Giant arachnoid granulation in a patient with benign intracranial hypertension (2009: 1b)

We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation 7(GAG) in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify GAG and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of GAGs can be used to evaluate the lesion as the cause of the patient's symptoms

The impact of synapsin III gene on the neurometabolite level alterations after single-dose methylphenidate in attention-deficit hyperactivity disorder patients

Objective: To investigate the neurometabolite level changes according to synapsin III gene rs133945G.A and rs133946C.G polymorphisms by using magnetic resonance spectroscopy (MRS) in patients with attention-deficit hyperactivity disorder (ADHD). Methods: Fifty-seven adults diagnosed with ADHD were recruited for the study. The participants were examined by single-voxel1H MRS when medication naïve and 30 minutes after oral administration of 10 mg methylphenidate (Mph). Those who had been on a stimulant discontinued the medication 48 hours before MRS imaging. Spectra were taken from the anterior cingulate cortex, dorsolateral prefrontal cortex, striatum, and cerebellum, and N-acetylaspartate (NAA), choline, and creatine levels were examined. For genotyping of the synapsin III gene polymorphisms, DNA was isolated from peripheral blood leukocytes. The effects of age, sex, and ADHD subtypes were controlled in the analyses. Results: After a single dose of Mph, choline levels increased significantly in the striatum of rs133945G.A polymorphism-GG genotypes (P=0.020) and NAA levels rose in the anterior cingulate cortex of rs133946C.G polymorphism-CG genotypes (P=0.014). Both rs133945G.A and rs133946C.G polymorphisms were found to statistically significantly affect the alteration of NAA levels in response to Mph in dorsolateral prefrontal cortex with two-way repeated measure of analysis of variance. Post hoc comparisons revealed a significant difference between CG and GG genotypes of rs133946C.G polymorphisms after Bonferroni adjustment (P=0.016). Conclusion: Synapsin III gene polymorphisms may be affecting the changes in neurometabolite levels in response to Mph in adult ADHD patients. Future studies are needed to confirm our findings. © 2016 Başay et al

The volume fraction of brain ventricles to total brain volume: A computed tomography stereological study

This study has been designed to estimate the volume fraction of the brain ventricles volume to total brain volume and to correlate them with gender and age in normal subjects. Cranial computed tomography (CT) images of 80 normally evaluated subjects (five female and five male for each decade) were selected from 1,073 CT examinations. The volumes of total brain, cerebral aqueduct, fourth, third, and lateral ventricles and their ratios were estimated using the Cavalieri method and volume fraction-stereological methods. The ratio of total brain ventricle volume to total brain volume was comparable between the two genders (p > 0.05, independent t test). Mean volume fraction of total ventricle volume to total brain volume was found to be 1.21% in the first and 3.37% in the last decades. Mean volume fraction was found to increase significantly with age (p < 0.01, r = 0.630, Pearson). In conclusion, the mean percentage of total ventricle volume within the total brain volume was found to be 2%. We demonstrated the volume fraction of total ventricle to total brain in normal subjects. Total ventricle volume to total brain volume fractions can be important tools in determining ventricle volumes, which denote variability in some diseases (Alzheimer, schizophrenia, neurodegenerative disorders, etc.) and can be estimated by stereological methods. Copyright © 2010 Via Medica

MRI Measures of Hippocampus in Mild Cognitive Impairment and Alzheimer Patients

OBJECTIVE: In this study we aimed to compare the hippocampal volumes of patients diagnosed as Alzheimer’s Disease (AD), Minimal Cognitive Impairment (MCI) and the healthy objects. We also tried to demonstrate whether there was a possible correlation between the cognitive tests and the hippocampal volumes. METHODS: Minimental State Examination, Adas-Cog and Global Deterioration Scale were administrated to the patients having Alzheimer’s Disease (n=20). We also performed Minimental State Examination, and Adas-Cog to MCI patients (n=20) and Minimental State Examination to the healthy control group (n=18). Both right and left hippocampal volumes were measured by a three dimensioned Surf Driver programm with the support of cranial magnetic resonance imaging (MRI). RESULTS: Both right and left hippocampal volumes of the Alzheimer’s Disease group were significantly smaller than the MCI and the control groups. Bilaterally hippocampal volumes of MCI group were also smaller than the control group. (Hippocampal volumes; AD 0.05). CONCLUSION: : Surf Driver method succesfully demonstrated the relative hippocampal atrophy in the AD and the MCI groups when compared with the healthy control

MRI Measures of Hippocampus in Mild Cognitive Impairment and Alzheimer Patients

OBJECTIVE: In this study we aimed to compare the hippocampal volumes of patients diagnosed as Alzheimer’s Disease (AD), Minimal Cognitive Impairment (MCI) and the healthy objects. We also tried to demonstrate whether there was a possible correlation between the cognitive tests and the hippocampal volumes. METHODS: Minimental State Examination, Adas-Cog and Global Deterioration Scale were administrated to the patients having Alzheimer’s Disease (n=20). We also performed Minimental State Examination, and Adas-Cog to MCI patients (n=20) and Minimental State Examination to the healthy control group (n=18). Both right and left hippocampal volumes were measured by a three dimensioned Surf Driver programm with the support of cranial magnetic resonance imaging (MRI). RESULTS: Both right and left hippocampal volumes of the Alzheimer’s Disease group were significantly smaller than the MCI and the control groups. Bilaterally hippocampal volumes of MCI group were also smaller than the control group. (Hippocampal volumes; AD 0.05). CONCLUSION: : Surf Driver method succesfully demonstrated the relative hippocampal atrophy in the AD and the MCI groups when compared with the healthy controls

