• Clinical and Experimental Pediatrics
• /
• v.55 no.9
• /
• pp.354-357
• /
• 2012

Behçet disease (BD) is rare in childhood. We report a 9-year-old boy with neuro-Behçet disease who presented diplopia and weakness on the left side after a cerebral concussion. Brain magnetic resonance imaging (MRI) revealed hyperintensity of the right mesodiencephalic junction on T2-weighted and fluid attenuated inversion recovery images. Prednisolone administration resulted in complete remission and normalization of abnormal MRI finding. Brain MRI is a useful diagnostic tool when the neurological sign is the first symptom of subclinical BD.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.2
• /
• pp.139-141
• /
• 2013

Presented here is a 36-year-old male with arterial hypertension who developed brainstem edema and intracranial hemorrhage. Magnetic resonance scan revealed diffuse brainstem hyperintensity in T2-weighted and fluid-attenuated inversion-recovery images, with an increase in apparent diffusion coefficient values. After a reduction in blood pressure, rapid resolution of the brainstem edema was observed on follow-up. The patient's condition was thus interpreted as hypertensive brainstem encephalopathy. While many consider this a vasogenic phenomenon, induced by sudden, severe hypertension, the precise mechanism remains unclear. Prompt recognition and aggressive antihypertensive treatment in such patients are essential to prevent permanent or life-threatening neurologic injury.

• Annals of Clinical Neurophysiology
• /
• v.8 no.1
• /
• pp.91-93
• /
• 2006

A 47-year-old male who had hypertension and diabetes mellitus for 7 years suddenly developed bradykinesia, generalized limb muscular rigidity, dysarthria and dysphagia. Uremia developed 5 months prior to this and he had been on hemodialysis. A T2-weighted brain MRI showed extensive hyperintensity over the bilateral basal ganglia, extending to the adjacent periventricular white matter. In T1-weighted images the lesions were hypointense. Supportive treatments were given and his symptoms improved. Exacerbation of glucose utilization failure or vasogenic edema is suggested as the etiology of basal ganglia lesions, but the exact underlying pathophysiology is unknown.

• Investigative Magnetic Resonance Imaging
• /
• v.23 no.2
• /
• pp.148-156
• /
• 2019

Hyperglycemia-induced hemichorea (HGHC) is a rare but characteristic hyperkinetic movement disorder involving limbs on one side of the body. In a 75-year-old woman with a left-sided HGHC, conventional brain MR imaging showed very subtle T1-hyperintensity and unique gadolinium enhancement in the basal ganglia contralateral to movements. Multi-parametric MRI was acquired using pulse sequence with quantification of relaxation times and proton density by multi-echo acquisition. Myelin map was reconstructed based on new tissue classification modeling. In this case report of multi-parametric MRI, quantitative measurement of myelin change related to HGHC in brain structures and its possible explanations are presented. This is the first study to demonstrate myelin loss related to hyperglycemic insult in multi-parametric quantitative MR imaging.

• Kosin Medical Journal
• /
• v.33 no.2
• /
• pp.257-262
• /
• 2018

Guillain-$Barr{\acute{e}}$ syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) are demyelinating neurologic disorders with different target organs. Although they share similar pathogenetic mechanism, reports of simultaneous occurrence of the 2 disorders are rare. A 2 year 6 month old girl visited our hospital for fever, cough, and general weakness. Although the muscle power of extremities showed mild weakness and voiding difficulty, initial deep tendon reflex of both knees and ankles was normal. A nerve conduction study to evaluate the weakness revealed the absence of F waves. Cerebrospinal fluid analysis demonstrated pleocytosis with lymphocyte predominance and elevated protein levels. Magnetic resonance imaging showed abnormal T2 hyperintensity in pons, medulla and spinal cord. Serum anti-GD1b antibody was positive. Based on clinical findings, laboratory findings, nerve conduction study, and neuroimaging, the diagnosis of GBS and ADEM was made. This is the first case of GBS accompanied by ADEM in Korea.

