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Gburek-Augustat J, Sorge I, Stange M, Kern J, Merkenschlager A, Nägele T, Krägeloh-Mann I. Acute and Chronic Kernicterus: MR Imaging Evolution of Globus Pallidus Signal Change during Childhood. AJNR Am J Neuroradiol 2023; 44:1090-1095. [PMID: 37620154 PMCID: PMC10494954 DOI: 10.3174/ajnr.a7948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/25/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND AND PURPOSE Despite its rarity in Western countries, kernicterus resulting from severe neonatal hyperbilirubinemia and its associated neurologic consequences still persists. Subtle MR imaging patterns may be overlooked, leading to diagnostic and prognostic uncertainties. The study systematically analyzes MR imaging pattern over time. MATERIALS AND METHODS A retrospective MR imaging study was conducted in Departments of Pediatric Neurology at the University Children's Hospitals in Leipzig, Germany, or Tübingen, Germany, between 2012 and 2022 in patients who presented beyond the neonatal period suspected of having chronic kernicterus. RESULTS Eight patients with a total of 15 MR images were identified. The clinical diagnosis of kernicterus was confirmed in all cases on the basis of typical MR imaging findings: Bilateral, diffuse hyperintensity of the globus pallidus was observed in the neonatal period on T1WI (1 MR imaging, at 2 weeks), in infancy on T2WI (4 MR images, at 9-26 months). In children 2 years of age and older, bilateral hyperintensity on T2WI was limited to the borders of the globus pallidus (8 MR images, at 20 months -13 years). Notably, 2 children exhibited normal initial MR imaging findings at 2 months of age. Hence, MR imaging depiction of kernicterus pathology evolves with time, first evident on T1WI, subsequently on T2WI, with a "blind window" during early infancy. The T2WI signal change initially involves the entire globus pallidus and later is limited to the borders. Kernicterus had not been diagnosed in any except 2 patients by previous investigators. CONCLUSIONS All patients presented with a characteristic clinical history and signs and an evolving MR imaging pattern. Nonetheless, the diagnosis of kernicterus was frequently missed. Abnormalities on later MR images appear to be underrecognized.
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Affiliation(s)
- J Gburek-Augustat
- From the Division of Neuropaediatrics (J.G.-A., A.M.), Hospital for Children and Adolescents, University Hospital Leipzig, Leipzig, Germany
| | - I Sorge
- Department of Pediatric Radiology (I.S.), University Hospital for Children and Adolescents, University Leipzig, Germany
| | - M Stange
- Department of Pediatrics (M.S.), University Hospital Halle, Halle, Germany
| | - J Kern
- Department of Paediatric Neurology (J.K., I.K.-M.), University Children's Hospital, Tübingen, Germany
| | - A Merkenschlager
- From the Division of Neuropaediatrics (J.G.-A., A.M.), Hospital for Children and Adolescents, University Hospital Leipzig, Leipzig, Germany
| | - T Nägele
- Department of Diagnostic and Interventional Neuroradiology (T.N.), Tübingen University Hospital, Tübingen, Germany
| | - I Krägeloh-Mann
- Department of Paediatric Neurology (J.K., I.K.-M.), University Children's Hospital, Tübingen, Germany
