Cases reported "Brain Edema"

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1/57. Presumed Eales' disease with neurologic involvement: report of three cases.

    PURPOSE: To report three cases of presumed Eales' disease with neurologic lesions. methods: case reports, systemic and neurologic evaluation, and magnetic resonance imaging. RESULTS: All three patients were young men who had seizures in the past; two had migrainous headache. magnetic resonance imaging showed putaminal infarct in two cases and edema in the white matter of temporal cortex was noticed in one case. Clinical features in all these patients were suggestive of Eales' disease. CONCLUSION: Ischemic infarction of the brain can be seen in clinically suspected cases of Eales' disease.
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2/57. Ictal deafness--a report of three cases.

    Though negative phenomena like motor inhibition, blindness or aphasia are described as an ictal manifestation of seizures, ictal deafness has not been reported so far. We observed transient ictal deafness in three cases of partial seizures. One of them had seizure spread to the temporal lobe to produce a complex partial seizure. Two of them have CT-detected lesions in the left temporal/parietal area. The other one had left temporal focus on EEG with a normal imaging study. The mechanism of such ictal negative phenomena is unclear. An epileptic focus around the primary auditory cortex, dampening its receptive ability may manifest as cortical deafness.
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3/57. Acute cortical blindness complicating pre-eclampsia.

    Cortical blindness in pre-eclampsia due petechial hemorrhages, ischemia, focal edema and infarction of the occipital cortex, is mostly reversible.
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4/57. diffusion-weighted imaging abnormalities in wernicke encephalopathy: reversible cytotoxic edema?

    BACKGROUND: wernicke encephalopathy (WE) is a metabolic disorder of the central nervous system resulting from vitamin B(1) deficiency. The exact mechanisms underlying the pathogenesis of the lesions in WE are not completely understood. Vitamin B1 deficiency is associated with intracellular and extracellular edema by glutamate(N-methyl-D-aspartate) receptor-mediated excitotoxicity. Conventional magnetic resonance imaging (MRI) cannot differentiate the types of edema. diffusion-weighted imaging (DWI) has been reported to detect early ischemic damage (cytotoxic edema) as bright areas of high signal intensity (SI) and vasogenic edema as areas of heterogeneous SI. OBJECTIVES: To describe the DWI findings and to characterize the types of edema in WE using DWI. SETTING: Tertiary referral center. DESIGN AND methods: Two patients with WE underwent DWI and conventional MRI with gadolinium enhancement. wernicke encephalopathy was diagnosed with salient conventional MRI findings (high SIs in the paramedian thalamus, periaqueductal gray matter, and mamillary bodies) and typical clinical history and symptoms. Apparent diffusion coefficient (ADC) values were measured in abnormal lesions by visual inspection of DWIs and T2-weighted echo planar images. RESULTS: T2-weighted and fluid-attenuated inversion recovery MRIs showed high SIs in the bilateral paramedian thalamus, mamillary bodies, and periaqueductal gray matter. The DWIs showed bright high SI in the corresponding lesions, and ADC values were decreased (patient 1: 512-545 x 10(-6)mm2/s; patient 2: 576-612 x 10(-6)mm2/s). The ADC decrease and the DWI high SI were normalized in 2 weeks with administration of thiamine hydrochloride. CONCLUSIONS: Abnormalities on DWI and ADC decrease became normalized with adequate therapy. The MRI abnormalities in WE might be owing to the "reversible cytotoxic edema" caused by vitamin B1 deficiency.
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ranking = 0.059652323749958
keywords = visual
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5/57. MR imaging of acute intermittent porphyria mimicking reversible posterior leukoencephalopathy syndrome.

    Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP.
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ranking = 1.05965232375
keywords = cortex, visual
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6/57. glycogen-rich and glycogen-depleted astrocytes in the oedematous human cerebral cortex associated with brain trauma, tumours and congenital malformations: an electron microscopy study.

    PRIMARY OBJECTIVE: The anaerobic mobilization of astrocyte glycogen in anoxic-ischemic regions of the oedematous human cerebral cortex is analysed. methods and PROCEDURES: Seventeen cortical biopsies of patients with brain trauma, brain tumours and congenital malformations were examined by conventional transmission electron microscopy. RESULTS: glycogen-rich and glycogen-depleted, clear or dense astrocytes cell bodies were observed in anoxic ischaemic regions of different brain cortical areas in perineuronal, neuropilar and perivascular localization. glycogen-rich astrocytes showed clear or moderately dense cytoplasm and accumulation of both beta-type or monogranular glycogen granules and alpha-type or multigranular glycogen particles. Focal regions of translucent cytoplasm were observed in areas of glycogen degradation. glycogen-depleted astrocytes exhibited a clear cytoplasm and scarce amount or absence of beta-type glycogen granules. Coexisting glycogen-rich and glycogen-depleted neuropilar astrocytic processes were observed in the vicinity of degenerated myelinated axons and degenerated axodendritic contacts. glycogen-rich and glycogen-depleted perivascular astrocytic processes were also found surrounding injured and collapsed cerebral capillaries. CONCLUSION: The findings suggest astrocytic glycogen mobilization during anoxic and ischaemic conditions, revealing the important contribution of astrocytes on neuronal survival under conditions of energy substrate limitations.
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keywords = cortex
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7/57. Sequential changes of brain CT and MRI after febrile status epilepticus in a 6-year-old girl.