• Korean Journal of Audiology
• /
• v.24 no.3
• /
• pp.157-160
• /
• 2020

A 38-year-old woman presented with a week's history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

• Journal of Audiology & Otology
• /
• v.24 no.3
• /
• pp.157-160
• /
• 2020

A 38-year-old woman presented with a week's history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

• Imaging Science in Dentistry
• /
• v.53 no.3
• /
• pp.239-245
• /
• 2023

Schwannomas are uncommon neoplasms of neurologic origin that are rare in the salivary glands. A schwannoma that persists for a long time is referred to as an ancient schwannoma if it is accompanied by degenerative changes on histology. The case described herein involved a 37-year-old man with an ancient schwannoma that had persisted for 20 years in his right parotid gland. Clinically, the lesion presented with swelling and pain. Computed tomography revealed a well-defined, multilocular enhanced lesion. T2-weighted magnetic resonance images displayed multilocular hyperintensity, while T1-weighted images showed a high signal at the lobulated margin and a homogeneous low signal internally. The preoperative diagnosis, based on the lesion's location and imaging diagnosis, was Warthin's tumor. However, a biopsy conducted after surgical excision identified the lesion as a schwannoma with cystic degeneration. This report also presents a summary of the characteristics of rare cases of schwannoma in the major salivary gland based on this case and a literature review.

• Korean Journal of Biological Psychiatry
• /
• v.3 no.2
• /
• pp.203-210
• /
• 1996

Objects : To investigate the relationship between the age of onset with the atrophy and the white matter hyperintensities observed in the brain MRI of Alzheimer patients. Methods : The authors measured volumetrically cortical and ventricular brain atrophy and rated semiquantitatively white matter signal hyperintensities in nine presenile and 18 senile Alzheimer patients, who were matched for dementia severity, according to NINCDS-ADRDA criteria and in age-matched 10 presenile and 11 senile control subjects. Results : Presenile Alzheimer patients showed significantly greater cortical and ventricular atrophy indices(p<0.05) but no difference in white matter hyperintensity scores compared to the age-matched control group. On the contrary, senile Alzheimer patients showed significantly greater white matter hyperintensity scores(p<0.05) but no difference in cortical and ventricular atrophy indices compared to the age-matched control group. Conclusion : An earlier onset was related to marked brain atrophy with less white matter lesions and a later onset is related to marked white matter lesions with less brain atrophy in Alzheimer's disease. Our results suggested the passible difference in the pathophysiology between the presenile and the senile-onset Alzheimer's disease.

• Investigative Magnetic Resonance Imaging
• /
• v.19 no.4
• /
• pp.231-236
• /
• 2015

A 17-year-old girl presented with complaints of headache and decreasing vision of one month's duration, without any history of fever, weight loss, or any evidence of an immuno-compromised state. Her neurological examination was normal, except for papilledema. Laboratory investigations were within normal limits, except for a slightly increased Erythrocyte Sedimentation Rate (ESR). Non-contrast computerized tomography of her head revealed complex mass in left frontal lobe with a concentric, slightly hyperdense, thickened wall, and moderate perilesional edema with mass effect. Differential diagnoses considered in this case were pilocytic astrocytoma, metastasis and abscess. Magnetic resonance imaging (MRI) obtained in 3.0 Tesla (3.0T) scanner revealed a lobulated outline cystic mass in the left frontal lobe with two concentric layers of T2 hypointense wall, with T2 hyperintensity between the concentric ring. Moderate perilesional edema and mass effect were seen. Post gadolinium study showed a markedly enhancing irregular wall with some enhancing nodular solid component. No restricted diffusion was seen in this mass in diffusion weighted imaging (DWI). Magnetic resonance spectroscopy (MRS) showed increased lactate and lipid peaks in the central part of this mass, although some areas at the wall and perilesional T2 hyperintensity showed an increased choline peak without significant decrease in N-acetylaspartate (NAA) level. Arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) enhanced perfusion study showed decrease in relative cerebral blood volume at this region. These features in MRI were suggestive of brain abscess. The patient underwent craniotomy with excision of a grayish nodular lesion. Abundant acid fast bacilli (AFB) in acid fast staining, and epithelioid cell granulomas, caseation necrosis and Langhans giant cells in histopathology, were conclusive of tubercular abscess. Tubercular brain abscess is a rare manifestation that simulates malignancy and cause diagnostic dilemma. MRI along with MRS and magnetic resonance perfusion studies, are powerful tools to differentiate lesions in such equivocal cases.