Reversible splenial lesion and complex visual disturbances due to carbamazepine withdrawal.

No abstract availabl

Erdheim-Chester disease: A systematic review.

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans-cell histiocytosis, associated in more than 50% of cases to BRAF(V600E) mutations in early multipotent myelomonocytic precursors or in tissue-resident histiocytes. It encompasses a spectrum of disorders ranging from asymptomatic bone lesions to multisystemic, life-threatening variants. We reviewed all published reports of histologically-confirmed ECD and explored clinical, radiological, prognostic and therapeutic characteristics in a population of 448 patients, including a unique patient from our Department. To find a clinically relevant signature defining differentiated prognostic profiles, the patients' disease features were compared in relation to their CNS involvement that occurred in 56% of the entire population. Diabetes insipidus, visual disturbances, pyramidal and extra-pyramidal syndromes were the most recurrent neurological signs, whereas concomitant pituitary involvement, retro-orbital masses and axial lesions in the presence of symmetric bilateral osteosclerosis of long bones depicted the typical ECD clinical picture. Patients with CNS infiltration showed a lower occurrence of heart involvement and a higher incidence of bone, skin, retro-peritoneal, lung, aortic and renal infiltration. No difference in the therapeutic algorithm was found after stratification for CNS involvement. A better understanding of the disease pathogenesis, including BRAF deregulation, in keeping with improved prognostic criteria, will provide novel suggestions for the management of ECD

Frontal lobe metabolic alterations in autism spectrum disorder: a 1H-magnetic resonance spectroscopy study.

Recently, neuroimaging studies were performed using 1H-magnetic resonance spectroscopy (1H-MRS), revealing a quantitative alteration of neurochemicals (such as neurotransmitters and metabolites) in several brain regions of patients with autism spectrum disorder (ASD). The involvement of the frontal lobe in the neurobiology of ASD has long been documented in the literature. Therefore, the aim of this study was to analyze the alterations of N-acetylaspartate/creatine (NAA/Cr) and choline/Cr (Cho/Cr) ratios in the frontal lobe subcortical white matter (WM) in ASD patients, in order to reveal any alteration of metabolites that might be the expression of specific clinical features of the disorder

Role of Magnetic Resonance Imaging in the Diagnosis of Fetal Brain Anomalies

Prenatal Ultrasonagraphy (US) is the mainstay modality to diagnose fetal abnormalities especially in early pregnancy. Fetal Magnetic Resonance Imaging (MRI) is a useful tool to confirm and to characterize a pathology that is suspected on US, especially in the detection of central nervous system pathologies.The use of ultrafast imaging tecniques gives additional importantant informations and optimal imaging quality, despite fetal motion, in clinical practice. Diffusion Weighted Imaging (DWI), Diffusion Tensor Imaging (DTI), MR Spetroscopy and Functional studies have potential applications in the fetal brain imaging. Fetal MRI could recognize, in contradistinction to US, the development of fetal brain, the multilayered appearance of the cerebral parenchyma, the timing of sulci development and the myelination. The most common indications for fetal MRI are ventriculomegaly, midline anomalies, malformations of cerebral cortical development, posterior fossa anomalies, suspected haemorraghic-ischemic lesions, tumors. Fetal MRI is a safe and powerful complement to US for clinical management and prognostication

Lhermitte-Duclos disease: MR diffusion and spectroscopy

AIM: To describe two cases of Lhermitte-Duclos disease studied with Diffusion MRI and MRi Spectroscopy. MATERIALS AND METHODS: Two patients showing a space-occupying lesion in the cerebellar hemisphere were studied by conventional MRI associated with Diffusion MRI and Spectroscopy. RESULTS: Conventional MRI showed the typical morphological pattern of Lhermitte-Duclos disease with a slow-growing cerebellar mass mainly involving the cortex and non-enhancing thickened cerebellar folia. The mass exerted mild compression of the IV ventricle causing hydrocephalus On Diffusion imaging showed the lesion to be hyperintense due to residual T2-activity and hypointense on the ADC map. Spectroscopy was typical with an increased lactate peak and a reduced choline peak, indicating abnormal anaerobic glycolysis and demyelination, respectively. DISCUSSION: Lhermitte-Duclos disease is a neurological condition which presents several signs and symptoms related to the cerebellar mass. Cowden's syndrome, an autosomal dominant neoplastic disorder with malignant features is associated in 40% of cases. MRI associated with functional examinations such as Diffusion Imaging and Spectroscopy is the imaging modality of choice in LDD patients. They allow a definite diagnosis as the neuroradiological findings correlate well with molecular biology theories regarding the malformative nature of dysplastic cerebellar gangliocytoma

MULTIMODAL DIAGNOSTIC APPROACH IN ISCHEMIC STROKE

Aim In our study, we explain the application of the new multimodal neuroradiological protocol for acute ischemic stroke. Material and methods Diffusion weighted Imaging, Perfusion weighted Imaging and Magnetic Resonance Angiography have become an important tool for the identification of early ischemic Injury. Results DWI lesions present irreversible damaged tissue – the infarct core. PWI maps demonstrate the area of minor perfusion in patients with acute vessel occlusion. Combined DWI and PWI has the potential to be more powerful than either study alone in predicting infarct outcome apart from CT and MRI. Discussion and conclusions In acute ischemic stroke multimodal MRI diagnostic approach is fundamental for a very early diagnosis and for the trombolytic therapy with recanalization of the occluded cerebral vessel