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Watanabe Y, Odaka M, Motoi H, Oyama Y, Shiga K, Ito S. Neurological prognostic factors for human herpes virus 6/7-associated acute encephalopathy in children: A single-center study. Brain Dev 2023; 45:102-109. [PMID: 36503814 DOI: 10.1016/j.braindev.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/15/2022] [Accepted: 10/10/2022] [Indexed: 11/21/2022]
Abstract
AIM To identify prognostic factors for severe neurological sequelae and epileptic seizures in children with human herpes virus (HHV) 6/7-associated acute encephalopathy (AE). METHODS We retrospectively studied pediatric cases of HHV6/7-associated AE between April 2011 and March 2021. Neurological sequelae were assessed using the Pediatric Cerebral Performance Category scale (PCPC) and the presence of epileptic seizures 1 year after onset. We investigated the prognostic factors between the non-severe sequelae group (PCPC scores ≤ 2) and severe sequelae group (PCPC scores ≥ 3) in patients without severe neurological complications before onset. RESULTS Forty patients, ranging from 4 to 95 months old, were included. AE with biphasic seizures and late reduced diffusion were the most common types of encephalopathy (n = 28). Among the 36 patients evaluated neurological sequelae, 17, nine, eight, and two were categorized as PCPC 1, 2, 3 and 4, respectively. Epileptic seizures were observed in nine patients. In the severe sequelae group, significantly more cases with coma in the acute phase and thalamic lesions on MRI and higher serum aspartate aminotransferase, alanine aminotransferase (ALT), and lactate dehydrogenase levels were observed. Multivariate analysis showed a significant between-group difference in the rate of coma (p = 0.0405). Patients with epileptic seizures had a higher rate of coma and thalamic lesions and higher serum ALT and urinary beta 2-microglobulin levels, but there was no significant difference in the multivariate analysis. CONCLUSIONS In HHV6/7-associated AE, coma was a significant prognostic factor for severe neurological sequelae.
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Affiliation(s)
- Yoshihiro Watanabe
- Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan.
| | - Mao Odaka
- Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Hirotaka Motoi
- Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Yoshitaka Oyama
- Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Kentaro Shiga
- Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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Abstract
Perinatal ischemic stroke is a common cause of lifelong disability.
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Affiliation(s)
- Nicholas V Stence
- Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 125, Aurora, CO 80045, USA.
| | - David M Mirsky
- Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 125, Aurora, CO 80045, USA
| | - Ilana Neuberger
- Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 125, Aurora, CO 80045, USA
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Belloch-Ripollés V, Carreres-Polo J. Transient reduced diffusion on magnetic resonance imaging due to transneuronal degeneration of the striatum. Rev Neurol 2022; 75:101. [PMID: 35866536 PMCID: PMC10280718 DOI: 10.33588/rn.7504.2022035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Indexed: 11/24/2022]
Affiliation(s)
| | - J Carreres-Polo
- Hospital Universitario y Politécnico La Fe, Valencia, España
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Montoya-Filardi A, García-Junco Albacete M, Ortolá Fortes P, Carreres Polo J. Carretera perdida: imagen de la degeneración neuronal secundaria. RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Montoya-Filardi A, García-Junco Albacete M, Ortolá Fortes P, Carreres Polo J. Imaging secondary neuronal degeneration. RADIOLOGIA 2022; 64:145-155. [DOI: 10.1016/j.rxeng.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
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Hagiwara K, Tanaka H, Miyoshi A, Kamada T, Shigeto H, Ohara S, Akamatsu N. Postoperative striatal degeneration: a hitherto unrecognized impact of frontal disconnection surgery for drug-resistant epilepsy. Illustrative cases. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE21644. [PMID: 36130543 PMCID: PMC9379656 DOI: 10.3171/case21644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/13/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Frontal disconnection surgery is a useful surgical option for patients with frontal epilepsy whose seizure onset zones are exceedingly large and thus are not amenable to conventional resective surgery. While it has the advantage of avoiding sequelae stemming from a large resection cavity, the impact of radical anatomofunctional disconnection of such a vast frontal region is not fully understood. OBSERVATIONS The authors have identified secondary degeneration in the striatum ipsilateral to the frontal disconnection surgery in two adult patients who had otherwise favorable postoperative outcomes following the surgery. On serial postoperative magnetic resonance imaging, the striatum showed transient restricted diffusion in the caudate head and rostral putamen around several weeks postoperatively and subsequent atrophy in the caudate head. The affected striatal regions (i.e., the anterior portion of the striatum) were congruent with the known fronto-striatal connectivity corresponding to the disconnected frontal regions anterior to the primary and supplementary motor areas. Both patients achieved 1-year seizure freedom without apparent disability related to the surgery. LESSONS The benign postoperative course despite the marked degenerative changes in the ipsilateral striatum supports the feasibility of the frontal disconnection surgery in otherwise inoperable patients with broad frontal epileptogenicity.
