• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.24-35
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• 2024

Spontaneous intracranial hypotension (SIH), which generally presents as orthostatic headache, is increasingly being identified due to improved imaging technologies and heightened awareness. Many prior studies have reported the characteristic brain MRI findings of SIH. However, recently, focus has shifted to spinal MRI, as SIH is believed to be caused by leakage of cerebrospinal fluid from the spinal dural sac. Advanced techniques such as ultrafast CT myelography and digital subtraction myelography have emerged as useful technique to identify the site of cerebrospinal fluid leakage. In this review, we discuss the diagnosis, spinal MRI findings, imaging techniques, and treatment of SIH.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.97-105
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• 1997

Purpose : Aseptic meningitis mainly caused by enterovirus is common in pediatric population especially during summer & fall. Most of pediatric patients restore their health without any complications with proper management. Between May to August of 1996, Masan and surrounding areas of the Kyoungsangnamdo were epidemic areas for the aseptic meningitis. The purpose of this study was to determine causative virus and describe correlation between disease and clinical symptoms in aseptic meningitis patients and those with fever and characteristic rashes without apparent meningitis symptoms. Methods : Between May to August, 1996, 57 patients with high fever and characteristic feature of rashes were reviewed. From 22 cerebrospinal fluid & 57 stool obtained specimens, viral culture and detection of enterovirus RNA were conducted. Collected specimens were kept in $-30^{\circ}C$ environment until sending of specimens to labortory. The virus identified through indirect immunofluorescence. RT-PCR method was used to identify enterovirus RNA in cerebralspinal fluid. Results : 1) One hundred fifty five pediatric patients with viral infection required hospitalization. Disease occurred higher rate in male than female with ratio of 1.94:1. Examined patients' age ranged from 15days old to 15years old. But most of patients(74.8%) were under age of 5years old. The time of occurrence was between May to August of 1996. 2) All patients had high fever and physical symptoms in those patients include headache, vomiting, abdominal pain, diarrhea, and rashes. The rashes observed mainly in patients under age of 4 years and were predominantly commom patients under age of 18 months olds)<0.001). 3) Between sampled patients and non-sampled patients, clinical course was similar. Echovirus type 9 was cultivated in 41 out of 57 cases of collected stool specimens. RT-PCR that used on CSF showed positive results in 10 out of 22 cases. Three cases of positive cultivated of positive results in RT-PCR were echovirus type 9. Conclusions : Echovirus type 9 was thought to be the causative agent of aseptic meningitis that was prevalent throughout mid areas of Kyoungsangnamdo from May to August, 1996. Additionally causative agent that responsible for high fever with rashes without meningitis symptoms also thought to be the same echovirus type 9.

• Journal of the Korean Society of Radiology
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• v.15 no.6
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• pp.927-933
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• 2021

The purpose of this study was to compare and analyze the differences in scan time, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the third lumbar vertebral region including the back fat, spinal cord, and cerebrospinal fluid using the mDixon, T2 TSE, and T2 spectral pre-saturation with inversion-recovery (SPIR) techniques. With the factors affecting the SNR fixed, the lumbar sagittal plane images of 30 adults were compared on mDixon, T2 TSE, and T2 SPIR imaging tests. The test times for mDixon, T2 TSE, and T2 SPIR were 115 seconds, 60 seconds, and 60 seconds, respectively. The mDixon T2 images showed higher SNR than the T2 TSE images at the third lumbar vertebral region (p<0.05), lower SNR in the back fat and cerebrospinal fluid (p<0.05) areas, and comparable SNR in the spinal cord (p>0.05). The CNR between the third lumbar vertebral area and back fat was higher in the mDixon T2 images, and the CNR of the cerebrospinal fluid and spinal cord images was higher in the T2 TSE images (p<0.05). The mDixon T2 FS images CNR was lower for the 3rd lumbar vertebral body region and back fat than the T2 SPIR images, and higher for the spinal cord and cerebrospinal fluid images (p<0.05). The CNR between the third lumbar body and back fat areas was higher in the mDixon T2 FS images (p<0.05), and there was no difference in the CNR in the images of the cerebrospinal fluid and the spinal cord (p>0.05). It is difficult to determine whether the mDixon technique is superior to the conventional T2 TSE and T2 SPIR techniques in terms of test time, SNR, and CNR. This study was confined to patients with simple lower back pain and was limited by controlled experimental conditions. Studies using clinically applied protocols are warranted in the future.

• Parasites, Hosts and Diseases
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• v.28 no.1
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• pp.1-10
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• 1990

To establish an animal model of intracranial sparganosis, the fate and behavior of the experimentally inoculated spargana were observed. A total of 102 scolices of spargana were injected into 22 cat brains, and the cats were sacrificed at 2 weeks, 1 month, 3 months and 6 months after the inoculation. Neurosparganosis was established in 77% of the cats. Of 43 recovered worms,19 (44%) were located in the subdural or subarachnoid space,16 (37%) in the brain Parenchyme, and 2 (5%) in the lateral ventricle. One was detected at the diploic space of the skull and 5 were outside the cranial cavity. All but one were alive, and had grown tails. They were distributed in the brain parenchyme randomly. There was no place which they could not invade. No adult was found in the intestine. Cerebrospinal fluid (CSF) was collected before inoculation, 1 week, 2 weeks, 1 month, 3 months and 6 months after inoculation. The level of anti-sparganum IgG antibody in CSF measured by ELISA began to increase above the criteria of positivity 1 month after inoculation. Three months after inocula- tion, the values markedly increased. The present findings reveal that intracranial inoculation of spargana into the brains of cats would be a good animal model of experimental neurosparganosis.

