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Increase in Ventricle Size and the Evolution of White Matter Changes on Serial Imaging in Critically Ill Patients with COVID-19.

Neurocrit Care 2021 Mar 5. Epub 2021 Mar 5.

Department of Neurology, NYU Langone Medical Center, New York, NY, 10016, USA.

Background: Evolution of brain magnetic resonance imaging (MRI) findings in critically ill patients with coronavirus disease 2019 (COVID-19) is unknown.

Methods: We retrospectively reviewed 4530 critically ill patients with COVID-19 admitted to three tertiary care hospitals in New York City from March 1 to June 30, 2020 to identify patients who had more than one brain MRI. We reviewed the initial and final MRI for each patient to (1) measure the percent change in the bicaudate index and third ventricular diameter and (2) evaluate changes in the presence and severity of white matter changes. Read More

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Neurocognitive Functions and Brain Volume in Patients with Endogenous Cushing's Syndrome Before and After Curative Surgery.

Indian J Endocrinol Metab 2020 Sep-Oct;24(5):396-401. Epub 2020 Nov 9.

Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Introduction: Cushing's syndrome (CS) leads to various neuropsychiatric manifestations due to structural and functional changes of the brain and contributes significantly in the impairment of health-related quality of life.

Aim And Objective: This study is conducted with aims to evaluate neurocognitive functions and brain volume in patients with endogenous Cushing's syndrome before and after curative surgery.

Methods: The diagnosis of CS was made by clinical features, abnormal cortisol dynamics, ACTH levels, and imaging studies. Read More

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November 2020

Detrimental effects of hypercortisolism on brain structure and related risk factors.

Sci Rep 2020 07 29;10(1):12708. Epub 2020 Jul 29.

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, People's Republic of China.

Brain structural abnormalities are often observed on magnetic resonance imaging (MRI) scans of Cushing's syndrome patients, but the pathogenesis is not fully understood. To understand the relationship between brain structural abnormalities and potential risk factors in active Cushing's disease (CD) patients, a total of 101 treatment-naïve CD patients and 95 sex-, age- and education matched controls with non-functioning adenomas (NFA) underwent clinical evaluation and MRI investigation, and the relative risk factors were analyzed. 14 patients in sustained remission after transsphenoidal surgery were followed. Read More

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Subcortical Atrophy and Motor Outcomes in Pallidal Deep Brain Stimulation for Parkinson Disease.

World Neurosurg 2020 10 12;142:e89-e94. Epub 2020 Jun 12.

Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address:

Background: Appropriate patient selection is critical for successful deep brain stimulation (DBS) for Parkinson disease (PD). Subcortical atrophy is a possible determinant of postoperative DBS outcomes in patients with idiopathic PD, but it has not been well evaluated for DBS of the globus pallidus interna (GPi). We investigated perioperative subcortical atrophy measures in patients with PD and their relationship to postoperative motor response in bilateral GPi-targeted DBS. Read More

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October 2020

The frontal skull Hounsfield unit value can predict ventricular enlargement in patients with subarachnoid haemorrhage.

Sci Rep 2018 07 5;8(1):10178. Epub 2018 Jul 5.

Department of Neurosurgery, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri, Gyonggi-do, Korea.

Hydrocephalus is a common complication following subarachnoid haemorrhage (SAH) arising from spontaneous aneurysm rupture. The Hounsfield unit (HU) value from computed tomography scans may reflect bone mineral density, which correlates with body mass index, which in turn is related to post-SAH ventricle size changes. We herein investigated potential associations between frontal skull HU values and ventricle size changes after SAH. Read More

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Prediction of Shunt Dependency After Intracerebral Hemorrhage and Intraventricular Hemorrhage.

Neurocrit Care 2018 10;29(2):233-240

Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan.

Background: Spontaneous intracerebral hemorrhage is a disease with high morbidity and mortality. Extension of the hemorrhage into the ventricles is associated with the development of acute hydrocephalus and a poor outcome. Although it can be managed by external ventricular drainage (EVD), a subset of these patients require placement of permanent ventricular shunts. Read More

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October 2018


M Delva I Delva

Georgian Med News 2017 Oct(271):91-95

Ukrainian Medical Stomatological Academy, Poltava, Ukraine.

