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C Calli

Publications and source records attributed to C Calli.

At least 19 recordsLinked to original sources

Cerebral cortical and deep venous thrombosis without sinus thrombosis: clinical MRI correlates.

BACKGROUND: Cortical and/or deep vein thrombosis (CDVT) without dural sinus involvement is uncommon and presents diagnostic difficulty for many reasons. Our aim is to determine the relationship between magnetic resonance imaging (MRI) findings and clinical findings in patients with CDVT. METHODS: Forty-six patients with venous stroke proved on MRI included in our Registry, corresponding to 0.1% of 4650 patients with stroke, were studied. Magnetic resonance angiography (MRA) was performed in all patients, and 18 of them had follow-up MRA. Outcome was evaluated by using the Glasgow Outcome Scale at the time of discharge and during follow-up. RESULTS: Thirty-two patients presented cortical venous stroke; 21 of them had involvement of the dorsomedial venous system, six had a defect in the posteroinferior venous group, and five had a defect in the anteroinferior venous group. Thirteen patients presented simultaneous involvement of the superficial and deep venous system; seven with a defect in the parietal and internal cerebral veins (three with involvement of vein of Gallen), four with a defect in the temporooccipital (vein of Labbé) and basal vein of Rosenthal, two with a deficit in the anterior frontotemporal and uncal-pterygoid venous system. One patient had deep venous thrombosis primarily localized to the thalami bilaterally and the basal ganglia on the right because of occlusion of the thalamostriate veins. The main presenting symptoms of CDVT were headache, focal neurologic signs, partial complex or secondary generalized seizures, and consciousness disturbances in those with deep venous thrombosis, presented alone or in combination at onset. CDVT was more than twofold more frequent in women than in men. Pregnancy, puerperium, oral contraceptive use, and infections were the most common predisposing factors. CONCLUSION: Computerized tomography, conventional MRI and diffusion-weighted imaging showing ischemic and/or hemorrhagic lesion that does not follow the boundary of classical arterial boundaries without signs of sinus thrombosis, and partial or generalized seizures followed by focal neurologic signs may predict CDVT. The outcome of patients with cortical venous stroke was good, but not in those with cortical plus deep venous infarction.

Adult↗

The mechanism of ischemic stroke in patients with dolichoectatic basilar artery.

Basilar artery dolichoectesia (BD) may cause brainstem ischemia by multiple mechanisms, including thrombosis, embolism, occlusion of deep penetrating arteries. The objective of this study was to determine and characterize clinical, imaging findings and hemodynamic mechanisms in patients with cerebrovascular event associated with BD and compare these data with those for patients with BD who did not have stroke. We studied 29 consecutive stroke, two transient ischemic attack (TIA) patients with BD who have been admitted to our stroke unit. We sought the diameter of ectasia, height of the bifurcation, lateral displacement, shape deformities, and blood flow velocity of the basilar artery (BA) by transcranial Doppler. Imaging and hemodynamic findings were compared with those found in a group of 18 patients without stroke or TIA. The main infarct localization was pons, eight (28%) with restricted single lesion, 10 (32%) with multiple lesions involving thalamus, midbrain, posterior cerebral artery (PCA) territory. Patients with BD were more probably to have had stroke fitting a clinical and imaging patterns of multiple infarcts than those with restricted infarct in territories supplied by branches of the BA (60% vs. 40%). Hypertension and atherosclerotic changes of the posterior circulation were more frequent in patients with stroke than those without (P = 0.004 and P = 0.028, respectively), whilst the incidence of other vascular risk factors were not significantly different in two groups. Patients with stroke/TIA had more often low blood flow velocity but not significant in the BA when compared with those for BD patients without cerebrovascular event (71% vs. 39%; P = 0.1). Reduced blood flow velocity in the BA was correlated significantly with distal lesions involving thalamus, midbrain and PCA territory rather than those located in the territory supplied by branches of the BA (P = 0.02). In conclusion, it seems probably that BD may cause vertebrobasilar system ischemia by multiple mechanisms, especially reduced blood flow in the BA and atheromatous changes in the vertebrobasilar system may precipitate thromboembolic stroke.

Adult↗

Wallenberg's lateral medullary syndrome: diffusion-weighted imaging findings.