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Örgel A, Hauser TK, Nägele T, Horger M. [Image Findings in Central Pontine Myelinolysis (CPM) and Extrapontine Myelinolysis (EPM)]. ROFO-FORTSCHR RONTG 2017; 189:103-107. [PMID: 28142166 DOI: 10.1055/s-0042-120176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Örgel A, Hauser TK, Nägele T, Horger M. Imaging findings in Wernicke‘s encephalopathy – Bildgebung der Wernicke-Enzephalopathie. ROFO-FORTSCHR RONTG 2016; 188:1107-1110. [PMID: 27907938 DOI: 10.1055/s-0042-115316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lindig T, Bender B, Heckl S, Nägele T, Ioanoviciu S, Horger M. MR-Bildgebung der Epstein-Barr-Virus-Enzephalitis. ROFO-FORTSCHR RONTG 2016; 188:899-903. [DOI: 10.1055/s-0042-115245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schulze M, Groeschel S, Gburek-Augustat J, Nägele T, Horger M. [Lysosomal storage diseases]. ROFO-FORTSCHR RONTG 2015; 187:1057-60. [PMID: 26609772 DOI: 10.1055/s-0035-1552368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Marquetand J, Bischof F, Nägele T. P4. Contrast-enhancing lesions within the spinal chord help to identify IRIS in patients with natalizumab-PML. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Distelbarth H, Nägele T, Heyer AG. Responses of antioxidant enzymes to cold and high light are not correlated to freezing tolerance in natural accessions of Arabidopsis thaliana. Plant Biol (Stuttg) 2013; 15:982-990. [PMID: 23578291 DOI: 10.1111/j.1438-8677.2012.00718.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 11/06/2012] [Indexed: 06/02/2023]
Abstract
Low temperatures and high light cause imbalances in primary and secondary reactions of photosynthesis, and thus can result in oxidative stress. Plants employ a range of low-molecular weight antioxidants and antioxidant enzymes to prevent oxidative damage, and antioxidant defence is considered an important component of stress tolerance. To figure out whether oxidative stress and antioxidant defence are key factors defining the different cold acclimation capacities of natural accessions of the model plant Arabidopsis thaliana, we investigated hydrogen peroxide (H2 O2 ) production, antioxidant enzyme activity and lipid peroxidation during a time course of cold treatment and exposure to high light in four differentially cold-tolerant natural accessions of Arabidopsis (C24, Nd, Rsch, Te) that span the European distribution range of the species. All accessions except Rsch (from Russia) had elevated H2 O2 in the cold, indicating that production of reactive oxygen species is part of the cold response in Arabidopsis. Glutathione reductase activity increased in all but Rsch, while ascorbate peroxidase and superoxide dismutase were unchanged and catalase decreased in all but Rsch. Under high light, the Scandinavian accession Te had elevated levels of H2 O2 . Te appeared most sensitive to oxidative stress, having higher malondialdehyde (MDA) levels in the cold and under high light, while only high light caused elevated MDA in the other accessions. Although the most freezing-tolerant, Te had the highest sensitivity to oxidative stress. No correlation was found between freezing tolerance and activity of antioxidant enzymes in the four accessions investigated, arguing against a key role for antioxidant defence in the differential cold acclimation capacities of Arabidopsis accessions.
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Affiliation(s)
- H Distelbarth
- Department of Plant Biotechnology, Institute of Biology, University of Stuttgart, Stuttgart, Germany
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Krope K, Speil A, Pantazis G, Nägele T, Horger M. [MR imaging in the diagnosis of primary and secondary cerebral infections]. ROFO-FORTSCHR RONTG 2013; 185:539-45. [PMID: 23494507 DOI: 10.1055/s-0032-1330714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Cerebral infections may develop into a life-threatening condition. Fast and correct diagnosis is crucial for a differentiated therapy and MRI imaging is widely accepted as the method of choice. Both specific MR sequences and imaging characteristics of major cerebral infections are addressed in this overview. Furthermore, limitations and pitfalls of the method are discussed.
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Affiliation(s)
- K Krope
- Radiologie, Universität Tübingen.
