[Clinical validity of the quantitative gait variables in patients with multiple sclerosis. A comparison of the Timed 25-foot Walk Test and the GAITRite ® Electronic Walkway system]

INTRODUCTION. Multiple sclerosis is an inflammatory and degenerative disease in which gait alteration is one of the first symptoms. Its quantitative evaluation is often made by the Timed 25-foot Walk Test (T25FW), although it's limited to know only the distance, the time employed and number of steps. AIM. To compare the T25FW with the results from the GAITRite ® Electronic Walkway system (GEW), to know if there is some variability between them. PATIENTS AND METHODS. The sample consisted in 85 subjects with multiple sclerosis and able to walking, with or without aids (EDSS: 1.0-6.5). Four walkings were made along the 8 m-length carpet from GEW system, while a different evaluator measured the time employed with a chronometer, and the number of steps in a 25 feet distance marked side by side in the carpet. Velocity was calculated in function of distance and time employed. A mean from the four walkings was made and both of the measures were correlated with SPSS v. 18, considering a results of p < 0.001, statistically significant. RESULTS. Time employed (p = 1.000), velocity (p = 0.9995), cadence (p = 0.3296) and number of steps (p = 1.000) were not statistically different. CONCLUSIONS. GEW system has the same clinical validity in gait evaluation in multiple sclerosis patients than the T25FW.

Burkitt lymphoma as a cause of carotidynia: imaging features. A case report

We describe a patient with Burkitt lymphoma who developed carotidynia. MRI showed thickening of the walls of both common carotid arteries and PET CT showed increased radiotracer uptake in the same regions. MRI was essential in establishing the diagnosis of this rare clinical presentation.

Evaluation of the pituitary gland using magnetic resonance imaging: T1-weighted vs. VIBE imaging

Volumetric interpolated breath-hold examination (VIBE) is used for abdominal imaging as a fast and efficient modality. Evaluation of brain lesions using VIBE is not common and its use for the pituitary gland has not yet been addressed. Our goal was to compare coronal T1-weighted (T1W) and VIBE images in patients undergoing studies of the pituitary gland. We hypothesized that, for this purpose, VIBE is superior to T1W images. T1W and VIBE images of the pituitary gland in 32 patients were evaluated. The two sequences were compared with specific attention to: contrast enhancement (gland and cavernous sinuses) and ability to view the anatomy of the cavernous sinuses. In patients with macroadenomas, visualization of the optic chiasm was also assessed. Images were rated as: VIBE being better, equal, or worse in comparison to T1W images. We also compared VIBE and T1W images specifically looking at micro/macro-adenomas and post-surgical patients. Statistical analysis was performed using chi-square statistics. Of the 32 patients, the VIBE sequence showed superior contrast enhancement in 18 patients, six were found as being equal to T1W, and in eight instances VIBE was found to be worse than T1W. These results were statistically significant (p=.02). When looking at micro/macro-adenomas and post-surgical patients specifically, there was a trend to VIBE being superior to T1W but these data were not statistically significant. Visualization of chiasm in macroadenomas was similar for both techniques. VIBE was significantly superior to T1W with respect to pituitary and cavernous sinus contrast enhancement and cavernous sinus anatomy. A trend towards VIBE being superior in the evaluation of adenomas (pre- and post-operative) was seen, but it was not statistically significant. This is likely due to the small population size.

Intrasellar fat graft gains weight with the patient: imaging features

We describe a 56-year-old man with an intrasellar craniopharyngioma who underwent transphenoidal resection and abdominal fat grafting of the dural opening. Follow-up MRI showed hypertrophy of the sellar fat graft concurrent with the patient's weight gain. To our best of knowledge sellar fat graft hypertrophy has not been reported before.

A midline sagittal brain view depicted in Da Vinci's "Saint Jerome in the wilderness"

It is estimated that around the year 1480 Leonardo da Vinci painted Saint Jerome in the Wilderness, representing the saint during his years of retreat in the Syrian dessert where he lived the life of a hermit. One may interpret Leonardo's Saint Jerome in the Wilderness as St. Jerome practicing self-chastisement with a stone in his right hand, seemingly punching his chest repeatedly. The stone, the lion and a cardinal's hat are conventionally linked to the saint. A skull was also almost always present with the image of the saint symbolically representing penance. With careful analysis of the painting one can identify the skull which is hidden in an arc represented as a lion's tail. The image is of a hemicranium (midline sagittal view) showing the intracranial dura, including the falx and tentorium, and venous system with the sinuses and major deep veins. This may have been the first time when the intracranial sinuses and the major deep venous vessels were illustrated.