PURPOSE: To investigate the efficacy of diffusion-weighted imaging in patients with Wallenberg's lateral medullary syndrome. MATERIAL AND METHODS: Thirteen patients with Wallenberg's lateral medullary syndrome were examined with conventional and echoplanar diffusion-weighted magnetic resonance (MR) imaging in a 1.5 T magnetic resonance unit. MR examinations were obtained in the acute or subacute stage of clinical syndrome, and diffusion-weighted imaging (DWI) was considered to be positive for infarction when an increase in signal was seen on b = 1000 s/mm2 images in the posterolateral medullary localization. RESULTS: DWIs were positive in 12 patients in the acute or subacute stages of this clinical syndrome. A false-negative result was obtained in only one patient examined within the first day, 10 h after onset of the symptoms. In the visual evaluation of the DWI, the contrast between normal and infarcted brainstem area was better in the high b-value images than in the apparent diffusion coefficient map images. CONCLUSION: DWI is a valuable technique for examining patients presenting with the signs and symptoms of Wallenberg's syndrome and high b-value images can provide complementary data to T2-weighted images. However, because most of our case group were in either the acute or subacute stage, true sensitivity of the method in the hyperacute stage of the syndrome remains unclear.

Adult↗

Report of diffusion-weighted MRI in two cases with different cerebral hydatid disease.

PURPOSE: To present MRI findings in two cases of cerebral hydatid disease with an emphasis on diffusion-weighted imaging (DWI) findings of Echinococcus granulosus (EG) versus Echinococcus alveolaris (EA). RESULTS: EG lesions were isointense with cerebrospinal fluid in all sequences including DWI. On DWI, EA lesions remained hypointense on b = 1000 s/mm2 diffusion-weighted images. Apparent diffusion coefficient (ADC) values of EG and EA lesions were completely different from each other, 2.88 +/- 0.24 x 10(-3) s/mm2 and 1.33 +/- 0.15 x 10(-3) s/mm2, respectively. CONCLUSION: The ADC values could not be used to discriminate from other differential diagnoses.

Adult↗

Role of the constructive interference in steady-state sequence in the classification of sacral meningeal cysts.

PURPOSE: To investigate the role of the CISS (constructive interference in steady state) sequence in sacral meningeal cysts. MATERIAL AND METHODS: Fourteen patients with sacral meningeal cysts were included. Conventional T1W and T2W sequences and the CISS sequence (TR/TE = 12.25/5.90) were obtained at 1.5-T. The 1-mm-thick base images and multiplanar reformatted images of the CISS sequence were studied. The sacral meningeal cysts were classified by the CISS sequence in accordance with the previously described surgical and histopathological criteria. RESULTS: A total of 25 sacral meningeal cysts were identified in the 14 patients. The cysts and their contents were visualized by the CISS sequence, and the CISS sequence was superior to the T1W and T2W images. Fifteen of the cysts were consistent with type I lesions (extradural meningeal cysts without nerve fibers inside) and 10 cysts with type II lesions (extradural meningeal cysts with nerve fibers inside). There were no type III lesions (intradural meningeal cysts) in the sacral region. CONCLUSION: Previous studies have indicated that conventional MRI as well as magnetic resonance myelography are inconsistent for a classification of sacral meningeal cysts. The CISS sequence with its capability to obtain T2W thin slice acquisitions is superior in showing the nerve root fibers contained in the cysts, which is essential in the differentiation of type I and II cysts. Application of the CISS sequence is recommended in the diagnosis of sacral meningeal cysts.

Adult↗

Proton MR spectroscopy in the diagnosis and differentiation of encephalitis from other mimicking lesions.

In this study, proton magnetic resonance spectroscopy (1H MRS) findings of encephalitis were reported. For comparison, other lesions mimicking encephalitis on conventional magnetic resonance (MR) imaging were included in the study. These lesions consisted of acute infarctions and low grade infiltrative gliomas. The 1H MRS findings of encephalitis and gliomas were almost the same whereas infarctions revealed high lactate levels differentiating the disorder from other two pathologies. The differentiation of encephalitis and gliomas based on MR findings could reliably made with short time follow up MR examinations where gliomas tend to grow in contrast to encephalitis which showed regression.

Adolescent↗

Multiple, primary spinal-paraspinal hydatid cysts.

A patient is presented with widespread primary hydatid cysts in spinal-paraspinal locations, secondary to Echinococcus granulosus. An alternative mechanism to explain how the embryos gained access to the body is proposed: The embryos penetrated the intestinal muscle and may have directly entered into the inferior vena cava system through small venous connections between this system and portal circulation. Various conditions in daily life associated with Valsalva maneuver might have caused such an atypical passage of the embryos to the inferior caval system toward the retroperitoneum and spinal-paraspinal structures via lumber epidural venous plexuses.

Echinococcosis↗

Isolated pontine infarction due to rhinocerebral mucormycosis.

We report a patient with rhinocerebral mucormycosis whose initial central nervous system involvement was isolated pontine infarction due to basilar arteritis caused by the fungus. The patient was diagnosed and followed by MRI and CT and basilar arteritis was demonstrated well on MRI studies. Involvement of the skull base was shown on CT in the later stage of the disease. The unusual initial presentation of the infection is discussed.