    Brain CT or MRI occasionally shows transient or permanent changes in the brain after status epilepticus (SE). The mechanism for these changes has not been well elucidated. We performed repeated imaging studies on a patient with febrile SE characterized by right hemiconvulsion. CT showed transient mild edema on both hemispheres immediately after the cessation of SE. The edema improved the next day. But aphasia and right hemiparesis were observed. On day 17, CT revealed edema on left hemisphere and MRI showed a high signal intensity in cortex and subcortical white matter of the left hemisphere on T2-weighted images. Although right hemiparesis and aphasia were improved, severe atrophy of the left hemisphere was noted on CT and MRI. The results suggest that brain edema observed in several days after SE but not edema observed immediately after the cessation of SE is more pathological for the permanent brain damage. Possible mechanisms of the initial brain edema and the second edema preceded severe atrophy in left hemisphere were discussed.
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keywords = cortex
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8/57. A light and electron microscopic study of oedematous human cerebral cortex in two patients with post-traumatic seizures.

    PRIMARY OBJECTIVE: Brain cortical biopsies of two patients with clinical diagnosis of complicated brain trauma who had seizures, were studied by means of light and electron microscopes in order to correlate structural alterations with seizure activity. methods AND PROCEDURES: biopsy samples of left frontal cortex and right parietal cortex were processed by current techniques for light and transmission electron microscopy. RESULTS: The tissue showed severe vasogenic oedema with perivascular and intraparenchymatous haemorrhages. At the capillary wall, increased vesicular and vacuolar transendothelial transport, open endothelial junctions, thickened basement membrane and swollen perivascular astrocytic end-feet were observed. Some pyramidal and non-pyramidal nerve cells appeared dense and shrunken and others exhibited marked intraneuronal enlargement of membrane compartment. The myelinated axons displayed signs of degeneration and a process of axonal sprouting. Numerous swollen asymmetrical axo-dendritic synaptic contacts were observed in the neuropil, which exhibited mostly closely aggregated spheroidal synaptic vesicles toward the presynaptic membrane and numerous exocytotic vesicles sites. The perisynaptic astrocytic ensheathment appeared retracted or absent, whereas the extracellular space appeared notably dilated. Synaptic disassembly was also observed. CONCLUSION: The findings demonstrate, in two patients with post-traumatic seizure activity, brain barrier dysfunction, vasogenic oedema, anoxic-ischaemic neurons, axonal sprouting, numerous altered excitatory synapses and synaptic disassembly. Some considerations on clinical and research applications are discussed.
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keywords = cortex
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9/57. Edema of the cortical gray matter of the human cerebrum.

    Five cases of brain tumor are reported in which an extracellular edema of the cerebral cortex was recognized in the form of lakes of eosinophilic, PAS positive material, presumably serum proteins, permeating among the neuronal and glial cells and processes. In three, the astrocytes and their processes were stained in replicate paraffin sections by a gold sublimate technique. The astrocytic changes were variable. Most often, the astrocytes changed from protoplasmic to fibrillary, with long deeply stained processes, the cells sometimes becoming large and distorted. Many became enlarged and smudgy, with short stubby processes. Only a few showed the fragmentation and disintegration of processes. Only a few showed the fragmentation and disintegration of processes which are regularly observed in edematous white matter. The neuronal processes remained essentially normal. In comparison with edema of white matter, edema of the cortex is rare, involves only small portions of tissue, and differs in its effects on astrocytes. The edema in both cortex and white matter is extracellular. We have not been able to recognize a specific intracellular form of edema, grossly or with light microscopic techniques.
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keywords = cortex
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10/57. Unexplained drowsiness and progressive visual loss: methanol poisoning diagnosed at autopsy.

    A patient was admitted to the emergency department with a reduced level of consciousness and deteriorating vision. Her pupils became fixed and dilated and she developed a third nerve palsy with extensor posturing of her limbs. biochemistry profile showed an increased serum osmolar gap with a raised anion gap metabolic acidosis. Supportive treatment was instituted, but she made no recovery and brainstem death was later confirmed. Post mortem examination and toxicology screen confirmed the cause of death as methanol poisoning leading to cerebral oedema and transtentorial herniation. We highlight some of the diagnostic difficulties associated with treating a patient with a reduced level of consciousness. The clinical and biochemical findings that are critical in establishing a diagnosis of methanol intoxication are discussed. The definitive management of methanol poisoning is reviewed.
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ranking = 0.23860929499983
keywords = visual
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