magnetic resonance imaging
Enfermedad de Creutzfeldt-Jakob. Creutzfeldt-Jakob disease
Palabras clave: (DeCS),
demencia,
difusión,
Enfermedad de Creutzfeldt-Jakob,
enfermedad priónica,
resonancia magnética,
Puntaje Global de Potenciales Evocados Multimodales Sensoriales en el Estudio de Pacientes Con Esclerosis Múltiple. Global Score Of Sensory Multimodal Evoked Potentials In The Study Of Patients With Multiple Sclerosis.
Introduction: Multiple sclerosis (MS) is a demyelinating, inflammatory and degenerative disease of the central nervous system. Multimodal sensory evoked potentials (MSEP) have been used to evaluate the integrity of sensory pathways but have not been globally considered as a tool to MS diagnose.
Objective: to evaluate the relationship between the global score of MSEP with the degree of disability and the presence of structural lesions in MS patients.
Methods: Thirty-five patients with relapsing-remitting MS were studied in the International Center for Neurological Restoration. The score of the MSEP was correlated to the disability scale of Kurtzke and the degree of lesions evidenced in magnetic resonance images.
Results: A significant correlation was found between the global score and disability scale (R=0.33, p<0.05) and between the global score and the number of lesion levels detected in the resonance images (R=0.42, p< 0.05).
Conclusion: The relationship between the global score of the MSEP and the structural lesions and degree of disability confirms its utility to study MS patients, even though they aren’t part of the diagnostic criteria.
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Factores Clínicos y Radiológicos Relacionados Con la Progresión de la Discapacidad en Esclerosis Múltiple. Clinical And Radiological Factors Related To The Progression Of Disability In Multiple Sclerosis
Multiple Sclerosis is a chronic demyelinating disease of the central nervous system, of unknown cause, of variable prognosis with high cost treatment. It may include sensory, motor, cognitive and behavioral alterations, as well as fatigue, pain, sexual and sphincter dysfunction, it represents a common cause of severe physical disability in young adults. Different factors that contribute to the progression of disability have been described. This work aims to describe clinical and radiological factors related to the progression of disability in patients with multiple sclerosis. A narrative review about clinical and radiological factors related to disability progression was made in PubMed, Embase, Science Direct, Scopus, and Lilacs data bases. We found 217 articles, after removing duplicates and systematic reviews, meta-analysis and clinical trials, 20 articles were left. Some factors such as vitamin D levels, general symptoms, brain atrophy, gray matter lesions, among others, are related to disability progression in multiple sclerosis. Magnetic resonance is the most important test for diagnosis and follow-up of the disease. The most appropriate way to assess the progression of disability includes clinical evaluation, magnetic resonance imaging, and other diagnostic tests.
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Palabras clave: Biomarcadores,
esclerosis múltiple,
Imagen por Resonancia Magnética,
Personas con Discapacidad,
Pronóstico,
Demencia Rápidamente Progresiva Como Manifestación de Recaída en Linfoma de Células Del Manto: Experiencia en Diagnóstico y Tratamiento. Rapidly Progressive Dementia As A Manifestation Of Relapse In Mantle Cell Lymphoma: Experience In Diagnosis And Treatment
Introduction: Rapidly progressive dementia is an entity that has a multiple and heterogeneous etiology. It is characterized by the alteration of two or more cognitive domains in a period of less than 1 to 2 years. The involvement of the central nervous system attributed to mantle cell lymphoma is rare with a poor prognosis and mainly debuts in the late stages of the disease as a relapse. Case Report: A 61-year-old male with a history of mantle cell lymphoma who presents a relapse of the central nervous system, given by a clinical course compatible with a rapidly progressive dementia and which is confirmed by flow cytometry studies in cerebrospinal fluid. It presents an adequate response to management with a tyrosine kinase inhibitor (Ibrutinib), resolving clinical symptoms and imaging findings. Discussion: The involvement of the central nervous system secondary to mantle cell lymphoma is a rare complication and debuts as a relapse with variable clinical manifestations that requires a timely intervention with the aim of improving patient survival. Therapy with a single agent such as Ibrutinib seems to be a good alternative in cases of refractoriness and neurological involvement.
