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NRAD - Artigos
Mostrando recursos 1 - 20 de 38
Optimized T1- and T2-weighted volumetric brain imaging as a diagnostic tool in very preterm neonates. - Nossin-Manor, R; Chung, AD; Morris, D; Soares-Fernandes, JP; Thomas, B; Cheng, HL; Whyte, HE; Taylor, MJ; Sled, JG; Shroff, MM
T1- and T2-W MR sequences used for obtaining diagnostic information and morphometric measurements in the neonatal brain are frequently acquired using different imaging protocols. Optimizing one protocol for obtaining both kinds of information is valuable.
To determine whether high-resolution T1- and T2-W volumetric sequences optimized for preterm brain imaging could provide both diagnostic and morphometric value.
MATERIALS AND METHODS:
Thirty preterm neonates born between 24 and 32 weeks' gestational age were scanned during the first 2 weeks after birth. T1- and T2-W high-resolution sequences were optimized in terms of signal-to-noise ratio, contrast-to-noise ratio and scan time and compared to conventional spin-echo-based sequences.
Stroke and Cardiac Papillary Fibroelastoma: Mechanical Thrombectomy after Thrombolytic Therapy - Santos, AF; Pinho, J; Ramos, V; Pardal, F; Rocha, J; Ferreira, C
We describe a case of a 34-year-old man with a sudden development of right hemiparesis and aphasia because of infarction of the left middle cerebral artery that was submitted to intravenous (IV) recombinant tissue plasminogen activator and mechanical thrombectomy. Transesophageal echocardiogram showed a small mass on the anterior leaflet of the mitral valve. Cardiac surgery was performed, and histological examination of the removed material was consistent with cardiac papillary fibroelastoma (CPF). Experience in using IV thrombolysis for the treatment of embolic stroke because of CPF is limited. To the best of our knowledge, only 3 patients are reported in literature...
Hemangioma intracraniano - Rocha, J; Marques, C; Adams, A; Rodrigues, J
A case of intracranial hemangioma in a neonate is described by the authors. The rarity of the condition raised differential diagnosis problems.
From juvenile parkinsonism to encephalitis lethargica, a new phenotype of post-streptococcal disorders: case report. - Beleza, P; Soares-Fernandes, J; Jordão, MJ; Almeida, F
We report the case of a 16-year-old boy presented with a mild akinetic-rigid parkinsonism shortly after a post-streptococcal infection. After stopping corticoids, he had a rapid neurological deterioration to a fatal encephalitis lethargica-like syndrome. Serum analysis demonstrated consistently elevated anti-streptolysin-O. This case illustrates a new severe phenotype in the spectrum of the post-streptococcal disorders. This etiology should be considered in the differential diagnosis of a movement disorder with a rapid detrimental evolution.
MR imaging for diagnostic evaluation of encephalopathy in the newborn. - Shroff, MM; Soares-Fernandes, JP; Whyte, H; Raybaud, C
Magnetic resonance (MR) imaging is used with increasing frequency to evaluate the neonatal brain because it can provide important diagnostic and prognostic information that is needed for optimal treatment and appropriate counseling. Special care must be taken in preparing encephalopathic neonates for an MR study, transporting them from the intensive care unit, monitoring their vital signs, and optimizing MR sequences and protocols. Moreover, to accurately interpret the findings, specific knowledge is needed about the normal MR imaging appearances of the physiologic processes of myelination, cell migration, and sulcation, as well as patterns of injury, in the neonatal brain at various...
Primary spinal glioblastoma: A case report and review of the literature - Morais, N; Mascarenhas, L; Soares- Fernandes, JP; Silva, A; Magalhães, Z; Moreira da Costa, JA
Primary spinal glioblastoma (GBM) is a rare disease, with an aggressive course and a poor prognosis. We report a case of a 19-year-old male with a 4-week history of progressive weakness in both lower limbs, which progressed to paraparesis with a left predominance and difficulty in initiating urination over a week. Spine magnetic resonance imaging (MRI) showed an intramedullary expansile mass localised between T6 and T11. We performed a laminotomy and laminoplasty between T6 and T11 and the tumour was partially removed. Histopathological study was compatible with GBM. The patient was administered focal spine radiotherapy with chemotherapy with temozolamide. Serial...
