Intra-cranial and spinal foreign body reactions represent potential complications of medical procedures. Their diagnosis may be challenging as they frequently show an insidious clinical presentation ...and can mimic other life-threatening conditions. Their pathophysiological mechanism is represented by a local inflammatory response due to retained or migrated surgical elements. Cranial interventions may be responsible for the presence of retained foreign objects represented by surgical materials (such as sponges, bone wax, and Teflon). Spinal diagnostic and therapeutic procedures, including myelography, chordotomy, vertebroplasty, and device implantation, are another potential source of foreign bodies. These reactions can also follow material migration or embolization, for example in the case of Lipiodol, Teflon, and cement vertebroplasty. Imaging exams, especially CT and MRI, have a central role in the differential diagnosis of these conditions together with patient history. Neuroradiological findings are dependent on the type of material that has been left in or migrated from the surgical area. Knowledge of these entities is relevant for clinical practice as the correct identification of foreign bodies and related inflammatory reactions, material embolisms, or migrations can be difficult. This pictorial review reports neuroradiological semeiotics and differential diagnosis of foreign body-related imaging abnormalities in the brain and spine.
Whether chemotherapy (ChT) and radiotherapy (RT) determine neurocognitive impairment in acute lymphoblastic leukemia long-term survivors (ALL LTSs) through similar mechanisms affecting the same brain ...regions is still unknown. We compared neurocognitive alterations, regional brain tissue volumes (by voxel-based morphometry), and functional connectivity of the main default-mode network hubs (by seed-based analysis of resting state functional MRI data), in 13 ALL LTSs treated with RT and ChT (Group A) and 13 treated with ChT only (Group B). Group A performed significantly worse than Group B at the digit span and digit symbol tests (
= 0.023 and 0.013, respectively). Increased connectivity between the medial prefrontal cortex (the main anterior hub of the default-mode network) and the rolandic operculi was present in Group A compared to Group B, along with the absence of significant differences in regional brain tissue volumes. In these regions, the functional connectivity correlated inversely with the speed of processing scores, independent of treatment group. These results suggest that similar mechanisms may be involved in the neurocognitive deficits in ALL LTS patients, regardless of the treatment group. Further studies are needed to clarify whether these changes represent a direct expression of the mechanisms underlying the cognitive deficits or ineffective compensatory phenomena.
An original maxillofacial fracture detection system (MFDS), based on convolutional neural networks and transfer learning, is proposed to detect traumatic fractures in patients. A convolutional neural ...network pre-trained on non-medical images was re-trained and fine-tuned using computed tomography (CT) scans to produce a model for the classification of future CTs as either “fracture” or “noFracture”. The model was trained on a total of 148 CTs (120 patients labeled with “fracture” and 28 patients labeled with “noFracture”). The validation dataset, used for statistical analysis, was characterized by 30 patients (5 with “noFracture” and 25 with “fracture”). An additional 30 CT scans, comprising 25 “fracture” and 5 “noFracture” images, were used as the test dataset for final testing. Tests were carried out both by considering the single slices and by grouping the slices for patients. A patient was categorized as fractured if two consecutive slices were classified with a fracture probability higher than 0.99. The patients’ results show that the model accuracy in classifying the maxillofacial fractures is 80%. Even if the MFDS model cannot replace the radiologist’s work, it can provide valuable assistive support, reducing the risk of human error, preventing patient harm by minimizing diagnostic delays, and reducing the incongruous burden of hospitalization.
Abstract
Background
We report an extremely unusual case of anterior clinoid process (ACP) metastasis as the first presentation of a signet ring cell carcinoma.
Case Description
A 54-year-old female ...patient presented with right-sided visual disturbances due to optic nerve compression from a computed tomography (CT)-identified right anterior clinoid bone lesion. Contrast-enhanced magnetic resonance imaging showed an extra-axial, well-bordered enhancing mass extending from the right ACP toward the inner lumen of the optic canal. Pterional approach was adopted to remove the lesion and decompress the optic canal. Histological examination demonstrated a metastasis from a signet ring cell carcinoma. Postoperative CT showed near-total resection of the tumor and decompression of the optic canal. Visual defect remained unchanged.
