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  • 1
    Electronic Resource
    Electronic Resource
    Long echo time STIR sequence MRI of optic nerves in optic neuritis (1996)
    Springer
    Neuroradiology 38 (1996), S. 66-69 
    Details
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Optic neuritis ; Multiple sclerosis ; Visual evoked potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI of the optic nerves was obtained in 13 patients with acute optic neuritis and 13 with a previous optic neuritis (ON), assessed by clinical features, visual fields and visual evoked potentials. Results of the conventional short tau inversion recovery (STIR) sequence obtained with a short echo time (STE-STIR; 22 ms) were compared with those of a long echo time (LTE-STIR: 80 ms) sequence. The conventional STE-STIR sequence revealed lesions in the optic nerves in 78.5% of acute and 58.8% of previous ON. The LTE-STIR sequence showed abnormalities in 92.8% of acutely symptomatic nerves and 94.1% of nerves with previous ON. The optic nerve lesions appeared significantly longer with the LTE-STIR sequence than with the conventional STE-STIR sequences, in both acute and previous ON.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00593226
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  • 2
    Electronic Resource
    Electronic Resource
    Randomized placebo-controlled trial of mitoxantrone in relapsing-remitting multiple sclerosis: 24-month clinical and MRI outcome (1997)
    Springer
    Journal of neurology 244 (1997), S. 153-159 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Mitoxantrone ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We designed a randomized, placebo-controlled, multicentre trial involving 51 relapsing-remitting multiple sclerosis patients to determine the clinical efficacy of mitoxantrone treatment over 2 years. Patients were allocated either to the mitoxantrone group (27 patients receiving IV infusion of mitoxantrone every month for 1 year at the dosage of 8 mg/m2) or to the placebo group (24 patients, receiving IV infusion of saline every month for 1 year) using a centralized randomization system. Disability at entry and at 12–24 months was evaluated by four blinded neurologists trained in the application of the Kurtzke Expanded Disability Scale (EDSS). In addition, the number and clinical characteristics of the exacerbations over the 24 months were recorded by the local investigators. MRI, at 0,12 and 24 months, was performed with a 0.2 T permanent unit. MRI data were analysed by two blinded neuroradiologists. All patients underwent a clinical evaluation. A statistically significant difference in the mean number of exacerbations was observed between the mitoxantrone group and placebo group both during the 1st and the 2nd year. Although there was no statistically significant benefit in terms of mean EDSS progression over 2 years, the proportion of patients with confirmed progression of the disease, as measured by a one point increase on the EDSS scale, was significantly reduced at the 2nd year evaluation in the mitoxantrone group. Forty-two (23 mitoxantrone, 19 placebo) patients underwent all MRI examinations during the 24-month period. We observed a trend towards a reduction in the number of new lesions on T2-weighted images in the mitoxantrone group. Our study suggests that mitoxantrone might be effective in reducing disease activity, both by decreasing the mean number of exacerbations and by slowing the clinical progression sustained by most patients after 1 year from the end of treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050066
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  • 3
    Electronic Resource
    Electronic Resource
    Acute hemispheric stroke: Correlation between three-dimensional transcranial Doppler, MR-angiography, CT and clinical findings (1993)
    Springer
    Neurological sciences 14 (1993), S. 225-232 
    Details
    ISSN: 1590-3478
    Keywords: TCD-3D ; stroke ; MR angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Sono stati esaminati 50 pazienti affetti da stroke ischemico e 67 controlli privi di patologia vascolare intra o extracranica. I pazienti, entro 24 ore dall'evento acuto, sono stati valutati clinicamente mediante esame obiettivo neurologico (quantificato con la Canadian Neurological Scale o CNS) e sottoposti a Doppler transcranico 3D e tomografia computerizzata (TC) del cranio, quest'ultimo esame è stato ripetuto dopo il 15° giorno dall'evento. 15 pazienti sono stati sottoposti anche ad Angiografia, a risonanza magnetica nucleare (Angio-RMN) e Angiografia Digitalizzata in sottrazione di immagine (ADS). Abbiamo utilizzato i seguenti parametri Doppler: indice di asimmetria interemisferico (AI), velocità media (Vm) e indice di pulsatilità (I.P.), relativi all'arteria cerebrale media (ACM). Il confronto tra pazienti e controlli tramite l'analisi della varianza (ANOVA) relativamente all'AI è risultato significativo: F=50.8, p〈0.0001. La correlazione tra CNS e AI è risultata altrettanto valida: r=−0.56, p〈0.001. La correlazione fra CNS e TC cranio è risultata molto significativa: r=−0.72, p〈0.0001. Il Doppler transcranico ha permesso una valutazione quantitativa delle alterazioni emodinamiche e dei circoli collaterali di compenso ed è risultata una metodica valida per lo studio dello Stroke ischemico mostrando una buona correlazione con i dati clinici, con l'Angio-RMN e con l'estensione dell'area ischemica alla TC cranio.