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Korn A, Hauser TK, Nägele T, Beschorner R, Horger M. [Acute disseminated encephalomyelitis]. ROFO-FORTSCHR RONTG 2013; 185:195-8. [PMID: 23450348 DOI: 10.1055/s-0032-1319229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Krägeloh-Mann I, Groeschel S, Kehrer C, Opherk K, Nägele T, Handgretinger R, Müller I. Juvenile metachromatic leukodystrophy 10 years post transplant compared with a non-transplanted cohort. Bone Marrow Transplant 2013; 48:369-75. [PMID: 22941383 DOI: 10.1038/bmt.2012.155] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 07/12/2012] [Accepted: 07/13/2012] [Indexed: 11/08/2022]
Abstract
Metachromatic leukodystrophy (MLD) is a rare inborn error of metabolism leading to severe neurological symptoms and early death. Hematopoietic SCT (HSCT) is considered a treatment option, but results are inconsistent and comparison with natural history is practically missing. We compare a girl with juvenile MLD 10 years after allogeneic HSCT not only with her untreated sister, but also with a large cohort of untreated patients. The girl received HSCT at the age of 5 years when first motor signs appeared. Over 10 years she was stable with respect to her clinical course and gained cognitive abilities. Magnetic resonance imaging (MRI) showed clear regression of white matter changes and magnetic resonance spectroscopy (MRS) demonstrated a reversal of the initial choline increase and N-acetyl-aspartate (NAA) decrease. Only axonal demyelinating neuropathy showed some progression. Her gross motor function and MRI-scores were clearly better compared with her sister and the cohort of untreated patients. Difference to her sister became apparent only 4 years after HSCT. We conclude that HSCT, early in the course of disease, can lead to stabilization of juvenile MLD with a course clearly different from the natural history. HSCT may prevent disease progression, if performed sufficient time before loss of walking, which typically initiates rapid deterioration.
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Affiliation(s)
- I Krägeloh-Mann
- Department for Pediatric Neurology, University Children's Hospital, Tübingen, Germany
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Horger M, Beschorner R, Beck R, Nägele T, Schulze M, Ernemann U, Heckl S. Common and uncommon imaging findings in progressive multifocal leukoencephalopathy (PML) with differential diagnostic considerations. Clin Neurol Neurosurg 2012; 114:1123-30. [PMID: 22771304 DOI: 10.1016/j.clineuro.2012.06.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 06/16/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To provide a practical review of the spectrum of possible imaging findings in patients with progressive multifocal leukoencephalopathy (PML) and to address differentials. CONCLUSION PML manifests with a broad spectrum of imaging features. Besides knowledge of preferential location, extent, temporal course, enhancement, results of functional imaging and clinical setting, recognition of imaging findings reflecting active demyelination may help the clinician in appropriately narrowing down the differential diagnosis.
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Affiliation(s)
- M Horger
- Department of Radiology, Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
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Horger M, Fenchel M, Spira D, Nägele T, Ernemann U, Heckl S. Frühsommermeningoenzephalitis (FSME): Bildgebung und Differenzialdiagnosen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Krope K, Speil A, Pantazis G, Wiesinger B, Nägele T, Horger M. Differenzierbarkeit zwischen hämatogenen und postoperativen intrakraniellen Abszessen mittels diffusionsgewichteter Bildgebung (DWI). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Horger M, Fenchel M, Spira D, Nägele T, Claussen CD, Heckl S, Ernemann U. Gewöhnliche und außergewöhnliche Manifestationsformen der progressiven multifokalen Leukoenzephalopathie (PML) in der Bildgebung bei hämatologischen immunkompromittierten Patienten mit differentialdia. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fenchel M, Korn A, Nägele T, Ernemann U, Horger M. [X-linked adrenoleukodystrophy (X-ALD)]. ROFO-FORTSCHR RONTG 2012; 183:1093-6. [PMID: 22220308 DOI: 10.1055/s-0031-1295619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Bender B, Mänz C, Korn A, Nägele T, Klose U. Optimized 3D magnetization-prepared rapid acquisition of gradient echo: identification of thalamus substructures at 3T. AJNR Am J Neuroradiol 2011; 32:2110-5. [PMID: 21979493 DOI: 10.3174/ajnr.a2705] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Because the substructures of the thalamus are not visible on standard T1- and T2-weighted MR images, planning of deep brain stimulation implantation relies on stereotactic atlas coordinates. The goal of the present work was to test whether an optimized 3D MPRAGE protocol can depict thalamus substructures. MATERIALS AND METHODS After optimization of the TI to maximize contrast between gray matter and white matter, 6 healthy subjects were scanned at 3T with the optimized 3D MPRAGE. The results were compared with stereotactic atlases, and 2 expert readers trained in thalamic anatomy identified the 4 large thalamic nuclei groups. RESULTS There was a high agreement between the different atlases and the resulting MR images. The 4 large thalamic nuclei groups (anterior, lateral, medial, posterior) could be detected reliably. The inter-reader consistency on the size and location was 75%-92%. CONCLUSIONS The optimized 3D MPRAGE protocol improves contrast in the thalamus, and the 4 large thalamic nuclei groups can be identified with high inter-reader agreement.