Conclusion
Metastasis should be considered in the differential diagnosis of the ACP lesions. The early suspicion and identification of this extremely rare pathological entity can be helpful for the prompt management of patients, especially in the absence of any other signs of oncological diseases.
Background
Megalencephaly‐polymicrogyria‐polydactyly‐hydrocephalus (MPPH) is a developmental brain disorder characterized by megalencephaly and bilateral perisylvian polymicrogyria due to defects in ...genes of the PI3K‐AKT pathway. Only a few patients with CCND2 mutations have been reported to date.
Methods
We describe an individual harboring a de novo variant in CCND2 undergoing neuroradiological evaluation including diffusion tensor imaging (DTI).
Results
The individual presented with a severe brain malformation extending to both brainstem and cerebellum with hypomyelination not previously reported in CCND2‐related disorder. Severe hypoplasia and white matter disorganization were confirmed by DTI.
Conclusion
This report expands the phenotypic spectrum of the disorder due to CCND2 variants.
Neuroimaging findings of the presented individual with CCND2‐related disorder
Delayed post‐hypoxic leukoencephalopathy (DPHLE) is a rare demyelinating syndrome that follows an episode of prolonged cerebral hypoxia after a relatively lucid intervening period of variable length. ...Although the pathophysiology still remains obscure, it has been suggested that hypoxic‐metabolic injuries to oligodendrocytes may play a crucial role. We describe the case of a patient with chronic respiratory problems who fell into a coma during morphine therapy. After a brief period of successful recovery, neurocognitive and behavioral disorders suddenly appeared and a diagnosis of DPHLE was made also taking into account the MRI picture. The antioxidant therapy has probably facilitated the almost complete neurological recovery within 4 weeks. A peculiar finding was the presence of anti‐CV2/CRMP5 antibodies in serum, which may stand as potential factors implicated in oligodendrocytes damage.
Motor involvement in Fabry disease Cocozza, Sirio; Ugga, Lorenzo; Pontillo, Giuseppe ...
Molecular genetics and metabolism reports,
03/2018, Letnik:
14, Številka:
C
Journal Article
Currarino syndrome is a rare congenital disorder characterized by the triad of anorectal anomalies, sacrococcygeal dysgenesis and presacral mass. Because of the anorectal anomalies, the extrinsic ...compression due to the presacral mass and neurologic deficits, patients usually present with gastrointestinal symptoms, most commonly chronic constipation. Most cases of Currarino syndromes are diagnosed in childhood, at birth or in the pre-birth period and, even if adult presentation has been reported in few sporadic case reports, the diagnosis in the late stages of life remains extremely rare. In this paper, we describe the imaging findings of an elderly man with a past medical history of megacolon surgically treated in his childhood, who was diagnosed with Currarino syndrome at the age of 72.
Foix–Chavany–Marie syndrome (FCMS) is a rare type of pseudobulbar palsy characterized by automatic‐voluntary dissociation of movements that depend on V, VII, IX, X, and XII cranial nerves. Most of ...cases are due to bilateral ischemic lesions of anterior opercula, but the syndrome has also been described after unilateral opercular damage either isolated or associated with contralateral cortico‐nuclear tract involvement. Here, we report the clinical and neuroradiological characteristics of a patient with FCMS due to sequential, bilateral, and symmetrical infarcts of corona radiata, presenting with slurred speech, severe hypophonia, and right central‐type facial palsy that rapidly progressed to inability to speak and swallow. In addition, we observed a sudden onset of neuro‐behavioral changes with psychomotor slowing, aggressive, and oppositive conducts along with emotional lability and involuntary crying. To the best of our knowledge, only one other FCMS case has been previously reported with this peculiar lesional topography.
Meningioangiomatosis is a rare congenital hamartomatous malformation of the leptomeninges that can also involve the adjacent cerebral tissue, sometime arising in association with neurofibromatosis. ...Here we report the case of a 55-year-old man with neuroradiological evidence of meningioangiomatosis, known to be a well-defined malformative-dysplastic lesion, preceding the onset of central nervous system B-cell lymphoma. We describe for the first time this unusual association, highlighting how meningioangiomatosis could accompany different pathologies more frequently than thought.
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