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Affiliation(s)
| | - Hideaki Tanaka
- Department of Neurosurgery, Fukuoka Sanno Hospital, Fukuoka, Japan; and
| | | | | | - Hiroshi Shigeto
- Epilepsy and Sleep Center
- Division of Medical Technology, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinji Ohara
- Epilepsy and Sleep Center
- Department of Neurosurgery, Fukuoka Sanno Hospital, Fukuoka, Japan; and
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Baudat C, Maréchal B, Corredor-Jerez R, Kober T, Meuli R, Hagmann P, Michel P, Maeder P, Dunet V. Automated MRI-based volumetry of basal ganglia and thalamus at the chronic phase of cortical stroke. Neuroradiology 2020; 62:1371-1380. [PMID: 32556424 PMCID: PMC7568697 DOI: 10.1007/s00234-020-02477-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/10/2020] [Indexed: 12/11/2022]
Abstract
Purpose We aimed at assessing the potential of automated MR morphometry to assess individual basal ganglia and thalamus volumetric changes at the chronic phase after cortical stroke. Methods Ninety-six patients (mean age: 65 ± 18 years, male 55) with cortical stroke at the chronic phase were retrospectively included. Patients were scanned at 1.5 T or 3 T using a T1-MPRAGE sequence. Resulting 3D images were processed with the MorphoBox prototype software to automatically segment basal ganglia and thalamus structures, and to obtain Z scores considering the confounding effects of age and sex. Stroke volume was estimated by manual delineation on T2-SE imaging. Z scores were compared between ipsi- and contralateral stroke side and according to the vascular territory. Potential relationship between Z scores and stroke volume was assessed using the Spearman correlation coefficient. Results Basal ganglia and thalamus volume Z scores were lower ipsilaterally to MCA territory stroke (p values < 0.034) while they were not different between ipsi- and contralateral stroke sides in non-MCA territory stroke (p values > 0.37). In MCA territory stroke, ipsilateral caudate nucleus (rho = − 0.34, p = 0.007), putamen (rho = − 0.50, p < 0.001), pallidum (rho = − 0.44, p < 0.001), and thalamus (rho = − 0.48, p < 0.001) volume Z scores negatively correlated with the cortical stroke volume. This relation was not influenced by cardiovascular risk factors or time since stroke. Conclusion Automated MR morphometry demonstrated atrophy of ipsilateral basal ganglia and thalamus at the chronic phase after cortical stroke in the MCA territory. The atrophy was related to stroke volume. These results confirm the potential role for automated MRI morphometry to assess remote changes after stroke.