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Affiliation(s)
- B Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany.
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Fenchel M, Hauser TK, Nägele T, Ernemann U, Horger M. [Metachromatic Leukodystrophy (MLD): MRI findings]. ROFO-FORTSCHR RONTG 2011; 183:893-895. [PMID: 22232791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Horger M, Ritz R, Beschorner R, Fenchel M, Nägele T, Danz S, Ernemann U. Spinal pilocytic astrocytoma: MR imaging findings at first presentation and following surgery. Eur J Radiol 2011; 79:389-99. [DOI: 10.1016/j.ejrad.2010.04.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 04/15/2010] [Accepted: 04/15/2010] [Indexed: 11/15/2022]
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Krope K, Pantazis G, Nägele T, Claussen CD, Horger M. [Sporadic creutzfeld-jacob disease]. ROFO-FORTSCHR RONTG 2011; 183:593-6. [PMID: 21751129 DOI: 10.1055/s-0031-1274713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Korn A, Ernemann U, Nägele T, Spira D, Horger M. [Posterior reversible encephalopathy syndrome]. ROFO-FORTSCHR RONTG 2010; 182:377-80. [PMID: 20425694 DOI: 10.1055/s-0030-1249449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bisdas S, Nägele T, Schlemmer HP, Boss A, Claussen CD, Pichler B, Ernemann U. Switching on the lights for real-time multimodality tumor neuroimaging: The integrated positron-emission tomography/MR imaging system. AJNR Am J Neuroradiol 2010; 31:610-4. [PMID: 19942710 DOI: 10.3174/ajnr.a1900] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A recent report of the feasibility of simultaneous PET/MR imaging of the healthy human brain has sparked excitement in the field of neuroimaging because of its potential influence and utility in clinical neuroscience research. The aim of this communication is to discuss the benefits and current drawbacks of the hybrid imaging system and to highlight some perspectives of the new technique for brain neoplasms.
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Affiliation(s)
- S Bisdas
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University, Tübingen, Germany.
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Boss A, Bisdas S, Kolb A, Hofmann M, Nägele T, Ernemann U, Schlemmer HP, Claussen C, Reimold M, Pfannenberg C, Pichler B, Stegger L. Hybride PET/MRT-Bildgebung von intracraniellen Tumoren: Erste Erfahrungen und Vergleich zum PET/CT. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Boss A, Kolb A, Hofmann M, Bisdas S, Nägele T, Ernemann U, Stegger L, Schlemmer HP, Claussen C, Pfannenberg C, Reimold M, Pichler B, Klose U. Diffusion-Tensor-Bildgebung und Traktographie an einem humanen PET/MRT-Hybridsystem. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Breit S, Wächter T, Schmid-Bielenberg D, Weiss D, Leitner P, Nägele T, Freudenstein D, Gasser T, Krüger R. Effective long-term subthalamic stimulation in PARK8 positive Parkinson's disease. J Neurol 2010; 257:1205-7. [PMID: 20177695 DOI: 10.1007/s00415-010-5493-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Accepted: 01/29/2010] [Indexed: 11/25/2022]
Abstract
Whether patients with genetically defined Parkinson's disease (PD) may be particularly eligible to benefit from deep brain stimulation of the nucleus subthalamicus (STN-DBS) is currently the subject of debate. We report on a patient with advanced PD due to R793M missense mutation in the LRRK2 gene successfully treated by STN-DBS. Disease onset was at age 42 with bradykinesia, rigidity and rest tremor. During the course of the disease he developed severe motor fluctuations, dyskinesias, postural instability with falls, but preserved levodopa responsiveness. At age 60 the patient was treated by bilateral DBS of the STN. At one year after surgery a 66% improvement of the UPDRS motor score in the off-medication state was determined. During the long-term follow-up there was sustained benefit with 56% improvement of motor score after 8 years. Our report adds evidence that patients with LRRK2 monogenetic Parkinsonism are well suited candidates for DBS treatment and may indicate a potential genetic predictor for positive long-term effect of STN-DBS treatment.
