Postspinal baş ağrısı sonrası gelişen ve atipik prezentasyon gösteren posterior reversibl ensefalopati sendromu

Headache is common in the postpartum period. Post-dural puncture head- ache (PDPH) is the most common major complication after spinal anaes- thesia. the clinical features and history of spinal anaesthesia are sufficient for diagnosis. However, the differential diagnosis is extensive and the evaluation of persistent symptoms requires a multidisciplinary approach for diagno- sis and treatment. Here, we report an 31 year-old woman with a history of normal pregnancy, presenting with persistent headache that started on postpartum day 2, and was refractory to conservative therapy of PDPH; the patient developed hypertension, seizures, visual disturbances, and altered mental status on postpartum day 7. the clinical outcome and neuroimaging findings of the patient were compatible with an atypical presentation of pos- terior reversible encephalopathy syndrome (PRES) associated with late post- partum preeclampsia. She showed dramatic improvement with antihyper- tensive therapy. PRES is a frequently reversible acute neurologic entity with different aetiologies including preeclampsia/eclampsia. However, a delay in diagnosis and treatment can result in permanent brain damage and death. Therefore, it is important to recognise atypical clinical and radiological pre- sentations of PRES for early diagnosis and treatment.Doğum sonrası dönemde baş ağrısı sık görülür. Postspinal baş ağrısı (PSBA) spinal anestezi sonrası en çok görülen büyük komplikasyondur. Tanı için klinik tablo ve spinal anestezi öyküsü yeterlidir. Fakat ayırıcı tanı listesi çok geniştir ve devam eden semptomlar varlığında tanı ve tedavi için çok yönlü yaklaşım gerekmektedir. Burada, sorunsuz bir gebeliği takiben postpartum 2. günde başlayan ve PSBA tedavisine yanıt vermeyen inatçı baş ağrısı ve 1. haftada hipertansiyon, görme bozukluğu, konvülziyon ve şuur durumunda bozukluk gelişen 31 yaşında kadın hastayı sunuyoruz. Olgunun klinik gidişi ve nöroradyolojik bulgular ile geç başlangıçlı preek- lampsiye bağlı, atipik prezentasyon gösteren posterior reversibl ensefalopa- ti sendromu (PRES) tanısı konmuştur. Hasta antihipertansif tedavi ile dra- matik iyileşme göstermiştir. PRES preeklampsi/eklampsiyi de içeren farklı etiyolojik etkenlere bağlı ortaya çıkan, çoğu zaman geri dönüşü olan akut bir nörolojik tablodur. Ancak tanı ve tedavide gecikme, kalıcı beyin hasa- rı ve ölüme neden olabilir. Bu nedenle PRES erken evre tanı ve tedavisi açısından atipik klinik ve radyolojik prezentasyonun bilinmesi önemlidir

Corrigendum to “Detection of visual and frontoparietal network perfusion deficits in Parkinson’s disease dementia” [Eur. J. Radiol. 144 (2021) 109985]

This study was supported by TUBITAK 1001 project #115S219, Istanbul University Scientific Research Projects Unit project #1567/42362 and Bogazici University Scientific Research Projects Unit project #15222.The authors would like to add the following grant support that was accidentally not included in the original article. Acknowledgements: This study was supported by TUBITAK 1001 project #115S219, Istanbul University Scientific Research Projects Unit project #1567/42362 and Bogazici University Scientific Research Projects Unit project #15222. The authors would like to apologize for any inconvenience caused.Publisher's Versio

Detection of visual and frontoparietal network perfusion deficits in Parkinson's disease dementia

PubMed: ID34619619Mild cognitive impairment of Parkinson's disease (PD) may be an early manifestation that may progressively worsen to dementia. Cognitive decline has been associated with changes in the brain perfusion pattern. This study aimed to evaluate cerebral blood flow (CBF) deficits specific to different stages of cognitive decline. Seventeen patients with cognitively normal PD (PD-CN), 18 patients with PD with mild cognitive impairment (PD-MCI), and 16 patients with PD with dementia (PDD) were included in this study. The participants were scanned using a 3 T Philips MRI scanner. Arterial spin labelling magnetic resonance (ASL-MR) images were acquired, followed by calculation of the CBF maps, and registration onto the MNI152 brain atlas. A whole-brain voxel-based CBF comparison was performed among the patient groups using age as a covariate. The mean age of patients with PDD was significantly higher than that of patients with PD-MCI (P = 0.015) and PD-CN (P = 0.001). The CBF values of the three groups were significantly different in the left cuneus of the visual network (VN), left inferior frontal gyrus of the frontoparietal network (FPN), and left dorsomedial nucleus of the thalamus. PDD had lower perfusion values than PD-MCI group in the same regions detected in the main group analysis. Additionally, comparison of PDD with PD-CN and non-demented groups revealed that the perfusion reduction extended into the bilateral cuneus of the VN, bilateral thalami, and left inferior frontal gyrus of the FPN. PDD could be separated from PD-MCI and PD-CN stages with CBF deficits in non-dopaminergically mediated posterior and dopaminergically mediated frontal networks.Publisher's Versio