Aim - identify neuroimaging characteristics associated with different post-stroke fatigue (PSF) domains within first 6 months after ischemic strokes. There were enrolled in the study 107 patients with acute ischemic strokes. General PSF and certain PSF domains (global, physical, mental, motivational, activity-related) were measured by multidimensional fatigue inventory-20 (MFI-20) scale at hospital stay, in 1, 3 and 6 months after stroke occurrence. Read More

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October 2017

Developing easy to perform routine MRI measurements as potential surrogates for cognitive impairment in MS.

Clin Neurol Neurosurg 2017 Feb 29;153:73-78. Epub 2016 Dec 29.

University of Western Ontario (Western), London Health Sciences Center, University Hospital, Department of Radiology/Medical Imaging, LHSC-UH, 339 Windermere Road B10-006, London, ON N5A 5A5, Canada.

Objectives: One of the most frequently disabling symptoms in Multiple Sclerosis (MS) is cognitive impairment which is often insidious in onset and therefore difficult to recognize in the early stages, for both persons with MS and clinicians. A biomarker that would help identify those at risk of cognitive impairment, or with only mild impairment, would be a useful tool for clinicians. Using MRI, already an integral tool in the diagnosis and monitoring of disease activity in MS, would be ideal. Read More

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February 2017

Impairment of visuospatial/visuoconstructional skills in multiple sclerosis patients: the correlation with regional lesion load and subcortical atrophy.

Neurologia 2016 Apr 3;31(3):169-75. Epub 2015 Sep 3.

Servicio de Neurología, Hospital Universitario de Getafe, Getafe, España.

Introduction: About 20% to 26% of patients with multiple sclerosis (MS) show alterations in visuospatial/visuoconstructive (VS-VC) skills even though temporo-parieto-occipital impairment is a frequent finding in magnetic resonance imaging. No studies have specifically analysed the relationship between these functions and lesion volume (LV) in these specific brain areas.

Objective: To evaluate the relationship between VS-VC impairment and magnetic resonance imaging temporo-parieto-occipital LV with subcortical atrophy in patients with MS. Read More

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Endoscopic colloid cyst resection in the absence of ventriculomegaly.

Neurosurgery 2013 Sep;73(1 Suppl Operative):ons39-46; ons46-7

Center for Minimally Invasive Neurosurgery, Prince of Wales Hospital/University of New South Wales, Sydney, Australia.

Background: The absence of ventriculomegaly has been considered an overt or relative contraindication to the endoscopic resection of colloid cysts. In the past, endoscopic removal of colloid cysts in the absence of ventriculomegaly has been considered ill advised. Reports of successful endoscopic surgery in small ventricles are surfacing. Read More

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September 2013

A radiographic analysis of ventricular trajectories.

World Neurosurg 2013 Jul-Aug;80(1-2):173-8. Epub 2012 Dec 12.

Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, USA.

Background: The prevalent method of ventriculostomy placement is via freehand insertion to cannulate the ventricle at a 90° angle to the skull to get ideal placement. Our goal was to test the validity of this practice in patients without midline shift and with normal ventricular size.

Methods: This study was a virtual radiographic analysis of 3-dimensional data of skull and ventricular anatomy. Read More

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November 2013

Predictors of long-term shunt-dependent hydrocephalus in patients with intracerebral hemorrhage requiring emergency cerebrospinal fluid diversion.

Neurosurg Focus 2012 Apr;32(4):E5

Departments of Neurological Surgery, Mount Sinai Hospital, New York, New York 10032, USA.

Object: Intracerebral hemorrhage (ICH) is frequently complicated by acute hydrocephalus, necessitating emergency CSF diversion with a subset of patients, ultimately requiring long-term treatment via placement of permanent ventricular shunts. It is unclear what factors may predict the need for ventricular shunt placement in this patient population.

