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brain drain

Matthieu Delion, Mickael Dinomais, Philippe Mercier
Surgery of the posterior fossa represents a technical challenge because of the proximity of the vessels of the cerebellum. If the arterial vascularization of the cerebellum is well known, the main arterial variations and the whole venous vascularization are probably under recognized. We describe the vascular organization and the main variations through photographs of colored latex perfused brains, obtained with a surgical microscope. The arterial vascularization of the cerebellum is based on three arteries which all originate from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior and inferior cerebellar artery (AICA), and the posterior and inferior cerebellar artery (PICA)...
October 20, 2016: Cerebellum
Tilman Schubert, Yijing Wu, Kevin M Johnson, Oliver Wieben, Jane Maksimovic, Charles Mistretta, Patrick Turski
OBJECTIVES: Time-of-arrival (TOA) maps can be derived from high-resolution 4-dimensional (4D) contrast-enhanced magnetic resonance angiography (MRA) data sets to provide a quantitative description of contrast material arrival time in each voxel. This information can further be processed to create a compressed time evolution curve that virtually shortens the contrast bolus (virtual bolus [VB]). The purpose of this project was to determine whether TOA-enhanced 4D MRA and/or VB imaging improve the display of contrast kinetics in patients with vascular disease...
November 2016: Investigative Radiology
Louise Dunphy, Prashanth Shetty, Rabinder Randhawa, Kharil Amir Rani, Yaw Duodu
A 39-year-old man, born in India but resident in the UK for 10 years, was travelling in America when he became feverish with an altered mentation. He reported a 10-day history of fever, photophobia, headache and fatigue. His medical history included hypothyroidism and migraine. He was a non-smoker, did not consume alcohol and denied a history of drug use. He was transferred to the emergency department. Laboratory investigations confirmed hyponatraemia (sodium 128 mmol/L). A chest radiograph confirmed no focal consolidation...
October 7, 2016: BMJ Case Reports
Morgane Choquet, Emilie Pluquet, Sandrine Castelain, Raphaël Guihéneuf, Véronique Decroix
BACKGROUND: Aggregatibacter aphrophilus, a commensal of the oro-pharyngeal flora and member of the HACEK group of organisms, is an uncommonly encountered clinical pathogen. It has already been described as the causative agent of brain abscesses, empyema, meningitis, sinusitis, otitis media, bacteriemia, pneumonia, osteomyelitis, peritonitis, endocarditis and wound infections. Herein we report the first case of bartholinitis due to A. aphrophilus. CASE PRESENTATION: A 33-year-old woman was admitted for a 3-day genital pain without fever and urinary functional signs...
October 18, 2016: BMC Infectious Diseases
Zhengzhen Chen, Huihuang Qiao, Yu Guo, Jiance Li, Huizhong Miao, Caiyun Wen, Xindong Wen, Xiaofen Zhang, Xindong Yang, Chengchun Chen
BACKGROUND AND PURPOSE: Understanding the anatomy of the anterior septal vein (ASV) is critical for minimally invasive procedures to the third ventricle and for assessing lesion size and venous drainage in the anterior cranial fossa. Accordingly, this study evaluated topographic anatomy and anatomic variation of the ASV using susceptibility-weighted imaging (SWI). METHODS: Sixty volunteers were examined using a 3.0T MR system. The diameter of the ASV and distance between bilateral septal points were measured...
2016: PloS One
Li-Xia Zhou, Su-Zhen Dong, Ming-Feng Zhang
PURPOSE: To present three fetal vein of Galen aneurysmal malformations (VGAMs), which were diagnosed through magnetic resonance imaging (MRI), and highlight these cardiovascular findings. MATERIALS AND METHODS: We retrospectively reviewed three fetuses with VGAM at 31, 32, and 33 weeks of gestation. Feeding arteries and draining veins were observed by MRI. Secondary changes in the brain and high-output heart failure caused by high blood flow in the lesion were evaluated...