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Horger M, Nägele T, Joanoviciu SD, Danz S, Ernemann U, Tübingen. [Cerebritis and brain abscess: imaging findings]. ROFO-FORTSCHR RONTG 2009; 181:831-5. [PMID: 19938374 DOI: 10.1055/s-0029-1239604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wilke M, Müller-Hansen I, Wernet D, Nägele T, Poets CF. Severe bilateral intracranial haemorrhage due to alloimmune thrombozytopenia in a premature infant. Arch Dis Child Fetal Neonatal Ed 2009; 94:F427-8. [PMID: 19846398 DOI: 10.1136/adc.2008.155424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- M Wilke
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
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Müssig K, Horger M, Nägele T, Ernemann U. [Imaging findings in pituitary adenomas]. ROFO-FORTSCHR RONTG 2009; 181:616-20. [PMID: 19725167 DOI: 10.1055/s-0029-1233252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nägele T. Moderne strukturelle und funktionelle MR-Diagnostik:. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schulze D, Korn A, Schulze M, Thomas C, Nägele T, Ernemann U. Restenoserate nach stentgestützter Angioplastie im langfristigen Verlauf: Was sind die Risikofaktoren? ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ries BG, Goelz R, Nägele T, Poets C, Ernemann U. Inkubator-MRT – Neonatolog. Patienten im Fokus: Klin. Anwendungen, Untersuchungsqualität u. Patientensicherheit. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lindig TM, Heide SE, Kumar V, Mang SC, Nägele T, Grodd W, Schöls L, Klose U. Realisierung axialer Diffusions-Tensor-Bildgebung im lumbalen Spinalmark bei 3T. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bender B, Nägele T, Ernemann U, Klose U. Bestimmung des Anteils von zerebrospinaler und interstitieller Flüssigkeit im Gehirn. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Thomas C, Korn A, Ketelsen D, Tsiflikas I, Reimann AJ, Brodoefel H, Nägele T, Kopp A, Claussen CD, Ernemann U, Heuschmid M. Nichtinvasive Dual-Energy-CT-Angiographie der Halsgefäße: Stenosedetektion und -graduierung nach automatischer Entfernung von kalkhaltigen Plaques im Vergleich zur digitalen Subtraktionsangiographie. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Horger M, Sauter A, Beck R, Nägele T, Ernemann U. [Imaging findings in Herpesvirus-1 Encephalitis]. ROFO-FORTSCHR RONTG 2009; 181:197-200. [PMID: 19259921 DOI: 10.1055/s-0029-1214197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Breit S, Wächter T, Schöls L, Gasser T, Nägele T, Freudenstein D, Krüger R. Effective thalamic deep brain stimulation for neuropathic tremor in a patient with severe demyelinating neuropathy. J Neurol Neurosurg Psychiatry 2009; 80:235-6. [PMID: 19151022 DOI: 10.1136/jnnp.2008.145656] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Postural and action tremor in peripheral neuropathy is characteristic of Roussy-Levy syndrome. A patient with a severe demyelinating neuropathy and disabling neuropathic tremor successfully treated by deep brain stimulation (DBS) is reported. Disease onset was at age 63 years with sensory symptoms and slight action tremor. Within the following 9 years a severe, drug resistant, postural and action tremor developed rendering the patient unable to feed himself. At age 72 years the patient was treated by bilateral DBS of the ventral intermediate thalamic nucleus, with a useful 30% reduction in tremor. The clinical benefit of the stimulation remained stable over a 1 year postoperative observation period.