Adult↗

Two siblings with juvenile hyaline fibromatosis: case reports and review of the literature.

In this paper, we describe two siblings with Juvenile Hyaline Fibromatosis (JHF) who were diagnosed at the age of 34 and 29 years respectively. JHF is a very congenital disease, mainly diagnosed in the first few years of life, with less than 40 published cases in literature. All the main clinical features of this syndrome, which may be summarised as multiple subcutaneous tumours, marked gingival hypertrophy, flexion contractures and osteolytic lesions were present in both of these cases. Clinical, radiological and histological differential diagnosis of JHF were made. Recent information about histopathology, treatment and prognosis of JHF was also reviewed.

Adult↗

Hypertrophic cranial pachymeningitis involving dural sinuses: a pseudo signal-void appearance on MRI.

A case of hypertrophic cranial pachymeningitis with an unusual and misleading manifestation is reported. CT detected calcified tentorium and superior sagittal sinus. MR imaging and MR angiography depicted tentorial thickening as well as occlusion of all major dural sinuses. Fibrocalcific occlusion of dural sinuses showed interestingly signal-void appearance on spin-echo images which could readily be interpreted as being patent sinuses.

Adult↗

Varix of the inferior pulmonary vein: computed tomography and magnetic resonance angiography findings.

A 37-yr-old male presented with a 2-week history of intermittent episodes of mild haemoptysis. Computed tomography and magnetic resonance imaging revealed a varix of the inferior pulmonary vein. The diagnosis was confirmed using magnetic resonance angiography and conventional angiography. This condition is relatively rare, and few cases have previously been demonstrated by means of magnetic resonance imaging and angiography.

Adult↗

Transcatheter arterial embolization of internal mammary artery in a hepatocellular carcinoma with abdominal wall invasion.

Transcatheter arterial embolization (TAE) is alternatively employed to surgical resection in the management of hepatocellular carcinoma (HCC). TAE through the hepatic artery is sometimes insufficient since the blood supply to HCC may be from the collateral vessels as well. We report a case of HCC with abdominal wall invasion who underwent TAE through the right internal mammary artery after insufficient embolization of the tumor through the hepatic artery.

Abdominal Muscles↗

Cervical osseous changes associated with vertebral artery tortuosity.

Vertebral artery tortuosity causing neural foraminal widening is a well described abnormality that should not be confused with other causes of neural foraminal enlargement, particularly on conventional roentgenograms. We, hereby, describe CT features of another cervical osseous change due to the vertebral artery tortuosity, the so called "tubular shaped vertebral artery canal", which is embedded in the vertebral body instead of causing neural foramen enlargement. Catheter and MR angiographic studies have also been performed to confirm the vertebral artery tortuosity causing the osseous changes.

Adult↗

Retroclival epidural hematoma secondary to decompressive craniectomy in cerebellar infarction: MR demonstration.

Epidural hematomas of the clivus are very uncommon. We, hereby, present a case of retroclival epidural hematoma as a complication of posterior fossa decompressive surgery for the management of acute cerebellar infarction. Serial MRI examinations of the patient was documented and demonstrated. In addition, the etiology of retroclival epidural hematomas were also discussed.

Adult↗

Chondrosarcoma causing cervical neural foramen widening.

Various neoplastic, vascular, and developmental causes may lead to spinal neural foraminal widening, the most common causes of spinal dumbbell lesions being schwannomas and neurofibromas. Occasionally, some other slow-growing tumors may cause neural foraminal widening. We report an exceptional case of a low-grade spinal chondrosarcoma which apparently developed from a pre-existing osteochondroma in the neural arcus of C6. The lesion passed through the C5-C6 foramen, producing a dumbbell mass.

Adolescent↗

Petrous apex mucocele: high resolution CT.

Mucocele of the petrous apex is very rare, only three cases having been reported. Since this area is inaccessible to direct examination, imaging, preferably high resolution computed tomography (HR CT) is essential. We report a case showing an eroding, non enhancing mass with sharp, lobulated contours, within the petrous apex. The presence of a large air cell on the opposite side suggested a mucocele.

Abducens Nerve↗

Hypoplastic lumbar pedicle in association with conjoined nerve root MRI demonstration.

We report a case of aberrant hypoplastic pedicle of the fourth lumbar vertebra and ipsilateral conjoined nerve root. Ipsilateral retroisthmic laminar defect, dysplastic lamina and transverse process, enlargement of neural foramen, hypoplasia of superior and inferior articular facet were present as associated with other neural arch anomalies. The extent of these anomalies was well demonstrated by MR imaging.

Adult↗