Stroke remains one of the leading causes of death and disability in Europe. The European Stroke Action Plan (ESAP) defines four main targets for the years 2018 to 2030. The COVID-19 pandemic forced ...the use of innovative technologies and created pressure to improve internet networks. Moreover, 5G internet network will be helpful for the transfer and collecting of extremely big databases. Nowadays, the speed of internet connection is a limiting factor for robotic systems, which can be controlled and commanded potentially from various places in the world. Innovative technologies can be implemented for acute stroke patient management soon. Artificial intelligence (AI) and robotics are used increasingly often without the exception of medicine. Their implementation can be achieved in every level of stroke care. In this article, all steps of stroke health care processes are discussed in terms of how to improve them (including prehospital diagnosis, consultation, transfer of the patient, diagnosis, techniques of the treatment as well as rehabilitation and usage of AI). New ethical problems have also been discovered. Everything must be aligned to the concept of “time is brain”.
Infantile hemangiomas (IH) are the most common benign vascular tumors of infancy. Ocular complications due to orbital IH include strabismal, deprivational, or anisometropic astigmatism, and visual ...loss secondary to amblyopia.
We report a case of a two-month-old female infant with a severe deep orbital IH. The diagnosis was established by clinical examination and magnetic resonance imaging (MRI). The patient was treated with oral propranolol for six months. Complete tumor regression was observed clinically and by MRI following the treatment. The patient showed no adverse effects or tumor recurrence at the 14-month follow-up.
Despite its benign nature, periorbital IH requires a rapid diagnosis and prompt treatment to prevent vision loss, particularly in infants. Our case confirms that oral propranolol may be regarded as a safe drug for periorbital IH with an excellent outcome.
Introduction: Axial-loaded magnetic resonance imaging (MRI), which can simulate an upright position of the patient may cause a significant reduction of the dural sac cross-sectional area (DCSA) ...compared with standard MRI, thus providing valuable information in the assessment of the lumbar spinal canal. The purpose of this study was to investigate excessiveness of the change in DCSA and depth of lateral recesses (DLRs) before and after axial-loaded imaging in relation to body mass index (BMI) of the subjects.Methods: Twenty patients were scanned to evaluate DCSA and DLR at three consecutive lumbar spine intervertebral disc levels (L3/4, L4/5, and L5/S1) on conventional-recumbent MRI, and after axial loading were applied.Results: Axial-loaded MRI demonstrates a significant difference of DSCA in comparison to conventional MRI. Furthermore, results show a significant correlation between the DCSA and BMI on level L3/L4, both before and after axial loading MRI. With axial loading, there is a reduction of DSCA of 12.2%, 12.1%, and 2.1% at the levels L3/L4, L4/L5, and L5/S1, respectively. After axial loading has been applied, the depth of the neural foramen has been reduced by an average of 10.1%.Conclusion: Axial-loaded MRI reduces DCSA and DLRs in comparison to standard MRI. Information obtained in this way may be useful to explain the patient’s symptomatology and may provide an additional insight that can influence the treatment decision plan accordingly.
Vertebral artery fenestration is a rare vascular anomaly. It most commonly occurs in extracranial segments of the vertebral artery. This congenital anomaly can occur during the various stages of ...embryonic development of the vertebral artery. This usually does not have clinical significance, but the possibility of associated anomalies such as saccular aneurysms and arteriovenous malformations should be noted. Awareness of vascular anomalies is key to avoiding iatrogenic injury during endovascular diagnostic and therapeutic interventions. Here, we present incidental findings of vertebral artery fenestration in a 46-year-old woman evidenced by CT angiography of the neck's blood vessells after I .V. contrast medium applications.
Aim
To assess hand function and explore the relationship between hand function and neuroimaging findings in children with unilateral spastic cerebral palsy (US CP).
Methods
Hand function was assessed ...using Manual Ability Classification System (MACS, I-V). Brain lesions were divided into five groups: brain maldevelopment (MAL), periventricular white matter lesions (PV WM), cortical/subcortical gray matter lesions (C/SC GM), nonspecific and normal findings.
Results
Of 114 children with US CP (77 boys and 37 girls), 56 were with right-sided and 58 with left-sided involvement. MACS I was found in 49 (42.9%), MACS II in 19 (16.7%), MACS III in 19 (16.7 %), MACS IV in 9 (7.9%) and MACS V in 18 (15.8%) children (p=0.002). Computed tomography (CT) as the only neuroimaging has been done in 18 (15.8%), magnetic resonance imaging (MRI) at 94 (82.5%) children, whereas 2 (1.7%) children had neither CT nor MRI. The CT showed PV WM in eight (44.4%), C/SC GM lesions in six (33.3%), and normal findings in four (22.2%) children (p=0.709). The MRI showed MAL in eight (8.5%), PV WM in 46 (48.9%), C/SC GM in 28 (29.8%), miscellaneous in two (2.1%), and normal finding in 10 (10.7%) children (p=0.0001). Mild hand dysfunction (MACS I and II) was assessed in 68 (59.7%) children, of which 33 had PV WM lesions (p=0.001).
Conclusion
Mild hand dysfunction in children with US CP has been significantly associated with PV WM lesions. The type of brain lesion may help to identify its timing and predict the level of hand dysfunction.
A fetus with suspicion for holoprosencephaly and various brain malformations were seen on ultrasound and send for magnetic resonance imaging (MRI). Immediately after the birth of the female patient ...ultrasound and MRI was made which confirmed lobar holoprosencephaly. Fetal MRI stands out as a powerful diagnostic tool for detecting anomalies and other disorders. By developing new sequences and raising image quality will enable visualization of small details.
