11/20. Value of ultrasound for identification of acute hemorrhagic necrosis of thalamus and basal ganglia in an asphyxiated term infant.An infant with profound intrapartum and postpartum asphyxia demonstrated striking bilateral echodensities in the region of the thalamus and basal ganglia on ultrasound scan. Neuropathological examination confirmed the presence of symmetrical areas of hemorrhagic necrosis involving the thalamus, caudate, putamen, and globus pallidus. The findings demonstrate the value of ultrasonography in the identification of this variety of perinatal hypoxic-ischemic injury.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
12/20. Paraballism caused by bilateral hemorrhagic infarction in basal ganglia.Bilateral ballism developed gradually in a 75-year-old woman after head trauma. Computerized tomography revealed bilateral hemorrhagic infarction in the head of the caudate nucleus and the putamen. haloperidol abolished the symptoms completely within 2 days. After 18 days, haloperidol was gradually withdrawal over 16 days. The patient remained without ballistic movements thereafter.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
13/20. Acute fatal deterioration in putaminal hemorrhage.BACKGROUND: Clinical deterioration in patients with spontaneous intracerebral hemorrhage has rarely been studied. It has been previously thought that intracranial hematomas bleed in a monophasic fashion. Recent studies have demonstrated continuous active bleeding within hours after the event, resulting in enlargement of the hematoma. However, acute sudden and fatal deterioration suggesting a rebleed is rarely reported. SUMMARY OF REPORTS: An 84-year-old man was admitted with a moderate-size hemorrhage in the putamen and was treated for hypertension during the first day of admission. He acutely demonstrated extensor posturing and light-fixed pupils. Repeat CT scan showed massive enlargement of the intracranial hematoma and extension into the ventricles causing acute hydrocephalus. A 72-year-old man was admitted with a mid-size hemorrhage in the putamen. Acute deterioration with loss of all brain stem reflexes except for cornea reflexes was associated with a large increase in volume of the hematoma, 7 hours after the initial hemorrhage. An 85-year-old woman was admitted with a small hemorrhage in the putamen and recovered to be able to walk unassisted. She suddenly died from a recurrent massive putaminal hemorrhage 2 weeks after the ictus. CONCLUSIONS: patients with spontaneous intracerebral hemorrhage in the putamen may die acutely from fatal catastrophic enlargement of the initial hematoma hours to days after the ictus. In some patients with spontaneous intracerebral hemorrhage and clinical deterioration, rebleeding may be a possible mechanism.- - - - - - - - - - ranking = 4keywords = putamen (Clic here for more details about this article) |
14/20. Unusual case of hypertonic hemorrhage.Hemorrhage arose simultaneously in the leftside putamen and the brain stem region in a 45-year-old hypertonic woman. The cause of death, which occurred on the seventh day after the incident, was the recurrence of hemorrhage into the brain stem, which was disclosed at autopsy. Possible causes of recurrent brain stem hemorrhage are discussed.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
15/20. Neuropathology of propionic acidemia: a report of two patients with basal ganglia lesions.propionic acidemia is a rare genetic disorder of amino acid metabolism caused by deficient activity of propionyl coenzyme a carboxylase. Neuropathologic changes previously reported in infants have been white-matter vacuolization or spongiosis. In children who survive beyond infancy, abnormalities have been found primarily in the basal ganglia. We report neuropathologic findings in two patients with propionic acidemia diagnosed in infancy who survived 35 months and 9 years, respectively. Examination of the brain of the 35-month-old boy showed vascular and parenchymal mineralization, focal pallor and spongy change, and foci of acute neuronal injury. These changes were similar to those previously described. The 9-year-old girl was in good metabolic control when she died, and presented a neuropathologic picture not previously described. She was found at autopsy to have acute hemorrhagic lesions in the caudate, putamen, and globus pallidus bilaterally and in the left ventral thalamus. There was focal neuronal loss, but no acute hypoxic/ischemic neuronal injury. Vascular proliferation and swollen endothelial cells were seen in the basal ganglia, thalamus, and substantia nigra, but not in other regions of the brain. Electron microscopy showed swelling of endothelial cells with viable adjacent brain parenchyma. The endothelial changes suggest a breakdown of the blood-brain barrier.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
16/20. Hemiparkinsonism following haemorrhage in the contralateral substantia nigra.We report a patient with right hemiparkinsonism following haemorrhage in the left substantia nigra. The hemiparkinsonism responded to treatment with trihexyphenidyl hydrochloride and deteriorated after temporary discontinuation of the drug. Single photon emission computed tomography using technetium 99m d, l-hexamethylpropyleneamine oxide showed reduced uptake in the left putamen, globus pallidus and thalamus.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
17/20. Occurrence of severe vasospasm following intraventricular hemorrhage from an arteriovenous malformation. Report of two cases.The authors present two rare cases of severe cerebral vasospasm following the rupture of arteriovenous malformations (AVMs). Computerized tomography revealed intracerebral hemorrhage in the thalamus in one case and in the putamen in the other, both accompanied by cast formation of intraventricular clots without radiological evidence of subarachnoid hemorrhage. Initial angiograms showed arterial narrowing of the bilateral internal carotid arteries in the supraclinoid portion but failed to demonstrate an arteriovenous shunt. Subsequent angiograms clearly demonstrated the existence of an AVM. Radiological features and possible mechanisms are discussed.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
18/20. necrosis and haemorrhage of the putamen in methanol poisoning shown on MRI.methanol, a highly toxic substance, is used as an industrial solvent and in automobile antifreeze. Acute methanol poisoning produces severe metabolic acidosis and serious neurologic sequelae. We describe a 50-year-old woman with accidental methanol intoxication who was in a vegetative state. MRI showed haemorrhagic necrosis of the putamina and oedema in the deep white matter.- - - - - - - - - - ranking = 4keywords = putamen (Clic here for more details about this article) |
19/20. Subcortical crossed aphasia.A 55 year-old, right-handed, hypertensive woman with global aphasia, due to a spontaneous hemorrhage in the right putamen extending to the periventricular white matter was examined thirteen days after the acute onset of stroke. She had left hemiplegia and inability to speak. She displayed no spontaneous speech output and was capable only of occasional undifferentiated grunts in conversation. Other language modalities such as auditory and reading comprehension, naming, repetition and writing were severely impaired. Her aphasia was classified as global aphasia. Forty-five days after the onset of stroke, rapid recovery from the aphasia with mild deficits in speaking, naming, and repetition was detected. This case is a good example of crossed aphasia, favouring the importance of deep structures of the right hemisphere in this type of aphasia. Rapid recovery is an important feature.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
20/20. magnetic resonance imaging and 11C-N-methylspiperone/positron emission tomography studies in a patient with the interval form of carbon monoxide poisoning.Magnetic resonance (MR) and (11)C-N-methylspiperone ((11)C-NMSP)/positron emission tomography (PET) imagings were repeatedly performed in a 50-year-old man with the interval form of carbon monoxide (CO) poisoning. In MR images obtained when delayed neuropsychiatric symptoms developed (two months after poisoning), the inner segments of the bilateral globus pallidus appeared as high signal intensities in the T1-weighted and low signal intensities in the T2-weighted images, suggesting prior focal hemorrhage in these areas. A PET study with (11)C-NMSP performed at that time showed an increase in dopamine D2 receptor binding in the caudate and putamen. Treatment with bromocriptine was very effective and five months after the poisoning, MR and (11)C-NMSP/PET images showed improvement, concomitantly with the disappearance of the neuropsychiatric symptoms.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
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