Methods: The authors performed a retrospective analysis of a prospective database (ICH Outcomes Project) containing patients with nontraumatic ICH admitted to the neurological ICU at Columbia University Medical Center between January 2009 and September 2011. Read More

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Midlife psychological distress associated with late-life brain atrophy and white matter lesions: a 32-year population study of women.

Psychosom Med 2012 Feb-Mar;74(2):120-5. Epub 2012 Jan 27.

Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.

Objective: Long-standing psychological distress increases the risk of dementia, especially Alzheimer's disease. The present study examines the relationship between midlife psychological distress and late-life brain atrophy and white matter lesions (WMLs), which are common findings on neuroimaging in elderly subjects.

Methods: A population-based sample of 1462 women, aged 38 to 60 years, was examined in 1968, with subsequent examinations in 1974, 1980, 1992, and 2000. Read More

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Attention deficits in Japanese multiple sclerosis patients with minor brain lesion loads.

Neuropsychiatr Dis Treat 2011 16;7:745-51. Epub 2011 Dec 16.

Department of Neurology, Showa University School of Medicine, Tokyo, Japan.

Background: To investigate whether Japanese multiple sclerosis (MS) patients with minor brain lesion loads have attention deficits and brain atrophy, and to correlate their circumstance.

Method: Twenty-one Japanese patients with relapsing-remitting MS were included in this study. Attention deficits were evaluated using Clinical Assessment for Attention (CAT) standardized according to age groups. Read More

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Prediction of ventriculoperitoneal shunt dependency in patients with aneurysmal subarachnoid hemorrhage.

J Neurosurg 2009 Jan;110(1):44-9

Department of Neurosurgery, University of Illinois at Chicago, Illinois, USA.

Object: Patients with subarachnoid hemorrhage treated using external ventricular drainage due to obstructive hydrocephalus commonly remain shunt-dependent. Based on identified risk factors for external ventricular drain (EVD) challenge failure, the authors sought to determine the likelihood that a patient will require a permanent shunt.

Methods: The authors reviewed 89 consecutive cases of aneurysmal subarachnoid hemorrhage with obstructive hydrocephalus for parameters associated with EVD challenge failure and permanent shunt requirement. Read More

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January 2009

Direction and predictive factors for the shift of brain structure during deep brain stimulation electrode implantation for advanced Parkinson's disease.

Neuromodulation 2008 Oct;11(4):302-10

Department of Neurological Surgery and Division of Applied System Neuroscience, Department of Advanced Medical Science, Nihon University School of Medicine, Tokyo, Japan.

Objectives.  The aims of this study were to clarify the direction and degree of brain shift, and to determine the predictive factors for a brain shift during deep brain stimulation (DBS) of the subthalamic nucleus (STN). Materials and Methods. Read More

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October 2008

Relationship between the extent of T2 lesions and the onset of secondary progression in multiple sclerosis.

Eur J Neurol 2007 Nov;14(11):1210-5

Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.

Patients with relapsing-remitting multiple sclerosis (MS) are at risk of converting to a secondary progressive disease course. To assess the relationship between brain magnetic resonance imaging (MRI) findings and onset of secondary progression, we reanalyzed the initial brain MRI scans of 90 relapsing-remitting MS patients, who were clinically followed up for at least 10 years (median 14 years) after their scan, for the number and volume of T2 lesions, and for two measures of brain atrophy (bicaudate ratio and third ventricle width). The relationship to development of secondary progression was studied with Cox regression models and Kaplan-Meier survival analyses. Read More

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November 2007

Brain atrophy in alcoholics: relationship with alcohol intake; liver disease; nutritional status, and inflammation.

Alcohol Alcohol 2007 Nov-Dec;42(6):533-8. Epub 2007 Sep 11.

Servicio de Medicina Interna, Hospital Universitario.Ofra s/n, Tenerife, Canary Islands Spain.

Objectives: Brain atrophy is a common finding in alcoholics. Several mechanisms may be involved, including ethanol itself, malnutrition, liver failure, and, possibly, ethanol-induced hormone and cytokine changes. The aim of this study was to analyse the relation of brain atrophy-assessed by computerized tomography (CT) scan-and the aforementioned alterations. Read More

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January 2008

Extent of acute hydrocephalus after aneurysmal subarachnoid hemorrhage as a risk factor for delayed cerebral infarction.