September 30, 2016: Journal of Magnetic Resonance Imaging: JMRI
Rodrigo Hasbun
Nosocomial meningitis can occur in association with central nervous system (CNS) devices such as cerebrospinal shunts or drains, intrathecal pumps, and deep brain stimulators and carry substantial morbidity and mortality. Diagnosing and treating these infections may be challenging to physicians as cerebrospinal fluid cultures may be negative due to previous antibiotic therapy and cerebrospinal abnormalities may be secondary to the primary neurosurgical issue that prompted the placement of the CNS device (e...
November 2016: Current Infectious Disease Reports
Dattaraj Paramanand Sawarkar, Satish Varma, Pankaj Kumar Singh, Ramesh Doddamani, Amandeep Jagdevan, Bhawani Shanker Sharma
INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a rare condition with the potential to cause severe morbidity and mortality. CVST can also occur after vestibular schwannoma (VS) surgery with the thrombosis of transverse and sigmoid sinus. However, there is not a single report of superior sagittal sinus (SSS) thrombosis after VS surgery reported in the literature. CASE REPORT: A 45-year-old lady presented to our centre with large left sided solid cystic VS...
September 26, 2016: World Neurosurgery
Joana Chaves Gonçalves Rodrigues de Carvalho, Francisco Javier Tercero Machin, Luis San Roman Manzanera, Jordi Blasco Andaluz, Sílvia Herrero Nogués, Núria Peix Soriano, Victor Obach Baurier, Enrique Jesus Carrero Cardenal
BACKGROUND AND OBJECTIVES: Dural arteriovenous fistulas are anomalous shunts between dural arterial and venous channels whose nidus is located between the dural leaflets. For those circumstances when invasive treatment is mandatory, endovascular techniques have grown to become the mainstay of practice, choice attributable to their reported safety and effectiveness. We describe the unique and rare case of a dural arteriovenous fistula treated by transarterial embolization and complicated by an intraventricular hemorrhage...
September 24, 2016: Revista Brasileira de Anestesiologia
Mariem Rekik, Khaoula Achour, Anouer Abdallah, Sonia Lebib, Imen Miri, Fatima Zahra Ben Salah, Catherine Dziri
OBJECTIVE: The aim of our study was to assess the bladder and sphincter function after brain injury (BI) and to review their association with quality of life (QOL). MATERIAL/PATIENTS AND METHODS: We conducted a cross-sectional study, including patients referred to physical and rehabilitation medicine department at the Med Kassab Institute of Orthopedics. The initial gravity data were collected. The bladder-sphincter assessment included evaluation of the urine drain mode, the irritative disorders, obstructive disorders, disorders of transit and the existence of secondary anal lesions...
September 2016: Annals of Physical and Rehabilitation Medicine
X Y Yeoh, P S Lim, K C Pua
Intracranial complications of chronic otitis media have been on the decline with advent of antibiotics. Septic thrombosis of the sigmoid sinus is rarer compared to commoner complications such as otogenic brain abscesses and meningitis. This patient presented with recurrent infection after left mastoidectomy secondary to cholesteatoma and a contralateral internal jugular vein thrombosis with parapharyngeal abscess, which was drained. He recovered well postoperatively with antibiotics.
2016: Case Reports in Otolaryngology
Christine Bollwein, Annika Plate, Wieland H Sommer, Kolja M Thierfelder, Hendrik Janssen, Maximilian F Reiser, Andreas Straube, Louisa von Baumgarten
INTRODUCTION: Although the diagnostic performance of whole-brain computed tomographic perfusion (WB-CTP) in the detection of supratentorial infarctions is well established, its value in the detection of infratentorial strokes remains less well defined. We examined its diagnostic accuracy in the detection of infratentorial infarctions and compared it to nonenhanced computed tomography (NECT), aiming to identify factors influencing its detection rate. METHODS: Out of a cohort of 1380 patients who underwent WB-CTP due to suspected stroke, we retrospectively included all patients with MRI-confirmed infratentorial strokes and compared it to control patients without infratentorial strokes...
September 20, 2016: Neuroradiology
Rashmi Mishra, Pavithra Reddy, Misbahuddin Khaja
Cerebral air embolism (CAE) is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT) scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful...
