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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 42 (2000), S. 795-802 
    ISSN: 1432-1920
    Keywords: Key words Corpus callosum ; Ischaemia ; Demyelination ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI has facilitated diagnostic assessment of the corpus callosum. Diagnostic classification of solitary or multiple lesions of the corpus callosum has not attracted much attention, although signal abnormalities are not uncommon. Our aim was to identify characteristic imaging features of lesions frequently encountered in practice. We reviewed the case histories of 59 patients with lesions shown on MRI. The nature of the lesions was based on clinical features and/or long term follow-up (ischaemic 20, Virchow-Robin spaces 3, diffuse axonal injury 7, multiple sclerosis 11, hydrocephalus 5, acute disseminated encephalomyelitis 5, Marchiafava-Bignami disease 4, lymphoma 2, glioblastoma hamartoma each 1). The location in the sagittal plane, the relationship to the borders of the corpus callosum and midline and the size were documented. The 20 ischaemic lesions were asymmetrical but adjacent to the midline; the latter was involved in new or large lesions. Diffuse axonal injury commonly resulted in large lesions, which tended to be asymmetrical; the midline and borders of the corpus callosum were always involved. Lesions in MS were small, at the lower border of the corpus callosum next to the septum pellucidum, and crossed the midline asymmetrically. Acute disseminated encephalomyelitis and the other perivenous inflammatory diseases caused relatively large, asymmetrical lesions. Hydrocephalus resulted in lesions of the upper part of the corpus callosum, and mostly in its posterior two thirds; they were found in the midline. Lesions in Marchiafava-Bignami disease were large, often symmetrically in the midline in the splenium and did not reach the edge of the corpus callosum.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Keywords: Accuracy central sulcus; cortical mapping; frameless neuronavigation; image guided surgery.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. The purpose of this prospective study was to localize the central sulcus by frameless neuronavigation and to project this anatomical structure to the outside of the skull on the skin. This method was analyzed in respect to its practicability, accuracy, and potential applications.  Method. In 27 patients investigated (28 unaffected hemispheres), the central sulcus was virtually projected to the outside of the skull using frameless neuronavigation and a virtual pointer elongation of 15 or 20 mm. The following parameters were measured on the scalp: 1. the distance between the bregma and the midline junction of the central sulcus, and 2. the angle between the central sulcus and the midline. These dada were compared with measurements based on the original axial MR images of these patients. Finally, a laboratory phantom study was designed in analogy to a patient's examination for estimation of the overall accuracy of the neuronavigation system in the experimental setup used in this study.  Findings. Virtual pointer projection of the central sulcus to the outside of the skull using frameless neuronavigation was found to be easily possible. The distance between the bregma and the midline junction of the central sulcus amounted to a mean of 55 mm on the left and 56 mm on the right. The angle between the central sulcus and the midline reached a mean of 63° on the left and 60° on the right. These data confirmed results of other studies with no frameless neuronavigation devices. The phantom study revealed a mean overall inaccuracy of 0.9 mm at a virtual pointer elongation of 15 mm. At a virtual pointer elongation of 20 mm, the mean overall inaccuracy of our study was 1.1 mm. These results correspond to the inaccuracy of frame based stereotaxy.  Interpretation. It is easily possible, valid, and reliable to virtually project the central sulcus to the outside of the skull with an acceptably low inaccuracy using frameless neuronavigation. This is important for research studies that correlate and integrate different functional imaging methods with the aid of frameless neuronavigation.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0942-0940
    Keywords: Keywords: Spinal haematoma; MRI; spontaneous; subdural; acute haemorrhage.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. The diagnosis of spontaneous spinal haematomas mainly depends on magnetic resonance imaging. This study evaluates the MRI characteristics of spinal epidural and subdural haematomas. The results were correlated with medical history, coagulation abnormalities and therapeutic outcome to provide guidelines for early diagnosis and treatment of spinal epidural and subdural hematomas.  Summary of Background Data. Imaging signs of epidural and subdural haematomas have been reported before, however without special attention to the differential-diagnostic and therapeutic implications of haematoma localisation.  Method. Seven patients (3 women, 4 men, age range 55–86 years) with acute progressive neurological deficits and without a history of severe trauma were studied. In all cases neurological examinations were performed after admission followed by MRI studies with T2 and T1 weighted images, before and after administration of contrast agent. Spinal angiography was performed twice to exclude a vascular malformation. All patients underwent open surgery.  