Stroke 2007 Sep 2;38(9):2496-9. Epub 2007 Aug 2.

Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.

Background And Purpose: Delayed cerebral infarction (DCI) is an important cause of poor outcome after subarachnoid hemorrhage. Cerebral perfusion is a predictor for DCI. Because acute hydrocephalus may impair cerebral perfusion, we evaluated the predictive value of the extent of acute hydrocephalus on the development of DCI. Read More

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September 2007

The relationship between whole brain volume and disability in multiple sclerosis: a comparison of normalized gray vs. white matter with misclassification correction.

Neuroimage 2005 Jul 20;26(4):1068-77. Epub 2005 Apr 20.

Department of Neurology, SUNY-University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14203, USA.

We used SPM99 to obtain normalized whole brain volumes of gray matter, white matter, and total parenchyma in patients with multiple sclerosis (MS) (n = 41) and age-/sex-matched normal controls (n = 18). As SPM99's automated gray/white matter volumes were significantly influenced by tissue compartment misclassification due to the effect of MS-related brain lesions, we corrected these automated volumes for misclassification before performing our primary analyses. For MS patients (disease duration = 9. Read More

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Whole-brain atrophy in multiple sclerosis measured by automated versus semiautomated MR imaging segmentation.

AJNR Am J Neuroradiol 2004 Jun-Jul;25(6):985-96

Buffalo Neuroimaging Analysis Center, University at Buffalo, State University of New York, Buffalo, NY, USA.

Background And Purpose: Semiautomated and automated methods are used to measure whole-brain atrophy in multiple sclerosis (MS), but their comparative reliability, sensitivity, and validity are unknown.

Methods: Brain parenchymal fraction (BPF) was measured in patients with MS (n = 52) and healthy control subjects (n = 17) by four methods: semiautomated or automated segmentation and 2D or 3D pulse sequences. Linear measures of atrophy, whole-brain lesion volumes, and clinical data were used to explore validity. Read More

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October 2004

Prediction of neuropsychological impairment in multiple sclerosis: comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden.

Arch Neurol 2004 Feb;61(2):226-30

Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo General Hospital, NY 14203, USA.

Background: Cognition and magnetic resonance imaging correlations are well established in patients with multiple sclerosis (MS), but it is unclear whether lesion burden or atrophy accounts for most of the predictive variance. These indices have been directly compared in only a few studies. No such study included measurement of the third ventricle, which was strongly predictive of neuropsychological competence in the early literature. Read More

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February 2004

Loss of brain volume in endogenous Cushing's syndrome and its reversibility after correction of hypercortisolism.

J Clin Endocrinol Metab 2002 May;87(5):1949-54

Department of Medicine and Department of Diagnostic Radiology, Division of Endocrinology, Centre Hospitalier de l'Université de Montréal, Montréal, Canada H2W 1T8.

Chronic exposure to excess glucocorticoids results in cognitive and psychological impairment. A few studies have indicated that cerebral atrophy can be found in patients with Cushing's syndrome (CS), but its evolution after cure has not been studied extensively. We report the presence of apparent cerebral atrophy in CS and its reversibility after the correction of hypercortisolism. Read More

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CNS manifestations of Nasu-Hakola disease: a frontal dementia with bone cysts.

Neurology 2001 Jun;56(11):1552-8

Department of Human Molecular Genetics, National Public Health Institute, Helsinki, Finland.

Background: Nasu-Hakola disease or polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLOSL) is a genetically heterogeneous disease characterized by a combination of systemic bone cysts and dementia.

Objective: The authors present a neurologic, neuroradiologic, and neuropathologic analysis of a series of PLOSL patients in which the diagnosis has been confirmed by molecular genetic methods.

Methods: Clinical, neurophysiologic, and imaging follow-up data on eight patients as well as autopsy samples of three patients were analyzed in this study. Read More

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Diagnosing dementia and normal aging: clinical relevance of brain ratios and cognitive performance in a Brazilian sample.

