摘要:

Regions of cerebral cortex activated in normal subjects making simple, repetitive, voluntary wrist movements were studied with positron emission tomography (PET). The regional cerebral metabolic rate of glucose utilization was studied with 2‐[18F]fluoro‐2‐deoxy‐D‐glucose (FDG), and regional cerebral blood flow was studied with15O‐labeled water. No significant activation was found with the cerebral metabolic rate studies. Studies of regional cerebral blood flow showed significant activation of the contralateral sensorimotor cortex region of 42%, of the ipsilateral sensorimotor cortex region of 19%, and of the medial frontal cortex of 30% compared with the resting state. Increases in blood flow in the contralateral sensorimotor cortex and medial frontal cortex were visible on every activated scan. Measurement of regional cerebral blood flow seems to be more sensitive than regional cerebral metabolic rate of glucose utilization for studying cortical activation with voluntary movement.

ISSN:1051-2284    

DOI:10.1111/jon1994411

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

This study investigated the relationship between diminished regional cerebral blood flow (rCBF) and the recovery of fluent speech in aphasia. Single‐photon emission computed tomographic brain scans using [123I]N‐isopropyl‐p‐iodoamphetamine were obtained from 14 nonfluent aphasic patients within 30 days of cerebral infarction. Measurements of speech fluency were acquired initially and at 3 months after infarction. Nearly all of the patients exhibited significant hypoperfusion to combinations of the anterior and posterior regions of the basal ganglion, the periventricular white matter, and the inferior frontal regions. Only the inferior frontal area was significantly associated with recovery of fluent speech. This region was hypoperfused in 4 of 5 patients with poor recovery while 8 of the 9 patients with good speech fluency recovery demonstrated normal rCBF to the inferior frontal region.

ISSN:1051-2284    

DOI:10.1111/jon1994416

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

Presented are the results of an extensive noninvasive assessment of supraclinoid internal carotid artery (ICA) stenosis with moyamoya‐like vasculopathy in 3 patients with a history of stroke. Five noninvasive criteria for the diagnosis based on magnetic resonance imaging of the brain, and hemodynamic testing using ocular pneumoplethysmography, duplex carotid ultrasound, and transcranial Doppler sonography were established: (1) normal ocular pneumoplethysmography demonstrating no pressure significant stenosis to the level of the ophthalmic artery; (2) abnormal Doppler spectral waveforms showing either no flow or a high‐resistance flow pattern for the ipsilateral cervical internal carotid artery; (3) paradoxically low flow velocities for the ipsilateral intracranial (ICA) and middle cerebral artery (MCA), and markedly abnormal high velocities for the contralateral ICA and MCA; (4) decreased ipsilateral MCA vasomotor reactivity; and (5) deep MCA territory ipsilateral subcortical watershed infarction evidenced by magnetic resonance imaging. This report demonstrates that a noninvasive battery of tests may be useful in the early diagnosis and treatment of these patients.

ISSN:1051-2284    

DOI:10.1111/jon19944111

出版商:Wiley    

年代:2016

数据来源: WILEY

ISSN:1051-2284    

DOI:10.1111/jon19944116

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

Transcranial color‐coded real‐time sonography (TCCS) was applied to 26 patients with ventricular enlargement to quantify the ventricular size and to estimate intracranial pressure. Intracranial pressures, as determined by lumbar, epidural, or ventricular tonometry, ranged from 6.5 to 55 cm H20 (8 patients had pressures>18 cm H20). The widths of the third ventricle and the frontal horns of both lateral ventricles depicted by TCCS were compared to corresponding computed tomography data: TCCS and computed tomography findings correlated well for the third ventricle (r= 0.96) and for the right (r= 0.86) and left (r= 0.92) frontal horns. The capability of the septum pellucidum to undulate relative to the ventricular wall during short (20‐degree) rotatory movements of the head was related to intracranial pressure. In all patients with intracranial pressure below 17 cm H20, rotatory head movements induced septum pellucidum undulation; no lateral deflection of the septum pellucidum was found in patients with an intracranial pressure above 21 cm H20. Therefore, TCCS may be employed to quantify and follow‐up ventricular enlargement. Dynamic neurosonographic tests may allow a gross estimation of intracranial pressure.

