkish Society of Radiology 2010

Wallenberg Syndrome following neck cracking: A case report

Cracking the neck is an age-old practice in contravention of its dangerous affects. One of these affects is Brain stem strokes and in this report we describe a patient with Wallenberg syndrome due to neck cracking who is the one of the rare cases in the literature

Sudden akathisia and parkinsonism in a uremic patient

The authors report here a case of sudden developed severe akathisia and parkinsonism with basal ganglia lesions in a 52-years-old diabetic uremic patient. Magnetic resonance of brain showed hyperintensities on T1 weighted images on bilateral basal ganglia

Wallenberg Syndrome following neck cracking: A case report

Cracking the neck is an age-old practice in contravention of its dangerous affects. One of these affects is Brain stem strokes and in this report we describe a patient with Wallenberg syndrome due to neck cracking who is the one of the rare cases in the literature

A case of PICA infarction presenting as vestibuler neuritis

We reported a patient of 50 years old men, who presented with severe acute vertigo and nausea such as vestibuler neuritis without usually symptom or signs of cerebellar dysfunction. Cranial MRI of patient showed acute left infarct in the territory of posterior inferior cerebellar artery (PICA). Clinicians should be aware of the possibility of a cerebellar infarct in patient with acute vestibular syndrome even if the pattern of vertigo and nausea is typical of a vestibular neuritis

Association between cholesterols, homocysteine and silent brain infarcts

Background The aim of this study was to assess the relationship between total plasma homocysteine, cholesterol levels, vitamin B12, folate, thyroid hormones, urea, ferritin, uric acid, C-reactive protein, cardiovascular risk factors and silent brain infarct (SBI) in patients without any neurological disorder. Whether the factors of interest were associated with SBI is investigated. Methods One hundred and forty-two subjects with a mean age of 52.1 ± 13.1 years (21-87 years) without any history of stroke, transient ischaemic attack and neurological abnormality were enrolled in this cross-sectional study. The subjects underwent brain magnetic resonance imaging and blood chemistry determinations. Student's t-test was used to compare differences in means of laboratory results between the groups with and without SBI. The χ2-test was used for categorized variables. Multiple logistic regression analysis was used to determine the independent predictors of SBI. Results The group comprised 56 men and 86 women. SBI were found in 40 patients (28%). The low-density lipoprotein levels were significantly higher in the infarct group (P = 0.019), homocysteine concentrations were significantly higher in the men-infarct group (P = 0,029) and total cholesterol levels were significantly higher in the women-infarct group than the women non-infarct group (P = 0.006). Conclusion Serum low-density lipoprotein, total cholesterol and homocysteine levels were associated with SBI. © 2009 The Authors Journal compilation © 2009 Royal Australasian College of Physicians

Ruptured dissecting aneurysms arising from non-vertebral arteries of the posterior circulation: Endovascular treatment perspective

PURPOSE: Most intracranial dissecting aneurysms involve the posterior circulation, and the intradural segment of the vertebral artery is affected in majority of these. The aim of this report is to summarize the results of endovascular treatment in patients with ruptured dissecting aneurysms of the non-vertebral posterior circulation. MATERIALS AND METHODS: During the past six years, the medical records of 23 patients with subarachnoid hemorrhage related to dissecting aneurysm arising from non-vertebral arteries of the posterior circulation were reviewed retrospectively. RESULTS: The locations of the aneurysms were as follows: seven in the posterior cerebral artery, five in the superior cerebellar artery, six in the basilar artery trunk, and five in the posterior inferior cerebellar artery. Two basilar artery aneurysms were treated in the chronic stage with stent-assisted coil embolization. In the remaining patients, the aneurysm was coiled with or without parent vessel occlusion in the acute stage. One patient re-bled and died 20 days after initial treatment. At follow-up, recanalization had occurred in two patients, whose aneurysms were re-embolized successfully. Overall, three patients had permanent neurological sequelae, two had transient neurological sequelae, and one patient died. CONCLUSION: Embolization with or without parent artery occlusion is feasible with an acceptable morbidity and mortality rate in the treatment of dissecting aneurysms confined to non-vertebral arteries of the posterior circulation. © Turkish Society of Radiology 2009

Relationship between the DAT1 gene and the effects of methylphenidate administration in adult attention deficit hyperactivity disorder: A magnetic resonance spectroscopy study

OBJECTIVE: This study investigated the relationship between DAT1 gene polymorphisms and the effects of methylphenidate (MPH) administration on N-acetyl aspartate (NAA), creatine (Cr), and choline (Cho) levels in the anterior cingulate cortex, prefrontal cortex, striatum, and cerebellum in adult patients with attention deficit hyperactivity disorder (ADHD). This was the first study to investigate the relationship between DAT gene variable number tandem repeat (VNTR) polymorphisms and the responses of brain metabolites to MPH. PATIENTS AND METHODS: Samples in this study were collected from 60 patients aged between 18 and 60 years with ADHD according to DSM-IV criteria. Genetic analysis of DAT1 gene polymorphisms was carried out using blood samples obtained after a detailed clinical evaluation. Levels of NAA, Cr, and Cho were measured in the anterior cingulate cortex, prefrontal cortex, striatum, and cerebellum by magnetic resonance spectroscopy. After this evaluation, 10 mg of MPH was given orally to patients, and the levels of the same metabolites were measured 30 min later. RESULTS: No marked difference in NAA, Cr, or Cho levels was detected before and after MPH administration with respect to the DAT1 gene VNTR polymorphisms. A considerable increase in Cr levels in the cerebellum was identified after MPH administration in individuals with the 10/10 repeat genotype as the DAT1 VNTR polymorphism (p=0.008). CONCLUSIONS: An increase in the previously decreased blood flow after MPH therapy may induce an increase in creatine levels in patients with the 10/10 repeat genotype. Our results thus suggest that the 10R allele as the DAT1 gene VNTR polymorphism might be associated with MPH-related changes in brain metabolites in adults with ADHD