Three-dimensional computed tomography of a complete stylohyoid ossification with articulation

The stylohyoid chain presents considerable anatomic variability. Three-dimensional (3D) CT is accepted as the method of choice for morphological assessment of the stylohyoid complex. We present volume-rendered, 3D multislice CT images of an unusual, incidental case of bilateral complete stylohyoid ossification with articulations. © Springer-Verlag 2008

Neuroimaging evaluation of non-aneurismatic “top of the basilar” syndrome

Purpose: We aim to evaluate the clinical and imaging features of “Top of the basilar” syndrome (TOB-S). Method: We retrospectively evaluated the clinical and imaging features of thirty consecutive TOB-S patients. We analyzed the ischemic parenchymal lesions and vascular disturbances with anatomic correlation by using magnetic resonance imaging (MRI), diffusion-weighted MRI (DWI), computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA). Results: Thirty patients (14 males and 16 females) with a mean age of 61 years (range: 32–78 years) were diagnosed as TOB-S based on the neuroimaging and clinical findings. Large artery atherosclerosis (LAA) was the common etiology (63.3%), including the subgroups of in situ steno/occlusive, artery to artery embolus (AA), arterial branch (AB) occlusion, and AA+AB combination. The other etiologies were cardioembolism (CE) (16.6%), arterial dissection (AD) (10.0%), vasculitis (6.6%), and undetermined (3.3%). The patients represented ‘superficial', ‘deep' and ‘superficial plus deep' infarcts with segmental, territorial or scattered patterns. The most clinical manifestations were motor deficits, alteration of consciousness, visual/oculomotor disturbance, cerebellar dysfunction, behavioral disorder and speech disorder. Conclusion: The accurate evaluation of imaging findings in TOB-S is essential for diagnosis and appropriate management. Familiarity with the vascular anatomy, supplying territories, and infarction patterns of the ischemic lesions is crucial. © 2016, Ege University Press. All Rights Reserved

Relationship between the SNAP-25 gene and the effects of methylphenidate on the anterior cingulate cortex of patients with adult attention deficit hyperactivity disorder: A magnetic resonance spectroscopy study

Objective: The effects of certain genetic alterations in the brain function of patients with attention deficit hyperactivity disorder (ADHD) remain unclear and, in fact, there is a limited amount of data in this field. For example, the relationship between the SNAP-25 polymorphism and brain metabolites in response to methylphenidate (MPH) has yet to be investigated. Thus, the present study aimed to determine the relationship between changes in creatine (Cr), choline (Cho), and N-acetyl aspartate (NAA) levels in the prefrontal cortex (PFC) and anterior cingulate cortex (ACC) of adults with ADHD and the SNAP-25 gene polymorphism following the use of MPH. Patients and Methods: The present study assessed 60 patients between 18 and 60 years of age who were diagnosed with ADHD according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Genetic analyses were carried out using blood samples obtained from the ADHD patients and included a detailed clinical evaluation for the SNAP-25 gene polymorphism. The NAA, Cr, and Cho levels in the ACC and PFC were measured using magnetic resonance spectroscopy (MRS). Following the evaluation, 10 mg of oral MPH was given to the patients, and the same metabolite levels were measured after 30 minutes. Results: The levels of NAA, Cr, and Cho in the PFC and ACC of patients with the SNAP-25 Ddel and Mnll polymorphism genotypes did not significantly differ before and after the administration of MPH. However, in patients with the SNAP-25 Ddel polymorphism T/T genotype and the Mnll polymorphism G/G genotype, there was a significant increase in NAA levels in the ACC after MPH treatment compared with before MPH treatment. Conclusion: The present results suggest that the SNAP-25 Ddel and Mnll polymorphisms might be associated with MPH-related changes in NAA levels in the ACC

Cerebral Venous Thrombosis, A Retrospective Study of 14 Patients and Review of Literature

OBJECTIVE: Cerebral venous thrombosis is thrombosis of brain veins and sinuses which are due to prothrombotic process. They present with various neurological symptoms. The annual incidence is 3- 4/million. METHODS: Symptoms, demographic data, etiologic factors, clinical and radiological features of 14 consecutive patients between July 1st 2006 and July 1st 2008 with cerebral venous thrombosis are evaluated retrospectively. RESULTS: The study group comprised 4 men and 10 women. Their mean age was 44.2±19 years. Headache is the most frequent symptom, present in %92.8 of the patients. Papilloedema (50%), impairment of level of consciousness (14.3%), vertigo (14.3%), visual disturbances (14.3%) were the other symptoms. Eight patients were admitted just because of headache. Seven patients had one and seven patients had more than one sinus involvement. CONCLUSION: The incidence is rare but the outcome of this disorder is generally favourable if diagnosed. Cerebral venous thrombosis must be remembered in the differantial diagnosis of headaches of unknown etiologi