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Palabras clave: demencia,
Imagen por Resonancia Magnética,
linfocitos B,
linfoma de células del manto,
Sub-estudio de Neuroimagen del Proyecto Atahualpa. Neuroimaging Substudy Of The Atahualpa Project
The Atahualpa Project includes a Neuroimaging sub-study, which consists in the practice of MRIs and MRAs to all participants aged ≥60 years, as well as those presenting with specific neurological complains. Likewise, all participants aged ≥20 years have been invited for the practice of a head CT. MRIs and MRAs have been performed with the use of a Philips Intera 1.5T MRI machine, and TCs with the use of a Philips Brilliance 64 CT scanner, following established protocols. All exams have been independently reviewed by a neurologist and a neuroradiologist, with adequate kappa coefficients for inter-rater agreement. MRIs studies have been focused on the evaluation of global cortical atrophy, posterior parietal atrophy, bicaudate index, Evans index, hippocampal atrophy, signatures of cerebral small vessel disease, and lesions consistent with ischemic or hemorrhagic strokes. By the use of MRI, we have assessed the prevalence of intracranial artery stenosis, intracranial dolichoectasia and variations in the configuration of the circle of Willis. Using CT, we have focused on the diagnosis of neurocysticercosis, pineal gland calcifications, as well as in variations and characteristics of skull bones, cerebellar atrophy, and severity of carotid siphon calcifications. In the present study, we focused on the description of basic protocols used for assessment of previously mentioned lesions of interest.
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Síndrome de Tolosa-Hunt: Hallazgos en Resonancia Magnética Cerebral antes y después del tratamiento con Terapia Corticoidal Sistémica.
Tolosa-Hunt syndrome is characterized by painful ophthalmoplegia due to a granulomatous inflammation in the cavernous sinus. Corticosteroid therapy dramatically resolves both clinical and radiological findings. We report a case of a patient 55 years old, initially managed as cavernous sinus thrombophlebitis, and by means of magnetic resonance imaging studies, was then diagnosed as Tolosa-Hunt syndrome. After receiving adequate therapy, clinical symptoms improved. We recommend serial magnetic resonance imaging studies when Tolosa-Hunt syndrome is suspected in order to differentiate it from other cavernous sinus lesions that can mimic it clinically and radiologically.
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Valor del Potencial Evocado Auditivo de Latencia Media en el estudio de personas con Esclerosis Múltiple Forma Brote–Remisión.
A prospective study was carried out to establish the utility of Auditory Middle Latency Response (AMLR) in the evaluation of patients with relapsing- remitting multiple sclerosis. Twenty subjects were evaluated with the multimodal battery of auditory, visual and somatosensory evoked potentials, AMLR, and motor evoked potential by transcraneal magnetic stimulation. The results showed the following abnormalities: 60 % in the AMLR, (only 50 % of them with clinical symptoms), 25% in the auditory brainstem response, 85 % in the visual response and 90 % in somatosensorial and motor potentials. We found significant differences between the auditory tests and the rest of the electrophysiological techniques (rate comparison, p<.05). Those differences disappeared when auditory tests were considered together. There was a significant association between anatomical and functional tests in the evaluation of the auditory pathway, and a positive correlation between the absolute latency of Na, Pa, and Pb components and the temporal course of the disease. The results suggest the convenience of including AMLR in the battery of evoked potentials for the study of relapsing- remitting multiple sclerosis patients.
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Quiste Aracnoideo de Presentación Ictal.
Arachnoid cysts are benign cystic cavities surrounded by membranes that are indistinguishable from the arachnoid membrane. They contain cerebrospinal fluid in contact with the subarachnoid space. They are frequently asymptomatic and incidentally diagnosed in the adult. Their clinical onset is variable and depends on their size and possible triggering factors. We report a case in which a big arachnoid cyst presented in an unusual way, not finding a background or any triggering factors that might justify this clinical presentation. It is necessary to perform a differential diagnosis from other common affections of sudden onset. Surgical treatment by cystoperitoneal shunting resulted in a complete resolution of symptoms.
