• Title/Summary/Keyword: cerebrospinal fluid

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Signal Change of Normal Saline by Oxygen Injection in FLAIR Image (산소주입에 의한 FLAIR 영상에서 생리식염수의 신호 변화)

  • Shin, Woon-Jae
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.55-63
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    • 2019
  • It was reported that there were some cases in which signal was not inhibited but high signal appeared in cerebrospinal fluid on FLAIR(fluid attenuated inversion recovery) of MRI(Magnetic Resonance Imaging) in case a person inhales high-concentration oxygen. This study was to prepare basic database. We produced a phantom fixed with agar gel and by using it, obtained the images of the signals of normal saline into which oxygen was injected and normal saline diluted with contrast media by changing the TI(Inversion Time) of FLAIR technique and analyzed them. In the result of FLAIR technique of MRI using Philips Achieva MR 3.0T in Busan P Hospital, the SNR(Signal to Noise Ratio) of normal saline into which oxygen was injected was higher than the SNR of normal saline into which oxygen was not injected. However, it was not higher than the SNR of normal saline diluted with contrast media. In the TI 1,800ms, we could obtain the images which do not have the rise of the signal due to oxygen. In the CNR(Contrast to Noise Ratio) of normal saline into which oxygen was injected and normal saline diluted with contrast media as well, it was higher in the TI 1,800ms than in the TI 2,800ms that is mainly used clinically. It is thought that the result of this study could be basic database for studies on change of signal of cerebrospinal fluid as a result of injection of oxygen in FLAIR technique of MRI.

A Study on Naosuixiaoshuo in Huangdineijing (『황제내경(黃帝內經)』의 뇌수소삭(腦髓消爍)에 대한 소고(小考))

  • Kim, Beom-seok;Baik, You-sang
    • Journal of Korean Medical classics
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    • v.31 no.1
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    • pp.127-138
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    • 2018
  • Objectives : The paper reviews the texts related to Naosuxiaoshuo in Huangdineijing, and investigates its cause, mechanism, prognosis and symptom expressions. Methods : The paper searches for the texts within Huangdineijing that deal with Naosuxiaoshuo, and tries to clarify the significance and the characteristics of Naosuxiaoshuo using the annotators comments regarding this issue. Moreover, the paper tries to search for similarities between the symptoms of Naosuxiaoshuo and the relevant diseases in modern medicine. Results : Naosuxiaoshuo is a serious disease where the diminishing of the brain's parenchyma can even lead to death. The cause is yin-deficiency based on the lack of vital essence and body fluid, and it also can be caused by the external pathogen or other stimulations. Moreover, it shows some similarities with brain atrophy and cerebrospinal fluid diseases. Conclusions : Naosuxiaoshuo should be treated with a focus on yin-tonifying dealing with spleen related to production of body fluid and the kidney related to storage of vital essence. It is also important to prevent external pathogens or stimulations damaging the bone marrow.

Diffusion-weighted Imaging and Apparent Diffusion Coefficient Maps for the Evaluation of Pyogenic Ventriculitis

  • Kim, Hyeong-Seok;Hong, Jae-Taek;Lee, Sang-Won;Son, Byung-Chul;Sung, Jae-Hoon;Kim, Moon-Chan
    • Journal of Korean Neurosurgical Society
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    • v.38 no.1
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    • pp.23-27
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    • 2005
  • Objective : The aim of this study is to assess the significance of an apparent diffusion coefficient[ADC] study for diagnosis of ventriculitis. Methods : Seven patients with ventriculitis were enrolled in this study. Diffusion-weighted[DW] magnetic resonance images[MRI] and ADC maps in the dependent intraventricular collection, periventricular white matter and non-dependent cerebrospinal fluid[CSF] were obtained. The images and ADC data from the different lesions were compared. Results : The DW MRI showed marked hyperintensity in the purulent pus lesion, and the corresponding ADC maps revealed prominent hypointensity and restricted ADC values compared with the non-dependent CSF and normal white matter. Conclusion : The decreased ADC value and increased signal intensity of the dependent intraventricular fluid on the DW MRI show restricted water diffusion in the purulent fluid, which is indicative of a pyogenic ventriculitis diagnosis.

An adverse event following 2009 H1N1 influenza vaccination: a case of acute disseminated encephalomyelitis

  • Lee, Sang-Teak;Choe, Young-June;Moon, Won-Jin;Choi, Jin-Woo;Lee, Ran
    • Clinical and Experimental Pediatrics
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    • v.54 no.10
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    • pp.422-424
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    • 2011
  • Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system that typically follows an infection or vaccination and has a favorable long-term prognosis. We describe the first reported case of ADEM after vaccination against novel influenza A (H1N1). A previously healthy 34-month-old boy who developed ADEM presented with a seizure and left-sided weakness 5 days after vaccination against novel influenza A (H1N1). Cerebrospinal fluid examination revealed elevated cell counts. T2-weighted images and fluid-attenuated inversion recovery images revealed multiple patchy hyperintense lesions in the frontal and parietal subcortical white matter and the left thalamus. After the administration of intravenous corticosteroid, the patient's clinical symptoms improved and he recovered completely without neurologic sequelae.