Primary angiitis of the central nervous system: an infrequent form of presentation - Jordão, MJ; Almeida, F; Moreira da Costa, JA; Rocha, J
Primary angiitis of the central nervous system (CNS) is a rare disease. Clinical signs and symptoms include headache and cognitive disorders associated to multifocal neurological deficits. A definitive diagnosis can only be achieved by means of a cerebromeningeal biopsy.
We describe the case of a 15-year-old male who first reported lower back pain and progressive paresis of the right lower limb, later followed by laterocollis on the right side. Magnetic resonance (MR) scanning of the brain and spinal cord revealed a pseudotumoral lesion in the right cerebellum and two lesions in the spinal cord. Dexamethasone was administered and surgical resection...
Neonatal pyruvate dehydrogenase deficiency due to a R302H mutation in the PDHA1 gene: MRI findings - Soares-Fernandes, JP; Teixeira-Gomes, R; Cruz, R; Ribeiro, M; Magalhães, Z; Rocha, JF; Leijser, LM
Pyruvate dehydrogenase (PDH) deficiency is one of the most common causes of congenital lactic acidosis. Correlations between the genetic defect and neuroimaging findings are lacking. We present conventional and diffusion-weighted MRI findings in a 7-day-old male neonate with PDH deficiency due to a mosaicism for the R302H mutation in the PDHA1 gene. Corpus callosum dysgenesis, widespread increased diffusion in the white matter, and bilateral subependymal cysts were the main features. Although confirmation of PDH deficiency depends on specialized biochemical analyses, neonatal MRI plays a role in evaluating the pattern and extent of brain damage, and potentially in early diagnosis and...
Probable acute disseminated encephalomyelitis due to Haemophilus influenzae meningitis - Beleza, P; Ribeiro, M; Pereira, J; Jordão, MJ; Almeida, F
We report the case of a 17-year-old male on long-term steroid therapy for minimal lesion glomerulopathy who, after an upper respiratory infection, presented with Haemophilus influenzae type b meningitis. Twenty-four hours later he developed depression of consciousness which progressed to coma and left hemiparesis. Brain magnetic resonance imaging (MRI) revealed multiple lesions (hyperintense on T2 and slightly hypointense on Tl) involving mainly white matter suggestive of inflammation. MRI features were compatible with acute disseminated encephalomyelitis (ADEM), although a differential diagnosis included cerebritis or vasculitis, secondary to bacterial meningitis. The patient was treated with high-dose steroids which resulted in a gradual...
Reverse crossed cerebellar diaschisis - Ribeiro, M; Beleza, P; Fernandes, J; Almeida, F; Rocha, J
Cerebral Magnetic Resonance imaging in acute postictal period is performed to exclude structural processes that can be responsible for the epileptic activity. Sometimes, the findings are the result of the epileptic activity, and not the cause reflecting the pathophysiologic changes during epileptic activity. In this paper we describe a patient with status epilepticus who has developed hemicerebellar involvement contralateral to a frontal epileptogenic focus. This phenomenon of Reverse Crossed Cerebellar Diaschisis is rare and has been describe only in Single Photon Emission Computed Tomography (SPECT).
Wallerian degeneration after stroke: a new prognostic factor? - Soares-Fernandes, J; Beleza, P; Ribeiro, M; Maré, R; Almeida, F; Rocha, J
Wallerian degeneration (WD) after ischemic stroke has been associated to persistent motor impairment, but signal intensity changes on conventional magnetic resonance imaging (MRI) are generally not detected until four weeks after the event. We report a 54 year old male patient, referred to our hospital for sudden-onset left hemiparesis. Cerebral CT showed right fronto-parietal infarct (middle cerebral artery stroke). We performed two CT control, which revealed no haemorrhagic transformation. MRI, obtained 13 days after the onset, demonstrated the infarct, mainly subcortical, extending throughout fronto-temporo-parietal areas and restricted diffusion in the ipsilateral corticospinal tract. In conclusion, WD is apparent on diffusion-weighted...