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Affiliation(s)
- S Breit
- Centre of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
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Fischer L, Martus P, Weller M, Klasen HA, Rohden B, Röth A, Storek B, Hummel M, Nägele T, Thiel E, Korfel A. Meningeal dissemination in primary CNS lymphoma: prospective evaluation of 282 patients. Neurology 2008; 71:1102-8. [PMID: 18824675 DOI: 10.1212/01.wnl.0000326958.52546.f5] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The impact of meningeal dissemination in primary CNS lymphoma (PCNSL) is debated, and the reported frequency varies. We prospectively evaluated the diagnostic value of PCR in comparison with CSF cytomorphology and MRI for diagnosing meningeal dissemination in PCNSL. METHODS We evaluated 282 patients from a multicenter therapy study for PCNSL for the presence of meningeal dissemination: 205 with CSF cytomorphology, 171 with PCR of the rearranged immunoglobulin heavy-chain genes in CSF, and 217 with cranial MRI. RESULTS Meningeal dissemination was found in 33 of 205 patients (16%) by cytomorphology, in 19 of 171 (11%) patients evaluated by PCR, and in 8 of 217 patients (4%) by MRI. Considering either of these methods, the relative frequency of meningeal dissemination was 17.4% (49 of 282 patients). PCR was monoclonal in 6 of 19 (32%) samples with positive cytomorphology, 1 of 13 samples (8%) with suspicious cytology, and in 10 of 105 (10%) cytologically negative samples. In 11 samples with positive and 12 with suspicious cytology, PCR showed only a polyclonal pattern. The probability of meningeal dissemination detection was higher in cases with CSF pleocytosis (>5/microL) with an OR of 2.48 (95% CI 1.15-5.34, p = 0.018). CSF protein had no predictive value for meningeal dissemination detection. CONCLUSIONS We found a low rate of meningeal dissemination in primary CNS lymphoma in this large prospective study. The rate of discordant PCR and cytomorphologic results was high. Thus, the methods should be regarded as complementary. CSF pleocytosis had predictive value for meningeal dissemination detection.
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Affiliation(s)
- L Fischer
- Department of Hematology, Oncology & Transfusion Medicine, Charité Campus Benjamin Franklin, Berlin, Germany.
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Horger M, Schulze M, Mroue A, Nägele T, Ernemann U. [Radiologic imaging of primary CNS lymphomas]. ROFO-FORTSCHR RONTG 2008; 180:863-866. [PMID: 19238636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Horger M, Schulze M, Mroue A, Nägele T, Ernemann U. Radiologische Bildgebung primärer ZNS-Lymphome. ROFO-FORTSCHR RONTG 2008; 180:863-6. [DOI: 10.1055/s-0028-1085551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wasser K, Gröschel K, Pilgram S, Ernemann U, Schnaudigel S, Nägele T, Knauth M, Kastrup A. Aortic calcification on plain chest radiography predicts embolic complications during carotid artery stenting. Akt Neurol 2008. [DOI: 10.1055/s-0028-1087019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schuhmann M, Ries B, Erneman U, Tatagiba M, Nägele T. O.084 Significance of (early) high-resolution MRI imaging in paediatric hydrocephalus. Clin Neurol Neurosurg 2008. [DOI: 10.1016/s0303-8467(08)70089-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gröschel K, Pilgram SM, Ernemann U, Schnaudigel S, Nägele T, Knauth M, Kastrup A. Aortic calcification on plain chest radiography predicts embolic complications during carotid artery stenting. Eur J Neurol 2008; 15:730-6. [DOI: 10.1111/j.1468-1331.2008.02183.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gharabaghi A, Rosahl SK, Feigl GC, Samii A, Liebig T, Heckl S, Mirzayan JM, Safavi-Abbasi S, Koerbel A, Löwenheim H, Nägele T, Shahidi R, Samii M, Tatagiba M. Surgical planning for retrosigmoid craniotomies improved by 3D computed tomography venography. Eur J Surg Oncol 2008; 34:227-31. [PMID: 17448624 DOI: 10.1016/j.ejso.2007.01.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2006] [Accepted: 01/29/2007] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE It is impossible to precisely anticipate the crooked course of the transverse and sigmoid sinuses and their individual relationship to superficial landmarks such as the asterion during retrosigmoid approaches. This study was designed to evaluate this anatomical relationship with the help of a surgical planning system and to analyze the impact of these in vivo findings on trepanation placement in retrosigmoid craniotomies. METHODS In a consecutive series of 123 patients with pathologies located in the cerebellopontine angle, 72 patients underwent surgical planning for retrosigmoid craniotomies based on 3D volumetric renderings of computed tomography venography. By opacity modulation of surfaces in 3D images the position of the asterion was assessed in relationship to the transverse-sigmoid sinus transition (TST) and compared to its intraoperative localization. We evaluated the impact of this additional information on trepanation placement. RESULTS The spatial relationship of the asterion and the underlying TST complex could be identified and recorded in 66 out of 72 cases. In the remaining 6 cases the sutures were ossified and not visible in the 3D CT reconstructions. The asterion was located on top of the TST in 51 cases, above the TST in 4 cases, and below the TST in 11 cases. The location of the trepanation was modified in 27 cases due to the preoperative imaging findings with major and minor modifications in 10 and 17 cases, respectively. CONCLUSION Volume-rendered images provide reliable 3D visualization of complex and hidden anatomical structures in the posterior fossa and thereby increase the precision in retrosigmoid approaches.