Findings. Acute and subacute hematomas were detected once in the cervical spine, in five cases in the thoracic region and once in the lumbar region. The hematomas had an epidural location in three cases and a subdural in four. In the thoracic region subdural haemorrhage was much more common than epidural hematomas. Subdural blood collections were mainly found ventral to the spinal cord. Epidural haemorrhage was always located dorsal to the spinal cord. The evaluation of the haematoma localisation may be difficult occasionally, but delineation of the dura is frequently possible in good quality MRI. The clue to the diagnosis of ventrally located subdural haemorrhage is the absence of the “curtain sign”, which is typical for epidural tumours.  Interpretation. Spontaneous spinal hematomas are frequently located in the thoracic spine. Subdural spinal haemorrhage is more frequent than epidural. Epidural haemorrhage is frequently located dorsal to the spinal cord because of the tight fixation of the dura to the vertebral bodies.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 0942-0940
    Keywords: Keywords: Neurological outcome; spontaneous spinal epidural haematoma; non-spontaneous spinal epidural haematoma; surgical timing; spinal cord compression.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. This retrospective study evaluated the neurological outcome of 26 patients with spontaneous and non-spontaneous spinal epidural haematoma (SEH) who underwent microsurgical clot removal. It was the objective of the present study to investigate whether the aetiology of the SEH has an influence on the neurological outcome.  Methods. The medical records and radiological investigations of 26 patients with SEH were re-examined, and the latency between symptom onset and operation, and the size of the haematoma were determined. Motor and sensory function had been evaluated before surgery and 90 days after discharge.  Findings. Fourteen patients with non-spontaneous SEH and 12 patients with spontaneous SEH were identified. After surgery, neurological deficits improved in 9 of the patients with spontaneous (75%) and in 13 of the patients with non-spontaneous SEH (93%). In cases of spontaneous SEH, the median latency between symptom onset and operation was longer (72 hrs vs 7 hrs) and the median extent of the haematoma was larger (3.5 vs 2 spinal segments), than in the non-spontaneous cases.  Interpretation. Neurological outcome seems to be related to the aetiology of the SEH. Better outcome was observed in patients with surgically treated non-spontaneous SEH. Two explanations for this finding are worth considering. First, patients with non-spontaneous SEH usually are already under medical surveillance and can undergo medullary decompression more rapidly. Second, the compression of the spinal cord is possibly less severe in non-spontaneous SEH because of their smaller size.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 10 (2000), S. 945-950 
    ISSN: 1432-1084
    Keywords: Key words: Capillary telangiectasia – Brain stem – MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Capillary telangiectasia is a vascular abnormality primarily of the brainstem. The clinical relevance is unclear as is the association with clearly pathologic findings such as cavernous haemangioma. We report on four cases with capillary telangiectasia proven by follow-up und describe the imaging characteristics. T2 abnormality was only observed in half of the patients as was the presence of a discernable collecting vein. Whereas two cases were incidental findings in neurologically normal persons and one had symptoms clearly attributable to lacunar stroke, one patient may have had symptoms due to the vascular abnormality in the pons.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 247 (2000), S. 465-466 
    ISSN: 1432-1459
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Dissektion ; Hirnnervenausfall ; Raeder-Syndrom ; Collet-Siccard-Syndrom ; Key words Dissection ; Cranial nerve deficiency ; Raeder's syndrome ; Collet-Sicard syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Acute cerebral nerve paresis can be caused in many different ways. One of the more rare causes of paresis of one or more neural pathways is dissection of the internal carotid artery. Early diagnosis is important, even with atypical symptoms, since prompt anticoagulative therapy can hinder stroke from embolism due to the dissection. We report on two patients with Raeder's syndrome and Collet-Sicard syndrome resulting from dissection of the internal carotid artery. Besides the cranial and caudal nerves involved in our study, loss of function has also been reported with the sixth to eighth cranial nerves, so that any painful, sudden cranial nerve deficiency can indicate possible carotid dissection
    Notes: Zusammenfassung Akute Hirnnervenparesen können eine Vielzahl von Ursachen haben. Seltener Auslöser einer Parese eines oder multipler Hirnnerven ist eine Dissektion der A. carotis interna. Die frühzeitige Erkennung einer Karotisdissektion auch bei untypischer Symptomatik ist wichtig, da eine rechtzeitig begonnene antikoagulatorische Therapie einen Schlaganfall als Folge einer dissektionsbedingten Embolie verhindern kann. Wir berichten über 2 Patienten mit Läsionen der parakavernösen Hirnnerven (Raeder-Syndrom) sowie der kaudalen Hirnnerven (Collet-Siccard-Syndrom) als Folge einer Dissektion der A. carotis interna. Neben den in unseren Fällen beteiligten kranialen und kaudalen Hirnnerven sind auch Ausfälle der mittleren Hirnnerven (VI–VIII) beschrieben worden, so dass jeder schmerzhafte plötzliche Hirnnervenausfall auch an eine Karotisdissektion denken lassen muss.
    Type of Medium: Electronic Resource
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