2016: Case Reports in Critical Care
Melanie Lohrberg, Jörg Wilting
Histological studies of the lymphatic vascular system in adult mice are hampered because bones cannot be sectioned properly. Here, we decalcified the heads of 14-day-old mice, embedded them in paraffin and stained resultant serial sections with the lymphendothelial-specific antibodies Lyve-1 and Podoplanin. We show that the tissues with the highest lymphatic vascular density are the dermis and the oral mucous membranes. In contrast, the nasal mucous membrane is devoid of lymphatics, except for its most basal parts below the vomeronasal organ...
September 6, 2016: Cell and Tissue Research
Alessandro Capitanini, Luca Rosso, Laura Giannecchini, Ophelia Meniconi, Adamasco Cupisti
A 47-year old, Caucasian man underwent extracorporeal shock wave lithotripsy (ESWL) of a 14mm calcium stone in the right renal pelvis, without urinary tract obstruction or sepsis. 24 hours after ESWL septic shock occurred and the patient was admitted to the Intensive Care Unit (ICU). Escherichia coli emerged from the blood and urine culture. The patient developed acute renal failure and it was necessary to start a continuous renal replacement therapy (CRRT). Infection was successfully treated, patient recovered renal function and an improvement of general condition occurred...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Sierra M Farris, Monique L Giroux
BACKGROUND: Describe a rapid assessment for patients with idiopathic Parkinson's disease (PD) and deep brain stimulation of the subthalamic nucleus reporting worsening speech and/or gait problems. METHODS: We retrospectively reviewed 29 patients that had improvement in gait and/or speech within 30 min after turning stimulation off. Clinical data analyzed include unified PD rating scale motor scores and stimulation parameters before and after adjusting stimulation...
2016: Surgical Neurology International
Joo Whan Kim, Hyun-Tai Chung, Moon Hee Han, Dong Gyu Kim, Sun Ha Paek
Brain edema due to venous thrombosis following stereotactic radiosurgery for a cerebral arteriovenous malformation (AVM) has rarely been reported. We report a patient with a large AVM in the eloquent area, and brain edema developed in this area after repeat Gamma knife stereotactic radiosurgery (GKRS). An 18-year-old female presented with a 4-year-history of persistent headache. Magnetic resonance imaging and transfemoral carotid angiogram revealed a high-flow large AVM in the left parieto-occipital area. Brain edema developed and aggravated patient's symptoms after time-staged GKRS...
August 2016: Experimental Neurobiology
Satoru Tanioka, Yu Sato, Mai Nampei, Kazuhiko Tsuda, Shigehiko Niwa, Hidenori Suzuki
BACKGROUND: Cavernous sinus (CS) dural arteriovenous fistula (DAVF) rarely causes intracranial hemorrhage. The authors describe a case of CS DAVF presenting with intracranial hemorrhage, focusing on the findings in digital subtraction angiography (DSA) performed before and after the onset. CASE DESCRIPTION: An 80-year-old woman, diagnosed as Borden type 3 CS DAVF on DSA 2 years before, presented with subarachnoid hemorrhage and right temporal subcortical hemorrhage...
August 24, 2016: World Neurosurgery
Nazli Hossain, Nusrat Shah, Tahira Shah, Sidra Binte Lateef
OBJECTIVE: To study the perceptions of medical students about factors responsible for physicians'migration. STUDY DESIGN: Cross-sectional survey. PLACE AND DURATION OF STUDY: Dow Medical College and Civil Hospital, Karachi, from April to May 2015. METHODOLOGY: Aself-administered structured questionnaire was used including demographic details, attitudes about push and pull factors of migration, and reasons for migrating or not migrating abroad...
August 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Britta Engelhardt, Roxana O Carare, Ingo Bechmann, Alexander Flügel, Jon D Laman, Roy O Weller
Immune privilege of the central nervous system (CNS) has been ascribed to the presence of a blood-brain barrier and the lack of lymphatic vessels within the CNS parenchyma. However, immune reactions occur within the CNS and it is clear that the CNS has a unique relationship with the immune system. Recent developments in high-resolution imaging techniques have prompted a reassessment of the relationships between the CNS and the immune system. This review will take these developments into account in describing our present understanding of the anatomical connections of the CNS fluid drainage pathways towards regional lymph nodes and our current concept of immune cell trafficking into the CNS during immunosurveillance and neuroinflammation...
September 2016: Acta Neuropathologica
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