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Kastrup A, Gröschel K, Nägele T, Riecker A, Schmidt F, Schnaudigel S, Ernemann U. Effects of age and symptom status on silent ischemic lesions after carotid stenting with and without the use of distal filter devices. AJNR Am J Neuroradiol 2007; 29:608-12. [PMID: 18065503 DOI: 10.3174/ajnr.a0871] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The routine use of distal filter devices during carotid angioplasty and stent placement (CAS) is controversial. The aim of this study was to analyze their effects on the incidence of new diffusion-weighted imaging (DWI) lesions as surrogate markers for stroke in important subgroups. MATERIALS AND METHODS DWI was performed immediately before and after CAS in 68 patients with and 175 without protection, and patients were further subdivided according to their age or symptom status. RESULTS The proportion of patients with new ipsilateral DWI lesion(s) was significantly lower after protected versus unprotected CAS (52% versus 68%), as well as in symptomatic patients (56% versus 74%) or those at or younger than 75 years of age (46% versus 67%; all P < .05). Similarly, the total number of lesions was significantly lower after protected versus unprotected CAS (median, 1; interquartile range [IQR], 0-2; versus median, 1; IQR 0-4.75) and in symptomatic patients (median, 1; IQR, 0-3; versus median, 2; IQR, 0-6) or those at or younger than 75 years of age (median, 0; IQR, 0-2; versus median, 1; IQR, 0-4; all P < .05). In contrast, for asymptomatic patients (48% versus 52%; P = .8; median, 0; IQR, 0-2; versus median, 1; IQR, 0-2.5; P = .6) or those older than 75 years of age (73% versus 69%; P = .7; median, 1; IQR, 0-4; versus median, 1.5; IQR, 0-5.75; P = .6), the proportion of patients with new lesion(s) and the total number of these lesions were not significantly different between protected and unprotected CAS. CONCLUSIONS The use of distal filter devices generally reduces the incidence of new DWI lesions; however, this beneficial effect might not necessarily pertain to older and asymptomatic patients.
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Affiliation(s)
- A Kastrup
- Department of Neurology, University of Göttingen, Göttingen, Germany.
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Gharabaghi A, Heckl S, Kaminsky J, Torka W, Nägele T, Tatagiba M, Löwenheim H. Hirnnervenausfälle durch ungewöhnliche Schädelbasisläsionen des Sinus cavernosus. HNO 2007; 55:278-80. [PMID: 17410393 DOI: 10.1007/s00106-006-1459-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Gharabaghi
- Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Tübingen
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Boss A, Martirosian P, Klose U, Nägele T, Claussen CD, Schick F. Spin-labeling imaging of cerebral perfusion at 1.5 and 3.0 Tesla. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-972133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Roth P, Happold C, Nägele T, Weller M. Subpial haemorrhage: clinical presentation, neuroradiological findings and therapeutic consequences. Akt Neurol 2007. [DOI: 10.1055/s-2007-987858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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