ISSN:1051-2284    

DOI:10.1111/jon19944117

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

The chemical characteristics of 10 neoplastic and 11 infectious brain masses were studied by in vivo1H magnetic resonance spectroscopy. In tumors, peak height ratios ofn‐acetyl‐L‐aspartate to choline were decreased compared to those in normal brain tissue and infectious masses (p<0.02), but the ratios in normal brains and those with infections did not differ.N‐acetyl‐L‐aspartate—to‐creatine/phosphocreatine ratios were significantly lower in infectious masses and tumors compared to normal brain tissue (p= 0.003). However, in progressive multifocal leukoencephalopathy,N‐acetyl‐L‐aspartate appeared relatively unchanged. Lactate was greater than choline in 9 of 11 brains with infection, 0 of 14 control brains, and 1 of 10 tumors. Lactate‐to‐choline ratios were significantly elevated in infectious masses compared with tumors (p<0.01).1H magnetic resonance spectroscopy is promising for the noninvasive diagnosis of focal brain masses.

ISSN:1051-2284    

DOI:10.1111/jon19944123

出版商:Wiley    

年代:2016

数据来源: WILEY

ISSN:1051-2284    

DOI:10.1111/jon19944128

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

Since the introduction of transcranial Doppler sonography in the early 1980s, flow velocity estimates have assumed a 0‐ to 30‐degree angle of insonation. Based on limited radiological and anatomical studies. such an assumption appeared justified, and seemed to confer only minimal potential for error due to the cosine function in the Doppler formula. The introduction of transcranial color duplex sonography allows the direct evaluation of this assumption and the effect on flow velocities. Fifteen healthy volunteers were studied bilaterally using a unilateral transtemporal approach from the right. Velocity measurements were taken from the middle, anterior, and posterior cerebral arteries. Flow velocities were obtained with and without angle correction (0 degree). After completion of the color duplex study, velocities were obtained with a conventional, “blind” Doppler transducer at corresponding depths. For all insonated vessels the average angle of insonation was around 30 degrees. However, there was a wide variability of individual angles of insonation (0–70 degrees) in specific vessels. In 74.5% of all vessels, the angle‐corrected flow velocity did not exceed the uncorrected velocity by more than 25%. In 14.5% the angle‐corrected velocity was 25 to 50% higher and in 10.8% it was more than 50% higher as compared to the uncorrected velocity. Thus, the angle of insonation was unpredictable and often higher than originally expected. Angle‐corrected velocities were higher than uncorrected values, and were more than 25% higher in about one‐fourth of the vessels studied. Understanding of the clinical importance of such differences requires further study.

ISSN:1051-2284    

DOI:10.1111/jon19944129

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

A 72‐year‐old man had posturally induced syncopal episodes, followed by quadriparesis, coma, and death. Neuroimaging studies supported the clinical diagnosis confirmed by neuropathological findings.

ISSN:1051-2284    

DOI:10.1111/jon19944134

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

“Visceral larva migrans” syndrome is a zoonotic disease caused by the migration or presence in human tissue of nematode larva from lower‐order animals. This syndrome includes generalized illness. eosino philia. and symptoms arising from larval invasions of different organs including the liver, lungs. eyes, and central nervous system. There has been only one case report of the computed tomographic (CT) and magnetic resonance imaging (MRI) appearances of cerebral toxocaral disease . Described here is a patient with cerebral toxocaral disease with a high eosinophil count and toxocaral titer in the serum and abnormal CT and MRI findings who had spontaneous recovery of the clinical symptoms.

ISSN:1051-2284    

DOI:10.1111/jon19944139

出版商:Wiley    

年代:2016

数据来源: WILEY