Perfusion magnetic resonance neuroimaging Šehić, Adnan; Julardžija, Fuad; Jusufbegović, Merim ...
Journal of Health Sciences (Sarajevo),
08/2019, Letnik:
9, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The clinical appliance of perfusion is being continuously developed and it is closely related to technology development. The role of perfusion neuroimaging in the management of acute stroke has been ...to prove reduced regional blood flow and to give the contribution in the identification of ischemic areas, respectively the regions of hypoperfusion that can be treated by thrombolytic and/or endovascular recanalization therapy. There are two main approaches to the measurement of cerebral perfusion by magnetic resonance. The aim of this article is to compare different measuring approaches of MR perfusion neuroimaging.
Although total mesorectal excision reduces the local recurrence rate in comparison to other surgical approaches, the occurrence of local relapse is still common, especially in cases when there is ...malignant infiltration of the circumferential resection margin. Mesorectal fascia is an important prognostic and diagnostic factor and it may be argued that mesorectal fascia represents the circumferential resection margin if total mesorectal excision is used as a surgical approach. Tumor infiltration of mesorectal fascia warrants preoperative neoadjuvant therapy in order to reduce the risk of tumor relapse. The aim of this study was to show the importance of high-resolution phased-array magnetic resonance imaging (MRI) as a modality of choice in preoperative evaluation of the effects of neoadjuvant therapy on locally advanced rectal carcinoma. This prospective comparative study included 51 patients with locally advanced rectal carcinoma that infiltrated mesorectal fascia. All study patients underwent MRI scanning twice, i.e. before and after neoadjuvant chemoradiotherapy. MRI results before and after neoadjuvant chemoradiotherapy were compared to evaluate regression of tumor length and regression of tumor infiltration of mesorectal fascia. Gender distribution of 51 patients with rectal carcinoma subjected to neoadjuvant therapy was equal, and their average age was 51 (32-81) years. MRI results showed tumor regression from mesorectal fascia following chemoradiotherapy in 36 (70.5%) cases, and Wilcoxon test showed significant differences between pretherapeutic and post-treatment MRI findings (Z=-3.162, p=0.002) in the sense of regression of tumor infiltration of mesorectal fascia. In 41 (80.3%) cases there was a reduction of tumor length, where Wilcoxon test showed differences between pretherapeutic and post-treatment MRI findings (Z=-2.754, p=0.006) in the sense of tumor length reduction. The mean pretherapeutic tumor length was 5.4 (2.3-15) cm. The mean reduction of tumor length following chemoradiotherapy was 3.56 (0.3-4.1) cm. In all 36 patients that had tumor-free mesorectal fascia following surgical treatment, the post-treatment MRI results were confirmed by histopathology. In conclusion, MRI is important for evaluation of tumor infiltration of mesorectal fascia, and is useful on patient selection for appropriate treatment for rectal carcinoma. MRI reliably evaluates the effects of neoadjuvant therapy, which contributes to better outcome of treatment for this disease.
Objective. To present a rare disease, and to point out that clinical manifestations treated for a long period of time without an adequate response to therapy may be a manifestation of a rare ...disease.Case report. We present the case of a 3-year-old girl who had been drinking a large amount of water for the previous ten days with frequent urination, and who experienced the worsening of symptoms of scalp dermatitis that had been treated for a year without success. Physical examination revealed a maculopapular rash on the scalp, neck and both ear shells, and exophthalmos of the right eye with periorbital edema. Magnetic resonance imaging of the orbits showed extensive lesions of the skull bones. Further diagnostic evaluation revealed similar lesions in other bone structures. Biopsy of the affected region, microscopic and immunohistochemical analysis led to diagnosis of Langerhans cell histiocytosis.Conclusion. Langerhans cell histiocytosis mostly occurs in the first three years of life. The incidence is 4-5 patients per million children under 15 years of life. The clinical presentation is highly variable, and can range from isolated, self-healing skin and bone lesions to life-threatening multisystem diseases. Due to the diverse clinical picture, that is often unrecognized, these patients are often referred to other specialists, resulting in the treatment of individual symptoms rather than the underlying disease.
Background: MRI techniques of the lumbar spine have not provided data on the effect of gravity on the spine and on the relationship of anatomic structures during its action. Because conventional MRI ...examinations of the spine are usually performed in the supine position these are often exacerbated by standing upright and are not evident in the supine position the loading conditions differ from those known to cause symptoms in patients with lumbar instability. Axial loading imaging may improve diagnostics in the clinical management of LBP and lead to appropriate treatment decisions. Objective: The aim of this study is to determine the significance of alMRI in detecting the morphologic changes of the lumbar spine caused by axial loading and to compare it with conventional MRI images of the lumbar spine without loading. Methods: The study was conducted as a prospective, descriptive clinical trial. Imaging was performed with a MRI 1.5 T in the head-first supine position. Imaging was performed in two acts: without load and under load. Loading for alMRI was performed with the DynaWell L-Spine device. The onset of loading was 10 minutes before the start of alMRI. The loading continued throughout the imaging procedure. The height of the IV, AP and LL diameters of IV, IV disk surface area, DSCA and width of the IV foraminas before and under load was measured. Results: After evaluating the changes in the height and size of the lumbar disks, the size of the DSCA, and the narrowing of the intervertebral foramina significant differences were found between the images before and after axial loading. Conclusion alMRI provides information on morphological changes of all segments of the lumbar spine. This data represents significant information that can lead to more accurate and effective treatment of LBP.
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