resonancia magnética
Enfermedad de Creutzfeldt-Jakob. Creutzfeldt-Jakob disease
Palabras clave: (DeCS),
demencia,
difusión,
Enfermedad de Creutzfeldt-Jakob,
enfermedad priónica,
resonancia magnética,
Trombosis Venosa Cerebral: Consideraciones Actuales. Brain Venous Thrombosis: Current Considerations
Introduction: Cerebral venous thrombosis (CVT) is an uncommon cause of cerebrovascular disease that mainly affects children and young adults, mostly in fertile-age-women.
Objectives: A contemporary review of the epidemiological, anatomical, pathophysiological, diagnostic and treatment characteristics of CVT.
Materials and methods: A bibliographic research was performed in the PubMed / MEDLINE database and including studies published in the period 2015-2020.
Development: The estimated-annual-incidence has been increasing in last years. Its diagnosis is established by clinical studies and neuroimaging, and laboratory studies. Although, the diagnosis is generally late due to a highly variable and nonspecific clinical presentation. Treatment target is preventing potential mortal complications, followed by anticoagulant therapy. In some cases, surgical thrombolytic procedures are indicated.
Conclusions: The diagnosis is based on a combination of MRI or CT studies. The current gold-standard treatment is low molecular weight heparin and warfarin.
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Palabras clave: resonancia magnética,
tomografía computarizada,
trombosis cerebral,
Trombosis venosa,
Coeficiente de Difusión Aparente en Tejido Encefálico: Valores de Normalidad en Población Colombiana Clínicamente Sana. Apparent Diffusion Coefficient In Brain Tissue: Values Of Normality In Clinically Healthy Colombian Population
Introduction: The diffusion sequences in magnetic resonance, including the apparent diffusion coefficient (ADC), represent a fundamental tool for the radiologist in the clinical diagnosis. However, there is no standardization for measurements between normal limits or a range of normal ADC values. Objective: To determine normal ADC values in the brain tissue for the clinical and radiologically healthy population. Methods: Cross-sectional study on retrospective data, ADC values were measured for 21 encephalic regions (frontal gray, parietal and temporal substance, frontal and parietal white matter, caudate nucleus, putamen, thalamus, internal capsule, cerebellar hemispheres bilaterally and bridge of the brainstem) in 90 clinically and radiologically healthy subjects, in two private clinics in Bogotá. Results: Normal ADC values, in a clinical and radiologically healthy population, in 21 encephalic territories, comparative analysis of the results according to the sex and age of the patients, and correlation between the measurements made by two researchers. Conclusions: The findings serve as a reference for the Colombian and normal Latin American population, establish a point of comparison for the evaluation of intracranial pathologies, and open the possibility to develop new research projects that seek to determine ADC values in sick population.
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Meningitis Criptocócica. Diferentes Contextos Clínicos y Complicaciones. Serie de 7 Casos. Cryptococal Meningitis. Different Clinical Context And Complications. Seven Cases.
Introduction. Cryptococcal meningitis (CM) is a serious infection of the Central Nervous System. The diagnosis and treatment of these patients is often complex, due to the severity of the clinical manifestations and their complications. The aim of this study is to describe the different clinical contexts, the neuroradiological characteristics and the complications of patients with CM.
Patients. We performed a retrospective review of clinical and radiological factors of 7 patient’s diagnosis and treated with CM during the period October 2016 and September 2017, at the Eugenio Espejo Hospital.
Results. Male sex was predominant (6/7), with an average age of 31.6 years (Range 19-44). The average time for the diagnosis was 8.1 weeks. Immunosuppression causes were evidenced in 5 patients, two HIV positive, one case with Acute Lymphoblastic Leukemia, CD4 idiopathic lymphopenia and Primary Intestinal Linfagectasia respectively. Three patients developed complications as disseminated cryptococcosis, visual acuity and hearing loss, mortality rate reach 26.8% of patients. Hypoglycorrhachia was a relevant feature with average 12.7mmg / dl. In MRI, the most common lesion was dilatation of Virchow Robins spaces (5/7), followed by ischemic lesions.
Conclusions. CM is characterized for high morbidity and mortality, initial symptoms may be nonspecific and delays the diagnosis as well as initiation of antifungal agents. Several predisposing immunosuppressive conditions can be found and sometimes a diagnostic challenge.
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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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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.