    Notes: Abstract We examined 50 ischemic stroke patients and 67 controls free of vascular disease, intra- or extracranial. We assessed all subjects clinically by neurological examination (quantified on the Canadian Neurological Scale or CNS), by three-dimensional transcranial Doppler sonography (TCD-3D) and by computed tomography (CT) within 24 h of the acute event, repeating CT 15 days later. 15 patients also underwent magnetic resonance angiography (MRA) and digital subtraction angiography (DSA). We used the following Doppler parameters: interhemispheric asymmetry index (AI), mean flow velocity (mV) and pulsatility index (PI) for the middle cerebral artery (MCA). The difference between patients and controls on analysis of the variance (ANOVA) in respect of AI was significant: F=50.8, p〈0.0001. The CNS-AI correlation was equally valid: r=−0.56, p〈0.001. The CNS-CT correlation proved to be highly significant: r=−0.72, p〈0.0001. TCD-3D allowed quantitative evaluation of the hemodynamic changes and of the collateral blood supply and proved to be a sound method for the investigation of ischemic stroke, correlating well with the clinical findings, MRA and lesion size on CT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02335663
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  • 4
    Electronic Resource
    Electronic Resource
    Three-dimensional transcranial Doppler in acute ischemic stroke in the territory of the middle cerebral artery: Clinical and CT correlation (1991)
    Springer
    Neurological sciences 12 (1991), S. 545-555 
    Details
    ISSN: 1590-3478
    Keywords: TCD-3D ; stroke ; MCA ; basal artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Abbiamo studiato 34 pazienti affetti da stroke ischemico acuto, nel territorio dell'Arteria Cerebrale Media (MCA), utilizzando il Doppler transcranico in 3 dimensioni (TCD-3D). I parametri analizzati sono: velocità media; velocità sistolica e diastolica; gli indici di pulsatilità, di asimmetria interemisferica e di trasmissione della pulsatilità. Dei 34 pazienti: 11 hanno presentato un rallentamento marcato della velocità di flusso della MCA dell'emisfero infartuato, con un indice di asimmetria interemisferico (AI) maggiore del 40%; 8 pazienti un rallentamento modesto del flusso della MCA, con AI compreso tra 25–40%; in 2 pazienti abbiamo evidenziato, indirettamente, circoli collaterali di pertinenza dell'arteria cerebrale anteriore, in associazione ad un rallentamento del flusso della MCA; 5 pazienti mostravano una stenosi dell'MCA. Infine 9 pazienti non hanno presentato alterazioni dei parametri Doppler. La correlazione tra sintomatologia neurologica e AI è risultata significativa (r=0.76). La non invasività, la facile ed immediata esecuzione e soprattutto, la buona attendibilità dell'esame, ci consente di affermare che il TCD-3D, introducendo miglioramenti sostanziali nella metodica del Doppler transcranico tradizionale, risulta particolarmente utile nella valutazione emodinamica della circolazione cerebrale in caso di stroke ischemico.
    Notes: Abstract We studied 34 patients with acute ischeiic stroke in the territory of the middle cerebral artery (MCA) by three-dimensional transcranial Doppler (TCD-3D). The parameters analyzed were: mean blood flow velocity, systolic and diastolic velocities; indices of pulsatility, hemisphere asymmetry and pulsatility transmission. Of the 34 patients 11 presented marked slowing of flow velocity in the MCA on the infarct side with an asymmetry index (AI) of over 40%, 8 patients with slightly reduced flow velocity in the MCA and an AI of 25–40%, 2 patients in whom there was indirect evidence of collateral circulations in the anterior cerebral artery distribution together with slowing of MCA flow; 5 patients had stenosis of the MCA, 9 patients showed no alterations of the Doppler parameters. The correlation between neurological symptom pattern and AI was significant (r=0.76). Noninvasive, easy to perform, performable at once and reliable, TCD-3D is a great improvement on traditional transcranial Doppler and is especially useful in assessing the hemodynamics of the cerebral circulation in ischemic stroke.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02336950
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  • 5
    Electronic Resource
    Electronic Resource
    EMG changes in chronically dialyzed uraemic subjects undergoing d, 1-Carnitine treatment (1981)
    Springer
    Neurological sciences 2 (1981), S. 255-262 
    Details
    ISSN: 1590-3478
    Keywords: EMG ; Carnitine ; fatty acids ; distal latency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario La deficienza muscolare di Carnitina secondaria al trattamento dialitico, induce frequentemente un accumulo di vacuoli lipidici nei muscoli striati associato ad un danneggiamento progressivo del miocardio. La registrazione seriata dei tracciati Emg ha mostrato la presenza di diverse famiglie di Unità Motorie nel tibiale anteriore probabilmente per un danno delle fibre nervose distali e di quelle muscolari da esse innervate almeno parzialmente dovuto all'accumulo di vacuoli lipidici. La somministrazione di d, 1-Carnitina a 20 pazienti in dialisi cronica ha abbreviato significativamente la Latenza Distale della risposta M evocata nel muscolo EDB da stimolazione dello Sciatico Popliteo Esterno ed anche alcune delle caratteristiche patologiche delle Unità Motorie, suggerendo la esistenza di un verosimile miglioramento carnitino-dipendente del metabolismo ossidativo degli Acidi Grassi sia nelle cellule muscolari che in quelle di Schwann. Il principale effetto collaterale dopo la somministrazione orale di D, 1-Carnitina (3 gr/pro die) è stata una sintomatologia simil-miastenica prontamente rientrata dopo la sospensione del farmaco.
    Notes: Abstract The deficiency of muscle Carnitine secondary to chronic dialysis frequently induces lipid storage in striated muscles associated with progressive myocardial involvement. Serial EMG recordings disclose the presence of several motor unit potential families in tibialis anterior muscle related to damage of peripheral nervous fibres and muscular districts due to the storage of lipid vacuoles. The administration of d, 1-Carnitine to twenty chronically dialyzed uraemic patients significantly improved the distal latency of the M response of the external peroneal nerve at the EDB muscle and the MUP properties suggesting a Carnitine-dependent amelioration of fatty acid oxidative processes both in muscle and Schwann cells. The main side effects folowing d, 1-Carnitine oral administration (3 g/daily) is a myasthenia-like symptom complex that is promptly reversed on drug interruption.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02335405
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