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Affiliation(s)
- Cindy Baudat
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Bénédicte Maréchal
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Ricardo Corredor-Jerez
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Tobias Kober
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Reto Meuli
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Patric Hagmann
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Patrik Michel
- Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philippe Maeder
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Vincent Dunet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
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Takita H, Shimono T, Manabe T, Kuki I, Amo K, Togawa M, Miki Y. DWI scoring system for prognosis of acute encephalopathy with biphasic seizures and late reduced diffusion. Jpn J Radiol 2020; 38:860-869. [PMID: 32385727 DOI: 10.1007/s11604-020-00984-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study was to predict neurological outcomes for acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) using diffusion-weighted imaging (DWI), and assess relationships between anatomical sites of lesions and their outcomes. MATERIALS AND METHODS We assessed DWI abnormalities and neurological outcomes in 30 patients with AESD, and classified patients into severe and non-severe groups according to their neurological outcomes. We also established a DWI scoring system as follows: zero for normal, and one for lesion at each location. Differences between the severe and non-severe groups were examined, and receiver operating characteristic (ROC) curve analysis was performed. RESULTS Nine (30%) patients were classified into the severe group. On DWI, patients in the severe group were more likely to have temporal lobe (P = 0.014), perirolandic (P = 0.008), and corpus callosum (P = 0.0008) lesions than those in the non-severe group. The total DWI scores were significantly higher in the severe group than those in the non-severe group (P = 0.0002). ROC curve showed an area under the curve of 0.929, with a cutoff value of five, sensitivity of 88.9%, and specificity of 81.0%. CONCLUSION Patients with severe AESD had more extensive DWI abnormalities than those with non-severe AESD. Our DWI scoring system may be useful for the prediction of outcomes of AESD. Widespread lesions seemed to have stronger influence on outcomes than each lesion location.
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Affiliation(s)
- Hirotaka Takita
- Departments of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-cho, Abeno-ku, Osaka, Japan. .,Department of Diagnostic Radiology, Osaka City General Hospital, Osaka, Japan.
| | - Taro Shimono
- Departments of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-cho, Abeno-ku, Osaka, Japan
| | - Takao Manabe
- Department of Diagnostic Radiology, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyoko Amo
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Masao Togawa
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Yukio Miki
- Departments of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-cho, Abeno-ku, Osaka, Japan
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Quantification of Microsurgical Anatomy in Three-Dimensional Model: Transfrontal Approach for Anterior Portion of the Thalamus. J Craniofac Surg 2019; 30:926-929. [PMID: 30807475 DOI: 10.1097/scs.0000000000005275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The thalamus located in the deep site of cerebrum with the risk of internal capsule injury during operation. The purpose of this study was to compare the anatomy for exposure and injury using simulative surgical corridor of 3-dimensional model. The 3-dimensional anatomy model of thalamus in cerebrum was created based on magnetic resonance imaging performed for 15 patients with trigeminal neuralgia. The midpoint of line between anterior edge and top of thalamus was the target exposed. Axis connecting the target with the anterior edge and top of caudate head was used to outline the cylinder, respectively, simulating surgical corridors 1 and 2 of transfrontal approach. Cerebral tissues involved in the corridors were observed, measured, and compared. Incision of cortex was made on the anterior portion of inferior frontal gyrus through corridor 1 and middle frontal gyrus through corridor 2. Both of the 2 corridors passed the caudate nucleus, the anterior limb and genu of internal capsule, ultimately reached the upper anterior portion of thalamus. The volumes of white matter, caudate head, and thalamus in the corridor 1 were more than those in corridor 2. Conversely, the volumes of cortex, internal capsule in corridor 2 were more than those in corridor 1. In conclusion, surgical anatomy-specific volume is helpful to postulate the intraoperative injury of transfrontal approach exposing anterior portion of the thalamus. The detailed information in the quantification of microsurgical anatomy will be used to develop minimally invasive operation.
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Late Persistent Increased Putaminal 18F-DOPA Uptake Following Ipsilateral Frontal Resection. Clin Nucl Med 2015; 40:e451-2. [DOI: 10.1097/rlu.0000000000000798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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