1/5. Bilateral basal ganglion haemorrhage in diabetic ketoacidotic coma: case report.We report bilateral oedema and haemorrhagic transformation in the basal ganglia of a 59-year old woman with severe diabetic ketoacidosis. Lack of cerebral vascular autoregulation, followed by blood-brain barrier disruption due to the so-called breakthrough mechanism is presumed to be the cause.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/5. Hypotensive hemorrhagic necrosis in basal ganglia and brainstem.Hypotensive hemorrhagic necrosis of the basal ganglia and brainstem has only occasionally been described. Three such cases are reported. Cardiac arrest had occurred in all cases, and it took at least 1 hour to restore adequate circulation. The patients remained comatose for 2 days to 2 weeks until death. Persistent hypotension causing ischemia in the distribution of deep perforating arteries is considered to have been the key underlying mechanism. hemorrhage is thought to have been caused by extravasation of red blood cells through damaged blood vessels.- - - - - - - - - - ranking = 5keywords = brain (Clic here for more details about this article) |
3/5. Possible acute hemorrhagic leukoencephalitis manifesting as intracerebral hemorrhage on computed tomography--case report.A 15-year-old girl presented with meningeal irritation and bilateral cerebral signs after contracting influenza. A lumbar puncture revealed bloody cerebrospinal fluid and polymorphonuclear predominant pleocytosis with an elevated protein level and normal glucose level. Computed tomography showed a hematoma in the right basal ganglia and lateral ventricles. Symmetrical low density areas were also noted in the bilateral white matter. The preliminary diagnosis was hemorrhagic cerebrovascular disease of unknown cause. However, her neurological condition deteriorated. Magnetic resonance (MR) imaging showed diffuse high intensity signals in the bilateral white matter and small spotty lesions, indicating hemorrhages in various stages. The final diagnosis was acute hemorrhagic leukoencephalitis (AHL). However, high-dose steroid administration and plasmapheresis failed to improve her condition. hypothermia could not control her intracranial pressure and she died 12 days after admission. The neuroimaging findings indicated the histological characteristics of AHL, but the hematoma formation is rare. AHL is a fulminant form of brain demyelination and can be fatal, so early diagnosis and aggressive treatment are important for successful recovery. Therefore, early investigation by MR imaging is necessary.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
4/5. diffusion MRI in the postmortem brain: case report.Postmortem brain of a ten-month-old child was examined by MR imaging, and diffusion MR imaging at the 12th hour after death in order to disclose the cause of death. There were basal ganglion lesions indicating a mitochondrial disorder. There was a prominent difference between the ADC values of the white matter (0.28 /-0.04 x 10(-3) mm2/s) and cortex (0.42 /-0.04 x 10(-3) mm2/s), and this was statistically significant (p< 0.0001). This difference suggested that in the postmortem brain the conditions in the white matter leading to restriction of movement of water molecules are more severe than that in the cortex.- - - - - - - - - - ranking = 6keywords = brain (Clic here for more details about this article) |
5/5. Evaluation of invasiveness and efficacy of 2 different keyhole approaches to large basal ganglia hematomas.BACKGROUND: The aim of this study was to evaluate the invasiveness and efficacy of 2 different keyhole approaches to large basal ganglia hematomas (LBGHs). methods: The invasiveness and efficacy of the temporal (15 cases) and the frontal (15 cases) microsurgical keyhole approach were retrospectively evaluated in 30 early-operated patients with LBGH, using recorded neuronavigation data. Invasiveness was assessed calculating the angles of brain retraction and the volume of brain exposed to surgery. Reduced invasiveness was related to a fall of these values. Efficacy was evaluated by comparing the volume of microscopically visualized clot and the largest hemorrhage diameter exposed with the 2 different keyhole approaches. Increased efficacy was related to a rise in these parameters. All estimations were correlated to the volume of residual clot detected on postoperative computed tomography scan. RESULTS: The comparison between both approaches revealed a significant reduction of invasiveness (smaller angles of brain retraction [P<.001] and reduced brain exposition [P<.001]), as well as a raised efficacy (increased volume of visualized clot [P<.001] and largest hemorrhage diameter exposed to surgery [P<.001]) for frontally approached LBGH. These patients showed less postoperative residual hematomas (P<.05). Residual clots were correlated to the evaluated brain retraction (P<.001) and volume of brain (P<.001), as well as volume of clot surgically exposed (P<.05). CONCLUSION: We conclude that the frontal approach to LBGH leads to less invasiveness and higher efficacy as evaluated by using neuronavigation data. This approach shows a reduced number of patients with residual postoperative clots.- - - - - - - - - - ranking = 6keywords = brain (Clic here for more details about this article) |