Infrequent Hemorrhagic Complications Following Surgical Drainage of Chronic Subdural Hematomas

  • Rusconi, Angelo;Sangiorgi, Simone;Bifone, Lidia;Balbi, Sergio
    • Journal of Korean Neurosurgical Society
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    • v.57 no.5
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    • pp.379-385
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    • 2015
  • Chronic subdural hematomas mainly occur amongst elderly people and usually develop after minor head injuries. In younger patients, subdural collections may be related to hypertension, coagulopathies, vascular abnormalities, and substance abuse. Different techniques can be used for the surgical treatment of symptomatic chronic subdural hematomas : single or double burr-hole evacuation, with or without subdural drainage, twist-drill craniostomies and classical craniotomies. Failure of the brain to re-expand, pneumocephalus, incomplete evacuation, and recurrence of the fluid collection are common complications following these procedures. Acute subdural hematomas may also occur. Rarely reported hemorrhagic complications include subarachnoid, intracerebral, intraventricular, and remote cerebellar hemorrhages. The causes of such uncommon complications are difficult to explain and remain poorly understood. Overdrainage and intracranial hypotension, rapid brain decompression and shift of the intracranial contents, cerebrospinal fluid loss, vascular dysregulation and impairment of venous outflow are the main mechanisms discussed in the literature. In this article we report three cases of different post-operative intracranial bleeding and review the related literature.

A Case of Subarachnoid Hemorrhage with Disseminated Intravascular Coagulation in a Maltese Dog (말티즈견에서 발생한 파종성혈관내응고를 동반한 거미막하 출혈 증례)

  • Jung, Hae-Won;Lee, Hee-Chun;Moon, Jong-Hyun;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.337-340
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    • 2014
  • An 11-year-old male Maltese dog was presented with sudden onset of convulsion and right sided circling. On neurological examination, left side proprioception and menace reflexes were delayed. Blood examinations indicated severe thrombocytopenia and increased hepatic enzymes. On brain magnetic resonance imaging, lesions were founded on the left lateral subarachnoid space area. Those lesions showed hyperintense on T1-weighted images, hyperintense on T2-weighted images and hyperintense on fluid attenuated inversion recovery images. Cerebrospinal fluid analysis revealed xanthochromia and erythrophagocytosis. Coagulation test results demonstrated that fibrin degradation product and D-dimer concentrations were higher than normal range. The patient expired few hours after presentation. This case report demonstrates intracranial hemorrhage with disseminated intravascular coagulation in a dog.

A Case Mollaret Meningitis (Mollaret Meningitis로 진단한 무균성 뇌막염 1례)

  • Jung, Min Kyung;Sung, Tae Jung;Kim, Ja Kyung;Yang, Eun Jung;Hong, Young Jin
    • Pediatric Infection and Vaccine
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    • v.7 no.1
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    • pp.159-164
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    • 2000
  • Mollaret meningitis is a rare syndrome first described by Mollaret in 1944, which is reccurent aseptic meningitis with characteristic clinical and spinal fluid cytologic findings. No etiology has been established. Several authors suggested the association with herpes virus infection, some found intracranial epidermoid tumor eventually in patients diagnosed of Mollaret meningitis. We experienced a case of 14-year old male who had 3 episodes of recurrent aseptic meningitis during four years. The patients initially presented with clinical and laboratory feature of bacterial meningitis, however, extensive serological investigation and cerebrospinal fluid analysis failed to reveal a specific cause. Immune system studies were unremarkable. Cranial computed tomography performed during the attack and magnetic resonance imaging when the patient was asymptomatic were both normal. A tentative diagnosis of Mollaret meningitis was established at the 3rd episode. We report this case with a review of related literatures.

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Aseptic Meningitis after a Lumbar Epidural Steroid Injection -A case report- (요부 경막외 스테로이드 주입 후 발생한 무균성 수막염 -증례 보고-)

  • Hwang, Byeong Mun;Leem, Jung Gil
    • The Korean Journal of Pain
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    • v.18 no.1
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    • pp.52-55
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    • 2005
  • Complications following a well conducted epidural steroid injection are rare. A 50-year-old man developed a headache and neck stiffness 2 days after a lumbar epidural steroid injection. Under the impression of aseptic meningitis, fluid and nonsteroidal anti-inflammatory drug therapy was started immediately after cerebrospinal fluid (CSF) sampling. The CSF was turbid, and revealed a white blood cell count, protein, glucose and pressure of $550/{\mu}l$ (98% lymphocyte), 107.9 mg/dl, 48 mg/dl (serum 113 mg/dl) and $17cmH_2O$, respectively. The CSF stain and culture, and antibody test and polymerase chain reaction for pathogens were negative. A computed tomography (CT) scan of the brain revealed no abnormality, and a chest roentgenogram and the results of the neurological examination were normal. Under the impression of aseptic meningitis, the condition was managed conservatively, without antibiotics. Seven days later, the clinical symptoms had improved, and the patient discharged.

Cerebral Toxoplasmosis Combined with Disseminated Tuberculosis

  • Hwang, Eui-Ho;Ahn, Poong-Gi;Lee, Dong-Min;Kim, Hyeok-Su
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.316-319
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    • 2012
  • A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.

Hemorrhagic Rupture of Arachnoid Cyst into the Intradural Space

  • Choi, Sun-Ju;Lee, Hui Joong;Hahm, Myong Hun
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.183-186
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    • 2017
  • A 7-year-old boy, diagnosed with an arachnoid cyst and subdural effusion on initial MRI, was admitted with left limb weakness and no history of head trauma. A subsequent follow-up MRI showed different stages of hematoma within multilayered enhancing membranes and in the arachnoid cyst, which was separated by the cerebrospinal fluid cleft. Craniotomy and fenestration of the cyst wall and hematoma removal were performed. The patient was diagnosed as a having a hemorrhagic rupture of an arachnoid cyst into the intradural space, probably via some one-way valve-like defect, based on the MRI and surgical findings. The MRI features and possible mechanism of this rare disease are discussed within the literature review.