Braz J Med Biol Res 1999 Sep;32(9):1133-43

Programa de Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.

The main objective of the present study was to evaluate the diagnostic value (clinical application) of brain measures and cognitive function. Alzheimer and multi-infarct patients (N = 30) and normal subjects over the age of 50 (N = 40) were submitted to a medical, neurological and cognitive investigation. The cognitive tests applied were Mini-Mental, word span, digit span, logical memory, spatial recognition span, Boston naming test, praxis, and calculation tests. Read More

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September 1999

Transient amnesia after perimesencephalic haemorrhage: the role of enlarged temporal horns.

J Neurol Neurosurg Psychiatry 1998 Oct;65(4):590-3

University Department of Neurology, Utrecht, The Netherlands.

Objectives: Although long term outcome of patients with perimesencephalic haemorrhage, a benign subset of subarachnoid haemorrhage, is excellent, some patients report an episode of amnesia for the first hours to days after the ictus. The relation between the occurrence of amnesia and the size of the ventricles on CT, including the temporal horns, were studied in patients with perimesencephalic haemorrhage.

Methods: Twenty seven consecutive patients with perimesencephalic haemorrhage were asked about the occurrence of amnesia. Read More

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October 1998

Correlates of leukoaraiosis and ventricular enlargement on magnetic resonance imaging: a study in normal elderly and cerebrovascular patients.

Eur J Neurol 1997 Jan;4(1):15-23

Il Clinica Neurologica, Università degli Studi di Grescia, Spedali Civili, Piazza Ospedale, BresciaDepartment of Neurological Sciences, Università "La Sapienza", Rome, ItalyUnità TC-RM-I Clinica Medica, Università "La Sapienza", Rome, ItalyI. Clinica Urologica, Università "La Sapienza", Rome, Italy.

Several studies have repeatedly demonstrated that leukoaraiosis as well as ventricular enlargement are common findings in normal elderly and in stroke patients, although there is no general consensus on prevalence rate as well as on their clinical correlations. It is also controversial whether white matter changes and ventricular enlargement are reciprocally related. In this study we investigated the prevalence and extent of white matter hyperintensities and the degree of ventricular enlargement on magnetic resonance imaging in 50 normal elderly individuals (mean age 62. Read More

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January 1997

CT measurement of suprasellar cistern predicts rate of cognitive decline in Alzheimer's disease.

J Int Neuropsychol Soc 1996 Mar;2(2):89-95

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

Previous studies reveal significant relationships between some quantitative computed tomography (CT) measures and level of cognitive functioning in patients with Alzheimer's disease (AD). This study was designed to determine whether measurements from CT scans of AD patients could predict future rates of decline in cognitive function. Subjects were 8 men and 19 women diagnosed with probable AD. Read More

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Thresholds for cerebral ischemia after severe head injury: relationship with late CT findings and outcome.

J Neurotrauma 1996 Jan;13(1):17-23

Division of Neurosurgery, Medical College of Virginia, Richmond, USA.

Cerebral ischemic insults in at least 30% of severely head injured patients at a very early stage following trauma and are associated with early death. To date, the threshold for ischemia of 18 mL/100g/min used in human head injury studies has been adopted from animal studies (by temporary occlusion of the middle cerebral artery). Since the traumatized brain becomes more susceptible to irreversible damage if accompanied by ischemia one may question whether the threshold for ischemic vulnerability is higher than 18 mL/100 g/min. Read More

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January 1996

Disordered water homeostasis in schizophrenia and cerebral ventricular size.

Br J Psychiatry 1995 Apr;166(4):501-6

Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa.

Background: A possible association between disordered water homeostasis and cerebral ventricular size in patients with schizophrenia was investigated.

Method: In a cross-sectional study of hospitalised patients, cerebral ventricular size was measured in 16 schizophrenic patients with disordered water homeostasis and 16 matched schizophrenic controls by magnetic resonance imaging.

Results: Ventricle to brain ratio, third ventricular index, bicaudate index and bifrontal index tended to be greater in those with schizophrenia with disordered water homeostasis, although differences were significant only for the bifrontal index (P < 0. Read More

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