• Parasites, Hosts and Diseases
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• v.28 no.2
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• pp.101-108
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• 1990

Surgically collected cystic fluid of Taenia solium metacestodes from patients of intracranial cystic lesion were compared in their protein composition with those from naturally infected pigs in Cheju Do, Korea and Ecuador. In non-denaturing discontinuous-polyacryla aide gel electrophoresis (disc-PAGE) , no discernible differences were recognized in banding patterns between the cystic fluids from Cheju Do and Ecuador, and between the cystic quids from pigs and human lesions except wider bands that corresponded to human albumin and T-globulin (in 4 of 9 patients). In reducing SDS-PAGE, bands in the cystic Ruid from Ecuador showed the same banding pattern with that from Cheju Do but two bands of 21 and 17 kDa were stained darker. Cystic quids (rom patients revealed the same protein compositions of the major protein bands of 94, 64, 15, 10 and 7 kDa as in the cystic fluid of pig origin, but human albumin (66 kDa), heavy and light chains of gamma globulin (55 and 22.5 kDa) were contaminated in 4 of 9 cystic fluids. Human CSF proteins seem to have been contaminated during cystic ftuid collection. In any cystic quid from patients, the majcr Protein component was 150 kDa which was subdivided into 15, 10 and 7 kDa in reducing SDS-PAGE.

• The Korean Journal of Cytopathology
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• v.19 no.2
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• pp.86-98
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• 2008

Cerebrospinal fluid (CSF) cytology is based on the cytopathologic findings of other body fluids. However, CSF's cytologic features are less familiar to physicians than are those of the other body fluid's cytology because of the small number of cases. The low overall diagnostic accuracy and the presence of false positivity still remain as problems. The incidence of lymphoreticular malignancies and metastatic carcinomas are rather higher than that of primary brain tumors. In this review, the characteristic cytologic findings of conventional CSF cytology are reviewed along with a brief note on the technical preparation and diagnostic pitfalls.

• Investigative Magnetic Resonance Imaging
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• v.17 no.2
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• pp.149-153
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• 2013

Detection of cerebrospinal fluid leakage or exact localization of leakage site after spinal surgery is difficult on conventional imaging studies. We report two patients with surgery-related spinal CSF leakage detected on magnetic resonance (MR) myelography. They presented with severe headache after spinal surgeries, lumbar discectomy and excision of spinal meningioma, respectively. The sites of spinal CSF leakage in the patients were detected accurately on MR myelography, and the patients recovered from the postoperative CSF leakage after being treated with an epidural blood patch or reoperation. MR myelography may be effective in demonstrating the exact site of surgery-related spinal CSF leakage.

• Pediatric Infection and Vaccine
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• v.21 no.3
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• pp.219-224
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• 2014

Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.

• Pediatric Infection and Vaccine
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• v.22 no.1
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• pp.40-44
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• 2015

Cases of incomplete Kawasaki disease (KD), wherein the patient does not fulfill the full diagnostic criteria for KD, are often detected in infants younger than 6 months of age. The clinical manifestations in infants with incomplete KD may resemble other infectious diseases, including meningitis. For this reason, clinicians may have difficulty differentiating incomplete KD from other infectious diseases in this population. Various neurological features are associated with KD, including aseptic meningitis, subdural effusion, facial nerve palsy, cerebral infarction, encephalopathy, and reversible corpus callosum splenial lesions on magnetic resonance imaging. We report a case of a 5-month-old girl with incomplete KD, associated with cerebrospinal fluid pleocytosis and an epidural fluid collection. Echocardiography indicated dilatation of the main coronary arteries. The girl made a complete recovery, with resolution of both the epidural fluid collection and coronary artery aneurysms. In this case, the child is well, and showed normal developmental milestones at the 7-month follow-up.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.607-611
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• 2010

Bickerstaff's brainstem encephalitis (BBE) is a rare disease diagnosed by specific clinical features such as 'progressive, relatively symmetric external ophthalmoplegia and ataxia by 4 weeks' and 'disturbance of consciousness or hyperreflexia' after the exclusion of other diseases involving the brain stem. Anti-ganglioside antibodies (GM, GD and GQ) in the serum or cerebrospinal fluid (CSF) are sometimes informative for the diagnosis of BBE because of the rarity of positive findings in other diagnositic methods: brain magnetic resonance imaging (MRI), routine CSF examination, motor nerve conduction study, and needle electromyography. We report a rare case of childhood BBE with elevated anti-GM1 antibodies in the serum, who had specific clinical symptoms such as a cranial polyneuropathy presenting as ophthalmoplegia, dysarthria, dysphagia, and facial weakness; progressive motor weakness; altered mental status; and ataxia. However, the brain MRI, routine CSF examination, nerve conduction studies, electromyography, somatosensory evoked potentials, and brainstem auditory evoked potentials were normal. BBE was suspected and the patient was successfully treated with intravenous immunoglobulins.